,,ii ,calendar ,no4 #afh #aaith ,,congress #ast ,session ,h4 ,r4 #ecga ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #ai 7legislative day1 ,september #af71 #bjbe,received1 read twice and ordered placed on the calendar ,,an ,,act ,making continuing appropriations and extensions for fiscal year #bjbf1 and for other purposes4 #a4 ,,short ,,title ,this ,act may be cited as the ,continuing ,appropriations and ,extensions ,act1 #bjbf4 #b4 ,,table ,,of ,,contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,,short ,,title4,sec4 #b4 ,,table ,,of ,,contents4,sec4 #c4 ,,references4,division ,a--,,continuing ,,appropriations ,,act1 #bjbf;,division ,b--,,miscellaneous ,e,x,t,e,n,s,i,o,n,s,division ,c--,,health ,e,x,t,e,n,d,e,r,s,title ,i--,public ,health ,extenders,title ,,ii--,medicare,title ,,iii--,human ,services,title ,,iv--,medicaid,title ,v--,food and ,drug ,administration,title ,,vi--,no ,surprises ,act ,implementation,division ,d--,,department ,,of ,,veterans ,,affairs ,e,x,t,e,n,d,e,r,s,title ,i--,health ,care ,matters,title ,,ii--,benefits,title ,,iii--,housing,title ,,iv--,other ,matters,division ,e--,,miscellaneous #c4 ,,references ,except as expressly provided otherwise1 any reference to this ,act contained in any division of this ,act shall be treated as referring only to the provisions of that division4 ,a ,,continuing ,,appropriations ,,act1 #bjbf ,the following sums are hereby appropriated1 out of any money in the ,treasury not otherwise appropriated1 and out of applicable corporate or other revenues1 receipts1 and funds1 for the several departments1 agencies1 corporations1 and other organizational units of ,government for fiscal year #bjbf1 and for other purposes1 namely3 #aja4 ,such amounts as may be necessary1 at a rate for operations as provided in the applicable appropriations ,acts for fiscal year #bjbe and under the authority and conditions provided in such ,acts1 for continuing projects or activities 7including the costs of direct loans and loan guarantees7 that are not otherwise specifically provided for in this ,act1 that were conducted in fiscal year #bjbe1 and for which appropriations1 funds1 or other authority were made available in the ,full-,year ,continuing ,appropriations ,act1 #bjbe 7division ,a of ,public ,law #aai-d71 except sections #aaaj1 #aaac1 #aaad1 and #abjg2 the proviso in paragraph 7#d7 of section #afjb2 and sections #agjh and #ahjh2 and except section #aaajd shall be applied by substituting #bjbj1 and #bjba for and #bjbj2 and except sections #ggd and #ggh of division ,b1 section #edj of division ,c1 and sections #aaj and #aab of division ,d of ,public ,law #aah-db as continued in effect by section #aaja of division ,a of ,public ,law #aai-d2 and except section #gjfi7;b7 of division ,f of ,public ,law #aah-dg1 as continued in effect by section #aaja of division ,a of ,public ,law #aai-d4 #ajb4 7a7 ,no appropriation or funds made available or authority granted pursuant to section #aja for the ,department of ,defense shall be used for3 7#a7 the new production of items not funded for production in fiscal year #bjbe or prior years2 7#b7 the increase in production rates above those sustained with fiscal year #bjbe funds2 or 7#c7 the initiation1 resumption1 or continuation of any project1 activity1 operation1 or organization 7defined as any project1 subproject1 activity1 budget activity1 program element1 and subprogram within a program element1 and for any investment items defined as a ,p-#a line item in a budget activity within an appropriation account and an ,r-#a line item that includes a program element and subprogram element within an appropriation account7 for which appropriations1 funds1 or other authority were not available during fiscal year #bjbe4 7b7 ,no appropriation or funds made available or authority granted pursuant to section #aja for the ,department of ,defense shall be used to initiate multi-year procurements utilizing advance procurement funding for economic order quantity procurement unless specifically appropriated later4 #ajc4 ,appropriations made by section #aja shall be available to the extent and in the manner that would be provided by the pertinent appropriations ,act4 #ajd4 ,except as otherwise provided in section #ajb1 no appropriation or funds made available or authority granted pursuant to section #aja shall be used to initiate or resume any project or activity for which appropriations1 funds1 or other authority were not available during fiscal year #bjbe4 #aje4 ,appropriations made and authority granted pursuant to this ,act shall cover all obligations or expenditures incurred for any project or activity during the period for which funds or authority for such project or activity are available under this ,act4 #ajf4 ,unless otherwise provided for in this ,act or in the applicable appropriations ,act for fiscal year #bjbf1 appropriations and funds made available and authority granted pursuant to this ,act shall be available until whichever of the following first occurs3 7#a7 ,the enactment into law of an appropriation for any project or activity provided for in this ,act4 7#b7 ,the enactment into law of the applicable appropriations ,act for fiscal year #bjbf without any provision for such project or activity4 7#c7 ,november #ba1 #bjbe4 #ajg4 ,expenditures made pursuant to this ,act shall be charged to the applicable appropriation1 fund1 or authorization whenever a bill in which such applicable appropriation1 fund1 or authorization is contained is enacted into law4 #ajh4 ,appropriations made and funds made available by or authority granted pursuant to this ,act may be used without regard to the time limitations for submission and approval of apportionments set forth in section #aeac of title #ca1 ,united ,states ,code1 but nothing in this ,act may be construed to waive any other provision of law governing the apportionment of funds4 #aji4 ,notwithstanding any other provision of this ,act1 except section #ajf1 for those programs that would otherwise have high initial rates of operation or complete distribution of appropriations at the beginning of fiscal year #bjbf because of distributions of funding to ,states1 foreign countries1 grantees1 or others1 such high initial rates of operation or complete distribution shall not be made1 and no grants shall be awarded for such programs funded by this ,act that would impinge on final funding prerogatives4 #aaj4 ,this ,act shall be implemented so that only the most limited funding action of that permitted in the ,act shall be taken in order to provide for continuation of projects and activities4 #aaa4 7a7 ,for entitlements and other mandatory payments whose budget authority was provided in an appropriations ,act specified in section #aja1 for expenses authorized under section #cbd of title #ch1 ,united ,states ,code1 and for activities under the ,food and ,nutrition ,act of #bjjh1 activities shall be continued at the rate to maintain program levels under current law1 under the authority and conditions provided in the applicable appropriations ,act1 to be continued through the date specified in section #ajf7c7 of this ,act4 7b7 ,notwithstanding section #ajf1 obligations for mandatory payments due on or about the first day of any month that begins after ,october #bjbe but not later than #cj days after the date specified in section #ajf7c7 may continue to be made1 and funds shall be available for such payments4 #aab4 ,amounts made available under section #aja for civilian personnel compensation and benefits in each department and agency may be apportioned up to the rate for operations necessary to avoid furloughs within such department or agency1 consistent with the applicable appropriations ,act for fiscal year #bjbe1 except that such authority provided under this section shall not be used until after the department or agency has taken all necessary actions to reduce or defer non-personnel-related administrative expenses4 #aac4 ,funds appropriated by this ,act may be obligated and expended notwithstanding section #aj of ,public ,law #ia-fgb 7#bb ,u4,s4,c4 #bdab71 section #ae of the ,state ,department ,basic ,authorities ,act of #aief 7#bb ,u4,s4,c4 #bfhj71 section #cac of the ,foreign ,relations ,authorization ,act1 ,fiscal ,years #aiid and #aiie 7#bb ,u4,s4,c4 #fbab71 and section #ejd7;a77#a7 of the ,national ,security ,act of #aidg 7#ej ,u4,s4,c4 #cjid7;a77#a774 #aad4 7a7 7#a7 ,for each amount incorporated by reference in this ,act that was previously designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a77i7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 each provision of law designating each such amount as an emergency requirement pursuant to such section shall not apply4 7#b7 ,each amount incorporated by reference in this ,act that was designated by the ,congress as an emergency requirement pursuant to section #bea7;b77#b77;,a77i7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe in the following provisions of law are designated by the ,congress as an emergency requirement pursuant to section #djja7;a77#a7 of ,s4 ,con4 ,res4 #ad 7#aagth ,congress71 the concurrent resolution on the budget for fiscal year #bjbb1 and to legislation establishing fiscal year #bjbf budget enforcement in the ,house of ,representatives3 section #aabjf7d7 of division ,a of ,public ,law #aai-d and #gjfh7;b7 of division ,f of ,public ,law #aah-dg1 as continued in effect by section #aaja of division ,a of ,public ,law #aai-d4 7b7 ,each amount incorporated by reference in this ,act that was previously designated by the ,congress as being for disaster relief pursuant to section #bea7;b77#b77;,d7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe is designated by the ,congress as being for disaster relief pursuant to a concurrent resolution on the budget4 7c7 ,each amount incorporated by reference in this ,act that was previously designated in division ,b of ,public ,law #aag-aei1 division ,j of ,public ,law #aag-eh1 or in section #ddc7;b7 of division ,g of ,public ,law #aag-cbh by the ,congress as an emergency requirement pursuant to a concurrent resolution on the budget shall continue to be treated as an amount specified in section #ajc7;b7 of division ,a of ,public ,law #aah-e4 #aae4 7a7 ,rescissions or cancellations of discretionary budget authority that continue pursuant to section #aja in ,treasury ,appropriations ,fund ,symbols 7,,tafs7-- 7#a7 to which other appropriations are not provided by this ,act1 but for which there is a current applicable ,,tafs that does receive an appropriation in this ,act2 or 7#b7 which are no-year ,,tafs and receive other appropriations in this ,act1 may be continued instead by reducing the rate for operations otherwise provided by section #aja for such current applicable ,,tafs1 as long as doing so does not impinge on the final funding prerogatives of the ,congress4 7b7 ,rescissions or cancellations described in subsection 7a7 shall continue in an amount equal to the lesser of-- 7#a7 the amount specified for rescission or cancellation in the applicable appropriations ,act referenced in section #aja of this ,act2 or 7#b7 the amount of balances available1 as of ,october #a1 #bjbe1 from the funds specified for rescission or cancellation in the applicable appropriations ,act referenced in section #aja of this ,act4 7c7 ,no later than ,november #g1 #bjbe1 the ,director of the ,office of ,management and ,budget shall provide to the ,committees on ,appropriations of the ,house of ,representatives and the ,senate a comprehensive list of the rescissions or cancellations that will