; or (2) result in a significant rule effecting provider or payer consolidation. (b) Public comment on impact to provider and payer consolidation Beginning for 2025, as part of any notice and comment rulemaking process that will result in a significant rule effecting provider or payer consolidation with respect to a proposed rule for parts B, C, and D of title XVIII of the Social Security Act ( 42 U.S.C. 1395j et seq. ), the Secretary shall seek public comment on the projected impact of such proposed rule on provider and payer consolidation in the aggregate. (c) Definitions In this section: (1) Provider and payer consolidation The term provider and payer consolidation includes the vertical or horizontal integration among providers of services (as defined in subsection (u) of section 1861 of the Social Security Act ( 42 U.S.C. 1395x )), suppliers (as defined in subsection (d) of such section), accountable care organizations under section 1899 of the Social Security Act ( 42 U.S.C. 1395jjj ), Medicare Advantage organizations, PDP sponsors, pharmacy benefit managers, pharmacies, and integrated delivery systems. (2) Applicable payment system The term applicable payment system includes— (A) with respect to outpatient hospital services, the prospective payment system for covered OPD services established under section 1833(t) of such Act ( 42 U.S.C. 1395(l) ); and (B) with respect to physicians’ services, the physician fee schedules established under section 1848 of such Act ( 42 U.S.C. 1395w–4 ). 3. Consideration of effects on provider and payer consolidation with respect to CMI models (a) In general Section 1115A(b)(4)(A) of the Social Security Act ( 42 U.S.C. 1315a(b)(4)(A) ) is amended— (1) in clause (i), by striking at the end and ; (2) in clause (ii), by striking the period at the end and inserting ; and