The Secretary shall waive the requirement of subparagraph (A) in the case of any State that demonstrates to the Secretary that—
(I)#
compliance with subparagraph (A) would be inconsistent with efficient or effective operation of the program operated by such State under this section; or
(II)#
the amount by which the savings yielded by an alternative cost containment system would be less than the savings yielded by a competitive bidding system is sufficiently minimal that the difference is not significant.