(4)(H) among members of the same affiliated group. (I) Clarification Chapter 35 of title 44, United States Code, shall not apply to the implementation of this paragraph. (J) 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 paragraph (4)(F)(I) 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), and (9)(A). (ii) Resident level The term resident level has the meaning given such term in paragraph (7)(C)(I). . (b) IME (1) In general Section 1886(d)(5)(B)(v) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(B)(v) ), in the third sentence, is amended by striking and (h)(10) and inserting (h)(10), and (h)(11) . (2) Conforming provision Section 1886(d)(5)(B) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(B) ) is amended by adding after clause (xiii) the following new clause: (xiv) For discharges occurring on or after July 1, 2024, insofar as an additional payment amount under this subparagraph is attributable to residency positions distributed to a hospital under subsection (h)(11), the indirect teaching adjustment factor shall be computed in the same manner as provided under clause (ii) with respect to such residency positions. .