<section xmlns="http://xml.house.gov/schemas/uslm/1.0" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:dcterms="http://purl.org/dc/terms/" style="-uslm-lc:I80" id="ida4e99216-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i"><num value="291i">§ 291i.</num><heading> Recovery of expenditures under certain conditions</heading><subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4e99217-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/a"><num value="a" class="bold">(a)</num><heading class="bold"> Persons liable</heading><chapeau style="-uslm-lc:I11" class="indent0">If any facility with respect to which funds have been paid under <ref href="/us/usc/t42/s291f">section 291f of this title</ref> shall, at any time within 20 years after the completion of construction or modernization—</chapeau><paragraph style="-uslm-lc:I12" class="indent1" id="ida4e99218-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/a/1"><num value="1">(1)</num><content> be sold or transferred to any entity (A) which is not qualified to file an application under <ref href="/us/usc/t42/s291e">section 291e of this title</ref>, or (B) which is not approved as a transferee by the State agency designated pursuant to <ref href="/us/usc/t42/s291d">section 291d of this title</ref>, or its successor, or</content>
</paragraph>
<paragraph style="-uslm-lc:I12" class="indent1" id="ida4e99219-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/a/2"><num value="2">(2)</num><content> cease to be a public health center or a public or other nonprofit hospital, outpatient facility, facility for long-term care, or rehabilitation facility,</content>
</paragraph>

<continuation style="-uslm-lc:I10" class="indent0 firstIndent0">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).</continuation>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4e9921a-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/b"><num value="b" class="bold">(b)</num><heading class="bold"> Notice to Secretary</heading><content><p style="-uslm-lc:I11" class="indent0">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.</p>
</content>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4e9921b-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c"><num value="c" class="bold">(c)</num><heading class="bold"> Amount of recovery; interest; interest period</heading><paragraph style="-uslm-lc:I11" class="indent0" id="ida4e9921c-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/1"><num value="1">(1)</num><content> 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.</content>
</paragraph>
<paragraph style="-uslm-lc:I11" class="indent0" id="ida4e9921d-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/2"><num value="2">(2)</num><subparagraph style="-uslm-lc:I11" class="indent0" id="ida4e9921e-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/2/A"><num value="A">(A)</num><chapeau> After the expiration of—</chapeau><clause style="-uslm-lc:I12" class="indent1" id="ida4e9921f-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/2/A/i"><num value="i">(i)</num><content> 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 <date date="1984-07-18">July 18, 1984</date>, or</content>
</clause>
<clause style="-uslm-lc:I12" class="indent1" id="ida4e99220-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/2/A/ii"><num value="ii">(ii)</num><content> thirty days after <date date="1984-07-18">July 18, 1984</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), in the case of a facility which was sold or transferred or the use of which changed before <date date="1984-07-18">July 18, 1984</date>.<ref class="footnoteRef" idref="fn002237">1</ref><note type="footnote" id="fn002237"><num>1</num> So in original. The period probably should be a comma.</note></content>
</clause>

<continuation style="-uslm-lc:I10" class="indent0 firstIndent0">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 ninety-day Treasury bill auction rate.</continuation>
</subparagraph>
<subparagraph style="-uslm-lc:I11" class="indent0" id="ida4e9b931-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/2/B"><num value="B">(B)</num><chapeau> The period referred to in subparagraph (A) is the period beginning—</chapeau><clause style="-uslm-lc:I12" class="indent1" id="ida4e9b932-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/2/B/i"><num value="i">(i)</num><content> in the case of a facility which was sold or transferred or the use of which changed before <date date="1984-07-18">July 18, 1984</date>, 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),</content>
</clause>
<clause style="-uslm-lc:I12" class="indent1" id="ida4e9b933-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/2/B/ii"><num value="ii">(ii)</num><content> 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</content>
</clause>
<clause style="-uslm-lc:I12" class="indent1" id="ida4e9b934-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/c/2/B/iii"><num value="iii">(iii)</num><content> 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 change of use for which such notice was to be provided,</content>
