Common use of Category 3 Clause in Contracts

Category 3. Pursuant to 42 CFR 438.704 (c), ASES may impose a civil money penalty for the Contractor’s imposition of premiums or charges in excess of the amounts permitted under the Medicaid program. The maximum amount of the penalty is $25,000 or double the amount of the excess charges, whichever is greater. ASES will deduct from the penalty the amount of overcharge and return it to the affected enrollees.

Category 3. Pursuant to 42 CFR 438.704 (c438.704(c), ASES may impose a civil money penalty for the Contractor’s imposition of premiums or charges in excess of the amounts permitted under the Medicaid program. The maximum amount of the penalty is the greater of twenty-five thousand dollars ($25,000 25,000) or double the amount of the excess charges, whichever is greater. ASES will deduct from the penalty the amount of overcharge and return it to the affected enrolleesEnrollees.