PUBLIC LAW 115–123—FEB. 9, 2018 

BIPARTISAN BUDGET ACT OF 2018 


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132 STAT. 64 PUBLIC LAW 115–123—FEB. 9, 2018 

Public Law 115–123 

115th Congress 

An Act 

To amend title 4, United States Code, to provide for the flying of the flag at 

half-staff in the event of the death of a first responder in the line of duty. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Bipartisan Budget Act of 2018’’. 

DIVISION A—HONORING HOMETOWN 

HEROES ACT 

SECTION 10101. SHORT TITLE. 

This division may be cited as the ‘‘Honoring Hometown Heroes 

Act’’. 

SEC. 10102. PERMITTING THE FLAG TO BE FLOWN AT HALF-STAFF 

IN THE EVENT OF THE DEATH OF A FIRST RESPONDER 

SERVING IN THE LINE OF DUTY. 

(a) AMENDMENT.—The sixth sentence of section 7(m) of title 

4, United States Code, is amended— 

(1) by striking ‘‘or’’ after ‘‘possession of the United States’’ 

and inserting a comma; 

(2) by inserting ‘‘or the death of a first responder working 

in any State, territory, or possession who dies while serving 

in the line of duty,’’ after ‘‘while serving on active duty,’’; 

(3) by striking ‘‘and’’ after ‘‘former officials of the District 

of Columbia’’ and inserting a comma; and 

(4) by inserting before the period the following: ‘‘, and 

first responders working in the District of Columbia’’. 

(b) FIRST RESPONDER DEFINED.—Such subsection is further 

amended— 

(1) in paragraph (2), by striking ‘‘, United States Code; 

and’’ and inserting a semicolon; 

(2) in paragraph (3), by striking the period at the end 

and inserting ‘‘; and’’; and 

(3) by adding at the end the following new paragraph: 

‘‘(4) the term ‘first responder’ means a ‘public safety officer’ 

as defined in section 1204 of title I of the Omnibus Crime 

Control and Safe Streets Act of 1968 (34 U.S.C. 10284).’’. 

(c) EFFECTIVE DATE.—The amendments made by this section 

shall apply with respect to deaths of first responders occurring 

on or after the date of the enactment of this Act. 

Applicability. 

4 USC 7 note. 

4 USC 1 note. 

Honoring 

Hometown 

Heroes Act. 

42 USC 1305 

note. 

Bipartisan 

Budget Act 

of 2018. 

Feb. 9, 2018 

[H.R. 1892] 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 65 

DIVISION B—SUPPLEMENTAL APPROPRIATIONS, TAX 

RELIEF, AND MEDICAID CHANGES RELATING TO CERTAIN DISASTERS AND FURTHER EXTENSION OF CONTINUING APPROPRIATIONS 

Subdivision 1—Further Additional Supplemental 

Appropriations for Disaster Relief Requirements Act, 2018 

The following sums in this subdivision are appropriated, out 

of any money in the Treasury not otherwise appropriated, for the 

fiscal year ending September 30, 2018 and for other purposes, 

namely: 

TITLE I 

DEPARTMENT OF AGRICULTURE 

AGRICULTURAL PROGRAMS 

PROCESSING, RESEARCH AND MARKETING

OFFICE OF THE SECRETARY

For an additional amount for the ‘‘Office of the Secretary’’, $2,360,000,000, which shall remain available until December 31, 

2019, for necessary expenses related to crops, trees, bushes, and 

vine losses related to the consequences of Hurricanes Harvey, Irma, 

Maria, and other hurricanes and wildfires occurring in calendar 

year 2017 under such terms and conditions as determined by the 

Secretary: Provided, That the Secretary may provide assistance 

for such losses in the form of block grants to eligible states and 

territories: Provided further, That the total amount of payments 

received under this heading and applicable policies of crop insurance 

under the Federal Crop Insurance Act (7 U.S.C. 1501 et seq.) 

or the Noninsured Crop Disaster Assistance Program (NAP) under 

section 196 of the Federal Agriculture Improvement and Reform 

Act of 1996 (7 U.S.C. 7333) shall not exceed 85 percent of the 

loss as determined by the Secretary: Provided further, That the 

total amount of payments received under this heading for producers 

who did not obtain a policy or plan of insurance for an insurable 

commodity for the 2017 crop year, or 2018 crop year as applicable, 

under the Federal Crop Insurance Act (7 U.S.C. 1501 et seq.) 

for the crop incurring the losses or did not file the required paperwork and pay the service fee by the applicable State filing deadline 

for a noninsurable commodity for the 2017 crop year, or 2018 

crop year as applicable, under NAP for the crop incurring the 

losses shall not exceed 65 percent of the loss as determined by 

the Secretary: Provided further, That producers receiving payments 

under this heading, as determined by the Secretary, shall be 

required to purchase crop insurance where crop insurance is available for the next two available crop years, and producers receiving 

payments under this heading shall be required to purchase coverage 

under NAP where crop insurance is not available in the next 

two available crop years, as determined by the Secretary: Provided 

further, That, not later than 90 days after the end of fiscal year 

2018, the Secretary shall submit a report to the Congress specifying 

the type, amount, and method of such assistance by state and 

territory and the status of the amounts obligated and plans for 

Deadline. 

Reports. 

Further 

Additional 

Supplemental 

Appropriations 

for Disaster 

Relief 

Requirements 

Act, 2018. 


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132 STAT. 66 PUBLIC LAW 115–123—FEB. 9, 2018 

further expenditure and include improvements that can be made 

to Federal Crop Insurance policies, either administratively or legislatively, to increase participation, particularly among underserved 

producers, in higher levels of coverage in future years for crops 

qualifying for assistance under this heading: Provided further, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

OFFICE OF INSPECTOR GENERAL

For an additional amount for ‘‘Office of Inspector General’’, 

$2,500,000, to remain available until expended, for oversight and 

audit of programs, grants, and activities funded by this subdivision 

and administered by the Department of Agriculture: Provided, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

AGRICULTURAL RESEARCH SERVICE

BUILDINGS AND FACILITIES

For an additional amount for ‘‘Buildings and Facilities’’, 

$22,000,000, to remain available until expended, for necessary 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

FARM SERVICE AGENCY

EMERGENCY CONSERVATION PROGRAM

For an additional amount for the ‘‘Emergency Conservation 

Program’’, for necessary expenses related to the consequences of 

Hurricanes Harvey, Irma, and Maria and of wildfires occurring 

in calendar year 2017, and other natural disasters, $400,000,000, 

to remain available until expended: Provided, That such amount 

is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

NATURAL RESOURCES CONSERVATION SERVICE

WATERSHED AND FLOOD PREVENTION OPERATIONS

For an additional amount for ‘‘Watershed and Flood Prevention 

Operations’’, for necessary expenses for the Emergency Watershed 

Protection Program related to the consequences of Hurricanes 

Harvey, Irma, and Maria and of wildfires occurring in calendar 

year 2017, and other natural disasters, $541,000,000, to remain 

available until expended: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 67 

RURAL DEVELOPMENT PROGRAMS 

RURAL HOUSING SERVICE

RURAL HOUSING INSURANCE FUND PROGRAM ACCOUNT

For an additional amount for ‘‘Rural Housing Insurance Fund 

Program Account’’, $18,672,000, to remain available until September 30, 2019, for the cost of direct loans, including the cost 

of modifying loans as defined in section 502 of the Congressional 

Budget Act of 1974, for the rehabilitation of section 515 rental 

housing (42 U.S.C. 1485) in areas impacted by Hurricanes Harvey, 

Irma, and Maria where owners were not required to carry national 

flood insurance: Provided, That such amount is designated by the 

Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

RURAL UTILITIES SERVICE

RURAL WATER AND WASTE DISPOSAL PROGRAM ACCOUNT

For an additional amount for the ‘‘Rural Water and Waste 

Disposal Program Account’’, $165,475,000, to remain available until 

expended, for grants to repair drinking water systems and sewer 

and solid waste disposal systems impacted by Hurricanes Harvey, 

Irma, and Maria: Provided, That not to exceed $2,000,000 of the 

amount appropriated under this heading shall be for technical 

assistance grants for rural water and waste systems pursuant to 

section 306(a)(22) of the Consolidated Farm and Rural Development 

Act: Provided further, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

DOMESTIC FOOD PROGRAMS 

FOOD AND NUTRITION SERVICE

SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, 

AND CHILDREN (WIC)

For an additional amount for the ‘‘Special Supplemental Nutrition Program for Women, Infants, and Children’’, $14,000,000, to 

remain available until September 30, 2019, for infrastructure grants 

to the Commonwealth of Puerto Rico and the U.S. Virgin Islands 

to assist in the repair and restoration of buildings, equipment, 

technology, and other infrastructure damaged as a consequence 

of Hurricanes Irma and Maria: Provided, That such amount is 

designated by the Congress as being for an emergency requirement 

pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and 

Emergency Deficit Control Act of 1985. 

COMMODITY ASSISTANCE PROGRAM

For an additional amount for ‘‘Commodity Assistance Program’’ 

for the emergency food assistance program as authorized by section 

27(a) of the Food and Nutrition Act of 2008 (7 U.S.C. 2036(a)) 


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132 STAT. 68 PUBLIC LAW 115–123—FEB. 9, 2018 

and section 204(a)(1) of the Emergency Food Assistance Act of 

1983 (7 U.S.C. 7508(a)(1)), $24,000,000, to remain available until 

September 30, 2019, for necessary expenses of those jurisdictions 

that received a major disaster or emergency declaration pursuant 

to section 401 or 501, respectively, of the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act (42 U.S.C. 5170, 5191) related 

to the consequences of Hurricanes Harvey, Irma, and Maria or 

due to wildfires in 2017: Provided, That notwithstanding any other 

provisions of the Emergency Food Assistance Act of 1983, the Secretary of Agriculture may provide resources to Puerto Rico, the 

Virgin Islands of the United States, and affected States, as determined by the Secretary, to assist affected families and individuals 

without regard to sections 204 and 214 of such Act (7 U.S.C. 

7508, 7515) by allocating additional foods and funds for administrative expenses from resources specifically appropriated, transferred, 

or reprogrammed: Provided further, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

RELATED AGENCIES AND FOOD AND DRUG 

ADMINISTRATION 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

FOOD AND DRUG ADMINISTRATION

BUILDINGS AND FACILITIES

(INCLUDING TRANSFER OF FUNDS)

For an additional amount for ‘‘Buildings and Facilities’’, $7,600,000, to remain available until expended, for necessary 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria: Provided, That such amount may be transferred to 

‘‘Department of Health and Human Services—Food and Drug 

Administration—Salaries and Expenses’’ for costs related to repair 

of facilities, for replacement of equipment, and for other increases 

in facility-related costs: Provided further, That obligations incurred 

for the purposes provided herein prior to the date of enactment 

of this subdivision may be charged to funds appropriated by this 

paragraph: Provided further, That such amount is designated by 

the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

GENERAL PROVISION—THIS TITLE 

SEC. 20101. (a) Section 1501(b) of the Agricultural Act of 2014 

(7 U.S.C. 9081(b)) is amended— 

(1) in paragraph (1), in the matter before subparagraph 

(A), by inserting ‘‘sold livestock for a reduced sale price, or 

both’’ after ‘‘normal mortality,’’; 

(2) in paragraph (2), by striking ‘‘applicable livestock on 

the day before the date of death of the livestock, as determined 

by the Secretary.’’ and inserting the following: 

‘‘affected livestock, as determined by the Secretary, on, as 

applicable— 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 69 

‘‘(A) the day before the date of death of the livestock; 

or 

‘‘(B) the day before the date of the event that caused 

the harm to the livestock that resulted in a reduced sale 

price.’’; and 

(3) by adding at the end the following new paragraph: 

‘‘(4) A payment made under paragraph (1) to an eligible 

producer on a farm that sold livestock for a reduced sale price 

shall— 

‘‘(A) be made if the sale occurs within a reasonable 

period following the event, as determined by the Secretary; 

and 

‘‘(B) be reduced by the amount that the producer 

received for the sale.’’. 

(b) Section 1501(d)(1) of the Agricultural Act of 2014 (7 U.S.C. 

9081(d)(1)) is amended by striking ‘‘not more than $20,000,000 

of’’. 

(c) Section 1501(e)(4)(C) of the Agricultural Act of 2014 (7 

U.S.C. 9081(e)(4)(C)) is amended by striking ‘‘500 acres’’ and 

inserting ‘‘1,000 acres’’. 

(d) Section 1501 of the Agricultural Act of 2014 (7 U.S.C. 

9081) is amended— 

(1) in subsection (e)(4)— 

(A) by striking subparagraph (B); and 

(B) by redesignating subparagraph (C), as amended 

by subsection (c), as subparagraph (B); and 

(2) in subsection (f)(2), by striking ‘‘subsection (e)’’ and 

inserting ‘‘subsections (b) and (e)’’. 

(e) Section 1501 of the Agricultural Act of 2014 (7 U.S.C. 

9081), as amended by this section, shall apply with respect to 

losses described in such section 1501 incurred on or after January 

1, 2017. 

(f) The amounts provided by subsections (a) through (e) for 

fiscal year 2018 are designated by the Congress as being for an 

emergency requirement pursuant to section 251(b)(2)(A)(i) of the 

Balanced Budget and Emergency Deficit Control Act of 1985. 

TITLE II 

DEPARTMENT OF COMMERCE 

ECONOMIC DEVELOPMENT ADMINISTRATION

ECONOMIC DEVELOPMENT ASSISTANCE PROGRAMS

(INCLUDING TRANSFERS OF FUNDS)

Pursuant to section 703 of the Public Works and Economic 

Development Act (42 U.S.C. 3233), for an additional amount for 

‘‘Economic Development Assistance Programs’’ for necessary 

expenses related to flood mitigation, disaster relief, long-term 

recovery, and restoration of infrastructure in areas that received 

a major disaster designation as a result of Hurricanes Harvey, 

Irma, and Maria, and of wildfires and other natural disasters occurring in calendar year 2017 under the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.), 

$600,000,000, to remain available until expended: Provided, That 

Applicability. 

Effective date. 

7 USC 9081 note. 


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132 STAT. 70 PUBLIC LAW 115–123—FEB. 9, 2018 

the amount provided under this heading is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further, That within the amount appropriated, up to 2 percent of funds may be transferred to the ‘‘Salaries 

and Expenses’’ account for administration and oversight activities: 

Provided further, That within the amount appropriated, $1,000,000 

shall be transferred to the ‘‘Office of Inspector General’’ account 

for carrying out investigations and audits related to the funding 

provided under this heading. 

NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION

OPERATIONS, RESEARCH, AND FACILITIES

For an additional amount for ‘‘Operations, Research, and Facilities’’ for necessary expenses related to the consequences of Hurricanes Harvey, Irma, and Maria, $120,904,000, to remain available 

until September 30, 2019, as follows: 

(1) $12,904,000 for repair and replacement of observing 

assets, Federal real property, and equipment; 

(2) $18,000,000 for marine debris assessment and removal; 

(3) $40,000,000 for mapping, charting, and geodesy services; 

and 

(4) $50,000,000 to improve weather forecasting, hurricane 

intensity forecasting and flood forecasting and mitigation 

capabilities, including data assimilation from ocean observing 

platforms and satellites: 

Provided, That the amount provided under this heading is designated by the Congress as being for an emergency requirement 

pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and 

Emergency Deficit Control Act of 1985: Provided further, That the 

National Oceanic and Atmospheric Administration shall submit 

a spending plan to the Committees on Appropriations of the House 

of Representatives and the Senate within 45 days after the date 

of enactment of this subdivision. 

