,,ii  #aaf? ,,congress  #b;d ,session   
,h4 ,r4 #hijj  ,,9 ,,! ,,s5ate ,,( ,,!  
,,unit$ ,,/ates  ,decemb] #i1           
#bjbj,receiv$  ,,an ,,act  ,mak+ fur!r  
cont9u+ appropriations = fiscal ye>     
#bjba1 & = o!r purposes4  #a4 ,%ort     
title ,?is ,act may be cit$ z ! ,fur!r  
,cont9u+ ,appropriations ,act1 #bjba1 & 
,o!r ,ext5sions ,act4  #b4 ,table (     
cont5ts ,! table ( cont5ts ( ?is ,act is
 z foll[s3 ,sec4 #a4 ,%ort title4,sec4  
#b4 ,table ( cont5ts4,sec4 #c4          
,ref]5ces4  ,division ,a--,fur!r        
,cont9u+ ,appropriations ,act1          
#bjba;,division ,b--,heal?              
,extenders,title ,i--,m$ic>e & ,m$icaid 
,extenders,title ,,ii--,public ,heal?   
,ext5d]s & ,food & ,drug ,adm9i/ration  
,provisions,title ,,iii--,offsets,title 
,,iv--,budget>y ,effects  #c4 ,ref]5ces 
,except z expressly provid$ o!rwise1 any
 ref]5ce to ?is ,act conta9$ 9 any      
division ( ?is ,act %all be treat$ z    
ref]r+ only to ! provisions ( t         
division4  ,a ,fur!r ,cont9u+           

,appropriations ,act1 #bjba  #aja4 ,!   
,cont9u+ ,appropriations ,act1 #bjba    
7division ,a ( ,public ,law #aaf-aei7 is
 am5d$ by /rik+ ! date specifi$ 9       
section #ajf7c7 & ins]t+ ,decemb] #ah1  
#bjbj4  ,?is division may be cit$ z !   
,fur!r ,cont9u+ ,appropriations ,act1   
#bjba4  ,b ,heal? ,ext5d]s  ,i ,m$ic>e &
 ,m$icaid ,ext5d]s  #aaja4 ,ext5sion ( !
 "w geographic index floor "u ! m$ic>e  
program ,section #ahdh7;e77#a77;,e7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7;e77#a77;,e771 z am5d$ by     
section #chja ( ! ,,c>es ,act 7,public  
,law #aaf-acf7 & section #bbja ( !      
,cont9u+ ,appropriations ,act1 #bjba &  
,o!r ,ext5sions ,act 7,public ,law      
#aaf-aei71 is am5d$ by /rik+ ,decemb]   
#ab1 #bjbj & ins]t+ ,decemb] #ai1 #bjbj4
  #aajb4 ,ext5sion ( fund+ outrea* &    
assi/ance = l[-income programs  7a7     
,/ate heal? insurance programs          
,subsection 7a77#a77;,b77xi7 ( section  
#aai ( ! ,m$ic>e ,improvem5ts = ,pati5ts
 & ,provid]s ,act ( #bjjh 7#db ,u4,s4,c4

 #acie;b-#c note71 z am5d$ by section   
#ccjf ( ! ,pati5t ,protection &         
,af=dable ,c>e ,act 7,public ,law       
#aaa-adh71 section #faj ( ! ,am]ican    
,taxpay] ,relief ,act ( #bjab 7,public  
,law #aab-bdj71 section #aaaj ( !       
,pa?way = ,,sgr ,re=m ,act ( #bjac      
7,public ,law #aac-fg71 section #aaj ( !
 ,protect+ ,access to ,m$ic>e ,act (    
#bjad 7,public ,law #aac-ic71 section   
#bjh ( ! ,m$ic>e ,access & ,,*ip        
,reau?orization ,act ( #bjae 7,public   
,law #aad-aj71 section #ejbjg ( division
 ,e ( ! ,bip>tisan ,budget ,act ( #bjah 
7,public ,law #aae-abc71 section #adjb (
 division ,b ( ! ,cont9u+               
,appropriations ,act1 #bjbj1 & ,heal?   
,ext5d]s ,act ( #bjai 7,public ,law     
#aaf-ei71 section #adjb ( division ,b ( 
! ,fur!r ,cont9u+ ,appropriations ,act1 
#bjbj1 & ,fur!r ,heal? ,ext5d]s ,act (  
#bjai 7,public ,law #aaf-fi71 section   
#ajc ( division ,n ( ! ,fur!r           
,consolidat$ ,appropriations ,act1 #bjbj
 7,public ,law #aaf-id71 section #chjc (

