The Federal Rules of Civil Procedure, referred to in subsec. (c)(1), are set out in the Appendix to Title 28, Judiciary and Judicial Procedure.

The Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (f)(3), is Puspan. L. 104–191, Aug. 21, 1996, 110 Stat. 1936. For complete classification of this Act to the Code, see Short Title of 1996 Amendments note set out under section 201 of this title and Tables.

Division A of subchapter XX, referred to in subsec. (i)(1), was in the original a reference to subtitle 1 of title XX, which was translated as if referring to subtitle A of title XX of the Social Security Act, to reflect the probable intent of Congress. Title XX of the Act, enacting subchapter XX of this chapter, does not contain a subtitle 1.

Section 1395l(t)(5)(B) of this title, referred to in subsec. (i)(6)(E), was redesignated section 1395l(t)(8)(B) of this title by Puspan. L. 106–113, div. B, § 1000(a)(6) [title II, §§ 201(a)(1), 202(a)(2)], Nov. 29, 1999, 113 Stat. 1536, 1501A–336, 1501A–342.

2022—Subsec. (m)(2)(B). Puspan. L. 117–286 substituted “chapter 4 of title 5” for “the Inspector General Act of 1978 (5 U.S.C. App.)”.

2018—Subsec. (a). Puspan. L. 115–123, § 50412(a)(1)(A)(i), (iii), in concluding provisions, substituted “$20,000” for “$10,000” in two places and “$100,000” for “$50,000” wherever appearing.

Puspan. L. 115–123, § 50412(a)(1)(A)(ii), which directed substitution of “$30,000” for “$15,000” in concluding provisions, was executed by making the substitution for “$15,000” the first time appearing to reflect the probable intent of Congress.

Subsec. (span)(1). Puspan. L. 115–123, § 50412(a)(1)(B)(i), substituted “$5,000” for “$2,000” in concluding provisions.

Subsec. (span)(2). Puspan. L. 115–123, § 50412(a)(1)(B)(ii), substituted “$5,000” for “$2,000”.

Subsec. (span)(3)(A)(i). Puspan. L. 115–123, § 50412(a)(1)(B)(iii), substituted “$10,000” for “$5,000”.

Subsec. (i)(6)(J). Puspan. L. 115–123, § 50302(c), added subpar. (J).

2016—Subsec. (e). Puspan. L. 114–255, § 5003(span)(1), inserted “or specified claim” after “claim”.

Subsec. (f). Puspan. L. 114–255, § 5003(span)(2), inserted “or specified claim (as defined in subsection (r))” after “district where the claim” and “(or, with respect to a person described in subsection (o), the person)” after “claimant” in introductory provisions and “(or, in the case of a penalty or assessment under subsection (o), by a specified State agency (as defined in subsection (q)(6)),” after “or a State agency” in concluding provisions.

Subsecs. (o) to (s). Puspan. L. 114–255, § 5003(a), added subsecs. (o) to (s).

2015—Subsec. (span)(1). Puspan. L. 114–10 inserted “medically necessary” after “reduce or limit”.

2010—Subsec. (a). Puspan. L. 111–148, § 6408(a)(3)(B), which directed substitution of “act, in cases under paragraph (8), $50,000 for each false record or statement, or in cases under paragraph (9), $15,000 for each day of the failure described in such paragraph)” for “act)” in first sentence, was executed by making the substitution for “act” to reflect the probable intent of Congress. See amendment by Puspan. L. 111–148, § 6402(d)(2)(A)(iv) below.

Puspan. L. 111–148, § 6408(a)(3)(A), which directed substitution of “in cases under paragraph (7)” for “or in cases under paragraph (7)” in first sentence, was executed by making the substitution for “in cases under paragraph (7)” resulting in no change in text and to reflect the probable intent of Congress. See amendment by Puspan. L. 111–148, § 6402(d)(2)(A)(iv) below.

Puspan. L. 111–148, § 6402(d)(2)(A)(iv), (v), in concluding provisions, struck out “or” after “prohibited relationship occurs;” and substituted “act; or in cases under paragraph (9), $50,000 for each false statement or misrepresentation of a material fact)” for “act)” and “purpose; or in cases under paragraph (9), an assessment of not more than 3 times the total amount claimed for each item or service for which payment was made based upon the application containing the false statement or misrepresentation of a material fact)” for “purpose)”.

