; and Home Health Quality Reporting Requirements (82 Fed. Reg. 35294 through 35332 (July 28, 2017) (herein referred to as the 2018 Home Health Proposed Rule )) and as such model may subsequently be revised through notice and comment rulemaking. (B) Calculation of budget neutral payment amounts (i) In general The Secretary shall, subject to subparagraph (F), calculate payment amounts under this subsection with respect to home health 30-day periods of care furnished in 2020 in a manner such that the estimated aggregate amount of expenditures under the prospective payment system under this subsection with application of this paragraph is equal to the estimated aggregate amount of expenditures under this subsection without application of this paragraph. (ii) Exclusion of adjustments from calculation Adjustments under paragraph (3) (including adjustments for case mix changes under clause (iv) of such paragraph) and paragraph (5) and subparagraphs (E) and (F) shall not be included in the calculation under clause (i). (C) Limiting savings compared to the 2018 home health proposed rule In order to reduce the aggregate amount of savings under the home health groupings model compared to the estimated impacts in the 2018 Home Health Proposed Rule, after calculating amounts in subparagraph (B), the Secretary shall reduce such 2020 amounts by 3.7 percent. (D) Standard prospective payment amounts for 2020 and subsequent years (i) Standard prospective payment amounts The standard prospective payment amounts for home health 30-day periods of care beginning with 2020 shall be the amounts reduced in subparagraph (C) subject to clauses (iv) and (v) of subparagraph (F). (ii) Application of adjustments Adjustments described in subparagraph (B)(ii) (other than the adjustment described in subparagraph (E)) shall be applied to such standard prospective payment amounts. (E) Transitional adjustments to home health groupings model In order to provide for a transition to the home health groupings model, the Secretary shall, after