,,ii  #aai? ,,congress  #a/ ,session    
,s4 #gci  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,febru>y #bf1          
#bjbe,mrs4 ,gillibr& 7= h]self & ,mr4   
,s*um]7 introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d title ,,xxxiii ( !  
,public ,heal? ,s]vice ,act ) respect to
 flexibility & fund+ = ! ,_w ,trade     
,c5t] ,heal? ,program4  #a4 ,%ort title 
,?is ,act may be cit$ z ! #i_/aa        
,respond] & ,survivor ,heal? ,fund+     
,correction ,act ( #bjbe4  #b4          
,flexibility = m5tal heal? condition    
c]tifications "u ! ,_w ,trade ,c5t]     
,heal? ,program  7a7 ,9 g5]al ,section  
#ccje7;a7 ( ! ,public ,heal? ,s]vice    
,act 7#db ,u4,s4,c4 #cjjmm-#d7;a77 is   
am5d$-- 7#a7 9 p>agraph 7#a77;,a71 by   
ins]t+ subject to p>agraph 7#f71 be=e =2
 &  7#b7 by add+ at ! end ! foll[+3     
7#f7 ,lic5s$ m5tal heal? provid]        
flexibility = m5tal heal? condition     
c]tifications  7,a7 ,9 g5]al ,= purposes

 ( an initial heal? evaluation describ$ 
9 p>agraph 7#a77;,a7 ) respect to a     
m5tal heal? condition 7includ+ any su*  
evaluation provid$ "u section #ccba7;b7 
or ?r\gh ! nationwide network "u section
 #ccac71 su* evaluation may be conduct$ 
by a physician or any o!r lic5s$ m5tal  
heal? provid] 9 a category ( m5tal heal?
 provid]s det]m9$ by ! ,,wtc ,program   
,adm9i/rator "u subp>agraph 7,b74  7,b7 
,categories ( lic5s$ m5tal heal?        
provid]s ,n lat] ?an #ahj days aft] !   
date ( enactm5t ( ! #i_/aa ,respond] &  
,survivor ,heal? ,fund+ ,correction ,act
 ( #bjbe1 ! ,,wtc ,program ,adm9i/rator 
%all issue regulations = ! categories ( 
lic5s$ m5tal heal? provid]s :o1 9       
addition to lic5s$ physicians1 may      
conduct evaluations "u subp>agraph 7,a7 
) respect to a m5tal heal? condition &  
make det]m9ations "u section #ccab7;b7 )
 respect to su* a condition4  4  7b7    
,flexibility = ,,wtc respond]s ,section 
#ccab7;b7 ( su* ,act 7#db ,u4,s4,c4     
#cjjmm-#bb7;b77 is am5d$-- 7#a7 9       

p>agraph 7#a77;,a7-- 7,a7 9 ! matt]     
prec$+ clause 7i71 by /rik+ physician & 
ins]t+ physician 7or1 9 ! case ( a m5tal
 heal? condition1 a physician or any o!r
 qualifi$ m5tal heal? provid]72 &  7,b7 
9 clause 7i71 by /rik+ physician &      
ins]t+ physician or o!r qualifi$ m5tal  
heal? provid]2  7#b7 9 p>agraph 7#b7--  
7,a7 9 subp>agraph 7,a7-- 7i7 9 ! matt] 
prec$+ clause 7i71 by /rik+ physician & 
ins]t+ physician 7or1 9 ! case ( a m5tal
 heal? condition1 a physician or any o!r
 qualifi$ m5tal heal? provid]72  7ii7 9 
clause 7i71 by /rik+ physician & ins]t+ 
physician or o!r qualifi$ m5tal heal?   
provid]2 &  7iii7 9 clause 7ii71 by     
/rik+ su* physician's det]m9ation &     
ins]t+ ! det]m9ation ( su* physician or 
o!r qualifi$ m5tal heal? provid]2 &     
7,b7 9 subp>agraph 7,b7-- 7i7 9 ! matt] 
prec$+ clause 7i71 by /rik+ physician   
det]m9ations & ins]t+ det]m9ations by   
physicians 7or1 9 ! case ( a m5tal heal?
 condition1 physicians or o!r qualifi$  
m5tal heal? provid]s72 &  7ii7 9 clause 

7i71 by /rik+ physician panel & ins]t+  
panel ( physicians 7or1 9 ! case ( a    
m5tal heal? condition1 physicians or o!r
 qualifi$ m5tal heal? provid]s72  7#c7 9
 p>agraph 7#e71 by /rik+ exam9+         
physician & ins]t+ exam9+ physician 7or1
 9 ! case ( a m5tal heal? condition1    
exam9+ physician or o!r qualifi$ m5tal  
heal? provid]72 &  7#d7 by add+ at ! end
 ! foll[+3  7#f7 ,def9ition ( qualifi$  
m5tal heal? provid] ,= purposes ( ?is   
subsection1 ! t]m qualifi$ m5tal heal?  
provid] means a lic5s$ m5tal heal?      
provid] 9 a category det]m9$ by ! ,,wtc 
,program ,adm9i/rator "u section        
#ccje7;a77#f77;,b74  4  #c4 ,crit]ia =  
cr$5tial+ heal? c>e provid]s p>ticipat+ 
9 ! nationwide network ,title ,,xxxiii (
 ! ,public ,heal? ,s]vice ,act 7#db     
,u4,s4,c4 #cjjmm et seq47 is am5d$--    
7#a7 9 section #ccje7;a77#b7 7#db       
,u4,s4,c4 #cjjmm-#d7;a77#b77-- 7,a7 9   
subp>agraph 7,a7-- 7i7 by /rik+ clause  
7iv72 &  7ii7 by r$esignat+ clauses 7v7 
& 7vi7 z clauses 7iv7 & 7v71            

