; and (B) the clinical basis on which the organization will determine coverage or payment for such item or service. (2) Qualifying physician defined For purposes of paragraph (1), the term qualifying physician means, with respect to an item or service subject to a process described in such paragraph that a provider of services or supplier is seeking to furnish to an individual, a physician that— (A) possesses a current and nonrestricted license to practice medicine in the State in which such item or service is to be furnished; (B) is actively engaged in the practice of medicine in the same or similar specialty as a provider of services or supplier that would typically furnish such item or service; and (C) is knowledgeable about the furnishing of, and has experience furnishing, such item or service. .