PROCUREMENT, ACQUISITION AND CONSTRUCTION

For an additional amount for ‘‘Procurement, Acquisition and 

Construction’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria, $79,232,000, to remain 

available until September 30, 2020, as follows: 

(1) $29,232,000 for repair and replacement of Federal real 

property and observing assets; and 

(2) $50,000,000 for improvements to operational and 

research weather supercomputing infrastructure and for 

improvement of satellite ground services used in hurricane 

intensity and track prediction: 

Provided, That the amount provided under this heading is designated by the Congress as being for an emergency requirement 

pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and 

Emergency Deficit Control Act of 1985: Provided further, That the 

National Oceanic and Atmospheric Administration shall submit 

a spending plan to the Committees on Appropriations of the House 

of Representatives and the Senate within 45 days after the date 

of enactment of this subdivision. 

Spending plan. 

Deadline. 

Spending plan. 

Deadline. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 71 

FISHERIES DISASTER ASSISTANCE

For an additional amount for ‘‘Fisheries Disaster Assistance’’ 

for necessary expenses associated with the mitigation of fishery 

disasters, $200,000,000, to remain available until expended: Provided, That funds shall be used for mitigating the effects of commercial fishery failures and fishery resource disasters declared by the 

Secretary of Commerce in calendar year 2017, as well those declared 

by the Secretary to be a direct result of Hurricanes Harvey, Irma, 

or Maria: Provided further, That the amount provided under this 

heading is designated by the Congress as being for an emergency 

requirement pursuant to section 251(b)(2)(A)(i) of the Balanced 

Budget and Emergency Deficit Control Act of 1985. 

DEPARTMENT OF JUSTICE 

UNITED STATES MARSHALS SERVICE

SALARIES AND EXPENSES

For an additional amount for ‘‘Salaries and Expenses’’ for necessary expenses related to the consequences of Hurricanes Harvey, 

Irma, and Maria, $2,500,000: Provided, That the amount provided 

under this heading is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

FEDERAL BUREAU OF INVESTIGATION

SALARIES AND EXPENSES

For an additional amount for ‘‘Salaries and Expenses’’ for necessary expenses related to the consequences of Hurricanes Harvey, 

Irma, and Maria, $21,200,000: Provided, That the amount provided 

under this heading is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

DRUG ENFORCEMENT ADMINISTRATION

SALARIES AND EXPENSES

For an additional amount for ‘‘Salaries and Expenses’’ for necessary expenses related to the consequences of Hurricanes Harvey, 

Irma, and Maria, $11,500,000: Provided, That the amount provided 

under this heading is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

FEDERAL PRISON SYSTEM

SALARIES AND EXPENSES

For an additional amount for ‘‘Salaries and Expenses’’ for necessary expenses related to the consequences of Hurricanes Harvey, 

Irma, and Maria, $16,000,000: Provided, That the amount provided 

under this heading is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 


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132 STAT. 72 PUBLIC LAW 115–123—FEB. 9, 2018 

BUILDINGS AND FACILITIES

For an additional amount for ‘‘Buildings and Facilities’’ for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $34,000,000, to remain available until 

expended: Provided, That the amount provided under this heading 

is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

SCIENCE 

NATIONAL AERONAUTICS AND SPACE ADMINISTRATION

CONSTRUCTION AND ENVIRONMENTAL COMPLIANCE AND RESTORATION

For an additional amount for ‘‘Construction and Environmental 

Compliance and Restoration’’ for repairs at National Aeronautics 

and Space Administration facilities damaged by hurricanes during 

2017, $81,300,000, to remain available until expended: Provided, That the amount provided under this heading is designated by 

the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

NATIONAL SCIENCE FOUNDATION

RESEARCH AND RELATED ACTIVITIES

For an additional amount for ‘‘Research and Related Activities’’ 

for necessary expenses to repair National Science Foundation radio 

observatory facilities damaged by hurricanes that occurred during 

2017, $16,300,000, to remain available until expended: Provided, 

That the amount provided under this heading is designated by 

the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985: Provided further, That the National 

Science Foundation shall submit a spending plan to the Committees 

on Appropriations of the House of Representatives and the Senate 

within 45 days after the date of enactment of this subdivision. 

RELATED AGENCIES 

LEGAL SERVICES CORPORATION

PAYMENT TO THE LEGAL SERVICES CORPORATION

For an additional amount for ‘‘Payment to the Legal Services 

Corporation’’ to carry out the purposes of the Legal Services Corporation Act by providing for necessary expenses related to the 

consequences of Hurricanes Harvey, Irma, and Maria and of the 

calendar year 2017 wildfires, $15,000,000: Provided, That the 

amount made available under this heading shall be used only 

to provide the mobile resources, technology, and disaster coordinators necessary to provide storm-related services to the Legal Services Corporation client population and only in the areas significantly 

affected by Hurricanes Harvey, Irma, and Maria and by the calendar year 2017 wildfires: Provided further, That such amount 

Spending plan. 

Deadline. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 73 

is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

and Emergency Deficit Control Act of 1985: Provided further, That 

none of the funds appropriated in this subdivision to the Legal 

Services Corporation shall be expended for any purpose prohibited 

or limited by, or contrary to any of the provisions of, sections 

501, 502, 503, 504, 505, and 506 of Public Law 105–119, and 

all funds appropriated in this subdivision to the Legal Services 

Corporation shall be subject to the same terms and conditions 

set forth in such sections, except that all references in sections 

502 and 503 to 1997 and 1998 shall be deemed to refer instead 

to 2017 and 2018, respectively, and except that sections 501 and 

503 of Public Law 104–134 (referenced by Public Law 105–119) 

shall not apply to the amount made available under this heading: 

Provided further, That, for the purposes of this subdivision, the 

Legal Services Corporation shall be considered an agency of the 

United States Government. 

GENERAL PROVISION—THIS TITLE 

SEC. 20201. (a) In recognition of the consistency of the MidBarataria Sediment Diversion, Mid-Breton Sound Sediment Diversion, and Calcasieu Ship Channel Salinity Control Measures 

projects, as selected by the 2017 Louisiana Comprehensive Master 

Plan for a Sustainable Coast, with the findings and policy declarations in section 2(6) of the Marine Mammal Protection Act (16 

U.S.C. 1361 et seq., as amended) regarding maintaining the health 

and stability of the marine ecosystem, within 120 days of the 

enactment of this section, the Secretary of Commerce shall issue 

a waiver pursuant to section 101(a)(3)(A) and this section to section 

101(a) and section 102(a) of the Act, for such projects that will 

remain in effect for the duration of the construction, operations 

and maintenance of the projects. No rulemaking, permit, determination, or other condition or limitation shall be required when issuing 

a waiver pursuant to this section. 

(b) Upon issuance of a waiver pursuant to this section, the 

State of Louisiana shall, in consultation with the Secretary of 

Commerce: 

(1) To the extent practicable and consistent with the purposes of the projects, minimize impacts on marine mammal 

species and population stocks; and 

(2) Monitor and evaluate the impacts of the projects on 

such species and population stocks. 

TITLE III 

DEPARTMENT OF DEFENSE 

DEPARTMENT OF DEFENSE—MILITARY 

OPERATION AND MAINTENANCE 

OPERATION AND MAINTENANCE, ARMY

For an additional amount for ‘‘Operation and Maintenance, 

Army’’, $20,110,000, for necessary expenses related to the consequences of Hurricanes Harvey, Irma, and Maria: Provided, That 

Louisiana. 

Consultation. 

Deadline. 

Waiver. 


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132 STAT. 74 PUBLIC LAW 115–123—FEB. 9, 2018 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

OPERATION AND MAINTENANCE, NAVY

For an additional amount for ‘‘Operation and Maintenance, Navy’’, $267,796,000, for necessary expenses related to the consequences of Hurricanes Harvey, Irma, and Maria: Provided, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

OPERATION AND MAINTENANCE, MARINE CORPS

For an additional amount for ‘‘Operation and Maintenance, Marine Corps’’, $17,920,000, for necessary expenses related to the 

consequences of Hurricanes Harvey, Irma, and Maria: Provided, That such amount is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

OPERATION AND MAINTENANCE, AIR FORCE

For an additional amount for ‘‘Operation and Maintenance, 

Air Force’’, $20,916,000, for necessary expenses related to the consequences of Hurricanes Harvey, Irma, and Maria: Provided, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

OPERATION AND MAINTENANCE, DEFENSE-WIDE

For an additional amount for ‘‘Operation and Maintenance, 

Defense-Wide’’, $2,650,000, for necessary expenses related to the 

consequences of Hurricanes Harvey, Irma, and Maria: Provided, 

That such amount is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

OPERATION AND MAINTENANCE, ARMY RESERVE

For an additional amount for ‘‘Operation and Maintenance, 

Army Reserve’’, $12,500,000, for necessary expenses related to the 

consequences of Hurricanes Harvey, Irma, and Maria: Provided, 

That such amount is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

OPERATION AND MAINTENANCE, NAVY RESERVE

For an additional amount for ‘‘Operation and Maintenance, 

Navy Reserve’’, $2,922,000, for necessary expenses related to the 

consequences of Hurricanes Harvey, Irma, and Maria: Provided, 

That such amount is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 75 

OPERATION AND MAINTENANCE, AIR FORCE RESERVE

For an additional amount for ‘‘Operation and Maintenance, 

Air Force Reserve’’, $5,770,000, for necessary expenses related to 

the consequences of Hurricanes Harvey, Irma, and Maria: Provided, 

That such amount is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

OPERATION AND MAINTENANCE, ARMY NATIONAL GUARD

For an additional amount for ‘‘Operation and Maintenance, 

Army National Guard’’, $55,471,000, for necessary expenses related 

to the consequences of Hurricanes Harvey, Irma, and Maria: Provided, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 

PROCUREMENT 

OTHER PROCUREMENT, NAVY

For an additional amount for ‘‘Other Procurement, Navy’’ 

$18,000,000, to remain available until September 30, 2020, for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

REVOLVING AND MANAGEMENT FUNDS 

DEFENSE WORKING CAPITAL FUNDS

For an additional amount for ‘‘Defense Working Capital Funds’’ 

for the Navy Working Capital Fund, $9,486,000, for necessary 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

OTHER DEPARTMENT OF DEFENSE PROGRAMS 

DEFENSE HEALTH PROGRAM

For an additional amount for operation and maintenance for 

‘‘Defense Health Program’’, $704,000, for necessary expenses related 

to the consequences of Hurricanes Harvey, Irma, and Maria: Provided, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 


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132 STAT. 76 PUBLIC LAW 115–123—FEB. 9, 2018 

TITLE IV 

CORPS OF ENGINEERS—CIVIL 

DEPARTMENT OF THE ARMY 

INVESTIGATIONS

For an additional amount for ‘‘Investigations’’ for necessary 

expenses related to the completion, or initiation and completion, 

of flood and storm damage reduction, including shore protection, 

studies which are currently authorized or which are authorized 

after the date of enactment of this subdivision, to reduce risk 

from future floods and hurricanes, at full Federal expense, 

$135,000,000, to remain available until expended: Provided, That 

of such amount, not less than $75,000,000 is available for such 

studies in States and insular areas that were impacted by Hurricanes Harvey, Irma, and Maria: Provided further, That funds made 

available under this heading shall be for high-priority studies of 

projects in States and insular areas with more than one floodrelated major disaster declared pursuant to the Robert T. Stafford 

Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 

et seq.) in calendar years 2014, 2015, 2016, or 2017: Provided 

further, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985: 

Provided further, That the Assistant Secretary of the Army for 

Civil Works shall provide a monthly report to the Committees 

on Appropriations of the House of Representatives and the Senate 

detailing the allocation and obligation of these funds, including 

new studies selected to be initiated using funds provided under 

this heading, beginning not later than 60 days after the enactment 

of this subdivision. 

CONSTRUCTION

For an additional amount for ‘‘Construction’’ for necessary 

expenses to address emergency situations at Corps of Engineers 

projects, and to construct, and rehabilitate and repair damages 

caused by natural disasters, to Corps of Engineers projects, 

$15,055,000,000, to remain available until expended: Provided, That 

of such amount, $15,000,000,000 is available to construct flood 

and storm damage reduction, including shore protection, projects 

which are currently authorized or which are authorized after the 

date of enactment of this subdivision, and flood and storm damage 

reduction, including shore protection, projects which have signed 

Chief’s Reports as of the date of enactment of this subdivision 

or which are studied using funds provided under the heading ‘‘Investigations’’ if the Secretary determines such projects to be technically 

feasible, economically justified, and environmentally acceptable, in 

States and insular areas with more than one flood-related major 

disaster declared pursuant to the Robert T. Stafford Disaster Relief 

and Emergency Assistance Act (42 U.S.C. 5121 et seq.) in calendar 

years 2014, 2015, 2016, or 2017: Provided further, That of the 

amounts in the preceding proviso, not less than $10,425,000,000 

shall be available for such projects within States and insular areas 

that were impacted by Hurricanes Harvey, Irma, and Maria: ProPuerto Rico. vided further, That all repair, rehabilitation, study, design, and 

Virgin Islands. 

Determination. 

Deadlines. 

Reports. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 77 

construction of Corps of Engineers projects in Puerto Rico and 

the United States Virgin Islands, using funds provided under this 

heading, shall be conducted at full Federal expense: Provided further, That for projects receiving funding under this heading, the 

provisions of section 902 of the Water Resources Development Act 

of 1986 shall not apply to these funds: Provided further, That 

the completion of ongoing construction projects receiving funds provided under this heading shall be at full Federal expense with 

respect to such funds: Provided further, That using funds provided 

under this heading, the non-Federal cash contribution for projects 

eligible for funding pursuant to the first proviso shall be financed 

in accordance with the provisions of section 103(k) of Public Law 

99–662 over a period of 30 years from the date of completion 

of the project or separable element: Provided further, That up 

to $50,000,000 of the funds made available under this heading 

shall be used for continuing authorities projects to reduce the risk 

of flooding and storm damage: Provided further, That any projects 

using funds appropriated under this heading shall be initiated 

only after non-Federal interests have entered into binding agreements with the Secretary requiring, where applicable, the nonFederal interests to pay 100 percent of the operation, maintenance, 

repair, replacement, and rehabilitation costs of the project and 

to hold and save the United States free from damages due to 

the construction or operation and maintenance of the project, except 

for damages due to the fault or negligence of the United States 

or its contractors: Provided further, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985: Provided further, That the Assistant 

Secretary of the Army for Civil Works shall provide a monthly 

report to the Committees on Appropriations of the House of Representatives and the Senate detailing the allocation and obligation 

of these funds, beginning not later than 60 days after the enactment 

of this subdivision. 

