US Code

Public Law 119-73 (01/23/2026)

42 U.S.C. § 300s–1a

Recovery of expenditures under certain conditions

(a)

Persons liable

If any facility with respect to which funds have been paid under this subchapter shall, at any time within 20 years after the completion of construction or modernization—
(1)
be sold or transferred to any entity (A) which is not qualified to file an application under section 300s–1 or 300t–12 of this title or (B) which is not approved as a transferee by the State Agency of the State in which such facility is located, or its successor, or
(2)
cease to be a public health center or a public or other nonprofit hospital, outpatient facility, facility for long-term care, or rehabilitation facility,
the United States shall be entitled to recover, whether from the transferor or the transferee (or, in the case of a facility which has ceased to be public or nonprofit, from the owners thereof) an amount determined under subsection (c).
(b)

Notice to Secretary

The transferor of a facility which is sold or transferred as described in subsection (a)(1), or the owner of a facility the use of which is changed as described in subsection (a)(2), shall provide the Secretary written notice of such sale, transfer, or change not later than the expiration of 10 days from the date on which such sale, transfer, or change occurs.

(c)

Amount of recovery; interest; interest period

(1)
Except as provided in paragraph (2), the amount the United States shall be entitled to recover under subsection (a) is an amount bearing the same ratio to the then value (as determined by the agreement of the parties or in an action brought in the district court of the United States for the district for which the facility involved is situated) of so much of the facility as constituted an approved project or projects as the amount of the Federal participation bore to the cost of the construction or modernization of such project or projects.
(2)
(A)
After the expiration of—
(i)
180 days after the date of the sale, transfer, or change of use for which a notice is required by subsection (b) in the case of a facility which is sold or transferred or the use of which changes after , or
(ii)
thirty days after , or if later 180 days after the date of the sale, transfer, or change of use for which a notice is required by subsection (b), in the case of a facility which was sold or transferred or the use of which changed before ,
the amount which the United States is entitled to recover under paragraph (1) with respect to a facility shall be the amount prescribed by paragraph (1) plus interest, during the period described in subparagraph (B), at a rate (determined by the Secretary) based on the average of the bond equivalent of the weekly 90-day Treasury bill auction rate.
(B)
The period referred to in subparagraph (A) is the period beginning—
(i)
1
1 So in original. The period probably should be a comma.
in the case of a facility which was sold or transferred or the use of which changed before , thirty days after such date or if later 180 days after the date of the sale, transfer, or change of use for which a notice is required by subsection (b).
(ii)
in the case of a facility with respect to which notice is provided in accordance with subsection (b), upon the expiration of 180 days after the receipt of such notice, or
(iii)
in the case of a facility with respect to which such notice is not provided as prescribed by subsection (b), on the date of the sale, transfer, or changes of use for which such notice was to be provided,
and ending on the date the amount the United States is entitled to under paragraph (1) is collected.
(d)

Waiver

(1)
The Secretary may waive the recovery rights of the United States under subsection (a)(1) with respect to a facility in any State if the Secretary determines, in accordance with regulations, that the entity to which the facility was sold or transferred—
(A)
has established an irrevocable trust—
(i)
section 300s–1(b)(1)(K) of this title in an amount equal to the greater of twice the cost of the remaining obligation of the facility under clause (ii) of or the amount, determined under subsection (c), that the United States is entitled to recover, and
(ii)
section 300s–1(b)(1)(K) of this title which will only be used by the entity to provide the care required by clause (ii) of ; and
(B)
section 300s–1(b)(1)(K) of this title will meet the obligation of the facility under clause (i) of .
(2)
The Secretary may waive the recovery rights of the United States under subsection (a)(2) with respect to a facility in any State if the Secretary determines, in accordance with regulations, that there is good cause for waiving such rights with respect to such facility.
(e)

Lien

The right of recovery of the United States under subsection (a) shall not constitute a lien on any facility with respect to which funds have been paid under this subchapter.

July 1, 1944, ch. 373Pub. L. 93–641, § 488 Stat. 2269Pub. L. 94–278, title XI, § 1106(c)90 Stat. 416Pub. L. 96–79, title II93 Stat. 632Pub. L. 98–369, div. B98 Stat. 1114(, title XVI, § 1622, formerly § 1631, as added , , ; amended , , ; renumbered § 1622 and amended , §§ 202(b), 203(c), , , 635; . title III, § 2381(b), , .)

Editorial Notes

Codification

section 300s–1 of this titlePub. L. 96–79Section was formerly classified to prior to the general revision of this subchapter by .

Prior Provisions

Pub. L. 93–641, § 488 Stat. 2265Pub. L. 96–79section 300q–2 of this titleA prior section 1622 of act , as added , , , was renumbered section 1602 as part of the general revision of this subchapter by and is classified to .

Amendments

Pub. L. 98–3691984— amended section generally. Prior to the amendment, section read as follows:

“(a) If any facility constructed, modernized, or converted with funds provided under this subchapter is, at any time within twenty years after the completion of such construction, modernization, or conversion with such funds—

“(1) sold or transferred to any person or entity (A) which is not qualified to file an application under section 300s–1 or 300t–12 of this title or (B) which is not approved as a transferee by the State Agency of the State in which such facility is located, or its successor; or

“(2) not used as a medical facility, and the Secretary has not determined that there is good cause for termination of such use,

the United States shall be entitled to recover from either the transferor or the transferee in the case of a sale or transfer or from the owner in the case of termination of use an amount bearing the same ratio to the then value (as determined by the agreement of the parties or by action brought in the district court of the United States for the district in which the facility is situated) of so much of such facility as constituted an approved project or projects, as the amount of the Federal participation bore to the cost of the construction, modernization, or conversion of such project or projects. Such right of recovery shall not constitute a lien upon such facility prior to judgment.

“(b) The Secretary may waive the recovery rights of the United States under subsection (a) of this section with respect to a facility in any State—

section 300m–3(c) of this title“(1) if (as determined under regulations prescribed by the Secretary) the amount which could be recovered under subsection (a) of this section with respect to such facility is applied to the development, expansion, or support of another medical facility located in such State which has been approved by the Statewide Health Coordinating Council for such State as consistent with the State health plan established pursuant to ; or

“(2) if the Secretary determines, in accordance with regulations, that there is good cause for waiving such requirement with respect to such facility.

If the amount which the United States is entitled to recover under subsection (a) of this section exceeds 90 per centum of the total cost of the construction or modernization project for a facility, a waiver under this subsection shall only apply with respect to an amount which is not more than 90 per centum of such total cost.”

Pub. L. 96–79, § 203(c)o1979—Subsec. (a)(1)(A). , substituted “section 300s–1 or 300t–12 of this title” for “section 300–3 of this title”.

Statutory Notes and Related Subsidiaries

Effective Date of 1979 Amendment

Pub. L. 96–79section 204 of Pub. L. 96–79section 300q of this titleAmendment by effective , see , set out as a note under .

Regulations and Personnel

section 2381(c) of Pub. L. 98–369section 291i of this titleRequirements for regulations and personnel to implement this section, see , set out as a note under .