101 STAT. 686 K j',
Infra. ^
21 USC 824.
PUBLIC LAW 100-93—AUG. 18, 1987
"(A) there is no basis under subsection (a) or (b) or section 1128A(a) for a Continuation of the exclusion, and "(B) there are reasonable assurances that the types of actions ,,- which formed the basis for the original exclusion have not recurred and will not recur. "(3) The Secretary shall promptly notify each appropriate State agency administering or supervising the administration of each State health care program (and, in the case of an exclusion effected pursuant to subsection (a) and to which section 304(a)(5) of the Controlled Substances Act may apply, the Attorney General) of the fact and circumstances of each termination of exclusion made under this subsection. "(h) DEFINITION OF STATE HEALTH CARE PROGRAM.—For purposes
Post, p. 689. 42 USC 1396. 42 USC 701. 42 USC 1397.
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of this section and sections 1128A and 1128B, the term 'State health care program' means— "(1) a State plan approved under title XIX, "(2) any program receiving funds under title V or from an allotment to a State under such title, or "(3) any program receiving funds under title XX or from an allotment to a State under such title, "(i) CONVICTED DEFINED.—For purposes of subsections (a) and (b), a physician or other individual is considered to have been 'convicted' of a criminal offense— "(1) when a judgment of conviction has been entered against the physician or individual by a Federal, State, or local court,
- regardless of whether there is an appeal pending or whether the
judgment of conviction or other record relating to criminal conduct has been expunged; "(2) when there has been a finding of guilt against the physician or individual by a Federal, State, or local court; "(3) when a plea of guilty or nolo contendere by the physician or individual has been accepted by a Federal, State, or local court; or
"(4) when the physician or individual has entered into participation in a first offender or other program where judgment of conviction has been withheld.". SEC. 3. CIVIL MONETARY PENALTIES.
(a) GROUNDS FOR IMPOSITION.—(1) Section 1128A(a)(l) (42 U.S.C. 1320a-7a(a)(l)) is amended by striking "the Secretary determines" and all that follows through "; or" and inserting ' the Secretary determines— "(A) is for a medical or other item or service that the person knows or has reason to know was not provided as o,, - claimed, "(B) is for a medical or other item or service and the person knows or has reason to know the claim is false or ^ fraudulent, "(C) is presented for a physician's service (or an item or service incident to a physician's service) by a person who knows or has reason to know that the individual who furnished (or supervised the furnishing of) the service— "(i) was not licensed as a physician, "(ii) was licensed as a physician, but such license had ,, been obtained through a misrepresentation of material / \ fact (including cheating on an examination required for licensing), or "(iii) represented to the patient at the time the
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