Program Fraud Civil Remedies Act, 61911-61921 [E6-17545]
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Federal Register / Vol. 71, No. 203 / Friday, October 20, 2006 / Rules and Regulations
Thus, Executive Order 13175 does not
apply to this rule.
CORPORATION FOR NATIONAL AND
COMMUNITY SERVICE
VIII. Congressional Review Act
45 CFR Part 2554
The Congressional Review Act, 5
U.S.C. 801 et seq., as added by the Small
Business Regulatory Enforcement
Fairness Act of 1996, generally provides
that before a rule may take effect, the
agency promulgating the rule must
submit a rule report, which includes a
copy of the rule, to each House of the
Congress and to the Comptroller General
of the United States. EPA will submit a
report containing this rule and other
required information to the U.S. Senate,
the U.S. House of Representatives, and
the Comptroller General of the United
States prior to publication of this final
rule in the Federal Register. This final
rule is not a ‘‘major rule’’ as defined by
5 U.S.C. 804(2).
List of Subjects in 40 CFR Part 180
Environmental protection,
Administrative practice and procedure,
Agricultural commodities, Pesticides
and pests, Reporting and recordkeeping
requirements.
Dated: October 12, 2006.
Lois Rossi,
Director, Registration Division, Office of
Pesticide Programs.
Therefore, 40 CFR chapter I is
amended as follows:
I
RIN 3045–AA42
Program Fraud Civil Remedies Act
Corporation for National and
Community Service.
ACTION: Final rule.
AGENCY:
SUMMARY: This final rule implements
the Program Fraud Civil Remedies Act
of 1986 (Act), which authorizes the
Corporation for National and
Community Service (Corporation) and
certain other Federal agencies to
impose, through administrative
adjudication, civil penalties and
assessments against any person who
makes, submits, or presents a false,
fictitious, or fraudulent claim or written
statement to the agency. The regulations
establish the procedures the Corporation
will follow in implementing the
provisions of the Act and specifies the
hearing and appeal rights of persons
subject to penalties and assessments
under the Act. They also designate the
Corporation’s Chief Financial Officer to
act on behalf of the Chief Executive
Officer in carrying out certain duties
and responsibilities under the
regulations.
2. Section 180.598 is amended by
adding text to paragraph (b) to read as
follows:
Effective Date: These regulations
are effective November 20, 2006.
FOR FURTHER INFORMATION CONTACT:
Irshad Abdal-Haqq, Office of the
General Counsel, Corporation for
National and Community Service, 1201
New York Ave. NW., Room 10600,
Washington, DC 20525, Telephone:
202–606–6675.
SUPPLEMENTARY INFORMATION:
§ 180.598 Novaluron; tolerances for
residues.
Background
DATES:
PART 180—[AMENDED]
1. The authority citation for part 180
continues to read as follows:
I
Authority: 21 U.S.C. 321(q), 346a and 371.
I
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(b) Section 18 emergency exemptions.
A time-limited tolerance is established
for residues of the fungicide novaluron,
1-[3-chloro-4-(1,1,2-trifluoro-2trifluoromethoxyethoxy) phenyl]-3-[2,6diflurobenzoyl]urea in connection with
use of the pesticide under a section 18
emergency exemption granted by EPA.
The tolerance will expire and is revoked
on the date specified in the following
table:
Parts per
million
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Commodity
Expiration/revocation date
0.15
12/31/09
Sugarcane, cane
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[FR Doc. E6–17566 Filed 10–19–06; 8:45 am]
BILLING CODE 6560–50–S
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In October 1986, Congress enacted the
Program Fraud Civil Remedies Act,
Public Law No. 99–509 (codified at 31
U.S.C. 3801–3812), to establish an
administrative remedy against any
person who makes a false claim or
written statement to any of certain
Federal agencies. In brief, it requires the
affected Federal agencies to follow
certain procedures in recovering
penalties (up to $5,000 per claim) and
assessments (up to double the amount
falsely claimed) against persons who file
false claims or statements for which the
liability is $150,000 or less. When the
Act was enacted, the Corporation for
National and Community Service did
not exist, and the Act did not apply to
the Corporation’s predecessor agency,
ACTION. However, that Act has since
become applicable to the Corporation as
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61911
a result of amendments to the Inspector
General Act, Public Law 103–82,
September 21, 1993. Those
amendments, inter alia, added the
Corporation for National and
Community Service as an
‘‘establishment’’ under the Inspector
General Act and, by doing so, operated
to bring the Corporation within the
provisions of the Program Fraud Civil
Remedies Act.
The Act requires each affected agency
to promulgate rules and regulations
necessary to implement its provisions.
Following the Act’s enactment, at the
request of the President’s Council on
Integrity and Efficiency (PCIE) an
interagency task force was established
under the leadership of the Department
of Health and Human Services to
develop model regulations for
implementation of the Act by all
affected agencies. This action was in
keeping with the stated desire of the
Senate Governmental Affairs Committee
that ‘‘the regulations would be
substantially uniform throughout the
government’’ (S. Rep. No. 99–212, 99th
Cong., 1st Sess. 12 (1985). Upon their
completion, the PCIE recommended
adoption of the model rules by all
affected agencies.
It is the policy of the Corporation to
use a plain language style when
promulgating regulations, and we have
done so in this document without
making substantive changes to the PCIE
model regulations. For the sake of
consistency, we relied, to the extent
practicable, on plain language
regulations issued by the Small
Business Administration in 1996. See 61
FR 2691, January 29, 1996.
A more detailed discussion of the
PCIE’s model regulations is found in the
promulgations of several of the agencies
that adopted them earlier, including
those of the Departments of Justice (53
FR 4034; February 11, 1988 and 53 FR
11645; April 8, 1988); Health and
Human Services (52 FR 27423; July 21,
1987 and 53 FR 11656, April 8, 1988);
and Transportation (52 FR 36968;
October 2, 1987 and 53 FR 880, January
14, 1988). Anyone desiring further
explanation of the model rules is
referred to the cited references.
The Corporation published a
proposed rule with request for comment
in the Federal Register on February 1,
2006 (71 FR 5211). Only one comment
was received. It expressed general
support for the rule as written without
any amendments. The commenter
believes the rule holds individuals
accountable for fraudulent activity and,
as such, improves government
operations. The commenter also
believes the rule’s penalty provisions
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will deter fraud. Finally, the commenter
expressed strong support for the use of
plain language in drafting the rule and
clearly specifying in the rule that due
process will be provided under the
rule’s procedures. Since there were no
other comments, the Corporation has
decided to issue the final rule as
proposed (subject only to minor
typographical corrections).
Statutory and Regulatory Analysis
Under the Act, false claims and
statements subject to its provisions are
to be investigated by an agency’s
investigating official. The results of the
investigation are then reviewed by an
agency reviewing official who
determines whether there is adequate
evidence to believe that the person
named in the report is liable under the
Act. Upon an affirmative finding of
adequate evidence, the reviewing
official sends to the Attorney General a
written notice of the official’s intent to
refer the matter to a presiding officer for
an administrative hearing. The agency
institutes administrative proceedings
against the person only if the Attorney
General or the Attorney General’s
designee approves. Any penalty or
assessment imposed under the Act may
be collected by the Attorney General
through the filing of a civil action, or by
offsetting amounts, other than tax
refunds, owed the particular party by
the Federal government.
The regulations designate the
Inspector General or his or her designee
as the agency’s investigating official.
They also designate the General Counsel
as the reviewing official. Any
administrative adjudication under the
Act will be presided over by an
Administrative Law Judge and any
appeals from the Administrative Law
Judge’s decision will be decided by the
Corporation’s Chief Executive Officer or
Chief Financial Officer. The regulations
designate the Corporation’s Chief
Financial Officer to act on behalf of the
Chief Executive Officer in carrying out
the duties and responsibilities of the
‘‘authority head’’ under the regulations.
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Paperwork Reduction Act
This rule contains no information
collection requirements and therefore is
not subject to the requirements of the
Paperwork Reduction Act of 1980 (44
U.S.C. 3501 et seq.).
Executive Order 12866
The Corporation has determined that
the rule is not an ‘‘economically
significant’’ rule within the meaning of
E.O. 12866 because it is not likely to
result in: (1) An annual effect on the
economy of $100 million or more, or an
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adverse and material effect on a sector
of the economy, productivity,
competition, jobs, the environment,
public health or safety, or State, local,
or tribal government or communities; (2)
the creation of a serious inconsistency
or interference with an action taken or
planned by another agency; (3) a
material alteration in the budgetary
impacts of entitlement, grants, user fees,
or loan programs or the rights and
obligations of recipients thereof; or (4)
the raising of novel legal or policy
issues arising out of legal mandates, the
President’s priorities, or the principles
set forth in E.O. 12866. However, this is
a significant rule and has been reviewed
by the Office of Management and
Budget.
Regulatory Flexibility Act
As required by the Regulatory
Flexibility Act of 1980 (5 U.S.C. 605(b)),
the Corporation certifies that this rule
will not have a significant economic
impact on a substantial number of small
entities. This regulatory action will not
result in (1) An annual effect on the
economy of $100 million or more; (2) a
major increase in costs or prices for
consumers, individual industries,
Federal, State, or local government
agencies, or geographic regions; or (3)
significant adverse effects on
competition, employment, investment,
productivity, innovation, or on the
ability of United States-based
enterprises to compete with foreignbased enterprises in domestic and
export markets. The rule establishes the
procedural mechanism for investigating
and adjudicating allegations of false
claims or statements made against
affected agencies. The rule, by itself,
does not impose any obligations on
entities including any entities that may
fall within the definition of ‘‘small
entities’’ as set forth in section 601(3) of
the Regulatory Flexibility Act, or within
the definition of ‘‘small business’’ as
found in Section 3 of the Small Business
Act, 15 U.S.C. 632, or within the Small
Business Size Standards found in 13
CFR part 121. These obligations would
not be created until an order is issued,
at which time the person subject to the
order would have a right to a hearing in
accordance with the regulations.
Therefore, the Corporation has not
performed the initial regulatory
flexibility analysis that is required
under the Regulatory Flexibility Act (5
U.S.C. 601 et seq.) for major rules that
are expected to have such results.
Unfunded Mandates
For purposes of Title II of the
Unfunded Mandates Reform Act of
1995, 2 U.S.C. 1531–1538, as well as
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Executive Order 12875, this regulatory
action does not contain any Federal
mandate that may result in increased
expenditures in either Federal, State,
local, or tribal governments in the
aggregate, or impose an annual burden
exceeding $100 million on the private
sector.
Executive Order 13132, Federalism
Executive Order 13132, Federalism,
prohibits an agency from publishing any
rule that has Federalism implications if
the rule either imposes substantial
direct compliance costs on State and
local governments and is not required
by statute, or the rule preempts State
law, unless the agency meets the
consultation and funding requirements
of section 6 of the Executive Order. This
rule does not have any Federalism
implications, as described above.
List of Subjects in 45 CFR Part 2554
Claims, Fraud, Organization and
function (government agencies),
Penalties.
I For the reasons stated in the preamble,
the Corporation for National and
Community Service adds a new part
2554 to Chapter XXV of Title 45 of the
Code of Federal Regulations to read as
follows:
PART 2554—PROGRAM FRAUD CIVIL
REMEDIES ACT REGULATIONS
Sec.
Overview and Definitions
2554.1 Overview of regulations.
2554.2 What kind of conduct will result in
program fraud enforcement?
2554.3 What is a claim?
2554.4 What is a statement?
2554.5 What is a false claim or statement?
2554.6 What does the phrase ‘‘know or have
reason to know’’ mean?
Procedures Leading to Issuance of a
Complaint
2554.7 Who investigates program fraud?
2554.8 What happens if program fraud is
suspected?
2554.9 Who is the Corporation’s authority
head?
2554.10 When will the Corporation issue a
complaint?
2554.11 What is contained in a complaint?
2554.12 How will the complaint be served?
Procedures Following Service of a
Complaint
2554.13 How does a defendant respond to
the complaint?
2554.14 What happens if a defendant fails
to file an answer?
2554.15 What happens once an answer is
filed?
Hearing Provisions
2554.16 What kind of hearing is
contemplated?
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2554.17 At the hearing, what rights do the
parties have?
2554.18 What is the role of the ALJ?
2554.19 Can the reviewing official or ALJ be
disqualified?
2554.20 How are issues brought to the
attention of the ALJ?
2554.21 How are papers served?
2554.22 How is time computed?
2554.23 What happens during a prehearing
conference?
2554.24 What rights are there to review
documents?
2554.25 What type of discovery is
authorized and how is it conducted?
2554.26 Are there limits on disclosure of
documents or discovery?
2554.27 Are witness lists exchanged before
the hearing?
2554.28 Can witnesses be subpoenaed?
2554.29 Who pays the costs for a subpoena?
2554.30 Are protective orders available?
2554.31 Where is the hearing held?
2554.32 How will the hearing be conducted
and who has the burden of proof?
2554.33 How is evidence presented at the
hearing?
2554.34 How is witness testimony
presented?
2554.35 Will the hearing proceedings be
recorded?
2554.36 Can a party informally discuss the
case with the ALJ?
2554.37 Are there sanctions for
misconduct?
2554.38 Are post-hearing briefs required?
Decisions and Appeals
2554.39 How is the case decided?
2554.40 How are penalty and assessment
amounts determined?
2554.41 Can a party request reconsideration
of the initial decision?
2554.42 When does the initial decision of
the ALJ become final?
2554.43 What are the procedures for
appealing the ALJ decision?
2554.44 What happens if an initial decision
is appealed?
2554.45 Are there any limitations on the
right to appeal to the authority head?
2554.46 How does the authority head
dispose of an appeal?
2554.47 What judicial review is available?
2554.48 Can the administrative complaint
be settled voluntarily?
2554.49 How are civil penalties and
assessments collected?
2554.50 What happens to collections?
2554.51 What if the investigation indicates
criminal misconduct?
2554.52 How does the Corporation protect
the rights of defendants?