MISSISSIPPI RIVER AND TRIBUTARIES

For an additional amount for ‘‘Mississippi River and Tributaries’’ for necessary expenses to address emergency situations at 

Corps of Engineers projects, and to construct, and rehabilitate and 

repair damages to Corps of Engineers projects, caused by natural 

disasters, $770,000,000, to remain available until expended: Provided, That of such amount, $400,000,000 is available to construct 

flood and storm damage reduction projects which are currently 

authorized or which are authorized after the date of enactment 

of this subdivision: Provided further, That such amount is designated by the Congress as being for an emergency requirement 

pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and 

Emergency Deficit Control Act of 1985: Provided further, That the 

Assistant Secretary of the Army for Civil Works shall provide 

a monthly report to the Committees on Appropriations of the House 

of Representatives and the Senate detailing the allocation and 

obligation of these funds, beginning not later than 60 days after 

the enactment of this subdivision. 

Deadlines. 

Reports. 

Deadlines. 

Reports. 

Time period. 


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132 STAT. 78 PUBLIC LAW 115–123—FEB. 9, 2018 

OPERATION AND MAINTENANCE

For an additional amount for ‘‘Operation and Maintenance’’ 

for necessary expenses to dredge Federal navigation projects in 

response to, and repair damages to Corps of Engineers Federal 

projects caused by, natural disasters, $608,000,000, to remain available until expended, of which such sums as are necessary to cover 

the Federal share of eligible operation and maintenance costs for 

coastal harbors and channels, and for inland harbors shall be 

derived from the Harbor Maintenance Trust Fund: Provided, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided 

further, That the Assistant Secretary of the Army for Civil Works 

shall provide a monthly report to the Committees on Appropriations 

of the House of Representatives and the Senate detailing the allocation and obligation of these funds, beginning not later than 60 

days after the enactment of this subdivision. 

FLOOD CONTROL AND COASTAL EMERGENCIES

For an additional amount for ‘‘Flood Control and Coastal Emergencies’’, as authorized by section 5 of the Act of August 18, 1941 

(33 U.S.C. 701n), for necessary expenses to prepare for flood, hurricane and other natural disasters and support emergency operations, 

repairs, and other activities in response to such disasters, as authorized by law, $810,000,000, to remain available until expended: 

Provided, That funding utilized for authorized shore protection 

projects shall restore such projects to the full project profile at 

full Federal expense: Provided further, That such amount is designated by the Congress as being for an emergency requirement 

pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and 

Emergency Deficit Control Act of 1985: Provided further, That the 

Assistant Secretary of the Army for Civil Works shall provide 

a monthly report to the Committees on Appropriations of the House 

of Representatives and the Senate detailing the allocation and 

obligation of these funds, beginning not later than 60 days after 

the enactment of this subdivision. 

EXPENSES

For an additional amount for ‘‘Expenses’’ for necessary expenses 

to administer and oversee the obligation and expenditure of 

amounts provided in this title for the Corps of Engineers, 

$20,000,000, to remain available until expended: Provided, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided 

further, That the Assistant Secretary of the Army for Civil Works 

shall provide a monthly report to the Committees on Appropriations 

of the House of Representatives and the Senate detailing the allocation and obligation of these funds, beginning not later than 60 

days after enactment of this subdivision. 

Deadlines. 

Reports. 

Deadlines. 

Reports. 

Deadlines. 

Reports. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 79 

DEPARTMENT OF ENERGY 

ENERGY PROGRAMS 

ELECTRICITY DELIVERY AND ENERGY RELIABILITY

For an additional amount for ‘‘Electricity Delivery and Energy Reliability’’, $13,000,000, to remain available until expended, for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, including technical assistance related 

to electric grids: Provided, That such amount is designated by 

the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

STRATEGIC PETROLEUM RESERVE

For an additional amount for ‘‘Strategic Petroleum Reserve’’, 

$8,716,000, to remain available until expended, for necessary 

expenses related to damages caused by Hurricanes Harvey, Irma, 

and Maria: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

GENERAL PROVISIONS—THIS TITLE 

SEC. 20401. In fiscal year 2018, and each fiscal year thereafter, 

the Chief of Engineers of the U.S. Army Corps of Engineers shall 

transmit to the Congress, after reasonable opportunity for comment, 

but without change, by the Assistant Secretary of the Army for 

Civil Works, a monthly report, the first of which shall be transmitted to Congress not later than 2 days after the date of enactment 

of this subdivision and monthly thereafter, which includes detailed 

estimates of damages to each Corps of Engineers project, caused 

by natural disasters or otherwise. 

SEC. 20402. From the unobligated balances of amounts made 

available to the U.S. Army Corps of Engineers, $518,900,000 under 

the heading ‘‘Corps of Engineers—Civil, Flood Control and Coastal 

Emergencies’’ and $210,000,000 under the heading ‘‘Corps of Engineers—Civil, Operations and Maintenance’’ in title X of the Disaster 

Relief Appropriations Act, 2013 (Public Law 113–2; 127 Stat. 25) 

shall be transferred to ‘‘Corps of Engineers—Civil, Construction’’, 

to remain available until expended, to rehabilitate, repair and construct Corps of Engineers projects: Provided, That those projects 

may only include construction expenses, including cost sharing, 

as described under the heading ‘‘Corps of Engineers—Civil, 

Construction’’ in title X of that Act or other construction expenses 

related to the consequences of Hurricane Sandy: Provided further, 

That amounts transferred pursuant to this section that were previously designated by the Congress as an emergency requirement 

pursuant to the Balanced Budget and Emergency Deficit Control 

Act are designated by the Congress as an emergency requirement 

pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and 

Emergency Deficit Control Act of 1985: Provided further, That the 

Assistant Secretary of the Army for Civil Works shall provide 

a monthly report to the Committees on Appropriations of the House 

of Representatives and the Senate detailing the allocation and 

Deadlines. 

Reports. 

Deadlines. 

Reports. 

33 USC 701n–2. 


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132 STAT. 80 PUBLIC LAW 115–123—FEB. 9, 2018 

obligation of these funds, beginning not later than 60 days after 

the enactment of this subdivision. 

TITLE V 

INDEPENDENT AGENCIES 

GENERAL SERVICES ADMINISTRATION

REAL PROPERTY ACTIVITIES

FEDERAL BUILDINGS FUND

For an additional amount to be deposited in the ‘‘Federal 

Buildings Fund’’, $126,951,000, to remain available until expended, 

for necessary expenses related to the consequences of Hurricanes 

Harvey, Maria, and Irma for repair and alteration of buildings 

under the custody and control of the Administrator of General 

Services, and real property management and related activities not 

otherwise provided for: Provided, That funds may be used to 

reimburse the ‘‘Federal Buildings Fund’’ for obligations incurred 

for this purpose prior to enactment of this subdivision: Provided 

further, That not more than $15,000,000 shall be available for 

tenant improvements in damaged U.S. courthouses: Provided further, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 

SMALL BUSINESS ADMINISTRATION

OFFICE OF INSPECTOR GENERAL

For an additional amount for the ‘‘Office of Inspector General’’, 

$7,000,000, to remain available until expended: Provided, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

DISASTER LOANS PROGRAM ACCOUNT

(INCLUDING TRANSFER OF FUNDS)

For an additional amount for the ‘‘Disaster Loans Program 

Account’’ for the cost of direct loans authorized by section 7(b) 

of the Small Business Act, $1,652,000,000, to remain available 

until expended: Provided, That up to $618,000,000 may be transferred to and merged with ‘‘Salaries and Expenses’’ for administrative expenses to carry out the disaster loan program authorized 

by section 7(b) of the Small Business Act: Provided further, That 

none of the funds provided under this heading may be used for 

indirect administrative expenses: Provided further, That the amount 

provided under this heading is designated by the Congress as 

being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 81 

TITLE VI 

DEPARTMENT OF HOMELAND SECURITY 

DEPARTMENTAL MANAGEMENT, OPERATIONS, 

INTELLIGENCE, AND OVERSIGHT 

OFFICE OF INSPECTOR GENERAL

OPERATIONS AND SUPPORT

For an additional amount for ‘‘Operations and Support’’ for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $25,000,000, to remain available until 

September 30, 2020, for audits and investigations of activities 

funded by this title: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

SECURITY, ENFORCEMENT, AND INVESTIGATIONS 

U.S. CUSTOMS AND BORDER PROTECTION

OPERATIONS AND SUPPORT

For an additional amount for ‘‘Operations and Support’’ for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $104,494,000, to remain available until 

September 30, 2019: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985: Provided further, That not more than 

$39,400,000 may be used to carry out U.S. Customs and Border 

Protection activities in fiscal year 2018 in Puerto Rico and the 

United States Virgin Islands, in addition to any other amounts 

available for such purposes. 

PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS

For an additional amount for ‘‘Procurement, Construction, and 

Improvements’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria, including for the 

reconstruction of facilities affected, $45,000,000, to remain available 

until September 30, 2022: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985: Provided further, That funds are provided to carry out U.S. Customs and Border Protection activities 

in Puerto Rico and the United States Virgin Islands, in addition 

to any other amounts available for such purposes. 

U.S. IMMIGRATION AND CUSTOMS ENFORCEMENT

OPERATIONS AND SUPPORT

For an additional amount for ‘‘Operations and Support’’ for 

necessary expenses related to the consequences of Hurricanes 

Puerto Rico. 

Virgin Islands. 


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132 STAT. 82 PUBLIC LAW 115–123—FEB. 9, 2018 

Harvey, Irma, and Maria, $30,905,000, to remain available until 

September 30, 2019: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS

For an additional amount for ‘‘Procurement, Construction, and 

Improvements’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria, $33,052,000, to remain 

available until September 30, 2022: Provided, That such amount 

is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

TRANSPORTATION SECURITY ADMINISTRATION

OPERATIONS AND SUPPORT

For an additional amount for ‘‘Operations and Support’’ for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $10,322,000, to remain available until 

September 30, 2019: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

COAST GUARD

OPERATING EXPENSES

For an additional amount for ‘‘Operating Expenses’’ for necessary expenses related to the consequences of Hurricanes Harvey, 

Irma, and Maria, $112,136,000, to remain available until September 

30, 2019: Provided, That such amount is designated by the Congress 

as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

ENVIRONMENTAL COMPLIANCE AND RESTORATION

For an additional amount for ‘‘Environmental Compliance and 

Restoration’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria, $4,038,000, to remain 

available until September 30, 2022: Provided, That such amount 

is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

ACQUISITION, CONSTRUCTION, AND IMPROVEMENTS

For an additional amount for Acquisition, Construction, and 

Improvements’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, Maria, and Matthew, $718,919,000, 

to remain available until September 30, 2022: Provided, That, not 

later than 60 days after enactment of this subdivision, the Secretary 

Deadline. 

Expenditure 

plan. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 83 

of Homeland Security, or her designee, shall submit to the Committees on Appropriations of the House of Representatives and the 

Senate a detailed expenditure plan for funds appropriated under 

this heading: Provided further, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

PROTECTION, PREPAREDNESS, RESPONSE, AND RECOVERY 

FEDERAL EMERGENCY MANAGEMENT AGENCY

OPERATIONS AND SUPPORT

For an additional amount for ‘‘Operations and Support’’ for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $58,800,000, to remain available until 

September 30, 2019: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS

For an additional amount for ‘‘Procurement, Construction, and 

Improvements’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria, $1,200,000, to remain 

available until September 30, 2020: Provided, That such amount 

is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

DISASTER RELIEF FUND

For an additional amount for ‘‘Disaster Relief Fund’’ for major 

disasters declared pursuant to the Robert T. Stafford Disaster Relief 

and Emergency Assistance Act (42 U.S.C. 5121 et seq.), 

$23,500,000,000, to remain available until expended: Provided, That 

the Administrator of the Federal Emergency Management Agency 

shall publish on the Agency’s website not later than 5 days after 

an award of a public assistance grant under section 406 or 428 

of the Robert T. Stafford Disaster Relief and Emergency Assistance 

Act (42 U.S.C. 5172 or 5189f) that is in excess of $1,000,000, 

the specifics of each such grant award: Provided further, That 

for any mission assignment or mission assignment task order to 

another Federal department or agency regarding a major disaster 

in excess of $1,000,000, not later than 5 days after the issuance 

of such mission assignment or mission assignment task order, the 

Administrator shall publish on the Agency’s website the following: 

the name of the impacted State, the disaster declaration for such 

State, the assigned agency, the assistance requested, a description 

of the disaster, the total cost estimate, and the amount obligated: 

Provided further, That not later than 10 days after the last day 

of each month until a mission assignment or mission assignment 

task order described in the preceding proviso is completed and 

closed out, the Administrator shall update any changes to the 

total cost estimate and the amount obligated: Provided further, 

That for a disaster declaration related to Hurricanes Harvey, Irma, Hurricane 

Harvey. 

Hurricane Irma. 

Hurricane Maria. 

Updates. 

Grants. 

Web postings. 

Deadlines. 

Missions. 

Cost estimates. 


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132 STAT. 84 PUBLIC LAW 115–123—FEB. 9, 2018 

or Maria, the Administrator shall submit to the Committees on 

Appropriations of the House of Representatives and the Senate, 

not later than 5 days after the first day of each month beginning 

after the date of enactment of this subdivision, and shall publish 

on the Agency’s website, not later than 10 days after the first 

day of each such month, an estimate or actual amount, if available, 

for the current fiscal year of the cost of the following categories 

of spending: public assistance, individual assistance, operations, 

mitigation, administrative, and any other relevant category 

(including emergency measures and disaster resources): Provided, 

further, That not later than 10 days after the first day of each 

month, the Administrator shall publish on the Agency’s website 

the report (referred to as the Disaster Relief Monthly Report) as 

required by Public Law 114–4: Provided further, That of the 

amounts provided under this heading for the Disaster Relief Fund, 

up to $150,000,000 shall be transferred to the Disaster Assistance 

Direct Loan Program Account for the cost to lend a territory or 

possession of the United States that portion of assistance for which 

the territory or possession is responsible under the cost-sharing 

provisions of the major disaster declaration for Hurricanes Irma 

or Maria, as authorized under section 319 of the Robert T. Stafford 

Disaster Relief and Emergency Assistance Act (42 U.S.C. 5162): 

Provided further, That of the amount provided under this paragraph 

for transfer, up to $1,000,000 may be transferred to the Disaster 

Assistance Direct Loan Program Account for administrative 

expenses to carry out the Advance of Non-Federal Share program, 

as authorized by section 319 of the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act (42 U.S.C. 5162): Provided 

further, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 

RESEARCH, DEVELOPMENT, TRAINING, AND SERVICES 

FEDERAL LAW ENFORCEMENT TRAINING CENTERS

OPERATIONS AND SUPPORT

For an additional amount for ‘‘Operations and Support’’ for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $5,374,000, to remain available until 

September 30, 2019: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

PROCUREMENT, CONSTRUCTION, AND IMPROVEMENTS

For an additional amount for ‘‘Procurement, Construction, and 

Improvements’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria, $5,000,000, to remain 

available until September 30, 2022: Provided, That such amount 

is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

Reports. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 85 

GENERAL PROVISIONS—THIS TITLE 

SEC. 20601. The Administrator of the Federal Emergency 

Management Agency may provide assistance, pursuant to section 

428 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.), for critical services as defined 

in section 406 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act for the duration of the recovery for incidents 

DR–4336–PR, DR–4339–PR, DR–4340–USVI, and DR–4335–USVI 

to— 

(1) replace or restore the function of a facility or system 

to industry standards without regard to the pre-disaster condition of the facility or system; and 

(2) replace or restore components of the facility or system 

not damaged by the disaster where necessary to fully effectuate 

the replacement or restoration of disaster-damaged components 

to restore the function of the facility or system to industry 

standards. 

