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The Commissioner may require the payment of a surcharge as a condition of accepting within such six-month grace period the late payment of the applicable maintenance fee . It may require the use of a pacemaker or powerful heart medications . If concerned about project risks and the adequacy of contingencies , FTA may require the creation of a capital reserve account of potential revenue sources to offset potential cost overruns in excess of the sources identified in the FFGA . Depending on inter alia " the degree of interactivity involved " and the " nature of the visual images produced " the OFLC may require the material to be resubmitted as a computer game . Such treatment may require the coordinated efforts of a team of medical professionals , such as pediatricians ; surgeons ; physicians who diagnose and treat heart abnormalities ( cardiologists ) ; and / or other health care professionals .