Authority: Pub. L. 99–509, Secs. 6101–
6104, 100 Stat. 1874 (31 U.S.C. 3801–3812);
42 U.S.C. 12651c–12651d.
Overview and Definitions
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§ 2554.1
Overview of regulations.
(a) Statutory basis. This part
implements the Program Fraud Civil
Remedies Act of 1986, 31 U.S.C. 3801–
3812 (‘‘the Act’’). The Act provides the
Corporation and other federal agencies
with an administrative remedy to
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impose civil penalties and assessments
against persons making false claims and
statements. The Act also provides due
process protections to all persons who
are subject to administrative
proceedings under this part.
(b) Possible remedies for program
fraud. In addition to any other penalties
that may be prescribed by law, a person
who submits, or causes to be submitted,
a false claim or a false statement to the
Corporation is subject to a civil penalty
of not more than $5,000 for each
statement or claim, regardless of
whether property, services, or money is
actually delivered or paid by the
Corporation. If the Corporation has
made any payment, transferred
property, or provided services in
reliance on a false claim, the person
submitting it also is subject to an
assessment of not more than twice the
amount of the false claim. This
assessment is in lieu of damages
sustained by the Corporation because of
the false claim.
§ 2554.2 What kind of conduct will result in
program fraud enforcement?
(a) Any person who makes, or causes
to be made, a false, fictitious, or
fraudulent claim or written statement to
the Corporation is subject to program
fraud enforcement. A ‘‘person’’ means
any individual, partnership,
corporation, association, or other legal
entity.
(b) If more than one person makes a
false claim or statement, each person is
liable for a civil penalty. If more than
one person makes a false claim which
has induced the Corporation to make
payment, an assessment is imposed
against each person. The liability of
each such person to pay the assessment
is joint and several, that is, each is
responsible for the entire amount.
(c) No proof of specific intent to
defraud is required to establish liability
under this part.
§ 2554.3
What is a claim?
(a) Claim means any request, demand,
or submission:
(1) Made to the Corporation for
property, services, or money;
(2) Made to a recipient of property,
services, or money from the Corporation
or to a party to a contract with the
Corporation for property or services, or
for the payment of money. This
provision applies only when the claim
is related to property, services or money
from the Corporation or to a contract
with the Corporation; or
(3) Made to the Corporation which
decreases an obligation to pay or
account for property, services, or
money.
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61913
(b) A claim can relate to grants, loans,
insurance, or other benefits, and
includes the Corporation guaranteed
loans made by participating lenders. A
claim is made when it is received by the
Corporation, an agent, fiscal
intermediary, or other entity acting for
the Corporation, or when it is received
by the recipient of property, services, or
money, or the party to a contract.
(c) Each voucher, invoice, claim form,
or individual request or demand for
property, services, or money constitutes
a separate claim.
§ 2554.4
What is a statement?
A ‘‘statement’’ means any written
representation, certification, affirmation,
document, record, or accounting or
bookkeeping entry made with respect to
a claim or with respect to a contract, bid
or proposal for a contract, grant, loan or
other benefit from the Corporation.
‘‘From the Corporation’’ means that the
Corporation provides some portion of
the money or property in connection
with the contract, bid, grant, loan, or
benefit, or is potentially liable to
another party for some portion of the
money or property under such contract,
bid, grant, loan, or benefit. A statement
is made, presented, or submitted to the
Corporation when it is received by the
Corporation or an agent, fiscal
intermediary, or other entity acting for
the Corporation.
§ 2554.5 What is a false claim or
statement?
(a) A claim submitted to the
Corporation is a ‘‘false’’ claim if the
person making the claim, or causing the
claim to be made, knows or has reason
to know that the claim:
(1) Is false, fictitious or fraudulent;
(2) Includes or is supported by a
written statement which asserts or
contains a material fact which is false,
fictitious, or fraudulent;
(3) Includes or is supported by a
written statement which is false,
fictitious or fraudulent because it omits
a material fact that the person making
the statement has a duty to include in
the statement; or
(4) Is for payment for the provision of
property or services which the person
has not provided as claimed.
(b) A statement submitted to the
Corporation is a false statement if the
person making the statement, or causing
the statement to be made, knows or has
reason to know that the statement:
(1) Asserts a material fact which is
false, fictitious, or fraudulent; or
(2) Is false, fictitious, or fraudulent
because it omits a material fact that the
person making the statement has a duty
to include in the statement. In addition,
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the statement must contain or be
accompanied by an express certification
or affirmation of the truthfulness and
accuracy of the contents of the
statement.
§ 2554.6 What does the phrase ‘‘know or
have reason to know’’ mean?
A person knows or has reason to
know (that a claim or statement is false)
if the person:
(a) Has actual knowledge that the
claim or statement is false, fictitious, or
fraudulent; or
(b) Acts in deliberate ignorance of the
truth or falsity of the claim or statement;
or
(c) Acts in reckless disregard of the
truth or falsity of the claim or statement.
Procedures Leading to Issuance of a
Complaint
§ 2554.7
Who investigates program fraud?
The Inspector General, or his
designee, is the investigating official
responsible for investigating allegations
that a false claim or statement has been
made. In this regard, the Inspector
General has authority under the
Program Fraud Civil Remedies Act and
the Inspector General Act of 1978 (5
U.S.C. App. 3), as amended, to issue
administrative subpoenas for the
production of records and documents.
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§ 2554.8 What happens if program fraud is
suspected?
(a) If the investigating official
concludes that an action under this Part
is warranted, the investigating official
submits a report containing the findings
and conclusions of the investigation to
a reviewing official. The reviewing
official is the General Counsel or his or
her designee. If the reviewing official
determines that the report provides
adequate evidence that a person
submitted a false claim or statement, the
reviewing official transmits to the
Attorney General written notice of an
intention to refer the matter for
adjudication, with a request for
approval of such referral. This notice
will include the reviewing official’s
statements concerning:
(1) The reasons for the referral;
(2) The claims or statements upon
which liability would be based;
(3) The evidence that supports
liability;
(4) An estimate of the amount of
money or the value of property,
services, or other benefits requested or
demanded in the false claim or
statement;
(5) Any exculpatory or mitigating
circumstances that may relate to the
claims or statements known by the
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reviewing official or the investigating
official; and
(6) A statement that there is a
reasonable prospect of collecting an
appropriate amount of penalties and
assessments.
(b) If at any time, the Attorney
General or his or her designee requests
in writing that this administrative
process be stayed, the authority head, as
identified in § 2554.9 of this Part, must
stay the process immediately. The
authority head may order the process
resumed only upon receipt of the
written authorization of the Attorney
General.
§ 2554.9 Who is the Corporation’s
authority head?
The Corporation’s ‘‘authority head’’ is
the Chief Executive Officer or his or her
designee. For purposes of this Part, the
Corporation’s Chief Financial Officer is
designated to act on behalf of the Chief
Executive Officer.
§ 2554.10 When will the Corporation issue
a complaint?
The Corporation will issue a
complaint:
(a) If the Attorney General (or
designee) approves the referral of the
allegations for adjudication; and
(b) In a case of submission of false
claims, if the amount of money or the
value of property or services demanded
or requested in a false claim, or a group
of related claims submitted at the same
time, does not exceed $150,000. ‘‘A
group of related claims submitted at the
same time’’ includes only those claims
arising from the same transaction (such
as a grant, loan, application, or contract)
which are submitted together as part of
a single request, demand, or submission.
§ 2554.11 What is contained in a
complaint?
(a) A complaint is a written statement
giving notice to the person alleged to be
liable under 31 U.S.C. 3802 of the
specific allegations being referred for
adjudication and of the person’s right to
request a hearing with respect to those
allegations. The person alleged to have
made false statements or to have
submitted false claims to the
Corporation is referred to as the
‘‘defendant.’’
(b) The reviewing official may join in
a single complaint, false claims or
statements that are unrelated, or that
were not submitted simultaneously,
regardless of the amount of money or
the value of property or services
demanded or requested.
(c) The complaint will state that the
Corporation seeks to impose civil
penalties, assessments, or both, against
each defendant and will include:
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(1) The allegations of liability against
each defendant, including the statutory
basis for liability, identification of the
claims or statements involved, and the
reasons liability allegedly arises from
such claims or statements;
(2) The maximum amount of penalties
and assessments for which each
defendant may be held liable;
(3) A statement that each defendant
may request a hearing by filing an
answer and may be represented by a
representative;
(4) Instructions for filing such an
answer;
(5) A warning that failure to file an
answer within 30 days of service of the
complaint will result in imposition of
the maximum amount of penalties and
assessments.
(d) The reviewing official must serve
any complaint on the defendant and, if
a hearing is requested by the defendant,
provide a copy to the Administrative
Law Judge (ALJ) assigned to the case.
§ 2554.12
served?
How will the complaint be
(a) The complaint must be served on
individual defendants directly, a
partnership through a general partner,
and on corporations or on
unincorporated associations through an
executive officer or a director, except
that service also may be made on any
person authorized by appointment or by
law to receive process for the defendant.
(b) The complaint may be served
either by:
(1) Registered or certified mail (return
receipt requested) addressed to the
defendant at his or her residence, usual
dwelling place, principal office or place
of business; or by
(2) Personal delivery by anyone 18
years of age or older.
(c) The date of service is the date of
personal delivery or, in the case of
service by registered or certified mail,
the date of postmark.
(d) Proof of service—
(1) When service is made by
registered or certified mail, the return
postal receipt will serve as proof of
service.
(2) When service is made by personal
delivery, an affidavit of the individual
serving the complaint, or written
acknowledgment of receipt by the
defendant or a representative, will serve
as proof of service.
(e) When served with the complaint,
the defendant also should be served
with a copy of this Part 2554 and 31
U.S.C. 3801–3812.
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Procedures Following Service of a
Complaint
§ 2554.13 How does a defendant respond
to the complaint?
(a) A defendant may file an answer
with the reviewing official within 30
days of service of the complaint. An
answer will be considered a request for
an oral hearing.
(b) In the answer, a defendant—
(1) Must admit or deny each of the
allegations of liability contained in the
complaint (a failure to deny an
allegation is considered an admission);
(2) Must state any defense on which
the defendant intends to rely;
(3) May state any reasons why he or
she believes the penalties, assessments,
or both should be less than the statutory
maximum; and
(4) Must state the name, address, and
telephone number of the person
authorized by the defendant to act as
defendant’s representative, if any.
(c) If the defendant is unable to file an
answer which meets the requirements
set forth in paragraph (b) of this section,
the defendant may file with the
reviewing official a general answer
denying liability, requesting a hearing,
and requesting an extension of time in
which to file a complete answer. A
general answer must be filed within 30
days of service of the complaint.
(d) If the defendant initially files a
general answer requesting an extension
of time, the reviewing official must
promptly file with the ALJ the
complaint, the general answer, and the
request for an extension of time.
(e) For good cause shown, the ALJ
may grant the defendant up to 30
additional days within which to file an
answer meeting the requirements of
paragraph (b) of this section. Such
answer must be filed with the ALJ and
a copy must be served on the reviewing
official.
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§ 2554.14 What happens if a defendant
fails to file an answer?
(a) If a defendant does not file any
answer within 30 days after service of
the complaint, the reviewing official
will refer the complaint to the ALJ.
(b) Once the complaint is referred, the
ALJ will promptly serve on the
defendant a notice that an initial
decision will be issued.
(c) The ALJ will assume the facts
alleged in the complaint to be true and,
if such facts establish liability under the
statute, the ALJ will issue an initial
decision imposing the maximum
amount of penalties and assessments
allowed under the statute.
(d) Except as otherwise provided in
this section, when a defendant fails to
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file a timely answer, the defendant
waives any right to further review of the
penalties and assessments imposed in
the initial decision.
(e) The initial decision becomes final
30 days after it is issued.
(f) If, at any time before an initial
decision becomes final, a defendant files
a motion with the ALJ asking that the
case be reopened and describing the
extraordinary circumstances that
prevented the defendant from filing an
answer, the initial decision will be
stayed until the ALJ makes a decision
on the motion. The reviewing official
may respond to the motion.
(g) If, in his motion to reopen, a
defendant demonstrates extraordinary
circumstances excusing his failure to
file a timely answer, the ALJ will
withdraw the initial decision, and grant
the defendant an opportunity to answer
the complaint.
(h) A decision by the ALJ to deny a
defendant’s motion to reopen a case is
not subject to review or reconsideration.
(i) The defendant may appeal to the
authority head the decision denying a
motion to reopen by filing a notice of
appeal with the authority head within
15 days after the ALJ denies the motion.
The timely filing of a notice of appeal
shall stay the initial decision until the
authority head decides the issue.
(j) If the defendant files a timely
notice of appeal with the authority
head, the ALJ shall forward the record
of the proceeding to the authority head.
(k) The authority head shall decide
expeditiously whether extraordinary
circumstances excuse the defendant’s
failure to file a timely answer based
solely on the record before the ALJ.
(l) If the authority head decides that
extraordinary circumstances excused
the defendant’s failure to file a timely
answer, the authority head shall remand
the case to the ALJ with instructions to
grant the defendant an opportunity to
answer.
(m) If the authority head decides that
the defendant’s failure to file a timely
answer is not excused, the authority
head shall reinstate the initial decision
of the ALJ, which shall become final
and binding upon the parties 30 days
after the authority head issues such
decision.
§ 2554.15
is filed?
What happens once an answer
(a) When the reviewing official
receives an answer, he must file
concurrently, the complaint and the
answer with the ALJ, along with a
designation of a Corporation
representative.
(b) When the ALJ receives the
complaint and the answer, the ALJ will
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promptly serve a notice of oral hearing
upon the defendant and the
representative for the Corporation, in
the same manner as the complaint,
service of which is described in
§ 2554.12. The notice of oral hearing
must be served within six years of the
date on which the claim or statement is
made.
