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The $140 million increase in estimated payments for CY 2024 reflects the effects of the CY 2024 home health payment update percentage increase of 3.0 percent ($525 million increase), a 0.4 percent increase in payments due to the new lower FDL ratio, which would increase outlier payments in order to target to pay no more than 2.5 percent of total payments as outlier payments ($70 million increase) and an estimated 2.6 percent decrease in payments that reflects the effects of the permanent behavior adjustment ($455 million decrease)