Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/529bv.pdf
Page Number: 756

529US3

Unit: $U55

[09-26-01 13:01:09] PAGES PGT: OPIN

Cite as: 529 U. S. 667 (2000)

681

Opinion of the Court

viders once services are rendered to patients. Payments
are made in a manner calculated to maintain provider
§ 413.5(b); Good Samaritan Hospital, 508 U. S.,
stability.
at 406.
Incentives are given for long-term improvements,
such as capital costs and education. §§ 413.85, 413.134(e),
413.153(b)(2)(iii). Subsidies, deﬁned as “special treatment,”
are awarded to certain providers.
In short,
provider organizations play a vital role and maintain a high
level of responsibility in carrying out the program’s pur-
poses. Medicare funds, in turn, provide beneﬁts extending
beyond isolated, point-of-sale treatment transactions. The
funds health care organizations receive for participating in
the Medicare program constitute “beneﬁts” within the mean-
ing of 18 U. S. C. § 666(b).

Id., pt. 412G.

Our discussion should not be taken to suggest that federal
funds disbursed under an assistance program will result in
coverage of all recipient fraud under § 666(b). Any receipt
of federal funds can, at some level of generality, be character-
ized as a beneﬁt. The statute does not employ this broad,
almost limitless use of the term. Doing so would turn al-
most every act of fraud or bribery into a federal offense,
upsetting the proper
federal balance. To determine
whether an organization participating in a federal assistance
program receives “beneﬁts,” an examination must be under-
taken of the program’s structure, operation, and purpose.
The inquiry should examine the conditions under which the
organization receives the federal payments. The answer
could depend, as it does here, on whether the recipient’s own
operations are one of the reasons for maintaining the pro-
gram. Health care organizations participating in the Medi-
care program satisfy this standard.

The Government has a legitimate and signiﬁcant interest
in prohibiting ﬁnancial fraud or acts of bribery being perpe-
trated upon Medicare providers. Fraudulent acts threaten
the program’s integrity. They raise the risk participating
organizations will lack the resources requisite to provide the