Page:United States Statutes at Large Volume 124.djvu/774

124 STAT. 748 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(B) LEVEL OF SCREENING.—The Secretary shall deter- mine the level of screening conducted under this paragraph according to the risk of fraud, waste, and abuse, as deter- mined by the Secretary, with respect to the category of provider of medical or other items or services or supplier. Such screening— ‘‘(i) shall include a licensure check, which may include such checks across States; and ‘‘(ii) may, as the Secretary determines appropriate based on the risk of fraud, waste, and abuse described in the preceding sentence, include— ‘‘(I) a criminal background check; ‘‘(II) fingerprinting; ‘‘(III) unscheduled and unannounced site visits, including preenrollment site visits; ‘‘(IV) database checks (including such checks across States); and ‘‘(V) such other screening as the Secretary determines appropriate. ‘‘(C) APPLICATION FEES.— ‘‘(i) INDIVIDUAL PROVIDERS.—Except as provided in clause (iii), the Secretary shall impose a fee on each individual provider of medical or other items or services or supplier (such as a physician, physician assistant, nurse practitioner, or clinical nurse specialist) with respect to which screening is conducted under this paragraph in an amount equal to— ‘‘(I) for 2010, $200; and ‘‘(II) for 2011 and each subsequent year, the amount determined under this clause for the pre- ceding year, adjusted by the percentage change in the consumer price index for all urban con- sumers (all items; United States city average) for the 12-month period ending with June of the pre- vious year. ‘‘(ii) INSTITUTIONAL PROVIDERS.—Except as pro- vided in clause (iii), the Secretary shall impose a fee on each institutional provider of medical or other items or services or supplier (such as a hospital or skilled nursing facility) with respect to which screening is conducted under this paragraph in an amount equal to— ‘‘(I) for 2010, $500; and ‘‘(II) for 2011 and each subsequent year, the amount determined under this clause for the pre- ceding year, adjusted by the percentage change in the consumer price index for all urban con- sumers (all items; United States city average) for the 12-month period ending with June of the pre- vious year. ‘‘(iii) HARDSHIP EXCEPTION; WAIVER FOR CERTAIN MEDICAID PROVIDERS.—The Secretary may, on a case- by-case basis, exempt a provider of medical or other items or services or supplier from the imposition of an application fee under this subparagraph if the Sec- retary determines that the imposition of the application fee would result in a hardship. The Secretary may Determination. Determination.