§ 355.3 Basis for civil penalties and assessments. ( a ) *Claims.* ( 1 ) Except as provided in paragraph (c) of this section, any person who makes a claim that the person knows or has reason to know— ( i ) Is false, fictitious, or fraudulent;
( ii ) Includes or is supported by any written statement which asserts a material fact which is false, fictitious, or fraudulent;
( iii ) Includes or is supported by any written statement that— ( A ) Omits a material fact;
( B ) Is false, fictitious, or fraudulent as a result of such omission; and
( C ) Is a statement in which the person making such statement has a duty to include such material fact; or
( iv ) Is for payment for the provision of property or services which the person has not provided as claimed, shall be subject, in addition to any other remedy that may be prescribed by law, to a civil penalty of not more than $5,000 for each such claim. This penalty is subject to adjustment in accord with part 356 of this chapter.
( 2 ) Each voucher, invoice, claim form, or other individual request or demand for property, services, or money constitutes a separate claim.
( 3 ) A claim shall be considered made to an authority, recipient, or party when such claim is actually made to an agent, fiscal intermediary, or other entity, including any state or political subdivision thereof, acting for or on behalf of such authority, recipient, or party.
( 4 ) Each claim for property, services, or money is subject to a civil penalty regardless of whether such property, services, or money is actually delivered or paid.
( 5 ) If the Government has made any payment (including transferred property or provided services) on a claim, a person subject to a civil penalty under paragraph (a)(1) of this section shall also be subject to an assessment of not more than twice the amount of such claim or that portion thereof that is determined to be in violation of paragraph (a)(1) of this section. Such assessment shall be in lieu of damages sustained by the Government because of such claim. However, such assessment shall not be in lieu of any recovery of erroneous payments as authorized by section 10 of the Railroad Retirement Act or section 2(d) of the Railroad Unemployment Insurance Act.
( b ) *Statements.* ( 1 ) Except as provided in paragraph (c) of this section, any person who makes a written statement that— ( i ) The person knows or has reason to know— ( A ) Asserts a material fact which is false, fictitious, or fraudulent; or
( B ) Is false, fictitious, or fraudulent because it omits a material fact that the person making the statement has a duty to include in such statement; and
( ii ) Contains or is accompanied by an express certification or affirmation of the truthfulness and accuracy of the contents of the statement, shall be subject, in addition to any other remedy that may be prescribed by law, to a civil penalty of not more than $5,000 for each such statement. This penalty is subject to adjustment in accord with part 356 of this chapter.
( 2 ) Each written representation, certification, or affirmation constitutes a separate statement.
( 3 ) A statement shall be considered made to an authority when such statement is actually made to an agent, fiscal intermediary, or other entity, including any state or political subdivision thereof, acting for or behalf of such authority.
( c ) ( 1 ) In the case of any claim or statement made by any individual relating to any of the benefits listed in paragraph (c)(2) of this section received by such individual, such individual may be held liable for penalties and assessments under this section only if such claim or statement is made by such individual in making application for such benefits with respect to such individual's eligibility to receive such benefits.
( 2 ) For purposes of this paragraph, the term “benefits” means any annuity or other benefit under the Railroad Retirement Act of 1974 which are intended for the personal use of the individual who receives the benefits or for a member of the individual's family.
( d ) No proof of specific intent to defraud is required to establish liability under this section.
( e ) In any case in which it is determined that more than one person is liable for making a claim or statement under this section, each such person may be held liable for a civil penalty under this section.
( f ) In any case in which it is determined that more than one person is liable for making a claim under this section on which the Government has made payment (including transferred property or provided services), an assessment may be imposed against any such person or jointly and severally against any combination of such persons.
[52 FR 47706, Dec. 16, 1987, as amended at 62 FR 3791, Jan. 27, 1997]