PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2157
‘‘(I) use data from the Medicaid Statistical Information System (MSIS) and other available data; ‘‘(II) exclude expenditures attributable to covered outpatient prescription drugs that are not covered part D drugs (as defined in section 1860D– 2(e)); and ‘‘(III) reduce such expenditures by the product of such portion and the adjustment factor (described in clause (iii)). ‘‘(iii) ADJUSTMENT FACTOR.—The adjustment factor described in this clause for a State is equal to the ratio for the State for 2003 of— ‘‘(I) aggregate payments under agreements under section 1927; to ‘‘(II) the gross expenditures under this title for covered outpatient drugs referred to in clause (i). Such factor shall be determined based on information reported by the State in the medicaid financial management reports (form CMS–64) for the 4 quarters of calendar year 2003 and such other data as the Secretary may require. ‘‘(C) WEIGHTED AVERAGE.—The weighted average under subparagraph (A) shall be determined taking into account— ‘‘(i) with respect to subparagraph (A)(i), the average number of full-benefit dual eligible individuals in 2003 who are not described in clause (ii); and ‘‘(ii) with respect to subparagraph (A)(ii), the average number of full-benefit dual eligible individuals in such year who received in 2003 medical assistance for covered outpatient drugs through a medicaid managed care plan. ‘‘(4) APPLICABLE GROWTH FACTOR.—The applicable growth factor under this paragraph for— ‘‘(A) each of 2004, 2005, and 2006, is the average annual percent change (to that year from the previous year) of the per capita amount of prescription drug expenditures (as determined based on the most recent National Health Expenditure projections for the years involved); and ‘‘(B) a succeeding year, is the annual percentage increase specified in section 1860D–2(b)(6) for the year. ‘‘(5) FACTOR.—The factor under this paragraph for a month— ‘‘(A) in 2006 is 90 percent; 1⁄3 percent; ‘‘(B) in 2007 is 88 2⁄3 percent; ‘‘(C) in 2008 is 86 ‘‘(D) in 2009 is 85 percent; 1⁄3 percent; ‘‘(E) in 2010 is 83 2⁄3 percent; ‘‘(F) in 2011 is 81 ‘‘(G) in 2012 is 80 percent; 1⁄3 percent; ‘‘(H) in 2013 is 78 2⁄3 percent; or ‘‘(I) in 2014 is 76 ‘‘(J) after December 2014, is 75 percent. ‘‘(6) FULL-BENEFIT DUAL ELIGIBLE INDIVIDUAL DEFINED.—
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