(c) The notice must include:
(1) The tentative time, place and
nature of the hearing;
(2) The legal authority and
jurisdiction under which the hearing is
to be held;
(3) The matters of fact and law to be
asserted;
(4) A description of the procedures for
the conduct of the hearing;
(5) The name, address, and telephone
number of the defendant’s
representative and the representative for
the Corporation; and
(6) Such other matters as the ALJ
deems appropriate.
(d) The six-year statute of limitation
may be extended by agreement of the
parties.
Hearing Provisions
§ 2554.16 What kind of hearing is
contemplated?
The hearing is a formal proceeding
conducted by the ALJ during which a
defendant will have the opportunity to
cross-examine witnesses, present
testimony, and dispute liability.
§ 2554.17 At the hearing, what rights do
the parties have?
(a) The parties to the hearing shall be
the defendant and the Corporation.
Pursuant to 31 U.S.C. 3730(c)(5), a
private plaintiff in an action under the
False Claims Act may participate in the
hearing to the extent authorized by the
provisions of that Act.
(b) Each party has the right to:
(1) Be represented by a representative;
(2) Request a pre-hearing conference
and participate in any conference held
by the ALJ;
(3) Conduct discovery;
(4) Agree to stipulations of fact or law
which will be made a part of the record;
(5) Present evidence relevant to the
issues at the hearing;
(6) Present and cross-examine
witnesses;
(7) Present arguments at the hearing
as permitted by the ALJ; and
(8) Submit written briefs and
proposed findings of fact and
conclusions of law after the hearing, as
permitted by the ALJ.
§ 2554.18
What is the role of the ALJ?
An ALJ retained by the Corporation
serves as the presiding officer at all
hearings.
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(a) The ALJ shall conduct a fair and
impartial hearing, avoid delay, maintain
order, and assure that a record of the
proceeding is made.
(b) The ALJ has the authority to—
(1) Set and change the date, time, and
place of the hearing upon reasonable
notice to the parties;
(2) Continue or recess the hearing in
whole or in part for a reasonable period
of time;
(3) Hold conferences to identify or
simplify the issues, or to consider other
matters that may aid in the expeditious
disposition of the proceeding;
(4) Administer oaths and affirmations;
(5) Issue subpoenas requiring the
attendance of witnesses and the
production of documents at depositions
or at hearings;
(6) Rule on motions and other
procedural matters;
(7) Regulate the scope and timing of
discovery;
(8) Regulate the course of the hearing
and the conduct of representatives and
parties;
(9) Examine witnesses;
(10) Receive, rule on, exclude, or limit
evidence;
(11) Upon motion of a party, take
official notice of facts;
(12) Upon motion of a party, decide
cases, in whole or in part, by summary
judgment where there is no disputed
issue of material fact;
(13) Conduct any conference,
argument, or hearing on motions in
person or by telephone; and
(14) Exercise such other authority as
is necessary to carry out the
responsibilities of the ALJ under this
part.
(c) The ALJ does not have the
authority to find Federal statutes or
regulations invalid.
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§ 2554.19 Can the reviewing official or ALJ
be disqualified?
(a) A reviewing official or an ALJ may
disqualify himself or herself at any time.
(b) Upon motion of any party, the
reviewing official or ALJ may be
disqualified as follows:
(1) The motion must be supported by
an affidavit containing specific facts
establishing that personal bias or other
reason for disqualification exists,
including the time and circumstances of
the discovery of such facts;
(2) The motion must be filed promptly
after discovery of the grounds for
disqualification, or the objection will be
deemed waived; and
(3) The party, or representative of
record, must certify in writing that the
motion is made in good faith.
(c) Once a motion has been filed to
disqualify the reviewing official, the ALJ
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will halt the proceedings until resolving
the matter of disqualification. If the ALJ
determines that the reviewing official is
disqualified, the ALJ will dismiss the
complaint without prejudice. If the ALJ
disqualifies himself or herself, the case
will be promptly reassigned to another
ALJ.
§ 2554.20 How are issues brought to the
attention of the ALJ?
address. When a party is represented by
a representative, service shall be made
upon such representative in lieu of the
actual party.
(c) Proof of service. A certificate of the
individual serving the document by
personal delivery or by mail, setting
forth the manner of service, shall be
proof of service.
§ 2554.22
(a) All applications to the ALJ for an
order or ruling shall be by motion.
Motions shall state the relief sought, the
authority relied upon, and the facts
alleged, and shall be filed with the ALJ
and served on all other parties.
(b) Except for motions made during a
prehearing conference or at the hearing,
all motions shall be in writing. The ALJ
may require that oral motions be
reduced to writing.
(c) Within 15 days after a written
motion is served, or such other time as
may be fixed by the ALJ, any party may
file a response to such motion.
(d) The ALJ may not grant a written
motion before the time for filing
responses thereto has expired, except
upon consent of the parties or following
a hearing on the motion, but may
overrule or deny such motion without
awaiting a response.
(e) The ALJ shall make a reasonable
effort to dispose of all outstanding
motions prior to the beginning of the
hearing.
§ 2554.21
How are papers served?
(a) Form. (1) Documents filed with the
ALJ shall include an original and two
copies.
(2) Every pleading and paper filed in
the proceeding shall contain a caption
setting forth the title of the action, the
case number assigned by the ALJ, and
a designation of the paper (e.g., motion
to quash subpoena).
(3) Every pleading and paper shall be
signed by, and shall contain the address
and telephone number of the party or
the person on whose behalf the paper
was filed, or his or her representative.
(4) Papers are considered filed when
they are mailed. Date of mailing may be
established by a certificate from the
party or its representative or by proof
that the document was sent by certified
or registered mail.
(b) Service. A party filing a document
with the ALJ shall at the time of filing,
serve a copy of such document on every
other party. Service upon any party of
any document other than those required
to be served as prescribed in § 2554.12
shall be made by delivering a copy or
by placing a copy of the document in
the United States mail, postage prepaid
and addressed, to the party’s last known
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How is time computed?
(a) In computing any period of time
under this part or in an order issued
thereunder, the time begins with the day
following the act, event, or default, and
includes the last day of the period,
unless it is a Saturday, Sunday, or legal
holiday observed by the Federal
government, in which event it includes
the next business day.
(b) When the period of time allowed
is less than seven days, intermediate
Saturdays, Sundays, and legal holidays
observed by the Federal government
shall be excluded from the computation.
(c) Where a document has been served
or issued by placing it in the mail, an
additional five days will be added to the
time permitted for any response.
§ 2554.23 What happens during a
prehearing conference?
(a) The ALJ may schedule prehearing
conferences as appropriate.
(b) Upon the motion of any party, the
ALJ shall schedule at least one
prehearing conference at a reasonable
time in advance of the hearing.
(c) The ALJ may use prehearing
conferences to discuss the following:
(1) Simplification of the issues;
(2) The necessity or desirability of
amendments to the pleadings, including
the need for a more definite statement;
(3) Stipulations and admissions of fact
or as to the contents and authenticity of
documents;
(4) Whether the parties can agree to
submission of the case on a stipulated
record;
(5) Whether a party chooses to waive
appearances at an oral hearing and to
submit only documentary evidence
(subject to the objection of other parties)
and written argument;
(6) Limitation of the number of
witnesses;
(7) Scheduling dates for the exchange
of witness lists and of proposed
exhibits;
(8) Discovery;
(9) The time and place for the hearing;
and
(10) Such other matters as may tend
to expedite the fair and just disposition
of the proceedings.
(d) The ALJ may issue an order
containing all matters agreed upon by
the parties or ordered by the ALJ at a
prehearing conference.
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§ 2554.24 What rights are there to review
documents?
(a) Upon written request to the
reviewing official, the defendant may
review any relevant and material
documents, transcripts, records, and
other materials that relate to the
allegations set out in the complaint and
upon which the findings and
conclusions of the investigating official
under § 2554.8 are based, unless such
documents are subject to a privilege
under Federal law. Upon payment of
fees for duplication, the defendant may
obtain copies of such documents.
(b) Upon written request to the
reviewing official, the defendant also
may obtain a copy of all exculpatory
information in the possession of the
reviewing official or investigating
official relating to the allegations in the
complaint, even if it is contained in a
document that would otherwise be
privileged. If the document would
otherwise be privileged, only that
portion containing exculpatory
information must be disclosed.
(c) The notice sent to the Attorney
General from the reviewing official as
described in § 2554.8 is not discoverable
under any circumstances.
(d) The defendant may file a motion
to compel disclosure of the documents
subject to the provisions of this section.
Such a motion may only be filed with
the ALJ following the filing of an answer
pursuant to § 2554.13.
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§ 2554.25 What type of discovery is
authorized and how is it conducted?
(a) The following types of discovery
are authorized:
(1) Requests for production of
documents for inspection and copying;
(2) Requests for admissions of the
authenticity of any relevant document
or of the truth of any relevant fact;
(3) Written interrogatories; and
(4) Depositions.
(b) For the purpose of this section and
§§ 2554.27 and 2554.28, the term
‘‘documents’’ includes information,
documents, reports, answers, records,
accounts, papers, and other data and
documentary evidence. Nothing
contained herein shall be interpreted to
require the creation of a document.
(c) Unless mutually agreed to by the
parties, discovery is available only as
ordered by the ALJ. The ALJ shall
regulate the timing of discovery.
(d) Motions for discovery. (1) A party
seeking discovery may file a motion
with the ALJ. Such a motion shall be
accompanied by a copy of the requested
discovery, or in the case of depositions,
a summary of the scope of the proposed
deposition.
(2) Within ten days of service, a party
may file an opposition to the motion
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and/or a motion for protective order as
provided in § 2554.30.
(3) The ALJ may grant a motion for
discovery only if he or she finds that the
discovery sought—
(i) Is necessary for the expeditious,
fair, and reasonable consideration of the
issues;
(ii) Is not unduly costly or
burdensome;
(iii) Will not unduly delay the
proceeding; and
(iv) Does not seek privileged
information.
(4) The burden of showing that
discovery should be allowed is on the
party seeking discovery.
(5) The ALJ may grant discovery
subject to a protective order under
§ 2554.30.
(e) Depositions. (1) If a motion for
deposition is granted, the ALJ shall
issue a subpoena for the deponent,
which may require the deponent to
produce documents. The subpoena shall
specify the time and place at which the
deposition will be held.
(2) The party seeking to depose shall
serve the subpoena in the manner
prescribed in § 2554.12.
(3) The deponent may file with the
ALJ a motion to quash the subpoena or
a motion for a protective order within
ten days of service.
(4) The party seeking to depose shall
provide for the taking of a verbatim
transcript of the deposition, which it
shall make available to all other parties
for inspection and copying.
(f) Each party shall bear its own costs
of discovery.
§ 2554.26 Are there limits on disclosure of
documents or discovery?
(a) Upon written request to the
reviewing official, the defendant may
review all non-privileged, relevant and
material documents, records and other
material related to the allegations
contained in the complaint. After
paying the Corporation a reasonable fee
for duplication, the defendant may
obtain a copy of the records described.
(b) Upon written request to the
reviewing official, the defendant may
obtain a copy of all exculpatory
information in the possession of the
reviewing official or investigating
official relating to the allegations in the
complaint. If the document would
otherwise be privileged, only the
portion of the document containing
exculpatory information must be
disclosed. As used in this section, the
term ‘‘information’’ does not include
legal materials such as statutes or case
law obtained through legal research.
(c) The notice sent to the Attorney
General from the reviewing official is
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not discoverable under any
circumstances.
(d) Other discovery is available only
as ordered by the ALJ and includes only
those methods of discovery allowed by
§ 2554.25.
§ 2554.27 Are witness lists exchanged
before the hearing?
(a) At least 15 days before the hearing
or at such other time as ordered by the
ALJ, the parties must exchange witness
lists and copies of proposed hearing
exhibits, including copies of any written
statements or transcripts of deposition
testimony that the party intends to offer
in lieu of live testimony.
(b) If a party objects, the ALJ will not
admit into evidence the testimony of
any witness whose name does not
appear on the witness list or any exhibit
not provided to an opposing party
unless the ALJ finds good cause for the
omission or concludes that there is no
prejudice to the objecting party.
(c) Unless a party objects within the
time set by the ALJ, documents
exchanged in accordance with this
section are deemed to be authentic for
the purpose of admissibility at the
hearing.
§ 2554.28
Can witnesses be subpoenaed?
(a) A party wishing to procure the
appearance and testimony of any
individual at the hearing may request
that the ALJ issue a subpoena.
(b) A subpoena requiring the
attendance and testimony of an
individual may also require the
individual to produce documents at the
hearing.
(c) A party seeking a subpoena shall
file a written request therefore not less
than 15 days before the date fixed for
the hearing unless otherwise allowed by
the ALJ for good cause shown. Such
request shall specify any documents to
be produced and shall designate the
witnesses and describe the address and
location thereof with sufficient
particularity to permit such witnesses to
be found.
(d) The subpoena shall specify the
time and place at which the witness is
to appear and any documents the
witness is to produce.
(e) The party seeking the subpoena
shall serve it in the manner prescribed
in § 2554.12. A subpoena on a party or
upon an individual under the control of
a party may be served by first class mail.
(f) A party or the individual to whom
the subpoena is directed may file with
the ALJ a motion to quash the subpoena
within ten days after service or on or
before the time specified in the
subpoena for compliance if it is less
than ten days after service.
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§ 2554.29 Who pays the costs for a
subpoena?
(c) As agreed upon by the defendant
and the ALJ.
The party requesting a subpoena shall
pay the cost of the fees and mileage of
any witness subpoenaed in the amounts
that would be payable to a witness in a
proceeding in United States District
Court. A check for witness fees and
mileage shall accompany the subpoena
when served, except that when a
subpoena is issued on behalf of the
authority, a check for witness fees and
mileage need not accompany the
subpoena.
§ 2554.30
Are protective orders available?
(a) A party or a prospective witness or
deponent may file a motion for a
protective order with respect to
discovery sought by an opposing party
or with respect to the hearing, seeking
to limit the availability or disclosure of
evidence.
