90-590-100 Me. Code R. § 3

Current through 2024-51, December 18, 2024
Section 590-100-3 - PENALTIES; FINES

The MHDO Board may assess fines pursuant to 22 M.R.S. § 8705-A in accordance with the following schedules:

A. A hospital that fails to file inpatient and outpatient service data and/or to meet the standards for data and the provisions for compliance as set forth in 90-590 C.M.R Chapter 241 is considered in civil violation under 22 M.R.S. §8705-A for which fines may be adjudged as follows:
1. $100 per day for the first week of non-compliance;
2. $250 per day for the second week of non-compliance;
3. $500 per day for the third week of non-compliance; and
4. $1,000 per day for the fourth week of non-compliance and each week thereafter, not to exceed a maximum of $25,000 per any one occurrence.
B. A payor that fails to file health care claims data and/or to meet the standards for data and the provisions for compliance as set forth in 90-590 C.M.R Chapter 243 is considered in civil violation under 22 M.R.S. §8705-A for which fines may be adjudged as follows:
1. $100 per day for the first week of non-compliance;
2. $250 per day for the second week of non-compliance;
3. $500 per day for the third week of non-compliance; and
4. $1,000 per day for the fourth week of non-compliance and each week thereafter, not to exceed a maximum of $25,000 per any one occurrence.
C. A payor that fails to file supplemental health care data sets and/or to meet the standards for data and the provisions for compliance as set forth in 90-590 C.M.R Chapter 247 is considered in civil violation under 22 M.R.S. §8705-A for which fines may be adjudged as follows:
1. $100 per day for the first week of non-compliance;
2. $250 per day for the second week of non-compliance;
3. $500 per day for the third week of non-compliance; and
4. $1,000 per day for the fourth week of non-compliance and each week thereafter, not to exceed a maximum of $25,000 per any one occurrence.
D. A payor or health care provider, excluding health care practitioners, that fails to file quality data and/or to meet the standards for data and the provisions for compliance as set forth in 90-590 C.M.R Chapter 270 is considered in civil violation under 22 M.R.S. §8705-A for which fines may be adjudged as follows:
1. $100 per day for the first week of non-compliance;
2. $250 per day for the second week of non-compliance;
3. $500 per day for the third week of non-compliance; and
4. $1,000 per day for the fourth week of non-compliance and each week thereafter, not to exceed a maximum of $25,000 per any one occurrence.

A health care practitioner that fails to file quality data and/or to meet the standards for data and the provisions for compliance as set forth in 90-590 C.M.R Chapter 270 is considered in civil violation under 22 M.R.S. §8705-A for which fines may be adjudged as follows:

1. $50 per day for the first week of non-compliance;
2. $75 per day for the second week of non-compliance;
3. $100 per day for the third week of non-compliance; and each week thereafter, not to exceed a maximum of $2,500 per any one occurrence.
E. A parent entity, health care facility, and/or hospital that fails to file financial data and/or to meet the standards for data and the provisions for compliance as set forth in 90-590 C.M.R Chapter 300, is considered in civil violation under 22 M.R.S. Sec.8705-A for which fines may be adjudged as follows:
1. $100 per day for the first week of non-compliance;
2. $250 per day for the second week of non-compliance;
3. $500 per day for the third week of non-compliance; and
4. $1,000 per day for the fourth week of non-compliance and each week thereafter, not to exceed a maximum of $25,000 per any one occurrence.
F. A prescription drug manufacturer, wholesale drug distributor or PBM that fails to file prescription drug price data and/or to meet the standards for data and the provisions for compliance as set forth in 90-590 C.M.R Chapter 570 Section 2 is considered in civil violation under 22 M.R.S. §8705-A for which fines may be adjudged as follows:
1. $100 per day for the first week of non-compliance;
2. $250 per day for the second week of non-compliance;
3. $500 per day for the third week of non-compliance; and
4. $1,000 per day for the fourth week of non-compliance and each week thereafter, not to exceed a maximum of $25,000 per any one occurrence.
G. A prescription drug manufacturer, wholesale drug distributor or PBM that fails to file prescription drug price data and/or to meet the standards for data and the provisions for compliance as set forth in 90-590 C.M.R Chapter 570 Section 4 is considered in civil violation under 22 M.R.S. §8735 for which a fine of $30,000 may be adjudged for each day of the violation.
1.Certification of Accuracy. A notification or report to the MHDO by a reporting entity shall include a signed, written certification of the notification or report's accuracy.
2.Audit. With a 30-day notice, the MHDO may audit the finalized data submitted by a reporting entity, and that entity shall pay for the costs of the audit.
3.Corrective Action Plan. The MHDO may require a reporting entity to develop a corrective action plan to correct any deficiencies in compliance discovered during an audit.
H. A health care facility, payor, prescription drug manufacturer, wholesale drug distributor or PBM that fails to pay the annual assessment levied for the operational costs of the MHDO as set forth in 90-590 C.M.R Chapter 10, is considered in civil violation under 22 M.R.S. §8705-A for which fines may be adjudged at $1,000 per day of non-compliance, not to exceed a maximum of $25,000 per any one occurrence.
I. Any person or entity, as defined under section 2, that receives data or information pursuant to 90-590 C.M.R Chapter 120, and intentionally or knowingly uses, sells or transfers the data in violation of the rules for commercial advantage, pecuniary gain, personal gain or malicious harm is considered in civil violation under 22 M.R.S., §8705-A for which a fine not to exceed $500,000 may be adjudged.

The MHDO Board may, in its discretion, suspend, in whole or in part, any of the above-mentioned fines.

90-590 C.M.R. ch. 100, § 3