42 CFR § 1003.420 - Determinations regarding the amount of penalties and assessments.

---
identifier: "/us/cfr/t42/s1003.420"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 1003.420 - Determinations regarding the amount of penalties and assessments."
title_number: 42
title_name: "Public Health"
section_number: "1003.420"
section_name: "Determinations regarding the amount of penalties and assessments."
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"
---


# 1003.420 Determinations regarding the amount of penalties and assessments.

In considering the factors listed in § 1003.140, aggravating circumstances include—

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

(b) There were many such violations (or the nature and circumstances indicate a pattern of incidents);

(c) The amount of money, remuneration, damages, or tainted claims involved in the violation was $15,000 or more; or

(d) Patient harm, premature discharge, or a need for additional services or subsequent hospital admission resulted, or could have resulted, from the incident; and

(e) The contracting organization knowingly or routinely engaged in any prohibited practice that acted as an inducement to reduce or limit medically necessary services provided with respect to a specific enrollee in the organization.