SEC. 20602. Notwithstanding section 404 or 420 of the Robert 

T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 

5170c and 8187), for fiscal years 2017 and 2018, the President 

shall provide hazard mitigation assistance in accordance with such 

section 404 in any area in which assistance was provided under 

such section 420. 

SEC. 20603. The third proviso of the second paragraph in title 

I of Public Law 115–72 under the heading ‘‘Federal Emergency 

Management Agency—Disaster Relief Fund’’ shall be amended by 

striking ‘‘180 days’’ and inserting ‘‘365 days’’: Provided, That 

amounts repurposed pursuant to this section that were previously 

designated by the Congress as an emergency requirement pursuant 

to the Balanced Budget and Emergency Deficit Control Act are 

designated by the Congress as an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

SEC. 20604. (a) DEFINITION OF PRIVATE NONPROFIT FACILITY.— Section 102(11)(B) of the Robert T. Stafford Disaster Relief and 

Emergency Assistance Act (42 U.S.C. 5122(11)(B)) is amended to 

read as follows: 

‘‘(A) IN GENERAL.—The term ‘private nonprofit facility’ 

means private nonprofit educational (without regard to 

the religious character of the facility), utility, irrigation, 

emergency, medical, rehabilitational, and temporary or 

permanent custodial care facilities (including those for the 

aged and disabled) and facilities on Indian reservations, 

as defined by the President. 

‘‘(B) ADDITIONAL FACILITIES.—In addition to the facilities described in subparagraph (A), the term ‘private nonprofit facility’ includes any private nonprofit facility that 

provides essential social services to the general public 

(including museums, zoos, performing arts facilities, 

community arts centers, community centers, libraries, 

homeless shelters, senior citizen centers, rehabilitation 

facilities, shelter workshops, broadcasting facilities, houses 

of worship, and facilities that provide health and safety 

services of a governmental nature), as defined by the President. No house of worship may be excluded from this 

definition because leadership or membership in the 

131 Stat. 1225. 

President. 


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132 STAT. 86 PUBLIC LAW 115–123—FEB. 9, 2018 

organization operating the house of worship is limited to 

persons who share a religious faith or practice.’’. 

(b) REPAIR, RESTORATION, AND REPLACEMENT OF DAMAGED

FACILITIES.—Section 406(a)(3) of the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act (42 U.S.C. 5172(a)(3)) is 

amended by adding at the end the following: 

‘‘(C) RELIGIOUS FACILITIES.—A church, synagogue, 

mosque, temple, or other house of worship, educational 

facility, or any other private nonprofit facility, shall be 

eligible for contributions under paragraph (1)(B), without 

regard to the religious character of the facility or the primary religious use of the facility. No house of worship, 

educational facility, or any other private nonprofit facility 

may be excluded from receiving contributions under paragraph (1)(B) because leadership or membership in the 

organization operating the house of worship is limited to 

persons who share a religious faith or practice.’’. 

(c) APPLICABILITY.—This section and the amendments made 

by this section shall apply— 

(1) to the provision of assistance in response to a major 

disaster or emergency declared on or after August 23, 2017; 

or 

(2) with respect to— 

(A) any application for assistance that, as of the date 

of enactment of this Act, is pending before Federal Emergency Management Agency; and 

(B) any application for assistance that has been denied, 

where a challenge to that denial is not yet finally resolved 

as of the date of enactment of this Act. 

SEC. 20605. (a) The Federal share of assistance, including direct 

Federal assistance, provided under section 407 of the Robert T. 

Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 

5173), with respect to a major disaster declared pursuant to such 

Act for damages resulting from a wildfire in calendar year 2017, 

shall be 90 percent of the eligible costs under such section. 

(b) The Federal share provided by subsection (a) shall apply 

to assistance provided before, on, or after the date of enactment 

of this Act. 

FEDERAL COST-SHARE ADJUSTMENTS FOR REPAIR, RESTORATION, AND

REPLACEMENT OF DAMAGED FACILITIES

SEC. 20606. Section 406(b) of the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act (42 U.S.C. 5172(b)) is amended 

by inserting after paragraph (2) the following: 

‘‘(3) INCREASED FEDERAL SHARE.— 

‘‘(A) INCENTIVE MEASURES.—The President may provide 

incentives to a State or Tribal government to invest in 

measures that increase readiness for, and resilience from, 

a major disaster by recognizing such investments through 

a sliding scale that increases the minimum Federal share 

to 85 percent. Such measures may include— 

‘‘(i) the adoption of a mitigation plan approved 

under section 322; 

‘‘(ii) investments in disaster relief, insurance, and 

emergency management programs; 

Applicability. 

Effective date. 

Effective date. 

42 USC 5122 

note. 


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‘‘(iii) encouraging the adoption and enforcement 

of the latest published editions of relevant consensusbased codes, specifications, and standards that incorporate the latest hazard-resistant designs and establish 

minimum acceptable criteria for the design, construction, and maintenance of residential structures and 

facilities that may be eligible for assistance under this 

Act for the purpose of protecting the health, safety, 

and general welfare of the buildings’ users against 

disasters; 

‘‘(iv) facilitating participation in the community 

rating system; and 

‘‘(v) funding mitigation projects or granting tax 

incentives for projects that reduce risk. 

‘‘(B) COMPREHENSIVE GUIDANCE.—Not later than 1 year 

after the date of enactment of this paragraph, the President, acting through the Administrator, shall issue comprehensive guidance to State and Tribal governments 

regarding the measures and investments, weighted appropriately based on actuarial assessments of eligible actions, 

that will be recognized for the purpose of increasing the 

Federal share under this section. Guidance shall ensure 

that the agency’s review of eligible measures and investments does not unduly delay determining the appropriate 

Federal cost share. 

‘‘(C) REPORT.—One year after the issuance of the guidance required by subparagraph (B), the Administrator shall 

submit to the Committee on Transportation and Infrastructure of the House of Representatives and the Committee 

on Homeland Security and Governmental Affairs of the 

Senate a report regarding the analysis of the Federal cost 

shares paid under this section. 

‘‘(D) SAVINGS CLAUSE.—Nothing in this paragraph prevents the President from increasing the Federal cost share 

above 85 percent.’’. 

SEC. 20607. Division F of the Consolidated Appropriations Act, 

2017, is amended by inserting the following at the end of Title 

V: 

‘‘SEC. 545. (a) PREMIUM PAY AUTHORITY.—During calendar year 

2017, any premium pay that is funded, either directly or through 

reimbursement, by the ‘Federal Emergency Management Agency— 

Disaster Relief Fund’ shall be exempted from the aggregate of 

basic pay and premium pay calculated under section 5547(a) of 

title 5, United States Code, and any other provision of law limiting 

the aggregate amount of premium pay payable on a biweekly or 

calendar year basis. 

‘‘(b) OVERTIME AUTHORITY.—During calendar year 2017, any 

overtime that is funded, either directly or through reimbursement, 

by the ‘Federal Emergency Management Agency—Disaster Relief 

Fund’ shall be exempted from any annual limit on the amount 

of overtime payable in a calendar or fiscal year. 

‘‘(c) APPLICABILITY OF AGGREGATE LIMITATION ON PAY.—In 

determining whether an employee’s pay exceeds the applicable 

annual rate of basic pay payable under section 5307 of title 5, 

United States Code, the head of an Executive agency shall not 

include pay exempted under this section. 

131 Stat. 433. 

Deadline. 

President. 


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‘‘(d) LIMITATION OF PAY AUTHORITY.—Pay exempted from otherwise applicable limits under subsection (a) shall not cause the 

aggregate pay earned for the calendar year in which the exempted 

pay is earned to exceed the rate of basic pay payable for a position 

at level II of the Executive Schedule under section 5313 of title 

5, United States Code. 

‘‘(e) EFFECTIVE DATE.—This section shall take effect as if 

enacted on December 31, 2016.’’. 

TITLE VII 

DEPARTMENT OF THE INTERIOR 

UNITED STATES FISH AND WILDLIFE SERVICE

CONSTRUCTION

For an additional amount for ‘‘Construction’’ for necessary 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria, $210,629,000, to remain available until expended: Provided, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 

NATIONAL PARK SERVICE

HISTORIC PRESERVATION FUND

For an additional amount for the ‘‘Historic Preservation Fund’’ 

for necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $50,000,000, to remain available until 

September 30, 2019, including costs to States and territories necessary to complete compliance activities required by section 306108 

of title 54, United States Code (formerly section 106 of the National 

Historic Preservation Act) and costs needed to administer the program: Provided, That grants shall only be available for areas that 

have received a major disaster declaration pursuant to the Robert 

T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 

5121 et seq.): Provided further, That individual grants shall not 

be subject to a non-Federal matching requirement: Provided further, 

That such amount is designated by the Congress as being for 

an emergency requirement pursuant to section 251(b)(2)(A)(i) of 

the Balanced Budget and Emergency Deficit Control Act of 1985. 

CONSTRUCTION

For an additional amount for ‘‘Construction’’ for necessary 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria, $207,600,000, to remain available until expended: Provided, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 


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UNITED STATES GEOLOGICAL SURVEY

SURVEYS, INVESTIGATIONS, AND RESEARCH

For an additional amount for ‘‘Surveys, Investigations, and 

Research’’ for necessary expenses related to the consequences of 

Hurricanes Harvey, Irma, and Maria, and in those areas impacted 

by a major disaster declared pursuant to the Robert T. Stafford 

Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 

et seq.) with respect to wildfires in 2017, $42,246,000, to remain 

available until expended: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

DEPARTMENTAL OFFICES

INSULAR AFFAIRS

ASSISTANCE TO TERRITORIES

For an additional amount for ‘‘Technical Assistance’’ for financial management expenses related to the consequences of Hurricanes Irma and Maria, $3,000,000, to remain available until 

expended: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

OFFICE OF INSPECTOR GENERAL

SALARIES AND EXPENSES

For an additional amount for ‘‘Salaries and Expenses’’ for necessary expenses related to the consequences of Hurricanes Harvey, 

Irma, and Maria, $2,500,000, to remain available until expended: 

Provided, That such amount is designated by the Congress as 

being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

ENVIRONMENTAL PROTECTION AGENCY

HAZARDOUS SUBSTANCE SUPERFUND

For an additional amount for ‘‘Hazardous Substance Superfund’’ 

for necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $6,200,000, to remain available until 

expended: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

LEAKING UNDERGROUND STORAGE TANK TRUST FUND PROGRAM

For an additional amount for ‘‘Leaking Underground Storage 

Tank Fund’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria, $7,000,000, to remain 


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132 STAT. 90 PUBLIC LAW 115–123—FEB. 9, 2018 

available until expended: Provided, That such amount is designated 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

STATE AND TRIBAL ASSISTANCE GRANTS

For an additional amount for ‘‘State and Tribal Assistance 

Grants’’ for necessary expenses related to the consequences of Hurricanes Harvey, Irma, and Maria for the hazardous waste financial 

assistance grants program and for other solid waste management 

activities, $50,000,000, to remain available until expended: Provided, That none of these funds allocated within Region 2 shall 

be subject to cost share requirements under section 3011(b) of 

the Solid Waste Disposal Act: Provided further, That such amount 

is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

ADMINISTRATIVE PROVISION—ENVIRONMENTAL PROTECTION AGENCY

Of amounts previously appropriated for capitalization grants 

for the State Revolving Funds under title VI of the Federal Water 

Pollution Control Act or under section 1452 of the Safe Drinking 

Water Act to a State or territory included as part of a disaster 

declaration related to Hurricanes Irma and Maria, all existing 

grant funds that are available but not drawn down shall not be 

subject to the matching or cost share requirements of sections 

602(b)(2), 602(b)(3) of the Federal Water Pollution Control Act nor 

the matching requirements of section 1452(e) of the Safe Drinking 

Water Act and shall be awarded to such state or territory: Provided, 

That, notwithstanding the requirements of section 603(d) of the 

Federal Water Pollution Control Act or section 1452(f) of the Safe 

Drinking Water Act, the state or territory shall utilize the full 

amount of such funds, excluding existing loans, to provide additional 

subsidization to eligible recipients in the form of forgiveness of 

principal, negative interest loans or grants or any combination 

of these: Provided further, That such funds may be used for eligible 

projects whose purpose is to repair damage incurred as a result 

of Hurricanes Irma and Maria, reduce flood damage risk and vulnerability or to enhance resiliency to rapid hydrologic change or a 

natural disaster at treatment works as defined by section 212 

of the Federal Water Pollution Control Act or a public drinking 

water system under section 1452 of the Safe Drinking Water Act: 

Provided further, That any project involving the repair or replacement of a lead service line shall replace the entire lead service 

line, not just a portion. 

RELATED AGENCIES 

DEPARTMENT OF AGRICULTURE 

FOREST SERVICE

STATE AND PRIVATE FORESTRY

For an additional amount for ‘‘State and Private Forestry’’ 

for necessary expenses related to the consequences of Hurricanes 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 91 

Harvey, Irma, and Maria, $7,500,000, to remain available until 

expended: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

NATIONAL FOREST SYSTEM

For an additional amount for ‘‘National Forest System’’ for 

necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, $20,652,000, to remain available until 

expended: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

CAPITAL IMPROVEMENT AND MAINTENANCE

For an additional amount for ‘‘Capital Improvement and 

Maintenance’’ for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria, and the 2017 fire season, 

$91,600,000, to remain available until expended: Provided, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

GENERAL PROVISION—THIS TITLE 

SEC. 20701. Agencies receiving funds appropriated by this title 

shall each provide a monthly report to the Committees on Appropriations of the House of Representatives and the Senate detailing 

the allocation and obligation of these funds by account, beginning 

not later than 90 days after enactment of this Act. 

TITLE VIII 

DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

(INCLUDING TRANSFERS OF FUNDS)

For an additional amount for ‘‘Training and Employment Services’’, $100,000,000, for the dislocated workers assistance national 

reserve for necessary expenses directly related to the consequences 

of Hurricanes Harvey, Maria, and Irma and those jurisdictions 

that received a major disaster declaration pursuant to the Robert 

T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 

5121 et seq.) due to wildfires in 2017, which shall be available 

from the date of enactment of this subdivision through September 

30, 2019: Provided, That the Secretary of Labor may transfer up 

to $2,500,000 of such funds to any other Department of Labor 

account for reconstruction and recovery needs, including worker 

protection activities: Provided further, That these sums may be 

used to replace grant funds previously obligated to the impacted 

areas: Provided further, That of the amount provided, up to 

Reports. 

Deadline. 


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$500,000, to remain available until expended, shall be transferred 

to ‘‘Office of Inspector General’’for oversight of activities responding 

to such hurricanes and wildfires: Provided further, That such 

amount is designated by the Congress as being for an emergency 

requirement pursuant to section 251(b)(2)(A)(i) of the Balanced 

Budget and Emergency Deficit Control Act of 1985. 

