; (3) in subsection (h), by striking each of fiscal years 2010 through 2015 and inserting fiscal year 2021 ; and (4) by adding at the end the following new subsection: (j) Authority To implement improvements to program The Secretary may make such improvements to the demonstration program not inconsistent with the preceding provisions of this section as the Secretary determines appropriate for purposes of— (1) improving coordination of care; (2) lowering expenditures; (3) increasing access to items and services under the program; or (4) improving the quality of items and services furnished under the program. .