(b) In issuing a protective order, the
ALJ may make any order which justice
requires to protect a party or person
from annoyance, embarrassment,
oppression, or undue burden or
expense, including one or more of the
following:
(1) That the discovery not be had;
(2) That the discovery may be had
only on specified terms and conditions,
including a designation of the time or
place;
(3) That the discovery may be had
only through a method of discovery
other than that requested;
(4) That certain matters not be
inquired into, or that the scope of
discovery be limited to certain matters;
(5) That discovery be conducted with
no one present except persons
designated by the ALJ;
(6) That the contents of discovery or
evidence be sealed;
(7) That a deposition after being
sealed be opened only by order of the
ALJ;
(8) That a trade secret or other
confidential research, development,
commercial information, or facts
pertaining to any criminal investigation,
proceeding, or other administrative
investigation not be disclosed or be
disclosed only in a designated way; or
(9) That the parties simultaneously
file specified documents or information
enclosed in sealed envelopes to be
opened as directed by the ALJ.
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§ 2554.31
Where is the hearing held?
The ALJ will hold the hearing in any
judicial district of the United States:
(a) In which the defendant resides or
transacts business; or
(b) In which the claim or statement on
which liability is based was made,
presented or submitted to the
Corporation; or
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§ 2554.32 How will the hearing be
conducted and who has the burden of
proof?
(a) The ALJ conducts a hearing in
order to determine whether a defendant
is liable for a civil penalty, assessment,
or both and, if so, the appropriate
amount of the civil penalty and/or
assessment. The hearing will be
recorded and transcribed, and the
transcript of testimony, exhibits
admitted at the hearing, and all papers
and requests filed in the proceeding
constitute the record for a decision by
the ALJ.
(b) The Corporation must prove a
defendant’s liability and any aggravating
factors by a preponderance of the
evidence.
(c) A defendant must prove any
affirmative defenses and any mitigating
factors by a preponderance of the
evidence.
(d) The hearing will be open to the
public unless otherwise ordered by the
ALJ for good cause shown.
§ 2554.33 How is evidence presented at
the hearing?
(a) The ALJ shall determine the
admissibility of evidence.
(b) Except as provided in this part, the
ALJ shall not be bound by the Federal
Rules of Evidence. However, the ALJ
may apply the Federal Rules of
Evidence where appropriate, e.g., to
exclude unreliable evidence.
(c) The ALJ shall exclude irrelevant
and immaterial evidence.
(d) Although relevant, evidence may
be excluded if its probative value is
substantially outweighed by the danger
of unfair prejudice, confusion of the
issues, or by considerations of undue
delay or needless presentation of
cumulative evidence.
(e) Although relevant, evidence may
be excluded if it is privileged under
Federal law.
(f) Evidence concerning offers of
compromise or settlement shall be
inadmissible to the extent provided in
Rule 408 of the Federal Rules of
Evidence.
(g) The ALJ shall permit the parties to
introduce rebuttal witnesses and
evidence.
§ 2554.34 How is witness testimony
presented?
(a) Except as provided in paragraph
(b) of this section, testimony at the
hearing shall be given orally by
witnesses under oath or affirmation.
(b) At the discretion of the ALJ,
testimony may be admitted in the form
of a written statement or deposition.
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Any such written statement must be
provided to all other parties along with
the last known address of such witness,
in a manner which allows sufficient
time for other parties to subpoena such
witness for cross-examination at the
hearing. Prior written statements of
witnesses proposed to testify at the
hearing and deposition transcripts shall
be exchanged as provided in
§ 2554.27(a).
(c) The ALJ shall exercise reasonable
control over the mode and order of
interrogating witnesses and presenting
evidence so as to:
(1) Make the interrogation and
presentation effective for the
ascertainment of the truth;
(2) Avoid needless consumption of
time; and
(3) Protect witnesses from harassment
or undue embarrassment.
(d) The ALJ shall permit the parties to
conduct such cross-examination as may
be required for a full and true disclosure
of the facts.
(e) At the discretion of the ALJ, a
witness may be cross-examined on
matters relevant to the proceeding
without regard to the scope of his or her
direct examination. To the extent
permitted by the ALJ, cross-examination
on matters outside the scope of direct
examination shall be conducted in the
manner of direct examination and may
proceed by leading questions only if the
witness is a hostile witness, an adverse
party, or a witness identified with an
adverse party.
(f) Upon motion of any party, the ALJ
shall order witnesses excluded so that
they cannot hear the testimony of other
witnesses. This rule does not authorize
exclusion of—
(1) A party who is an individual;
(2) In the case of a party that is not
an individual, an officer or employee of
the party appearing for the entity pro se
or designated by the party’s
representative; or
(3) An individual whose presence is
shown by a party to be essential to the
presentation of its case, including an
individual employed by the
Government engaged in assisting the
representative for the Government.
§ 2554.35 Will the hearing proceedings be
recorded?
The hearing will be recorded and
transcribed. Transcripts may be
obtained following the hearing from the
ALJ at a cost not to exceed the actual
cost of duplication. The transcript of
testimony, exhibits and other evidence
admitted at the hearing, and all papers
and requests filed in the proceeding
constitute the record for the decision by
the ALJ and the authority head. The
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record may be inspected and copied
(upon payment of a reasonable fee) by
anyone, unless otherwise ordered by the
ALJ pursuant to § 2554.30.
§ 2554.36 Can a party informally discuss
the case with the ALJ?
No. Such discussions are forbidden as
‘‘ex parte communications’’ with the
ALJ. No party or person (except
employees of the ALJ’s office) shall
communicate in any way with the ALJ
on any matter at issue in a case, unless
on notice and opportunity for all parties
to participate.
This does not prohibit a person or
party from inquiring about the status of
a case or asking routine questions
concerning administrative functions or
procedures.
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§ 2554.37 Are there sanctions for
misconduct?
(a) The ALJ may sanction a person,
including any party or representative
for—
(1) Failing to comply with an order,
rule, or procedure governing the
proceeding;
(2) Failing to prosecute or defend an
action; or
(3) Engaging in other misconduct that
interferes with the speedy, orderly, or
fair conduct of the hearing.
(b) Any such sanction, including but
not limited to those listed in paragraphs
(c), (d), and (e) of this section, shall
reasonably relate to the severity and
nature of the failure or misconduct.
(c) When a party fails to comply with
an order, including an order for taking
a deposition, the production of evidence
within the party’s control, or a request
for admission, the ALJ may—
(1) Draw an inference in favor of the
requesting party with regard to the
information sought;
(2) In the case of requests for
admission, deem each matter of which
an admission is requested to be
admitted;
(3) Prohibit the party failing to
comply with such order from
introducing evidence concerning, or
otherwise relying upon testimony
relating to the information sought; and
(4) Strike any part of the pleadings or
other submissions of the party failing to
comply with such request.
(d) If a party fails to prosecute or
defend an action under this part
commenced by service of a notice of
hearing, the ALJ may dismiss the action
or may issue an initial decision
imposing penalties and assessments.
(e) The ALJ may refuse to consider
any motion, request, response, brief or
other document which is not filed in a
timely fashion.
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§ 2554.38 Are post-hearing briefs
required?
The ALJ may require the parties to file
post-hearing briefs. In any event, any
party may file a post-hearing brief. The
ALJ shall fix the time for filing such
briefs, not to exceed 60 days from the
date the parties receive the transcript of
the hearing or, if applicable, the
stipulated record. Such briefs may be
accompanied by proposed findings of
fact and conclusions of law. The ALJ
may permit the parties to file reply
briefs.
Decisions and Appeals
§ 2554.39
How is the case decided?
(a) The ALJ will issue an initial
decision based only on the record. It
will contain findings of fact,
conclusions of law, and the amount of
any penalties and assessments imposed.
(b) The ALJ will serve the initial
decision on all parties within 90 days
after close of the hearing or expiration
of any allowed time for submission of
post-hearing briefs. If the ALJ fails to
meet this deadline, he or she shall
promptly notify the parties of the reason
for the delay and set a new deadline.
(c) The findings of fact must include
a finding on each of the following
issues:
(1) Whether any one or more of the
claims or statements identified in the
complaint violate this part; and
(2) If the defendant is liable for
penalties or assessments, the
appropriate amount of any such
penalties or assessments, considering
any mitigating or aggravating factors.
(d) The initial decision will include a
description of the right of a defendant
found liable for a civil penalty or
assessment to file a motion for
reconsideration with the ALJ or a notice
of appeal with the authority head.
§ 2554.40 How are penalty and
assessment amounts determined?
(a) In determining an appropriate
amount of civil penalties and
assessments, the ALJ and the authority
head, upon appeal, should evaluate any
circumstances that mitigate or aggravate
the violation and should articulate in
their opinions the reasons that support
the penalties and assessments they
impose. Because of the intangible costs
of fraud, the expense of investigating
such conduct, and the need to deter
others who might be similarly tempted,
ordinarily double damages and a
significant civil penalty should be
imposed.
(b) Although not exhaustive, the
following factors are among those that
may influence that ALJ and the
authority head in determining the
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61919
amount of penalties and assessments to
impose with respect to the misconduct
(i.e., the false, fictitious, or fraudulent
claims or statements) charged in the
complaint:
(1) The number of false, fictitious, or
fraudulent claims or statements;
(2) The time period over which such
claims or statements were made;
(3) The degree of the defendant’s
culpability with respect to the
misconduct;
(4) The amount of money or the value
of the property, services, or benefit
falsely claimed;
(5) The value of the Government’s
actual loss as a result of the misconduct,
including foreseeable consequential
damages and the costs of investigation;
(6) The relationship of the amount
imposed as civil penalties to the amount
of the Government’s loss;
(7) The potential or actual impact of
the misconduct upon national defense,
public health or safety, or public
confidence in the management of
Government programs and operations,
including particularly the impact on the
intended beneficiaries of such programs;
(8) Whether the defendant has
engaged in a pattern of the same or
similar misconduct;
(9) Whether the defendant attempted
to conceal the misconduct;
(10) The degree to which the
defendant has involved others in the
misconduct or in concealing it;
(11) Where the misconduct of
employees or agents is imputed to the
defendant, the extent to which the
defendant’s practices fostered or
attempted to preclude such misconduct;
(12) Whether the defendant
cooperated in or obstructed an
investigation of the misconduct;
(13) Whether the defendant assisted
in identifying and prosecuting other
wrongdoers;
(14) The complexity of the program or
transaction, and the degree of the
defendant’s sophistication with respect
to it, including the extent of the
defendant’s prior participation in the
program or in similar transactions;
(15) Whether the defendant has been
found, in any criminal, civil, or
administrative proceeding to have
engaged in similar misconduct or to
have dealt dishonestly with the
Government of the United States or of
a State, directly or indirectly; and
(16) The need to deter the defendant
and others from engaging in the same or
similar misconduct.
(c) Nothing in this section shall be
construed to limit the ALJ or the
authority head from considering any
other factors that in any given case may
mitigate or aggravate the offense for
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which penalties and assessments are
imposed.
§ 2554.41 Can a party request
reconsideration of the initial decision?
(a) Any party may file a motion for
reconsideration of the initial decision
with the ALJ within 20 days of receipt
of the initial decision. If the initial
decision was served by mail, there is a
rebuttable presumption that the initial
decision was received by the party 5
days from the date of mailing.
(b) A motion for reconsideration must
be accompanied by a supporting brief
and must describe specifically each
allegedly erroneous decision.
(c) Any response to a motion for
reconsideration will only be allowed if
it is requested by the ALJ.
(d) The ALJ will dispose of a motion
for reconsideration by denying it or by
issuing a revised initial decision.
(e) If the ALJ issues a revised initial
decision upon motion of a party, that
party may not file another motion for
reconsideration.
§ 2554.42 When does the initial decision of
the ALJ become final?
(a) The initial decision of the ALJ
becomes the final decision of the
Corporation, and shall be binding on all
parties 30 days after it is issued, unless
any party timely files a motion for
reconsideration or any defendant
adjudged to have submitted a false
claim or statement timely appeals to the
Corporation’s authority head, as set
forth in § 2554.43.
(b) If the ALJ disposes of a motion for
reconsideration by denying it or by
issuing a revised initial decision, the
ALJ’s order on the motion for
reconsideration becomes the final
decision of the Corporation 30 days after
the order is issued, unless a defendant
adjudged to have submitted a false
claim or statement timely appeals to the
authority head, within 30 days of the
ALJ’s order, as set forth in § 2554.43.
mstockstill on PROD1PC61 with RULES
§ 2554.43 What are the procedures for
appealing the ALJ decision?
(a) Any defendant who submits a
timely answer and is found liable for a
civil penalty or assessment in an initial
decision may appeal the decision.
(b) The defendant may file a notice of
appeal with the authority head within
30 days following issuance of the initial
decision, serving a copy of the notice of
appeal on all parties and the ALJ. The
authority head may extend this deadline
for up to an additional 30 days if an
extension request is filed within the
initial 30-day period and shows good
cause.
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(c) The defendant’s appeal will not be
considered until all timely motions for
reconsideration have been resolved.
(d) If a timely motion for
reconsideration is denied, a notice of
appeal may be filed within 30 days
following such denial or issuance of a
revised initial decision, whichever
applies.
(e) A notice of appeal must be
supported by a written brief specifying
why the initial decision should be
reversed or modified.
(f) The Corporation’s representative
may file a brief in opposition to the
notice of appeal within 30 days of
receiving the defendant’s notice of
appeal and supporting brief.
(g) If a defendant timely files a notice
of appeal, and the time for filing
motions for reconsideration has expired,
the ALJ will forward the record of the
proceeding to the authority head.
§ 2554.44 What happens if an initial
decision is appealed?
(a) An initial decision is stayed
automatically pending disposition of a
motion for reconsideration or of an
appeal to the authority head.
(b) No administrative stay is available
following a final decision of the
authority head.
§ 2554.45 Are there any limitations on the
right to appeal to the authority head?
