; or (B) to the extent the inclusion of payment calculation factors or certain data sources thereunder disproportionately impacts the resulting payment calculation with respect to each such territory, either generally or relative to the States, disregard the factor or data source or devise and apply an appropriate adjustment factor. (5) For purposes of extending the full benefits of payments to such territories intended under the respective titles, ensure that the application of payment calculation factors with respect to such territories occurs in a manner that takes into account the geographic and demographic differences, abnormalities in the cost of delivering care in such territories, and the potential disproportionate impact to each such territory, either generally or relative to the States. . (b) Implementation The Secretary of Health and Human Services shall determine and apply the payment calculation adjustments authorized under section 1108(h) of the Social Security Act ( 42 U.S.C. 1308(h) ), as added by subsection (a), as soon as practicable after the date of enactment of this Act in order to allow for the application of appropriate payment calculation factors to Puerto Rico, the United States Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa under titles XVIII and XIX of the Social Security Act ( 42 U.S.C. 1395 et seq., 1396 et seq.) at the earliest feasible opportunity. 2203. Sense of Congress regarding Federal health programs in territories of the United States It is the sense of Congress that— (1) the territories of the United States should receive more equitable and sustainable treatment under Federal health policies and programs, including the Medicare and Medicaid programs, in a fiscally responsible manner; and (2) the treatment of the territories of the United States under Federal health programs, with appropriate Federal oversight, should aim to— (A) improve patient outcomes and strengthen health care systems in the territories