JOB CORPS

For an additional amount for ‘‘Job Corps’’ for construction, 

rehabilitation and acquisition for Job Corps Centers in Puerto Rico, 

$30,900,000, which shall be available upon the date of enactment 

of this subdivision and remain available for obligation through 

June 30, 2021: Provided, That such amount is designated by the 

Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

GENERAL PROVISIONS—DEPARTMENT OF LABOR

DEFERRAL OF INTEREST PAYMENTS FOR VIRGIN ISLANDS

SEC. 20801. Notwithstanding any other provision of law, the 

interest payment of the Virgin Islands that was due under section 

1202(b)(1) of the Social Security Act on September 29, 2017, shall 

not be due until September 28, 2018, and no interest shall accrue 

on such amount through September 28, 2018: Provided, That such 

amount is designated by the Congress as being for an emergency 

requirement pursuant to section 251(b)(2)(A)(i) of the Balanced 

Budget and Emergency Deficit Control Act of 1985. 

FLEXIBILITY IN USE OF FUNDS UNDER WIOA

SEC. 20802. (a) IN GENERAL.—Notwithstanding section 133(b)(4) 

of the Workforce Innovation and Opportunity Act, in States, as 

defined by section 3(56) of such Act, affected by Hurricanes Harvey, 

Irma, and Maria, a local board, as defined by section 3(33) of 

such Act, in a local area, as defined by section 3(32) of such 

Act, affected by such Hurricanes may transfer, if such transfer 

is approved by the Governor, up to 100 percent of the funds allocated 

to the local area for Program Years 2016 and 2017 for Youth 

Workforce Investment activities under paragraphs (2) or (3) of 

section 128(b) of such Act, for Adult employment and training 

activities under paragraphs (2)(A) or (3) of section 133(b) of such 

Act, or for Dislocated Worker employment and training activities 

under paragraph (2)(B) of section 133(b) of such Act among— 

(1) adult employment and training activities; 

(2) dislocated worker employment and training activities; 

and 

(3) youth workforce investment activities. 

(b) THE VIRGIN ISLANDS.—Except for the funds reserved to 

carry out required statewide activities under sections 127(b) and 

134(a)(2) of the Workforce Innovation and Opportunity Act, the 

Governor of the Virgin Islands may authorize the transfer of up 

to 100 percent of the remaining funds provided to the Virgin Islands 

for Program Years 2016 and 2017 for Youth Workforce Investment 

activities under section 127(b)(1)(B) of such Act, for Adult employment and training activities under section 132(b)(1)(A) of such 

Deadline. 

Time period. 


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Act, or for Dislocated Worker employment and training activities 

under section 133(b)(2)(A) of such Act among— 

(1) adult employment and training activities; 

(2) dislocated worker employment and training activities; 

and 

(3) youth workforce investment activities. 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

CENTERS FOR DISEASE CONTROL AND PREVENTION

CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT

(INCLUDING TRANSFER OF FUNDS)

For an additional amount for ‘‘CDC-Wide Activities and Program Support’’, $200,000,000, to remain available until September 

30, 2020, for response, recovery, preparation, mitigation, and other 

expenses directly related to the consequences of Hurricanes Harvey, 

Irma, and Maria: Provided, That obligations incurred for the purposes provided herein prior to the date of enactment of this subdivision may be charged to funds appropriated by this paragraph: 

Provided further, That of the amount provided, not less than $6,000,000 shall be transferred to the ‘‘Buildings and Facilities’’ 

account for the purposes provided herein: Provided further, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

NATIONAL INSTITUTES OF HEALTH

OFFICE OF THE DIRECTOR

For an additional amount for fiscal year 2018 for ‘‘Office of 

the Director’’, $50,000,000, to remain available until September 

30, 2020, for response, recovery, and other expenses directly related 

to the consequences of Hurricanes Harvey, Irma, and Maria: Provided, That obligations incurred for these purposes prior to the 

date of enactment of this subdivision may be charged to funds 

appropriated by this paragraph: Provided further, That funds appropriated by this paragraph may be used for construction grants 

or contracts under section 404I of the Public Health Service Act 

without regard to section 404I(c)(2): Provided further, That such 

amount is designated by the Congress as being for an emergency 

requirement pursuant to section 251(b)(2)(A)(i) of the Balanced 

Budget and Emergency Deficit Control Act of 1985. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

CHILDREN AND FAMILIES SERVICES PROGRAMS

For an additional amount for ‘‘Children and Families Services 

Programs’’, $650,000,000, to remain available until September 30, 

2021, for Head Start programs, for necessary expenses directly 

related to the consequences of Hurricanes Harvey, Irma, and Maria, 

including making payments under the Head Start Act: Provided, 

That none of the funds appropriated in this paragraph shall be 

included in the calculation of the ‘‘base grant’’ in subsequent fiscal 


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years, as such term is defined in sections 640(a)(7)(A), 641A(h)(1)(B), 

or 645(d)(3) of the Head Start Act: Provided further, That funds 

appropriated in this paragraph are not subject to the allocation 

requirements of section 640(a) of the Head Start Act: Provided 

further, That funds appropriated in this paragraph shall not be 

available for costs that are reimbursed by the Federal Emergency 

Management Agency, under a contract for insurance, or by selfinsurance: Provided further, That up to $12,500,000 shall be available for Federal administrative expenses: Provided further, That 

obligations incurred for the purposes provided herein prior to the 

date of enactment of this subdivision may be charged to funds 

appropriated under this heading: Provided further, That such 

amount is designated by the Congress as being for an emergency 

requirement pursuant to section 251(b)(2)(A)(i) of the Balanced 

Budget and Emergency Deficit Control Act of 1985. 

OFFICE OF THE SECRETARY

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

(INCLUDING TRANSFERS OF FUNDS)

For an additional amount for the ‘‘Public Health and Social 

Services Emergency Fund’’, $162,000,000, to remain available until 

September 30, 2020, for response, recovery, preparation, mitigation 

and other expenses directly related to the consequences of Hurricanes Harvey, Irma, and Maria, including activities authorized 

under section 319(a) of the Public Health Service Act (referred 

to in this subdivision as the ‘‘PHS Act’’): Provided, That of the 

amount provided, $60,000,000 shall be transferred to ‘‘Health 

Resources and Services Administration—Primary Health Care’’, for 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria for disaster response and recovery, for the Health Centers Program under section 330 of the PHS Act: Provided further, 

That not less than $50,000,000, of amounts transferred under the 

preceding proviso, shall be available for alteration, renovation, 

construction, equipment, and other capital improvement costs as 

necessary to meet the needs of areas affected by Hurricanes Harvey, 

Irma, and Maria: Provided further, That the time limitation in 

section 330(e)(3) of the PHS Act shall not apply to funds made 

available under the preceding proviso: Provided further, That of 

the amount provided, not less than $20,000,000 shall be transferred 

to ‘‘Substance Abuse and Mental Health Services Administration— 

Health Surveillance and Program Support’’ for grants, contracts, 

and cooperative agreements for behavioral health treatment, crisis 

counseling, and other related helplines, and for other similar programs to provide support to individuals impacted by Hurricanes 

Harvey, Irma, and Maria: Provided further, That of the amount 

provided, up to $2,000,000, to remain available until expended, 

shall be transferred to ‘‘Office of the Secretary—Office of Inspector 

General’’ for oversight of activities responding to such hurricanes: 

Provided further, That obligations incurred for the purposes provided herein prior to the date of enactment of this subdivision 

may be charged to funds appropriated under this heading: Provided 

further, That funds appropriated in this paragraph shall not be 

available for costs that are reimbursed by the Federal Emergency 

Management Agency, under a contract for insurance, or by selfVerDate Sep 11 2014 07:07 Oct 27, 2018 Jkt 079139 PO 00123 Frm 00032 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL123.115 PUBL123

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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 95 

insurance: Provided further, That such amount is designated by 

the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

GENERAL PROVISION—DEPARTMENT OF HEALTH AND HUMAN

SERVICES

DIRECT HIRE AUTHORITY FOR CERTAIN EMERGENCY RESPONSE

POSITIONS

SEC. 20803. (a) IN GENERAL.—As the Secretary of Health and 

Human Services determines necessary to respond to a critical hiring 

need for emergency response positions, after providing public notice 

and without regard to the provisions of sections 3309 through 

3319 of title 5, United States Code, the Secretary may appoint 

candidates directly to the following positions, consistent with subsection (b), to perform critical work directly relating to the consequences of Hurricanes Harvey, Irma, and Maria: 

(1) Intermittent disaster-response personnel in the National 

Disaster Medical System, under section 2812 of the Public 

Health Service Act (42 U.S.C. 300hh–11). 

(2) Term or temporary related positions in the Centers 

for Disease Control and Prevention and the Office of the Assistant Secretary for Preparedness and Response. 

(b) EXPIRATION.—The authority under subsection (a) shall 

expire 270 days after the date of enactment of this section. 

DEPARTMENT OF EDUCATION 

HURRICANE EDUCATION RECOVERY

(INCLUDING TRANSFER OF FUNDS)

For an additional amount for ‘‘Hurricane Education Recovery’’ 

for necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria, or wildfires in 2017 for which a major 

disaster or emergency has been declared under sections 401 or 

501 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170 and 5190) (referred to under this heading 

as ‘‘covered disaster or emergency’’), $2,700,000,000, to remain available through September 30, 2022, for assisting in meeting the 

educational needs of individuals affected by a covered disaster or 

emergency: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further, That— 

(1) such funds shall be used— 

(A) to make awards to eligible entities for immediate 

aid to restart school operations, in accordance with paragraph (2); 

(B) for temporary emergency impact aid for displaced 

students, in accordance with paragraph (2); 

(C) for emergency assistance to institutions of higher 

education and students attending institutions of higher 

education in an area directly affected by a covered disaster 

or emergency in accordance with paragraph (3); 

Determination. 

Notice. 


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(D) for payments to institutions of higher education 

to help defray the unexpected expenses associated with 

enrolling displaced students from institutions of higher 

education directly affected by a covered disaster or emergency, in accordance with paragraph (4); and 

(E) to provide assistance to local educational agencies 

serving homeless children and youth in accordance with 

paragraph (5); 

(2) immediate aid to restart school operations and temporary emergency impact aid for displaced students described 

in subparagraphs (A) and (B) of paragraph (1) shall be provided 

under the statutory terms and conditions that applied to assistance under sections 102 and 107 of title IV of division B 

of Public Law 109–148, respectively, except that such sections 

shall be applied so that— 

(A) each reference to a major disaster declared in 

accordance with section 401 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170) 

shall be to a major disaster or emergency declared by 

the President in accordance with section 401 or 501, respectively, of such Act; 

(B) each reference to Hurricane Katrina or Hurricane 

Rita shall be a reference to a covered disaster or emergency; 

(C) each reference to August 22, 2005 shall be to the 

date that is one week prior to the date that the major 

disaster or emergency was declared for the area; 

(D) each reference to the States of Louisiana, Mississippi, Alabama, and Texas shall be to the States or 

territories affected by a covered disaster or emergency, 

and each reference to the State educational agencies of 

Louisiana, Mississippi, Alabama, or Texas shall be a reference to the State educational agencies that serve the 

states or territories affected by a covered disaster or emergency; 

(E) each reference to the 2005–2006 school year shall 

be to the 2017–2018 school year; 

(F) the references in section 102(h)(1) of title IV of 

division B of Public Law 109–148 to the number of nonpublic and public elementary schools and secondary schools 

in the State shall be to the number of students in nonpublic and public elementary schools and secondary schools 

in the State, and the reference in such section to the 

National Center for Data Statistics Common Core of Data 

for the 2003–2004 school year shall be to the most recent 

and appropriate data set for the 2016–2017 school year; 

(G) in determining the amount of immediate aid provided to restart school operations as described in section 

102(b) of title IV of division B of Public Law 109–148, 

the Secretary shall consider the number of students 

enrolled, during the 2016–2017 school year, in elementary 

schools and secondary schools that were closed as a result 

of a covered disaster or emergency; 

(H) in determining the amount of emergency impact 

aid that a State educational agency is eligible to receive 

under paragraph (1)(B), the Secretary shall, subject to section 107(d)(1)(B) of such title, provide— 


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(i) $9,000 for each displaced student who is an 

English learner, as that term is defined in section 

8101 of the Elementary and Secondary Education Act 

of 1965 (20 U.S.C. 7801); 

(ii) $10,000 for each displaced student who is a 

child with a disability (regardless of whether the child 

is an English learner); and 

(iii) $8,500 for each displaced student who is not 

a child with a disability or an English learner; 

(I) with respect to the emergency impact aid provided 

under paragraph (1)(B), the Secretary may modify the State 

educational agency and local educational agency application 

timelines in section 107(c) of such title; and 

(J) each reference to a public elementary school may 

include, as determined by the local educational agency, 

a publicly-funded preschool program that enrolls children 

below the age of kindergarten entry and is part of an 

elementary school; 

(3) $100,000,000 of the funds made available under this 

heading shall be for programs authorized under subpart 3 

of Part A, part C of title IV and part B of title VII of the 

Higher Education Act of 1965 (20 U.S.C. 1087–51 et seq., 

1138 et seq.) for institutions located in an area affected by 

a covered disaster or emergency, and students enrolled in such 

institutions, except that— 

(A) any requirements relating to matching, Federal 

share, reservation of funds, or maintenance of effort under 

such parts that would otherwise be applicable to that 

assistance shall not apply; 

(B) such assistance may be used for student financial 

assistance; 

(C) such assistance may also be used for faculty and 

staff salaries, equipment, student supplies and 

instruments, or any purpose authorized under the Higher 

Education Act of 1965, by institutions of higher education 

that are located in areas affected by a covered disaster 

or emergency; and 

(D) the Secretary shall prioritize, to the extent possible, 

students who are homeless or at risk of becoming homeless 

as a result of displacement, and institutions that have 

sustained extensive damage, by a covered disaster or emergency; 

(4) up to $75,000,000 of the funds made available under 

this heading shall be for payments to institutions of higher 

education to help defray the unexpected expenses associated 

with enrolling displaced students from institutions of higher 

education at which operations have been disrupted by a covered 

disaster or emergency, in accordance with criteria established 

by the Secretary and made publicly available; 

(5) $25,000,000 of the funds made available under this 

heading shall be available to provide assistance to local educational agencies serving homeless children and youths displaced by a covered disaster or emergency, consistent with 

section 723 of the McKinney-Vento Homeless Assistance Act 

(42 U.S.C. 11431–11435) and with section 106 of title IV of 

division B of Public Law 109–148, except that funds shall 

be disbursed based on demonstrated need and the number 


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132 STAT. 98 PUBLIC LAW 115–123—FEB. 9, 2018 

of homeless children and youth enrolled as a result of displacement by a covered disaster or emergency; 

(6) section 437 of the General Education Provisions Act 

(20 U.S.C. 1232) and section 553 of title 5, United States 

Code, shall not apply to activities under this heading; 

(7) $4,000,000 of the funds made available under this 

heading, to remain available until expended, shall be transferred to the Office of the Inspector General of the Department 

of Education for oversight of activities supported with funds 

appropriated under this heading, and up to $3,000,000 of the 

funds made available under this heading shall be for program 

administration; 

(8) up to $35,000,000 of the funds made available under 

this heading shall be to carry out activities authorized under 

section 4631(b) of the Elementary and Secondary Education 

Act of 1965 (20 U.S.C. 7281(b)): Provided, That obligations 

incurred for the purposes provided herein prior to the date 

of enactment of this subdivision may be charged to funds appropriated under this paragraph; 

(9) the Secretary may waive, modify, or provide extensions 

for certain requirements of the Higher Education Act of 1965 

(20 U.S.C. 1001 et seq.) for affected individuals, affected students, and affected institutions in covered disaster or emergency 

areas in the same manner as the Secretary was authorized 

to waive, modify, or provide extensions for certain requirements 

of such Act under provisions of subtitle B of title IV of division 

B of Public Law 109–148 for affected individuals, affected students, and affected institutions in areas affected by Hurricane 

Katrina and Hurricane Rita, except that the cost associated 

with any action taken by the Secretary under this paragraph 

is designated by the Congress as being for an emergency 

requirement pursuant to section 251(b)(2)(A)(i) of the Balanced 

Budget and Emergency Deficit Control Act of 1985; and 

(10) if any provision under this heading or application 

of such provision to any person or circumstance is held to 

be unconstitutional, the remainder of the provisions under this 

heading and the application of such provisions to any person 

or circumstance shall not be affected thereby. 

