Chapter 38, Section 3803, Subsection (c) · 31 U.S.C. Chapter 38 — ADMINISTRATIVE REMEDIES FOR FALSE CLAIMS AND STATEMENTS

Contents

(c)

(1)No allegations of liability under section 3802 of this title with respect to any claim made, presented, or submitted by any person shall be referred to a presiding officer under paragraph (2) of subsection (b) if the reviewing official determines that—

(A)an amount of money in excess of $1,000,000; or

(B)property or services with a value in excess of $1,000,000,

is requested or demanded in violation of section 3802 of this title in such claim or in a group of related claims which are submitted at the time such claim is submitted.

(2)

(A)Except as provided in subparagraph (B) of this paragraph, no allegations of liability against an individual under section 3802 of this title with respect to any claim or statement made, presented, or submitted, or caused to be made, presented, or submitted, by such individual relating to any benefits received by such individual shall be referred to a presiding officer under paragraph (2) of subsection (b).

(B)Allegations of liability against an individual under section 3802 of this title with respect to any claim or statement made, presented, or submitted, or caused to be made, presented, or submitted, by such individual relating to any benefits received by such individual may be referred to a presiding officer under paragraph (2) of subsection (b) if—

(i)such claim or statement is made by such individual in making application for such benefits;

(ii)such allegations relate to the eligibility of such individual to receive such benefits; and

(iii)with respect to such claim or statement, the individual—

(I)has actual knowledge that the claim or statement is false, fictitious, or fraudulent;

(II)acts in deliberate ignorance of the truth or falsity of the claim or statement; or

(III)acts in reckless disregard of the truth or falsity of the claim or statement.

(C)For purposes of this subsection, the term “benefits” means—

(i)benefits under the supplemental security income program under title XVI of the Social Security Act;

(ii)old age, survivors, and disability insurance benefits under title II of the Social Security Act;

(iii)benefits under title XVIII of the Social Security Act;

(iv)assistance under a State program funded under part A of title IV of the Social Security Act;

(v)medical assistance under a State plan approved under section 1902(a) of the Social Security Act;

(vi)benefits under title XX of the Social Security Act;

(vii)benefits under the supplemental nutrition assistance program (as defined in section 3 of the Food and Nutrition Act of 2008);

(viii)benefits under chapters 11, 13, 15, 17, and 21 of title 38;

(ix)benefits under the Black Lung Benefits Act;

(x)benefits under the special supplemental nutrition program for women, infants, and children established under section 17 of the Child Nutrition Act of 1966;

(xi)benefits under section 336 of the Older Americans Act;

(xii)any annuity or other benefit under the Railroad Retirement Act of 1974;

(xiii)benefits under the Richard B. Russell National School Lunch Act;

(xiv)benefits under any housing assistance program for lower income families or elderly or handicapped persons which is administered by the Secretary of Housing and Urban Development or the Secretary of Agriculture;

(xv)benefits under the Low-Income Home Energy Assistance Act of 1981; and

(xvi)benefits under part A of the Energy Conservation in Existing Buildings Act of 1976,

which are intended for the personal use of the individual who receives the benefits or for a member of the individual’s family.

(3)The maximum amount in paragraph (1) shall be adjusted for inflation in the same manner and to the same extent as civil monetary penalties under the Federal Civil Penalties Inflation Adjustment Act 1 (28 U.S.C. 2461 note).

United States Government work; public domain under 17 U.S.C. § 105.