[Code of Federal Regulations]

[Title 45, Volume 1]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 45CFR79.2]



[Page 282-283]

 

                        TITLE 45--PUBLIC WELFARE

 

                    SUBTITLE A--DEPARTMENT OF HEALTH

                           AND HUMAN SERVICES

 

PART 79_PROGRAM FRAUD CIVIL REMEDIES--Table of Contents

 

Sec.  79.2  Definitions.



    ALJ means an Administrative Law Judge in the authority appointed 

pursuant to 5 U.S.C. 3105 or detailed to the authority pursuant to 5 

U.S.C. 3344.

    Authority means the Department of Health and Human Services.

    Authority head means the Departmental Grant Appeals Board of the 

Department of Health and Human Services.

    Benefit means, in the context of statement, anything of value, 

including but not limited to any advantage, preference, privilege, 

license, permit, favorable decision, ruling, status, or loan guarantee.

    Claim means any request, demand, or submission--

    (a) Made to the authority for property, services, or money 

(including money representing grants, loans, insurance, or benefits);

    (b) Made to a recipient of property, services, or money from the 

authority or to a party to a contract with the authority--

    (1) For property or services if the United States--

    (i) Provided such property or services;

    (ii) Provided any portion of the funds for the purchase of such 

property or services; or

    (iii) Will reimburse such recipient or party for the purchase of 

such property or services; or

    (2) For the payment of money (including money representing grants, 

loans, insurance, or benefits) if the United States--

    (i) Provided any portion of the money requested or demanded; or

    (ii) Will reimburse such recipient or party for any portion of the 

money paid on such request or demand: or

    (c) Made to the authority which has the effect of decreasing an 

obligation to pay or account for property, services, or money.

    Complaint means the administrative complaint served by the reviewing 

official on the defendant under Sec.  79.7.

    Defendant means any person alleged in a complaint under Sec.  79.7 

to be liable for a civil penalty or assessment under Sec.  79.3.

    Department means the Department of Health and Human Services.

    Government means the United States Government.

    Individual means a natural person.

    Initial decision means the written decision of the ALJ required by 

Sec. Sec.  79.10 or 79.37, and includes a revised initial decision 

issued following a remand or a motion for reconsideration.

    Investigating official means the Inspector General of the Department 

of Health and Human Services or an officer or employee of the Office of 

the Inspector General designated by the Inspector General and serving in 

a position for which the rate of basic pay is not less than the minimum 

rate of basic pay for grade GS-16 under the General Schedule.

    Knows or has reason to know, means that a person, with respect to a 

claim or statement--

    (a) Has actual knowledge that the claim or statement is false, 

fictitious, or fraudulent;

    (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.

    Makes, wherever it appears, shall include the terms presents, 

submits, and causes to be made, presented, or submitted. As the context 

requires, making or made, shall likewise include the corresponding forms 

of such terms.

    Person means any individual, partnership, corporation, association 

or private organization, and includes the plural of that term.

    Representative means an attorney who is a member in good standing of 

the bar of any State, Territory, or possession of the United States or 

of the District of Columbia or the Commonwealth of Puerto Rico.

    Reviewing official means the General Counsel of the Department or 

his or her designee who is--

    (a) Not subject to supervision by, or required to report to, the 

investigating official;

    (b) Not employed in the organizational unit of the authority in 

which



[[Page 283]]



the investigating official is employed; and

    (c) Serving in a position for which the rate of basic pay is not 

less than the minimum rate of basic pay for grade GS-16 under the 

General Schedule.

    Statement means any representation, certification, affirmation, 

document, record, or accounting or bookkeeping entry made--

    (a) With respect to a claim or to obtain the approval or payment of 

a claim (including relating to eligibility to make a claim); or

    (b) With respect to (including relating to eligibility for)--

    (1) A contract with, or a bid or proposal for a contract with; or

    (2) A grant, loan, or benefit from, the authority, or any State, 

political subdivision of a State, or other party, if the United States 

Government provides any portion of the money or property under such 

contract or for such grant, loan, or benefit, or if the Government will 

reimburse such State, political subdivision, or party for any portion of 

the money or property under such contract or for such grant, loan, or 

benefit,