; and (IV) be applied immediately upon the expiration of the TDAPA period for a product to avoid a gap between the TDAPA and availability of the post-TDAPA add-on adjustment. (ii) Implementation This policy shall not be implemented in a budget neutral manner. . (b) New devices and other technologies As part of the promulgation of the annual rule for the Medicare end-stage renal disease prospective payment system under section 1881(b)(14) of the Social Security Act ( 42 U.S.C. 1395rr(b)(14) ) for calendar year 2022, and in consultation with stakeholders, the Secretary of Health and Human Services (in this section referred to as the Secretary ) shall ensure that the single payment amount is adequate to cover the cost of the new innovative device or other technology with substantial clinical improvement and increase the single payment amount if the Secretary determines such payment amount is not adequate to cover such cost. In carrying out the preceding sentence, the Secretary shall use the cost and utilization data collected during a 3-year transitional payment period, as otherwise described in the final regulation published on November 9, 2020 (85 Fed. Reg. 71398 et seq.). 202. Ensuring medicare advantage supports kidney care innovative therapies Section 1853(c) of the Social Security Act ( 42 U.S.C. 1395ww–23(c) ) is amended by adding the following new paragraph: (8) Adjustment for innovative products for enrolles with end stage renal disease If the Secretary makes a determination with respect to the application of the End Stage Renal Disease Transitional Drug Add-On Payment Adjustment or the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies to a product under this title that will result in an increase in the costs to Medicare+Choice of providing benefits under contracts under this part for the period of the Transitional Drug Add-On Payment Adjustment or the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies, the Secretary shall directly make