124 STAT. 484 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(i) for the rate year beginning in 2012 and each subsequent rate year, by the productivity adjustment described in section 1886(b)(3)(B)(xi)(II); and ‘‘(ii) for each of the rate years beginning in 2010 through 2019, by the other adjustment described in paragraph (3). ‘‘(B) SPECIAL RULE.—The application of this paragraph may result in such update being less than 0.0 for a rate year, and may result in payment rates under the system described in paragraph (1) for a rate year being less than such payment rates for the preceding rate year. ‘‘(3) OTHER ADJUSTMENT.— ‘‘(A) IN GENERAL.—For purposes of paragraph (2)(A)(ii), the other adjustment described in this paragraph is— ‘‘(i) for each of the rate years beginning in 2010 and 2011, 0.25 percentage point; and ‘‘(ii) subject to subparagraph (B), for each of the rate years beginning in 2012 through 2019, 0.2 percent- age point. ‘‘(B) REDUCTION OF OTHER ADJUSTMENT.—Subpara- graph (A)(ii) shall be applied with respect to any of rate years 2014 through 2019 by substituting ‘0.0 percentage points’ for ‘0.2 percentage point’, if for such rate year— ‘‘(i) the excess (if any) of— ‘‘(I) the total percentage of the non-elderly insured population for the preceding rate year (based on the most recent estimates available from the Director of the Congressional Budget Office before a vote in either House on the Patient Protec- tion and Affordable Care Act that, if determined in the affirmative, would clear such Act for enroll- ment); over ‘‘(II) the total percentage of the non-elderly insured population for such preceding rate year (as estimated by the Secretary); exceeds ‘‘(ii) 5 percentage points.’’. (g) HOSPICE CARE.—Section 1814(i)(1)(C) of the Social Security Act (42 U.S.C. 1395f(i)(1)(C)), as amended by section 3132, is amended by adding at the end the following new clauses: ‘‘(iv) After determining the market basket percentage increase under clause (ii)(VII) or (iii), as applicable, with respect to fiscal year 2013 and each subsequent fiscal year, the Secretary shall reduce such percentage— ‘‘(I) for 2013 and each subsequent fiscal year, by the produc- tivity adjustment described in section 1886(b)(3)(B)(xi)(II); and ‘‘(II) subject to clause (v), for each of fiscal years 2013 through 2019, by 0.5 percentage point. The application of this clause may result in the market basket percentage increase under clause (ii)(VII) or (iii), as applicable, being less than 0.0 for a fiscal year, and may result in payment rates under this subsection for a fiscal year being less than such payment rates for the preceding fiscal year. ‘‘(v) Clause (iv)(II) shall be applied with respect to any of fiscal years 2014 through 2019 by substituting ‘0.0 percentage points’ for ‘0.5 percentage point’, if for such fiscal year— ‘‘(I) the excess (if any) of— Applicability.
