124 STAT. 428 PUBLIC LAW 111–148—MAR. 23, 2010 adjustment under subclause (I) for the year may not exceed 3.5 percent of the amount (or amounts) applicable under clause (i)(III) as of the date of enactment of the Patient Protection and Affordable Care Act.’’. (2) MEDPAC STUDY AND REPORT.— (A) STUDY.—The Medicare Payment Advisory Commis- sion shall conduct a study on the implementation of the amendments made by paragraph (1). Such study shall include an analysis of the impact of such amendments on— (i) access to care; (ii) quality outcomes; (iii) the number of home health agencies; and (iv) rural agencies, urban agencies, for-profit agen- cies, and nonprofit agencies. (B) REPORT.—Not later than January 1, 2015, the Medicare Payment Advisory Commission shall submit to Congress a report on the study conducted under subpara- graph (A), together with recommendations for such legisla- tion and administrative action as the Commission deter- mines appropriate. (b) PROGRAM-SPECIFIC OUTLIER CAP.—Section 1895(b) of the Social Security Act (42 U.S.C. 1395fff(b)) is amended— (1) in paragraph (3)(C), by striking ‘‘the aggregate’’ and all that follows through the period at the end and inserting ‘‘5 percent of the total payments estimated to be made based on the prospective payment system under this subsection for the period.’’; and (2) in paragraph (5)— (A) by striking ‘‘OUTLIERS.—The Secretary’’ and inserting the following: ‘‘OUTLIERS.— ‘‘(A) IN GENERAL.—Subject to subparagraph (B), the Secretary’’; (B) in subparagraph (A), as added by subparagraph (A), by striking ‘‘5 percent’’ and inserting ‘‘2.5 percent’’; and (C) by adding at the end the following new subpara- graph: ‘‘(B) PROGRAM SPECIFIC OUTLIER CAP.—The estimated total amount of additional payments or payment adjust- ments made under subparagraph (A) with respect to a home health agency for a year (beginning with 2011) may not exceed an amount equal to 10 percent of the estimated total amount of payments made under this section (without regard to this paragraph) with respect to the home health agency for the year.’’. (c) APPLICATION OF THE MEDICARE RURAL HOME HEALTH ADD- ON POLICY.—Section 421 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108– 173; 117 Stat. 2283), as amended by section 5201(b) of the Deficit Reduction Act of 2005 (Public Law 109–171; 120 Stat. 46), is amended— (1) in the section heading, by striking ‘‘ONE-YEAR’’ and inserting ‘‘TEMPORARY’’; and (2) in subsection (a)— 42 USC 1395fff note.
