42 CFR §493.37

1. (a)HHS will issue a certificate of waiver to a laboratory only if the laboratory meets the requirements of § 493.35.
2. (b)Laboratories issued a certificate of waiver—
   1. (1)Are subject to the requirements of this subpart and § 493.15(e) of subpart A of this part; and
   2. (2)Must permit announced or unannounced inspections by HHS in accordance with subpart Q of this part.
3. (c)Laboratories must remit the certificate of waiver fee specified in subpart F of this part.
4. (d)In accordance with subpart R of this part, HHS will suspend or revoke or limit a laboratory's certificate of waiver for failure to comply with the requirements of this subpart. In addition, failure to meet the requirements of this subpart will result in suspension or denial of payments under Medicare and Medicaid in accordance with subpart R of this part.
5. (e)
   1. (1)A certificate of waiver issued under this subpart is valid for no more than 2 years. In the event of a non-compliance determination resulting in HHS action to revoke, suspend, or limit the laboratory's certificate of waiver, HHS will provide the laboratory with a statement of grounds on which the determination of non-compliance is based and offer an opportunity for appeal as provided in subpart R of this part.
   2. (2)If the laboratory requests a hearing within the time specified by HHS, it retains its certificate of waiver or reissued certificate of waiver until a decision is made by an administrative law judge, as specified in subpart R of this part, except when HHS finds that conditions at the laboratory pose an imminent and serious risk to human health.
   3. (3)For laboratories receiving payment from the Medicare or Medicaid program, such payments will be suspended on the effective date specified in the notice to the laboratory of a non-compliance determination even if there has been no appeals decision issued.
6. (f)A laboratory seeking to renew its certificate of waiver must—
   1. (1)Complete the renewal application prescribed by HHS and return it to HHS not less than 9 months nor more than 1 year before the expiration of the certificate; and
   2. (2)Meet the requirements of §§ 493.35 and 493.37.
7. (g)A laboratory with a certificate of waiver that wishes to perform examinations or tests not listed in the waiver test category must meet the requirements set forth in subpart C or subpart D of this part, as applicable.