,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #bica  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,augu/ #a1 #bjac ,mr4 
,coble introduc$ ! foll[+ bill2 :i* 0   
ref]r$ to ! ,committee on ! ,judici>y   
,a ,,bill  ,to am5d ! false claims      
provisions ( title #ca1 ,unit$ ,/ates   
,code1 ) respect to heal? c>e programs1 
& = o!r purposes4  #a4 ,%ort title ,?is 
,act may be cit$ z ! ,fairness 9 ,heal? 
,c>e ,claims1 ,guidance1 &              
,inve/igations ,act4  #b4 ,rules =      
actions "u false claims provisions bas$ 
on claims submitt$ "u c]ta9 heal? c>e   
programs  7a7 ,9 g5]al ,sub*apt] ,,iii (
 *apt] #cg ( title #ca1 ,unit$ ,/ates   
,code1 is am5d$ by add+ at ! end !      
foll[+3  #cgcd4 ,rules = c]ta9 actions  
bas$ on heal? c>e claims  7a7 ,9 g5]al  
,9 ! case ( any action t is br\ght "u   
section #cgcj & is bas$ on a claim      
submitt$ ) respect to a ,f$]al heal? c>e
 program1 sections #cgbi ?r\gh #cgcc    
%all apply only to ! ext5t t su*        
sections are consi/5t ) ! provisions (  

?is section4  7b7 ,inve/igations ( false
 claims to ,f$]al heal? c>e programs    
7#a7 ,9 g5]al ,be=e reque/+ any         
in=mation f a physician1 hospital1 or   
o!r provid] or suppli] ( heal? c>e      
s]vices1 by any =mal or in=mal means1   
directly or 9 coop]ation ) an inve/igat+
 law en=cem5t ag5cy1 9 connection ) an  
inve/igation reasonably expect$ to      
conc]n #aj or m claims submitt$ to a    
,f$]al heal? c>e program by or on behalf
 ( a s+le entity1 ! ,attorney ,g5]al    
%all c]tify1 9 writ+1 t--  7,a7 ea*     
ag5cy responsible = promulgat+ relevant 
regulations1 guidel9es1 & bill+         
in/ructions1 directly or ?r\gh          
int]m$i>ies1 has exam9$ all regulations1
 guidel9es1 & bill+ in/ructions relevant
 to ! allegations1 all communications   
betwe5 ! alleg$ p]petrator & ! ag5cy &  
its int]m$i>ies1 & ea* ( ! alleg$ly     
false claims2  7,b7 9 ! view ( !        
responsible ag5cy (ficials & ! ,attorney
 ,g5]al1 ! allegations "u inve/igation  
are viable1 & ! relevant regulations1   

guidel9es & bill+ in/ructions 7         
unambigu\s dur+ ! relevant "t p]iod2 &  
7,c7 if prov5 to be true1 ! allegations 
are appropriately pursu$ "u section     
#cgbi4  7#b7 ,if c]tification n made ,if
 ! ,attorney ,g5]al 7or 8 or h]         
designee7 is unable to make !           
c]tifications requir$ "u p>agraph 7#a71 
& ! allegations 7 includ$ 9 an action   
br\ght by a p]son "u section #cgcj7;b71 
! ,attorney ,g5]al %all notify ! c\rt & 
! c\rt %all dismiss ^! allegations4  7c7
 ,actions if am\nt ( damages are mat]ial
 am\nt ,not)/&+ sections #cgbi ?r\gh    
#cgcc1 no action may be br\ght "u       
section #cgcj t is bas$ on a claim      
submitt$ or an ov]paym5t reta9$ )       
respect to a ,f$]al heal? c>e program   
unless ! am\nt ( damages alleg$ to h be5
 su/a9$ by ! ,unit$ ,/ates ,gov]nm5t )  
respect to su* claim or ov]paym5t is a  
mat]ial am\nt4  7d7 ,actions = claims   
submitt$ 9 reliance on (ficial guidance 
,not)/&+ sections #cgbi ?r\gh #cgcc1 no 
action may be br\ght "u section #cgcj   

bas$ on a claim submitt$ or an ov]paym5t
 reta9$ ) respect to a ,f$]al heal? c>e 
program--  7#a7 9 good fai? reliance on 
errone\s in=mation suppli$ by an ag5cy  
7or an ag5t !re(7 ab\t matt]s ( fact at 
issue2  7#b7 9 good fai? reliance on    
writt5 /atem5ts ( ,f$]al policy t       
affects ! claim or ov]paym5t t 7 provid$
 by a ,f$]al ag5cy 7or an ag5t !re(72 or
  7#c7 9 good fai? reliance on an audit 
or review by an ag5cy ( ! p]son submitt+
 ! claim or on ^: behalf ! claim 0      
submitt$1 or ( ! p]son reta9+ !         
ov]paym5t1 9 :i* no f9d+s 7 made t !    
claim or ov]paym5t violat$ !            
regulations1 guidel9es1 or in/ructions  
applicable to ! ,f$]al heal? c>e program
 at issue 9 ! claim or ov]paym5t4  7e7  
,action = claims submitt$ by p]sons 9   
sub/antial compliance ) model compliance
 plan ,not)/&+ sections #cgbi ?r\gh     
#cgcc1 no action may be br\ght "u       
section #cgcj bas$ on a claim submitt$  
by or on behalf ( a p]son1 or an        
ov]paym5t reta9$1 ) respect to a ,f$]al 

