Page:United States Statutes at Large Volume 124.djvu/506

 124 STAT. 480 PUBLIC LAW 111–148—MAR. 23, 2010 1, 2011, shall be determined as if subparagraph (A) had never applied.’’. Subtitle E—Ensuring Medicare Sustainability SEC. 3401. REVISION OF CERTAIN MARKET BASKET UPDATES AND INCORPORATION OF PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATES THAT DO NOT ALREADY INCORPORATE SUCH IMPROVEMENTS. (a) INPATIENT ACUTE HOSPITALS.—Section 1886(b)(3)(B) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(B)), as amended by section 3001(a)(3), is further amended— (1) in clause (i)(XX), by striking ‘‘clause (viii)’’ and inserting ‘‘clauses (viii), (ix), (xi), and (xii)’’; (2) in the first sentence of clause (viii), by inserting ‘‘of such applicable percentage increase (determined without regard to clause (ix), (xi), or (xii))’’ after ‘‘one-quarter’’; (3) in the first sentence of clause (ix)(I), by inserting ‘‘(deter- mined without regard to clause (viii), (xi), or (xii))’’ after ‘‘clause (i)’’ the second time it appears; and (4) by adding at the end the following new clauses: ‘‘(xi)(I) For 2012 and each subsequent fiscal year, after deter- mining the applicable percentage increase described in clause (i) and after application of clauses (viii) and (ix), such percentage increase shall be reduced by the productivity adjustment described in subclause (II). ‘‘(II) The productivity adjustment described in this subclause, with respect to a percentage, factor, or update for a fiscal year, year, cost reporting period, or other annual period, is a productivity adjustment equal to the 10-year moving average of changes in annual economy-wide private nonfarm business multi-factor produc- tivity (as projected by the Secretary for the 10-year period ending with the applicable fiscal year, year, cost reporting period, or other annual period). ‘‘(III) The application of subclause (I) may result in the applicable percentage increase described in clause (i) being less than 0.0 for a fiscal year, and may result in payment rates under this section for a fiscal year being less than such payment rates for the preceding fiscal year. ‘‘(xii) After determining the applicable percentage increase described in clause (i), and after application of clauses (viii), (ix), and (xi), the Secretary shall reduce such applicable percentage increase— ‘‘(I) for each of fiscal years 2010 and 2011, by 0.25 percent- age point; and ‘‘(II) subject to clause (xiii), for each of fiscal years 2012 through 2019, by 0.2 percentage point. The application of this clause may result in the applicable percent- age increase described in clause (i) being less than 0.0 for a fiscal year, and may result in payment rates under this section for a fiscal year being less than such payment rates for the preceding fiscal year. ‘‘(xiii) Clause (xii) shall be applied with respect to any of fiscal years 2014 through 2019 by substituting ‘0.0 percentage points’ for ‘0.2 percentage point’, if for such fiscal year— Applicability.