GENERAL PROVISION—DEPARTMENT OF EDUCATION

SEC. 20804. (a) Notwithstanding any other provision of law, 

the Secretary of Education is hereby authorized to forgive any 

outstanding balance owed to the Department of Education under 

the HBCU Hurricane Supplemental Loan program established 

pursuant to section 2601 of Public Law 109–234, as modified by 

section 307 of title III of division F of the Consolidated Appropriations Act, 2012 (Public Law 112–74), as carried forward by the 

Continuing Appropriations Resolution, 2013 (Public Law 112–175). 

(b) There are authorized to be appropriated, and there are 

hereby appropriated, such sums as may be necessary to carry 

out subsection (a): Provided, That such amount is designated by 

the Congress as an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balance Budget and Emergency Deficit Control 

Act of 1985. 

Loan forgiveness. 

Waiver authority. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 99 

GENERAL PROVISIONS—THIS TITLE 

(INCLUDING TRANSFER OF FUNDS)

SEC. 20805. Funds appropriated to the Department of Health 

and Human Services by this title may be transferred to, and merged 

with, other appropriation accounts under the headings ‘‘Centers 

for Disease Control and Prevention’’ and ‘‘Public Health and Social 

Services Emergency Fund’’ for the purposes specified in this title 

following consultation with the Office of Management and Budget: 

Provided, That the Committees on Appropriations in the House 

of Representatives and the Senate shall be notified 10 days in 

advance of any such transfer: Provided further, That, upon a determination that all or part of the funds transferred from an appropriation are not necessary, such amounts may be transferred back 

to that appropriation: Provided further, That none of the funds 

made available by this title may be transferred pursuant to the 

authority in section 205 of division H of Public Law 115–31 or 

section 241(a) of the PHS Act. 

SEC. 20806. Not later than 30 days after enactment of this 

subdivision, the Secretary of Health and Human Services shall 

provide a detailed spend plan of anticipated uses of funds made 

available in this title, including estimated personnel and administrative costs, to the Committees on Appropriations: Provided, That 

such plans shall be updated and submitted to the Committees 

on Appropriations every 60 days until all funds are expended or 

expire. 

SEC. 20807. Unless otherwise provided for by this title, the 

additional amounts appropriated by this title to appropriations 

accounts shall be available under the authorities and conditions 

applicable to such appropriations accounts for fiscal year 2018. 

TITLE IX 

LEGISLATIVE BRANCH 

GOVERNMENT ACCOUNTABILITY OFFICE 

SALARIES AND EXPENSES

For an additional amount for ‘‘Salaries and Expenses’’, 

$14,000,000, to remain available until expended, for audits and 

investigations relating to Hurricanes Harvey, Irma, and Maria and 

the 2017 wildfires: Provided, That such amount is designated by 

the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

TITLE X 

DEPARTMENT OF DEFENSE 

MILITARY CONSTRUCTION, NAVY AND MARINE CORPS

For an additional amount for ‘‘Military Construction, Navy 

and Marine Corps’’, $201,636,000, to remain available until September 30, 2022, for necessary expenses related to the consequences 

of Hurricanes Harvey, Irma, and Maria: Provided, That none of 

Updates. 

Deadlines. 

Spending plan. 

Cost estimates. 

Determination. 

Notification. 

Consultation. 


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132 STAT. 100 PUBLIC LAW 115–123—FEB. 9, 2018 

the funds made available to the Navy and Marine Corps for recovery 

efforts related to Hurricanes Harvey, Irma, and Maria in this 

subdivision shall be available for obligation until the Committees 

on Appropriations of the House of Representatives and the Senate 

receive form 1391 for each specific request: Provided further, That, 

not later than 60 days after enactment of this subdivision, the 

Secretary of the Navy, or his designee, shall submit to the Committees on Appropriations of House of Representatives and the Senate 

a detailed expenditure plan for funds provided under this heading: 

Provided further, That such funds may be obligated or expended 

for planning and design and military construction projects not otherwise authorized by law: Provided further, That such amount is 

designated by the Congress as being for an emergency requirement 

pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and 

Emergency Deficit Control Act of 1985. 

MILITARY CONSTRUCTION, ARMY NATIONAL GUARD

For an additional amount for ‘‘Military Construction, Army 

National Guard’’, $519,345,000, to remain available until September 

30, 2022, for necessary expenses related to the consequences of 

Hurricanes Harvey, Irma, and Maria: Provided, That none of the 

funds made available to the Army National Guard for recovery 

efforts related to Hurricanes Harvey, Irma, and Maria in this 

subdivision shall be available for obligation until the Committees 

on Appropriations of the House of Representatives and the Senate 

receive form 1391 for each specific request: Provided further, That, 

not later than 60 days after enactment of this subdivision, the 

Director of the Army National Guard, or his designee, shall submit 

to the Committees on Appropriations of the House of Representatives and the Senate a detailed expenditure plan for funds provided 

under this heading: Provided further, That such funds may be 

obligated or expended for planning and design and military 

construction projects not otherwise authorized by law: Provided 

further, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 

DEPARTMENT OF VETERANS AFFAIRS 

VETERANS HEALTH ADMINISTRATION

MEDICAL SERVICES

For an additional amount for ‘‘Medical Services’’, $11,075,000, 

to remain available until September 30, 2019, for necessary 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria: Provided, That such amount is designated by the Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

MEDICAL SUPPORT AND COMPLIANCE

For an additional amount for ‘‘Medical Support and Compliance’’, $3,209,000, to remain available until September 30, 2019, 

for necessary expenses related to the consequences of Hurricanes 

Harvey, Irma, and Maria: Provided, That such amount is designated 

Deadline. 

Expenditure 

plan. 

Deadline. 

Expenditure 

plan. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 101 

by the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

MEDICAL FACILITIES

For an additional amount for ‘‘Medical Facilities’’, $75,108,000, 

to remain available until September 30, 2022, for necessary 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria: Provided, That none of these funds shall be available 

for obligation until the Secretary of Veterans Affairs submits to 

the Committees on Appropriations of the House of Representatives 

and the Senate a detailed expenditure plan for funds provided 

under this heading: Provided further, That such amount is designated by the Congress as being for an emergency requirement 

pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and 

Emergency Deficit Control Act of 1985. 

DEPARTMENTAL ADMINISTRATION

CONSTRUCTION, MINOR PROJECTS

For an additional amount for ‘‘Construction, Minor Projects’’, 

$4,088,000, to remain available until September 30, 2022, for necessary expenses related to the consequences of Hurricanes Harvey, 

Irma, and Maria: Provided, That such amount is designated by 

the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985. 

GENERAL PROVISION—THIS TITLE 

SEC. 21001. Notwithstanding section 18236(b) of title 10, United 

States Code, the Secretary of Defense shall contribute to Puerto 

Rico, 100 percent of the total cost of construction (including the 

cost of architectural, engineering and design services) for the 

acquisition, construction, expansion, rehabilitation, or conversion 

of the Arroyo readiness center under paragraph (5) of section 

18233(a) of title 10, United States Code. 

TITLE XI 

DEPARTMENT OF TRANSPORTATION 

FEDERAL AVIATION ADMINISTRATION

OPERATIONS

(AIRPORT AND AIRWAY TRUST FUND)

For an additional amount for ‘‘Operations’’, $35,000,000, to 

be derived from the Airport and Airway Trust Fund and to remain 

available until expended, for necessary expenses related to the 

consequences of Hurricanes Harvey, Irma, and Maria, and other 

hurricanes occurring in calendar year 2017: Provided, That such 

amount is designated by the Congress as being for an emergency 

requirement pursuant to section 251(b)(2)(A)(i) of the Balanced 

Budget and Emergency Deficit Control Act of 1985. 

Puerto Rico. 

Expenditure 

plan. 


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132 STAT. 102 PUBLIC LAW 115–123—FEB. 9, 2018 

FACILITIES AND EQUIPMENT

(AIRPORT AND AIRWAY TRUST FUND)

For an additional amount for ‘‘Facilities and Equipment’’, 

$79,589,000, to be derived from the Airport and Airway Trust 

Fund and to remain available until expended, for necessary 

expenses related to the consequences of Hurricanes Harvey, Irma, 

and Maria, and other hurricanes occurring in calendar year 2017: 

Provided, That such amount is designated by the Congress as 

being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

FEDERAL HIGHWAY ADMINISTRATION

FEDERAL-AID HIGHWAYS

EMERGENCY RELIEF PROGRAM

For an additional amount for the ‘‘Emergency Relief Program’’ 

as authorized under section 125 of title 23, United States Code, 

$1,374,000,000, to remain available until expended: Provided, That 

notwithstanding section 125(d)(4) of title 23, United States Code, 

no limitation on the total obligations for projects under section 

125 of such title shall apply to the Virgin Islands, Guam, American 

Samoa, and the Commonwealth of the Northern Mariana Islands 

for fiscal year 2018 and fiscal year 2019: Provided further, That 

notwithstanding subsection (e) of section 120 of title 23, United 

States Code, for this fiscal year and hereafter, the Federal share 

for Emergency Relief funds made available under section 125 of 

such title to respond to damage caused by Hurricanes Irma and 

Maria, shall be 100 percent for Puerto Rico: Provided further, That 

such amount is designated by the Congress as being for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

FEDERAL TRANSIT ADMINISTRATION

PUBLIC TRANSPORTATION EMERGENCY RELIEF PROGRAM

For an additional amount for the ‘‘Public Transportation Emergency Relief Program’’ as authorized under section 5324 of title 

49, United States Code, $330,000,000 to remain available until 

expended, for transit systems affected by Hurricanes Harvey, Irma, 

and Maria with major disaster declarations in 2017: Provided, 

That not more than three-quarters of one percent of the funds 

for public transportation emergency relief shall be available for 

administrative expenses and ongoing program management oversight as authorized under sections 5334 and 5338(f)(2) of such 

title and shall be in addition to any other appropriations for such 

purpose: Provided further, That such amount is designated by the 

Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985. 

Applicability. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 103 

MARITIME ADMINISTRATION

OPERATIONS AND TRAINING

For an additional amount for ‘‘Operations and Training’’, 

$10,000,000, to remain available until expended, for necessary 

expenses, including for dredging, related to damage to Maritime 

Administration facilities resulting from Hurricane Harvey: Provided, That such amount is designated by the Congress as being 

for an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 

GENERAL PROVISION—DEPARTMENT OF TRANSPORTATION

SEC. 21101. Notwithstanding 49 U.S.C. 5302, for fiscal years 

2018, 2019, and 2020 the Secretary of Transportation shall treat 

an area as an ‘‘urbanized area’’ for purposes of 49 U.S.C. 5307 

and 5336(a) until the next decennial census following the enactment 

of this Act if the area was defined and designated as an ‘‘urbanized’’ 

area by the Secretary of Commerce in the 2000 decennial census 

and the population of such area fell below 50,000 after the 2000 

decennial census as a result of a major disaster: Provided, That 

an area treated as an ‘‘urbanized area’’ for purposes of this section 

shall be assigned the population and square miles of the urbanized 

area designated by the Secretary of Commerce in the 2000 decennial 

census: Provided further, That the term ‘‘major disaster’’ has the 

meaning given such term in section 102(2) of the Disaster Relief 

Act of 1974 (42 U.S.C. 5122(2)). 

DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 

COMMUNITY PLANNING AND DEVELOPMENT

COMMUNITY DEVELOPMENT FUND

(INCLUDING TRANSFERS OF FUNDS)

For an additional amount for ‘‘Community Development Fund’’, 

$28,000,000,000, to remain available until expended, for necessary 

expenses for activities authorized under title I of the Housing 

and Community Development Act of 1974 (42 U.S.C. 5301 et seq.) 

related to disaster relief, long-term recovery, restoration of infrastructure and housing, economic revitalization, and mitigation in 

the most impacted and distressed areas resulting from a major 

declared disaster that occurred in 2017 (except as otherwise provided under this heading) pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et 

seq.): Provided, That funds shall be awarded directly to the State, 

unit of general local government, or Indian tribe (as such term 

is defined in section 102 of the Housing and Community Development Act of 1974) at the discretion of the Secretary: Provided 

further, That of the amounts made available under this heading, 

up to $16,000,000,000 shall be allocated to meet unmet needs for 

grantees that have received or will receive allocations under this 

heading for major declared disasters that occurred in 2017 or under 

the same heading of Division B of Public Law 115–56, except 

that, of the amounts made available under this proviso, no less 

than $11,000,000,000 shall be allocated to the States and units 


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132 STAT. 104 PUBLIC LAW 115–123—FEB. 9, 2018 

of local government affected by Hurricane Maria, and of such 

amounts allocated to such grantees affected by Hurricane Maria, 

$2,000,000,000 shall be used to provide enhanced or improved electrical power systems: Provided further, That to the extent amounts 

under the previous proviso are insufficient to meet all unmet needs, 

the allocation amounts related to infrastructure shall be reduced 

proportionally based on the total infrastructure needs of all 

grantees: Provided further, That of the amounts made available 

under this heading, no less than $12,000,000,000 shall be allocated 

for mitigation activities to all grantees of funding provided under 

this heading, section 420 of division L of Public Law 114–113, 

section 145 of division C of Public Law 114–223, section 192 of 

division C of Public Law 114–223 (as added by section 101(3) 

of division A of Public Law 114–254), section 421 of division K 

of Public Law 115–31, and the same heading in division B of 

Public Law 115–56, and that such mitigation activities shall be 

subject to the same terms and conditions under this subdivision, 

as determined by the Secretary: Provided further, That all such 

grantees shall receive an allocation of funds under the preceding 

proviso in the same proportion that the amount of funds each 

grantee received or will receive under the second proviso of this 

heading or the headings and sections specified in the previous 

proviso bears to the amount of all funds provided to all grantees 

specified in the previous proviso: Provided further, That of the 

amounts made available under the second and fourth provisos of 

this heading, the Secretary shall allocate to all such grantees an 

aggregate amount not less than 33 percent of each such amounts 

of funds provided under this heading within 60 days after the 

enactment of this subdivision based on the best available data 

(especially with respect to data for all such grantees affected by 

Hurricanes Harvey, Irma, and Maria), and shall allocate no less 

than 100 percent of the funds provided under this heading by 

no later than December 1, 2018: Provided further, That the Secretary shall not prohibit the use of funds made available under 

this heading and the same heading in division B of Public Law 

115–56 for non-federal share as authorized by section 105(a)(9) 

of the Housing and Community Development Act of 1974 (42 U.S.C. 

