the body for therapeutic purposes or for enabling the production of a useful image for use in a diagnosis of a medical condition.

“(D) RECIPIENT COUNTRY.—The term ‘recipient country’ means Canada, Belgium, France, Germany, and the Netherlands.

“(2) LICENSES.—The Commission may issue a license authorizing the export (including shipment to and use at intermediate and ultimate consignees specified in the license) to a recipient country of highly enriched uranium for medical isotope production if, in addition to any other requirements of this Act (except subsection a.), the Commission determines that—

“(A) a recipient country that supplies an assurance letter to the United States Government in connection with the consideration by the Commission of the export license application has informed the United States Government that any intermediate consignees and the ultimate consignee specified in the application are required to use the highly enriched uranium solely to produce medical isotopes; and

“(B) the highly enriched uranium for medical isotope production will be irradiated only in a reactor in a recipient country that—

“(i) uses an alternative nuclear reactor fuel; or

“(ii) is the subject of an agreement with the United States Government to convert to an alternative nuclear reactor fuel when alternative nuclear reactor fuel can be used in the reactor.

“(3) REVIEW OF PHYSICAL PROTECTION REQUIREMENTS.—

“(A) IN GENERAL.—The Commission shall review the adequacy of physical protection requirements that, as of the date of an application under paragraph (2), are applicable to the transportation and storage of highly enriched uranium for medical isotope production or control of residual material after irradiation and extraction of medical isotopes.

“(B) IMPOSITION OF ADDITIONAL REQUIREMENTS.—If the Commission determines that additional physical protection requirements are necessary (including a limit on the quantity of highly enriched uranium that may be contained in a single shipment), the Commission shall impose such requirements as license conditions or through other appropriate means.

“(4) FIRST REPORT TO CONGRESS.—

“(A) NAS STUDY.—The Secretary shall enter into an