continue pursuant to section #aja3 ,provided1 ,that the information in such comprehensive list shall be periodically updated to reflect any subsequent changes in the amount of balances available1 as of ,october #a1 #bjbe1 from the funds specified for rescission or cancellation in the applicable appropriations ,act referenced in section #aja1 and such updates shall be transmitted to the ,committees on ,appropriations of the ,house of ,representatives and the ,senate upon request4 #aaf4 ,amounts made available by section #aja for ,domestic ,food ,programs--,food and ,nutrition ,service--,special ,supplemental ,nutrition ,program for ,women1 ,infants1 and ,children 7,,wic7 may be apportioned at the rate for operations necessary to maintain participation4 #aag4 ,section #bfj of the ,agricultural ,marketing ,act of #aidf 7#g ,u4,s4,c4 #afcf;i7 and section #idb of the ,livestock ,mandatory ,reporting ,act of #aiii 7#g ,u4,s4,c4 #afce note2 ,public ,law #ajf-gh7 shall be applied by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 #aah4 ,section #hcjb7;b7 of the ,agricultural ,act of #bjad 7#af ,u4,s4,c4 #chea;a7b77 shall be applied by substituting the date specified in section #ajf of this ,act for ,october #a1 #bjbc4 #aai4 7a7 ,amounts made available by section #aja for ,department of ,justice--,united ,states ,marshals ,service--,salaries and ,expenses may be apportioned up to the rate for operations necessary to maintain program operations4 7b7 ,in addition to amounts provided by section #aja1 for ,department of ,justice--,united ,states ,marshals ,service--,salaries and ,expenses1 there is appropriated #cj1jjj1jjj1 for an additional amount for fiscal year #bjbf1 to remain available until ,september #cj1 #bjbg1 to carry out protective operations4 #abj4 7a7 ,for the closeout of all ,space ,shuttle contracts and associated programs1 amounts that have expired but have not been cancelled in the ,exploration1 ,space ,operations1 ,human ,space ,flight1 ,space ,flight ,capabilities1 and ,exploration ,capabilities appropriations accounts shall remain available through fiscal year #bjcj for the liquidation of valid obligations incurred during the period of fiscal year #bjja through fiscal year #bjac4 7b7 7#a7 ,subject to paragraph 7#b71 this section shall become effective immediately upon enactment of this ,act4 7#b7 ,if this ,act is enacted after ,september #cj1 #bjbe1 this section shall be applied as if it were in effect on ,september #cj1 #bjbe4 #aba4 ,section #cjad7;a7 of title #ah1 ,united ,states ,code1 shall be applied by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 #abb4 ,notwithstanding section #aja1 the first proviso in each of sections #hjib and #hjif of title ,,viii of division ,a of ,public ,law #aah-dg shall be applied by substituting advances for reimbursements4 #abc4 ,notwithstanding sections #ajb and #ajd1 amounts made available by section #aja to the ,department of ,defense for ,research1 ,development1 ,test and ,evaluation1 ,air ,force shall be apportioned up to the rate for operations necessary for the ,e-#g ,wedgetail program1 in an amount not to exceed #aii1fgf1jjj1 only for the purpose of continued rapid prototyping activities to maintain program schedule and transition to production for the ,e-#g ,wedgetail program4 #abd4 ,of the unobligated balance of funds available to the ,department of ,defense for the ,e-#g program under the heading ,aircraft ,procurement1 ,air ,force in ,public ,law #aai-d1 #bjj1jjj1jjj is hereby transferred to and merged with amounts available for the ,e-#g program under the heading ,research1 ,development1 ,test and ,evaluation1 ,air ,force only for the purpose of continued rapid prototyping activities to maintain program schedule and transition to production for the ,e-#g ,wedgetail program4 #abe4 ,section #gag7;a7 of the ,defense ,production ,act of #aiej 7#ej ,u4,s4,c4 #defd7;a77 shall be applied by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 #abf4 ,notwithstanding sections #ajb and #ajd1 amounts made available by section #aja of this ,act to the ,department of ,defense for ,shipbuilding and ,conversion1 ,navy may be apportioned up to the rate for operations necessary to fund completion of prior year shipbuilding programs for the fiscal year #bjaf and fiscal year #bjah ,virginia ,class ,submarine ,programs1 in an amount not to exceed #aed1jjj1jjj4 #abg4 ,during the period covered by this ,act1 section #ajc7;f77#d77;,a7 of ,public ,law #ajh-cfa 7the ,calfed ,bay-,delta ,authorization ,act7 shall be applied by substituting #cb1fjj1jjj for #cj1jjj1jjj4 #abh4 7a7 ,amounts made available by section #aja in the first proviso under the heading ,department of ,energy--,atomic ,energy ,defense ,activities--,national ,nuclear ,security ,administration--,weapons ,activities may be apportioned up to the rate for operations necessary to maintain current operations for the safe1 secure transport of nuclear weapons4 7b7 ,the ,director of the ,office of ,management and ,budget and the ,secretary of ,energy shall notify the ,committees on ,appropriations of the ,house of ,representatives and the ,senate not later than #c days after each use of the authority provided in subsection 7a74 #abi4 ,notwithstanding section #aja1 the matter preceding the first proviso under the heading ,office of ,personnel ,management--,salaries and ,expenses in title ,v of division ,b of ,public ,law #aah-dg shall be applied by substituting #aig1ddf1jjj for #bai1jgf1jjj1 and the second proviso under such heading in such title of such division of such ,act shall be applied by substituting #bad1fje1jjj for #aib1ige1jjj4 #acj4 ,notwithstanding any other provision of this ,act1 except section #ajf1 the ,district of ,columbia may expend local funds made available under the heading ,district of ,columbia--,district of ,columbia ,funds for such programs and activities under the ,district of ,columbia ,appropriations ,act1 #bjbd 7title ,,iv of division ,b of ,public ,law #aah-dg7 at the rate set forth in the ,fiscal ,year #bjbf ,local ,budget ,act of #bjbe 7,d4,c4 ,bill ,no4 #bf-bfj7 as modified as of the date of enactment of this ,act4 #aca4 ,notwithstanding section #aja1 paragraph 7#a7 under the heading ,department of the ,treasury--,departmental ,offices--,salaries and ,expenses in title ,i of division ,b of ,public ,law #aah-dg shall be applied by substituting #a1cej1jjj for #cej1jjj3 ,provided1 ,that such amounts may be obligated in the account and budget structure set forth in the fiscal year #bjbf ,president's ,budget1 submitted pursuant to section #aaje7;a7 of title #ca1 ,united ,states ,code1 and accompanying justification materials4 #acb4 ,amounts made available by section #aja for ,small ,business ,administration--,business ,loans ,program ,account may be apportioned up to the rate for operations necessary to accommodate increased demand for commitments for general business loans authorized under paragraphs 7#a7 through 7#ce7 of section #g7;a7 of the ,small ,business ,act 7#ae ,u4,s4,c4 #fcf7;a771 for commitments to guarantee trust certificates authorized by section #e7;g7 of the ,small ,business ,act 7#ae ,u4,s4,c4 #fcd7;g771 for commitments to guarantee loans under section #ejc of the ,small ,business ,investment ,act of #aieh 7#ae ,u4,s4,c4 #fig71 and for commitments to guarantee debentures under section #cjc7;b7 of the ,small ,business ,investment ,act of #aieh 7#ae ,u4,s4,c4 #fhc7;b774 #acc4 ,notwithstanding section #aja1 amounts are provided for ,department of the ,treasury--,office of ,terrorism and ,financial ,intelligence--,salaries and ,expenses at a rate for operations of #bcg1ffb1jjj4 #acd4 ,notwithstanding section #aja1 section #afje of ,public ,law #aai-d shall be applied by substituting through the end of the last applicable pay period that commences on or before the date specified in section #ajf7c7 of the ,continuing ,appropriations ,act1 #bjbf for through the date specified in section #aajf of this ,act4 #ace4 ,section #a7;b7 of ,public ,law #aag-be 7#ace ,stat4 #big2 #acf ,stat4 #bacc2 #acf ,stat4 #eihd2 #ach ,stat4 #agga2 #aci ,stat4 #df7 shall be applied in each of paragraphs 7#c7 and 7#d7 by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 #acf4 ,in addition to amounts otherwise provided by section #aja for ,the ,judiciary--,supreme ,court of the ,united ,states--,salaries and ,expenses1 there is appropriated #bh1jjj1jjj1 for an additional amount for fiscal year #bjbf1 to remain available until expended1 for the protection of the ,supreme ,court ,justices1 including the purchase and hire of passenger motor vehicles as authorized by #ca ,u4,s4,c4 #acdc and #acdd1 to be expended as the ,chief ,justice may approve4 #acg4 ,section #baj;,g7i7 of the ,homeland ,security ,act of #bjjb 7#f ,u4,s4,c4 #abdn7i77 shall be applied by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 #ach4 ,section #bbe7;e7 of division ,a of ,public ,law #aaf-f 7#di ,u4,s4,c4 #ddija note7 shall be applied by substituting fiscal year #bjai through the date specified in section #ajf of the ,continuing ,appropriations ,act1 #bjbf for fiscal years #bjai through #bjbe4 #aci4 ,amounts made available by section #aja to the ,department of ,homeland ,security under the heading ,federal ,emergency ,management ,agency--,disaster ,relief ,fund may be apportioned up to the rate for operations necessary to carry out response and recovery activities under the ,robert ,t4 ,stafford ,disaster ,relief and ,emergency ,assistance ,act 7#db ,u4,s4,c4 #eaba et seq474 #adj4 ,section #bbg7;a7 of the ,federal ,cybersecurity ,enhancement ,act of #bjae 7#f ,u4,s4,c4 #aebe7;a77 shall be applied by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 #ada4 ,section #aaa7;a7 of the ,cybersecurity ,information ,sharing ,act of #bjae 7#f ,u4,s4,c4 #aeaj7;a77 shall be applied by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 #adb4 ,section #bbbj;,a7s77#a7 of the ,homeland ,security ,act of #bjjb 7#f ,u4,s4,c4 #ffe;g7s77#a77 shall be applied by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 #adc4 ,during the period covered by this ,act1 section #c7;b77#b77;,c7 of the ,pittman-,robertson ,wildlife ,restoration ,act 7#af ,u4,s4,c4 #ffi;b7b77#b77;,c77 shall be applied by substituting #bjbg for #bjbf4 #add4 ,during the period covered by this ,act1 section #agja of title ,,vii of division ,b of ,public ,law #aag-dc1 as amended1 shall be applied by substituting calendar years #bjba through #bjbf for #bjba or #bjbb or #bjbc or #bjbd each place it appears4 #ade4 ,amounts made available by section #aja for ,department of the ,interior--,department-,wide ,programs--,wildland ,fire ,management and ,department of ,agriculture--,forest ,service--,wildland ,fire ,management may be apportioned up to the rate for operations necessary for wildfire suppression activities4 #adf4 7a7 ,in addition to amounts otherwise provided by section #aja1 amounts are provided for ,department of ,health and ,human ,services--,indian ,health ,service--,indian ,health ,services at a rate for operations of #gb1bfe1jjj1 for an additional amount for costs of staffing and operating facilities that were opened1 renovated1 or expanded in fiscal years #bjbe and #bjbf1 and such amounts may be apportioned up to the rate for operations necessary to staff and operate such facilities4 7b7 ,in addition to amounts otherwise provided by section #aja1 amounts are provided for ,department of ,health and ,human ,services--,indian ,health ,service--,indian ,health ,facilities at a rate for operations of #h1jej1jjj1 for an additional amount for costs of staffing and