 ! ,,c>es ,act 7,public ,law #aaf-acf71 
& section #bbjc ( ! ,cont9u+            
,appropriations ,act1 #bjba & ,o!r      
,ext5sions ,act 7,public ,law #aaf-aei71
 is am5d$ by /rik+ ,decemb] #aa & ins]t+
 ,decemb] #ah4  7b7 ,area ag5cies on ag+
 ,subsection 7b77#a77;,b77xi7 ( su*     
section #aai1 z s am5d$1 is am5d$ by    
/rik+ ,decemb] #aa & ins]t+ ,decemb]    
#ah4  7c7 ,ag+ & disability res\rce     
c5t]s ,subsection 7c77#a77;,b77xi7 ( su*
 section #aai1 z s am5d$1 is am5d$ by   
/rik+ ,decemb] #aa & ins]t+ ,decemb]    
#ah4  7d7 ,contract ) ! national c5t] = 
b5efits & outrea* enrollm5t ,subsection 
7d77#b77xi7 ( su* section #aai1 z s     
am5d$1 is am5d$ by /rik+ ,decemb] #aa & 
ins]t+ ,decemb] #ah4  #aajc4 ,ext5sion (
 fund+ = quality measure endorsem5t1    
input1 & selection ,section             
#ahij7;d77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie;aaa7d77#b77 is    
am5d$ by /rik+ ,decemb] #aa ea* place   
su* phrase appe>s & ins]t+ ,decemb] #ah 
9 ea* su* place4  #aajd4 ,ext5sion (    

community m5tal heal? s]vices           
demon/ration program ,section           
#bbc7;d77#c7 ( ! ,protect+ ,access to   
,m$ic>e ,act ( #bjad 7#db ,u4,s4,c4     
#acif;a note71 z am5d$ by ,public ,law  
#aaf-aei1 is am5d$ by /rik+ ,decemb] #aa
 & ins]t+ ,decemb] #ah4  #aaje4         
,ext5sion ( sp\sal impov]i%m5t          
protections  7a7 ,9 g5]al ,section #bdjd
 ( ! ,pati5t ,protection & ,af=dable    
,c>e ,act 7#db ,u4,s4,c4 #acifr-#e      
note71 z am5d$ by ,public ,law #aaf-aei1
 is am5d$ by /rik+ ,decemb] #aa & ins]t+
 ,decemb] #ah4  7b7 ,rule ( con/ruction 
,no?+ 9 section #bdjd ( ,public ,law    
#aaa-adh 7#db ,u4,s4,c4 #acifr-#e note7 
or section #aijb7;a77#ag7 or #aibd ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77#ag71 #acifr-#e7 %all be     
con/ru$ z prohibit+ a ,/ate f-- 7#a7    
apply+ an income or res\rce disreg>d "u 
a me?odology au?oriz$ "u section        
#aijb7r77#b7 ( su* ,act 7#db ,u4,s4,c4  
#acif;a7r77#b77-- 7,a7 to ! income or   
res\rces ( an individual describ$ 9     

