Eliminating Kickbacks in Recovery Act of 2018

Summary: Eliminating Kickbacks in Recovery Act of 2018 This bill amends the federal criminal code make it a crime to knowingly and willfully solicit, receive, pay, or offer payment for referrals to a recovery home or clinical treatment facility, subject to limitations. A violator is subject to criminal penalties&#8212;a fine, a prison term of up to 10 years, or both.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Eliminating Kickbacks in Recovery 
Act of 2018''.

SEC. 2. CRIMINAL PENALTIES.

    (a) In General.--Chapter 11 of title 18, United States Code, is 
amended by inserting after section 219 the following:
``Sec. 220. Illegal remunerations for referrals to recovery homes and 
              clinical treatment facilities
    ``(a) Offense.--Except as provided in subsection (c), it shall be 
unlawful to, in or affecting interstate or foreign commerce, knowingly 
and willfully--
            ``(1) solicit or receive any remuneration (including any 
        kickback, bribe, or rebate) directly or covertly, in cash or in 
        kind, in return for referring a patient or patronage to a 
        recovery home or clinical treatment facility;
            ``(2) being a recovery home or clinical treatment facility, 
        or an officer or employee of a recovery home or clinical 
        treatment facility acting in the course of their employment, 
        pay or offering any remuneration (including any kickback, 
        bribe, or rebate) directly or covertly, in cash or in kind, 
        to--
                    ``(A) a person in exchange for the person referring 
                an individual to that recovery home or clinical 
                treatment facility; or
                    ``(B) an individual in exchange for that individual 
                using the services of that recovery home or clinical 
                treatment facility; or
            ``(3) being a clinical service provider, or an officer or 
        employee of a clinical service provider acting in the course of 
        their employment, pay, solicit, or receive any remuneration 
        (including any kickback, bribe, or rebate) directly or 
        covertly, in cash or in kind, to a recovery home or clinical 
        treatment facility, or to an officer or employee of a recovery 
        home or clinical treatment facility, in exchange for referring 
        an individual with a substance use disorder to a clinical 
        service provider for clinical services.
    ``(b) Penalty.--Any person who violates subsection (a) shall be 
fined not more than $200,000, imprisoned not more than 10 years, or 
both.
    ``(c) Applicability.--Subsection (a) shall not apply to--
            ``(1) a discount or other reduction in price obtained by a 
        provider of services or other entity under a health care 
        benefit program if the reduction in price is properly disclosed 
        and appropriately reflected in the costs claimed or charges 
        made by the provider or entity;
            ``(2) any amount paid by an employer to an employee (who 
        has a bona fide employment relationship with such employer) for 
        employment in the provision of covered items or services and 
        the employee's remuneration is not determined by the number of 
        individuals referred to a particular recovery home or clinical 
        treatment facility;
            ``(3) any amount paid by a vendor of goods or services to a 
        person authorized to act as a purchasing agent for a group of 
        individuals or entities who are furnishing services reimbursed 
        if--
                    ``(A) the person has a written contract, with each 
                such individual or entity, which specifies the amount 
                to be paid to the person, which amount may be a fixed 
                amount or a fixed percentage of the value of the 
                purchases made by each such individual or entity under 
                the contract; and
                    ``(B) in the case of a recovery home or clinical 
                treatment facility that is a provider of services, the 
                person discloses to the health care benefit program the 
                remuneration received from each such vendor with 
                respect to purchases made by or on behalf of the 
                entity;
            ``(4) a discount in the price of an applicable drug of a 
        manufacturer that is furnished to an applicable beneficiary 
        under the Medicare coverage gap discount program under section 
        1860D-14A(g) of the Social Security Act (42 U.S.C. 1395w-
        114a(g));
            ``(5) any payment made by a principal to an agent as 
        compensation for the services of the agent under a personal 
        services and management contract that meets the requirements of 
        section 1001.952(d) of title 42, Code of Federal Regulations, 
        as in effect on the date of enactment of this section;
            ``(6) a waiver or discount (as defined in section 
        1001.952(h)(5) of title 42, Code of Federal Regulations, as in 
        effect on the date of enactment of this section) of any 
        coinsurance or copayment by a health care benefit program, as 
        determined by the health care benefit program; or
            ``(7) any remuneration between a health center or entity 
        described under clause (i) or (ii) of section 1905(l)(2)(B) of 
        the Social Security Act (42 U.S.C. 1396d(l)(2)(B)) and any 
        individual or entity providing goods, items, services, 
        donations, loans, or a combination thereof, to such health 
        center entity pursuant to a contract, lease, grant, or other 
        agreement, if such agreement contributes to the ability of the 
        health center entity to maintain or increase the availability, 
        or enhance the quality, of services provided to a medically 
        underserved population served by the health center entity.
    ``(d) Intent Requirement.--With respect to a violation of this 
section, a person need not have actual knowledge of this section or 
specific intent to commit a violation of this section.
    ``(e) Definitions.--In this section--
            ``(1) the terms `applicable beneficiary' and `applicable 
        drug' have the meanings given those terms in section 1860D-
        14A(g) of the Social Security Act (42 U.S.C. 1395w-114a(g));
            ``(2) the term `clinical treatment facility' means a 
        medical setting other than a hospital that provides 
        detoxification, risk reduction, outpatient treatment, 
        residential treatment, or rehabilitation for substance use;
            ``(3) the term `health care benefit program' has the 
        meaning given the term in section 24(b); and
            ``(4) the term `recovery home' means a shared living 
        environment free from alcohol and illicit drug use and centered 
        on peer support and connections to promote sustained recovery 
        from substance use disorders.''.
    (b) Clerical Amendment.--The table of sections for chapter 11 of 
title 18, United States Code, is amended by inserting after the item 
related to section 219 the following:

``220. Illegal remunerations for referrals to recovery homes and 
                            clinical treatment facilities.''.