operating facilities that were opened1 renovated1 or expanded in fiscal years #bjbe and #bjbf1 and such amounts may be apportioned up to the rate for operations necessary to staff and operate such facilities4 #adg4 ,of the amounts made available in the third paragraph under the heading ,environmental ,protection ,agency--,state and ,tribal ,assistance ,grants in the ,disaster ,relief ,supplemental ,appropriations ,act1 #bjbc 7division ,n of ,public ,law #aag-cbh71 up to #ed1jjj1jjj shall be available for technical assistance and grants under section #addb7;b7 of the ,safe ,drinking ,water ,act 7#db ,u4,s4,c4 #cjj;j-#a7;b77 in areas where the ,president declared an emergency in ,august of fiscal year #bjbb pursuant to the ,robert ,t4 ,stafford ,disaster ,relief and ,emergency ,assistance ,act 7#db ,u4,s4,c4 #eaba et seq473 ,provided1 ,that amounts repurposed pursuant to this section that were previously designated by the ,congress as being for an emergency requirement pursuant to section #djja7;a77#a7 of ,s4 ,con4 ,res #ad 7#aagth ,congress71 the concurrent resolution on the budget for fiscal year #bjbb1 and section #a7;e7 of ,h4 ,res4 #aaea 7#aagth ,congress71 as engrossed in the ,house of ,representatives on ,june #h1 #bjbb1 are designated as being for an emergency requirement pursuant to section #djja7;a77#a7 of ,s4 ,con4 ,res4 #ad 7#aagth ,congress71 the concurrent resolution on the budget for fiscal year #bjbb1 and to legislation establishing fiscal year #bjbf budget enforcement in the ,house of ,representatives4 #adh4 ,notwithstanding section #aja1 the matter under the heading ,department of ,health and ,human ,services--,administration for ,children and ,families--,children and ,families ,services ,programs in title ,,ii of division ,d of ,public ,law #aah-dg shall be applied by adding the following after the second proviso3 ,provided further1 ,that for purposes of section #fdj7;a77#b77;,b77v7 of such ,act1 the base grant for each of the ,federated ,states of ,micronesia and the ,republic of the ,marshall ,islands shall be #h1jjj1jjj1 and shall be considered equal to the amount provided for base grants for such jurisdictions under such ,act for the prior fiscal year34 #adi4 ,notwithstanding any other provision of this ,act1 there is appropriated-- 7#a7 ,for payment to ,ashley ,paige ,turner1 heir of ,sylvester ,turner1 late a ,representative from the ,state of ,texas1 #agd1jjj4 7#b7 ,for payment to ,ramona ,grijalva1 widow of ,ral ,m4 ,grijalva1 late a ,representative from the ,state of ,arizona1 #agd1jjj4 7#c7 ,for payment to ,catherine ,m4 ,smith1 widow of ,gerald ,e4 ,connolly1 late a ,representative from the ,commonwealth of ,virginia1 #agd1jjj4 #aej4 ,notwithstanding any other provision of law1 no adjustment shall be made under section #fja7;a7 of the ,legislative ,reorganization ,act of #aidf 7#b ,u4,s4,c4 #deja7 7relating to cost of living adjustments for ,members of ,congress7 during the period covered by this ,act4 #aea4 ,in addition to amounts otherwise provided by section #aja1 for ,capitol ,police--,united ,states ,capitol ,police ,mutual ,aid ,reimbursements1 there is appropriated #cj1jjj1jjj1 for an additional amount for fiscal year #bjbf1 to remain available until expended1 for reimbursements for mutual aid and related training provided under the agreements described in section #gcjb of ,public ,law #ajh-deh3 ,provided1,that obligation of the funds made available in this section in this ,act shall be subject to notification to the ,chairmen and ,ranking ,members of the ,committees on ,appropriations of both ,houses of ,congress1 the ,senate ,committee on ,rules and ,administration1 and the ,committee on ,house ,administration of the amount and purpose of the expense within #ae days of obligation4 #aeb4 ,notwithstanding section #aja1 the matter under the heading ,native ,american ,veteran ,housing ,loan ,program ,account in title ,,ii of division ,a of ,public ,law #aah-db shall be applied by adding the following new paragraph3 ,in addition1 for the cost of direct loans1 #f1hfe1bce1 as authorized by subchapter ,v of chapter #cg of title #ch1 ,united ,states ,code3 ,provided1 ,that such costs1 including the cost of modifying such loans1 shall be as defined in section #ejb of the ,congressional ,budget ,act of #aigd3 ,provided further1 ,that funds made available under this heading are available to subsidize gross obligations for the principal amount of direct loans not to exceed #ge1jjj1jjj4 4 #aec4 ,section #adbd7;a7 of the ,better ,utilization of ,investments ,leading to ,development ,act of #bjah 7#bb ,u4,s4,c4 #ifbd7;a77 shall be applied by substituting the date specified in section #ajf of this ,act for the date that is #g years after the date of the enactment of this ,act4 #aed4 ,notwithstanding sections #aja and #ajf1 and sections #aaja1 #aajf1 and #aabja of ,public ,law #aai-d1 the fifth and sixth provisos under the heading ,millennium ,challenge ,corporation in title ,,iii of division ,f of ,public ,law #aah-dg shall be amended by substituting ,december #ca1 #bjbf for ,december #ca1 #bjbd each place it appears4 #aee4 ,notwithstanding section #ajf1 during fiscal year #bjbf1 the ,secretary of ,housing and ,urban ,development may use the unobligated balances of amounts made available in prior fiscal years in paragraphs 7#b71 7#c71 and 7#h7 under the heading ,public and ,indian ,housing--,tenant-,based ,rental ,assistance to support additional allocations under subparagraph 7,d7 of paragraph 7#a7 and subparagraph 7,b7 of paragraph 7#d7 of such heading to prevent the termination of rental assistance for families as the result of insufficient funding in the calendar year #bjbe funding cycle3 ,provided1,that amounts repurposed pursuant to this section that were previously designated by the ,congress as an emergency requirement pursuant to a concurrent resolution on the budget or the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe are designated by the ,congress as being for an emergency requirement pursuant to section #djja7;a77#a7 of ,s4 ,con4 ,res4 #ad 7#aagth ,congress71 the concurrent resolution on the budget for fiscal year #bjbb1 and to legislation establishing fiscal year #bjbf budget enforcement in the ,house of ,representatives4 #aef4 ,amounts made available by section #aja for ,department of ,transportation--,office of the ,secretary--,payments to ,air ,carriers may be apportioned up to the rate for operations necessary to maintain ,essential ,air ,service program operations4 #aeg4 ,section #dadd7;d7 of the ,motor ,carrier ,safety ,reauthorization ,act of #bjje 7#di ,u4,s4,c4 #caajj note7 shall be applied by substituting the date specified in section #ajf of this ,act for ,september #cj1 #bjbe4 ,this division may be cited as the ,continuing ,appropriations ,act1 #bjbf4 ,b ,,miscellaneous ,,extensions #aja4 ,united ,states grain standards ,the authorities 7including any limitations on the authorities7 provided by each provision of the ,united ,states ,grain ,standards ,act 7,public ,law #ij-dhg2 #g ,u4,s4,c4 #gd et seq47 and each provision of law amended by that ,act1 as in effect on ,september #cj1 #bjbe1 shall continue1 and the authorities 7and any such limitations7 shall be carried out1 until the later of-- 7#a7 ,november #ba1 #bjbe2 and 7#b7 the date specified in the provision of that ,act or the provision of law amended by that ,act4 ,c ,,health ,,extenders ,i ,public ,health ,extenders #aja4 ,extension for community health centers1 ,national ,health ,service ,corps1 and teaching health centers that operate ,,gme programs 7a7 ,extension for community health centers ,section #ajejc7;b77#a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bed;b-#b7;b77#a77 is amended-- 7#a7 in subparagraph 7,i71 by striking and at the end2 and 7#b7 by adding at the end the following3 7,k7 #fjf1ijd1aaj for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe2 and 4 7b7 ,extension for the ,national ,health ,service ,corps ,section #ajejc7;b77#b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #bed;b-#b7;b77#b77 is amended-- 7#a7 in subparagraph 7,j71 by striking and at the end2 7#b7 in subparagraph 7,k71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7,l7 #di1aej1fhe for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe4 4 7c7 ,teaching health centers that operate graduate medical education programs ,section #cdj;,h7g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;h7g77#a77 is amended-- 7#a7 in subparagraph 7,e71 by striking and at the end2 7#b7 in subparagraph 7,f71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7,g7 #bd1ica1ejg for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe4 4 7d7 ,application of provisions ,amounts appropriated pursuant to the amendments made by this section shall be subject to the requirements contained in ,public ,law #aag-cbh for funds for programs authorized under sections #ccj through #cdj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq474 7e7 ,conforming amendment ,section #cjad7;h77#d7 of title #ah1 ,united ,states ,code1 is amended by striking and section #baja7;d7 of division ,b of the ,full-,year ,continuing ,appropriations and ,extensions ,act1 #bjbe and inserting section #baja7;d7 of division ,b of the ,full-,year ,continuing ,appropriations and ,extensions ,act1 #bjbe1 and section #aja7;d7 of title ,i of division ,c of the ,continuing ,appropriations and ,extensions ,act1 #bjbf4 #ajb4 ,extension of special diabetes programs 7a7 ,extension of special diabetes programs for type i diabetes ,section #ccj;,b7b77#b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;c-#b7;b77#b77 is amended-- 7#a7 in subparagraph 7,f71 by striking and at the end2 7#b7 in subparagraph 7,g71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7,h7 #bb1feb1jee for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe1 to remain available until expended4 4 7b7 ,extending funding for special diabetes programs for ,indians ,section #ccj;,c7c77#b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;c-#c7;c77#b77 is amended-- 7#a7 in subparagraph 7,f71 by striking and at the end2 7#b7 in subparagraph 7,g71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7,h7 #bb1feb1jee for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe1 to remain available until expended4 4 #ajc4 ,national health security extensions 7a7 ,section #cai7;e77#h7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d7e77#h77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 7b7 ,section #cai,l7e77#a77;,d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#g;e7e77#a77;,d77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 7c7 ,section #cai,l-#a7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdg;d-#g;f7b77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 7d7 7#a7 ,section #bhaa;,a7g7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;hh-#aj;b7g77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 7#b7 ,section #bhaa;,b7g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;hh-#aj;c7g77#a77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 7#c7 ,section #bhaa;,c7g77#a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;hh-#aj;d7g77#a77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 7e7 ,section #bhab7;c77#d77;,b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;hh-#aa7;c77#d77;,b77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 ,,ii ,medicare #bja4 ,extension of increased inpatient hospital payment adjustment for certain low-volume hospitals 7a7 ,in general ,section #ahhf7;d77#ab7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#ab77 