Opinion ID: 476864
Heading Depth: 1
Heading Rank: 2

Heading: The CMPL

Text: 10 On August 13, 1981, Congress passed the CMPL, a civil statute providing monetary penalties for individuals who file false Medicare or Medicaid claims. 4 Congress passed the CMPL as an alternative procedure to existing federal and state enforcement mechanisms, after determining that those mechanisms were inadequate to combat the increasing incidence of Medicare fraud. 5 The CMPL authorizes the Secretary of HHS to impose penalties of up to $2,000 per claim and double the claim amount on any person who presents or causes to be presented a claim or claims that the person knew or had reason to know was not provided for by statute or regulation. 6 These sanctions expressly apply in addition to any other penalties that may be prescribed by law.... 42 U.S.C. Sec. 1320a-7a(a) (1983). The statute further provides that, in determining the amount of the penalty, the Secretary shall take into account (1) the nature of claims and the circumstances under which they were presented, (2) the degree of culpability, history of prior offenses, and financial condition of the person presenting the claims, and (3) such other matters as justice may require. 42 U.S.C. Sec. 1320a-7a(c) (1983). 11 The CMPL's provisions generally track the civil penalty provision of the False Claims Act (FCA), 31 U.S.C. Sec. 3729 (1983). 7 The CMPL thus provides an administrative alternative to the FCA and to maximum criminal penalties of $25,000, five years imprisonment, or both, for persons convicted of specified fraudulent acts, including the filing of false Medicare and Medicaid claims, under 42 U.S.C. Sec. 1395nn(c) (1983). The major difference of the CMPL from the FCA is that the CMPL provides the Secretary with an enforcement mechanism independant from prosecution by the Department of Justice in federal court. In addition, the CMPL creates new substantive liability if a claim-filer has reason to know that her claims are false, and changes the forum in and the evidentiary burdens by which the claims are prosecuted. 12 On December 30, 1982, the Secretary of HHS promulgated proposed rules for implementing the statute by notice and comment in the Federal Register. 8 47 Fed.Reg. 58,309 (1982). Two years after the statute was enacted, the Secretary adopted the final rules, to be effective September 26, 1983. 48 Fed.Reg. 38,827 (1983) (codified at 45 C.F.R. Secs. 101.100-101.133 (1984)). The Secretary recognized that Congress did not specifically make 42 U.S.C. Sec. 1320a-7a retroactive, but she inferred that Congress intended retroactive application from the fact that the CMPL was conceived as an alternative remedy to criminal prosecution of cases of fraud, which were not being prosecuted. 48 Fed.Reg. 38,828 (1983). 9 Attempting to avoid the Due Process problems that might arise from wholesale retroactive application of the CMPL, 48 Fed.Reg. 38,828-29 (1983), the Secretary enacted 45 C.F.R. Sec. 101.114(b) (1984). Section 101.114(b) permits the retroactive application of the CMPL only to conduct that would have violated the FCA at the time of the submission of the false claim, and conforms evidentiary burdens to the FCA. 10 The effect of the regulations is to insure that liability is imposed only on those who had notice that their conduct was illegal, albeit under a different statute, and that no substantive right pertaining to such illegal conduct is altered, amended, or abrogated. 13