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In paragraphs (d)(1)(i)(A)( 3 )( ii ), (d)(1)(i)(A)( 4 )( ii ), (d)(1)(ii)(A)( 3 )( ii ), (d)(1)(ii)(A)( 4 )( ii ), (d)(1)(iii)(A)( 3 )( ii ), (d)(1)(iii)(A)( 4 )( ii ), (d)(1)(iv)(A)( 3 )( ii ), (d)(1)(iv)(A)( 4 )( ii ), (d)(1)(v)(A)( 3 )( ii ), and (d)(1)(v)(A)( 4 )( ii ), removing the phrase “health equity adjusted quality performance score calculated according to § 425.512(b)” and adding in its place the phrase “quality score calculated according to § 425.512”

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Step 4: Using the results of Step 2 and Step 3, use the CF to calculate a direct PE scaling adjustment to ensure that the aggregate pool of direct PE costs calculated in Step 3 does not vary from the aggregate pool of direct PE costs for the current year