124 STAT. 487 PUBLIC LAW 111–148—MAR. 23, 2010 (l) LABORATORY SERVICES.—Section 1833(h)(2)(A) of the Social Security Act (42 U.S.C. 1395l(h)(2)(A)) is amended— (1) in clause (i)— (A) by inserting ‘‘, subject to clause (iv),’’ after ‘‘year) by’’; and (B) by striking ‘‘through 2013’’ and inserting ‘‘and 2010’’; and (2) by adding at the end the following new clause: ‘‘(iv) After determining the adjustment to the fee schedules under clause (i), the Secretary shall reduce such adjustment— ‘‘(I) for 2011 and each subsequent year, by the productivity adjustment described in section 1886(b)(3)(B)(xi)(II); and ‘‘(II) for each of 2011 through 2015, by 1.75 percentage points. Subclause (I) shall not apply in a year where the adjustment to the fee schedules determined under clause (i) is 0.0 or a percentage decrease for a year. The application of the productivity adjustment under subclause (I) shall not result in an adjustment to the fee schedules under clause (i) being less than 0.0 for a year. The application of subclause (II) may result in an adjustment to the fee schedules under clause (i) being less than 0.0 for a year, and may result in payment rates for a year being less than such pay- ment rates for the preceding year.’’. (m) CERTAIN DURABLE MEDICAL EQUIPMENT.—Section 1834(a)(14) of the Social Security Act (42 U.S.C. 1395m(a)(14)) is amended— (1) in subparagraph (K)— (A) by striking ‘‘2011, 2012, and 2013,’’; and (B) by inserting ‘‘and’’ after the semicolon at the end; (2) by striking subparagraphs (L) and (M) and inserting the following new subparagraph: ‘‘(L) for 2011 and each subsequent year— ‘‘(i) the percentage increase in the consumer price index for all urban consumers (United States city aver- age) for the 12-month period ending with June of the previous year, reduced by— ‘‘(ii) the productivity adjustment described in sec- tion 1886(b)(3)(B)(xi)(II).’’; and (3) by adding at the end the following flush sentence: ‘‘The application of subparagraph (L)(ii) may result in the cov- ered item update under this paragraph being less than 0.0 for a year, and may result in payment rates under this sub- section for a year being less than such payment rates for the preceding year.’’. (n) PROSTHETIC DEVICES, ORTHOTICS, AND PROSTHETICS.—Sec- tion 1834(h)(4) of the Social Security Act (42 U.S.C. 1395m(h)(4)) is amended— (1) in subparagraph (A)— (A) in clause (ix), by striking ‘‘and’’ at the end; (B) in clause (x)— (i) by striking ‘‘a subsequent year’’ and inserting ‘‘for each of 2007 through 2010’’; and
