for or recipient of benefits under this title shall not be
regarded as reliable unless the third party, under penalty
of perjury—
‘‘(A) certifies that the translation is accurate;
and
‘‘(B) discloses the nature and scope of the rela-
tionship between the third party and the applicant
or recipient, as the case may be.’’.
(2) EFFECTIVE DATE.—The amendment made
by paragraph (1) shall take effect on October 1,
1994.
(b) CIVIL MONETARY PENALTIES, ASSESSMENTS,
AND EXCLUSIONS FOR TITLE XVI.—
(1) IN GENERAL.—Title XI of such Act (42
U.S.C. 1301–1320b–14) is amended by inserting
after section 1128B the following:
‘‘SEC. 1129. CIVIL MONETARY PENALTIES AND ASSESS-
MENTS FOR TITLE XVI.
‘‘(a) Any person (including an organization, agency,
or other entity) who makes, or causes to be made, a state-
ment or representation of a material fact for use in deter-
mining any initial or continuing right to benefits or pay-
ments under title XVI that the person knows or should
know is false or misleading or knows or should know omits
a material fact shall be subject to, in addition to any other
penalties that may be prescribed by law, a civil money pen-
alty of not more than $5,000 for each such statement or
representation. Such person also shall be subject to an as-
sessment, in lieu of damages sustained by the United
States because of such statement or representation, of not
more than twice the amount of benefits or payments paid
as a result of such a statement or representation. In addi-
tion, the Secretary may make a determination in the same
proceeding to exclude the person from participation in the
programs under title XVIII and to direct the appropriate
State agency to exclude the person from participation in
any State health care program.
‘‘(b)(1) The Secretary may initiate a proceeding to
determine whether to impose a civil money penalty, assess-
ment, or exclusion under subsection (a) only as authorized
by the Attorney General pursuant to procedures agreed
upon by the Secretary and the Attorney General. The Sec-
retary may not initiate an action under this section with
respect to any violation described in subsection (a) later
than 6 years after the date the violation was committed.
The Secretary may initiate an action under this section
by serving notice of the action in any manner authorized
by Rule 4 of the Federal Rules of Civil Procedure.
‘‘(2) The Secretary shall not make a determination
adverse to any person under this section until the person
has been given written notice and an opportunity for the
determination to be made on the record after a hearing
at which the person is entitled to be represented by coun-
sel, to present witnesses, and to cross-examine witnesses
against the person.
‘‘(3) In a proceeding under this section which—
‘‘(A) is against a person who has been convicted
(whether upon a verdict after trial or upon a plea of
guilty or nolo contendere) of a Federal crime charg-
ing fraud or false statements; and
‘‘(B) involves the same transaction as in the
criminal action,
the person is estopped from denying the essential elements
of the criminal offense.
‘‘(4) The official conducting a hearing under this sec-
tion may sanction a person, including any party or attor-
ney, for failing to comply with an order or procedure, fail-
ing to defend an action, or other misconduct as would
interfere with the speedy, orderly, or fair conduct of the
hearing. Such sanction shall reasonably relate to the sever-
ity and nature of the failure or misconduct. Such sanction
may include—
‘‘(A) in the case of refusal to provide or permit
discovery, drawing negative factual inference or
treating such refusal as an admission by deeming
the matter, or certain facts, to be established;
‘‘(B) prohibiting a party from introducing cer-
tain evidence or otherwise supporting a particular
claim or defense;
‘‘(C) striking pleadings, in whole or in part;
‘‘(D) staying the proceedings;
‘‘(E) dismissal of the action;
‘‘(F) entering a default judgment;
‘‘(G) ordering the party or attorney to pay at-
torneys’ fees and other costs caused by the failure
or misconduct; and
‘‘(H) refusing to consider any motion or other
action which is not filed in a timely manner.
‘‘(c) In determining the amount or scope of any pen-
alty, assessment, or exclusion imposed pursuant to this
section, the Secretary shall take into account—
‘‘(1) the nature of the statements and represen-
tations referred to in subsection (a) and the cir-
cumstances under which they occurred;
‘‘(2) the degree of culpability, history of prior
offenses, and financial condition of the person com-
mitting the offense; and
‘‘(3) such other matters as justice may require.
‘‘(d)(1) Any person adversely affected by a deter-
mination of the Secretary under this section may obtain
a review of such determination in the United States Court
of Appeals for the circuit in which the person resides, or
in which the statement or representation referred to in
subsection (a) was made, by filing in such court (within
60 days following the date the person is notified of the
Secretary’s determination) a written petition requesting
that the determination be modified or set aside. A copy
of the petition shall be forthwith transmitted by the clerk
of the court to the Secretary, and thereupon the Secretary
shall file in the court the record in the proceeding as pro-
vided in section 2112 of title 28, United States Code.
