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HR 3590 EAS/PP
``The application of subparagraph (C) may result in
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the percentage increase under subparagraph (B) being
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less than 0.0 for a year, and may result in payment
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rates under the fee schedule under this subsection for
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a year being less than such payment rates for the pre-
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ceding year.''.
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(k) A
MBULATORY
S
URGICAL
C
ENTER
S
ERVICES
.--Sec-
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tion 1833(i)(2)(D) of the Social Security Act (42 U.S.C.
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1395l(i)(2)(D)) is amended--
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(1) by redesignating clause (v) as clause (vi);
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and
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(2) by inserting after clause (iv) the following
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new clause:
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``(v) In implementing the system de-
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scribed in clause (i) for 2011 and each sub-
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sequent year, any annual update under
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such system for the year, after application
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of clause (iv), shall be reduced by the pro-
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ductivity adjustment described in section
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1886(b)(3)(B)(xi)(II). The application of
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the preceding sentence may result in such
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update being less than 0.0 for a year, and
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may result in payment rates under the sys-
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tem described in clause (i) for a year being
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