Page:United States Statutes at Large Volume 110 Part 3.djvu/281

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PUBLIC LAW 104-191—AUG. 21, 1996 110 STAT. 2011 "(ii) Federal or State criminal convictions related to the delivery of a health care item or service. "(iii) Actions by Federal or State agencies responsible for the licensing and certification of health care providers, suppliers, and licensed health care practitioners, including— "(I) formal or official actions, such as revocation or suspension of a license (and the length of any such suspension), reprimand, censure or probation, "(ID any other loss of license or the right to apply for, or renew, a license of the provider, supplier, or practitioner, whether by operation of law, voluntary surrender, non-renewability, or otherwise, or "(III) any other negative action or finding by such Federal or State agency that is publicly available information. "(iv) Exclusion from participation in Federal or State health care programs (as defined in sections 1128B(f) and 1128(h), respectively). "(v) Any other adjudicated actions or decisions that the Secretary shall establish by regulation. "(B) EXCEPTION. —The term does not include any action with respect to a malpractice claim. "(2) PRACTITIONER.— The terms 'licensed health care practitioner', licensed practitioner', and 'practitioner' mean, with respect to a State, an individual who is licensed or otherwise authorized by the State to provide health care services (or any individual who, without authority holds himself or herself out to be so licensed or authorized). "(3) GOVERNMENT AGENCY.— The term 'Government agency* shall include: "(A) The Department of Justice. "(B) The Department of Health and Human Services. "(C) Any other Federal agency that either administers or provides payment for the delivery of health care services, including, but not limited to the Department of Defense and the Veterans' Administration. "(D) State law enforcement agencies. "(E) State medicaid fraud control units. "(F) Federal or State agencies responsible for the licensing and certification of health care providers and licensed health care practitioners. "(4) HEALTH PLAN.— The term 'health plan' has the meaning given such term by section 1128C(c). "(5) DETERMINATION OF CONVICTION.—For purposes of paragraph (1), the existence of a conviction shall be determined under paragraph (4) of section 1128(i).". (b) IMPROVED PREVENTION IN ISSUANCE OF MEDICARE PROVIDER NUMBERS. —Section 1842(r) (42 U.S.C. 1395u(r)) is amended by adding at the end the following new sentence: "Under such system, the Secretary may impose appropriate fees on such physicians to cover the costs of investigation and recertification activities with respect to the issuance of the identifiers.".