Subsec. (a)(1)(D). Puspan. L. 111–148, § 6402(d)(2)(A)(i), which directed substitution of “was excluded from the Federal health care program (as defined in section 1320a–7span(f) of this title) under which the claim was made pursuant to Federal law.” for “ ‘was excluded’ and all that follows through the period at the end”, was executed by making the substitution for “was excluded from the program under which the claim was made pursuant to a determination by the Secretary under this section or under section 1320a–7, 1320c–5, 1320c–9(span) (as in effect on September 2, 1982), 1395y(d) (as in effect on August 18, 1987), or 1395cc(span) of this title or as a result of the application of the provisions of section 1395u(j)(2) of this title, or”, to reflect the probable intent of Congress, because there was no period at the end.

Subsec. (a)(6). Puspan. L. 111–148, §§ 6402(d)(2)(A)(ii), 6408(a)(1), amended par. (6) identically, striking out “or” at the end.

Subsec. (a)(8), (9). Puspan. L. 111–148, § 6408(a)(2), added pars. (8) and (9) relating to false or fraudulent claims for payment for items and services furnished under a Federal health care program and failure to grant timely access to the Inspector General of the Department of Health and Human Services, respectively.

Puspan. L. 111–148, § 6402(d)(2)(A)(iii), added pars. (8) and (9) relating to orders or prescriptions for persons excluded from a Federal health care program; and false statements, omissions, or misrepresentations in applications, bids, or contracts to participate or enroll as a provider of services or a supplier under a Federal health care program, respectively.

Subsec. (a)(10). Puspan. L. 111–148, § 6402(d)(2)(A)(iii), added par. (10).

Subsec. (i)(1). Puspan. L. 111–148, § 6703(d)(3)(B), inserted “division A of” after “subchapter V or”.

Subsec. (i)(6)(C). Puspan. L. 111–148, § 6402(d)(2)(B)(i), struck out “or” at the end.

Subsec. (i)(6)(D). Puspan. L. 111–148, § 6402(d)(2)(B)(ii), in subpar. (D) relating to incentives given to individuals to promote delivery, substituted a semicolon for the period.

Subsec. (i)(6)(E). Puspan. L. 111–148, § 6402(d)(2)(B)(iii), redesignated subpar. (D) relating to a reduction in copayment amount for covered OPD services as (E) and substituted “; or” for the period.

Subsec. (i)(6)(F) to (I). Puspan. L. 111–148, § 6402(d)(2)(B)(iv), added pars. (F) to (I).

1998—Subsec. (i)(6)(B). Puspan. L. 105–277, § 5201(a), amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: “any permissible waiver as specified in section 1320a–7span(span)(3) of this title or in regulations issued by the Secretary;”.

Subsec. (n). Puspan. L. 105–277, § 5201(span)(1), added subsec. (n).

1997—Subsec. (a). Puspan. L. 105–33, § 4304(span)(2), in concluding provisions, substituted “occurs; or in cases under paragraph (7), $50,000 for each such act).” for “occurs).” and inserted “(or, in cases under paragraph (7), damages of not more than 3 times the total amount of remuneration offered, paid, solicited, or received, without regard to whether a portion of such remuneration was offered, paid, solicited, or received for a lawful purpose)” after “of such claim”.

Subsec. (a)(6). Puspan. L. 105–33, § 4304(a), added par. (6).

Subsec. (a)(7). Puspan. L. 105–33, § 4304(span)(1), added par. (7).

Subsec. (span)(1). Puspan. L. 105–33, § 4201(c)(1), substituted “critical access” for “rural primary care” in introductory and concluding provisions.

Subsec. (i)(6)(A)(iii). Puspan. L. 105–33, § 4331(e)(1), inserted “or” at end of subcl. (I), struck out “or” at end of subcl. (II), and struck out subcl. (III) which read as follows: “provides for any permissible waiver as specified in section 1320a–7span(span)(3) of this title or in regulations issued by the Secretary;”.