section #aijb7;a77#aj77;,a77ii77,,vi7 ( 
su* ,act 7#db ,u4,s4,c4                 
#acif;a7a77#aj77;,a77ii77,,vi77 7includ+
 a disreg>d ( ! income or res\rces ( su*
 individual's sp\se72 or  7,b7 on !     
basis ( an individual's ne$ = home &    
community-bas$ s]vices au?oriz$ "u      
subsection 7c71 7d71 7i71 or 7k7 (      
section #aiae ( su* ,act 7#db ,u4,s4,c4 
#acifn7 or "u section #aaae ( su* ,act  
7#db ,u4,s4,c4 #acae72 or  7#b7         
disreg>d+ an individual's sp\sal income 
& assets "u a plan am5dm5t to provide   
m$ical assi/ance = home & community-bas$
 s]vices = individuals by reason ( be+  
det]m9$ eligible "u section             
#aijb7;a77#aj77;,c7 ( su* ,act 7#db     
,u4,s4,c4 #acif;a7a77#aj77;,c77 or by   
reason ( section #aijb7;f7 ( su* ,act   
7#db ,u4,s4,c4 #acif;a7f77 or o!rwise on
 ! basis ( a r$uction ( income bas$ on  
co/s incurr$ = m$ical or o!r rem$ial c>e
 "u :i* ! ,/ate disreg>d$ ! income &    
assets ( ! individual's sp\se 9 det]m9+ 
! initial & ongo+ f9ancial eligibility (

 an individual = su* s]vices 9 place ( !
 sp\sal impov]i%m5t provisions appli$ "u
 section #aibd ( su* ,act 7#db ,u4,s4,c4
 #acifr-#e74  #aajf4 ,ext5sion ( delay (
 ,,d% r$uctions ,section #aibc7;f77#g7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acifr-#d7;f77#g77;,a77 is am5d$ by    
/rik+ ,decemb] #ab ea* place su* phrase 
appe>s & ins]t+ ,decemb] #ai 9 ea* su*  
place4  #aajg4 ,ext5sion ( ,money       
,foll[s ! ,p]son ,section               
#fjga7;h77#a77;,h7 ( ! ,deficit         
,r$uction ,act ( #bjje 7#db ,u4,s4,c4   
#acif;a note7 is am5d$ by /rik+ ,decemb]
 #aa & ins]t+ ,decemb] #ah4  ,,ii       
,public ,heal? ,ext5d]s & ,food & ,drug 
,adm9i/ration ,provisions  ,a ,public   
,heal? ,ext5d]s  #abja4 ,ext5d+ fund+ = 
community heal? c5t]s1 ,national ,heal? 
,s]vice ,corps1 & ,tea*+ ,heal? ,c5t]   
,,gme  7a7 ,community heal? c5t]s       
,section #ajejc7;b77#a77;,f7 ( ! ,pati5t
 ,protection & ,af=dable ,c>e ,act 7#db 
,u4,s4,c4 #bed;b-#b7;b77#a77;,f77 is    
am5d$-- 7#a7 by /rik+ #ghi1jda1jif &    

ins]t+ #hfe1gec1dbe2 &  7#b7 by /rik+   
,decemb] #aa1 #bjbj & ins]t+ ,decemb]   
#ah1 #bjbj4  7b7 ,national heal? s]vice 
corps ,section #ajejc7;b77#b77;,h7 ( !  
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4                     
#bed;b-#b7;b77#b77;,h77 is am5d$-- 7#a7 
by /rik+ #fa1aej1fhe & ins]t+           
#fg1jie1hij2 &  7#b7 by /rik+ ,decemb]  
#aa1 #bjbj & ins]t+ ,decemb] #ah1 #bjbj4
  7c7 ,tea*+ heal? c5t]s t op]ate       
graduate m$ical education programs      
,section #cdj;,h7g77#a7 ( ! ,public     
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bef;h7g77#a77 is am5d$-- 7#a7 by /rik+ 
#bd1iec1dbe & ins]t+ #bg1cgi1deb2 &     
7#b7 by /rik+ ,decemb] #aa1 #bjbj &     
ins]t+ ,decemb] #ah1 #bjbj4  7d7        
,application ( provisions ,am\nts       
appropriat$ pursuant to ! am5dm5ts made 
by ?is section = ! p]iod beg9n+ on      
,decemb] #aa1 #bjbj1 & end+ on ,decemb] 
#ah1 #bjbj1 %all be subject to !        
requirem5ts conta9$ 9 ,public ,law      
#aaf-id = funds = programs au?oriz$ "u  

