(4) in subsection (d) (as so redesignated by
paragraph (3)) by amending paragraph (1) to read
as follows:
‘‘(1) in connection with claims presented under
this chapter, that a provider has charged for a
health care service or supply which the provider
knows or should have known involves—
‘‘(A) an item or service not provided as
claimed,
‘‘(B) charges in violation of applicable
charge limitations under section 8904(b), or
‘‘(C) an item or service furnished during a
period in which the provider was debarred from
participation under this chapter pursuant to a
determination by the Office under this section,
other than as permitted under subsection
(g)(2)(B);’’;
(5) in subsection (f) (as so redesignated by
paragraph (3)) by inserting after ‘‘under this sec-
tion’’ the first place it appears the following:
‘‘(where such debarment is not mandatory)’’;
(6) in subsection (g) (as so redesignated by
paragraph (3))—
(A) by striking ‘‘(g)(1)’’ and all that fol-
lows through the end of paragraph (1) and in-
serting the following:
‘‘(g)(1)(A) Except as provided in subparagraph (B),
debarment of a provider under subsection (b) or (c) shall
be effective at such time and upon such reasonable notice
to such provider, and to carriers and covered individuals,
as shall be specified in regulations prescribed by the Of-
fice. Any such provider that is debarred from participation
may request a hearing in accordance with subsection
(h)(1).
‘‘(B) Unless the Office determines that the health or
safety of individuals receiving health care services war-
rants an earlier effective date, the Office shall not make
a determination adverse to a provider under subsection
(c)(5) or (d) until such provider has been given reasonable
notice and an opportunity for the determination to be
made after a hearing as provided in accordance with sub-
section (h)(1).’’;
(B) in paragraph (3)—
(i) by inserting ‘‘of debarment’’ after
‘‘notice’’; and
(ii) by adding at the end the follow-
ing: ‘‘In the case of a debarment under
paragraph (1), (2), (3), or (4) of sub-
section (b), the minimum period of debar-
ment shall not be less than 3 years, except
as provided in paragraph (4)(B)(ii).’’;
(C) in paragraph (4)(B)(i)(I) by striking
‘‘subsection (b) or (c)’’ and inserting ‘‘sub-
section (b), (c), or (d)’’; and
(D) by striking paragraph (6);
(7) in subsection (h) (as so redesignated by
paragraph (3)) by striking ‘‘(h)(1)’’ and all that fol-
lows through the end of paragraph (2) and inserting
the following:
‘‘(h)(1) Any provider of health care services or sup-
plies that is the subject of an adverse determination by
the Office under this section shall be entitled to reasonable
notice and an opportunity to request a hearing of record,
and to judicial review as provided in this subsection after
the Office renders a final decision. The Office shall grant
a request for a hearing upon a showing that due process
rights have not previously been afforded with respect to
any finding of fact which is relied upon as a cause for
an adverse determination under this section. Such hearing
shall be conducted without regard to subchapter II of
chapter 5 and chapter 7 of this title by a hearing officer
who shall be designated by the Director of the Office and
who shall not otherwise have been involved in the adverse
determination being appealed. A request for a hearing
under this subsection shall be filed within such period and
in accordance with such procedures as the Office shall pre-
scribe by regulation.
‘‘(2) Any provider adversely affected by a final deci-
sion under paragraph (1) made after a hearing to which
such provider was a party may seek review of such deci-
sion in the United States District Court for the District
of Columbia or for the district in which the plaintiff re-
sides or has his or her principal place of business by filing
a notice of appeal in such court within 60 days after the
date the decision is issued, and by simultaneously sending
copies of such notice by certified mail to the Director of
the Office and to the Attorney General. In answer to the
appeal, the Director of the Office shall promptly file in
such court a certified copy of the transcript of the record,
if the Office conducted a hearing, and other evidence upon
which the findings and decision complained of are based.
The court shall have power to enter, upon the pleadings
and evidence of record, a judgment affirming, modifying,
or setting aside, in whole or in part, the decision of the
Office, with or without remanding the case for a rehear-
ing. The district court shall not set aside or remand the
decision of the Office unless there is not substantial evi-
dence on the record, taken as whole, to support the find-
ings by the Office of a cause for action under this section
or unless action taken by the Office constitutes an abuse
of discretion.’’; and
(8) in subsection (i) (as so redesignated by
paragraph (3))—
(A) by striking ‘‘subsection (c)’’ and in-
serting ‘‘subsection (d)’’; and
(B) by adding at the end the following:
‘‘The amount of a penalty or assessment as fi-
nally determined by the Office, or other amount
the Office may agree to in compromise, may be
deducted from any sum then or later owing by
the United States to the party against whom
the penalty or assessment has been levied.’’.
(b) EFFECTIVE DATE.—
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section
shall take effect on the date of the enactment of this
Act.
(2) EXCEPTIONS.—(A) Paragraphs (2), (3),
and (5) of section 8902a(c) of title 5, United States
Code, as amended by subsection (a)(3), shall apply
only to the extent that the misconduct which is the
basis for debarment under such paragraph (2), (3),