42 U.S.C. § 1011 | Penalties for fraud

(a)

In general

Whoever—

(1)

knowingly and willfully makes or causes to be made any false statement or representation of a material fact in an application for benefits under this subchapter;

(2)

at any time knowingly and willfully makes or causes to be made any false statement or representation of a material fact for use in determining any right to the benefits;

(3)

having knowledge of the occurrence of any event affecting—

(A)

his or her initial or continued right to the benefits; or

(B)

the initial or continued right to the benefits of any other individual in whose behalf he or she has applied for or is receiving the benefit,

conceals or fails to disclose the event with an intent fraudulently to secure the benefit either in a greater amount or quantity than is due or when no such benefit is authorized;

(4)

having made application to receive any such benefit for the use and benefit of another and having received it, knowingly and willfully converts the benefit or any part thereof to a use other than for the use and benefit of the other individual; or

(5)

conspires to commit any offense described in any of paragraphs (1) through (3),

shall be fined under title 18, imprisoned not more than 5 years, or both, except that in the case of a person who receives a fee or other income for services performed in connection with any determination with respect to benefits under this subchapter (including a claimant representative, translator, or current or former employee of the Social Security Administration), or who is a physician or other health care provider who submits, or causes the submission of, medical or other evidence in connection with any such determination, such person shall be guilty of a felony and upon conviction thereof shall be fined under title 18, or imprisoned for not more than ten years, or both.

(b)

Court order for restitution

(1)

In general

Any Federal court, when sentencing a defendant convicted of an offense under subsection (a), may order, in addition to or in lieu of any other penalty authorized by law, that the defendant make restitution to the Commissioner of Social Security, in any case in which such offense results in—

(A)

the Commissioner of Social Security making a benefit payment that should not have been made, or

(B)

section 1007(i) of this title an individual suffering a financial loss due to the defendant’s violation of subsection (a) in his or her capacity as the individual’s representative payee appointed pursuant to .

(2)

Related provisions

Sections 3612, 3663, and 3664 of title 18 shall apply with respect to the issuance and enforcement of orders of restitution under this subsection. In so applying such sections, the Commissioner of Social Security shall be considered the victim.

(3)

Stated reasons for not ordering restitution

If the court does not order restitution, or orders only partial restitution, under this subsection, the court shall state on the record the reasons therefor.

(4)

Receipt of restitution payments

(A)

In general

Except as provided in subparagraph (B), funds paid to the Commissioner of Social Security as restitution pursuant to a court order shall be deposited as miscellaneous receipts in the general fund of the Treasury.

(B)

Payment to the individual

In the case of funds paid to the Commissioner of Social Security pursuant to paragraph (1)(B), the Commissioner of Social Security shall certify for payment to the individual described in such paragraph an amount equal to the lesser of the amount of the funds so paid or the individual’s outstanding financial loss as described in such paragraph, except that such amount may be reduced by any overpayment of benefits owed under this subchapter, subchapter II, or subchapter XVI by the individual.

Aug. 14, 1935, ch. 531 Pub. L. 106–169, title II, § 251(a)Dec. 14, 1999113 Stat. 1852 Pub. L. 108–203, title II, § 209(b)Mar. 2, 2004118 Stat. 514 Pub. L. 114–74, title VIII, § 813(a)(2)Nov. 2, 2015129 Stat. 602(, title VIII, § 811, as added , , ; amended , , ; , (b)(2), , , 603.)

Editorial Notes

Prior Provisions

section 1001 of this titleFor prior provisions, see note set out under .

Amendments

Pub. L. 114–74, § 813(b)(2)2015—Subsec. (a). , inserted before period at end of concluding provisions “, except that in the case of a person who receives a fee or other income for services performed in connection with any determination with respect to benefits under this subchapter (including a claimant representative, translator, or current or former employee of the Social Security Administration), or who is a physician or other health care provider who submits, or causes the submission of, medical or other evidence in connection with any such determination, such person shall be guilty of a felony and upon conviction thereof shall be fined under title 18, or imprisoned for not more than ten years, or both”.

Pub. L. 114–74, § 813(a)(2)Subsec. (a)(5). , added par. (5).

Pub. L. 108–203 section 1007 of this title2004—Subsec. (b). amended heading and text of subsec. (b) generally. Prior to amendment, text read as follows: “If a person or organization violates subsection (a) of this section in the person’s or organization’s role as, or in applying to become, a representative payee under on behalf of a qualified individual, and the violation includes a willful misuse of funds by the person or entity, the court may also require that full or partial restitution of funds be made to the qualified individual.”

Statutory Notes and Related Subsidiaries

Effective Date of 2004 Amendment

Pub. L. 108–203Mar. 2, 2004section 209(d) of Pub. L. 108–203 section 408 of this titleAmendment by applicable with respect to violations occurring on or after , see , set out as a note under .