sections #ccj ?r\gh #cdj ( ! ,public    
,heal? ,s]vice ,act4  7e7 ,con=m+       
am5dm5ts ,p>agraph 7#d7 ( section       
#cjad7;h7 ( title #ah1 ,unit$ ,/ates    
,code1 z am5d$ by section #chca7;e7 ( ! 
,,c>es ,act 7,public ,law #aaf-acf71 is 
am5d$-- 7#a7 by /rik+ ,social ,s]vices  
,act11 & ins]t+ ,social ,s]vices ,act12 
&  7#b7 by /rik+ & section #baja ( !    
,cont9u+ ,appropriations ,act1 #bjba &  
,o!r ,ext5sions ,act & ins]t+ section   
#baja ( ! ,cont9u+ ,appropriations ,act1
 #bjba & ,o!r ,ext5sions ,act1 & section
 #abja7;d7 ( ! ,fur!r ,cont9u+          
,appropriations ,act1 #bjba1 & ,o!r     
,ext5sions ,act4  #abjb4 ,diabetes      
programs  7a7 ,special diabetes programs
 = type ,i diabetes ,section            
#ccj;,b7b77#b77;,d7 ( ! ,public ,heal?  
,s]vice ,act 7#db ,u4,s4,c4             
#bed;c-#b7;b77#b77;,d77 is am5d$-- 7#a7 
by /rik+ #bi1ehi1jdb & ins]t+           
#cb1dfe1gec2 &  7#b7 by /rik+ ,decemb]  
#aa1 #bjbj & ins]t+ ,decemb] #ah1 #bjbj4
  7b7 ,special diabetes programs =      

,indians ,section #ccj;,c7c77#b77;,d7 ( 
! ,public ,heal? ,s]vice ,act 7#db      
,u4,s4,c4 #bed;c-#c7;c77#b77;,d77 is    
am5d$-- 7#a7 by /rik+ #bi1ehi1jdb &     
ins]t+ #cb1dfe1gec2 &  7#b7 by /rik+    
,decemb] #aa1 #bjbj & ins]t+ ,decemb]   
#ah1 #bjbj4  #abjc4 ,p]sonal            
responsibility education2 sexual risk   
avoidance education  7a7 ,sexual risk   
avoidance education ,section #eaj ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#gaj7 is am5d$ by /rik+ ,decemb] #aa1   
#bjbj ea* place x appe>s & ins]t+       
,decemb] #ah1 #bjbj4  7b7 ,p]sonal      
responsibility education ,section #eac (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #gac7 is am5d$ by /rik+ ,decemb] #aa1  
#bjbj ea* place x appe>s & ins]t+       
,decemb] #ah1 #bjbj4  ,b ,food & ,drug  
,adm9i/ration ,provisions  #abaa4 ,r>e  
p$iatric disease priority review v\*]   
ext5sion ,section #ebi7;b77#e7 ( !      
,f$]al ,food1 ,drug1 & ,cosmetic ,act   
7#ba ,u4,s4,c4 #cfj;ff7b77#e77 is       
am5d$-- 7#a7 by /rik+ ,decemb] #aa1     

