HEALTH MAINTENANCE ORGANIZATIONS.

SEC. 157. HEALTH MAINTENANCE ORGANIZATIONS. (a) Revisions in the Payment Methodology for Risk Contractors.— Section 4204(b) of OBRA-1990 is amended to read as follows: “(b) Revisions in the Payment Methodology for Risk Contractors.— (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 years108 STAT. 4442 beginning with 1997 for organizations with a risk-sharing contract under section 1876(g) of the Social Security Act. “(B) In proposing the revisions required under subparagraph (A), the Secretary shall consider— “(i) the difference in costs associated with medicare beneficiaries with differing health status and demographic characteristics; and “(ii) the effects of using alternative geographic classifications on the determinations of costs associated with beneficiaries residing in different areas. “(2) Not later than 3 months after the date of submittal of the proposal under paragraph (1), the Comptroller General shall review the proposal and shall report to Congress on the appropriateness of the proposed modifications.”. (b) Miscellaneous and Technical Corrections.— (1) Section 1876(a)(3) (42 U.S.C. 1395mm(a)(3)) is amended by striking “subsection (c)(7)” and inserting “subsections (c)(2)(B)(ii) and (c)(7)”. (2) Section 4204(c)(3) of OBRA-1990 is amended by striking “for 1991” and inserting “for years beginning with 1991”. (3) Section 4204(d)(2) of OBRA-1990 is amended by striking “amendment” and inserting “amendments”. (4) Section 1876(a)(1)(E)(ii)(I) (42 U.S.C. 1395mm(a)(l)€(ii)(I)) is amended by striking the comma after “contributed to”. (5) Section 4204(e)(2) of OBRA-1990 is amended by striking “(which has a risk-sharing contract under section 1876 of the Social Security Act)”. (6) Section 4204(f)(4) of OBRA-1990 is amended by striking “final”. (7) Section 1862(b)(3)(C) (42 U.S.C. 1395y(b)(3)(C)) is amended— (A) in the heading, by striking “plan” and inserting “plan or a large group health plan”; (B) by striking “group health plan” and inserting “group health plan or a large group health plan”; (C) by striking “, unless such incentive is also offered to all individuals who are eligible for coverage under the plan”; and (D) by striking “the first sentence of subsection (a) and other than subsection (b)” and inserting “subsections (a) and (b)”. (8) The amendments made by this subsection shall take effect as if included in the enactment of OBRA-1990.