; (C) in clause (ii), by inserting attributable to the implementation of paragraphs (2)(B) and (4)(B) after expenditures ; and (D) in clause (iii)— (i) by adding attributable to the implementation of paragraphs (2)(B) and (4)(B) after expenditures ; and (ii) by adding at the end the following: If such a temporary increase or decrease does not exceed 2.00 percent in any given year, the Secretary shall apply the entire increase or decrease in the next calendar year payment update; however, if such a temporary increase or decrease exceeds 2.00, to provide for minimal disruption to patients and providers, the Secretary shall phase in the temporary increase or decrease in equal amounts not to exceed 2.00 percent in any given year through the respective calendar year payment updates. . (b) Effective date The amendments made by this section shall take effect as if included in the enactment of such section 51001(a)(2).