5305(a)(9)): Provided further, That of the amounts made available 

under this heading, grantees may establish grant programs to assist 

small businesses for working capital purposes to aid in recovery: 

Provided further, That as a condition of making any grant, the 

Secretary shall certify in advance that such grantee has in place 

proficient financial controls and procurement processes and has 

established adequate procedures to prevent any duplication of benefits as defined by section 312 of the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act (42 U.S.C. 5155), to ensure 

timely expenditure of funds, to maintain comprehensive websites 

regarding all disaster recovery activities assisted with these funds, 

and to detect and prevent waste, fraud, and abuse of funds: Provided 

further, That with respect to any such duplication of benefits, the 

Secretary and any grantee under this section shall not take into 

consideration or reduce the amount provided to any applicant for 

assistance from the grantee where such applicant applied for and 

was approved, but declined assistance related to such major 

declared disasters that occurred in 2014, 2015, 2016, and 2017 

from the Small Business Administration under section 7(b) of the 

Web posting. Small Business Act (15 U.S.C. 636(b)): Provided further, That the 

Records. 

Contracts. 

Determination. 

Certification. 

Deadlines. 

Determination. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 105 

Secretary shall require grantees to maintain on a public website 

information containing common reporting criteria established by 

the Department that permits individuals and entities awaiting 

assistance and the general public to see how all grant funds are 

used, including copies of all relevant procurement documents, 

grantee administrative contracts and details of ongoing procurement 

processes, as determined by the Secretary: Provided further, That 

prior to the obligation of funds a grantee shall submit a plan 

to the Secretary for approval detailing the proposed use of all 

funds, including criteria for eligibility and how the use of these 

funds will address long-term recovery and restoration of infrastructure and housing, economic revitalization, and mitigation in the 

most impacted and distressed areas: Provided further, That such 

funds may not be used for activities reimbursable by, or for which 

funds are made available by, the Federal Emergency Management 

Agency or the Army Corps of Engineers: Provided further, That 

funds allocated under this heading shall not be considered relevant 

to the non-disaster formula allocations made pursuant to section 

106 of the Housing and Community Development Act of 1974 (42 

U.S.C. 5306): Provided further, That a State, unit of general local 

government, or Indian tribe may use up to 5 percent of its allocation 

for administrative costs: Provided further, That the sixth proviso 

under this heading in the Supplemental Appropriations for Disaster 

Relief Requirements Act, 2017 (division B of Public Law 115– 

56) is amended by striking ‘‘State or subdivision thereof’’ and 

inserting ‘‘State, unit of general local government, or Indian tribe 

(as such term is defined in section 102 of the Housing and Community Development Act of 1974 (42 U.S.C. 5302))’’: Provided further, 

That in administering the funds under this heading, the Secretary 

of Housing and Urban Development may waive, or specify alternative requirements for, any provision of any statute or regulation 

that the Secretary administers in connection with the obligation 

by the Secretary or the use by the recipient of these funds (except 

for requirements related to fair housing, nondiscrimination, labor 

standards, and the environment), if the Secretary finds that good 

cause exists for the waiver or alternative requirement and such 

waiver or alternative requirement would not be inconsistent with 

the overall purpose of title I of the Housing and Community 

Development Act of 1974: Provided further, That, notwithstanding 

the preceding proviso, recipients of funds provided under this 

heading that use such funds to supplement Federal assistance 

provided under section 402, 403, 404, 406, 407, 408(c)(4), or 502 

of the Robert T. Stafford Disaster Relief and Emergency Assistance 

Act (42 U.S.C. 5121 et seq.) may adopt, without review or public 

comment, any environmental review, approval, or permit performed 

by a Federal agency, and such adoption shall satisfy the responsibilities of the recipient with respect to such environmental review, 

approval or permit: Provided further, That, notwithstanding section 

104(g)(2) of the Housing and Community Development Act of 1974 

(42 U.S.C. 5304(g)(2)), the Secretary may, upon receipt of a request 

for release of funds and certification, immediately approve the 

release of funds for an activity or project assisted under this heading 

if the recipient has adopted an environmental review, approval 

or permit under the preceding proviso or the activity or project 

is categorically excluded from review under the National Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.): Provided further, 

That the Secretary shall publish via notice in the Federal Register Notice. 

Federal Register, 

publication. 

Deadline. 

Waiver authority. 

131 Stat. 1138. 

Plan. 


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132 STAT. 106 PUBLIC LAW 115–123—FEB. 9, 2018 

any waiver, or alternative requirement, to any statute or regulation 

that the Secretary administers pursuant to title I of the Housing 

and Community Development Act of 1974 no later than 5 days 

before the effective date of such waiver or alternative requirement: 

Provided further, That the eighth proviso under this heading in 

the Supplemental Appropriations for Disaster Relief Requirements 

Act, 2017 (division B of Public Law 115–56) is amended by inserting 

‘‘408(c)(4),’’ after ‘‘407,’’: Provided further, That of the amounts 

made available under this heading, up to $15,000,000 shall be 

made available for capacity building and technical assistance, 

including assistance on contracting and procurement processes, to 

support States, units of general local government, or Indian tribes 

(and their subrecipients) that receive allocations pursuant to this 

heading, received disaster recovery allocations under the same 

heading in Public Law 115–56, or may receive similar allocations 

for disaster recovery in future appropriations Acts: Provided further, 

That of the amounts made available under this heading, up to 

$10,000,000 shall be transferred, in aggregate, to ‘‘Department of 

Housing and Urban Development—Program Office Salaries and 

Expenses—Community Planning and Development’’ for necessary 

costs, including information technology costs, of administering and 

overseeing the obligation and expenditure of amounts under this 

heading: Provided further, That the amount specified in the preceding proviso shall be combined with funds appropriated under 

the same heading and for the same purpose in Public Law 115– 

56 and the aggregate of such amounts shall be available for any 

of the purposes specified under this heading or the same heading 

in Public Law 115–56 without limitation: Provided further, That, 

of the funds made available under this heading, $10,000,000 shall 

be transferred to the Office of the Inspector General for necessary 

costs of overseeing and auditing funds made available under this 

heading: Provided further, That such amount is designated by the 

Congress as being for an emergency requirement pursuant to section 

251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act of 1985: Provided further, That amounts repurposed pursuant to this section that were previously designated by the Congress 

as an emergency requirement pursuant to the Balanced Budget 

and Emergency Deficit Control Act are designated by the Congress 

as an emergency requirement pursuant to section 251(b)(2)(A)(i) 

of the Balanced Budget and Emergency Deficit Control Act of 1985. 

GENERAL PROVISIONS—DEPARTMENT OF HOUSING AND URBAN

DEVELOPMENT

SEC. 21102. Any funds made available under the heading 

‘‘Community Development Fund’’ under this subdivision that remain 

available, after the other funds under such heading have been 

allocated for necessary expenses for activities authorized under 

such heading, shall be used for additional mitigation activities 

in the most impacted and distressed areas resulting from a major 

declared disaster that occurred in 2014, 2015, 2016 or 2017: Provided, That such remaining funds shall be awarded to grantees 

of funding provided for disaster relief under the heading ‘‘Community Development Fund’’ in this subdivision, section 420 of division 

L of Public Law 114–113, section 145 of division C of Public Law 

114–223, section 192 of division C of Public Law 114–223 (as 

added by section 101(3) of division A of Public Law 114–254), 

131 Stat. 1138. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 107 

section 421 of division K of Public Law 115–31, and the same 

heading in division B of Public Law 115–56 subject to the same 

terms and conditions under this subdivision and such Acts respectively: Provided further, That each such grantee shall receive an 

allocation from such remaining funds in the same proportion that 

the amount of funds such grantee received under this subdivision 

and under the Acts specified in the previous proviso bears to the 

amount of all funds provided to all grantees specified in the previous 

proviso. 

SEC. 21103. For 2018, the Secretary of Housing and Urban 

Development may make temporary adjustments to the section 8 

housing choice voucher annual renewal funding allocations and 

administrative fee eligibility determinations for public housing 

agencies located in the most impacted and distressed areas in 

which a major Presidentially declared disaster occurred during 2017 

under title IV of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170 et seq.), to avoid significant 

adverse funding impacts that would otherwise result from the disaster, or to facilitate leasing up to a public housing agency’s authorized level of units under contract (but not to exceed such level), 

upon request by and in consultation with a public housing agency 

and supported by documentation as required by the Secretary that 

demonstrates the need for the adjustment. 

TITLE XII 

GENERAL PROVISIONS—THIS SUBDIVISION 

SEC. 21201. Each amount appropriated or made available by 

this subdivision is in addition to amounts otherwise appropriated 

for the fiscal year involved. 

SEC. 21202. No part of any appropriation contained in this 

subdivision shall remain available for obligation beyond the current 

fiscal year unless expressly so provided herein. 

SEC. 21203. Unless otherwise provided for by this subdivision, 

the additional amounts appropriated by this subdivision to appropriations accounts shall be available under the authorities and 

conditions applicable to such appropriations accounts for fiscal year 

2018. 

SEC. 21204. Each amount designated in this subdivision by 

the Congress as being for an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985 shall be available (or rescinded or 

transferred, if applicable) only if the President subsequently so 

designates all such amounts and transmits such designations to 

the Congress. 

SEC. 21205. For purposes of this subdivision, the consequences 

or impacts of any hurricane shall include damages caused by the 

storm at any time during the entirety of its duration as a cyclone, 

as defined by the National Hurricane Center. 

SEC. 21206. Any amount appropriated by this subdivision, designated by the Congress as an emergency requirement pursuant 

to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency 

Deficit Control Act of 1985 and subsequently so designated by 

the President, and transferred pursuant to transfer authorities 

provided by this subdivision shall retain such designation. 

President. 

President. 

Consultation. 


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132 STAT. 108 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 21207. The terms and conditions applicable to the funds 

provided in this subdivision, including those provided by this title, 

shall also apply to the funds made available in division B of Public 

Law 115–56 and in division A of Public Law 115–72. 

SEC. 21208. (a) Section 305 of division A of the Additional 

Supplemental Appropriations for Disaster Relief Requirements Act, 

2017 (Public Law 115–72) is amended— 

(1) in subsection (a)— 

(A) by striking ‘‘(1) Not later than December 31, 2017,’’ 

and inserting ‘‘Not later than March 31, 2018,’’; and 

(B) by striking paragraph (2); and 

(2) in subsection (b), by striking ‘‘receiving funds under this division’’ and inserting ‘‘expending more than $10,000,000 

of funds provided by this division and division B of Public 

Law 115–56 in any one fiscal year’’. 

(b) Section 305 of division A of the Additional Supplemental 

Appropriations for Disaster Relief Requirements Act, 2017 (Public 

Law 115–72), as amended by this section, shall apply to funds 

appropriated by this division as if they had been appropriated 

by that division. 

(c) In order to proactively prepare for oversight of future disaster relief funding, not later than one year after the date of 

enactment of this Act, the Director of the Office of Management 

and Budget shall issue standard guidance for Federal agencies 

to use in designing internal control plans for disaster relief funding. 

This guidance shall leverage existing internal control review processes and shall include, at a minimum, the following elements: 

(1) Robust criteria for identifying and documenting incremental risks and mitigating controls related to the funding. 

(2) Guidance for documenting the linkage between the 

incremental risks related to disaster funding and efforts to 

address known internal control risks. 

SEC. 21209. Any agency or department provided funding in 

excess of $3,000,000,000 by this subdivision, including the Federal 

Emergency Management Agency, the Department of Housing and 

Urban Development, and the Corps of Engineers, is directed to 

provide a report to the Committees on Appropriations of the House 

of Representatives and the Senate regarding its efforts to provide 

adequate resources and technical assistance for small, low-income 

communities affected by natural disasters. 

SEC. 21210. (a) Not later than 180 days after the date of 

enactment of this subdivision and in coordination with the Administrator of the Federal Emergency Management Agency, with support 

and contributions from the Secretary of the Treasury, the Secretary 

of Energy, and other Federal agencies having responsibilities 

defined under the National Disaster Recovery Framework, the Governor of the Commonwealth of Puerto Rico shall submit to Congress 

a report describing the Commonwealth’s 12- and 24-month economic 

and disaster recovery plan that— 

(1) defines the priorities, goals, and expected outcomes 

of the recovery effort for the Commonwealth, based on damage 

assessments prepared pursuant to Federal law, if applicable, 

including— 

(A) housing; 

(B) economic issues, including workforce development 

and industry expansion and cultivation; 

(C) health and social services; 

Deadline. 

Coordination. 

Puerto Rico. 

Reports. 

Plan. 

Reports. 

Criteria. 

Disaster 

assistance. 

Deadline. 

Guidance. 

31 USC 501 note. 

Applicability. 

Deadline. 

131 Stat. 1227. 

Applicability. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 109 

(D) natural and cultural resources; 

(E) governance and civic institutions; 

(F) electric power systems and grid restoration; 

(G) environmental issues, including solid waste facilities; and 

(H) other infrastructure systems, including repair, restoration, replacement, and improvement of public infrastructure such water and wastewater treatment facilities, 

communications networks, and transportation infrastructure; 

(2) is consistent with— 

(A) the Commonwealth’s fiscal capacity to provide longterm operation and maintenance of rebuilt or replaced 

assets; 

(B) alternative procedures and associated programmatic guidance adopted by the Administrator of the 

Federal Emergency Management Agency pursuant to section 428 of the Robert T. Stafford Disaster Relief and 

Emergency Assistance Act (42 U.S.C. 5189f); and 

(C) actions as may be necessary to mitigate 

vulnerabilities to future extreme weather events and natural disasters and increase community resilience, including 

encouraging the adoption and enforcement of the latest 

published editions of relevant consensus-based codes, specifications, and standards that incorporate the latest hazardresistant designs and establish minimum acceptable criteria for the design, construction, and maintenance of residential structures and facilities for the purpose of protecting the health, safety, and general welfare of the 

buildings’ users against disasters; 

(3) promotes transparency and accountability through 

appropriate public notification, outreach, and hearings; 

(4) identifies performance metrics for assessing and 

reporting on the progress toward achieving the Commonwealth’s recovery goals, as identified under paragraph (1); 

(5) is developed in coordination with the Oversight Board 

established under PROMESA; and 

(6) is certified by that Oversight Board to be consistent 

with the purpose set forth in section 101(a) of PROMESA 

(48 U.S.C. 2121(a)). 

(b) At the end of every 30-day period before the submission 

of the report described in subsection (a), the Governor of the 

Commonwealth of Puerto Rico, in coordination with the Administrator of the Federal Emergency Management Agency, shall provide 

to Congress interim status updates on progress developing such 

report. 