Upon such filing, the court shall have jurisdiction of the
proceeding and of the question determined therein, and
shall have the power to make and enter upon the plead-
ings, testimony, and proceedings set forth in such record
a decree affirming, modifying, remanding for further con-
sideration, or setting aside, in whole or in part, the deter-
mination of the Secretary and enforcing the same to the
extent that such order is affirmed or modified. No objec-
tion that has not been urged before the Secretary shall
be considered by the court, unless the failure or neglect
to urge such objection shall be excused because of extraor-
dinary circumstances.
‘‘(2) The findings of the Secretary with respect to
questions of fact, if supported by substantial evidence on
the record considered as a whole, shall be conclusive in
the review described in paragraph (1). If any party shall
apply to the court for leave to adduce additional evidence
and shall show to the satisfaction of the court that such
additional evidence is material and that there were reason-
able grounds for the failure to adduce such evidence in
the hearing before the Secretary, the court may order such
additional evidence to be taken before the Secretary and
to be made a part of the record. The Secretary may modify
its findings as to the facts, or make new findings, by rea-
son of additional evidence so taken and filed, and the Sec-
retary shall file with the court such modified or new find-
ings, which findings with respect to questions of fact, if
supported by substantial evidence on the record considered
as a whole shall be conclusive, and his recommendations,
if any, for the modification or setting aside of his original
order.
‘‘(3) Upon the filing of the record with the Sec-
retary’s original or modified order, the jurisdiction of the
court shall be exclusive and its judgment and decree shall
be final, except that the same shall be subject to review
by the Supreme Court of the United States, as provided
in section 1254 of title 28, United States Code.
‘‘(e)(1) Civil money penalties and assessments im-
posed under this section may be compromised by the Sec-
retary and may be recovered—
‘‘(A) in a civil action in the name of the United
States brought in United States district court for
the district where the statement or representation
referred to in subsection (a) was made, or where the
person resides, as determined by the Secretary;
‘‘(B) by means of reduction in tax refunds to
which the person is entitled, based on notice to the
Secretary of the Treasury as permitted under sec-
tion 3720A of title 31, United States Code;
‘‘(C) by decrease of any payment under title
XVI to which the person is entitled, notwithstanding
section 207 of this Act, as made applicable to this
title by reason of section 1631(d)(1);
‘‘(D) by authorities provided under the Debt
Collection Act of 1982, as amended, to the extent
applicable to debts arising under the Social Security
Act;
‘‘(E) by deduction of the amount of such pen-
alty or assessment, when finally determined, or the
amount agreed upon in compromise, from any sum
then or later owing by the United States to the per-
son against whom the penalty or assessment has
been assessed; or
‘‘(F) by any combination of the foregoing.
‘‘(f) A determination by the Secretary to impose a
penalty, assessment, or exclusion under this section shall
be final upon the expiration of the 60-day period referred
to in subsection (d). Matters that were raised or that could
have been raised in a hearing before the Secretary or in
an appeal pursuant to subsection (d) may not be raised
as a defense to a civil action by the United States to collect
a penalty and assessment imposed under this section.
‘‘(g) Whenever the Secretary’s determination to im-
pose a penalty, assessment, or exclusion under this section
with respect to a medical provider or physician becomes
final, the provisions of section 1128A(h) shall apply.
‘‘(h) Whenever the Secretary has reason to believe
that any person has engaged, is engaging, or is about to
engage in any activity which makes the person subject to
a civil monetary penalty under this section, the Secretary
may bring an action in an appropriate district court of
the United States (or, if applicable, a United States court
of any territory) to enjoin such activity, or to enjoin the
person from concealing, removing, encumbering, or dispos-
ing of assets which may be required in order to pay a civil
monetary penalty and assessment if any such penalty were
to be imposed or to seek other appropriate relief.
‘‘(i)(1) The provisions of subsections (d) and (e) of
section 205 shall apply with respect to this section to the
same extent as they are applicable with respect to title
II. The Secretary may delegate the authority granted by
section 205(d) (as made applicable to this section) to the
Inspector General of the Department of Health and
Human Services for purposes of any investigation under
this section.
‘‘(2) The Secretary may delegate authority granted
under this section to the Inspector General of the Social
Security Administration.
‘‘(j) For purposes of this section, the term ‘State
agency’ shall have the same meaning as in section
1128A(i)(1).
‘‘(k) A principal is liable for penalties, assessments,
and exclusions under this section for the actions of the
principal’s agent acting within the scope of the agency.’’.
