<prompt> Translate the following text to EnglishHifadhi ya HCFA inasema kuwa ni wazi kwamba sheria hiyo itakuwa na athari kubwa kwa idadi kubwa ya vyombo vidogo, kwani kikomo cha jumla kwa kila mteja kitapunguza malipo kwa karibu asilimia 9.  <response>: HCFA states that it is clear that the rule will have a significant impact on a substantial number of small entities since the aggregate per-beneficiary limitation will reduce payments by approximately 9 percent. 