Page:United States Statutes at Large Volume 113 Part 2.djvu/864

 113 STAT. 1501A-346 PUBLIC LAW 106-113—APPENDIX F "(B) UPDATE ADJUSTMENT FACTOR.—For purposes of subparagraph (A)(ii), subject to subparagraph (D), the 'update adjustment factor' for a year is equal (as estimated by the Secretary) to the sum of the following: "(i) PRIOR YEAR ADJUSTMENT COMPONENT.—An amount determined by— "(I) computing the difference (which may be positive or negative) between the amount of the allowed expenditures for physicians' services for the prior year (as determined under subparagraph (O) and the amount of the actual expenditures for such services for that year; "(II) dividing that difference by the amount of the actual expenditures for such services for that year; and " (III) multiplying that quotient by 0.75. "(ii) CUMULATIVE ADJUSTMENT COMPONENT. —An amount determined by— "(I) computing the difference (which may be positive or negative) between the amount of the allowed expenditures for physicians' services (as determined under subparagraph (O) from April 1, 1996, through the end of the prior year and the amount of the actual expenditures for such services during that period; " (II) dividing that difference by actual expenditures for such services for the prior year as increased by the sustainable growth rate under subsection (f) for the year for which the update adjustment factor is to be determined; and " (III) multiplying that quotient by 0.33. "(C) DETERMINATION OF ALLOWED EXPENDITURES.—For purposes of this paragraph: "(i) PERIOD UP TO APRIL i, 1999. —The allowed expenditures for physicians' services for a period before April 1, 1999, shall be the amount of the allowed expenditures for such period as determined under paragraph (3)(C). "(ii) TRANSITION TO CALENDAR YEAR ALLOWED EXPENDITURES.— Subject to subparagraph (E), the allowed expenditures for— "(I) the 9-month period beginning April 1, 1999, shall be the Secretary's estimate of the amount of the allowed expenditures that would be permitted under paragraph (3)(C) for such period; and "(II) the year of 1999, shall be the Secretary's estimate of the amount of the allowed expenditures that would be permitted under paragraph (3)(C) for such year. "(iii) YEARS BEGINNING WITH 2000. —The allowed expenditures for a year (beginning with 2000) is equal to the allowed expenditures for physicians' services for the previous year, increased by the sustainable growth rate under subsection (f) for the year involved.

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