(a) A defendant has no right to appear
personally, or through a representative,
before the authority head.
(b) There is no right to appeal any
interlocutory ruling.
(c) The authority head will not
consider any objection or evidence that
was not raised before the ALJ unless the
defendant demonstrates that the failure
to object was caused by extraordinary
circumstances. If the appealing
defendant demonstrates to the
satisfaction of the authority head that
extraordinary circumstances prevented
the presentation of evidence at the
hearing, and that the additional
evidence is material, the authority head
may remand the matter to the ALJ for
consideration of the additional
evidence.
§ 2554.46 How does the authority head
dispose of an appeal?
(a) The authority head may affirm,
reduce, reverse, compromise, remand,
or settle any penalty or assessment
imposed by the ALJ in the initial
decision or reconsideration decision.
(b) The authority head will promptly
serve each party to the appeal and the
ALJ with a copy of his or her decision.
This decision must contain a statement
describing the right of any person,
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against whom a penalty or assessment
has been made, to seek judicial review.
§ 2554.47 What judicial review is
available?
31 U.S.C. 3805 authorizes judicial
review by the appropriate United States
District Court of any final Corporation
decision imposing penalties or
assessments, and specifies the
procedures for such review. To obtain
judicial review, a defendant must file a
petition with the appropriate court in a
timely manner.
§ 2554.48 Can the administrative
complaint be settled voluntarily?
(a) Parties may make offers of
compromise or settlement at any time.
Any compromise or settlement must be
in writing.
(b) The reviewing official has the
exclusive authority to compromise or
settle the case from the date on which
the reviewing official is permitted to
issue a complaint until the ALJ issues
an initial decision.
(c) The authority head has exclusive
authority to compromise or settle the
case from the date of the ALJ’s initial
decision until initiation of any judicial
review or any action to collect the
penalties and assessments.
(d) The Attorney General has
exclusive authority to compromise or
settle the case while any judicial review
or any action to recover penalties and
assessments is pending.
(e) The investigating official may
recommend settlement terms to the
reviewing official, the authority head, or
the Attorney General, as appropriate.
The reviewing official may recommend
settlement terms to the authority head
or the Attorney General, as appropriate.
§ 2554.49 How are civil penalties and
assessments collected?
Section 3806 and 3808(b) of title 31,
United States Code, authorize actions
for collection of civil penalties and
assessments imposed under this Part
and specify the procedures for such
actions.
§ 2554.50
What happens to collections?
All amounts collected pursuant to this
part shall be deposited as miscellaneous
receipts in the Treasury of the United
States, except as provided in 31 U.S.C.
3806(g).
§ 2554.51 What if the investigation
indicates criminal misconduct?
(a) Any investigating official may:
(1) Refer allegations of criminal
misconduct directly to the Department
of Justice for prosecution or for suit
under the False Claims Act or other civil
proceeding;
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mstockstill on PROD1PC61 with RULES
(2) Defer or postpone a report or
referral to the reviewing official to avoid
interference with a criminal
investigation or prosecution; or
(3) Issue subpoenas under other
statutory authority.
(b) Nothing in this part limits the
requirement that the Corporation
employees report suspected violations
of criminal law to the Corporation’s
Office of Inspector General or to the
Attorney General.
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§ 2554.52 How does the Corporation
protect the rights of defendants?
These procedures separate the
functions of the investigating official,
reviewing official, and the ALJ, each of
whom report to a separate
organizational authority in accordance
with 31 U.S.C. 3801. Except for
purposes of settlement, or as a witness
or a representative in public
proceedings, no investigating official,
reviewing official, or Corporation
employee or agent who helps
investigate, prepare, or present a case
may (in such case, or a factually related
case) participate in the initial decision
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61921
or the review of the initial decision by
the authority head. This separation of
functions and organization is designed
to assure the independence and
impartiality of each government official
during every stage of the proceeding.
The representative for the Corporation
may be employed in the offices of either
the investigating official or the
reviewing official.
Dated: October 13, 2006.
Frank R. Trinity,
General Counsel.
[FR Doc. E6–17545 Filed 10–19–06; 8:45 am]
BILLING CODE 6050–28–P
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Agencies
[Federal Register Volume 71, Number 203 (Friday, October 20, 2006)]
[Rules and Regulations]
[Pages 61911-61921]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-17545]
=======================================================================
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CORPORATION FOR NATIONAL AND COMMUNITY SERVICE
45 CFR Part 2554
RIN 3045-AA42
Program Fraud Civil Remedies Act
AGENCY: Corporation for National and Community Service.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: This final rule implements the Program Fraud Civil Remedies
Act of 1986 (Act), which authorizes the Corporation for National and
Community Service (Corporation) and certain other Federal agencies to
impose, through administrative adjudication, civil penalties and
assessments against any person who makes, submits, or presents a false,
fictitious, or fraudulent claim or written statement to the agency. The
regulations establish the procedures the Corporation will follow in
implementing the provisions of the Act and specifies the hearing and
appeal rights of persons subject to penalties and assessments under the
Act. They also designate the Corporation's Chief Financial Officer to
act on behalf of the Chief Executive Officer in carrying out certain
duties and responsibilities under the regulations.
DATES: Effective Date: These regulations are effective November 20,
2006.
FOR FURTHER INFORMATION CONTACT: Irshad Abdal-Haqq, Office of the
General Counsel, Corporation for National and Community Service, 1201
New York Ave. NW., Room 10600, Washington, DC 20525, Telephone: 202-
606-6675.
SUPPLEMENTARY INFORMATION:
Background
In October 1986, Congress enacted the Program Fraud Civil Remedies
Act, Public Law No. 99-509 (codified at 31 U.S.C. 3801-3812), to
establish an administrative remedy against any person who makes a false
claim or written statement to any of certain Federal agencies. In
brief, it requires the affected Federal agencies to follow certain
procedures in recovering penalties (up to $5,000 per claim) and
assessments (up to double the amount falsely claimed) against persons
who file false claims or statements for which the liability is $150,000
or less. When the Act was enacted, the Corporation for National and
Community Service did not exist, and the Act did not apply to the
Corporation's predecessor agency, ACTION. However, that Act has since
become applicable to the Corporation as a result of amendments to the
Inspector General Act, Public Law 103-82, September 21, 1993. Those
amendments, inter alia, added the Corporation for National and
Community Service as an ``establishment'' under the Inspector General
Act and, by doing so, operated to bring the Corporation within the
provisions of the Program Fraud Civil Remedies Act.
The Act requires each affected agency to promulgate rules and
regulations necessary to implement its provisions. Following the Act's
enactment, at the request of the President's Council on Integrity and
Efficiency (PCIE) an interagency task force was established under the
leadership of the Department of Health and Human Services to develop
model regulations for implementation of the Act by all affected
agencies. This action was in keeping with the stated desire of the
Senate Governmental Affairs Committee that ``the regulations would be
substantially uniform throughout the government'' (S. Rep. No. 99-212,
99th Cong., 1st Sess. 12 (1985). Upon their completion, the PCIE
recommended adoption of the model rules by all affected agencies.
It is the policy of the Corporation to use a plain language style
when promulgating regulations, and we have done so in this document
without making substantive changes to the PCIE model regulations. For
the sake of consistency, we relied, to the extent practicable, on plain
language regulations issued by the Small Business Administration in
1996. See 61 FR 2691, January 29, 1996.
A more detailed discussion of the PCIE's model regulations is found
in the promulgations of several of the agencies that adopted them
earlier, including those of the Departments of Justice (53 FR 4034;
February 11, 1988 and 53 FR 11645; April 8, 1988); Health and Human
Services (52 FR 27423; July 21, 1987 and 53 FR 11656, April 8, 1988);
and Transportation (52 FR 36968; October 2, 1987 and 53 FR 880, January
14, 1988). Anyone desiring further explanation of the model rules is
referred to the cited references.
The Corporation published a proposed rule with request for comment
in the Federal Register on February 1, 2006 (71 FR 5211). Only one
comment was received. It expressed general support for the rule as
written without any amendments. The commenter believes the rule holds
individuals accountable for fraudulent activity and, as such, improves
government operations. The commenter also believes the rule's penalty
provisions
[[Page 61912]]
will deter fraud. Finally, the commenter expressed strong support for
the use of plain language in drafting the rule and clearly specifying
in the rule that due process will be provided under the rule's
procedures. Since there were no other comments, the Corporation has
decided to issue the final rule as proposed (subject only to minor
typographical corrections).
Statutory and Regulatory Analysis
Under the Act, false claims and statements subject to its
provisions are to be investigated by an agency's investigating
official. The results of the investigation are then reviewed by an
agency reviewing official who determines whether there is adequate
evidence to believe that the person named in the report is liable under
the Act. Upon an affirmative finding of adequate evidence, the
reviewing official sends to the Attorney General a written notice of
the official's intent to refer the matter to a presiding officer for an
administrative hearing. The agency institutes administrative
proceedings against the person only if the Attorney General or the
Attorney General's designee approves. Any penalty or assessment imposed
under the Act may be collected by the Attorney General through the
filing of a civil action, or by offsetting amounts, other than tax
refunds, owed the particular party by the Federal government.
The regulations designate the Inspector General or his or her
designee as the agency's investigating official. They also designate
the General Counsel as the reviewing official. Any administrative
adjudication under the Act will be presided over by an Administrative
Law Judge and any appeals from the Administrative Law Judge's decision
will be decided by the Corporation's Chief Executive Officer or Chief
Financial Officer. The regulations designate the Corporation's Chief
Financial Officer to act on behalf of the Chief Executive Officer in
carrying out the duties and responsibilities of the ``authority head''
under the regulations.
Paperwork Reduction Act
This rule contains no information collection requirements and
therefore is not subject to the requirements of the Paperwork Reduction
Act of 1980 (44 U.S.C. 3501 et seq.).
Executive Order 12866
The Corporation has determined that the rule is not an
``economically significant'' rule within the meaning of E.O. 12866
because it is not likely to result in: (1) An annual effect on the
economy of $100 million or more, or an adverse and material effect on a
sector of the economy, productivity, competition, jobs, the
environment, public health or safety, or State, local, or tribal
government or communities; (2) the creation of a serious inconsistency
or interference with an action taken or planned by another agency; (3)
a material alteration in the budgetary impacts of entitlement, grants,
user fees, or loan programs or the rights and obligations of recipients
thereof; or (4) the raising of novel legal or policy issues arising out
of legal mandates, the President's priorities, or the principles set
forth in E.O. 12866. However, this is a significant rule and has been
reviewed by the Office of Management and Budget.
Regulatory Flexibility Act
As required by the Regulatory Flexibility Act of 1980 (5 U.S.C.
605(b)), the Corporation certifies that this rule will not have a
significant economic impact on a substantial number of small entities.
This regulatory action will not result in (1) An annual effect on the
economy of $100 million or more; (2) a major increase in costs or
prices for consumers, individual industries, Federal, State, or local
government agencies, or geographic regions; or (3) significant adverse
effects on competition, employment, investment, productivity,
innovation, or on the ability of United States-based enterprises to
compete with foreign-based enterprises in domestic and export markets.
The rule establishes the procedural mechanism for investigating and
adjudicating allegations of false claims or statements made against
affected agencies. The rule, by itself, does not impose any obligations
on entities including any entities that may fall within the definition
of ``small entities'' as set forth in section 601(3) of the Regulatory
Flexibility Act, or within the definition of ``small business'' as
found in Section 3 of the Small Business Act, 15 U.S.C. 632, or within
the Small Business Size Standards found in 13 CFR part 121. These
obligations would not be created until an order is issued, at which
time the person subject to the order would have a right to a hearing in
accordance with the regulations. Therefore, the Corporation has not
performed the initial regulatory flexibility analysis that is required
under the Regulatory Flexibility Act (5 U.S.C. 601 et seq.) for major
rules that are expected to have such results.
Unfunded Mandates
For purposes of Title II of the Unfunded Mandates Reform Act of
1995, 2 U.S.C. 1531-1538, as well as Executive Order 12875, this
regulatory action does not contain any Federal mandate that may result
in increased expenditures in either Federal, State, local, or tribal
governments in the aggregate, or impose an annual burden exceeding $100
million on the private sector.
Executive Order 13132, Federalism
Executive Order 13132, Federalism, prohibits an agency from
publishing any rule that has Federalism implications if the rule either
imposes substantial direct compliance costs on State and local
governments and is not required by statute, or the rule preempts State
law, unless the agency meets the consultation and funding requirements
of section 6 of the Executive Order. This rule does not have any
Federalism implications, as described above.
List of Subjects in 45 CFR Part 2554
Claims, Fraud, Organization and function (government agencies),
Penalties.
0
For the reasons stated in the preamble, the Corporation for National
and Community Service adds a new part 2554 to Chapter XXV of Title 45
of the Code of Federal Regulations to read as follows:
PART 2554--PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS
Sec.
Overview and Definitions
2554.1 Overview of regulations.
2554.2 What kind of conduct will result in program fraud
enforcement?
2554.3 What is a claim?
2554.4 What is a statement?
2554.5 What is a false claim or statement?
2554.6 What does the phrase ``know or have reason to know'' mean?
Procedures Leading to Issuance of a Complaint
2554.7 Who investigates program fraud?
2554.8 What happens if program fraud is suspected?
2554.9 Who is the Corporation's authority head?
2554.10 When will the Corporation issue a complaint?
2554.11 What is contained in a complaint?
2554.12 How will the complaint be served?
Procedures Following Service of a Complaint
2554.13 How does a defendant respond to the complaint?
2554.14 What happens if a defendant fails to file an answer?
2554.15 What happens once an answer is filed?
Hearing Provisions
2554.16 What kind of hearing is contemplated?
[[Page 61913]]
2554.17 At the hearing, what rights do the parties have?
2554.18 What is the role of the ALJ?
2554.19 Can the reviewing official or ALJ be disqualified?
2554.20 How are issues brought to the attention of the ALJ?
2554.21 How are papers served?
2554.22 How is time computed?
2554.23 What happens during a prehearing conference?
2554.24 What rights are there to review documents?
2554.25 What type of discovery is authorized and how is it
conducted?