is amended-- 7#a7 in subparagraph 7,b71 by striking in fiscal year #bjbf and inserting during the portion of fiscal year #bjbf beginning on ,november #bb1 #bjbe1 and ending on ,september #cj1 #bjbf1 and in fiscal year #bjbg2 7#b7 in subparagraph 7,c77i7-- 7,a7 in the matter preceding subclause 7,i7-- 7i7 by inserting or portion of a fiscal year after for a fiscal year2 and 7ii7 by inserting and the portion of fiscal year #bjbf beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe after through #bjbe2 7,b7 in subclause 7,,iii71 by inserting and the portion of fiscal year #bjbf beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe after through #bjbe2 and 7,c7 in subclause 7,,iv71 by striking fiscal year #bjbf and inserting the portion of fiscal year #bjbf beginning on ,november #bb1 #bjbe1 and ending on ,september #cj1 #bjbf1 and fiscal year #bjbg2 and 7#c7 in subparagraph 7,d7-- 7,a7 in the matter preceding clause 7i71 by inserting or during the portion of fiscal year #bjbf beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe after through #bjbe2 and 7,b7 in clause 7ii71 by inserting and the portion of fiscal year #bjbf beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe after through #bjbe4 7b7 ,implementation ,notwithstanding any other provision of law1 the ,secretary of ,health and ,human ,services may implement the amendments made by this section by program instruction or otherwise4 #bjb4 ,extension of the ,medicare-dependent hospital 7,,mdh7 program 7a7 ,in general ,section #ahhf7;d77#e77;,g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#e77;,g77 is amended-- 7#a7 in clause 7i71 by striking ,october #a1 #bjbe and inserting ,november #bb1 #bjbe2 and 7#b7 in clause 7ii77,,ii71 by striking ,october #a1 #bjbe and inserting ,november #bb1 #bjbe4 7b7 ,conforming amendments 7#a7 ,in general ,section #ahhf7;b77#c77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7b77#c77;,d77 is amended-- 7,a7 in the matter preceding clause 7i71 by striking ,october #a1 #bjbe and inserting ,november #bb1 #bjbe2 and 7,b7 in clause 7iv71 by inserting and the portion of fiscal year #bjbf beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe after through fiscal year #bjbe4 7#b7 ,permitting hospitals to decline reclassification ,section #aceja7;e77#b7 of the ,omnibus ,budget ,reconciliation ,act of #aiic 7#db ,u4,s4,c4 #acieww note7 is amended by inserting 1 or the portion of fiscal year #bjbf beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe after through fiscal year #bjbe4 #bjc4 ,extension of add-on payments for ambulance services ,section #ahcd7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7l77 is amended-- 7#a7 in paragraph 7#ab77;,a71 by striking ,october #a1 #bjbe and inserting ,november #bb1 #bjbe2 and 7#b7 in paragraph 7#ac71 by striking ,october #a1 #bjbe each place it appears and inserting ,november #bb1 #bjbe in each such place4 #bjd4 ,extension of funding for quality measure endorsement1 input1 and selection ,section #ahij7;d77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;aaa7d77#b77 is amended-- 7#a7 in the first sentence1 by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe2 and 7#b7 in the third sentence1 by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #bje4 ,extension of funding outreach and assistance for low-income programs 7a7 ,state health insurance assistance programs ,subsection 7a77#a77;,b77xiv7 of section #aai of the ,medicare ,improvements for ,patients and ,providers ,act of #bjjh 7#db ,u4,s4,c4 #acie;b-#c note7 is amended by striking ,september #cj1 #bjbe1 #cj1jjj1jjj and inserting ,november #ba1 #bjbe1 #cb1acf1ihf4 7b7 ,area agencies on aging ,subsection 7b77#a77;,b77xiv7 of such section #aai is amended by striking ,september #cj1 #bjbe1 #cj1jjj1jjj and inserting ,november #ba1 #bjbe1 #cb1acf1ihf4 7c7 ,aging and disability resource centers ,subsection 7c77#a77;,b77xiv7 of such section #aai is amended by striking ,september #cj1 #bjbe1 #aj1jjj1jjj and inserting ,november #ba1 #bjbe1 #aj1gab1cbi4 7d7 ,coordination of efforts ,to inform older ,americans about benefits available under ,federal and ,state programs ,subsection 7d77#b77xiv7 of such section #aai is amended by striking ,september #cj1 #bjbe1 #cj1jjj1jjj and inserting ,november #ba1 #bjbe1 #cb1acf1ihf4 #bjf4 ,extension of the work geographic index floor ,section #ahdh7;e77#a77;,e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7;e77#a77;,e77 is amended by striking ,october #a1 #bjbe and inserting ,november #bb1 #bjbe4 #bjg4 ,extension of certain telehealth flexibilities 7a7 ,removing geographic requirements and expanding originating sites for telehealth services ,section #ahcd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77 is amended-- 7#a7 in paragraph 7#b77;,b77iii71 by striking ending ,september #cj1 #bjbe and inserting ending ,november #ba1 #bjbe2 and 7#b7 in paragraph 7#d77;,c77iii71 by striking ending on ,september #cj1 #bjbe and inserting ending on ,november #ba1 #bjbe4 7b7 ,expanding practitioners eligible ,to furnish telehealth services ,section #ahcd7m77#d77;,e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#d77;,e77 is amended by striking ending on ,september #cj1 #bjbe and inserting ending on ,november #ba1 #bjbe4 7c7 ,extending telehealth services for federally qualified health centers and rural health clinics ,section #ahcd7m77#h77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#h77;,a77 is amended by striking ending on ,september #cj1 #bjbe and inserting ending on ,november #ba1 #bjbe4 7d7 ,delaying the in-,person requirements under ,medicare for mental health services furnished through telehealth and telecommunications technology 7#a7 ,delay in requirements for mental health services furnished through telehealth ,section #ahcd7m77#g77;,b77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#g77;,b77i77 is amended1 in the matter preceding subclause 7,i71 by striking on or after ,october #a1 #bjbe and inserting on or after ,november #bb1 #bjbe4 7#b7 ,mental health visits furnished by rural health clinics ,section #ahcd7y77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7y77#b77 is amended by striking ,october #a1 #bjbe and inserting ,november #bb1 #bjbe4 7#c7 ,mental health visits furnished by ,federally qualified health centers ,section #ahcd7o77#d77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7o77#d77;,b77 is amended by striking ,october #a1 #bjbe and inserting ,november #bb1 #bjbe4 7e7 ,allowing for the furnishing of audio-,only telehealth services ,section #ahcd7m77#i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciem7m77#i77 is amended by striking ending on ,september #cj1 #bjbe and inserting ending on ,november #ba1 #bjbe4 7f7 ,extending use of telehealth ,to conduct face-to-,face encounter prior to recertification of eligibility for hospice care ,section #ahad7;a77#g77;,d77i77,,ii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;f7a77#g77;,d77i77,,ii77 is amended by striking ending on ,september #cj1 #bjbe and inserting ending on ,november #ba1 #bjbe4 7g7 ,program instruction authority ,the ,secretary of ,health and ,human ,services may implement the amendments made by this section through program instruction or otherwise4 #bjh4 ,extending acute hospital care at home waiver authorities ,section #ahff;,g7a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc-#g7;a77#a77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #bji4 ,extension of temporary inclusion of authorized oral antiviral drugs as covered part ,d drugs ,section #ahfj;,d-#b7;e77#a77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#ajb7;e77#a77;,c77 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #baj4 ,extension of funding for ,medicare hospice surveys ,section #c7;a77#b7 of the ,,impact ,act of #bjad 7,public ,law #aac-ahe7 is amended-- 7#a7 in subparagraph 7,a71 by striking and at the end2 7#b7 in subparagraph 7,b71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new subparagraph3 7,c7 #f1jjj1jjj for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe4 4 #baa4 ,medicare improvement fund ,section #ahih7;b77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;iii7b77#a77 is amended-- 7#a7 by striking fiscal year #bjbf and inserting fiscal year #bjbg2 and 7#b7 by striking #a1hjd1jjj1jjj and inserting #ffd1jjj1jjj4 ,,iii ,human ,services #cja4 ,sexual risk avoidance education extension ,section #eaj of the ,social ,security ,act 7#db ,u4,s4,c4 #gaj7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a7-- 7i7 by striking #bjbc1 for the period beginning on ,october #a1 #bjbc1 and ending on ,november #ag1 #bjbc1 for the period beginning on ,november #ah1 #bjbc1 and ending on ,january #ai1 #bjbd1 for the period beginning on ,january #bj1 #bjbd1 and ending on ,march #h1 #bjbd1 for the period beginning on ,march #i1 #bjbd1 and ending on ,september #cj1 #bjbd1 and for fiscal year #bjbe and inserting #bjbe1 and for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe2 and 7ii7 by striking fiscal year #bjbd and inserting fiscal year #bjbf2 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,a7-- 7,i7 by striking through #bjbc and inserting through #bjbe2 7,,ii7 by striking fiscal year #bjbd or #bjbe and inserting fiscal year #bjbf2 and 7,,iii7 by inserting 7or1 with respect to the applicable period1 for fiscal year #bjbf7 after an application for the fiscal year2 and 7ii7 in subparagraph 7,b77i71 by striking #bjbd or #bjbe and inserting #bjbf2 and 7#b7 in subsection 7f77#a7 by striking #bjbc1 for the period beginning on ,october #a1 #bjbc1 and ending on ,november #ag1 #bjbc1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbc1 for the period beginning on ,november #ah1 #bjbc1 and ending on ,january #ai1 #bjbd1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbc1 for the period beginning on ,january #bj1 #bjbd1 and ending on ,march #h1 #bjbd1 an amount equal to the pro rata portion of the amount appropriated for the period at the end of the corresponding sentence for fiscal year #bjbc1 for the period beginning on ,march #i1 #bjbd1 and ending on ,september #cj1 #bjbd1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbc1 and for fiscal year #bjbe1 an amount equal to the amount appropriated for fiscal year #bjbd and inserting #bjbe1 and for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbe4 #cjb4 ,personal responsibility education extension ,section #eac of the ,social ,security ,act 7#db ,u4,s4,c4 #gac7 is amended-- 7#a7 in subsection 7a77#a7-- 7,a7 in subparagraph 7,a71 in the matter preceding clause 7i71 by striking #bjbc1 for the period beginning on ,october #a1 #bjbc1 and ending on ,november #ag1 #bjbc1 for the period beginning on ,november #ah1 #bjbc1 and ending on ,january #ai1 #bjbd1 for the period beginning on ,january #bj1 #bjbd1 and ending on ,march #h1 #bjbd1 for the period beginning on ,march #i1 #bjbd1 and ending on ,september #cj1 #bjbd1 and for fiscal year #bjbe and inserting #bjbe1 and for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe2 and 7,b7 in subparagraph 7,b77i71 by striking the period beginning on ,october #a1 #bjbc1 and ending on ,november #ag1 #bjbc1 for the period beginning on ,november #ah1 #bjbc1 and ending on ,january #ai1 #bjbd1 for the period beginning on ,january #bj1 #bjbd1 and ending on ,march #h1 #bjbd1 for the period beginning on ,march #i1 #bjbd1 and ending on ,september #cj1 #bjbd1 and for fiscal year #bjbe and inserting fiscal years #bjbd and #bjbe1 and for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe2 7#b7 in subsection 7c77#c71 by striking #bjbd or #bjbe and inserting #bjbf2 