heal? c>e program if ! claim is         
submitt$1 or ! ov]paym5t reta9$1 9      
sub/antial compliance ) a model         
compliance plan issu$ by ! ,secret>y (  
,heal? & ,human ,s]vices ) respect to t 
,f$]al heal? c>e program4  7f7 ,/&>d (  
pro( ,9 any action br\ght "u section    
#cgcj ) respect to a claim submitt$1 or 
an ov]paym5t reta9$1 ) respect to a     
,f$]al heal? c>e program1 section       
#cgca7;c7 %all be appli$ by sub/itut+   
cle> & conv9c+ evid5ce = a prepond]ance 
( ! evid5ce4  7g7 ,rule ( con/ruction   
,no?+ 9 ?is section %all be con/ru$ to  
limit ! au?ority ( ! ,gov]nm5t ( !      
,unit$ ,/ates to recov] damages )       
respect to a claim submitt$1 or an      
ov]paym5t reta9$1 ) respect to a ,f$]al 
heal? c>e program "u provisions ( law   
o!r ?an section #cgbi4  7h7 ,def9itions2
 special rules ,= purposes ( ?is        
section--  7#a7 ! t]m claim means a     
claim z def9$ 9 section #cgbi7;c72  7#b7
 ! t]m ,f$]al heal? c>e program means-- 
7,a7 any plan or program t provides     

heal? c>e b5efits1 :e!r directly1 ?r\gh 
insurance1 or o!rwise1 & t is fund$     
directly1 9 :ole or 9 "p1 by ! ,unit$   
,/ates ,gov]nm5t2  7,b7 any ,/ate heal? 
c>e program1 z def9$ 9 section #aabh7;h7
 ( ! ,social ,security ,act2 or  7,c7   
any qualify+ heal? plan (f]$ ?r\gh an   
,ex*ange e/abli%$ "u1 or any o!r heal?  
plan e/abli%$ "u1 ! ,pati5t ,protection 
& ,af=dable ,c>e ,act 7,public ,law     
#aaa-adh72  7#c7 ! am\nt ( damages      
alleg$ to h be5 su/a9$ by ! ,unit$      
,/ates ,gov]nm5t ) respect to a claim   
submitt$ by 7or on behalf (7 a p]son    
%all be treat$ z a mat]ial am\nt only if
 su* am\nt exce$s a proportion 7specifi$
 9 regulations promulgat$ by ! ,secret>y
 ( ,heal? & ,human ,s]vices 9           
consultation ) ! ,secret>y ( ,def5se7 ( 
! total ( ! am\nts = :i* claims 7       
submitt$ by 7or on behalf (7 su* p]son--
  7,a7 to ! same ,f$]al heal? c>e       
program1 &  7,b7 = ! same cal5d> ye>1  z
 ! claim ^u :i* an action "u section    
#cgcj is bas$2  7#d7 9 det]m9+ :e!r an  

am\nt ( damages is a mat]ial am\nt "u   
p>agraph 7#c71 ) respect to a p]son--   
7,a7 ! am\nt ( damages = m ?an #a claim 
may be aggregat$ only if ! acts or      
omissions result+ 9 su* damages 7 "p ( a
 patt]n ( relat$ acts or omissions by   
su* p]son2 &  7,b7 if damages = m ?an #a
 claim are aggregat$ 9 accordance )     
subp>agraph 7,a71 ! proportion ref]r$ to
 9 p>agraph 7#c7 %all be det]m9$ by     
comp>+ ! am\nt ( su* aggregate damages  
to ! total ( ! am\nts = :i* claims 7    
submitt$ by 7or on behalf (7 su* p]son  
to ! same ,f$]al heal? c>e program = ea*
 ( ! cal5d> ye>s = :i* any claim ^u :i* 
su* aggregate damages 7 bas$ 0 submitt$2
  7#e7 ! t]m int]m$i>y means1 ) respect 
to a ,f$]al heal? c>e program1 a        
contractor ) an ag5cy1 a ,/ate1 or o!r  
entity t is engag$ 9 ! implem5tation ( t
 ,f$]al heal? c>e program2 &  7#f7 ! t]m
 ,/ate means ea* ( ! sev]al ,/ates1 !   
,di/rict ( ,columbia1 & any t]ritory or 
possession ( ! ,unit$ ,/ates4  4  7b7   
,con=m+ am5dm5t ,! table ( sections =   

*apt] #cg ( title #ca1 ,unit$ ,/ates    
,code1 is am5d$ by add+ at ! end !      
foll[+ new item3  #cgcd4 ,rules = c]ta9 
actions bas$ on heal? c>e claims4  4    
7c7 ,effective date ,! am5dm5ts made by 
?is section %all apply to any action or 
inve/igation "u sections #cgbi ?r\gh    
#cgcc ( title #ca1 ,unit$ ,/ates ,code1 
t is p5d+ on1 or comm5c$ on or aft]1 !  
date ( ! enactm5t ( ?is ,act4