2554.26 Are there limits on disclosure of documents or discovery?
2554.27 Are witness lists exchanged before the hearing?
2554.28 Can witnesses be subpoenaed?
2554.29 Who pays the costs for a subpoena?
2554.30 Are protective orders available?
2554.31 Where is the hearing held?
2554.32 How will the hearing be conducted and who has the burden of
proof?
2554.33 How is evidence presented at the hearing?
2554.34 How is witness testimony presented?
2554.35 Will the hearing proceedings be recorded?
2554.36 Can a party informally discuss the case with the ALJ?
2554.37 Are there sanctions for misconduct?
2554.38 Are post-hearing briefs required?
Decisions and Appeals
2554.39 How is the case decided?
2554.40 How are penalty and assessment amounts determined?
2554.41 Can a party request reconsideration of the initial decision?
2554.42 When does the initial decision of the ALJ become final?
2554.43 What are the procedures for appealing the ALJ decision?
2554.44 What happens if an initial decision is appealed?
2554.45 Are there any limitations on the right to appeal to the
authority head?
2554.46 How does the authority head dispose of an appeal?
2554.47 What judicial review is available?
2554.48 Can the administrative complaint be settled voluntarily?
2554.49 How are civil penalties and assessments collected?
2554.50 What happens to collections?
2554.51 What if the investigation indicates criminal misconduct?
2554.52 How does the Corporation protect the rights of defendants?
Authority: Pub. L. 99-509, Secs. 6101-6104, 100 Stat. 1874 (31
U.S.C. 3801-3812); 42 U.S.C. 12651c-12651d.
Overview and Definitions
Sec. 2554.1 Overview of regulations.
(a) Statutory basis. This part implements the Program Fraud Civil
Remedies Act of 1986, 31 U.S.C. 3801-3812 (``the Act''). The Act
provides the Corporation and other federal agencies with an
administrative remedy to impose civil penalties and assessments against
persons making false claims and statements. The Act also provides due
process protections to all persons who are subject to administrative
proceedings under this part.
(b) Possible remedies for program fraud. In addition to any other
penalties that may be prescribed by law, a person who submits, or
causes to be submitted, a false claim or a false statement to the
Corporation is subject to a civil penalty of not more than $5,000 for
each statement or claim, regardless of whether property, services, or
money is actually delivered or paid by the Corporation. If the
Corporation has made any payment, transferred property, or provided
services in reliance on a false claim, the person submitting it also is
subject to an assessment of not more than twice the amount of the false
claim. This assessment is in lieu of damages sustained by the
Corporation because of the false claim.
Sec. 2554.2 What kind of conduct will result in program fraud
enforcement?
(a) Any person who makes, or causes to be made, a false,
fictitious, or fraudulent claim or written statement to the Corporation
is subject to program fraud enforcement. A ``person'' means any
individual, partnership, corporation, association, or other legal
entity.
(b) If more than one person makes a false claim or statement, each
person is liable for a civil penalty. If more than one person makes a
false claim which has induced the Corporation to make payment, an
assessment is imposed against each person. The liability of each such
person to pay the assessment is joint and several, that is, each is
responsible for the entire amount.
(c) No proof of specific intent to defraud is required to establish
liability under this part.
Sec. 2554.3 What is a claim?
(a) Claim means any request, demand, or submission:
(1) Made to the Corporation for property, services, or money;
(2) Made to a recipient of property, services, or money from the
Corporation or to a party to a contract with the Corporation for
property or services, or for the payment of money. This provision
applies only when the claim is related to property, services or money
from the Corporation or to a contract with the Corporation; or
(3) Made to the Corporation which decreases an obligation to pay or
account for property, services, or money.
(b) A claim can relate to grants, loans, insurance, or other
benefits, and includes the Corporation guaranteed loans made by
participating lenders. A claim is made when it is received by the
Corporation, an agent, fiscal intermediary, or other entity acting for
the Corporation, or when it is received by the recipient of property,
services, or money, or the party to a contract.
(c) Each voucher, invoice, claim form, or individual request or
demand for property, services, or money constitutes a separate claim.
Sec. 2554.4 What is a statement?
A ``statement'' means any written representation, certification,
affirmation, document, record, or accounting or bookkeeping entry made
with respect to a claim or with respect to a contract, bid or proposal
for a contract, grant, loan or other benefit from the Corporation.
``From the Corporation'' means that the Corporation provides some
portion of the money or property in connection with the contract, bid,
grant, loan, or benefit, or is potentially liable to another party for
some portion of the money or property under such contract, bid, grant,
loan, or benefit. A statement is made, presented, or submitted to the
Corporation when it is received by the Corporation or an agent, fiscal
intermediary, or other entity acting for the Corporation.
Sec. 2554.5 What is a false claim or statement?
(a) A claim submitted to the Corporation is a ``false'' claim if
the person making the claim, or causing the claim to be made, knows or
has reason to know that the claim:
(1) Is false, fictitious or fraudulent;
(2) Includes or is supported by a written statement which asserts
or contains a material fact which is false, fictitious, or fraudulent;
(3) Includes or is supported by a written statement which is false,
fictitious or fraudulent because it omits a material fact that the
person making the statement has a duty to include in the statement; or
(4) Is for payment for the provision of property or services which
the person has not provided as claimed.
(b) A statement submitted to the Corporation is a false statement
if the person making the statement, or causing the statement to be
made, knows or has reason to know that the statement:
(1) Asserts a material fact which is false, fictitious, or
fraudulent; or
(2) Is false, fictitious, or fraudulent because it omits a material
fact that the person making the statement has a duty to include in the
statement. In addition,
[[Page 61914]]
the statement must contain or be accompanied by an express
certification or affirmation of the truthfulness and accuracy of the
contents of the statement.
Sec. 2554.6 What does the phrase ``know or have reason to know''
mean?
A person knows or has reason to know (that a claim or statement is
false) if the person:
(a) Has actual knowledge that the claim or statement is false,
fictitious, or fraudulent; or
(b) Acts in deliberate ignorance of the truth or falsity of the
claim or statement; or
(c) Acts in reckless disregard of the truth or falsity of the claim
or statement.
Procedures Leading to Issuance of a Complaint
Sec. 2554.7 Who investigates program fraud?
The Inspector General, or his designee, is the investigating
official responsible for investigating allegations that a false claim
or statement has been made. In this regard, the Inspector General has
authority under the Program Fraud Civil Remedies Act and the Inspector
General Act of 1978 (5 U.S.C. App. 3), as amended, to issue
administrative subpoenas for the production of records and documents.
Sec. 2554.8 What happens if program fraud is suspected?
(a) If the investigating official concludes that an action under
this Part is warranted, the investigating official submits a report
containing the findings and conclusions of the investigation to a
reviewing official. The reviewing official is the General Counsel or
his or her designee. If the reviewing official determines that the
report provides adequate evidence that a person submitted a false claim
or statement, the reviewing official transmits to the Attorney General
written notice of an intention to refer the matter for adjudication,
with a request for approval of such referral. This notice will include
the reviewing official's statements concerning:
(1) The reasons for the referral;
(2) The claims or statements upon which liability would be based;
(3) The evidence that supports liability;
(4) An estimate of the amount of money or the value of property,
services, or other benefits requested or demanded in the false claim or
statement;
(5) Any exculpatory or mitigating circumstances that may relate to
the claims or statements known by the reviewing official or the
investigating official; and
(6) A statement that there is a reasonable prospect of collecting
an appropriate amount of penalties and assessments.
(b) If at any time, the Attorney General or his or her designee
requests in writing that this administrative process be stayed, the
authority head, as identified in Sec. 2554.9 of this Part, must stay
the process immediately. The authority head may order the process
resumed only upon receipt of the written authorization of the Attorney
General.
Sec. 2554.9 Who is the Corporation's authority head?
The Corporation's ``authority head'' is the Chief Executive Officer
or his or her designee. For purposes of this Part, the Corporation's
Chief Financial Officer is designated to act on behalf of the Chief
Executive Officer.
Sec. 2554.10 When will the Corporation issue a complaint?
The Corporation will issue a complaint:
(a) If the Attorney General (or designee) approves the referral of
the allegations for adjudication; and
(b) In a case of submission of false claims, if the amount of money
or the value of property or services demanded or requested in a false
claim, or a group of related claims submitted at the same time, does
not exceed $150,000. ``A group of related claims submitted at the same
time'' includes only those claims arising from the same transaction
(such as a grant, loan, application, or contract) which are submitted
together as part of a single request, demand, or submission.
Sec. 2554.11 What is contained in a complaint?
(a) A complaint is a written statement giving notice to the person
alleged to be liable under 31 U.S.C. 3802 of the specific allegations
being referred for adjudication and of the person's right to request a
hearing with respect to those allegations. The person alleged to have
made false statements or to have submitted false claims to the
Corporation is referred to as the ``defendant.''
(b) The reviewing official may join in a single complaint, false
claims or statements that are unrelated, or that were not submitted
simultaneously, regardless of the amount of money or the value of
property or services demanded or requested.
(c) The complaint will state that the Corporation seeks to impose
civil penalties, assessments, or both, against each defendant and will
include:
(1) The allegations of liability against each defendant, including
the statutory basis for liability, identification of the claims or
statements involved, and the reasons liability allegedly arises from
such claims or statements;
(2) The maximum amount of penalties and assessments for which each
defendant may be held liable;
(3) A statement that each defendant may request a hearing by filing
an answer and may be represented by a representative;
(4) Instructions for filing such an answer;
(5) A warning that failure to file an answer within 30 days of
service of the complaint will result in imposition of the maximum
amount of penalties and assessments.
(d) The reviewing official must serve any complaint on the
defendant and, if a hearing is requested by the defendant, provide a
copy to the Administrative Law Judge (ALJ) assigned to the case.
Sec. 2554.12 How will the complaint be served?
(a) The complaint must be served on individual defendants directly,
a partnership through a general partner, and on corporations or on
unincorporated associations through an executive officer or a director,
except that service also may be made on any person authorized by
appointment or by law to receive process for the defendant.
(b) The complaint may be served either by:
(1) Registered or certified mail (return receipt requested)
addressed to the defendant at his or her residence, usual dwelling
place, principal office or place of business; or by
(2) Personal delivery by anyone 18 years of age or older.
(c) The date of service is the date of personal delivery or, in the
case of service by registered or certified mail, the date of postmark.
(d) Proof of service--
(1) When service is made by registered or certified mail, the
return postal receipt will serve as proof of service.
(2) When service is made by personal delivery, an affidavit of the
individual serving the complaint, or written acknowledgment of receipt
by the defendant or a representative, will serve as proof of service.
(e) When served with the complaint, the defendant also should be
served with a copy of this Part 2554 and 31 U.S.C. 3801-3812.
[[Page 61915]]
Procedures Following Service of a Complaint
Sec. 2554.13 How does a defendant respond to the complaint?
(a) A defendant may file an answer with the reviewing official
within 30 days of service of the complaint. An answer will be
considered a request for an oral hearing.
(b) In the answer, a defendant--
(1) Must admit or deny each of the allegations of liability
contained in the complaint (a failure to deny an allegation is
considered an admission);
(2) Must state any defense on which the defendant intends to rely;
(3) May state any reasons why he or she believes the penalties,
assessments, or both should be less than the statutory maximum; and
(4) Must state the name, address, and telephone number of the
person authorized by the defendant to act as defendant's
representative, if any.
(c) If the defendant is unable to file an answer which meets the
requirements set forth in paragraph (b) of this section, the defendant
may file with the reviewing official a general answer denying
liability, requesting a hearing, and requesting an extension of time in
which to file a complete answer. A general answer must be filed within
30 days of service of the complaint.
(d) If the defendant initially files a general answer requesting an
extension of time, the reviewing official must promptly file with the
ALJ the complaint, the general answer, and the request for an extension
of time.
(e) For good cause shown, the ALJ may grant the defendant up to 30
additional days within which to file an answer meeting the requirements
of paragraph (b) of this section. Such answer must be filed with the
ALJ and a copy must be served on the reviewing official.
Sec. 2554.14 What happens if a defendant fails to file an answer?
(a) If a defendant does not file any answer within 30 days after
service of the complaint, the reviewing official will refer the
complaint to the ALJ.
(b) Once the complaint is referred, the ALJ will promptly serve on
the defendant a notice that an initial decision will be issued.
(c) The ALJ will assume the facts alleged in the complaint to be
true and, if such facts establish liability under the statute, the ALJ
will issue an initial decision imposing the maximum amount of penalties
and assessments allowed under the statute.
(d) Except as otherwise provided in this section, when a defendant
fails to file a timely answer, the defendant waives any right to
further review of the penalties and assessments imposed in the initial
decision.
(e) The initial decision becomes final 30 days after it is issued.
(f) If, at any time before an initial decision becomes final, a
defendant files a motion with the ALJ asking that the case be reopened
and describing the extraordinary circumstances that prevented the
defendant from filing an answer, the initial decision will be stayed
until the ALJ makes a decision on the motion. The reviewing official
may respond to the motion.
(g) If, in his motion to reopen, a defendant demonstrates
extraordinary circumstances excusing his failure to file a timely
answer, the ALJ will withdraw the initial decision, and grant the
defendant an opportunity to answer the complaint.
(h) A decision by the ALJ to deny a defendant's motion to reopen a
case is not subject to review or reconsideration.
(i) The defendant may appeal to the authority head the decision
denying a motion to reopen by filing a notice of appeal with the
authority head within 15 days after the ALJ denies the motion. The
timely filing of a notice of appeal shall stay the initial decision
until the authority head decides the issue.
(j) If the defendant files a timely notice of appeal with the
authority head, the ALJ shall forward the record of the proceeding to
the authority head.
(k) The authority head shall decide expeditiously whether
extraordinary circumstances excuse the defendant's failure to file a
timely answer based solely on the record before the ALJ.
