attributable to the increase provided under this paragraph to, beginning in the fifth year after the effective date of such increase, apply such positions to the limitation amount under paragraph (4)(F) that may be aggregated pursuant to paragraph (4)(H) among members of the same affiliated group. (H) Definitions In this paragraph: (i) Otherwise applicable resident limit The term otherwise applicable resident limit means, with respect to a hospital, the limit otherwise applicable under subparagraphs (F)(i) and (H) of paragraph (4) on the resident level for the hospital determined without regard to this paragraph but taking into account paragraphs (7)(A), (7)(B), (8)(A), (8)(B), (9), (10)(A). and (10)(B). (ii) Reference resident level Except as otherwise provided in subclause (II), the term reference resident level means, with respect to a hospital, the resident level for the most recent cost reporting period of the hospital ending on or before the date of enactment of this paragraph, for which a cost report has been settled (or, if not, submitted (subject to audit)), as determined by the Secretary. (iii) Resident level The term resident level has the meaning given such term in paragraph (7)(C)(i). (iv) Qualifying hospital The term qualifying hospital means a hospital described in subparagraph (B)(i) or any of subclauses (I) through (IV) of subparagraph (C)(ii). (v) Historically Black medical school The term historically Black medical school means Howard University College of Medicine, Charles R. Drew University of Medicine and Science, Meharry Medical College, Morehouse School of Medicine, Xavier University Graduate School of Health Sciences and Medical School, and Maryland College of Osteopathic Medicine at Morgan State University. . (b) IME Section 1886(d)(5)(B) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(B) ) is amended— (1) in clause (v), in the third sentence, by striking subsections (h)(7), (h)(8), (h)(9), and (h)(10) and inserting subsections (h)(7), (h)(8), (h)(9), (h)(10), and (h)(11)