42 CFR § 1003.220 - Determinations regarding the amount of penalties and assessments and the period of exclusion.

---
identifier: "/us/cfr/t42/s1003.220"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 1003.220 - Determinations regarding the amount of penalties and assessments and the period of exclusion."
title_number: 42
title_name: "Public Health"
section_number: "1003.220"
section_name: "Determinations regarding the amount of penalties and assessments and the period of exclusion."
chapter_name: "OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "B"
subchapter_name: "OIG AUTHORITIES"
part_number: "1003"
part_name: "CIVIL MONEY PENALTIES, ASSESSMENTS AND EXCLUSIONS"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "42 U.S.C. 262a, 300jj-52, 1302, 1320a-7, 1320a-7a, 1320b-10, 1395u(j), 1395u(k), 1395cc(j), 1395w-141(i)(3), 1395dd(d)(1), 1395mm, 1395nn(g), 1395ss(d), 1396b(m), 11131(c), and 11137(b)(2)."
regulatory_source: "51 FR 34777, Sept. 30, 1986, unless otherwise noted."
cfr_part: "1003"
---


# 1003.220 Determinations regarding the amount of penalties and assessments and the period of exclusion.

In considering the factors listed in § 1003.140—

(a) It should be considered a mitigating circumstance if all the items or services or violations included in the action brought under this part were of the same type and occurred within a short period of time, there were few such items or services or violations, and the total amount claimed or requested for such items or services was less than $5,000.

(b) Aggravating circumstances include—

(1) The violations were of several types or occurred over a lengthy period of time;

(2) There were many such items or services or violations (or the nature and circumstances indicate a pattern of claims or requests for payment for such items or services or a pattern of violations);

(3) The amount claimed or requested for such items or services, or the amount of the overpayment was $50,000 or more;

(4) The violation resulted, or could have resulted, in patient harm, premature discharge, or a need for additional services or subsequent hospital admission; or

(5) The amount or type of financial, ownership, or control interest or the degree of responsibility a person has in an entity was substantial with respect to an action brought under § 1003.200(b)(3).