124 STAT. 1039 PUBLIC LAW 111–152—MAR. 30, 2010 ‘‘(II) actuarially equivalent (using processes and methods established under section 1860D– 11(c)) to an average expected payment of such percentage of such costs, for covered part D drugs that are applicable drugs under section 1860D– 14A(g)(2). ‘‘(ii) APPLICABLE GAP PERCENTAGE.—The applicable gap percentage specified in this clause for— ‘‘(I) 2013 and 2014 is 97.5 percent; ‘‘(II) 2015 and 2016 is 95 percent; ‘‘(III) 2017 is 90 percent; ‘‘(IV) 2018 is 85 percent; ‘‘(V) 2019 is 80 percent; and ‘‘(VI) 2020 and each subsequent year is 75 percent.’’; (D) in paragraph (3)(A), as restored under subsection (a)(2), by striking ‘‘paragraph (4)’’ and inserting ‘‘para- graphs (2)(C), (2)(D), and (4)’’; and (E) in paragraph (4)(E), by inserting before the period at the end the following: ‘‘, except that incurred costs shall not include the portion of the negotiated price that represents the reduction in coinsurance resulting from the application of paragraph (2)(D)’’; and (4) in section 1860D–22(a)(2)(A), by inserting before the period at the end the following: ‘‘, not taking into account the value of any discount or coverage provided during the gap in prescription drug coverage that occurs between the initial coverage limit under section 1860D–2(b)(3) during the year and the out-of-pocket threshold specified in section 1860D– 2(b)(4)(B)’’. (c) CONFORMING AMENDMENT TO AMP UNDER MEDICAID.—Sec- tion 1927(k)(1)(B)(i) of the Social Security Act (42 U.S.C. 1396r– 8(k)(1)(B)(i)), as amended by section 2503(a)(2)(B) of the Patient Protection and Affordable Care Act, is amended— (1) by striking ‘‘and’’ at the end of subclause (III); (2) by striking the period at the end of subclause (IV); and (3) by adding at the end the following new subclause: ‘‘(V) discounts provided by manufacturers under section 1860D–14A.’’. (d) REDUCING GROWTH RATE OF OUT-OF-POCKET COST THRESHOLD.—Section 1860D–2(b) of the Social Security Act (42 U.S.C. 1395w–102(b)) is amended— (1) in paragraph (4)(B)(i)— (A) in subclause (I), by striking ‘‘or’’ at the end; (B) by redesignating subclause (II) as subclause (VI); and (C) by inserting after subclause (I) the following new subclauses: ‘‘(II) for each of years 2007 through 2013, is equal to the amount specified in this subparagraph for the previous year, increased by the annual percentage increase described in paragraph (6) for the year involved; ‘‘(III) for 2014 and 2015, is equal to the amount specified in this subparagraph for the previous year, increased by the annual percentage increase 42 USC 1395w–132.