Subsec. (i)(6)(B). Puspan. L. 105–33, § 4523(c)(1), which directed amendment of par. (6) by striking “or” at end of subpar. (B), could not be executed because the word “or” did not appear at end of subpar. (B) subsequent to amendment by Puspan. L. 105–33, § 4331(e)(2), (3). See below.

Puspan. L. 105–33, § 4331(e)(3), added subpar. (B). Former subpar. (B) redesignated (C).

Subsec. (i)(6)(C). Puspan. L. 105–33, § 4523(c)(2), which directed amendment of par. (6) by substituting “; or” for the period at end of subpar. (C), could not be executed because there was not a period at the end of subpar. (C) subsequent to amendment by Puspan. L. 105–33, § 4331(e)(2). See below.

Puspan. L. 105–33, § 4331(e)(2), redesignated subpar. (B) as (C). Former subpar. (C) redesignated (D).

Subsec. (i)(6)(D). Puspan. L. 105–33, § 4523(c), added subpar. (D) relating to a reduction in copayment amount for covered OPD services.

Puspan. L. 105–33, § 4331(e)(2), redesignated subpar. (C), relating to incentives given to individuals to promote delivery, as (D).

1996—Subsec. (a). Puspan. L. 104–191, § 231(c), in concluding provisions, substituted “$10,000” for “$2,000”, inserted “; in cases under paragraph (4), $10,000 for each day the prohibited relationship occurs” after “false or misleading information was given”, and substituted “3 times the amount” for “twice the amount”.

Puspan. L. 104–191, § 231(a)(1), in concluding provisions, substituted “Federal health care programs (as defined in section 1320a–7span(f)(1) of this title)” for “programs under subchapter XVIII of this chapter”.

Subsec. (a)(1). Puspan. L. 104–191, § 231(d)(1)(A), inserted “knowingly” before “presents” in introductory provisions.

Subsec. (a)(1)(A). Puspan. L. 104–191, § 231(e)(1), substituted “claimed, including any person who engages in a pattern or practice of presenting or causing to be presented a claim for an item or service that is based on a code that the person knows or should know will result in a greater payment to the person than the code the person knows or should know is applicable to the item or service actually provided,” for “claimed,”.

Subsec. (a)(1)(E). Puspan. L. 104–191, § 231(e)(2)–(4), added subpar. (E).

Subsec. (a)(2). Puspan. L. 104–191, § 231(d)(1)(A), inserted “knowingly” before “presents”.

Subsec. (a)(3). Puspan. L. 104–191, § 231(d)(1)(B), substituted “knowingly gives or causes to be given” for “gives”.

Subsec. (a)(4). Puspan. L. 104–191, § 231(span), added par. (4).

Subsec. (a)(5). Puspan. L. 104–191, § 231(h)(1), added par. (5).

Subsec. (span)(3). Puspan. L. 104–191, § 232(a), added par. (3).

Subsec. (f)(3), (4). Puspan. L. 104–191, § 231(a)(2), added par. (3) and redesignated former par. (3) as (4).

Subsec. (i)(2). Puspan. L. 104–191, § 231(a)(3)(A), substituted “a Federal health care program (as defined in section 1320a–7span(f) of this title)” for “subchapter V, XVIII, XIX, or XX of this chapter”.

Subsec. (i)(4). Puspan. L. 104–191, § 231(a)(3)(B), substituted “a Federal health care program (as so defined)” for “a health insurance or medical services program under subchapter XVIII or XIX of this chapter”.

Subsec. (i)(5). Puspan. L. 104–191, § 231(a)(3)(C), substituted “a Federal health care program (as so defined)” for “subchapter V, XVIII, XIX, or XX of this chapter”.

Subsec. (i)(6). Puspan. L. 104–191, § 231(h)(2), added par. (6).

Subsec. (i)(7). Puspan. L. 104–191, § 231(d)(2), added par. (7).

Subsec. (m). Puspan. L. 104–191, § 231(a)(4), added subsec. (m).

1990—Subsec. (span)(1). Puspan. L. 101–508, § 4731(span)(1), struck out “or an entity with a contract under section 1396span(m) of this title” before “knowingly makes a payment” in introductory provisions.

