; and (II) the percentage of individuals in the State who receive medical assistance under a State plan under this title and who live in a rural area (as defined in section 1886(d)(2)(D)) of the State. (ii) Payments Subject to clause (iii), the payments made to a State under section 1903(a) for each calendar quarter shall be increased by the product of— (I) the reduction such State’s DSH allotment under paragraph (7)(A)(i)(II) for such fiscal year; and (II) the percentage of individuals in the State who receive medical assistance under a State plan under this title and who live in a rural area (as defined in section 1886(d)(2)(D)) of the State. (iii) Supplement, not supplant A State may only receive an increased allotment under clause (i) or an increased payment under clause (ii) if such State provides such assurances as the Secretary may require that any funds made available to such State pursuant to such clauses shall be used to supplement, and not supplant, amounts paid under this section to hospitals in the State that are located in rural areas (as defined in section 1886(d)(2)(D)). . (c) Applicability The amendments made by this section apply with respect to fiscal year 2018 and each subsequent fiscal year. B Other rural providers 111. Making permanent increased Medicare payments for ground ambulance services in rural areas Section 1834(l)(13) of the Social Security Act ( 42 U.S.C. 1395m(l)(13) ) is amended— (1) by striking Temporary increase and inserting Increase ; and (2) in subparagraph (A)— (A) in the matter preceding clause (i), by striking , and before January 1, 2018