Page:United States Statutes at Large Volume 95.djvu/817

 PUBLIC LAW 97-35—AUG. 13, 1981 as a defense to a civil action by the United States to collect a penalty or assessment assessed under this section. "(g) Whenever the Secretary's determination to impose a penalty or assessment under subsection (a) becomes final, he shall notify the appropriate State or local medical or professional organization, and the appropriate Professional Standards Review Organization, and the appropriate State or local licensing agency or organization (including the agency specified in section 1864(a) and 1902(a)(33)) that such a penalty or assessment has become final and the reasons therefor. "(h) For the purposes of this subsection: "(1) The term 'State agency' means the agency established or designated to administer or supervise the administration of the State plan under title XIX of this Act or designated to administer the State's program under title V of this Act. "(2) The term 'claim' means an application submitted by— "(A) a provider of services or other person, agency, or organization that furnishes an item or service under title XVIII of this Act, or "(B) a person, agency, or organization that furnishes an item or service for which medical assistance is provided under title XIX of this Act, or "(C) a person, agency, or organization that provides an item or service for which payment is made under title V of this Act or from an allotment to a State under such title, to the United States or a State agency, or agent thereof, for payment for health care services under title XVIII or XIX of this Act or for any item or service under title V of this Act. "(3) The term 'item or service' includes (A) any particular item, device, medical supply, or service claimed to have been provided to a patient and listed in an itemized claim for payment, and (B) in the case of a claim based on costs, any entry in the cost report, books of account or other documents supporting such claim. "(4) The term 'agency of the United States' includes any contractor acting as a fiscal intermediary, carrier, or fiscal agent or any other claims processing agent for a health insurance or medical services program under title XVIII or XIX of this Act.". (b) Section 1128 of such Act is amended— (1) by striking out ", for such period as he may deem appropriate," in subsection (a)(D, (2) by striking out "subsection (a)" in subsection (c) and inserting in lieu thereof "subsection (a) or (b)", (3) by redesignating subsections (b) and (c) as subsections (c) and (d), respectively, and (4) by inserting after subsection (a) the following new subsection: "(b) Whenever the Secretary makes a final determination to impose a civil money penalty or assessment against a person (including an organization, agency, or other entity) under section 1128A relating to a claim under title XVIII or XIX, the Secretary— ' (1) may bar the person from participation in the program under title XVIII, and "(2)(A) shall promptly notify each appropriate State agency administering or supervising the administration of a State plan approved under title XIX of the fact and circumstances of such determination, and (except as provided in subparagraph (B)) may require each such agency to bar the person from participation in the program established by such plan for such period as he shall

9-194 O—82

52:QL3

95 STAT. 791

42 USC 1395aa, 1396a. Definitions. 42 USC 1396. 42 USC 701.

42 USC 1395.

94 Stat. 2619. 42 USC 1320a-7.

