Civil Monetary Penalty (CMP)

What does CMP stand for in healthcare compliance?

In healthcare compliance, CMP stands for Civil Monetary Penalty. 

What is a Civil Monetary Penalty (CMP)? 

Before explaining what a civil monetary penalty is, you must understand the Civil Monetary Penalties Law (CMPL). The Civil Monetary Penalties Law is a piece of legislation that allows the Department of Health and Human Services to impose a civil monetary penalty, an exclusion from a program, or an evaluation of a physician who has engaged in abusive or fraudulent behaviors. In relation to the Civil Monetary Penalties Law, a civil monetary penalty refers to a fine for violating CMPL. According to PubMed, civil monetary penalties can range from $2,000 to over $100,000, depending on the violation. 

The Centers for Medicare and Medicaid Services states that civil monetary penalties can include assessments that are three times the amount of money paid, received, or requested or are three times the amount claimed for each item or service. And let’s not forget that the civil monetary penalties are adjusted yearly for inflation. Ouch. As you can probably imagine, these fines can become quite large. Because of this, the Civil Monetary Penalties Law serves as a deterrent when it comes to abuse and fraud. 

What counts as a violation of the Civil Monetary Penalties Law? According to the University of Florida’s Office of Clinical Research, some violations of the Civil Monetary Penalties Law include the following:

• • Violating the Anti-Kickback Statute

  • Violating the Physician Self-Referral Statute (Stark Law)

  • Violating physician agreements

  • Violating assignment provisions 

  • Providing false statements and/or misinterpretations on contracts or applications for participation in healthcare programs 

  • Providing inadequate medical screening examination for patients

  • Providing a claim that is under a fraudulent agreement, contract, or grant

  • Sharing inaccurate information in an attempt to sway someone’s decision regarding discharge

  • Using emblems or words that belong to the Department of Health and Human Services when permission was not granted 

  • Applying for funds from the Department of Health and Human Services by using false information or by failing to present information in an application, bid, or other documents

  • Offering payment to someone who is eligible for Medicaid or Medicare to influence the person to request service from a specific physician, provider, or supplier who accepts payments from Medicaid or Medicare

You should know that unlike criminal prosecutions the “beyond a reasonable doubt” standard does not apply to the Civil Monetary Penalties Law. The Office of Inspector General only has to prove responsibility by gathering a large amount of evidence. Avoiding a Civil Monetary Penalty (CMP) is a goal of all healthcare organizations.

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