; (3) in clause (ii)(II), in the first sentence, by striking a list of items to which this subparagraph applies and inserting a list of items for purposes of clause (i) ; (4) in clause (iii)(III), by striking to provide or manage the provision of prosthetics and custom-designed or -fabricated orthotics and inserting to provide or manage the provision of orthotics and prosthetics (and custom-designed or -fabricated orthotics, in the case of an item described in clause (ii)) ; and (5) by adding at the end the following new clause: (v) Exemption of off-the-shelf orthotics included in a competitive acquisition program This subparagraph shall not apply to an item of orthotics described in paragraph (2)(C) of section 1847(a) furnished on or after January 1, 2018, that is included in a competitive acquisition area under such section. . (b) Effective date The amendments made by subsection (a) shall apply to orthotics and prosthetics furnished on or after January 1, 2018. 4. Eligibility for Medicare payment for orthotics and prosthetics based on supplier qualifications and complexity of care Section 1834(h) of the Social Security Act ( 42 U.S.C. 1395m(h) ) is amended— (1) in paragraph (1)(F)(iii), in the matter preceding subclause (I), by striking other individual who and inserting other individual who, with respect to the provision of orthotics and prosthetics furnished on or after January 1, 2018, and subject to paragraph (5)(A), satisfies all applicable criteria of the provider qualification designation for such orthotic or prosthetic, and who ; (2) in paragraph (1)(F)(iv), by inserting before the period the following: and, with respect to the provision of orthotics and prosthetics furnished on or after January 1, 2018, and subject to paragraph (5)(A), satisfies all applicable criteria of the provider qualification designation for such orthotic or prosthetic