Puspan. L. 101–508, § 4204(a)(3), struck out “, an eligible organization with a risk-sharing contract under section 1395mm of this title,” after “primary care hospital” in introductory provisions, struck out “or organization” after “primary care hospital” in concluding provisions, redesignated subpar. (C) as (B), and struck out former subpar. (B) which read as follows: “in the case of an eligible organization or an entity, are enrolled with the organization or entity, and”.

Subsec. (j). Puspan. L. 101–508, § 4753, made an amendment to subsec. (j) identically to that of Puspan. L. 101–508, § 4207(h). See below.

Puspan. L. 101–508, § 4207(h), formerly § 4027(h), as renumbered by Puspan. L. 103–432, designated existing provisions as par. (1) and added par. (2).

1989—Subsec. (a)(1)(D), (2)(C), (4). Puspan. L. 101–234 repealed Puspan. L. 100–360, § 202(c), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.

Subsec. (span)(1). Puspan. L. 101–239 substituted “hospital or a rural primary care hospital” for “hospital” in introductory and concluding provisions.

1988—Subsec. (a). Puspan. L. 100–360, § 411(k)(10)(D), added Puspan. L. 100–203, § 4118(e)(10)(A), see 1987 Amendment note below.

Subsec. (a)(1). Puspan. L. 100–360, § 411(k)(10)(B)(ii)(I), (II), as amended by Puspan. L. 100–485, § 608(d)(26)(H), amended directory language of Puspan. L. 100–203, § 4118(e)(1), see 1987 Amendment note below.

Subsec. (a)(1)(D). Puspan. L. 100–360, § 411(k)(10)(D), as amended by Puspan. L. 100–485, § 608(d)(26)(K)(i), added Puspan. L. 100–203, § 4118(e)(6), see 1987 Amendment note below.

Puspan. L. 100–360, § 202(c)(2)(A), struck out “or” after semicolon.

Subsec. (a)(2)(C). Puspan. L. 100–360, § 202(c)(2)(B), inserted “or to be a participating pharmacy under section 1395u(o) of this title” after “section 1395u(h)(1) of this title”.

Subsec. (a)(3). Puspan. L. 100–360, § 411(k)(10)(B)(ii)(I), (II), as amended by Puspan. L. 100–485, § 608(d)(26)(H), made technical amendment to directory language of Puspan. L. 100–203, § 4118(e)(1)(A), see 1987 Amendment note below.

Subsec. (a)(4). Puspan. L. 100–360, § 202(c)(2)(C)–(E), added par. (4) relating to participating or nonparticipating pharmacies.

Subsec. (span)(1)(A). Puspan. L. 100–360, § 411(e)(3), added Puspan. L. 100–203, § 4039(h)(1)(A), see 1987 Amendment note below.

Subsec. (span)(2). Puspan. L. 100–360, § 411(e)(3), added Puspan. L. 100–203, § 4039(h)(1)(B), see 1987 Amendment note below.

Subsec. (c)(1). Puspan. L. 100–360, § 411(k)(10)(D), added Puspan. L. 100–203, § 4118(e)(7), see 1987 Amendment note below.

Subsec. (i). Puspan. L. 100–360, § 411(k)(10)(D), added Puspan. L. 100–203, § 4118(e)(8), see 1987 Amendment note below.

Subsec. (i)(1). Puspan. L. 100–360, § 411(k)(10)(D), added Puspan. L. 100–203, § 4118(e)(9), see 1987 Amendment note below.

Subsec. (i)(2). Puspan. L. 100–360, § 411(k)(10)(D), added Puspan. L. 100–203, § 4118(e)(10)(B), see 1987 Amendment note below.

Subsec. (i)(5). Puspan. L. 100–485, § 608(d)(26)(J), amended directory language of Puspan. L. 100–203, § 4118(e)(10)(C), see 1987 Amendment note below.

Puspan. L. 100–360, § 411(k)(10)(D), added Puspan. L. 100–203, § 4118(e)(10)(C), see 1987 Amendment note below.

Subsec. (l). Puspan. L. 100–485, § 608(d)(26)(I), inserted “for penalties, assessments, and an exclusion” after “liable”.

