; and (II) in any fiscal year other than the first fiscal year for which such State receives an allocation under subparagraph (C) that is not re-allocated under subparagraph (D), has a Health Disparities Elimination Program established under this section that, as determined by the Secretary, has made measurable progress towards meeting the State’s goals, as described under subsection (b)(1), based on reports and evaluations submitted under subsection (d). (2) Payments (A) In general Subject to the provisions of this section, the Secretary shall pay to each State with a State plan amendment approved under this section, from its allocation under paragraph (1)(C) and, in the case of a qualifying State, from its allocation under paragraph (1)(E)(i), an amount for each quarter equal to 90 percent of the sum expended by the State in such quarter for incentive payments made to qualified community health systems for initiatives approved pursuant to this section. (B) Status of incentive payments Incentive payments made under a State plan amendment approved under this section shall not be considered payment for health care items or services and shall not count towards any limit with respect to the maximum amount of payments that may be made to a provider under the State plan under this title (or under a waiver of such plan). (f) Definitions In this section: (1) The term health disparity means a disparity in care provided to a health disparity population, as defined in section 903(d) of the Public Health Service Act ( 42 U.S.C. 299a–1(d) ). (2) The term qualified community health system means— (A) a hospital described in a report submitted under section 1900(b)(6)(B)(ii)(III)