</clause>

<continuation style="-uslm-lc:I10" class="indent0 firstIndent0">and ending on the date the amount the United States is entitled to under paragraph (1) is collected.</continuation>
</subparagraph>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4e9b935-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/d"><num value="d" class="bold">(d)</num><heading class="bold"> Waiver</heading><paragraph style="-uslm-lc:I11" class="indent0" id="ida4e9b936-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/d/1"><num value="1">(1)</num><chapeau> 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—</chapeau><subparagraph style="-uslm-lc:I12" class="indent1" id="ida4e9b937-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/d/1/A"><num value="A">(A)</num><chapeau> has established an irrevocable trust—</chapeau><clause style="-uslm-lc:I13" class="indent2" id="ida4e9b938-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/d/1/A/i"><num value="i">(i)</num><content> in an amount equal to the greater of twice the cost of the remaining obligation of the facility under clause (2) of <ref href="/us/usc/t42/s291c/e">section 291c(e) of this title</ref> or the amount, determined under subsection (c), that the United States is entitled to recover, and</content>
</clause>
<clause style="-uslm-lc:I13" class="indent2" id="ida4e9b939-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/d/1/A/ii"><num value="ii">(ii)</num><content> which will only be used by the entity to provide the care required by clause (2) of <ref href="/us/usc/t42/s291c/e">section 291c(e) of this title</ref>; and</content>
</clause>
</subparagraph>
<subparagraph style="-uslm-lc:I12" class="indent1" id="ida4e9b93a-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/d/1/B"><num value="B">(B)</num><content> will meet the obligation of the facility under clause (1) of <ref href="/us/usc/t42/s291c/e">section 291c(e) of this title</ref>.</content>
</subparagraph>
</paragraph>
<paragraph style="-uslm-lc:I11" class="indent0" id="ida4e9b93b-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/d/2"><num value="2">(2)</num><content> 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.</content>
</paragraph>
</subsection>
<subsection style="-uslm-lc:I19" class="indent2 firstIndent-2" id="ida4e9b93c-09a0-11eb-a85b-f5cef3d06f4d" identifier="/us/usc/t42/s291i/e"><num value="e" class="bold">(e)</num><heading class="bold"> Lien</heading><content><p style="-uslm-lc:I11" class="indent0">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 <ref href="/us/usc/t42/s291f">section 291f of this title</ref>.</p>
</content>
</subsection>
<sourceCredit id="ida4e9b93d-09a0-11eb-a85b-f5cef3d06f4d">(<ref href="/us/act/1944-07-01/ch373">July 1, 1944, ch. 373</ref>, title VI, § 609, as added <ref href="/us/pl/88/443/s3/a">Pub. L. 88–443, § 3(a)</ref>, <date date="1964-08-18">Aug. 18, 1964</date>, <ref href="/us/stat/78/456">78 Stat. 456</ref>; amended <ref href="/us/pl/91/296/tI">Pub. L. 91–296, title I</ref> § 116(d), <date date="1970-06-30">June 30, 1970</date>, <ref href="/us/stat/84/342">84 Stat. 342</ref>; <ref href="/us/pl/98/369/dB/tIII/s2381/a">Pub. L. 98–369, div. B, title III, § 2381(a)</ref>, <date date="1984-07-18">July 18, 1984</date>, <ref href="/us/stat/98/1112">98 Stat. 1112</ref>.)</sourceCredit>
<notes type="uscNote" id="ida4e9b93e-09a0-11eb-a85b-f5cef3d06f4d">
<note style="-uslm-lc:I74" topic="priorProvisions" id="ida4e9b93f-09a0-11eb-a85b-f5cef3d06f4d"><heading class="centered smallCaps">Prior Provisions</heading><p style="-uslm-lc:I21" class="indent0">A prior section 291i, <ref href="/us/act/1944-07-01/ch373/tVI/s631">act July 1, 1944, ch. 373, title VI, § 631</ref>, as added <ref href="/us/act/1946-08-13/ch958/s2">Aug. 13, 1946, ch. 958, § 2</ref>, <ref href="/us/stat/60/1041">60 Stat. 1041</ref>; amended <ref href="/us/act/1948-06-19/ch544">June 19, 1948, ch. 544</ref>, <ref href="/us/stat/62/531">62 Stat. 531</ref>; <ref href="/us/act/1949-10-25/ch722/s9">Oct. 25, 1949, ch. 722, § 9</ref>, <ref href="/us/stat/63/901">63 Stat. 901</ref>; <ref href="/us/act/1954-07-12/ch471/s4/c">July 12, 1954, ch. 471, § 4(c)</ref>–(f), <ref href="/us/stat/68/465">68 Stat. 465</ref>, 466; <ref href="/us/act/1956-08-01/ch852/s19/a">Aug. 1, 1956, ch. 852, § 19(a)</ref>, (b), <ref href="/us/stat/70/911">70 Stat. 911</ref>; <date date="1959-06-25">June 25, 1959</date>, <ref href="/us/pl/86/70/s31/c">Pub. L. 86–70, § 31(c)</ref>, <ref href="/us/stat/73/149">73 Stat. 149</ref>; <date date="1960-07-12">July 12, 1960</date>, <ref href="/us/pl/86/624/s29/d">Pub. L. 86–624, § 29(d)</ref>, <ref href="/us/stat/74/419">74 Stat. 419</ref>; <date date="1961-10-05">Oct. 5, 1961</date>, <ref href="/us/pl/87/395/s5">Pub. L. 87–395, § 5</ref>, <ref href="/us/stat/75/826">75 Stat. 826</ref>; <date date="1962-09-25">Sept. 25, 1962</date>, <ref href="/us/pl/87/688/s4/a/2">Pub. L. 87–688, § 4(a)(2)</ref>, <ref href="/us/stat/76/587">76 Stat. 587</ref>, related to allotment percentages, and contained various definitions, prior to the general amendment of this subchapter by <ref href="/us/pl/88/443">Pub. L. 88–443</ref>. See <ref href="/us/usc/t42/s291b">section 291b of this title</ref>.</p>