respectively2  7,b7 by /rik+ subp>agraph
 7,b72 &  7,c7 by r$esignat+            
subp>agraphs 7,c7 & 7,d7 z subp>agraphs 
7,b7 & 7,c71 respectively2 &  7#b7 9    
section #ccac7;b77#a7 7#db ,u4,s4,c4    
#cjjmm-#bc7;b77#a771 by /rik+ ,data     
,c5t]s & ins]t+ ,,wtc ,program          
,adm9i/rator4  #d4 ,cl>ify+ calculation 
( enrollm5t  7a7 ,respond]s ,section    
#ccaa7;a7 ( su* ,act 7#db ,u4,s4,c4     
#cjjmm-#ba7;a77 is am5d$ by add+ at !   
end ! foll[+3  7#f7 ,deceas$ ,,wtc      
respond]s ,an individual kn[n to ! ,,wtc
 ,program ,adm9i/rator to be deceas$    
%all n be includ$ 9 any c\nt ( enrollees
 "u ?is subsection or section #ccea4  4 
7b7 ,survivors ,section #ccba7;a7 ( su* 
,act 7#db ,u4,s4,c4 #cjjmm-#ca7;a77 is  
am5d$ by add+ at ! end ! foll[+3  7#e7  
,deceas$ ,,wtc survivors ,an individual 
kn[n to ! ,,wtc ,program ,adm9i/rator to
 be deceas$ %all n be includ$ 9 any c\nt
 ( c]tifi$-eligible survivors "u ?is    
section or 9 any c\nt ( enrollees "u    
section #ccea4  4  #e4 ,"t p]iod = add+ 

heal? conditions to li/ = ,,wtc         
respond]s ,section #ccab7;a77#f7 ( !    
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjmm-#bb7;a77#f77 is am5d$--
 7#a7 9 subp>agraph 7,b71 by /rik+ #ij &
 ins]t+ #ahj2 &  7#b7 9 subp>agraph     
7,c71 9 ! second s5t5ce1 by /rik+ #ij & 
ins]t+ #ahj4  #f4 ,fund+ = ! ,_w ,trade 
,c5t] ,heal? ,program  7a7 ,9 g5]al     
,section #ccea ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4 #cjjmm-#fa7 
is am5d$-- 7#a7 9 subsection            
7a77#b77;,a71 by am5d+ clause 7xi7 to   
read z foll[s3  7xi7 = ea* ( fiscal ye>s
 #bjbf ?r\gh #bjij-- 7,i7 ! am\nt       
det]m9$ "u ?is subp>agraph = ! previ\s  
fiscal ye> multipli$ by #a4jg2 multipli$
 by  7,,ii7 ! ratio (-- 7aa7 ! total    
numb] ( individuals enroll$ 9 ! ,,wtc   
,program on ,july #a ( su* previ\s      
fiscal ye>2 to  7bb7 ! total numb] (    
individuals s enroll$ on ,july #a ( !   
fiscal ye> prior to su* previ\s fiscal  
ye>2 plus  2 &  7#b7 9 subsection 7c7-- 
7,a7 9 p>agraph 7#d7-- 7i7 by am5d+     

subp>agraph 7,a7 to read z foll[s3  7,a7
 = fiscal ye> #bjbe1 ! am\nt det]m9$ =  
su* fiscal ye> "u ?is p>agraph z 9      
effect on ! day be=e ! date ( enactm5t (
 ! #i_/aa ,respond] & ,survivor ,heal?  
,fund+ ,correction ,act ( #bjbe2  2     
7ii7 by am5d+ subp>agraph 7,b7 to read z
 foll[s3  7,b7 = fiscal ye> #bjbf1 !    
great] (-- 7i7 ! am\nt det]m9$ = su*    
fiscal ye> "u ?is p>agraph z 9 effect on
 ! day be=e ! date ( enactm5t ( ! #i_/aa
 ,respond] & ,survivor ,heal? ,fund+    
,correction ,act ( #bjbe2 or  7ii7 !    
am\nt exp5d$ = ! previ\s fiscal ye> = ! 
purposes describ$ 9 ?is p>agraph        
increas$ by #be p]c5t2 &  2 &  7iii7 9  
subp>agraph 7,c71 by /rik+ ! am\nt      
specifi$ "u ?is p>agraph = ! previ\s    
fiscal ye> & ins]t+ ! am\nt exp5d$ = !  
previ\s fiscal ye> = su* purposes2 &    
7,b7 9 p>agraph 7#e7-- 7i7 by am5d+     
subp>agraph 7,a7 to read z foll[s3  7,a7
 = fiscal ye> #bjbe1 ! am\nt det]m9$ =  
su* fiscal ye> "u ?is p>agraph z 9      
effect on ! day be=e ! date ( enactm5t (

