[Code of Federal Regulations]
[Title 38, Volume 2]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR42.3]

[Page 740-742]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 42--STANDARDS IMPLEMENTING THE PROGRAM FRAUD CIVIL REMEDIES ACT--Table 
of Contents
 
Sec. 42.3  Basis for civil penalties and assessments.

    (a) Claims. (1) Except as provided in paragraph (c) of this section, 
any person who makes a claim that the person knows or has reason to 
know--
    (i) Is false, fictitious, or fraudulent;
    (ii) Includes or is supported by any written statement which asserts 
a material fact which is false, fictitious, or fraudulent;
    (iii) Includes or is supported by any written statement that--
    (A) Omits a material fact;
    (B) Is false, fictitious, or fraudulent as a result of such 
omission; and

[[Page 741]]

    (C) Is a statement in which the person making the statement has a 
duty to include the material fact; or
    (iv) Is for payment for the provision of property or services which 
the person has not provided as claimed,

shall be subject, in addition to any other remedy that may be prescribed 
by law, to a civil penalty of not more than $5,500 for each claim.
    (2) Each voucher, invoice, claim form, or other individual request 
or demand for property, services, or money constitutes a separate claim.
    (3) A claim shall be considered made to the Department of Veterans 
Affairs, or to a recipient or party when such claim is actually made to 
an agency, fiscal intermediary, or other entity, including any State or 
political subdivision thereof, acting for or on behalf of the Department 
of Veterans Affairs, recipient, or party.
    (4) Each claim for property, services, or money is subject to a 
civil penalty regardless of whether the property, services, or money is 
actually delivered or paid.
    (5) If the Government has made any payment (including transferred 
property or provided services) on a claim, a person subject to a civil 
penalty under paragraph (a)(1) of this section shall also be subject to 
an assessment of not more than twice the amount of the claim or that 
portion thereof that is determined to be in violation of paragraph 
(a)(1) of this section. Such assessment shall be in lieu of damages by 
the Government because of the claim.
    (b) Statements. (1) Except as provided in paragraph (c) of this 
section, any person who makes a written statement that--
    (i) The person knows or has reason to know--
    (A) Asserts a material fact which is false, fictitious, or 
fraudulent; or
    (B) 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; and
    (ii) Contains or is accompanied by an express certification or 
affirmation of the truthfulness and accuracy of the contents of the 
statement,

shall be subject, in addition to any other remedy that may be prescribed 
by law, to a civil penalty of not more than $5,500 for each statement.
    (2) Each written representation, certification, or affirmation 
constitutes a separate statement, except that a certification or 
affirmation of the truthfulness and accuracy of the contents of a 
statement is not a separate statement.
    (3) A statement shall be considered made to the Department of 
Veterans Affairs when the statement is actually made to an agent, fiscal 
intermediary, or other entity, including any State or political 
subdivision thereof, acting for or on behalf of the Department of 
Veterans Affairs.
    (c) Applications for certain benefits. (1) In the case of any claim 
or statement made by an individual relating to any of the benefits 
listed in paragraph (c)(2) of this section received by the individual, 
the individual may be held liable for penalties and assessments under 
this section only if such claim or statement is made by the individual 
in making application for such benefits with respect to any element 
required to establish the individual's initial eligibility to receive or 
continue to receive the benefits.
    (2) For purposes of paragraph (c) of this section, the term benefits 
means benefits under chapters 11, 13, 15, 17, and 21 of title 38 which 
are intended for the personal use of the individual who receives the 
benefits or for a member of the individual's family.
    (3) For purposes of this paragraph, the term application shall 
include, but is not limited to, any report or statement made or 
submitted by or for applicant or recipient of a benefit under chapters 
11, 13, or 15 of title 38, United States Code, to establish eligibility 
or to remain eligible for the benefit.
    (4) This paragraph is not applicable to an individual receiving 
benefits in a fiduciary capacity in behalf of an individual eligible for 
any of the benefits listed in paragraph (c)(2) of this section.
    (d) No proof of specific intent to defraud is required to establish 
liability under this section.
    (e) In any case in which it is determined that more than one person 
is liable for making a claim or statement under this section, each 
person making

[[Page 742]]

the claim or statement may be held liable for a civil penalty under this 
section.
    (f) In any case in which it is determined that more than one person 
is liable for making a claim under this section on which the Government 
has made a payment (including transferred property or provided 
services), an assessment may be imposed against any of these persons or 
jointly and severally against any combination of these persons.

(Authority: 31 U.S.C. 3802)

[53 FR 16710, May 11, 1988, as amended at 61 FR 56449, Nov. 1, 1996]