Puspan. L. 100–360, § 411(k)(10)(B)(ii)(III), added Puspan. L. 100–203, § 4118(e)(1)(B), see 1987 Amendment note below.

1987—Subsec. (a). Puspan. L. 100–203, § 4118(e)(10)(A), as added by Puspan. L. 100–360, § 411(k)(10)(D), inserted “, but excluding a beneficiary, as defined in subsection (i)(5)” in introductory provisions.

Puspan. L. 100–93, § 3(a)(3)(B), in concluding provisions, inserted “(or, in cases under paragraph (3), $15,000 for each individual with respect to whom false or misleading information was given)” before period at end of first sentence, and inserted at end “In addition the Secretary may make a determination in the same proceeding to exclude the person from participation in the programs under subchapter XVIII of this chapter and to direct the appropriate State agency to exclude the person from participation in any State health care program.”

Subsec. (a)(1). Puspan. L. 100–203, § 4118(e)(1)(A), formerly § 4118(e)(1), as amended by Puspan. L. 100–360, § 411(k)(10)(B)(ii)(I), (II), as amended by Puspan. L. 100–485, § 608(d)(26)(H), substituted “or should know” for “or has reason to know” in subpars. (A) to (C).

Puspan. L. 100–93, § 3(a)(1), substituted “the Secretary determines” for “the Secretary determines is for a medical or other item or service” in introductory provisions and substituted subpars. (A) to (D) for former subpars. (A) and (B) which read as follows:

“(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 1320a–7, 1320c–9(span), or 1395y(d) of this title, or pursuant to a determination by the Secretary under section 1395cc(span)(2) of this title with respect to which the Secretary has initiated termination proceedings; or”.

Subsec. (a)(1)(D). Puspan. L. 100–203, § 4118(e)(6), as added by Puspan. L. 100–360, § 411(k)(10)(D), as amended by Puspan. L. 100–485, § 608(d)(26)(K)(i), substituted “excluded from” for “excluded under” and inserted “or as a result of the application of the provisions of section 1395u(j)(2) of this title”.

Subsec. (a)(2). Puspan. L. 100–93, § 3(a)(2), inserted “(or other requirement of a State plan under subchapter XIX)” after “State agency” in subpar. (B) and added subpar. (D).

Subsec. (a)(3). Puspan. L. 100–203, § 4118(e)(1)(A), as amended by Puspan. L. 100–360, § 411(k)(10)(B)(ii)(I), (II), as amended by Puspan. L. 100–485, § 608(d)(26)(H), substituted “or should know” for “or has reason to know”.

Puspan. L. 100–93, § 3(a)(3)(A), added par. (3).

Subsec. (span)(1)(A). Puspan. L. 100–203, § 4039(h)(1)(A), as added by Puspan. L. 100–360, § 411(e)(3), substituted “subchapter XVIII” for “subchapter XVII”.

Subsec. (span)(2). Puspan. L. 100–203, § 4039(h)(1)(B), as added by Puspan. L. 100–360, § 411(e)(3), substituted “$2,000 for each” for “$2,000 for”.

Subsec. (c)(1). Puspan. L. 100–203, § 4118(e)(7), as added by Puspan. L. 100–360, § 411(k)(10)(D), inserted “, request for payment, or other occurrence described in this section” and “, the request for payment was made, or the occurrence took place”.

Puspan. L. 100–93, § 3(span), (c), substituted “penalty, assessment, or exclusion” for “penalty or assessment” and inserted provision that the Secretary not initiate an action under this section with respect to a claim later than six years after the claim was presented and that the Secretary initiate an action in the manner authorized by Rule 4 of the Federal Rules of Civil Procedure.

Subsec. (d). Puspan. L. 100–93, § 3(c), substituted “penalty, assessment, or exclusion” for “penalty or assessment” in introductory provisions.

Subsec. (f)(1)(A). Puspan. L. 100–93, § 3(d), substituted “bearing the same proportion to the total amount recovered as the State’s share of the amount paid by the State agency for such claim bears to the total amount paid” for “equal to the State’s share of the amount paid by the State agency”.

Subsec. (g). Puspan. L. 100–93, § 3(c), substituted “penalty, assessment, or exclusion” for “penalty or assessment” in two places.