(2) CONFORMING AMENDMENTS.—Section 1128
of such Act (42 U.S.C. 1320a–7) is amended—
(A) in subsection (b)(7), by striking ‘‘or
section 1128B’’ and inserting ‘‘, section 1128B,
or section 1129’’;
(B) in subsection (b)(8)(B)(ii), by insert-
ing ‘‘and section 1129’’ after ‘‘section 1128A’’;
(C) in subsection (c)(1), by striking ‘‘or
under section 1128A’’ and inserting ‘‘, section
1128A, or section 1129’’;
(D) in subsection (c)(3)(A), by inserting
‘‘or section 1129’’ after ‘‘section 1128A’’;
(E) in subsection (d)(1), by striking ‘‘and
section 1128A’’ and inserting ‘‘, section 1128A,
and section 1129’’;
(F) in subsection (d)(2)(A), by striking ‘‘or
section 1128A’’ and inserting ‘‘, section 1128A,
or section 1129’’;
(G) in subsection (e)(1), by striking ‘‘or
section 1128A’’ and inserting ‘‘, section 1128A,
or section 1129’’;
(H) in subsection (f)(3), by inserting ‘‘,
1129,’’ after ‘‘sections 1128A’’;
(I) in subsection (g)(1), by striking ‘‘or
section 1128A’’ each place such term appears
and inserting ‘‘, section 1128A, or section
1129’’;
(J) in subsection (g)(2)(A), by inserting
‘‘and 
section 
1129(a)’’ 
after 
‘‘section
1128A(a)’’; and
(K) in subsection (h), by striking ‘‘1128A
and 1128B’’ and inserting ‘‘1128A, 1128B, and
1129’’.
(c) SSI FRAUD CONSIDERED A FELONY.—
(1) IN GENERAL.—Section 1632(a) of such Act
(42 U.S.C. 1383a(a)) is amended by striking ‘‘shall’’
the 1st place such term appears and all that follows
and inserting ‘‘shall be fined under title 18, United
States Code, imprisoned not more than 5 years, or
both.’’.
(2) 
CONFORMING
AMENDMENT.—Section
1632(b) of such Act (42 U.S.C. 1383a(b)) is amend-
ed to read as follows:
‘‘(b)(1) If a person or entity violates subsection (a)
in the person’s or entity’s role as, or in applying to be-
come, a payee under section 1631(a)(2) on behalf of an-
other individual (other than the person’s eligible spouse),
and the violation includes a willful misuse of funds by the
person or entity, the court may also require that full or
partial restitution of funds be made to such other
individual.
‘‘(2) Any person or entity convicted of a violation of
subsection (a) of this section or of section 208 may not
be certified as a payee under section 1631(a)(2).’’.
(d) AUTHORITY TO REDETERMINE ELIGIBILITY IN
DISABILITY CASES IF FRAUD IS INVOLVED, AND TO TER-
MINATE BENEFITS IF THERE IS INSUFFICIENT RELIABLE
EVIDENCE OF DISABILITY.—
(1) IN GENERAL.—Section 1631(e) of such Act
(42 U.S.C. 1383(e)) is amended by adding at the
end the following:
‘‘(6)(A) The Secretary shall immediately redetermine
the eligibility of an individual for benefits under this title
by reason of disability, disregarding any unreliable evi-
dence of disability, if there is reason to believe that fraud
was involved in the application of the individual for such
benefits, unless a United States attorney, or equivalent
State prosecutor, with jurisdiction over potential or actual
related criminal cases, certifies, in writing, that there is
a substantial risk that redetermining such eligibility would
jeopardize the criminal prosecution of any person who is
a subject of the investigation from which the information
is derived.
‘‘(B) If, after redetermining the eligibility of an indi-
vidual for benefits under this title by reason of disability,
the Secretary determines that there is insufficient reliable
evidence of disability, the Secretary may terminate such
eligibility.’’.
(2) EFFECTIVE DATE.—The amendment made
by paragraph (1) shall take effect on October 1,
1994, and shall apply to eligibility determinations
made before, on, or after such date.
(e) AVAILABILITY OF RECIPIENT IDENTIFYING IN-
FORMATION FROM THE INSPECTOR GENERAL, DEPART-
MENT OF HEALTH AND HUMAN SERVICES.—
(1) IN GENERAL.—Section 1631(e) of such Act
(42 U.S.C. 1383(e)), as amended by subsection (d)
of this section, is amended by adding at the end the
following:
‘‘(7) As soon as the Inspector General, Social Secu-
rity Administration, has reason to believe that fraud was
involved in the application of a recipient for benefits under
this title, the Inspector General shall make available to
the Secretary information identifying the recipient, unless
a United States attorney, or equivalent State prosecutor,
with jurisdiction over potential or actual related criminal
cases, certifies, in writing, that there is a substantial risk
that making the information so available or redetermining
the eligibility of the recipient for such benefits would jeop-
ardize the criminal prosecution of any person who is a sub-
ject of the investigation from which the information is
derived.’’.