I 
115TH CONGRESS 
2D SESSION 
H. R. 6878 
To amend title 18, United States Code, to establish criminal penalties for 
unlawful payments for referrals to recovery homes, clinical treatment 
facilities, and laboratories. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 25, 2018 
Mr. DEUTCH introduced the following bill; which was referred to the 
Committee on the Judiciary 
A BILL 
To amend title 18, United States Code, to establish criminal 
penalties for unlawful payments for referrals to recovery 
homes, clinical treatment facilities, and laboratories. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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: 
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‘‘§ 220. Illegal remunerations for referrals to recovery 
homes, clinical treatment facilities, and 
laboratories 
‘‘(a) OFFENSE.—Except as provided in subsection 
(b), whoever, with respect to services covered by a health 
care benefit program, in or affecting interstate or foreign 
commerce, knowingly and willfully— 
‘‘(1) solicits or receives any remuneration (in-
cluding any kickback, bribe, or rebate) directly or in-
directly, overtly or covertly, in cash or in-kind, in re-
turn for referring a patient or patronage to a recov-
ery home, clinical treatment facility, or laboratory; 
or 
‘‘(2) pays or offers any remuneration (including 
any kickback, bribe, or rebate) directly or indirectly, 
overtly or covertly, in cash or in-kind— 
‘‘(A) to induce a referral of an individual 
to a recovery home, clinical treatment facility, 
or laboratory; or 
‘‘(B) in exchange for an individual using 
the services of that recovery home, clinical 
treatment facility, or laboratory, 
shall be fined not more than $200,000, imprisoned not 
more than 10 years, or both, for each occurrence. 
‘‘(b) APPLICABILITY.—Subsection (a) shall not apply 
to— 
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‘‘(1) a discount or other reduction in price ob-
tained by a provider of services or other entity under 
a health care benefit program if the reduction in 
price is properly disclosed and appropriately re-
flected in the costs claimed or charges made by the 
provider or entity; 
‘‘(2) a payment made by an employer to an em-
ployee or independent contract (who has a bona fide 
employment or contractual relationship with such 
employer) for employment, if the employee’s pay-
ment is not determined by or does not vary by— 
‘‘(A) the number of individuals referred to 
a particular recovery home, clinical treatment 
facility, or laboratory; 
‘‘(B) the number of tests or procedures 
performed; or 
‘‘(C) the amount billed to or received from, 
in part or in whole, the health care benefit pro-
gram from the individuals referred to a par-
ticular recovery home, clinical treatment facil-
ity, or laboratory; 
‘‘(3) a discount in the price of an applicable 
drug of a manufacturer that is furnished to an ap-
plicable beneficiary under the Medicare coverage gap 
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discount program under section 1860D–14A(g) of 
the Social Security Act (42 U.S.C. 1395w–114a(g)); 
‘‘(4) a 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; 
‘‘(5) a waiver or discount (as defined in section 
1001.952(h)(5) of title 42, Code of Federal Regula-
tions, or any successor regulation) of any coinsur-
ance or copayment by a health care benefit program 
if— 
‘‘(A) the waiver or discount is not routinely 
provided; and 
‘‘(B) the waiver or discount is provided in 
good faith; 
‘‘(6) a remuneration described in section 
1128B(b)(3)(I) of the Social Security Act (42 
U.S.C. 1320a–7b(b)(3)(I)); 
‘‘(7) a remuneration made pursuant to an alter-
native payment model (as defined in section 
1833(z)(3)(C) of the Social Security Act) or pursu-
ant to a payment arrangement used by a State, 
health insurance issuer, or group health plan if the 
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Secretary of Health and Human Services has deter-
mined that such arrangement is necessary for care 
coordination or value-based care; or 
‘‘(8) any other payment, remuneration, dis-
count, or reduction as determined by the Attorney 
General, in consultation with the Secretary of 
Health and Human Services, by regulation. 
‘‘(c) RULE
OF
CONSTRUCTION.—Neither actual 
knowledge of this section nor specific intent to commit a 
violation of this section shall be an element of an offense 
under this section. 
‘‘(d) REGULATIONS.—The Attorney General, in con-
sultation with the Secretary of Health and Human Serv-
ices, may promulgate regulations to clarify the exceptions 
described in subsection (b). 
‘‘(e) DEFINITIONS.—In this section— 
‘‘(1) the terms ‘applicable beneficiary’ and ‘ap-
plicable 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 pro-
vides detoxification, risk reduction, outpatient treat-
ment and care, residential treatment, or rehabilita-
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