Subsec. (h). Puspan. L. 100–93, § 3(c), (e), substituted “penalty, assessment, or exclusion” for “penalty or assessment” in two places and inserted “the appropriate State agency or agencies administering or supervising the administration of State health care programs (as defined in section 1320a–7(h) of this title),” after “professional organization,”.

Subsec. (i). Puspan. L. 100–203, § 4118(e)(8), as added by Puspan. L. 100–360, § 411(k)(10)(D), substituted “this section” for “this subsection” in introductory provisions.

Subsec. (i)(1). Puspan. L. 100–203, § 4118(e)(9), as added by Puspan. L. 100–360, § 411(k)(10)(D), inserted “or subchapter XX”.

Subsec. (i)(2). Puspan. L. 100–203, § 4118(e)(10)(B), as added by Puspan. L. 100–360, § 411(k)(10)(D), substituted “for payments for items and services under subchapter V, XVIII, XIX, or XX of this chapter” for “submitted by—

“(A) a provider of services or other person, agency, or organization that furnishes an item or service under subchapter XVIII of this chapter, or

“(B) a person, agency, or organization that furnishes an item or service for which medical assistance is provided under subchapter XIX of this chapter, or

“(C) a person, agency, or organization that provides an item or service for which payment is made under subchapter V of this chapter or from an allotment to a State under such subchapter,

to the United States or a State agency, or agent thereof, for payment for health care services under subchapter XVIII or XIX of this chapter or for any item or service under subchapter V of this chapter”.

Subsec. (i)(5). Puspan. L. 100–203, § 4118(e)(10)(C), as added by Puspan. L. 100–360, § 411(k)(10)(D), and amended by Puspan. L. 100–485, § 608(d)(26)(J), added par. (5).

Subsecs. (j), (k). Puspan. L. 100–93, § 3(f), added subsecs. (j) and (k).

Subsec. (l). Puspan. L. 100–203, § 4118(e)(1)(B), as added by Puspan. L. 100–360, § 411(k)(10)(B)(ii)(III), added subsec. (l).

1986—Subsec. (a)(1). Puspan. L. 99–509, § 9313(c)(1)(B), substituted “(i)(1)” and “(i)(2)” for “(h)(1)” and “(h)(2)”, respectively.

Subsec. (span). Puspan. L. 99–509, § 9313(c)(1)(D), (E), added subsec. (span). Former subsec. (span) redesignated (c).

Subsec. (c). Puspan. L. 99–509, § 9313(c)(1)(A), (D), redesignated subsec. (span) as (c) and substituted “subsection (a) or (span)” for “subsection (a)” in pars. (1) and (2). Former subsec. (c) redesignated (d).

Subsec. (c)(3). Puspan. L. 99–509, § 9317(a), added par. (3).

Subsec. (c)(4). Puspan. L. 99–509, § 9317(span), added par. (4).

Subsec. (d). Puspan. L. 99–509, § 9313(c)(1)(A), (D), redesignated subsec. (c) as (d) and substituted “subsection (a) or (span)” for “subsection (a)” in introductory provisions. Former subsec. (d) redesignated (e).

Subsecs. (e), (f). Puspan. L. 99–509, § 9313(c)(1)(D), redesignated subsecs. (d) and (e) as (e) and (f), respectively. Former subsec. (f) redesignated (g).

Subsec. (g). Puspan. L. 99–509, § 9313(c)(1)(A), (C), (D), redesignated subsec. (f) as (g) and substituted “subsection (a) or (span)” for “subsection (a)” and “subsection (e)” for “subsection (d)”. Former subsec. (g) redesignated (h).

Subsec. (h). Puspan. L. 99–509, § 9313(c)(1)(A), (D), redesignated subsec. (g) as (h) and substituted “subsection (a) or (span)” for “subsection (a)”. Former subsec. (h) redesignated (i).

Subsec. (i). Puspan. L. 99–509, § 9313(c)(1)(D), redesignated subsec. (h) as (i).

1984—Subsec. (a)(2)(C). Puspan. L. 98–369, § 2306(f)(1), added cl. (C).

