offense.

Recidivists are health care providers who have been found guilty of the maximum number of
offenses and meted the penalty of revocation of accreditation in accordance with the herein Scale
of Administrative Penalties. Recidivists may no longer be accredited by the Corporation.

Rule V
GENERAL PROVISIONS

SECTION 172. Mitigating and Aggravating Circumstances

The following circumstances shall affect the gravity of the violation and the liability of the erring
health care provider:
a. Mitigating Circumstances – The following circumstances shall mitigate the liability: voluntary
admission of guilt; good track record; or first offense.
b. Aggravating Circumstances – The following circumstances shall aggravate the liability:
Previous conviction of an offense, as provided for in this Rules; connivance and/or conspiracy
to facilitate the commission of the violation; or gross negligence.
c. Such other similar circumstances that may mitigate or aggravate the violation and liability of
the health care provider as may be determined by the Arbitration Office or Board, as the case
may be.

SECTION 173. Application of Circumstances in the Imposition of Penalties

a. The presence of a mitigating circumstance without any aggravating circumstance shall limit
the imposable penalty to its minimum.
b. When there is neither a mitigating nor an aggravating circumstance, the imposable penalty
shall be between the minimum and the maximum of the applicable penalty for the offense
committed, at the discretion of the Corporation. The same shall apply when both mitigating
and aggravating circumstances are present.
c. The presence of any aggravating circumstance without any mitigating circumstance shall
increase the penalty for the offense to its maximum.

SECTION 174. Application of Suspension and Revocation of Accreditation

If the penalty of suspension imposed upon the health care provider exceeds the validity of the
current accreditation, the application for renewal or re-accreditation of the health care provider
shall not be acted upon until the full term of the suspension imposed has lapsed. Suspension shall
be carried out by the temporary cessation of the benefits or privileges of the health care provider
under the Program. Revocation shall be carried out by the permanent cessation of the benefits or
privileges of the health care provider under the Program.

Implementing Rules and Regulations of Republic Act 7875 As Amended Otherwise Known As the National Health Insurance Act of 2013
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