PUBLIC LAW 103-432—OCT. 31, 1994 108 STAT. 4441 the second opinion was in disagreement with the first opinion". (D) Section 1862(a) (42 U.S.C. 1395y(a)) is amended— (i) by adding "or" at the end of paragraph (14), (ii) by striking "; or" at the end of paragraph (15) and inserting a period, and (iii) by striking paragraph (16). (E) The third sentence of section 1866(a)(2)(A) (42 U.S.C. 1395w(a)(2)(A)) is amended by striking ", with respect to items and services furnished in connection with obtaining a second opinion required under section 1164(c)(2) (or a third opinion, if the second opinion was in disagreement with the first opinion),". (3) EFFECTIVE DATE.— The amendments made by this subsection shall apply to services provided on or after the date of the enactment of this Act. (b) MISCELLANEOUS AND TECHNICAL CORRECTIONS. — (1) The third sentence of section 1156(b)(1) (42 U.S.C. 1320c-5(b)(l)) is amended by striking "whehter" and inserting "whether". (2)(A) Section 1154(a)(9)(B) (42 U.S.C. 1320c-3(a)(9)(B)) is amended to read as follows: "(B) If the organization finds, after reasonable notice to and opportunity for discussion with the physician or practitioner concerned, that the physician or practitioner has furnished services in violation of section 1156(a) and the organization determines that the physician or practitioner should enter into a corrective action plan under section 1156(b)(1), the organization shall notify the State board or boards responsible for the licensing or disciplining of the physician or practitioner of its finding and of any action taken as a result of the finding.". (B) Subparagraph (D) of section 1160(b)(1) (42 U.S.C. 1320c- 9(b)(1)) is amended to read as follows: "(D) to provide notice in accordance with section 1154(a)(9)(B);". (3) Section 4205(d)(2)(B) of OBRA-1990 is amended by striking "amendments" and inserting "amendment". (4) Section 1160(d) (42 U.S.C. 1320c-9(d)) is amended by striking "subpena" and inserting "subpoena". (5) Section 4205(e)(2) of OBRA-1990 is amended by striking "amendments" and inserting "amendment" and by striking "all". (6)(A) Except as provided in subparagraph (B), the amendments made by this subsection shall take effect as if included in the enactment of OBRA-1990. (B) The amendments made by paragraph (2) (relating to the requirement on reporting of information to State boards) shall take effect on the date of the enactment of this Act. SEC. 157. HEALTH MAINTENANCE ORGANIZATIONS. (a) REVISIONS IN THE PAYMENT METHODOLOGY FOR RISK CON- TRACTORS. — Section 4204(b) of OBRA-1990 is amended to read as follows: "(b) REVISIONS IN THE PAYMENT METHODOLOGY FOR RISK CON- TRACTORS. —(1)(A) Not later than October 1, 1995, the Secretary of Health and Human Services (in this subsection referred to as the 'Secretary') shall submit a proposal to the Congress that provides for revisions to the payment method to be applied in years 42 USC 1320C-3 note. 42 USC 1320C-5 note. 42 USC 1320C-9 note. 42 USC 1320C-9 note. Effective date. 42 USC 1395mm note.
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