; (B) in item (aa), by striking 50 percent was instead a reference to 40 percent and inserting the applicable percent were instead a reference to 10 percentage points less than the applicable percent ; and (C) in item (bb)— (i) by striking 50 percent and inserting the applicable percent ; and (ii) by striking 40 percent and inserting 10 percentage points less than the applicable percent ; and (3) by striking subclause (III). (c) Effective date The amendments made by this section shall apply with respect to years beginning on or after January 1, 2021. 5. Addressing overlap in value based care programs (a) In general (1) CMI Section 1115A(a)(5) of the Social Security Act ( 42 U.S.C. 1315a(a)(5) ) is amended by adding at the end the following new sentence: In establishing such limits, the Secretary shall take into account payment and service delivery models in progress in such geographic areas. . (2) Repeal of Medicare duplication prohibition Section 1899(b) of the Social Security Act ( 42 U.S.C. 1395jjj(b) ) is amended by striking paragraph (4). (b) Report Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall conduct an assessment and submit to Congress a report on alternative payment model overlap in the Medicare program. Such report shall include a description of and recommendations relating to— (1) any issues regarding the existence of multiple alternative payment model participation opportunities for health care providers; and (2) obstacles created by competing incentives with respect to alternative payment models.