Page:United States Statutes at Large Volume 124.djvu/977

124 STAT. 951 PUBLIC LAW 111–148—MAR. 23, 2010 (ii) by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and indenting appropriately; and (iii) by adding at the end the following new subparagraph: ‘‘(B) LIMITED ADDITIONAL EXCEPTION.— ‘‘(i) IN GENERAL.—Subject to clause (ii), the Sec- retary shall not implement the recommendations con- tained in a proposal submitted by the Board or the President to Congress pursuant to this section in a proposal year (beginning with proposal year 2019) if— ‘‘(I) the Board was required to submit a pro- posal to Congress under this section in the year preceding the proposal year; and ‘‘(II) the Chief Actuary of the Centers for Medi- care & Medicaid Services makes a determination in the determination year that the growth rate described in subsection (c)(8) exceeds the growth rate described in subsection (c)(6)(A)(i). ‘‘(ii) LIMITED ADDITIONAL EXCEPTION MAY NOT BE APPLIED IN TWO CONSECUTIVE YEARS.—This subpara- graph shall not apply if the recommendations contained in a proposal submitted by the Board or the President to Congress pursuant to this section in the year pre- ceding the proposal year were not required to be imple- mented by reason of this subparagraph. ‘‘(iii) NO AFFECT ON REQUIREMENT TO SUBMIT PRO- POSALS OR FOR CONGRESSIONAL CONSIDERATION OF PRO- POSALS.—Clause (i) and (ii) shall not affect— ‘‘(I) the requirement of the Board or the Presi- dent to submit a proposal to Congress in a proposal year in accordance with the provisions of this sec- tion; or ‘‘(II) Congressional consideration of a legisla- tive proposal (described in subsection (c)(3)(B)(iv)) contained such a proposal in accordance with sub- section (d).’’; (4) in subsection (f)(3)(B)— (A) by striking ‘‘or advisory reports to Congress’’ and inserting ‘‘, advisory reports, or advisory recommendations’’; and (B) by inserting ‘‘or produce the public report under subsection (n)’’ after ‘‘this section’’; and (5) by adding at the end the following new subsections: ‘‘(n) ANNUAL PUBLIC REPORT.— ‘‘(1) IN GENERAL.—Not later than July 1, 2014, and annually thereafter, the Board shall produce a public report containing standardized information on system-wide health care costs, patient access to care, utilization, and quality-of- care that allows for comparison by region, types of services, types of providers, and both private payers and the program under this title. ‘‘(2) REQUIREMENTS.—Each report produced pursuant to paragraph (1) shall include information with respect to the following areas: ‘‘(A) The quality and costs of care for the population at the most local level determined practical by the Board Determination.