#bjbj ea* place x appe>s & ins]t+       
,decemb] #ah1 #bjbj2 &  7#b7 9          
subp>agraph 7,b71 by /rik+ ,decemb] #aa1
 #bjbb & ins]t+ ,decemb] #ah1 #bjbb4    
,,iii ,(fsets  #acja4 ,transp>5cy (     
m$ic>e second>y pay] report+ in=mation  
,section #ahfb7;b77#h77;,g7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#ciey7b77#h77;,g77 is am5d$-- 7#a7 by   
/rik+ in=mation4--,! ,secret>y & ins]t+ 
in=mation4-- 7i7 ,9 g5]al ,! ,secret>y  
2 &  7#b7 by add+ at ! end ! foll[+ new 
clause3  7ii7 ,specifi$ in=mation ,9    
respond+ to any qu]y made on or aft] !  
date t is #a ye> aft] ! date ( !        
enactm5t ( ?is clause f an applicable   
plan relat$ to a det]m9ation describ$ 9 
subp>agraph 7,a77i71 ! ,secret>y1       
not)/&+ any o!r provision ( law1 %all   
provide to su* applicable plan-- 7,i7   
:e!r a claimant subject to ! qu]y is1 or
 dur+ ! prec$+ #c-ye> p]iod has be51    
entitl$ to b5efits "u ! program "u ?is  
title on any basis2 &  7,,ii7 to ! ext5t
 applicable1 ! plan "n & address ( any  

,m$ic>e ,advantage plan "u "p ,c & any  
prescription drug plan "u "p ,d 9 :i* ! 
claimant is enroll$ or has be5 enroll$  
dur+ su* p]iod4  4  #acjb4 ,disp5sation 
( n>cotic drugs = ! purpose ( reliev+   
acute )drawal symptoms f opioid use     
disord] ,n lat] ?an #ahj days aft] !    
date ( enactm5t ( ?is ,act1 ! ,attorney 
,g5]al %all revise section #acjf4jg7;b7 
( title #ba1 ,code ( ,f$]al             
,regulations1 s t practition]s1 9       
accordance ) applicable ,/ate1 ,f$]al1  
or local laws relat+ to controll$       
sub/ances1 are all[$ to disp5se n m ?an 
a ?ree-day supply ( n>cotic drugs to "o 
p]son or = "o p]son's use at "o "t = !  
purpose ( initiat+ ma9t5ance treatm5t or
 detoxification treatm5t 7or bo?74      
#acjc4 ,m$icaid ,improvem5t ,fund       
,section #aida7;b77#c77;,a7 ( ! ,social 
,security ,act 7#db ,u4,s4,c            
#acifw-#a7;b77#c77;,a77 is am5d$ by     
/rik+ #c1ddf1jjj1jjj & ins]t+           
#c1dfd1jjj1jjj4  ,,iv ,budget>y ,effects
  #adja4 ,budget>y effects  7a7         

,/atutory ,,paygo ,scorec>ds ,! budget>y
 effects ( ?is division %all n be ent]$ 
on ei!r ,,paygo scorec>d ma9ta9$        
pursuant to section #d7;d7 ( ! ,/atutory
 ,pay-,z-,y-,g ,act ( #bjaj4  7b7 ,s5ate
 ,,paygo ,scorec>ds ,! budget>y effects 
( ?is division %all n be ent]$ on any   
,,paygo scorec>d ma9ta9$ = purposes (   
section #dajf ( ,h4 ,con4 ,res4 #ga     
7#aae? ,congress74  7c7 ,classification 
( ,budget>y ,effects ,not)/&+ ,rule #c (
 ! ,budget ,scorekeep+ ,guidel9es set =?
 9 ! jo9t explanatory /atem5t ( !       
committee ( conf]5ce accompany+         
,conf]5ce ,report #aje-bag & section    
#bej7;c77#h7 ( ! ,balanc$ ,budget &     
,em]g5cy ,deficit ,control ,act ( #aihe1
 ! budget>y effects ( ?is division %all 
n be e/imat$-- 7#a7 = purposes ( section
 #bea ( su* ,act2 &  7#b7 = purposes (  
p>agraph 7#d77;,c7 ( section #c ( !     
,/atutory ,pay-,z-,y-,g ,act ( #bjaj z  
be+ includ$ 9 an appropriation ,act4    
,pass$ ! ,h\se ( ,repres5tatives        
,decemb] #i1 #bjbj4;,*]yl ,l4           

,johnson1,cl]k