18 U.S.C. § 220 — Illegal remunerations for referrals to re-

Page 84 TITLE 18—CRIMES AND CRIMINAL PROCEDURE § 219 tion 218 of title 18 of the United States Code in relation to which there has been a final conviction for any vio- lation of chapter 11 of title 18. SEC. 2. The head of each Executive department and agency described in section 1 may exercise the author- ity hereby delegated by promulgating implementing regulations; provided that the Secretary of Defense, the Administrator of General Services and the Adminis- trator of the National Aeronautics and Space Adminis- tration jointly shall issue government-wide imple- menting regulations related to voiding or rescission of contracts. SEC. 3. Implementing regulations adopted pursuant to this Order shall, at a minimum, provide the following procedural protections: (a) Written notice of the proposed action shall be given in each case to the person or entity affected; (b) The person or entity affected shall be afforded an opportunity to submit pertinent information on its be- half before a final decision is made; (c) Upon the request of the person or entity affected, a hearing shall be held at which it shall have the oppor- tunity to call witnesses on its behalf and confront any witness the agency may present; and (d) The head of the agency or his designee shall issue a final written decision specifying the amount of res- titution or any other remedy authorized by section 218, provided that such remedy shall take into consider- ation the fair value of any tangible benefits received and retained by the agency. RONALD REAGAN. § 219. Officers and employees acting as agents of foreign principals (a) Whoever, being a public official, is or acts as an agent of a foreign principal required to register under the Foreign Agents Registration Act of 1938 or a lobbyist required to register under the Lobbying Disclosure Act of 1995 in connection with the representation of a foreign entity, as defined in section 3(6) of that Act shall be fined under this title or imprisoned for not more than two years, or both. (b) Nothing in this section shall apply to the employment of any agent of a foreign principal as a special Government employee in any case in which the head of the employing agency cer- tifies that such employment is required in the national interest. A copy of any certification under this paragraph shall be forwarded by the head of such agency to the Attorney General who shall cause the same to be filed with the registration statement and other documents filed by such agent, and made available for pub- lic inspection in accordance with section 6 of the Foreign Agents Registration Act of 1938, as amended. (c) For the purpose of this section ‘‘public offi- cial’’ means Member of Congress, Delegate, or Resident Commissioner, either before or after he has qualified, or an officer or employee or per- son acting for or on behalf of the United States, or any department, agency, or branch of Govern- ment thereof, including the District of Colum- bia, in any official function, under or by author- ity of any such department, agency, or branch of Government. (Added Pub. L. 89–486, § 8(b), July 4, 1966, 80 Stat. 249; amended Pub. L. 98–473, title II, § 1116, Oct. 12, 1984, 98 Stat. 2149; Pub. L. 99–646, § 30, Nov. 10, 1986, 100 Stat. 3598; Pub. L. 101–647, title XXXV, § 3511, Nov. 29, 1990, 104 Stat. 4922; Pub. L. 104–65, § 12(b), Dec. 19, 1995, 109 Stat. 701.) Editorial Notes REFERENCES IN TEXT The Foreign Agents Registration Act of 1938, as amended, referred to in subsec. (a), is act June 8, 1938, ch. 327, 52 Stat. 631, which is classified generally to sub- chapter II (§ 611 et seq.) of chapter 11 of Title 22, For- eign Relations and Intercourse. Section 6 of the For- eign Agents Registration Act of 1938 is classified to sec- tion 616 of Title 22. For complete classification of this Act to the Code, see Short Title note set out under sec- tion 611 of Title 22 and Tables. The Lobbying Disclosure Act of 1995, referred to in subsec. (a), is Pub. L. 104–65, Dec. 19, 1995, 109 Stat. 691, which is classified principally to chapter 26 (§ 1601 et seq.) of Title 2, The Congress. Section 3(6) of the Act is classified to section 1602(6) of Title 2. For complete classification of this Act to the Code, see Short Title note set out under section 1601 of Title 2 and Tables. PRIOR PROVISIONS A prior section 219 was renumbered section 214. AMENDMENTS 1995—Subsec. (a). Pub. L. 104–65 substituted ‘‘or a lob- byist required to register under the Lobbying Disclo- sure Act of 1995 in connection with the representation of a foreign entity, as defined in section 3(6) of that Act’’ for ‘‘, as amended,’’. 1990—Subsec. (c). Pub. L. 101–647 substituted ‘‘Govern- ment’’ for ‘‘Governments’’ before ‘‘thereof’’. 1986—Subsec. (a). Pub. L. 99–646, § 30(1), designated first par. as subsec. (a) and amended it generally, which prior to amendment read as follows: ‘‘Whoever, being a public official of the United States in the executive, legislative, or judicial branch of the Government or in any agency of the United States, including the District of Columbia, is or acts as an agent of a foreign prin- cipal required to register under the Foreign Agents Registration Act of 1938, as amended, shall be fined not more than $10,000 or imprisoned for not more than two years, or both.’’ Subsec. (b). Pub. L. 99–646, § 30(2), designated second par. as subsec. (b). Subsec. (c). Pub. L. 99–646, § 30(2), (3), designated third par. as subsec. (c) and substituted ‘‘Delegate’’ for ‘‘Del- egate from the District of Columbia’’ and ‘‘branch of Government’’ for ‘‘branch of Government, or a juror’’. 