Page:United States Statutes at Large Volume 95.djvu/815

 PUBLIC LAW 97-35—AUG. 13, 1981

95 STAT. 789

CHAPTER 2-OTHER ADMINISTRATIVE CHANGES CIVIL MONETARY PENALTIES

SEC. 2105. (a) Part A of title XI of the Social Security Act is amended by inserting after section 1128 the following new section: "CIVIL MONETARY PENALTIES

"SEC. 1128A. (a) Any person (including an organization, agency, or 42 USC other entity) that presents or causes to be presented to an officer, 1320a-7a. employee, or agent of the United States, or of any department or agency thereof, or of any State agency (as defined in subsection (h)(D), a claim (as defined in subsection (h)(2)) that the Secretary determines— "(1) is for a medical or other item or service— "(A) that the person knows or has reason to know was not provided as claimed, or "(B) payment for which may not be made under the program under which such claim was made, pursuant to a determination by the Secretary under section 1128, 1160(b), 94 Stat. 2619. 1862(d), or 1866(b)(2), or "(2) is submitted in violation of an agreement between the 42 USC 1320a-7, 1320C-9, 1395y, person and the United States or a State agency, 1395CC. shall be subject, in addition to any other penalties that may be prescribed by law, to a civil money penalty of not more than $2,000 for each item or service. In addition, such a person shall be subject to an assessment of not more than twice the amount claimed for each such item or service in lieu of damages sustained by the United States or a State agency because of such claim. "(b)(l) The Secretary may initiate a proceeding to determine whether to impose a civil money penalty or assessment under subsection (a) only as authorized by the Attorney General pursuant to procedures agreed upon by them. "(2) The Secretary shall not make a determination adverse to any Notice and person under subsection (a) until the person has been given written hearing. notice and an opportunity for the determination to be made on the record after a hearing at which the person is entitled to be represented by counsel, to present witnesses, and to cross-examine witnesses against the person. "(c) In determining the amount or scope of any penalty or assessment imposed pursuant to subsection (a), the Secretary shall take into account— "(1) the nature of claims and the circumstances under which they were presented, "(2) the degree of culpability, history of prior offenses, and financial condition of the person presenting the claims, and "(3) such other matters as justice may require. "(d) Any person adversely affected by a determination of the Secretary under this section may obtain a review of such determination in the United States Court of Appeals for the circuit in which the person resides, or in which the claim was presented, by filing in such court (within sixty days following the date the person is notified of the Secretary's determination) a written petition requesting that the determination be modified or set aside. A copy of the petition shall be forthwith transmitted by the clerk of the court to the Secretary, and thereupon the Secretary shall file in the Court the record in the proceeding as provided in section 2112 of title 28, United States Code.

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