Maryland Code, Health-General § 2-504.1

(1) Is in lieu of full payment or full adjustment of the paid claim and not in addition to repayment of the claim;

(2) May not be less than the federal financial participation share of the identified improper claim amount;

(3) May not be imposed if the claim was included in the universe of claims under an extrapolation calculation; and

(4) Is only available if the provider has not been subjected to a repayment penalty or fine, a criminal action, or a civil false claims action under either federal or State law for the same claim.

(c)(1) A civil money remedy may not exceed the amount of reimbursement that the provider received for the paid claim.

(2) In determining whether to impose a civil money remedy under this section and in setting the amount of the civil money remedy, the Inspector General shall consider:

(3) In weighing the factors set forth in paragraph (2) of this subsection, the Inspector General shall, if appropriate, give special consideration to the extent to which the provider's size, operations, or financial condition:

(1) States the total amount of the civil money remedy; and

(2) Includes the following information:

(f)(1) An order that imposes a civil money remedy is final when the provider has exhausted all opportunities to contest the civil money remedy in accordance with Title 10, Subtitle 2 of the State Government Article.

(2) After exhaustion of all appeals, a provider shall pay a civil money remedy to the Department within 10 days after the provider receives a final order that affirms the imposition of the civil money remedy unless the Inspector General negotiates and approves a repayment schedule.