1984—Pub. L. 98–473 substituted ‘‘a public official’’ for ‘‘an officer or employee’’ in first par., and inserted par. defining ‘‘public official’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1995 AMENDMENT Amendment by Pub. L. 104–65 effective Jan. 1, 1996, except as otherwise provided, see section 24 of Pub. L. 104–65, set out as an Effective Date note under section 1601 of Title 2, The Congress. EFFECTIVE DATE Section effective ninety days after July 4, 1966, see section 9 of Pub. L. 89–486, set out as an Effective Date of 1966 Amendment note under section 611 of Title 22, Foreign Relations and Intercourse. § 220. Illegal remunerations for referrals to re- covery homes, clinical treatment facilities, and laboratories (a) OFFENSE.—Except as provided in subsection (b), whoever, with respect to services covered by a health care benefit program, in or affecting interstate or foreign commerce, knowingly and willfully— (1) solicits or receives any remuneration (in- cluding any kickback, bribe, or rebate) di- rectly or indirectly, overtly or covertly, in Page 85 TITLE 18—CRIMES AND CRIMINAL PROCEDURE [§ 223 cash or in kind, in return for referring a pa- tient or patronage to a recovery home, clinical treatment facility, or laboratory; or (2) pays or offers any remuneration (includ- ing any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind— (A) to induce a referral of an individual to a recovery home, clinical treatment facility, or laboratory; or (B) in exchange for an individual using the services of that recovery home, clinical treatment facility, or laboratory, shall be fined not more than $200,000, imprisoned not more than 10 years, or both, for each occur- rence. (b) APPLICABILITY.—Subsection (a) shall not apply to— (1) a discount or other reduction in price ob- tained by a provider of services or other entity under a health care benefit program if the re- duction in price is properly disclosed and ap- propriately reflected in the costs claimed or charges made by the provider or entity; (2) a payment made by an employer to an employee or independent contractor (who has a bona fide employment or contractual rela- tionship with such employer) for employment, if the employee’s payment is not determined by or does not vary by— (A) the number of individuals referred to a particular recovery home, clinical treatment facility, or laboratory; (B) the number of tests or procedures per- formed; or (C) the amount billed to or received from, in part or in whole, the health care benefit program from the individuals referred to a particular recovery home, clinical treatment facility, or laboratory; (3) a discount in the price of an applicable drug of a manufacturer that is furnished to an applicable beneficiary under the Medicare cov- erage gap discount program under section 1860D–14A(g) of the Social Security Act (42 U.S.C. 1395w–114a(g)); (4) a payment made by a principal to an agent as compensation for the services of the agent under a personal services and manage- ment contract that meets the requirements of section 1001.952(d) of title 42, Code of Federal Regulations, as in effect on the date of enact- ment of this section; (5) a waiver or discount (as defined in sec- tion 1001.952(h)(5) of title 42, Code of Federal Regulations, or any successor regulation) of any coinsurance or copayment by a health care benefit program if— (A) the waiver or discount is not routinely provided; and (B) the waiver or discount is provided in good faith; (6) a remuneration described in section 1128B(b)(3)(I) of the Social Security Act (42 U.S.C. 1320a–7b(b)(3)(I)); (7) a remuneration made pursuant to an al- ternative payment model (as defined in sec- tion 1833(z)(3)(C) of the Social Security Act) or pursuant to a payment arrangement used by a State, health insurance issuer, or group health plan if the Secretary of Health and Human Services has determined that such arrange- ment is necessary for care coordination or value-based care; or (8) any other payment, remuneration, dis- count, or reduction as determined by the At- torney General, in consultation with the Sec- retary of Health and Human Services, by regu- lation. (c) REGULATIONS.—The Attorney General, in consultation with the Secretary of Health and Human Services, may promulgate regulations to clarify the exceptions described in subsection (b). (d) PREEMPTION.— (1) FEDERAL LAW.—This section shall not apply to conduct that is prohibited under sec- tion 1128B of the Social Security Act (42 U.S.C. 1320a–7b). (2) STATE LAW.—Nothing in this section shall be construed to occupy the field in which any provisions of this section operate to the exclu- sion of State laws on the same subject matter. (e) DEFINITIONS.—In this section— (1) the terms ‘‘applicable beneficiary’’ and ‘‘applicable drug’’ have the meanings given those terms in section 1860D–14A(g) of the So- cial Security Act (42 U.S.C. 1395w–114a(g)); (2) the term ‘‘clinical treatment facility’’ means a medical setting, other than a hos- pital, that provides detoxification, risk reduc- tion, outpatient treatment and care, residen- tial treatment, or rehabilitation for substance use, pursuant to licensure or certification under State law; (3) the term ‘‘health care benefit program’’ has the meaning given the term in section 24(b); (4) the term ‘‘laboratory’’ has the meaning given the term in section 353 of the Public Health Service Act (42 U.S.C. 263a); and (5) the term ‘‘recovery home’’ means a shared living environment that is, or purports to be, free from alcohol and illicit drug use and centered on peer support and connection to services that promote sustained recovery from substance use disorders. (Added Pub. L. 115–271, title VIII, § 8122(a), Oct. 24, 2018, 132 Stat. 4108.) Editorial Notes REFERENCES IN TEXT The date of enactment of this section, referred to in subsec. (b)(4), is the date of enactment of Pub. L. 115–271, which was approved Oct. 24, 2018. Section 1833(z)(3)(C) of the Social Security Act, re- ferred to in subsec. (b)(7), is classified to section 1395l(z)(3)(C) of Title 42, The Public Health and Welfare. PRIOR PROVISIONS A prior section 220 was renumbered section 215. [§§ 221, 222. Renumbered §§ 216, 217] [§ 223. Repealed. Pub. L. 87–849, § 1(c), Oct. 23, 1962, 76 Stat. 1125] Section, act June 25, 1948, ch. 645, 62 Stat. 696, related to transactions of the Home Owners’ Loan Corporation.