and 7#c7 in subsection 7f71 by striking #bjbc1 for the period beginning on ,october #a1 #bjbc1 and ending on ,november #ag1 #bjbc1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbc1 for the period beginning on ,november #ah1 #bjbc1 and ending on ,january #ai1 #bjbd1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbc1 for the period beginning on ,january #bj1 #bjbd1 and ending on ,march #h1 #bjbd1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbc1 for the period beginning on ,march #i1 #bjbd1 and ending on ,september #cj1 #bjbd1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbc1 and for fiscal year #bjbe1 an amount equal to the amount appropriated for fiscal year #bjbd for fiscal year #bjbd and inserting #bjbe1 and for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe1 an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year #bjbe4 #cjc4 ,extension of funding for family-to-family health information centers ,section #eja7;c77#a77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #gja7;c77#a77;,a77 is amended-- 7#a7 in clause 7vii71 by striking and at the end2 7#b7 in clause 7viii71 by adding 2 and at the end2 and 7#c7 by adding at the end the following new clause3 7ix7 #hed1gie for the portion of fiscal year #bjbf beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe4 4 ,,iv ,medicaid #dja4 ,modifying certain disproportionate share hospital allotments 7a7 ,extending ,tennessee ,,dsh allotments ,section #aibc7;f77#f77;,a77vi7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d7;f77#f77;,a77vi77 is amended-- 7#a7 in the heading1 by inserting and a portion of fiscal year #bjbf after #bjbe2 and 7#b7 by inserting 1 and the ,,dsh allotment for ,tennessee for the portion of fiscal year #bjbf beginning ,october #a1 #bjbe1 and ending ,november #ba1 #bjbe1 shall be #g1efd1icb before the period4 7b7 ,delaying ,,dsh allotment reductions ,section #aibc7;f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#d7;f77 is amended-- 7#a7 in paragraph 7#g77;,a7-- 7,a7 in clause 7i7-- 7i7 in the matter preceding subclause 7,i71 by striking ,for each of fiscal years #bjbf through #bjbh and inserting ,for the period beginning ,november #bb1 #bjbe1 and ending ,september #cj1 #bjbf1 and for each of fiscal years #bjbg and #bjbh2 7ii7 in subclause 7,i71 by inserting or period after the fiscal year2 and 7iii7 in subclause 7,,ii71 by inserting or period after in the fiscal year2 and 7,b7 in clause 7ii71 by striking for each of fiscal years #bjbf through #bjbh and inserting for the period beginning ,november #bb1 #bjbe1 and ending ,september #cj1 #bjbf1 and for each of fiscal years #bjbg and #bjbh2 and 7#b7 in paragraph 7#h71 by striking #bjbg and inserting #bjbh4 ,v ,food and ,drug ,administration #eja4 ,short title ,this title may be cited as the ,over-the-,counter ,monograph ,drug ,user ,fee ,amendments4 #ejb4 ,finding ,congress finds that the fees authorized by the amendments made in this title will be dedicated to over-the-counter 7,,otc7 monograph drug activities1 as set forth in the goals identified for purposes of part #aj of subchapter ,c of chapter ,,vii of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#ga et seq471 in the letters from the ,secretary of ,health and ,human ,services to the ,chairman of the ,committee on ,energy and ,commerce of the ,house of ,representatives and the ,chairman of the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 as set forth in the ,congressional ,record4 #ejc4 ,definitions ,section #gdd,l7#i77;,a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#ga7i77;,a77 is amended-- 7#a7 in clause 7v71 by striking 2 or and inserting a semicolon2 7#b7 in clause 7vi7-- 7,a7 by striking addition and inserting the addition2 and 7,b7 by striking the period and inserting 2 or2 and 7#c7 by adding at the end the following3 7vii7 the addition or modification of a testing procedure applicable to one or more ,,otc monograph drugs1 provided that such additional or modified testing procedure reflects a voluntary consensus standard with respect to pharmaceutical quality that is-- 7,i7 established by a national or international standards development organization2 and 7,,ii7 recognized by the ,secretary through a process described in guidance for industry1 initially published in ,july #bjbc1 or any successor guidance1 publicly available on the website of the ,food and ,drug ,administration1 which addresses voluntary consensus standards for pharmaceutical quality4 4 #ejd4 ,authority to assess and use ,,otc monograph fees 7a7 ,types of fees ,section #gdd,m7a77#a7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#gb7;a77#a77 is amended-- 7#a7 in subparagraph 7,a7-- 7,a7 by striking on ,december #ca of the fiscal year or at any time during the preceding #ab-month period and inserting at any time during the applicable period specified in clause 7ii7 for a fiscal year2 7,b7 by striking ,each person and inserting the following3 7i7 ,assessment of fees ,each person 2 and 7,c7 by adding at the end the following3 7ii7 ,applicable period ,for purposes of clause 7i71 the applicable period is-- 7,i7 for fiscal year #bjbf1 the #ab-month period ending on ,december #ca1 #bjbe2 7,,ii7 for fiscal year #bjbg1 the #i-month period ending on ,september #cj1 #bjbf2 and 7,,iii7 for fiscal year #bjbh and each subsequent fiscal year1 the #ab-month period ending on ,september #cj of the preceding fiscal year4 2 7#b7 in subparagraph 7,b77i71 by amending subclause 7,i7 to read as follows3 7,i7 has ceased all activities related to ,,otc monograph drugs prior to-- 7aa7 for purposes of fiscal year #bjbf1 ,january #a1 #bjbe2 7bb7 for purposes of fiscal year #bjbg1 ,january #a1 #bjbf2 and 7cc7 for purposes of fiscal year #bjbh and each subsequent fiscal year1 ,october #a of the preceding fiscal year2 and 2 and 7#c7 by amending subparagraph 7,d7 to read as follows3 7,d7 ,due date 7i7 ,fiscal year #bjbf ,for fiscal year #bjbf1 the facility fees required under subparagraph 7,a7 shall be due on the later of-- 7,i7 the first business day of ,june of such year2 or 7,,ii7 the first business day after the enactment of an appropriations ,act providing for the collection and obligation of fees under this section for such year4 7ii7 ,fiscal year #bjbg ,for fiscal year #bjbg1 the facility fees required under subparagraph 7,a7 shall be due-- 7,i7 in a first installment representing #ej percent of such fee1 on the later of-- 7aa7 ,october #a1 #bjbf2 or 7bb7 the first business day after the enactment of an appropriations ,act providing for the collection and obligation of fees under this section for such year2 and 7,,ii7 in a second installment representing the remaining #ej percent of such fee1 on-- 7aa7 ,february #a1 #bjbg2 or 7bb7 if an appropriations ,act described in subclause 7,i77bb7 is not in effect on ,february #a1 #bjbg1 the first business day after enactment of such an appropriations ,act4 7iii7 ,subsequent fiscal years ,for fiscal year #bjbh and each subsequent fiscal year1 the facility fees required under subparagraph 7,a7 shall be due on the later of-- 7,i7 the first business day on or after ,october #a of the fiscal year2 or 7,,ii7 the first business day after the date of enactment of an appropriations ,act providing for the collection and obligation of fees under this section for the fiscal year4 4 7b7 ,fee revenue amounts ,section #gdd,m7b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#gb7;b77 is amended to read as follows3 7b7 ,fee revenue amounts 7#a7 ,in general ,for each of the fiscal years #bjbf through #bjcj1 fees under subsection 7a77#a7 shall be established to generate a total facility fee revenue amount equal to the sum of-- 7,a7 the annual base revenue for the fiscal year 7as determined under paragraph 7#b772 7,b7 the dollar amount equal to the inflation adjustment for the fiscal year 7as determined under subsection 7c77#a772 7,c7 the dollar amount equal to the operating reserve adjustment for the fiscal year1 if applicable 7as determined under subsection 7c77#b772 7,d7 additional direct cost adjustments 7as determined under subsection 7c77#c772 7,e7 an additional dollar amount equal to-- 7i7 #b1cgc1jjj for fiscal year #bjbf2 7ii7 #a1bcc1jjj for fiscal year #bjbg2 and 7iii7 #hed1jjj for fiscal year #bjbh2 and 7,f7 in the case of a fiscal year for which the ,secretary applies the one-time facility fee workload adjustment under subsection 7c77#d71 the dollar amount equal to such adjustment4 7#b7 ,annual base revenue ,for purposes of paragraph 7#a71 the dollar amount of the annual base revenue for a fiscal year shall be-- 7,a7 for fiscal year #bjbf1 the dollar amount of the total revenue amount established for fiscal year #bjbe under this subsection as in effect on the day before the date of enactment of the ,over-the-,counter ,monograph ,drug ,user ,fee ,amendments1 not including any adjustments made for such fiscal year #bjbe under subsection 7c77#b71 as so in effect2 and 7,b7 for fiscal years #bjbg through #bjcj1 the dollar amount of the total revenue amount established under this subsection for the previous fiscal year1 not including any adjustments made for such previous fiscal year under subsection 7c77#b7 or 7c77#c74 4 7c7 ,adjustments2 annual fee setting ,section #gdd,m7c7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#gb7;c77 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 in subparagraph 7,a71 in the matter preceding clause 7i7-- 7i7 by striking subsection 7b77#b77;,b7 and inserting subsection 7b77#a77;,b72 and 7ii7 by striking fiscal year #bjbb and each subsequent fiscal year and inserting each fiscal year2 7,b7 in subparagraph 7,b71 by striking fiscal year #bjbb and all that follows through the period at the end and inserting the following3 a fiscal year shall be equal to the product of-- 7i7 for fiscal year #bjbf-- 7,i7 the fee for fiscal year #bjbe under subsection 7a77#b72 and 7,,ii7 the inflation adjustment percentage under subparagraph 7,c72 and 7ii7 for each of fiscal years #bjbg through #bjcj-- 7,i7 the applicable fee under subsection 7a77#b7 for the preceding fiscal year2 and 7,,ii7 the inflation adjustment percentage under subparagraph 7,c74 2 and 7,c7 in subparagraph 7,c7-- 7i7 in the matter preceding clause 7i71 by inserting the sum of after is equal to2 7ii7 by striking clause 7i72 7iii7 by redesignating subclauses 7,i7 and 7,,ii7 of clause 7ii7 as clauses 7i7 and 7ii71 respectively1 and adjusting the margins accordingly2 7iv7 by striking 7ii7 for each of fiscal years #bjbd and #bjbe1 the sum of--2 and 7v7 in clause 7ii71 as so redesignated1 by striking ,washington-,baltimore1 ,,dc-,,md-,,va-,,wv and inserting ,washington-,arlington-,alexandria-,,dc- ,,va-,,md-,,wv2 7#b7 in paragraph 7#b7-- 7,a7 in subparagraph 7,a7-- 7i7 by striking fiscal year #bjba and subsequent fiscal years and inserting each fiscal year2 7ii7 by striking subsections 7b77#a77;,b7 and 7b77#b77;,c7 and inserting subsection 7b77#a77;,c72 and 7iii7 by striking the number of weeks specified in subparagraph 7,b7 and inserting #aj weeks2 7,b7 by striking subparagraph 7,b72 7,c7 by redesignating subparagraphs 7,c7 and 7,d7 as subparagraphs 7,b7 and 7,c71 respectively2 and 7,d7 in subparagraph 7,c71 as so redesignated1 by striking paragraph 7#d7 establishing and inserting paragraph 7#e7 publishing2 7#c7 in paragraph 7#c7-- 7,a7 in the matter preceding subparagraph 7,a71 by striking subsection 7b77#b77;,d7 and inserting subsection 7b77#a77;,d72 and 7,b7 by striking subparagraphs 7,a7 through 7,e7 and inserting the following3 7,a7 #ace1jjj for fiscal year #bjbf2 7,b7 #cjj1jjj for fiscal year #bjbg2 