<p style="-uslm-lc:I21" class="indent0">Provisions similar to those comprising this section were contained in <ref href="/us/usc/t42/s291h/e">section 291h(e) of this title</ref>, <ref href="/us/act/1944-07-01/ch373/tVI/s625">act July 1, 1944, ch. 373, title VI, § 625</ref>, as added <ref href="/us/act/1946-08-13/ch958/s2">Aug. 13, 1946, ch. 958, § 2</ref>, <ref href="/us/stat/60/1041">60 Stat. 1041</ref>; amended <ref href="/us/act/1949-10-25/ch722/s3/c">Oct. 25, 1949, ch. 722, § 3(c)</ref>, <ref href="/us/stat/63/899">63 Stat. 899</ref>, 901; <ref href="/us/act/1954-07-12/ch471/s4/b">July 12, 1954, ch. 471, § 4(b)</ref>, <ref href="/us/stat/68/464">68 Stat. 464</ref>, prior to the general amendment of this subchapter by <ref href="/us/pl/88/443">Pub. L. 88–443</ref>.</p>
</note>
<note style="-uslm-lc:I74" topic="amendments" id="ida4e9b940-09a0-11eb-a85b-f5cef3d06f4d"><heading class="centered smallCaps">Amendments</heading><p style="-uslm-lc:I21" class="indent0">1984—<ref href="/us/pl/98/369">Pub. L. 98–369</ref> amended section generally. Prior to amendment, section read as follows: “If any facility with respect to which funds have been paid under <ref href="/us/usc/t42/s291f">section 291f of this title</ref> shall, at any time within twenty years after the completion of construction—</p>
<p style="-uslm-lc:I22" class="indent1">“(a) be sold or transferred to any person, agency, or organization (1) which is not qualified to file an application under <ref href="/us/usc/t42/s291e">section 291e of this title</ref>, or (2) which is not approved as a transferee by the State agency designated pursuant to <ref href="/us/usc/t42/s291d">section 291d of this title</ref>, or its successor, or</p>
<p style="-uslm-lc:I22" class="indent1">“(b) cease to be a public health center or a public or other nonprofit hospital, outpatient facility, facility for long-term care, or rehabilitation facility, unless the Surgeon General determines, in accordance with regulations, that there is good cause for releasing the applicant or other owner from this obligation,</p>
<p style="-uslm-lc:I33" class="indent0 firstIndent0">the United States shall be entitled to recover from either 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 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 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 under such project or projects. Such right of recovery shall not constitute a lien upon said facility prior to judgment.”</p>
<p style="-uslm-lc:I21" class="indent0">1970—Cl. (b). <ref href="/us/pl/91/296">Pub. L. 91–296</ref> substituted “outpatient facility” for “diagnostic or treatment center”.</p>
</note>
<note style="-uslm-lc:I85" topic="transferOfFunctions" id="ida4e9e051-09a0-11eb-a85b-f5cef3d06f4d">
<heading class="centered smallCaps">Transfer of Functions</heading>
<p style="-uslm-lc:I21" class="indent0">Office of Surgeon General abolished by section 3 of Reorg. Plan No. 3 of 1966, eff. <date date="1966-06-25">June 25, 1966</date>, 31 F.R. 8855, <ref href="/us/stat/80/1610">80 Stat. 1610</ref>, and functions thereof transferred to Secretary of Health, Education, and Welfare by section 1 of Reorg. Plan No. 3 of 1966, set out as a note under <ref href="/us/usc/t42/s202">section 202 of this title</ref>. Secretary of Health, Education, and Welfare redesignated Secretary of Health and Human Services by <ref href="/us/pl/96/88/s509/b">section 509(b) of Pub. L. 96–88</ref> which is classified to <ref href="/us/usc/t20/s3508/b">section 3508(b) of Title 20</ref>, Education. Office of Surgeon General reestablished within the Office of the Assistant Secretary for Health, see Notice of Department of Health and Human Services, Office of the Assistant Secretary for Health, <date date="1987-03-30">Mar. 30, 1987</date>, 52 F.R. 11754.</p>
</note>
<note style="-uslm-lc:I74" topic="miscellaneous" id="ida4e9e052-09a0-11eb-a85b-f5cef3d06f4d"><heading class="centered smallCaps">Regulations and Personnel</heading><p><ref href="/us/pl/98/369/dB/tIII/s2381/c">Pub. L. 98–369, div. B, title III, § 2381(c)</ref>, <date date="1984-07-18">July 18, 1984</date>, <ref href="/us/stat/98/1116">98 Stat. 1116</ref>, provided that: <quotedContent origin="/us/pl/98/369/dB/tIII/s2381/c">“Not later than the expiration of the one-hundred-and-eighty-day period beginning on the date of the enactment of this section [<date date="1984-07-18">July 18, 1984</date>], the Secretary shall have in effect regulations and personnel to place in effect the amendments made by this section [amending sections 291i and 300s–1a of this title].”</quotedContent>
</p>
</note>
</notes>
</section>