101 STAT. 684
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42 USC 1395, 1^96.
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except that (A) the Secretary shall not exclude pursuant to this paragraph a physician who is the sole community physician or sole source of essential specialized services in a community if a State requests that the physician not be excluded, and (B) the Secretary shall take into account, in determining whether to exclude any other physician pursuant to this paragraph, access of beneficiaries to physician services for which payment may be made under title XVIII or XIX. "(c) NOTICE, EFFECTIVE DATE, AND P E R I O D OF EXCLUSION.—(1) An
Post, p. 686.
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PUBLIC LAW 100-93—AUG. 18, 1987
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exclusion under this section or under section 1128A shall be effective a t such t i m e and upon such reasonable notice to the public and to the individual or entity excluded a s may be specified in regulations consistent with paragraph (2). "(2)(A) Except a s provided in subparagraph (B), such a n exclusion shall be effective with respect to services furnished to a n individual on or after the effective date of the exclusion. "(B) Unless the Secretary determine s that the health and safety of individuals receiving services w a r r a n t s the exclusion taking effect earlier, a n exclusion shall not apply to payments made under title XVIII or under a State health care program for— "(i) inpatient institutional services furnished to a n individual who w a s admitted to such institution before the date of the exclusion, or "(ii) home health services and hospice care furnished to a n individual under a plan of care established before the date of the exclusion, until the passage of 30 days after the effective date of the exclusion. "(3)(A) The Secretary shall specify, in the notice of exclusion under paragraph (1) and the w r i t t e n notice under section 1128A, the minimum period (or, in the case of a n exclusion of a n individual under subsection (b)(12), the period) of the exclusion. "(B) In the case of a n exclusion under subsection (a), the minimum period of exclusion shall be not less than five years, except that, upon the request of a State, the Secretary may waive the exclusion under subsection (a)(1) in the case of a n individual or entity that is the sole community physician or sole source of essential specialized services in a community. The Secretary's decision w h e the r to waive the exclusion shall not be reviewable. "(C) In the case of a n exclusion of a n individual under subsection (b)(12), the period of the exclusion shall be equal to the s u m of— "(i) the length of the period in which the individual failed to g r a n t the immediate access described in that subsection, and "(ii) a n additional period, not to exceed 90 days, set by the Secretary. "(d) NOTICE TO STATE A G E N C I E S A N D EXCLUSION U N D E R STATE J H E A L T H CARE PROGRAMS.—(1) Subject to paragraph (3), the Sec-
'^[','"•,*, r e t a r y shall exercise the authority under subsection (b) in a m a n n e r f < that results in a n individual's or entity's exclusion from all the ••Hh. programs under title XVIII and all the State health care programs in which the individual or entity may otherwise participate. "(2) The Secretary shall promptly notify each a p p r o p r i a t e State agency administering or supervising the administration of each State health care program (and, in the case of a n exclusion effected pursuant to subsection (a) and to which section 304(a)(5) of the 21 USC 824. Controlled Substances Act may apply, the Attorney General)—
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