7 USC 1515 - Program compliance and integrity

U.S Code last checked for updates: Nov 23, 2024

§ 1515.

Program compliance and integrity

(a)

Purpose

(1)

In general

(2)

Role of insurance providers

(b)

Notification of compliance problems

(1)

Notification of errors, omissions, and failures

(2)

Time for notification

(3)

Effect of failure to timely notify

(c)

Reconciling producer information

(1)

In general

(2)

Frequency

(3)

Corrections

(A)

In general

In addition to the corrections permitted by the Corporation as of the day before February 7, 2014, the Corporation shall establish procedures that allow an agent or an approved insurance provider, subject to subparagraph (B)—

(i)

within a reasonable amount of time following the applicable sales closing date, to correct errors in information that is provided by a producer for the purpose of obtaining coverage under any policy or plan of insurance made available under this subchapter to ensure that the eligibility information is correct and consistent with information reported by the producer for other programs administered by the Secretary;

(ii)

within a reasonable amount of time following—

(I)

the acreage reporting date, to reconcile errors in the information reported by the producer with correct information determined from any other program administered by the Secretary; or

(II)

the date of any subsequent correction of data by the Farm Service Agency made as a result of the verification of information, to make conforming corrections; and

(iii)

at any time, to correct electronic transmission errors that were made by an agent or approved insurance provider, or such errors made by the Farm Service Agency or any other agency of the Department of Agriculture in transmitting the information provided by the producer for purposes of other programs of the Department to the extent an agent or approved insurance provider relied upon the erroneous information for crop insurance purposes.

(B)

Limitation

In accordance with the procedures of the Corporation, correction to the information described in clauses (i) and (ii) of subparagraph (A) may only be made if the corrections do not allow the producer—

(i)

to avoid ineligibility requirements for insurance or obtain a disproportionate benefit under the crop insurance program or any related program administered by the Secretary;

(ii)

to obtain, enhance, or increase an insurance guarantee or indemnity if a cause of loss exists or has occurred before any correction has been made, or avoid premium owed if no loss is likely to occur; or

(iii)

to avoid an obligation or requirement under any Federal or State law.

(C)

Exception to late filing sanctions

(D)

Late payment of debt

(d)

Identification and elimination of fraud, waste, and abuse

(1)

FSA monitoring program

The Secretary shall develop and implement a coordinated plan for the Farm Service Agency to assist the Corporation in the ongoing monitoring of programs carried out under this subchapter, including—

(A)

at the request of the Corporation or, subject to paragraph (2), on its own initiative if the Farm Service Agency has reason to suspect the existence of program fraud, waste, or abuse, conducting fact finding relative to allegations of program fraud, waste, or abuse;

(B)

reporting to the Corporation, in writing in a timely manner, the results of any fact finding conducted pursuant to subparagraph (A), any allegation of fraud, waste, or abuse, and any identified program vulnerabilities;

(C)

assisting the Corporation and approved insurance providers in auditing a statistically appropriate number of claims made under any policy or plan of insurance under this subchapter; and

(D)

using published aggregate data from the National Agricultural Statistics Service or any other data source to—

(i)

detect yield disparities or other data anomalies that indicate potential fraud; and

(ii)

target the relevant counties, crops, regions, companies, or agents associated with that potential fraud for audits and other enforcement actions.

(2)

FSA inquiry

(3)

Use of field infrastructure

(4)

Maintenance of provider effort

(A)

In general

(B)

Notification of providers

(C)

Response

(5)

Corporation response to provider reports

(A)

Prompt response

(B)

Cooperative effort

(C)

Failure to timely respond

(e)

Consultation with State FSA committees

(f)

Detection of disparate performance

(1)

Covered activities

The Secretary shall establish procedures under which the Corporation will be able to identify the following:

(A)

Any agent engaged in the sale of coverage offered under this subchapter where the loss claims associated with such sales by the agent are equal to or greater than 150 percent (or an appropriate percentage specified by the Corporation) of the mean for all loss claims associated with such sales by all other agents operating in the same area, as determined by the Corporation.

(B)

Any person performing loss adjustment services relative to coverage offered under this subchapter where such loss adjustments performed by the person result in accepted or denied claims equal to or greater than 150 percent (or an appropriate percentage specified by the Corporation) of the mean for accepted or denied claims (as applicable) for all other persons performing loss adjustment services in the same area, as determined by the Corporation.

(2)

Review

(A)

Review required

(B)

Remedial action

(3)

Oversight of agents and loss adjusters

(g)

Submission of information to Corporation to support compliance efforts

(1)

Types of information required

The Secretary shall establish procedures under which approved insurance providers shall submit to the Corporation the following information with respect to each policy or plan of insurance offered under this subchapter:

(A)

The name and identification number of the insured.

(B)

The agricultural commodity to be insured.

