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Federal Register / Vol. 86, No. 154 / Friday, August 13, 2021 / Rules and Regulations
5 U.S.C. App. 3, as amended, to issue administrative subpoenas for the production of records and documents.
1174.5 Review of suspected program fraud by the reviewing official.

a If the investigating official concludes that the results of his or her investigation warrant an action under this part, the investigating official shall submit to the reviewing official a report containing the investigations findings and conclusions.
b If the reviewing official determines that the report provides adequate evidence that a person made a false, fictitious or fraudulent claim or statement, the reviewing official shall transmit to the Attorney General written notice of the reviewing officials intention to refer the matter for adjudication, with a request for approval of such referral. This notice will include the reviewing officials statement concerning:
1 The reasons for the referral;
2 The claims or statements that form the basis for liability;
3 The evidence that supports liability;
4 An estimate of the amount of money or the value of property, services, or other benefits requested or demanded in the false claim or statement;
5 Any exculpatory or mitigating circumstances that may relate to the claims or statements that are known by the reviewing official or the investigating official; and 6 A statement that there is a reasonable prospect of collecting an appropriate amount of penalties and assessments.
c If, at any time, the Attorney General or designee requests in writing that the authority stay this administrative process, the authority head must stay the process immediately.
The authority head may resume the process only upon receipt of the Attorney Generals written authorization.

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The authority may issue a complaint only if:
a The Attorney General or designee approves the reviewing officials referral of the allegations for adjudication; and b In a case of submission of false claims, if the amount of money or the value of property or services that a false claim or a group of related claims submitted at the same time demanded or requested does not exceed $150,000.

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Contents of a complaint.

a The complaint will state that the authority seeks to impose civil penalties, assessments, or both, against the defendant and will include:
1 The allegations of liability against the defendant and the statutory basis for liability, identification of the claims or statements involved, and the reasons liability allegedly arises from such claims or statements;
2 The maximum amount of penalties and assessments for which the defendant may be held liable;
3 A statement that the defendant may request a hearing by filing an answer and may be represented by a representative;
4 Instructions for filing such an answer; and 5 A warning that failure to file an answer within thirty days of service of the complaint will result in an imposition of the maximum amount of penalties and assessments.
b The reviewing official must serve the complaint on the defendant and, if the defendant requests a hearing, provide a copy to the ALJ assigned to the case.
1174.8

Service of a complaint.

a The reviewing official must serve the complaint on an individual defendant directly, on a partnership through a general partner, and on a corporation or an unincorporated association through an executive officer or a director, except that the reviewing official may also make service on any person authorized by appointment or by law to receive process for the defendant.
b The reviewing official may serve the complaint either by:
1 Registered or certified mail; or 2 Personal delivery by anyone eighteen years of age or older.
c The date of service is the date of personal delivery or, in the case of service by registered or certified mail, the date of postmark.
d When the reviewing official serves the complaint, he or she should also serve the defendant with a copy of this part and 31 U.S.C. 38013812.
Subpart CProcedures Following Service of a Complaint
1174.6 Prerequisites for issuing a complaint.

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1174.7

1174.9

Answer to a complaint.

a A defendant may file an answer with the reviewing official within thirty days of service of the complaint. An answer will be considered a request for an oral hearing.
b In the answer, the defendant 1 Must admit or deny each allegation of liability contained in the complaint a failure to deny an allegation is considered an admission;

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2 Must state any defense on which the defendant intends to rely;
3 May state any reasons why the penalties, assessments, or both should be less than the statutory maximum; and 4 Must state the name, address, and telephone number of the person the defendant authorized to act as the defendants representative, if any.
c If the defendant is unable to file a timely answer which meets the requirements set forth in paragraph b of this section, the defendant may file with the reviewing official a general answer denying liability, requesting a hearing, and requesting an extension of time in which to file a complete answer.
The defendant must file a general answer within thirty days of service of the complaint.
d If the defendant initially files a general answer requesting an extension of time, the reviewing official must promptly file with the ALJ the complaint, the general answer, and the request for an extension of time.
e For good cause shown, the ALJ
may grant the defendant up to thirty additional days within which to file an answer that meets the requirements of paragraph b of this section. The defendant must file such an answer with the ALJ and must serve a copy on the reviewing official.
1174.10
answer.

Default upon failure to file an
a If the defendant does not file any answer within thirty days after service of the complaint, the reviewing official may refer the complaint to the ALJ.
b Once the reviewing official refers the complaint, the ALJ will promptly serve on the defendant a notice that the ALJ will issue an initial decision.
c The ALJ will assume the facts alleged in the complaint to be true and, if such facts establish liability under the statute, the ALJ will issue an initial decision imposing the maximum amount of penalties and assessments allowed under the PFCRA.
d Except as otherwise provided in this section, when a defendant fails to file a timely answer, the defendant waives any right to further review of the penalties and assessments the ALJ may impose in the initial decision.
e The initial decision becomes final thirty days after the ALJ issues it.
f At any time before an initial decision becomes final, a defendant may file a motion with the ALJ asking that the ALJ reopen the case. An ALJ may only reopen a case if he or she determines that the defendant set forth in the motion extraordinary circumstances that prevented the defendant from filing a timely answer.

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