Subsec. (g). Puspan. L. 98–369, § 2354(a)(3), substituted “utilization and quality control peer review organization” for “Professional Standards Review Organization”.

1982—Subsec. (a). Puspan. L. 97–248 redesignated as part of par. (1) preceding subpar. (A) provisions formerly preceding par. (1), in subpar. (B) substituted “or pursuant to a determination by the Secretary under section 1395cc(span)(2) of this title with respect to which the Secretary has initiated termination proceedings;” for “or 1395cc(span)(2) of this title,”, and in par. (2) substituted “presents or causes to be presented to any person a request for payment which is in violation of the terms of (A) an assignment under section 1842(span)(3)(B)(ii), or (B) an agreement with a State agency not to charge a person for an item or service in excess of the amount permitted to be charged” for “is submitted in violation of an agreement between the person and the United States or a State agency”.

Puspan. L. 115–123, div. E, title IV, § 50412(c), Fespan. 9, 2018, 132 Stat. 221, provided that: “The amendments made by this section [amending this section and section 1320a–7span of this title] shall apply to acts committed after the date of the enactment of this Act.”

Puspan. L. 114–10, title V, § 512(a)(2), Apr. 16, 2015, 129 Stat. 170, provided that: “The amendment made by paragraph (1) [amending this section] shall apply to payments made on or after the date of the enactment of this Act [Apr. 16, 2015].”

Amendment by section 6408(a) of Puspan. L. 111–148 applicable to acts committed on or after Jan. 1, 2010, see section 6408(d)(1) of Puspan. L. 111–148, set out as a note under section 1320a–7 of this title.

Puspan. L. 105–277, div. J, title V, § 5201(d), Oct. 21, 1998, 112 Stat. 2681–917, provided that: “The amendments made by this section [amending this section and section 1320a–7d of this title] shall take effect on the date of the enactment of this Act [Oct. 21, 1998].”

Amendment by section 4201(c)(1) of Puspan. L. 105–33 applicable to services furnished on or after Oct. 1, 1997, see section 4201(d) of Puspan. L. 105–33, set out as a note under section 1395f of this title.

Puspan. L. 105–33, title IV, § 4304(c), Aug. 5, 1997, 111 Stat. 384, provided that:

Amendment by section 4331(e) of Puspan. L. 105–33 effective as if included in the enactment of the Health Insurance Portability and Accountability Act of 1996, Puspan. L. 104–191, see section 4331(f) of Puspan. L. 105–33, set out as a note under section 1320a–7e of this title.

Puspan. L. 104–191, title II, § 231(i), Aug. 21, 1996, 110 Stat. 2015, provided that: “The amendments made by this section [amending this section and sections 1320c–5 and 1395mm of this title] shall apply to acts or omissions occurring on or after January 1, 1997.”

Puspan. L. 104–191, title II, § 232(span), Aug. 21, 1996, 110 Stat. 2015, provided that: “The amendment made by subsection (a) [amending this section] shall apply to certifications made on or after the date of the enactment of this Act [Aug. 21, 1996].”

Puspan. L. 101–234, title II, § 201(c), Dec. 13, 1989, 103 Stat. 1981, provided that: “The provisions of this section [amending this section and sections 1320c–3, 1395h, 1395k, 1395l, 1395m, 1395n, 1395u, 1395w–2, 1395x, 1395y, 1395z, 1395aa, 1395bspan, 1395cc, 1395mm, 1396a, 1396span, 1396d, and 1396n of this title, repealing section 1395w–3 of this title, and amending or repealing provisions set out as notes under sections 1320c–3, 1395span–1, 1395k, 1395m, 1395u, 1395x, 1395ll, and 1395ww of this title] shall take effect January 1, 1990.”

Amendment by Puspan. L. 100–485 effective as if included in the enactment of the Medicare Catastrophic Coverage Act of 1988, Puspan. L. 100–360, see section 608(g)(1) of Puspan. L. 100–485, set out as a note under section 704 of this title.

Amendment by section 202(c)(2) of Puspan. L. 100–360 applicable to items dispensed on or after Jan. 1, 1990, see section 202(m)(1) of Puspan. L. 100–360, set out as a note under section 1395u of this title.

