; (iii) in paragraph (3)— (I) by striking in-network providers and inserting participating providers ; and (II) by striking a clinical trial and inserting an approved clinical trial ; and (iv) in paragraph (4), by striking out-of-network and inserting nonparticipating providers ; (B) in subsection (b)(2)(A), by striking participating health care provider and inserting participating provider ; and (C) in subsection (d)(1)(A)(v), by striking cooperative group and inserting A cooperative group . (5) Effective date The amendments made by this subsection shall apply with respect to plan years beginning on or after January 1, 2024. (b) Medicare (1) Amendment relating to definition of routine costs of care Section 1862(m) of the Social Security Act ( 42 U.S.C. 1395y(m) ) is amended— (A) in paragraph (1), by inserting before as defined by the Secretary the following: subject to paragraph (3),