PUBLIC LAW 100-203—DEC. 22, 1987
101 STAT. 1330-111
to exclusion from the medicare program under section 1128(a) of the Social Security Act. (c) LIMITATION ON APPLICATION OF 2 PERCENT HOSPITAL LAB DIF-
FERENTIAL.—Section 1833(h)(2) of such Act is amended by striking "hospital laboratory" and inserting "laboratory in a sole community hospital".
42 USC 1395Z.
(d) INTERMEDIATE SANCTIONS.—
(1) Part B of title XVIII of such Act is amended by adding at the end thereof the following new section: "INTERMEDIATE SANCTIONS FOR PROVIDERS OF CLINICAL DIAGNOSTIC LABORATORY TESTS 35b
"SEC. 1846. (a) If the Secretary determines that any provider or 42 USC 1395w-2. clinical laboratory certified for participation under this title no longer substantially meets the conditions of participation specified under this title with respect to the provision of clinical diagnostic laboratory tests under this part, the Secretary may (for a period not to exceed one year) impose intermediate sanctions developed pursut ant to subsection (b), in lieu of canceling immediately the certification of the provider or clinical laboratory. "(b)(1) The Secretary shall develop and implement— "(A) a range of intermediate sanctions to apply to providers or certified clinical laboratories under the conditions described in subsection (a), and "(B) appropriate procedures for appealing determinations relating to the imposition of such sanctions. "(2)(A) The intermediate sanctions developed under paragraph (1) shall include— "(i) directed plans of correction, "(ii) civil fines and penalties, "(iii) payment for the costs of onsite monitoring by an agency responsible for conducting certification surveys, and "(iv) suspension of all or part of the payments to which a provider or certified clinical laboratory would otherwise be entitled under this title with respect to clinical diagnostic laboratory tests provided on or after the date in which the Secretary determines that intermediate sanctions should be imposed pursuant to subsection (a).^* "(B) The sanctions specified in subparagraph (A) are in addition to sanctions otherwise available under State or Federal law. "(3) The Secretary shall develop and implement specific procedures with respect to when and how each of the intermediate sanctions developed under paragraph (1) is to be applied, the amounts of any fines, and the severity of each of these penalties. Such procedures shall be designed so as to minimize the time between identification of violations and imposition of these sanctions and shall provide for the imposition of incrementally more severe fines for repeated or uncorrected deficiencies.". (2) The amendment made by paragraph (1) shall become Effective date. effective on January 1, 1990. 42 USC l395w-2 (e) STATE CERTIFICATION OF HIGH-VOLUME PHYSICIAN OFFICE LABS.—
(1) Section 1861(s) of such Act (42 U.S.C. 1395x(s)) is amended, in the sentence following paragraph (11), by inserting "a labora^""Copy read "TESTS" ". ' • Subparagraphs " '(i)", " '(ii)", " '(iii)", and " '(iv)" indented incorrectly.