Enforcement: Note the Major CMP Increases Under the Bipartisan Budget Act

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article summarizes enforcement-related changes tied to the Bipartisan Budget Act of 2018 and explains why the updates matter for Medicare providers and compliance teams. It focuses on major increases affecting civil monetary penalties, criminal penalties, and prison sentencing provisions connected to federal healthcare program violations, with context from legal analysis and references to the Social Security Act and related enforcement authorities.

Why This Topic Matters

The article is relevant to Medicare compliance, audit, billing integrity, and healthcare fraud-and-abuse risk management because it highlights significant penalty increases that can affect provider exposure and enforcement strategy.

Article Sections

  1. Background

    Introduces the legislative and enforcement context for the penalty changes and identifies the broader federal healthcare program authorities involved.

  2. Civil

    Summarizes changes affecting civil monetary penalties under the Social Security Act and discusses the categories of violations referenced in the source.

  3. Criminal

    Summarizes changes affecting criminal penalties under the Social Security Act and references the related federal healthcare program enforcement framework.

  4. Prison sentencing

    Describes the sentencing changes discussed in the article for specified federal healthcare-related offenses.

  5. Warning

    Presents the article’s compliance-focused caution about heightened enforcement attention and fraud, waste, and abuse concerns.

What You Will Learn

  • How the Bipartisan Budget Act of 2018 affected federal healthcare enforcement penalties
  • Which broad enforcement categories were updated for Medicare and related programs
  • How the article frames the compliance significance of the penalty changes
  • What organizations and legal authorities are cited in the discussion

Who Should Read This

  • Medical coders
  • Compliance officers
  • Billing staff
  • Healthcare attorneys
  • Medicare providers
  • Revenue cycle professionals

Codes Discussed


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