§ 61.11 - Reporting other adjudicated actions or decisions.


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  • (a) Who must report. Federal and State governmental agencies and health plans must report other adjudicated actions or decisions as defined in §61.3 related to the delivery, payment or provision of a health care item or service against health care providers, suppliers, and practitioners (regardless of whether the other adjudicated action or decision is subject to a pending appeal).

    (b) Entities described in paragraph (a) of this section must report the information as required in §61.10(b).

    (c) Entities described in paragraph (a) of this section should report, if known the information as described in §61.10(c).

    (d) Sanctions for failure to report. Any health plan that fails to report information on an other adjudicated action or decision required to be reported under this section will be subject to a civil money penalty (CMP) of not more than $25,000 for each such action not reported. Such penalty will be imposed and collected in the same manner as CMPs under subsection (a) of section 1128A of the Act. The Secretary will provide for publication of a public report that identifies those Government agencies that have failed to report information on other adjudicated actions as required to be reported under this section.