(l) If the authority head decides that extraordinary circumstances
excused the defendant's failure to file a timely answer, the authority
head shall remand the case to the ALJ with instructions to grant the
defendant an opportunity to answer.
(m) If the authority head decides that the defendant's failure to
file a timely answer is not excused, the authority head shall reinstate
the initial decision of the ALJ, which shall become final and binding
upon the parties 30 days after the authority head issues such decision.
Sec. 2554.15 What happens once an answer is filed?
(a) When the reviewing official receives an answer, he must file
concurrently, the complaint and the answer with the ALJ, along with a
designation of a Corporation representative.
(b) When the ALJ receives the complaint and the answer, the ALJ
will promptly serve a notice of oral hearing upon the defendant and the
representative for the Corporation, in the same manner as the
complaint, service of which is described in Sec. 2554.12. The notice
of oral hearing must be served within six years of the date on which
the claim or statement is made.
(c) The notice must include:
(1) The tentative time, place and nature of the hearing;
(2) The legal authority and jurisdiction under which the hearing is
to be held;
(3) The matters of fact and law to be asserted;
(4) A description of the procedures for the conduct of the hearing;
(5) The name, address, and telephone number of the defendant's
representative and the representative for the Corporation; and
(6) Such other matters as the ALJ deems appropriate.
(d) The six-year statute of limitation may be extended by agreement
of the parties.
Hearing Provisions
Sec. 2554.16 What kind of hearing is contemplated?
The hearing is a formal proceeding conducted by the ALJ during
which a defendant will have the opportunity to cross-examine witnesses,
present testimony, and dispute liability.
Sec. 2554.17 At the hearing, what rights do the parties have?
(a) The parties to the hearing shall be the defendant and the
Corporation. Pursuant to 31 U.S.C. 3730(c)(5), a private plaintiff in
an action under the False Claims Act may participate in the hearing to
the extent authorized by the provisions of that Act.
(b) Each party has the right to:
(1) Be represented by a representative;
(2) Request a pre-hearing conference and participate in any
conference held by the ALJ;
(3) Conduct discovery;
(4) Agree to stipulations of fact or law which will be made a part
of the record;
(5) Present evidence relevant to the issues at the hearing;
(6) Present and cross-examine witnesses;
(7) Present arguments at the hearing as permitted by the ALJ; and
(8) Submit written briefs and proposed findings of fact and
conclusions of law after the hearing, as permitted by the ALJ.
Sec. 2554.18 What is the role of the ALJ?
An ALJ retained by the Corporation serves as the presiding officer
at all hearings.
[[Page 61916]]
(a) The ALJ shall conduct a fair and impartial hearing, avoid
delay, maintain order, and assure that a record of the proceeding is
made.
(b) The ALJ has the authority to--
(1) Set and change the date, time, and place of the hearing upon
reasonable notice to the parties;
(2) Continue or recess the hearing in whole or in part for a
reasonable period of time;
(3) Hold conferences to identify or simplify the issues, or to
consider other matters that may aid in the expeditious disposition of
the proceeding;
(4) Administer oaths and affirmations;
(5) Issue subpoenas requiring the attendance of witnesses and the
production of documents at depositions or at hearings;
(6) Rule on motions and other procedural matters;
(7) Regulate the scope and timing of discovery;
(8) Regulate the course of the hearing and the conduct of
representatives and parties;
(9) Examine witnesses;
(10) Receive, rule on, exclude, or limit evidence;
(11) Upon motion of a party, take official notice of facts;
(12) Upon motion of a party, decide cases, in whole or in part, by
summary judgment where there is no disputed issue of material fact;
(13) Conduct any conference, argument, or hearing on motions in
person or by telephone; and
(14) Exercise such other authority as is necessary to carry out the
responsibilities of the ALJ under this part.
(c) The ALJ does not have the authority to find Federal statutes or
regulations invalid.
Sec. 2554.19 Can the reviewing official or ALJ be disqualified?
(a) A reviewing official or an ALJ may disqualify himself or
herself at any time.
(b) Upon motion of any party, the reviewing official or ALJ may be
disqualified as follows:
(1) The motion must be supported by an affidavit containing
specific facts establishing that personal bias or other reason for
disqualification exists, including the time and circumstances of the
discovery of such facts;
(2) The motion must be filed promptly after discovery of the
grounds for disqualification, or the objection will be deemed waived;
and
(3) The party, or representative of record, must certify in writing
that the motion is made in good faith.
(c) Once a motion has been filed to disqualify the reviewing
official, the ALJ will halt the proceedings until resolving the matter
of disqualification. If the ALJ determines that the reviewing official
is disqualified, the ALJ will dismiss the complaint without prejudice.
If the ALJ disqualifies himself or herself, the case will be promptly
reassigned to another ALJ.
Sec. 2554.20 How are issues brought to the attention of the ALJ?
(a) All applications to the ALJ for an order or ruling shall be by
motion. Motions shall state the relief sought, the authority relied
upon, and the facts alleged, and shall be filed with the ALJ and served
on all other parties.
(b) Except for motions made during a prehearing conference or at
the hearing, all motions shall be in writing. The ALJ may require that
oral motions be reduced to writing.
(c) Within 15 days after a written motion is served, or such other
time as may be fixed by the ALJ, any party may file a response to such
motion.
(d) The ALJ may not grant a written motion before the time for
filing responses thereto has expired, except upon consent of the
parties or following a hearing on the motion, but may overrule or deny
such motion without awaiting a response.
(e) The ALJ shall make a reasonable effort to dispose of all
outstanding motions prior to the beginning of the hearing.
Sec. 2554.21 How are papers served?
(a) Form. (1) Documents filed with the ALJ shall include an
original and two copies.
(2) Every pleading and paper filed in the proceeding shall contain
a caption setting forth the title of the action, the case number
assigned by the ALJ, and a designation of the paper (e.g., motion to
quash subpoena).
(3) Every pleading and paper shall be signed by, and shall contain
the address and telephone number of the party or the person on whose
behalf the paper was filed, or his or her representative.
(4) Papers are considered filed when they are mailed. Date of
mailing may be established by a certificate from the party or its
representative or by proof that the document was sent by certified or
registered mail.
(b) Service. A party filing a document with the ALJ shall at the
time of filing, serve a copy of such document on every other party.
Service upon any party of any document other than those required to be
served as prescribed in Sec. 2554.12 shall be made by delivering a
copy or by placing a copy of the document in the United States mail,
postage prepaid and addressed, to the party's last known address. When
a party is represented by a representative, service shall be made upon
such representative in lieu of the actual party.
(c) Proof of service. A certificate of the individual serving the
document by personal delivery or by mail, setting forth the manner of
service, shall be proof of service.
Sec. 2554.22 How is time computed?
(a) In computing any period of time under this part or in an order
issued thereunder, the time begins with the day following the act,
event, or default, and includes the last day of the period, unless it
is a Saturday, Sunday, or legal holiday observed by the Federal
government, in which event it includes the next business day.
(b) When the period of time allowed is less than seven days,
intermediate Saturdays, Sundays, and legal holidays observed by the
Federal government shall be excluded from the computation.
(c) Where a document has been served or issued by placing it in the
mail, an additional five days will be added to the time permitted for
any response.
Sec. 2554.23 What happens during a prehearing conference?
(a) The ALJ may schedule prehearing conferences as appropriate.
(b) Upon the motion of any party, the ALJ shall schedule at least
one prehearing conference at a reasonable time in advance of the
hearing.
(c) The ALJ may use prehearing conferences to discuss the
following:
(1) Simplification of the issues;
(2) The necessity or desirability of amendments to the pleadings,
including the need for a more definite statement;
(3) Stipulations and admissions of fact or as to the contents and
authenticity of documents;
(4) Whether the parties can agree to submission of the case on a
stipulated record;
(5) Whether a party chooses to waive appearances at an oral hearing
and to submit only documentary evidence (subject to the objection of
other parties) and written argument;
(6) Limitation of the number of witnesses;
(7) Scheduling dates for the exchange of witness lists and of
proposed exhibits;
(8) Discovery;
(9) The time and place for the hearing; and
(10) Such other matters as may tend to expedite the fair and just
disposition of the proceedings.
(d) The ALJ may issue an order containing all matters agreed upon
by the parties or ordered by the ALJ at a prehearing conference.
[[Page 61917]]
Sec. 2554.24 What rights are there to review documents?
(a) Upon written request to the reviewing official, the defendant
may review any relevant and material documents, transcripts, records,
and other materials that relate to the allegations set out in the
complaint and upon which the findings and conclusions of the
investigating official under Sec. 2554.8 are based, unless such
documents are subject to a privilege under Federal law. Upon payment of
fees for duplication, the defendant may obtain copies of such
documents.
(b) Upon written request to the reviewing official, the defendant
also may obtain a copy of all exculpatory information in the possession
of the reviewing official or investigating official relating to the
allegations in the complaint, even if it is contained in a document
that would otherwise be privileged. If the document would otherwise be
privileged, only that portion containing exculpatory information must
be disclosed.
(c) The notice sent to the Attorney General from the reviewing
official as described in Sec. 2554.8 is not discoverable under any
circumstances.
(d) The defendant may file a motion to compel disclosure of the
documents subject to the provisions of this section. Such a motion may
only be filed with the ALJ following the filing of an answer pursuant
to Sec. 2554.13.
Sec. 2554.25 What type of discovery is authorized and how is it
conducted?
(a) The following types of discovery are authorized:
(1) Requests for production of documents for inspection and
copying;
(2) Requests for admissions of the authenticity of any relevant
document or of the truth of any relevant fact;
(3) Written interrogatories; and
(4) Depositions.
(b) For the purpose of this section and Sec. Sec. 2554.27 and
2554.28, the term ``documents'' includes information, documents,
reports, answers, records, accounts, papers, and other data and
documentary evidence. Nothing contained herein shall be interpreted to
require the creation of a document.
(c) Unless mutually agreed to by the parties, discovery is
available only as ordered by the ALJ. The ALJ shall regulate the timing
of discovery.
(d) Motions for discovery. (1) A party seeking discovery may file a
motion with the ALJ. Such a motion shall be accompanied by a copy of
the requested discovery, or in the case of depositions, a summary of
the scope of the proposed deposition.
(2) Within ten days of service, a party may file an opposition to
the motion and/or a motion for protective order as provided in Sec.
2554.30.
(3) The ALJ may grant a motion for discovery only if he or she
finds that the discovery sought--
(i) Is necessary for the expeditious, fair, and reasonable
consideration of the issues;
(ii) Is not unduly costly or burdensome;
(iii) Will not unduly delay the proceeding; and
(iv) Does not seek privileged information.
(4) The burden of showing that discovery should be allowed is on
the party seeking discovery.
(5) The ALJ may grant discovery subject to a protective order under
Sec. 2554.30.
(e) Depositions. (1) If a motion for deposition is granted, the ALJ
shall issue a subpoena for the deponent, which may require the deponent
to produce documents. The subpoena shall specify the time and place at
which the deposition will be held.
(2) The party seeking to depose shall serve the subpoena in the
manner prescribed in Sec. 2554.12.
(3) The deponent may file with the ALJ a motion to quash the
subpoena or a motion for a protective order within ten days of service.
(4) The party seeking to depose shall provide for the taking of a
verbatim transcript of the deposition, which it shall make available to
all other parties for inspection and copying.
(f) Each party shall bear its own costs of discovery.
Sec. 2554.26 Are there limits on disclosure of documents or
discovery?
(a) Upon written request to the reviewing official, the defendant
may review all non-privileged, relevant and material documents, records
and other material related to the allegations contained in the
complaint. After paying the Corporation a reasonable fee for
duplication, the defendant may obtain a copy of the records described.
(b) Upon written request to the reviewing official, the defendant
may obtain a copy of all exculpatory information in the possession of
the reviewing official or investigating official relating to the
allegations in the complaint. If the document would otherwise be
privileged, only the portion of the document containing exculpatory
information must be disclosed. As used in this section, the term
``information'' does not include legal materials such as statutes or
case law obtained through legal research.
(c) The notice sent to the Attorney General from the reviewing
official is not discoverable under any circumstances.
(d) Other discovery is available only as ordered by the ALJ and
includes only those methods of discovery allowed by Sec. 2554.25.
Sec. 2554.27 Are witness lists exchanged before the hearing?
(a) At least 15 days before the hearing or at such other time as
ordered by the ALJ, the parties must exchange witness lists and copies
of proposed hearing exhibits, including copies of any written
statements or transcripts of deposition testimony that the party
intends to offer in lieu of live testimony.
(b) If a party objects, the ALJ will not admit into evidence the
testimony of any witness whose name does not appear on the witness list
or any exhibit not provided to an opposing party unless the ALJ finds
good cause for the omission or concludes that there is no prejudice to
the objecting party.
(c) Unless a party objects within the time set by the ALJ,
documents exchanged in accordance with this section are deemed to be
authentic for the purpose of admissibility at the hearing.
Sec. 2554.28 Can witnesses be subpoenaed?
(a) A party wishing to procure the appearance and testimony of any
individual at the hearing may request that the ALJ issue a subpoena.
(b) A subpoena requiring the attendance and testimony of an
individual may also require the individual to produce documents at the
hearing.
(c) A party seeking a subpoena shall file a written request
therefore not less than 15 days before the date fixed for the hearing
unless otherwise allowed by the ALJ for good cause shown. Such request
shall specify any documents to be produced and shall designate the
witnesses and describe the address and location thereof with sufficient
particularity to permit such witnesses to be found.
(d) The subpoena shall specify the time and place at which the
witness is to appear and any documents the witness is to produce.
(e) The party seeking the subpoena shall serve it in the manner
prescribed in Sec. 2554.12. A subpoena on a party or upon an
individual under the control of a party may be served by first class
mail.
(f) A party or the individual to whom the subpoena is directed may
file with the ALJ a motion to quash the subpoena within ten days after
service or on or before the time specified in the subpoena for
compliance if it is less than ten days after service.
