Page:United States Statutes at Large Volume 124.djvu/520

 124 STAT. 494 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(II) take into account any delivery system reforms or other payment changes that have been enacted or published in final rules but not yet implemented as of the making of such calculation. ‘‘(C) MEDICARE PER CAPITA TARGET GROWTH RATE.— For purposes of this section, the Medicare per capita target growth rate for an implementation year shall be calculated as the projected 5-year average (ending with such year) percentage increase in— ‘‘(i) with respect to a determination year that is prior to 2018, the average of the projected percentage increase (if any) in— ‘‘(I) the Consumer Price Index for All Urban Consumers (all items; United States city average); and ‘‘(II) the medical care expenditure category of the Consumer Price Index for All Urban Con- sumers (United States city average); and ‘‘(ii) with respect to a determination year that is after 2017, the nominal gross domestic product per capita plus 1.0 percentage point. ‘‘(7) SAVINGS REQUIREMENT.— ‘‘(A) IN GENERAL.—If, with respect to a determination year, the Chief Actuary of the Centers for Medicare & Medicaid Services makes a determination under paragraph (6)(A) that the growth rate described in clause (i) of such paragraph exceeds the growth rate described in clause (ii) of such paragraph, the Chief Actuary shall establish an applicable savings target for the implementation year. ‘‘(B) APPLICABLE SAVINGS TARGET.—For purposes of this section, the applicable savings target for an implementation year shall be an amount equal to the product of— ‘‘(i) the total amount of projected Medicare program spending for the proposal year; and ‘‘(ii) the applicable percent for the implementation year. ‘‘(C) APPLICABLE PERCENT.—For purposes of subpara- graph (B), the applicable percent for an implementation year is the lesser of— ‘‘(i) in the case of— ‘‘(I) implementation year 2015, 0.5 percent; ‘‘(II) implementation year 2016, 1.0 percent; ‘‘(III) implementation year 2017, 1.25 percent; and ‘‘(IV) implementation year 2018 or any subse- quent implementation year, 1.5 percent; and ‘‘(ii) the projected excess for the implementation year (expressed as a percent) determined under subparagraph (A). ‘‘(8) PER CAPITA RATE OF GROWTH IN NATIONAL HEALTH EXPENDITURES.—In each determination year (beginning in 2018), the Chief Actuary of the Centers for Medicare & Med- icaid Services shall project the per capita rate of growth in national health expenditures for the implementation year. Such rate of growth for an implementation year shall be calculated as the projected 5-year average (ending with such year) percent- age increase in national health care expenditures. Effective date.