Title IV, SEC. 4112. USE OF REAL GDP TO ADJUST FOR VOLUME AND INTENSITY; REPEAL OF RESTRICTION ON MAXIMUM REDUCTION PERMITTED IN DEFAULT UPDATE. (a) Use of Real GDP to Adjust for Volume and Intensity. Section 1848(f)(2)(B)(iii) (42 U.S.C. 1395w 4(f)(2)(B)(iii)), as added by section 4111(a), is amended to read as follows: ``(iii) 1 plus the average per capita growth in the real gross domestic product (divided by 100) for the 5-fiscal-year period ending with the previous fiscal year (increased by 1.5 percentage points for the category of services consisting of primary care services), and''. (b) Repeal of Restriction on Maximum Reduction. Section 1848(d)(3)(B)(ii) (42 U.S.C. 1395w 4(d)(3)(B)(ii)), as amended by section 13512(b) of OBRA 1993, is amended (1) in the heading, by inserting ``in certain years'' after ``adjustment''; (2) in the matter preceding subclause (I), by striking ``for a year''; (3) in subclause (I), by adding ``and'' at the end; (4) in subclause (II), by striking ``, and'' and inserting a period; and (5) by striking subclause (III).