7,c7 #ee1jjj for fiscal year #bjbh2 7,d7 #cj1jjj for fiscal year #bjbi2 and 7,e7 #j for fiscal year #bjcj4 2 and 7#d7 by striking paragraph 7#d7 and inserting the following3 7#d7 ,one-time facility fee workload adjustment 7,a7 ,in general ,in addition to the adjustments under paragraphs 7#a71 7#b71 and 7#c71 the ,secretary may further increase the fee revenues and fees through a one-time adjustment made for fiscal year #bjbh1 #bjbi1 or #bjcj1 in accordance with this paragraph4 7,b7 ,adjustment described 7i7 ,conditions for adjustment ,an adjustment under this paragraph may be made for a fiscal year only if-- 7,i7 an adjustment under this paragraph had not been made for any prior fiscal year2 7,,ii7 the average number of ,,otc monograph drug facilities subject to a facility fee under subsection 7a77#a7 over the period of the preceding #c fiscal years exceeds #a1fbe2 and 7,,iii7 with respect to facilities described in subclause 7,,ii71 the average number of such facilities 7expressed as a percentage7 that appeared on the arrears lists pursuant to subsection 7e77#a77;,a77i7 over the period of the preceding #c fiscal years is less than #cj percent4 7ii7 ,amount of adjustment ,an adjustment under this paragraph for a fiscal year shall equal the product of-- 7,i7 the total facility revenue amount determined under subsection 7b7 for the fiscal year1 exclusive of the adjustment under this paragraph for such fiscal year2 and 7,,ii7 the excess facility percentage described in clause 7iii74 7iii7 ,excess facility percentage ,the excess facility percentage described in this clause is-- 7,i7 the amount by which the average number of ,,otc monograph drug facilities subject to a facility fee under subsection 7a77#a7 over the preceding #c fiscal years exceeds #a1fbe2 divided by 7,,ii7 #a1fbe4 7#e7 ,annual fee setting ,the ,secretary shall1 not later than #fj days before the first day of each fiscal year-- 7,a7 establish for such fiscal year1 based on the revenue amounts under subsection 7b7 and the adjustments provided under this subsection-- 7i7 ,,otc monograph drug facility fees under subsection 7a77#a72 and 7ii7 ,,otc monograph order request fees under subsection 7a77#b72 and 7,b7 publish such fee revenue amounts1 facility fees1 and ,,otc monograph order request fees in the ,federal ,register4 4 7d7 ,crediting and availability of fees ,section #gdd,m7f7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#gb7;f77 is amended-- 7#a7 in paragraph 7#b77;,d7-- 7,a7 in the subparagraph heading1 by striking in subsequent years2 and 7,b7 by striking 7after fiscal year #bjba72 and 7#b7 in paragraph 7#c71 by striking #bjba through #bjbe and inserting #bjbf through #bjcj4 #eje4 ,reauthorization2 reporting requirements 7a7 ,performance report ,section #gdd,n of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#gc7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by striking ,beginning with fiscal year #bjba1 and not later than #abj calendar days after the end of each fiscal year thereafter and inserting the following3 7#a7 ,in general ,not later than #abj calendar days after the end of each fiscal year 2 7,b7 by striking section #chfa7;b7 of the ,,cares ,act and inserting section #b of the ,over-the-,counter ,monograph ,drug ,user ,fee ,amendments2 and 7,c7 by adding at the end the following3 7#b7 ,additional information ,beginning with fiscal year #bjbf1 the annual report under this subsection shall include-- 7,a7 the progress of the ,food and ,drug ,administration in achieving the goals1 and future plans for meeting the goals1 including-- 7i7 the number of ,tier #a ,,otc monograph order requests for which a proposed order was issued1 and the number of such requests for which a final order was issued1 in the previous fiscal year2 7ii7 the number of ,tier #b ,,otc monograph order requests for which a proposed order was issued1 and the number of such requests for which a final order was issued1 in the previous fiscal year2 7iii7 the number of specified safety ,,otc monograph order requests for which a proposed order was issued1 and the number of such requests for which a final order was issued1 in the previous fiscal year2 7iv7 the number of generally recognized as safe and effective finalization ,,otc monograph order requests for which a proposed order was issued1 and the number of such requests for which a final order was issued1 in the previous fiscal year2 7v7 the average timeline for processing ,,otc monograph order requests1 in the aggregate and by submission type1 in the previous fiscal year2 and 7vi7 postmarket safety activities with respect to ,,otc monograph drugs1 including-- 7,i7 collecting1 developing1 and reviewing safety information on ,,otc monograph drugs1 including adverse event reports2 7,,ii7 developing and using improved analytical tools1 adverse event data-collection systems1 including information technology systems1 to assess potential safety problems1 including access to external databases2 and 7,,iii7 activities under section #gfj2 7,b7 information regarding registration of ,,otc monograph drug facilities and contract manufacturing organization facilities and payment of registration fees by such facilities1 including-- 7i7 the ,,otc monograph drug facilities and contract manufacturing organization facilities that were first registered under section #eaj7;c7 or #eaj7;i7 in the fiscal year2 and 7ii7 for each ,,otc monograph drug facility and contract manufacturing organization facility that was assessed a facility fee under section #gdd,m7a7 in the fiscal year1 whether the facility paid such fee2 7,c7 the status of implementation of evidence and testing standards under section #eje;,g7r7 for nonprescription drugs intended for topical administration1 including-- 7i7 the application of evidence or testing standards2 and 7ii7 the number of active ingredient requests for nonprescription drugs intended for topical administration reviewed using the standards under section #eje;,g7b72 and 7,d7 the progress of the ,food and ,drug ,administration in allowing nonclinical testing alternatives to animal testing for the consideration of sunscreen active ingredients4 7#c7 ,confidentiality ,nothing in paragraph 7#b7 shall be construed to authorize the disclosure of information that is prohibited from disclosure under section #cja7;j7 of this ,act or section #aije of title #ah1 ,united ,states ,code1 or that is subject to withholding under section #eeb7;b77#d7 of title #e1 ,united ,states ,code4 2 7#b7 in subsection 7b71 by striking fiscal year #bjba and each subsequent fiscal year and inserting each fiscal year2 and 7#c7 in subsection 7d7-- 7,a7 by striking #bjbe each place it appears and inserting #bjcj2 and 7,b7 by adding at the end the following3 7#d7 ,minutes of negotiation meetings 7,a7 ,public availability ,the ,secretary shall make publicly available1 on the public website of the ,food and ,drug ,administration1 robust written minutes of all negotiation meetings conducted under this subsection between the ,food and ,drug ,administration and the regulated industry1 not later than #cj days after each such negotiation meeting4 7,b7 ,content ,the robust written minutes described under subparagraph 7,a7 shall contain1 in detail1 any substantive proposal made by any party to the negotiations as well as significant controversies or differences of opinion during the negotiations and their resolution4 4 7b7 ,,gao report 7#a7 ,in general ,not later than ,september #cj1 #bjbg1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report assessing the supply chain of over-the-counter monograph drugs4 7#b7 ,contents ,the report required under paragraph 7#a7 shall include an assessment of-- 7,a7 the overall stability of the supply chain of over-the-counter monograph drugs2 7,b7 what information is collected by the ,food and ,drug ,administration with respect to the supply chain of over-the-counter monograph drugs2 7,c7 how the ,food and ,drug ,administration uses information collected on the supply chain of over-the-counter monograph drugs to inform regulatory decisions2 7,d7 how the ,food and ,drug ,administration coordinates with other ,federal agencies to monitor and mitigate disruptions to the supply chain of over-the-counter monograph drugs2 and 7,e7 the unique characteristics of the over-the-counter monograph drug marketplace and what additional authorities or information the ,food and ,drug ,administration may need to ensure the stability of the supply chain of over-the-counter monograph drugs4 #ejf4 ,treatment of active ingredients for topical administration 7a7 ,in general ,section #eje;,g of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee;h7 is amended by adding at the end the following3 7r7 ,evidence and testing standards for active ingredients for topical administration 7#a7 ,evidence and testing standards for active ingredients for topical administration ,the ,secretary shall-- 7,a7 in evaluating the generally recognized as safe and effective status of active ingredients used in nonprescription drugs intended for topical administration for purposes of subsection 7a71 utilize standards that allow for the use of real world evidence 7as defined in section #eje;,f7b771 as appropriate1 as part of a comprehensive evaluation of scientific evidence to demonstrate the safety and effectiveness of such active ingredients1 to supplement evidence from traditional clinical trials1 provided that such standards allow the ,secretary to evaluate whether the benefits of such active ingredients outweigh the risks2 and 7,b7 apply subsection 7b77#f77;,c7 to the regulation of active ingredients used in drugs intended for topical administration4 7#b7 ,non-animal testing methods for topical active ingredients 7,a7 ,in general ,the ,secretary shall consider the types of nonclinical tests described in paragraphs 7#a7 through 7#d7 of the first subsection 7z7 of section #eje 7as inserted by section #cbji7;a77#b7 of the ,health ,extenders1 ,improving ,access to ,medicare1 ,medicaid1 and ,,chip1 and ,strengthening ,public ,health ,act of #bjbb 7division ,,ff of ,public ,law #aag-cbh771 or any other alternative to animal testing that the ,secretary determines appropriate1 in the consideration of drugs intended for topical administration under this section4 7,b7 ,guidance ,not later than #a year after the date of enactment of this subsection1 the ,secretary shall issue new draft guidance on how sponsors can use nonclinical testing alternatives to animal testing1 as appropriate1 to meet safety and efficacy standards under this section for drugs intended for topical administration4 7#c7 ,clarification ,nothing in this subsection shall be construed to alter1 supersede1 or limit the standards for making determinations of whether a drug is generally recognized as safe and effective under section #bja7p7 or the standards set forth under section #eje for determining the safety and effectiveness of drugs4 4 7b7 ,sunscreen final administrative order ,a final administrative order on nonprescription sunscreen active ingredients issued under section #ched of the ,coronavirus ,aid1 ,relief1 and ,economic ,security ,act 7,public ,law #aaf-acf2 #ba ,u4,s4,c4 #cfj;fff-#c note7 shall-- 7#a7 account for historical data regarding the safety of sunscreen active ingredients that have previously been accepted for marketing in the ,united ,states2 7#b7 account for the role of broad spectrum sunscreens with a ,sun ,protection ,factor of #ae or higher in effective skin cancer prevention2 and 7#c7 incorporate the evidence and testing standards for sunscreen active