,i #aaeth ,,congress #b;d ,session ,h4 ,r4 #fijb ,,in ,,the ,,house ,,of ,,representatives ,september #bf1 #bjah,mr4 ,knight 7for himself and ,ms4 ,eshoo7 introduced the following bill2 which was referred to the ,committee on the ,judiciary ,a ,,bill ,to amend title #ah1 ,united ,states ,code1 to establish criminal penalties for unlawful payments for referrals to recovery homes and clinical treatment facilities4 #a4 ,short title ,this ,act may be cited as the ,eliminating ,kickbacks in ,recovery ,act of #bjah4 #b4 ,criminal penalties 7a7 ,in general ,chapter #aa of title #ah1 ,united ,states ,code1 is amended by inserting after section #bai the following3 #bbj4 ,illegal remunerations for referrals to recovery homes and clinical treatment facilities 7a7 ,offense ,except as provided in subsection 7b71 whoever1 with respect to services covered by a health care benefit program1 in or affecting interstate or foreign commerce1 knowingly and willfully-- 7#a7 solicits or receives any remuneration 7including any kickback1 bribe1 or rebate7 directly or indirectly1 overtly or covertly1 in cash or in-kind1 in return for referring a patient or patronage to a recovery home or clinical treatment facility2 or 7#b7 pays or offers any remuneration 7including any kickback1 bribe1 or rebate7 directly or indirectly1 overtly or covertly1 in cash or in-kind-- 7,a7 to induce a referral of an individual to a recovery home or clinical treatment facility2 or 7,b7 in exchange for an individual using the services of that recovery home or clinical treatment facility1 shall be fined not more than #bjj1jjj1 imprisoned not more than #aj years1 or both1 for each occurrence4 7b7 ,applicability ,subsection 7a7 shall not apply to-- 7#a7 a discount or other reduction in price obtained by a provider of services or other entity under a health care benefit program if the reduction in price is properly disclosed and appropriately reflected in the costs claimed or charges made by the provider or entity2 7#b7 a payment made by an employer to an employee or independent contract 7who has a bona fide employment or contractual relationship with such employer7 for employment1 if the employee's payment is not determined by or does not vary by-- 7,a7 the number of individuals referred to a particular recovery home or clinical treatment facility2 7,b7 the number of tests or procedures performed2 or 7,c7 the amount billed to or received from1 in part or in whole1 the health care benefit program from the individuals referred to a particular recovery home or clinical treatment facility2 7#c7 a discount in the price of an applicable drug of a manufacturer that is furnished to an applicable beneficiary under the ,medicare coverage gap discount program under section #ahfj;,d-#ad;,a7g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad;a7g772 7#d7 a payment made by a principal to an agent as compensation for the services of the agent under a personal services and management contract that meets the requirements of section #ajja4ieb7;d7 of title #db1 ,code of ,federal ,regulations1 as in effect on the date of enactment of this section2 7#e7 a waiver or discount 7as defined in section #ajja4ieb7;h77#e7 of title #db1 ,code of ,federal ,regulations1 or any successor regulation7 of any coinsurance or copayment by a health care benefit program if-- 7,a7 the waiver or discount is not routinely provided2 and 7,b7 the waiver or discount is provided in good faith2 7#f7 a remuneration described in section #aabh;,b7b77#c77;,i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7b77#c77;,i772 7#g7 a remuneration made pursuant to an alternative payment model 7as defined in section #ahcc7z77#c77;,c7 of the ,social ,security ,act7 or pursuant to a payment arrangement used by a ,state1 health insurance issuer1 or group health plan if the ,secretary of ,health and ,human ,services has determined that such arrangement is necessary for care coordination or value-based care2 or 7#h7 any other payment1 remuneration1 discount1 or reduction as determined by the ,attorney ,general1 in consultation with the ,secretary of ,health and ,human ,services1 by regulation4 7c7 ,regulations ,the ,attorney ,general1 in consultation with the ,secretary of ,health and ,human ,services1 may promulgate regulations to clarify the exceptions described in subsection 7b74 7d7 ,definitions ,in this section-- 7#a7 the terms applicable beneficiary and applicable drug have the meanings given those terms in section #ahfj;,d-#ad;,a7g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad;a7g772 7#b7 the term clinical treatment facility means a medical setting1 other than a hospital or a facility that is owned and operated by1 controlled by1 or controlled in common by a hospital1 that provides detoxification1 risk reduction1 outpatient treatment and care1 residential treatment1 or rehabilitation for substance use1 pursuant to licensure or certification under ,state law2 7#c7 the term health care benefit program has the meaning given the term in section #bd7;b72 and 7#d7 the term recovery home means a shared living environment1 except for a facility that is owned and operated by1 controlled by1 or controlled in common by a hospital1 or purports to be1 free from alcohol and illicit drug use and centered on peer support and connection to services that promote sustained recovery from substance use disorders4 4 7b7 ,clerical amendment ,the table of sections for chapter #aa of title #ah1 ,united ,states ,code1 is amended by inserting after the item related to section #bai the following3 #bbj4 ,illegal remunerations for referrals to recovery homes and clinical treatment facilities4 4