PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2185 (2) EFFECTIVE DATE.— The amendments made by paragraph (1) shall apply to services furnished on or after January 1, 1991. (d) STUDIES. — (1) GAO STUDY OF ALTERNATIVE PAYMENT METHODOLOGY FOR MALPRACTICE COMPONENT. —The Comptroller General shall pro- vide for— (A) a study of alternative ways of paying, under section 1848 of the Social Security Act, for the malpractice compo- nent for physicieuis' services, in a manner that would assure, to the extent practicable, payment for medicare's share of malpractice insurance premiums, and (B) a study to examine alternative resolution procedures for malpractice claims respecting professional services fur- nished under the medicare program. The examination under subparagraph (B) shall include review of the feasibility of establishing procedures that involve no-fault payment or that involve mandatory arbitration. By not later than April 1, 1991, the Comptroller General shall submit a report to Congress on the results of the studies. (2) STUDY OF PAYMENTS TO RISK-CONTRACTING PLANS.—The Secretary of Health and Human Services (in this subsection referred to as the "Secretary") shall conduct a study of how pa3mients under section 1848 of the Social Security Act may affect payments to eligible organizations with risk-sharing con- tracts under section 1876 of such Act. By not later than April 1, 1990, the Secretary shall submit a report to Congress on such study and shall include in the report such recommendations for such changes in the methodology for payment under such risk- sharing contracts as the Secretary deems appropriate. (3) STUDY OF VOLUME PERFORMANCE STANDARD RATES OF IN- CREASE BY GEOGRAPHY, SPECIALTY, AND TYPE OF SERVICE. —The Secretary shall conduct a study of the feasibility of establishing, under section 1848(f) of the Social Security Act, separate performance standard rates of increase for services furnished by or within each of the following (including combinations of the following): (A) Geographic area (such as a region. State, or other area). (B) Specialty or group of specialties of physicisins. (C) T^ype of services (such as primary care, services of hospital-based physicians, and other inpatient services). Such study shall also include the scope of services included within, or excluded from, the rate of increase in expenditure system. By not later than July 1, 1990, the Secretary shall submit a report to Congress on such study and shall include in the report such recommendations respecting the feasibility of establishing separate performance standard rates of increase in expenditures as the Secretary deems appropriate. (4) HHS VISIT CODE MODIFICATION STUDY.— The Secretary shall conduct a study of the desirability of including time as a factor in establishing visit codes. By not later than July 1, 1991, the Secretary shall consult with the Physician Payment Review Commission, and submit a report to Congress on such study and shall include in the report recommendations respecting the desirability of modifying the number of visit codes, whether greater coding uniformity would result from including time in visit codes when compared with clarifying the clinical descrip- 42 USC 1395i note. 42 USC 1395W-4 note. Reports. Reports. Reports. Reports.
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