 ! #i_/aa ,respond] & ,survivor ,heal?  
,fund+ ,correction ,act ( #bjbe2  2     
7ii7 by r$esignat+ subp>agraph 7,b7 z   
subp>agraph 7,c72  7iii7 by ins]t+ aft] 
subp>agraph 7,a7 ! foll[+3  7,b7 =      
fiscal ye> #bjbf1 ! great] (-- 7i7 !    
am\nt det]m9$ = su* fiscal ye> "u ?is   
p>agraph z 9 effect on ! day be=e ! date
 ( enactm5t ( ! #i_/aa ,respond] &      
,survivor ,heal? ,fund+ ,correction ,act
 ( #bjbe2 or  7ii7 ! am\nt exp5d$ = !   
previ\s fiscal ye> = ! purpose describ$ 
9 ?is p>agraph increas$ by #be p]c5t2 & 
2 &  7iv7 9 subp>agraph 7,c71 z s       
r$esignat$1 by /rik+ ! am\nt specifi$ "u
 ?is p>agraph = ! previ\s fiscal ye> &  
ins]t+ ! am\nt exp5d$ = ! previ\s fiscal
 ye> = su* purpose4  7b7 ,te*nical      
am5dm5ts ,title ,,xxxiii ( ! ,public    
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjjmm et seq47 is am5d$-- 7#a7 9       
section #cceb 7#db ,u4,s4,c4            
#cjjmm-#fb71 by am5d+ subsection 7d7 to 
read z foll[s3  7d7 ,rema9+ am\nts      
,am\nts rema9+ 9 ! ,supplem5tal ,fund   

%all rev]t to ! ,treasury 9 accordance )
 section #aeeb ( title #ca1 ,unit$      
,/ates ,code4  2  7#b7 9 section #ccec  
7#db ,u4,s4,c4 #cjjmm-#fc71 by am5d+    
subsection 7d7 to read z foll[s3  7d7   
,rema9+ am\nts ,am\nts rema9+ 9 !       
,special ,fund %all rev]t to ! ,treasury
 9 accordance ) section #aeeb ( title   
#ca1 ,unit$ ,/ates ,code4  2 &  7#c7 9  
section #cced 7#db ,u4,s4,c4            
#cjjmm-#fd71 by am5d+ subsection 7d7 to 
read z foll[s3  7d7 ,rema9+ am\nts      
,am\nts rema9+ 9 ! ,p5tagon_/,%anksville
 ,fund %all rev]t to ! ,treasury 9      
accordance ) section #aeeb ( title #ca1 
,unit$ ,/ates ,code4  4  #g4 ,report to 
,congress  7a7 ,9 g5]al ,n lat] ?an #c  
ye>s aft] ! date ( enactm5t ( ?is ,act1 
! ,secret>y ( ,heal? & ,human ,s]vices  
7ref]r$ to 9 ?is section z ! ,secret>y7 
%all conduct an assessm5t ( anticipat$  
budget au?ority & outlays ( ! ,_w ,trade
 ,c5t] ,heal? ,program 7ref]r$ to 9 ?is 
section z ! ,program7 ?r\gh ! duration (
 ! ,program & submit a report summ>iz+  

su* assessm5t to-- 7#a7 ! ,speak] &     
m9ority lead] ( ! ,h\se (               
,repres5tatives2  7#b7 ! majority &     
m9ority lead]s ( ! ,s5ate2  7#c7 !      
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions & ,committee on !    
,budget ( ! ,s5ate2 &  7#d7 ! ,committee
 on ,en]gy & ,comm]ce & ! ,committee on 
! ,budget ( ! ,h\se ( ,repres5tatives4  
7b7 ,inclusions ,! report requir$ "u    
subsection 7a7 %all include-- 7#a7 a    
projection ( ,program budget>y ne$s on a
 p]-fiscal ye> basis ?r\gh fiscal ye>   
#bjij2  7#b7 a review ( ,program model+ 
= ea* ( fiscal ye>s #bjag ?r\gh ! fiscal
 ye> prior to ! fiscal ye> 9 :i* !      
report is issu$ to assess h[ anticipat$ 
budget>y ne$s comp>$ to actual          
exp5ditures2  7#c7 an assessm5t ( !     
project$ budget au?ority & exp5ditures (
 ! ,program ?r\gh fiscal ye> #bjij2 &   
7#d7 any recomm5dations ( ! ,secret>y to
 make *anges to ! =mula "u section      
#ccea7;a77#b77;,a7 ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4             

#cjjmm-#fa7;a77#b77;,a771 z am5d$ by    
section #f7;a77#a71 to fully (fset      
anticipat$ ,program exp5ditures ?r\gh   
fiscal ye> #bjij4