[[Page 61918]]
Sec. 2554.29 Who pays the costs for a subpoena?
The party requesting a subpoena shall pay the cost of the fees and
mileage of any witness subpoenaed in the amounts that would be payable
to a witness in a proceeding in United States District Court. A check
for witness fees and mileage shall accompany the subpoena when served,
except that when a subpoena is issued on behalf of the authority, a
check for witness fees and mileage need not accompany the subpoena.
Sec. 2554.30 Are protective orders available?
(a) A party or a prospective witness or deponent may file a motion
for a protective order with respect to discovery sought by an opposing
party or with respect to the hearing, seeking to limit the availability
or disclosure of evidence.
(b) In issuing a protective order, the ALJ may make any order which
justice requires to protect a party or person from annoyance,
embarrassment, oppression, or undue burden or expense, including one or
more of the following:
(1) That the discovery not be had;
(2) That the discovery may be had only on specified terms and
conditions, including a designation of the time or place;
(3) That the discovery may be had only through a method of
discovery other than that requested;
(4) That certain matters not be inquired into, or that the scope of
discovery be limited to certain matters;
(5) That discovery be conducted with no one present except persons
designated by the ALJ;
(6) That the contents of discovery or evidence be sealed;
(7) That a deposition after being sealed be opened only by order of
the ALJ;
(8) That a trade secret or other confidential research,
development, commercial information, or facts pertaining to any
criminal investigation, proceeding, or other administrative
investigation not be disclosed or be disclosed only in a designated
way; or
(9) That the parties simultaneously file specified documents or
information enclosed in sealed envelopes to be opened as directed by
the ALJ.
Sec. 2554.31 Where is the hearing held?
The ALJ will hold the hearing in any judicial district of the
United States:
(a) In which the defendant resides or transacts business; or
(b) In which the claim or statement on which liability is based was
made, presented or submitted to the Corporation; or
(c) As agreed upon by the defendant and the ALJ.
Sec. 2554.32 How will the hearing be conducted and who has the burden
of proof?
(a) The ALJ conducts a hearing in order to determine whether a
defendant is liable for a civil penalty, assessment, or both and, if
so, the appropriate amount of the civil penalty and/or assessment. The
hearing will be recorded and transcribed, and the transcript of
testimony, exhibits admitted at the hearing, and all papers and
requests filed in the proceeding constitute the record for a decision
by the ALJ.
(b) The Corporation must prove a defendant's liability and any
aggravating factors by a preponderance of the evidence.
(c) A defendant must prove any affirmative defenses and any
mitigating factors by a preponderance of the evidence.
(d) The hearing will be open to the public unless otherwise ordered
by the ALJ for good cause shown.
Sec. 2554.33 How is evidence presented at the hearing?
(a) The ALJ shall determine the admissibility of evidence.
(b) Except as provided in this part, the ALJ shall not be bound by
the Federal Rules of Evidence. However, the ALJ may apply the Federal
Rules of Evidence where appropriate, e.g., to exclude unreliable
evidence.
(c) The ALJ shall exclude irrelevant and immaterial evidence.
(d) Although relevant, evidence may be excluded if its probative
value is substantially outweighed by the danger of unfair prejudice,
confusion of the issues, or by considerations of undue delay or
needless presentation of cumulative evidence.
(e) Although relevant, evidence may be excluded if it is privileged
under Federal law.
(f) Evidence concerning offers of compromise or settlement shall be
inadmissible to the extent provided in Rule 408 of the Federal Rules of
Evidence.
(g) The ALJ shall permit the parties to introduce rebuttal
witnesses and evidence.
Sec. 2554.34 How is witness testimony presented?
(a) Except as provided in paragraph (b) of this section, testimony
at the hearing shall be given orally by witnesses under oath or
affirmation.
(b) At the discretion of the ALJ, testimony may be admitted in the
form of a written statement or deposition. Any such written statement
must be provided to all other parties along with the last known address
of such witness, in a manner which allows sufficient time for other
parties to subpoena such witness for cross-examination at the hearing.
Prior written statements of witnesses proposed to testify at the
hearing and deposition transcripts shall be exchanged as provided in
Sec. 2554.27(a).
(c) The ALJ shall exercise reasonable control over the mode and
order of interrogating witnesses and presenting evidence so as to:
(1) Make the interrogation and presentation effective for the
ascertainment of the truth;
(2) Avoid needless consumption of time; and
(3) Protect witnesses from harassment or undue embarrassment.
(d) The ALJ shall permit the parties to conduct such cross-
examination as may be required for a full and true disclosure of the
facts.
(e) At the discretion of the ALJ, a witness may be cross-examined
on matters relevant to the proceeding without regard to the scope of
his or her direct examination. To the extent permitted by the ALJ,
cross-examination on matters outside the scope of direct examination
shall be conducted in the manner of direct examination and may proceed
by leading questions only if the witness is a hostile witness, an
adverse party, or a witness identified with an adverse party.
(f) Upon motion of any party, the ALJ shall order witnesses
excluded so that they cannot hear the testimony of other witnesses.
This rule does not authorize exclusion of--
(1) A party who is an individual;
(2) In the case of a party that is not an individual, an officer or
employee of the party appearing for the entity pro se or designated by
the party's representative; or
(3) An individual whose presence is shown by a party to be
essential to the presentation of its case, including an individual
employed by the Government engaged in assisting the representative for
the Government.
Sec. 2554.35 Will the hearing proceedings be recorded?
The hearing will be recorded and transcribed. Transcripts may be
obtained following the hearing from the ALJ at a cost not to exceed the
actual cost of duplication. The transcript of testimony, exhibits and
other evidence admitted at the hearing, and all papers and requests
filed in the proceeding constitute the record for the decision by the
ALJ and the authority head. The
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record may be inspected and copied (upon payment of a reasonable fee)
by anyone, unless otherwise ordered by the ALJ pursuant to Sec.
2554.30.
Sec. 2554.36 Can a party informally discuss the case with the ALJ?
No. Such discussions are forbidden as ``ex parte communications''
with the ALJ. No party or person (except employees of the ALJ's office)
shall communicate in any way with the ALJ on any matter at issue in a
case, unless on notice and opportunity for all parties to participate.
This does not prohibit a person or party from inquiring about the
status of a case or asking routine questions concerning administrative
functions or procedures.
Sec. 2554.37 Are there sanctions for misconduct?
(a) The ALJ may sanction a person, including any party or
representative for--
(1) Failing to comply with an order, rule, or procedure governing
the proceeding;
(2) Failing to prosecute or defend an action; or
(3) Engaging in other misconduct that interferes with the speedy,
orderly, or fair conduct of the hearing.
(b) Any such sanction, including but not limited to those listed in
paragraphs (c), (d), and (e) of this section, shall reasonably relate
to the severity and nature of the failure or misconduct.
(c) When a party fails to comply with an order, including an order
for taking a deposition, the production of evidence within the party's
control, or a request for admission, the ALJ may--
(1) Draw an inference in favor of the requesting party with regard
to the information sought;
(2) In the case of requests for admission, deem each matter of
which an admission is requested to be admitted;
(3) Prohibit the party failing to comply with such order from
introducing evidence concerning, or otherwise relying upon testimony
relating to the information sought; and
(4) Strike any part of the pleadings or other submissions of the
party failing to comply with such request.
(d) If a party fails to prosecute or defend an action under this
part commenced by service of a notice of hearing, the ALJ may dismiss
the action or may issue an initial decision imposing penalties and
assessments.
(e) The ALJ may refuse to consider any motion, request, response,
brief or other document which is not filed in a timely fashion.
Sec. 2554.38 Are post-hearing briefs required?
The ALJ may require the parties to file post-hearing briefs. In any
event, any party may file a post-hearing brief. The ALJ shall fix the
time for filing such briefs, not to exceed 60 days from the date the
parties receive the transcript of the hearing or, if applicable, the
stipulated record. Such briefs may be accompanied by proposed findings
of fact and conclusions of law. The ALJ may permit the parties to file
reply briefs.
Decisions and Appeals
Sec. 2554.39 How is the case decided?
(a) The ALJ will issue an initial decision based only on the
record. It will contain findings of fact, conclusions of law, and the
amount of any penalties and assessments imposed.
(b) The ALJ will serve the initial decision on all parties within
90 days after close of the hearing or expiration of any allowed time
for submission of post-hearing briefs. If the ALJ fails to meet this
deadline, he or she shall promptly notify the parties of the reason for
the delay and set a new deadline.
(c) The findings of fact must include a finding on each of the
following issues:
(1) Whether any one or more of the claims or statements identified
in the complaint violate this part; and
(2) If the defendant is liable for penalties or assessments, the
appropriate amount of any such penalties or assessments, considering
any mitigating or aggravating factors.
(d) The initial decision will include a description of the right of
a defendant found liable for a civil penalty or assessment to file a
motion for reconsideration with the ALJ or a notice of appeal with the
authority head.
Sec. 2554.40 How are penalty and assessment amounts determined?
(a) In determining an appropriate amount of civil penalties and
assessments, the ALJ and the authority head, upon appeal, should
evaluate any circumstances that mitigate or aggravate the violation and
should articulate in their opinions the reasons that support the
penalties and assessments they impose. Because of the intangible costs
of fraud, the expense of investigating such conduct, and the need to
deter others who might be similarly tempted, ordinarily double damages
and a significant civil penalty should be imposed.
(b) Although not exhaustive, the following factors are among those
that may influence that ALJ and the authority head in determining the
amount of penalties and assessments to impose with respect to the
misconduct (i.e., the false, fictitious, or fraudulent claims or
statements) charged in the complaint:
(1) The number of false, fictitious, or fraudulent claims or
statements;
(2) The time period over which such claims or statements were made;
(3) The degree of the defendant's culpability with respect to the
misconduct;
(4) The amount of money or the value of the property, services, or
benefit falsely claimed;
(5) The value of the Government's actual loss as a result of the
misconduct, including foreseeable consequential damages and the costs
of investigation;
(6) The relationship of the amount imposed as civil penalties to
the amount of the Government's loss;
(7) The potential or actual impact of the misconduct upon national
defense, public health or safety, or public confidence in the
management of Government programs and operations, including
particularly the impact on the intended beneficiaries of such programs;
(8) Whether the defendant has engaged in a pattern of the same or
similar misconduct;
(9) Whether the defendant attempted to conceal the misconduct;
(10) The degree to which the defendant has involved others in the
misconduct or in concealing it;
(11) Where the misconduct of employees or agents is imputed to the
defendant, the extent to which the defendant's practices fostered or
attempted to preclude such misconduct;
(12) Whether the defendant cooperated in or obstructed an
investigation of the misconduct;
(13) Whether the defendant assisted in identifying and prosecuting
other wrongdoers;
(14) The complexity of the program or transaction, and the degree
of the defendant's sophistication with respect to it, including the
extent of the defendant's prior participation in the program or in
similar transactions;
(15) Whether the defendant has been found, in any criminal, civil,
or administrative proceeding to have engaged in similar misconduct or
to have dealt dishonestly with the Government of the United States or
of a State, directly or indirectly; and
(16) The need to deter the defendant and others from engaging in
the same or similar misconduct.
(c) Nothing in this section shall be construed to limit the ALJ or
the authority head from considering any other factors that in any given
case may mitigate or aggravate the offense for
[[Page 61920]]
which penalties and assessments are imposed.
Sec. 2554.41 Can a party request reconsideration of the initial
decision?
(a) Any party may file a motion for reconsideration of the initial
decision with the ALJ within 20 days of receipt of the initial
decision. If the initial decision was served by mail, there is a
rebuttable presumption that the initial decision was received by the
party 5 days from the date of mailing.
(b) A motion for reconsideration must be accompanied by a
supporting brief and must describe specifically each allegedly
erroneous decision.
(c) Any response to a motion for reconsideration will only be
allowed if it is requested by the ALJ.
(d) The ALJ will dispose of a motion for reconsideration by denying
it or by issuing a revised initial decision.
(e) If the ALJ issues a revised initial decision upon motion of a
party, that party may not file another motion for reconsideration.
Sec. 2554.42 When does the initial decision of the ALJ become final?
(a) The initial decision of the ALJ becomes the final decision of
the Corporation, and shall be binding on all parties 30 days after it
is issued, unless any party timely files a motion for reconsideration
or any defendant adjudged to have submitted a false claim or statement
timely appeals to the Corporation's authority head, as set forth in
Sec. 2554.43.
(b) If the ALJ disposes of a motion for reconsideration by denying
it or by issuing a revised initial decision, the ALJ's order on the
motion for reconsideration becomes the final decision of the
Corporation 30 days after the order is issued, unless a defendant
adjudged to have submitted a false claim or statement timely appeals to
the authority head, within 30 days of the ALJ's order, as set forth in
Sec. 2554.43.
Sec. 2554.43 What are the procedures for appealing the ALJ decision?
(a) Any defendant who submits a timely answer and is found liable
for a civil penalty or assessment in an initial decision may appeal the
decision.
(b) The defendant may file a notice of appeal with the authority
head within 30 days following issuance of the initial decision, serving
a copy of the notice of appeal on all parties and the ALJ. The
authority head may extend this deadline for up to an additional 30 days
if an extension request is filed within the initial 30-day period and
shows good cause.
(c) The defendant's appeal will not be considered until all timely
motions for reconsideration have been resolved.
(d) If a timely motion for reconsideration is denied, a notice of
appeal may be filed within 30 days following such denial or issuance of
a revised initial decision, whichever applies.
(e) A notice of appeal must be supported by a written brief
specifying why the initial decision should be reversed or modified.
(f) The Corporation's representative may file a brief in opposition
to the notice of appeal within 30 days of receiving the defendant's
notice of appeal and supporting brief.
(g) If a defendant timely files a notice of appeal, and the time
for filing motions for reconsideration has expired, the ALJ will
forward the record of the proceeding to the authority head.
Sec. 2554.44 What happens if an initial decision is appealed?