Title IV, SEC. 4034. REPEAL OF PRO PRECERTIFICATION REQUIREMENT FOR CERTAIN 
SURGICAL PROCEDURES. 
      (a) In General. Section 1164 (42 U.S.C. 1320c	13) is repealed. 

      (b) Conforming Amendments. 

        (1) Section 1154 (42 U.S.C. 1320c	3) is amended 

          (A) in subsection (a), by striking paragraph (12), and 

          (B) in subsection (d), by striking ``(and except as provided in 
        section 1164)''. 

        (2) Section 1833 (42 U.S.C. 1395l) is amended 

          (A) in subsection (a)(1)(D)(i), by striking ``, or for tests 
        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)''; 

          (B) in subsection (a)(1), by striking clause (G); 

          (C) in subsection (a)(2)(A), by striking ``, to items and services 
        (other than clinical diagnostic laboratory tests) 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),''; 

          (D) in subsection (a)(2)(D)(i) 

            (i) by striking ``basis,'' and inserting ``basis or'', and 

            (ii) by striking ``, or for tests 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)''; 

          (E) in subsection (a)(3), by striking ``and for 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)''; and 

          (F) in the first sentence of subsection (b), by striking ``(4)'' and 
        all that follows through ``and (5)'' and inserting and ``(4)''. 

        (3) Section 1834(g)(1)(B) (42 U.S.C. 1395m(g)(1)(B)) is amended by 
      striking ``and for 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)''. 

        (4) Section 1862(a) (42 U.S.C. 1395y(a)) is amended 

          (A) by adding ``or'' at the end of paragraph (14), 

          (B) by striking ``; or'' at the end of paragraph (15) and inserting a 
        period, and 

          (C) by striking paragraph (16). 

        (5) 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),''. 

      (c) Effective Date. The amendments made by this section shall apply to 
    services provided on or after the date of the enactment of this Act.