Civil Monetary Penalties
Administrative penalties HHS-OIG may impose on healthcare providers for various violations including HIPAA breaches, kickbacks, and billing for excluded individuals.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Compliance Program
- Primary sources
- 1
- Workspace handoff
- compliance binder →
Where this comes up
Compliance committees and practice managers operate at this level — written policy, workforce training, sanction policy, monitoring and auditing cadence, response and corrective action. The seven elements of an effective compliance program (OIG) are the scaffolding; this term lives somewhere on that scaffold.
Full definition
What it is in practice
The HHS-OIG CMP authorities include per-claim penalties for false claims, per-violation penalties for HIPAA breaches (tiered by culpability), and per-day penalties for failure to maintain records.
How it shows up in your practice
CMP exposure is the dollar measure of compliance program ROI. A defensible compliance program is a CMP-mitigation strategy.
Sources
- HHS-OIG — Compliance Program Guidancehttps://oig.hhs.gov/documents/compliance-guidance/812/physician.pdf
Map CMP exposure in the Compliance Binder
Open compliance binder →Related terms
- Compliance ProgramFalse Claims ActFederal statute (31 USC 3729-3733) that imposes liability on persons and companies who defraud federal programs.
- Compliance ProgramAnti-Kickback Statute (AKS)Federal criminal statute (42 USC 1320a-7b(b)) that prohibits offering, paying, soliciting, or receiving remuneration to induce or reward referrals for items or services payable by federal health programs.
- Compliance ProgramOIG Compliance ProgramVoluntary compliance program structure recommended by HHS-OIG for physician practices.
- EnrollmentLEIE Exclusion ScreeningMonthly screening of staff and vendors against the HHS-OIG List of Excluded Individuals/Entities (LEIE).
- Compliance ProgramOCR Civil Monetary Penalties (HIPAA)HHS Office for Civil Rights' tiered CMP structure for HIPAA violations, with maximums adjusted annually for inflation.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryAnti-Kickback Statute (AKS)Federal criminal statute (42 USC 1320a-7b(b)) that prohibits offering, paying, soliciting, or receiving remuneration to induce or reward referrals for items or services payable by federal health programs.
- GlossaryOIG Compliance ProgramVoluntary compliance program structure recommended by HHS-OIG for physician practices.
- GlossaryOCR Civil Monetary Penalties (HIPAA)HHS Office for Civil Rights' tiered CMP structure for HIPAA violations, with maximums adjusted annually for inflation.
- GlossaryFalse Claims ActFederal statute (31 USC 3729-3733) that imposes liability on persons and companies who defraud federal programs.
- GlossaryLEIE Exclusion ScreeningMonthly screening of staff and vendors against the HHS-OIG List of Excluded Individuals/Entities (LEIE).
- RegulationAnti-Kickback Safe Harbors Overview (42 CFR 1001.952)Approximately 30 safe harbors define payment and business practices that, despite generating remuneration, do not result in AKS liability when all conditions are met.
- BillingWhat to Do When a Payer Says You're UnderbillingGot a letter saying you're underbilling? Here's what it actually means, whether you should worry, and what action to take.
- ComplianceAmbulatory Surgery Center Compliance: CMS + State + Infection Control42 CFR Part 416 Conditions for Coverage, CMS State Operations Manual Appendix L, the ASC Infection Control Surveyor Worksheet, and where state ASC licensure tightens the standard.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.