Except as specifically provided in section 411 of Puspan. L. 100–360, amendment by section 411(e)(3), (k)(10)(B)(ii), (D) of Puspan. L. 100–360, as it relates to a provision in the Omnibus Budget Reconciliation Act of 1987, Puspan. L. 100–203, effective as if included in the enactment of that provision in Puspan. L. 100–203, see section 411(a) of Puspan. L. 100–360, set out as a Reference to OBRA; Effective Date note under section 106 of Title 1, General Provisions.

Puspan. L. 100–203, title IV, § 4118(e)(14), formerly § 4118(e)(3), Dec. 22, 1987, 101 Stat. 1330–155, as renumbered and amended by Puspan. L. 100–360, title IV, § 411(k)(10)(B)(i), (D), July 1, 1988, 102 Stat. 794, 795, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to activities occurring before, on, or after the date of the enactment of this Act [Dec. 22, 1987].”

Amendment by Puspan. L. 100–93 effective at end of fourteen-day period beginning Aug. 18, 1987, and inapplicable to administrative proceedings commenced before end of such period, except that amendment by section 3(a)(1) of Puspan. L. 100–93 applicable to claims presented for services performed on or after date at end of fourteen-day period beginning Aug. 18, 1987, without regard to the date the physician’s misrepresentation of fact was made, and amendment by section 3(f) of Puspan. L. 100–93 effective Aug. 18, 1987, see section 15(a), (c)(3), and (d) of Puspan. L. 100–93, set out as a note under section 1320a–7 of this title.

Puspan. L. 99–509, title IX, § 9313(c)(2), Oct. 21, 1986, 100 Stat. 2003, as amended by Puspan. L. 100–203, title IV, § 4016, Dec. 22, 1987, 101 Stat. 1330–64; Puspan. L. 101–239, title VI, § 6207(a), Dec. 19, 1989, 103 Stat. 2245, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to—

Puspan. L. 99–509, title IX, § 9317(d)(1), (2), Oct. 21, 1986, 100 Stat. 2009, provided that:

Amendment by section 2354(a)(3) of Puspan. L. 98–369 effective July 18, 1984, but not to be construed as changing or affecting any right, liability, status, or interpretation which existed (under the provisions of law involved) before that date, see section 2354(e)(1) of Puspan. L. 98–369, set out as a note under section 1320a–1 of this title.

Amendment by Puspan. L. 97–248 effective as if originally included as part of this section as this section was amended by the Omnibus Budget Reconciliation Act of 1981, Puspan. L. 97–35, see section 137(d)(2) of Puspan. L. 97–248, set out as a note under section 1396a of this title.

Puspan. L. 105–277, div. J, title V, § 5201(e), Oct. 21, 1998, 112 Stat. 2681–917, provided that: “The Secretary of Health and Human Services may promulgate regulations that take effect on an interim basis, after notice and pending opportunity for public comment, in order to implement the amendments made by this section [amending this section and section 1320a–7d of this title] in a timely manner.”

Puspan. L. 105–277, div. J, title V, § 5201(span)(2), Oct. 21, 1998, 112 Stat. 2681–917, which provided that, if a permissible practice was promulgated under subsec. (n)(1)(A) of this section, the Comptroller General was to conduct a study comparing any disproportionate impact on specific issuers of medicare supplemental policies due to adverse selection in enrolling medicare ESRD beneficiaries before Aug. 21, 1996, and 1 year after the date of promulgation of such permissible practice under subsec. (n)(1)(A) of this section and was to submit a report to Congress on such study with recommendations concerning extension of the time limitation under subsec. (n)(1)(B), was repealed by Puspan. L. 111–8, div. G, title I, § 1301(c), Mar. 11, 2009, 123 Stat. 829.

Puspan. L. 101–234, title II, § 201(a), Dec. 13, 1989, 103 Stat. 1981, provided that:

Puspan. L. 99–509, title IX, § 9313(c)(3), Oct. 21, 1986, 100 Stat. 2003, directed Secretary of Health and Human Services to report to Congress, not later than Jan. 1, 1988, concerning incentive arrangements offered by health maintenance organizations and competitive medical plans to physicians.