PUBLIC LAW 106-113—APPENDIX F 113 STAT. 1501A-347 " (D) RESTRICTION ON UPDATE ADJUSTMENT FACTOR. — The update adjustment factor determined under subparagraph (B) for a year may not be less than -0.07 or greater than 0.03. "(E) RECALCULATION OF ALLOWED EXPENDITURES FOR UPDATES BEGINNING WITH 2001. —For purposes of determining the update adjustment factor for a year beginning with 2001, the Secretary shall recompute the allowed expenditures for previous periods beginning on or after April 1, 1999, consistent with subsection (f)(3). " (F) TRANSITIONAL ADJUSTMENT DESIGNED TO PROVIDE FOR BUDGET NEUTRALITY.—Under this subparagraph the Secretary shall provide for an adjustment to the update under subparagraph (A)— "(i) for each of 2001, 2002, 2003, and 2004, of - 0.2 percent; and "(ii) for 2005 of+0.8 percent.". (2) PUBLICATION CHANGE.— (A) IN GENERAL. — Section 1848(d)(1)(E) (42 U.S.C. 1395w-4(d)(l)(E)) is amended to read as follows: " (E) PUBLICATION AND DISSEMINATION OF INFORMA- TION.—The Secretary shall— "(i) cause to have published in the Federal Register not later than November 1 of each year (beginning with 2000) the conversion factor which will apply to physicians' services for the succeeding year, the update determined under paragraph (4) for such succeeding year, and the allowed expenditures under such paragraph for such succeeding year; and "(ii) make available to the Medicare Payment Advisory Commission and the public by March 1 of each year (beginning with 2000) an estimate of the sustainable growth rate and of the conversion factor which will apply to physicians' services for the succeeding year and data used in making such estimate.". (B) MEDPAC REVIEW OF CONVERSION FACTOR ESTI- MATES.— Section 1805(b)(1)(D) (42 U.S.C. 1395b-6(b)(l)(D)) is amended by inserting "and including a review of the estimate of the conversion factor submitted under section 1848(d)(l)(E)(ii)" before the period at the end. (C) ONE-TIME PUBLICATION OF INI^ORMATION ON TRANSI- TION.— The Secretary of Health and Human Services shall cause to have published in the Federal Register, not later than 90 days after the date of the ensictment of this section, the Secretary's determination, based upon the best available data,of— (i) the allowed expenditures under subclauses (I) and (II) of subsection (d)(4)(C)(ii) of section 1848 of the Social Security Act (42 U.S.C. 1395w-4), as added by subsection (a)(1)(B), for the 9-month period beginning on April 1, 1999, and for 1999; (ii) the estimated actual expenditures described in subsection (d) of such section for 1999; and (iii) the sustainable growth rate under subsection (f) of such section for 2000. (3) CONFORMING AMENDMENTS.— (A) Section 1848 (42 U.S.C. 1395w-4) is amended— 69-194-01-28:QL3Pan2
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