(C)

The elected coverage level, including the price election, of the insured.

(D)

The actual production history to be used to establish insurable yields.

(2)

Time for submission

(A)

In general

(B)

Actual production history

(i)

In general

(ii)

Correction of errors

(h)

Sanctions for program noncompliance and fraud

(1)

False information

(2)

Compliance

(3)

Authorized sanctions

If the Secretary determines that a person covered by this subsection has committed a material violation under paragraph (1) or (2), the following sanctions may be imposed:

(A)

Civil fines

A civil fine may be imposed for each violation in an amount not to exceed the greater of—

(i)

the amount of the pecuniary gain obtained as a result of the false or inaccurate information provided or the noncompliance with a requirement of this subchapter; or

(ii)

$10,000.

(B)

Producer disqualification

In the case of a violation committed by a producer, the producer may be disqualified for a period of up to 5 years from receiving any monetary or nonmonetary benefit provided under each of the following:

(i)

This subchapter.

(ii)

The Agricultural Market Transition Act (7 U.S.C. 7201 et seq.), including the noninsured crop disaster assistance program under section 196 of that Act (7 U.S.C. 7333).

(iii)

The Agricultural Act of 1949 (7 U.S.C. 1421 et seq.).

(iv)

The Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.).

(v)

The Agricultural Adjustment Act of 1938 (7 U.S.C. 1281 et seq.).

(vi)

Title XII of the Food Security Act of 1985 (16 U.S.C. 3801 et seq.).

(vii)

The Consolidated Farm and Rural Development Act (7 U.S.C. 1921 et seq.).

(viii)

Any law that provides assistance to a producer of an agricultural commodity affected by a crop loss or a decline in the prices of agricultural commodities.

(C)

Disqualification of other persons

(4)

Assessment of sanction

The Secretary shall consider the gravity of the violation of the person covered by this subsection in determining—

(A)

whether to impose a sanction under this subsection; and

(B)

the type and amount of the sanction to be imposed.

(5)

Disclosure of sanctions

Each policy or plan of insurance under this subchapter shall provide notice describing the sanctions prescribed under paragraph (3) for willfully and intentionally—

(A)

providing false or inaccurate information to the Corporation or to an approved insurance provider; or

(B)

failing to comply with a requirement of the Corporation.

(6)

Insurance fund

(i)

Annual report on program compliance and integrity efforts

(1)

Report required

(2)

Information regarding fraud, waste, and abuse

(j)

Information management

(1)

Systems maintenance and upgrades

(A)

In general

(B)

Requirement

(i)

In general

(ii)

Acreage report streamlining initiative project

(2)

Use of available information technologies

(3)

Use of private sector

(k)

Continuing education for loss adjusters and agents

(1)

In general

(2)

Requirements

The requirements for continuing education described in paragraph (1) shall ensure that loss adjusters and agents of approved insurance providers are familiar with—

(A)

the policies and plans of insurance available under this subchapter, including the regulations promulgated to carry out this subchapter;

(B)

efforts to promote program integrity through the elimination of waste, fraud, and abuse; and

(C)

other aspects of adjusting, delivering, and servicing policies and plans of insurance by adjustors and agents, as determined by the Secretary, including conservation activities and agronomic practices (including organic and sustainable practices) that are common and appropriate to the area in which the insured crop being inspected is produced.

(l)

Funding

(1)

Information technology

(A)

In general

For purposes of subsection (j)(1), the Corporation may use, from amounts made available from the insurance fund established under section 1516(c) of this title, not more than—

(i)

(I)

for fiscal year 2014, $14,000,000; and

(II)

for each of fiscal years 2015 through 2018, $9,000,000; or

(ii)

if the Acreage Crop Reporting Streamlining Initiative (ACRSI) project is substantially completed by September 30, 2015, not more than $14,000,000 for each of the fiscal years 2015 through 2018.

(B)

Notification

(2)

Data mining

(Feb. 16, 1938, ch. 30, title V, § 515, as added Pub. L. 103–354, title I, § 109, Oct. 13, 1994, 108 Stat. 3197; amended Pub. L. 106–224, title I, § 121(a), June 20, 2000, 114 Stat. 372; Pub. L. 110–234, title XII, §§ 12021, 12033(c)(2), May 22, 2008, 122 Stat. 1382, 1405; Pub. L. 110–246, § 4(a), title XII, §§ 12021, 12033(c)(2), June 18, 2008, 122 Stat. 1664, 2144, 2167; Pub. L. 110–398, § 1(c), Oct. 13, 2008, 122 Stat. 4214; Pub. L. 113–79, title XI, §§ 11019, 11020, Feb. 7, 2014, 128 Stat. 966, 968; Pub. L. 115–334, title XI, §§ 11115–11117, Dec. 20, 2018, 132 Stat. 4925.)

cite as: 7 USC 1515