Page:United States Statutes at Large Volume 124.djvu/509

124 STAT. 483 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(I) the excess (if any) of— ‘‘(aa) the total percentage of the non- elderly insured population for the preceding fiscal year (based on the most recent estimates available from the Director of the Congres- sional Budget Office before a vote in either House on the Patient Protection and Afford- able Care Act that, if determined in the affirmative, would clear such Act for enroll- ment); over ‘‘(bb) the total percentage of the non- elderly insured population for such preceding fiscal year (as estimated by the Secretary); exceeds ‘‘(II) 5 percentage points.’’. (e) HOME HEALTH AGENCIES.—Section 1895(b)(3)(B) of the Social Security Act (42 U.S.C. 1395fff(b)(3)(B)) is amended— (1) in clause (ii)(V), by striking ‘‘clause (v)’’ and inserting ‘‘clauses (v) and (vi)’’; and (2) by adding at the end the following new clause: ‘‘(vi) ADJUSTMENTS.—After determining the home health market basket percentage increase under clause (iii), and after application of clause (v), the Secretary shall reduce such percentage— ‘‘(I) for 2015 and each subsequent year, by the productivity adjustment described in section 1886(b)(3)(B)(xi)(II); and ‘‘(II) for each of 2011 and 2012, by 1 percentage point. The application of this clause may result in the home health market basket percentage increase under clause (iii) being less than 0.0 for a year, and may result in payment rates under the system under this sub- section for a year being less than such payment rates for the preceding year.’’. (f) PSYCHIATRIC HOSPITALS.—Section 1886 of the Social Security Act, as amended by sections 3001, 3008, 3025, and 3133, is amended by adding at the end the following new subsection: ‘‘(s) PROSPECTIVE PAYMENT FOR PSYCHIATRIC HOSPITALS.— ‘‘(1) REFERENCE TO ESTABLISHMENT AND IMPLEMENTATION OF SYSTEM.—For provisions related to the establishment and implementation of a prospective payment system for payments under this title for inpatient hospital services furnished by psychiatric hospitals (as described in clause (i) of subsection (d)(1)(B)) and psychiatric units (as described in the matter following clause (v) of such subsection), see section 124 of the Medicare, Medicaid, and SCHIP Balanced Budget Refine- ment Act of 1999. ‘‘(2) IMPLEMENTATION FOR RATE YEAR BEGINNING IN 2010 AND SUBSEQUENT RATE YEARS.— ‘‘(A) IN GENERAL.—In implementing the system described in paragraph (1) for the rate year beginning in 2010 and any subsequent rate year, any update to a base rate for days during the rate year for a psychiatric hospital or unit, respectively, shall be reduced— 42 USC 1395ww.