by the Secretary. (2) Incentives for participating providers (A) Initial incentive period (i) In general The Secretary shall provide, in the case of services described in clause (ii) furnished during 2018, 2019, and 2020, for payment rates that are 5 percent greater than the rates established under paragraph (1). (ii) Services described The services described in this clause are items and professional services, under the public health insurance option by a physician or other health care practitioner who participates in both Medicare and the public health insurance option. (iii) Special rules A pediatrician and any other health care practitioner who is a type of practitioner that does not typically participate in Medicare (as determined by the Secretary) shall also be eligible for the increased payment rates under clause (i). (B) Subsequent periods Beginning with 2021 and for subsequent years, the Secretary shall continue to use an administrative process to set such rates in order to promote payment accuracy, to ensure adequate beneficiary access to providers, and to promote affordability and the efficient delivery of medical care consistent with subsection (a)(1). Such rates shall not be set at levels expected to increase average medical costs per enrollee covered under the public health insurance option beyond what would be expected if the process under paragraph (1)(B) and subparagraph (A) were continued, as certified by the Office of the Actuary of the Centers for Medicare & Medicaid Services. (C) Establishment of a provider network Health care providers participating under Medicare are participating providers in the public health insurance option unless they opt out in a process established by the Secretary. (3) Administrative process for setting rates Chapter 5 of title 5, United States Code, shall apply to the process for the initial establishment of payment rates under this subsection but not to the specific methodology for establishing such rates or the calculation of such rates. (4) Construction Nothing