; (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. In the case where such a temporary increase or decrease exceeds 2.00 percent, 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. Notwithstanding the preceding sentence, the Secretary shall complete any such phase-in adjustment no later than 2029 and shall have the authority, after 2025, to waive the phase-in requirement as necessary to achieve budget neutrality by 2029. Prior to implementing such phase-in adjustments after 2025, the Secretary shall first receive certification from the Office of the Actuary of the Centers for Medicare & Medicaid Services that any such adjustments are appropriate. . (b) Effective date The amendments made by this section shall take effect as if included in the enactment of such section 51001(a)(2).