; and (C) meets, with respect to the program under this title, such cost reduction and quality goals as the Secretary determines appropriate. . (e) Construction Nothing in this section (or the amendments made by this section) shall be construed to affect the authority of the Secretary of Health and Human Services to waive under section 1899 of the Social Security Act ( 42 U.S.C. 1395jjj ) the requirements imposed under the provisions of this section (or such amendments) or to affect the authority of the Secretary to implement the provisions under section 1848(q) of such Act ( 42 U.S.C. 1395w–4(q) ) (relating to the eligible professionals Merit-Based Incentive Payment System under the Medicare program) or section 1833(z) of such Act ( 42 U.S.C. 1395l(z) ) (relating to incentive payments for participation in eligible alternative payment models under such program). (f) Effective date The amendments made by this section shall apply to items and services furnished on or after the first day of the first month beginning more than 12 months after the date of the enactment of this Act. 4. Clarification of certain entities subject to stark rule and anti-markup rule Section 1877(h) of the Social Security Act ( 42 U.S.C. 1395nn(h) ) is further amended by adding at the end the following new paragraph: (9) Clarification of certain entities subject to anti-markup rule In applying this section, the term entity shall include a physician’s practice when it bills under this title for the technical component or the professional component of a specified non-ancillary service, including when such service is billed in compliance with section 1842(n)(1). . 5. Clarification of supervision of technical component of anatomic pathology services Section 1861(s)(17) of the Social Security Act ( 42 U.S.C. 1395x(s)(17) ) is amended— (1) by striking and at the end of subparagraph (A); (2) by redesignating subparagraph (B) as subparagraph (C)