ingredients detailed in section #eje;,g7r7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee;h7 7as added by subsection 7a774 #ejg4 ,increasing the clarity and predictability of the process for developing applications for ,rx-to-nonprescription switches 7a7 ,in general ,section #eje7;b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee7;b77 is amended by adding at the end the following3 7#g7 ,rx-to-nonprescription switches 7,a7 ,meetings ,any person planning to submit an application for an ,rx-to-nonprescription switch may submit to the ,secretary a written request for a meeting1 for purposes of developing a plan for such application that addresses the potential risks to public health of such switch and the evidence necessary to support such application1 including the design of any necessary studies1 and the format and content of the planned application4 ,the ,secretary may grant such a meeting1 as appropriate1 consistent with established procedures for granting meetings with1 and providing written responses to1 applications under this section4 ,each such meeting shall be documented in meeting minutes4 7,b7 ,guidance 7i7 ,in general ,not later than #ah months after the date of enactment of this paragraph1 the ,secretary shall issue guidance to increase the clarity and predictability of the process and standards for approval of applications for nonprescription drugs under this section1 including in the case of applications for an ,rx-to-nonprescription switch1 especially with respect to prescription drugs with well-established safety profiles for which an applicant may seek approval for nonprescription use4 7ii7 ,contents ,the guidance under clause 7i7 shall-- 7,i7 describe how published reports in medical literature1 any previous finding of safety or effectiveness for the drug under this section1 the results of significant human experience with the drug1 unpublished studies and other data1 and other sources of information may be used to support an application for a nonprescription drug1 including in the context of an application for an ,rx-to-nonprescription switch2 7,,ii7 set forth procedures for sponsors to request meetings described in subparagraph 7,a7 and document the recommendations made in such meetings2 7,,iii7 describe evidentiary expectations to support approval of an application for a nonprescription drug1 including in the context of an application for an ,rx-to-nonprescription switch1 including how sponsors can demonstrate that consumers can appropriately self-select and use the drug and comprehend the nonprescription drug label2 and 7,,iv7 provide recommendations for how mechanisms1 in addition to the required ,drug ,facts ,label1 such as mobile applications and decisions aids1 can be incorporated into the information submitted in support of an application for an ,rx-to-nonprescription switch4 7,c7 ,plan to engage with stakeholders ,not later than #a year after the date of enactment of this paragraph1 the ,secretary shall develop and make publicly available on the website of the ,food and ,drug ,administration a plan to engage stakeholders on steps and factors for application holders and other stakeholders to consider in identifying approved prescription drugs that may be promising candidates for applications for an ,rx-to-nonprescription switch4 7,d7 ,definition ,for purposes of this paragraph1 the term ,rx-to-nonprescription switch means the approval of an application1 or supplemental application1 as applicable1 submitted under this section by the holder of an approved application for a prescription drug seeking approval to market such drug as a nonprescription drug1 including for-- 7i7 a full ,rx-to-nonprescription switch1 under which a drug previously approved for prescription use only is-- 7,i7 approved for nonprescription use under the same conditions as applied to the drug when approved for prescription use2 or 7,,ii7 approved for nonprescription use subject to one or more additional conditions for nonprescription use2 and 7ii7 a partial ,rx-to-nonprescription switch1 under which the drug is approved for nonprescription use only under certain conditions described in the approved labeling1 while the drug otherwise remains approved for prescription use only4 7,e7 ,rule of construction ,nothing in this paragraph shall be construed to-- 7i7 supersede or modify the authority of the ,secretary under section #eje;,g with respect to the regulation of ,,otc monograph drugs2 or 7ii7 authorize the disclosure by the ,secretary of confidential commercial information or trade secrets4 4 7b7 ,,gao ,report 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report that evaluates-- 7,a7 the number of applications for an ,rx-to-nonprescription switch approved during the period beginning on ,october #a1 #bjbb1 and ending on the date of the report2 7,b7 the number of drugs for which an application for an ,rx-to-nonprescription switch was approved during such period subject to an additional condition for nonprescription use2 7,c7 among the drugs for which an application for a full or partial ,rx-to-nonprescription switch was approved during such period1 the average length of time from receipt by the ,food and ,drug ,administration of the application to the approval of such application2 7,d7 the number of partial ,rx-to-nonprescription switch applications approved during such period1 and the number of applications for such a partial switch not approved2 7,e7 any barriers to timely and predictable review of applications for an ,rx-to-nonprescription switch2 7,f7 engagement by the ,food and ,drug ,administration with public stakeholders1 including public meetings or additional activities to support review of applications for an ,rx-to-nonprescription switch2 and 7,g7 opportunities for collaboration between the ,center for ,drug ,evaluation and ,research and the ,centers for ,medicare ,medicaid ,services for the purpose of analyzing health insurance claims data for commonly prescribed drugs that appear to be suitable for an ,rx-to-nonprescription switch4 7#b7 ,definition ,in this subsection1 the term ,rx-to-nonprescription switch has the meaning given such term in paragraph 7#g7 of section #eje7;b7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #bdd7;b771 as added by subsection 7a74 #ejh4 ,regulation of certain nonprescription drugs that are marketed without an approved drug application 7a7 ,development advice to sponsors or requestors ,section #eje;,g7h7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee;h7h77 is amended by striking sponsors or requestors and inserting sponsors1 requestors1 or organizations nominated by sponsors or requestors to represent their interests in a proceeding4 7b7 ,technical correction ,section #eje;,g7b77#b77;,a77iv77,,iii7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee;h7b77#b77;,a77iv77,,iii77 is amended by striking requestors and inserting sponsors or requestors4 #eji4 ,sunset dates 7a7 ,authorization ,sections #gdd,l and #gdd,m of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#ga2 #cgi;j-#gb7 shall cease to be effective ,october #a1 #bjcj4 7b7 ,reporting requirements ,section #gdd,n of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#gc7 shall cease to be effective ,january #ca1 #bjca4 #eaj4 ,effective date ,the amendments made by this title shall take effect on ,october #a1 #bjbe1 or the date of the enactment of this ,act1 whichever is later1 except that fees under part #aj of subchapter ,c of chapter ,,vii of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#ga et seq47 shall be assessed beginning ,october #a1 #bjbe1 regardless of the date of the enactment of this ,act4 #eaa4 ,savings clause ,notwithstanding the amendments made by this title1 part #aj of subchapter ,c of chapter ,,vii of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cgi;j-#ga et seq471 as in effect on the day before the date of enactment of this ,act1 shall continue to be in effect with respect to assessing and collecting any fee required by such part for a fiscal year prior to fiscal year #bjbf4 ,,vi ,no ,surprises ,act ,implementation #fja4 ,extending availability of funding for ,no ,surprises ,act implementation ,section #aah7;a7 of division ,,bb of the ,consolidated ,appropriations ,act1 #bjba 7,public ,law #aaf-bfj7 is amended-- 7#a7 by striking otherwise appropriated1 to the ,secretary of ,health and ,human ,services and inserting the following3 otherwise appropriated-- 7#a7 to the ,secretary of ,health and ,human ,services 2 7#b7 in paragraph 7#a71 as so inserted1 by striking ,september #cj1 #bjbe4 and inserting ,november #ba1 #bjbe2 and2 and 7#c7 by adding at the end the following new paragraph3 7#b7 to the ,secretary of ,health and ,human ,services1 in addition to amounts otherwise appropriated under paragraph 7#a71 #ae1jjj1jjj for the period beginning on ,october #a1 #bjbe1 and ending on ,november #ba1 #bjbe4 4 ,d ,,department ,,of ,,veterans ,,affairs ,,extenders ,i ,health ,care ,matters #aja4 ,extension of authority for collection of copayments for hospital care and nursing home care ,section #agaj7;f77#b77;,b7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #ajb4 ,extension of requirement to provide nursing home care to certain veterans with service-connected disabilities ,section #agaj;,a7d7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #ajc4 ,extension of ,staff ,sergeant ,parker ,gordon ,fox ,suicide ,prevention ,grant ,program ,section #bja7;j7 of the ,commander ,john ,scott ,hannon ,veterans ,mental ,health ,care ,improvement ,act of #bjai 7,public ,law #aaf-aga2 #ch ,u4,s4,c4 #agbj;,f note7 is amended by striking the date that is three years after the date on which the first grant is awarded under this section and inserting ,november #ba1 #bjbe4 #ajd4 ,extension of funding for expansion of ,rural ,access ,network for ,growth ,enhancement ,program ,section #b7;d7 of the ,sgt4 ,ketchum ,rural ,veterans ,mental ,health ,act of #bjba 7,public ,law #aag-ba2 #ch ,u4,s4,c4 #agab;,a note7 is amended by striking #bjbe and inserting #bjbf4 ,,ii ,benefits #bja4 ,extension of requirement for quarterly briefings on administration of authorities relating to determinations regarding presumptions of service connection based on toxic exposure ,section #bjb7;b77#b7 of the ,sergeant ,first ,class ,heath ,robinson ,honoring our ,promise to ,address ,comprehensive ,toxics ,act of #bjbb 7,public ,law #aag-afh7 is amended by striking ,on a quarterly basis during the two-year period beginning on the date of the enactment of this ,act1 and inserting ,on a quarterly basis during the period beginning on the date of the enactment of this ,act and ending on ,december #ca1 #bjbf14 #bjb4 ,extension of requirement relating to restoration of entitlement to educational assistance in cases of closure or disapproval of educational institutions ,section #cfii7;c77#b77;,c7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #bjc4 ,extension of temporary clarification of licensure requirements for contractor medical professionals to perform medical disability examinations for the ,department of ,veterans ,affairs under pilot program for use of contract physicians for disability examinations ,section #bjjb7;a77#d7 of the ,johnny ,isakson and ,david ,p4 ,roe1 ,m4,d4 ,veterans ,health ,care and ,benefits ,improvement ,act of #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #eaja note7 is amended by striking five years and inserting six years4 #bjd4 ,extension of authority to maintain regional office in ,republic of ,philippines ,section #cae7;b7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 ,,iii ,housing #cja4 ,extension of authorization of appropriations for homeless women veterans and homeless veterans with children reintegration grant program ,section #bjba;,a7f77#a7 of title #ch1 ,united ,states ,code1 is amended by striking #bjbe and inserting #bjbf4 #cjb4 ,extension of authority for treatment and rehabilitation for seriously mentally ill and homeless veterans 7a7 ,general treatment ,section #bjca7;b7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 7b7 ,additional services at certain locations ,section #bjcc7;d7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #cjc4 ,extension of funding for financial assistance for supportive services for very low-income veteran families in permanent housing ,of the amounts appropriated to the ,department of ,veterans ,affairs for fiscal year #bjbf for ,medical ,services1 #ib1jjj1jjj shall be available until ,november #ba1 #bjbe1 to carry out subsections 7a71 7b71 and 7c7 of section #bjdd of title #ch1 ,united ,states ,code4 #cjd4 ,extension of funding for grant program for homeless veterans with special needs ,of the amounts appropriated to the ,department of ,veterans ,affairs for fiscal year #bjbf for ,medical ,services1 #hcc1ccc shall be available until ,november #ba1 #bjbe1 for the purposes of the program under section #bjfa of title #ch1 ,united ,states ,code4 #cje4 ,extension of authority to provide assistance for specially adapted housing for disabled veterans residing temporarily in housing owned by a family member ,section #bajb;,a7e7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #cjf4 ,extension of authority for specially adapted housing assistive technology grant program ,section #bajh7;g7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #cjg4 ,improvements to ,partial ,claim ,program of the ,department of ,veterans ,affairs 7a7 ,clarification of relationship to other powers of ,secretary ,section #cgbj7;h7 of title #ch1 ,united ,states ,code1 is amended by striking of subsection 7a7 and all that follows through the period at the end and inserting of subsection 7a7 in conjunction with the purchase of a loan under section #cgcb7;a77#b7 of this title unless the ,secretary determines the purchase would be made consistent with section #cgcb7;d7 of this title44 7b7 ,administration of ,partial ,claim ,program ,section #cgcg of such title is amended-- 7#a7 in subsection 7b77#b71 by striking first lien guaranteed loan for such property and inserting amount of indebtedness under the guaranteed loan that the ,secretary does not purchase2 and 7#b7 in subsection 7c7-- 7,a7 in paragraph 7#b77;,b77ii71 by striking #abj days and inserting #ahj days2 and 7,b7 by amending paragraph 7#c7 to read as follows3 7#c7 ,an amount paid to the holder of a loan as a partial claim-- 7,a7 shall not alter the guaranty calculation specified by section #cgjc of this title2 7,b7 shall be included1 for the purpose of a liquidation sale1 in the same manner as any other advance allowed by the ,secretary2 and 7,c7 shall not be claimed under the guaranty or increase the ,secretary's cost of acquisition of the property securing the defaulted loan4 4 7c7 ,requirements of loan holder ,section 7d77#a7 of such section is amending by inserting and servicing the loan after documents4 7d7 ,default and foreclosure ,subsection 7e7 of such section is amended-- 7#a7 in paragraph 7#a7-- 7,a7 in subparagraph 7,a71 by striking an individual who and all that follows through the period at the end and inserting the following3 a borrower who defaults on a partial claim shall be liable to the ,secretary for any loss suffered by the ,secretary with respect to such default1 and such loss may be recovered in the same manner as any other debt due the ,united ,states4 ,the ,secretary shall not restore housing loan entitlement under section #cgjb7;b7 of this title until such loss is repaid in full42 and 7,b7 by amending subparagraph 7,b7 to read as follows3 7,b7 ,the ,secretary may charge administrative costs1 fees1 and interest1 as appropriate1 with respect to any default under a partial claim in a manner similar to the interest and administrative costs charged under section #ecae of this title4 2 and 7#b7 by amending paragraph 7#b7 to read as follows3 7#b7 ,notwithstanding section #bdaj of title #bh1 a nonjudicial sale of real property to satisfy a loan guaranteed under this chapter shall discharge the property from a partial claim interest held by the ,secretary1 provided that the holder of the guaranteed loan conducts the non-judicial sale and distributes the sale proceeds1 if any1 in accordance with the ,state or local law where such property is situated4 4 7e7 ,guidance in advance of regulations ,subsection 7h7 of such section is amended to read as follows3 7h7 ,guidance in advance of regulations ,notwithstanding any other provision of law1 the ,secretary may1 before prescribing regulations1 issue administrative guidance with respect to the ,partial ,claim ,program under this section and the loss mitigation options prescribed under section #cgcb7;d7 of this title1 including any additional terms1 conditions1 and requirements the ,secretary determines necessary4 4 #cjh4 ,government ,accountability ,office reports on ,partial ,claim ,program of the ,department of ,veterans ,affairs and other matters 7a7 ,annual reports 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and every year thereafter until the ,partial ,claim ,program terminates1 the ,comptroller ,general of the ,united ,states shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report4 7#b7 ,elements ,each report required by paragraph 7#a7 shall include1 for the period covered by the report and disaggregated by quarter1 the following3 7,a7 ,key data on the performance of the ,partial ,claim ,program1 including-- 7i7 the number of partial claims filed and approved2 and 7ii7 the redefault and foreclosure rates of loans for which a partial claim was made4 7,b7 ,a comparison of the data described in subparagraph 7,a7 with data on the performance of other loss mitigation options provided by the ,department of ,veterans ,affairs4 7,c7 ,the number of housing loans insured1 guaranteed1 or made by the ,secretary of ,veterans ,affairs under chapter #cg of title #ch1 ,united ,states ,code4 7,d7 ,the number of applications for housing loan benefits under such chapter denied4 7,e7 ,the number of housing loans insured1 guaranteed1 or made by the ,secretary under such chapter refinanced under section #cgaj7;a77#h7 or #cgab of title #ch1 ,united ,states ,code4 7,f7 ,the number of veterans who owe a payment on a mortgage associated with a loan insured1 guaranteed1 or made by the ,secretary under such chapter that is at least-- 7i7 #fj days late2 and 7ii7 #ij days late4 7b7 ,assessment 7#a7 ,in general ,not later than one year before the ,partial ,claim ,program terminates1 the ,comptroller ,general shall-- 7,a7 conduct an assessment of the benefits and challenges of the ,partial ,claim ,program2 and 7,b7 submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the findings of the ,comptroller ,general with respect to that assessment4 7#b7 ,considerations ,in conducting the assessment required by paragraph 7#a71 the ,comptroller ,general shall consider the following3 7,a7 ,the characteristics of borrowers for whom a partial claim was made compared to the characteristics of borrowers provided other loss mitigation options by the ,department of ,veterans ,affairs4 7,b7 ,the performance of loans guaranteed under chapter #cg of title #ch1 ,united ,states ,code1 following various loss mitigation actions4 7,c7 ,the information the ,department considered in determining whether a borrower would benefit from a partial claim compared to other loss mitigation options4 7,d7 ,the costs to taxpayers of the ,partial ,claim ,program compared to the costs of other loss mitigation options provided by the ,department4 7,e7 ,any similarities and differences in the ,department's administration and use of the ,partial ,claim ,program compared to the ,department's administration and use of the ,,covid-#ai ,veterans ,assistance ,partial ,claim ,payment program established under subpart ,f of part #cf of title #ch1 ,code of ,regulations4 7,f7 ,the information the ,department learned from the ,,covid-#ai ,veterans ,assistance ,partial ,claim ,payment program and the extent to which those lessons learned were applied to the ,partial ,claim ,program4 7,g7 ,the types of information the ,department collected to monitor the performance and effectiveness of the ,partial ,claim ,program and how the ,department used that information to make any needed adjustments to the program4 7,h7 ,how the use by the ,department of partial claims compares to the use of partial claims by other ,federal housing agencies1 including1 for each partial claim program-- 7i7 the volume of loans for which partial claims have been made2 7ii7 the results for borrowers 7including redefault and foreclosure rates72 and 7iii7 the costs to taxpayers4 7c7 ,partial ,claim ,program defined ,in this section1 the term ,partial ,claim ,program means the ,partial ,claim ,program of the ,department of ,veterans ,affairs carried out under section #cgcg of title #ch1 ,united ,states ,code4 ,,iv ,other ,matters #dja4 ,extension of subpoena authority of ,inspector ,general of ,department of ,veterans ,affairs ,section #cab7;d77#g77;,a7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #djb4 ,extension of authority for ,secretary of ,veterans ,affairs to transport individuals to and from facilities of ,department of ,veterans ,affairs ,section #aaa;,a7a77#b7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #djc4 ,extension of authority relating to vendee loan program ,section #cgcc7;a77#h7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in the matter preceding subparagraph 7,a71 by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe2 and 7#b7 in subparagraph 7,c71 by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 #djd4 ,extension of authority for transfer of real property ,section #haah7;a77#e7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbe and inserting ,november #ba1 #bjbe4 ,e ,,miscellaneous #aja4 ,,budgetary ,,effects 7a7 ,statutory ,,paygo ,scorecards ,the budgetary effects of divisions ,b through ,d shall not be entered on either ,,paygo scorecard maintained pursuant to section #d7;d7 of the ,statutory ,pay-,as-,you-,go ,act of #bjaj4 7b7 ,senate ,,paygo ,scorecards ,the budgetary effects of divisions ,b through ,d shall not be entered on any ,,paygo scorecard maintained for purposes of section #dajf of ,h4 ,con4 ,res4 #ga 7#aaeth ,congress74 7c7 ,classification of ,budgetary ,effects ,notwithstanding ,rule #c of the ,budget ,scorekeeping ,guidelines set forth in the joint explanatory statement of the committee of conference accompanying ,conference ,report #aje-bag and section #bej7;c77#h7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe1 the budgetary effects of divisions ,b through ,d shall not be estimated-- 7#a7 for purposes of section #bea of such ,act2 7#b7 for purposes of an allocation to the ,committee on ,appropriations pursuant to section #cjb7;a7 of the ,congressional ,budget ,act of #aigd2 and 7#c7 for purposes of paragraph 7#d77;,c7 of section #c of the ,statutory ,pay-,as-,you-,go ,act of #bjaj as being included in an appropriation ,act4 ,passed the ,house of ,representatives ,september #ai1 #bjbe4,kevin ,f4 ,mc,cumber1,clerk4 ,september #ai 7legislative day1 ,september #af71 #bjbe,received1 read twice and ordered placed on the calendar