(c) At the end of every 180-day period after the submission 

of the report described in subsection (a), the Governor of the 

Commonwealth of Puerto Rico, in coordination with the Administrator of the Federal Emergency Management Agency, shall make 

public a report on progress achieving the goals set forth in such 

report. 

(d) During the development, and after the submission, of the 

report required in subsection (a), the Oversight Board may provide 

to Congress reports on the status of coordination with the Governor 

of Puerto Rico. 

Time period. 

Time period. 

Updates. 

Certification. 


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132 STAT. 110 PUBLIC LAW 115–123—FEB. 9, 2018 

(e) Amounts made available by this subdivision to a covered 

territory for response to or recovery from Hurricane Irma or Hurricane Maria in an aggregate amount greater than $10,000,000 may 

be reviewed by the Oversight Board under the Oversight Board’s 

authority under 204(b)(2) of PROMESA (48 U.S.C. 2144(b)(2)). 

(f) When developing a Fiscal Plan while the recovery plan 

required under subsection (a) is in development and in effect, the 

Oversight Board shall use and incorporate, to the greatest extent 

feasible, damage assessments prepared pursuant to Federal law. 

(g) For purposes of this section, the terms ‘‘covered territory’’ 

and ‘‘Oversight Board’’ have the meaning given those term in section 

5 of PROMESA (48 U.S.C. 2104). 

This subdivision may be cited as the ‘‘Further Additional 

Supplemental Appropriations for Disaster Relief Requirements Act, 

2018’’. 

SUBDIVISION 2—TAX RELIEF AND MEDICAID CHANGES RELATING TO CERTAIN DISASTERS 

TITLE I—CALIFORNIA FIRES 

SEC. 20101. DEFINITIONS. 

For purposes of this title— 

(1) CALIFORNIA WILDFIRE DISASTER ZONE.—The term ‘‘California wildfire disaster zone’’ means that portion of the California wildfire disaster area determined by the President to 

warrant individual or individual and public assistance from 

the Federal Government under the Robert T. Stafford Disaster 

Relief and Emergency Assistance Act by reason of wildfires 

in California. 

(2) CALIFORNIA WILDFIRE DISASTER AREA.—The term ‘‘California wildfire disaster area’’ means an area with respect to 

which between January 1, 2017 through January 18, 2018 

a major disaster has been declared by the President under 

section 401 of such Act by reason of wildfires in California. 

SEC. 20102. SPECIAL DISASTER-RELATED RULES FOR USE OF RETIREMENT FUNDS. 

(a) TAX-FAVORED WITHDRAWALS FROM RETIREMENT PLANS.— 

(1) IN GENERAL.—Section 72(t) of the Internal Revenue 

Code of 1986 shall not apply to any qualified wildfire distribution. 

(2) AGGREGATE DOLLAR LIMITATION.— 

(A) IN GENERAL.—For purposes of this subsection, the 

aggregate amount of distributions received by an individual 

which may be treated as qualified wildfire distributions 

for any taxable year shall not exceed the excess (if any) 

of— 

(i) $100,000, over 

(ii) the aggregate amounts treated as qualified 

wildfire distributions received by such individual for 

all prior taxable years. 

Time period. 

President. 

Assessments. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 111 

(B) TREATMENT OF PLAN DISTRIBUTIONS.—If a distribution to an individual would (without regard to subparagraph (A)) be a qualified wildfire distribution, a plan shall 

not be treated as violating any requirement of the Internal 

Revenue Code of 1986 merely because the plan treats such 

distribution as a qualified wildfire distribution, unless the 

aggregate amount of such distributions from all plans maintained by the employer (and any member of any controlled 

group which includes the employer) to such individual 

exceeds $100,000. 

(C) CONTROLLED GROUP.—For purposes of subparagraph (B), the term ‘‘controlled group’’ means any group 

treated as a single employer under subsection (b), (c), (m), 

or (o) of section 414 of the Internal Revenue Code of 1986. 

(3) AMOUNT DISTRIBUTED MAY BE REPAID.— (A) IN GENERAL.—Any individual who receives a qualified wildfire distribution may, at any time during the 3- 

year period beginning on the day after the date on which 

such distribution was received, make one or more contributions in an aggregate amount not to exceed the amount 

of such distribution to an eligible retirement plan of which 

such individual is a beneficiary and to which a rollover 

contribution of such distribution could be made under section 402(c), 403(a)(4), 403(b)(8), 408(d)(3), or 457(e)(16), 

of the Internal Revenue Code of 1986, as the case may 

be. 

(B) TREATMENT OF REPAYMENTS OF DISTRIBUTIONS

FROM ELIGIBLE RETIREMENT PLANS OTHER THAN IRAS.—For 

purposes of the Internal Revenue Code of 1986, if a contribution is made pursuant to subparagraph (A) with 

respect to a qualified wildfire distribution from an eligible 

retirement plan other than an individual retirement plan, 

then the taxpayer shall, to the extent of the amount of 

the contribution, be treated as having received the qualified 

wildfire distribution in an eligible rollover distribution (as 

defined in section 402(c)(4) of such Code) and as having 

transferred the amount to the eligible retirement plan in 

a direct trustee to trustee transfer within 60 days of the 

distribution. 

(C) TREATMENT OF REPAYMENTS FOR DISTRIBUTIONS

FROM IRAS.—For purposes of the Internal Revenue Code 

of 1986, if a contribution is made pursuant to subparagraph 

(A) with respect to a qualified wildfire distribution from 

an individual retirement plan (as defined by section 

7701(a)(37) of such Code), then, to the extent of the amount 

of the contribution, the qualified wildfire distribution shall 

be treated as a distribution described in section 408(d)(3) 

of such Code and as having been transferred to the eligible 

retirement plan in a direct trustee to trustee transfer 

within 60 days of the distribution. 

(4) DEFINITIONS.—For purposes of this subsection— 

(A) QUALIFIED WILDFIRE DISTRIBUTION.—Except as provided in paragraph (2), the term ‘‘qualified wildfire distribution’’ means any distribution from an eligible retirement 

plan made on or after October 8, 2017, and before January 

1, 2019, to an individual whose principal place of abode 

during any portion of the period from October 8, 2017, 

Time periods. 

Deadline. 

Deadline. 

Time period. 

Effective date. 

Definition. 


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132 STAT. 112 PUBLIC LAW 115–123—FEB. 9, 2018 

to December 31, 2017, is located in the California wildfire 

disaster area and who has sustained an economic loss 

by reason of the wildfires to which the declaration of such 

area relates. 

(B) ELIGIBLE RETIREMENT PLAN.—The term ‘‘eligible 

retirement plan’’ shall have the meaning given such term 

by section 402(c)(8)(B) of the Internal Revenue Code of 

1986. 

(5) INCOME INCLUSION SPREAD OVER 3-YEAR PERIOD.— (A) IN GENERAL.—In the case of any qualified wildfire 

distribution, unless the taxpayer elects not to have this 

paragraph apply for any taxable year, any amount required 

to be included in gross income for such taxable year shall 

be so included ratably over the 3-taxable-year period beginning with such taxable year. 

(B) SPECIAL RULE.—For purposes of subparagraph (A), 

rules similar to the rules of subparagraph (E) of section 

408A(d)(3) of the Internal Revenue Code of 1986 shall 

apply. 

(6) SPECIAL RULES.— 

(A) EXEMPTION OF DISTRIBUTIONS FROM TRUSTEE TO

TRUSTEE TRANSFER AND WITHHOLDING RULES.—For purposes of sections 401(a)(31), 402(f), and 3405 of the Internal 

Revenue Code of 1986, qualified wildfire distributions shall 

not be treated as eligible rollover distributions. 

(B) QUALIFIED WILDFIRE DISTRIBUTIONS TREATED AS

MEETING PLAN DISTRIBUTION REQUIREMENTS.—For purposes 

the Internal Revenue Code of 1986, a qualified wildfire 

distribution shall be treated as meeting the requirements 

of sections 401(k)(2)(B)(i), 403(b)(7)(A)(ii), 403(b)(11), and 

457(d)(1)(A) of such Code. 

(b) RECONTRIBUTIONS OF WITHDRAWALS FOR HOME PURCHASES.— 

(1) RECONTRIBUTIONS.— 

(A) IN GENERAL.—Any individual who received a qualified distribution may, during the period beginning on 

October 8, 2017, and ending on June 30, 2018, make one 

or more contributions in an aggregate amount not to exceed 

the amount of such qualified distribution to an eligible 

retirement plan (as defined in section 402(c)(8)(B) of the 

Internal Revenue Code of 1986) of which such individual 

is a beneficiary and to which a rollover contribution of 

such distribution could be made under section 402(c), 

403(a)(4), 403(b)(8), or 408(d)(3), of such Code, as the case 

may be. 

(B) TREATMENT OF REPAYMENTS.—Rules similar to the 

rules of subparagraphs (B) and (C) of subsection (a)(3) 

shall apply for purposes of this subsection. 

(2) QUALIFIED DISTRIBUTION.—For purposes of this subsection, the term ‘‘qualified distribution’’ means any distribution— 

(A) described in section 401(k)(2)(B)(i)(IV), 

403(b)(7)(A)(ii) (but only to the extent such distribution 

relates to financial hardship), 403(b)(11)(B), or 72(t)(2)(F), 

of the Internal Revenue Code of 1986, 

(B) received after March 31, 2017, and before January 

15, 2018, and 

Time period. 

Definition. 

Applicability. 

Time period. 

Applicability. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 113 

(C) which was to be used to purchase or construct 

a principal residence in the California wildfire disaster 

area but which was not so purchased or constructed on 

account of the wildfires to which the declaration of such 

area relates. 

(c) LOANS FROM QUALIFIED PLANS.— 

(1) INCREASE IN LIMIT ON LOANS NOT TREATED AS DISTRIBUTIONS.—In the case of any loan from a qualified employer 

plan (as defined under section 72(p)(4) of the Internal Revenue 

Code of 1986) to a qualified individual made during the period 

beginning on the date of the enactment of this Act and ending 

on December 31, 2018— 

(A) clause (i) of section 72(p)(2)(A) of such Code shall 

be applied by substituting ‘‘$100,000’’ for ‘‘$50,000’’, and 

(B) clause (ii) of such section shall be applied by substituting ‘‘the present value of the nonforfeitable accrued 

benefit of the employee under the plan’’ for ‘‘one-half of 

the present value of the nonforfeitable accrued benefit of 

the employee under the plan’’. 

(2) DELAY OF REPAYMENT.—In the case of a qualified individual with an outstanding loan on or after October 8, 2017, 

from a qualified employer plan (as defined in section 72(p)(4) 

of the Internal Revenue Code of 1986)— 

(A) if the due date pursuant to subparagraph (B) or 

(C) of section 72(p)(2) of such Code for any repayment 

with respect to such loan occurs during the period beginning on October 8, 2017, and ending on December 31, 

2018, such due date shall be delayed for 1 year, 

(B) any subsequent repayments with respect to any 

such loan shall be appropriately adjusted to reflect the 

delay in the due date under paragraph (1) and any interest 

accruing during such delay, and 

(C) in determining the 5-year period and the term 

of a loan under subparagraph (B) or (C) of section 72(p)(2) 

of such Code, the period described in subparagraph (A) 

shall be disregarded. 

(3) QUALIFIED INDIVIDUAL.—For purposes of this subsection, 

the term ‘‘qualified individual’’ means any individual whose 

principal place of abode during any portion of the period from 

October 8, 2017, to December 31, 2017, is located in the California wildfire disaster area and who has sustained an economic 

loss by reason of wildfires to which the declaration of such 

area relates. 

(d) PROVISIONS RELATING TO PLAN AMENDMENTS.— 

(1) IN GENERAL.—If this subsection applies to any amendment to any plan or annuity contract, such plan or contract 

shall be treated as being operated in accordance with the terms 

of the plan during the period described in paragraph (2)(B)(i). 

(2) AMENDMENTS TO WHICH SUBSECTION APPLIES.— 

(A) IN GENERAL.—This subsection shall apply to any 

amendment to any plan or annuity contract which is 

made— 

(i) pursuant to any provision of this section, or 

pursuant to any regulation issued by the Secretary 

or the Secretary of Labor under any provision of this 

section, and 

Regulation. 

Applicability. 

Definition. 

Time period. 

Effective date. 

Time periods. 

Time period. 

Applicability. 


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132 STAT. 114 PUBLIC LAW 115–123—FEB. 9, 2018 

(ii) on or before the last day of the first plan 

year beginning on or after January 1, 2019, or such 

later date as the Secretary may prescribe. 

In the case of a governmental plan (as defined in section 

414(d) of the Internal Revenue Code of 1986), clause (ii) 

shall be applied by substituting the date which is 2 years 

after the date otherwise applied under clause (ii). 

(B) CONDITIONS.—This subsection shall not apply to 

any amendment unless— 

(i) during the period— 

(I) beginning on the date that this section 

or the regulation described in subparagraph (A)(i) 

takes effect (or in the case of a plan or contract 

amendment not required by this section or such 

regulation, the effective date specified by the plan), 

and 

(II) ending on the date described in subparagraph (A)(ii) (or, if earlier, the date the plan or 

contract amendment is adopted), 

the plan or contract is operated as if such plan or contract 

amendment were in effect, and 

(ii) such plan or contract amendment applies retroactively for such period. 

SEC. 20103. EMPLOYEE RETENTION CREDIT FOR EMPLOYERS 

AFFECTED BY CALIFORNIA WILDFIRES. 

(a) IN GENERAL.—For purposes of section 38 of the Internal 

Revenue Code of 1986, in the case of an eligible employer, the 

California wildfire employee retention credit shall be treated as 

a credit listed in subsection (b) of such section. For purposes of 

this subsection, the California wildfire employee retention credit 

for any taxable year is an amount equal to 40 percent of the 

qualified wages with respect to each eligible employee of such 

employer for such taxable year. For purposes of the preceding 

sentence, the amount of qualified wages which may be taken into 

account with respect to any individual shall not exceed $6,000. 

(b) DEFINITIONS.—For purposes of this section— 

(1) ELIGIBLE EMPLOYER.—The term ‘‘eligible employer’’ 

means any employer— 

(A) which conducted an active trade or business on 

October 8, 2017, in the California wildfire disaster zone, 

and 

(B) with respect to whom the trade or business 

described in subparagraph (A) is inoperable on any day 

after October 8, 2017, and before January 1, 2018, as 

a result of damage sustained by reason of the wildfires 

to which such declaration of such area relates. 

(2) ELIGIBLE EMPLOYEE.—The term ‘‘eligible employee’’ 

means with respect to an eligible employer an employee whose 

principal place of employment on October 8, 2017, with such 

eligible employer was in the California wildfire disaster zone. 

(3) QUALIFIED WAGES.—The term ‘‘qualified wages’’ means 

wages (as defined in section 51(c)(1) of the Internal Revenue 

Code of 1986, but without regard to section 3306(b)(2)(B) of 

such Code) paid or incurred by an eligible employer with respect 

to an eligible employee on any day after October 8, 2017, 

and before January 1, 2018, which occurs during the period— 

Effective date. 

Time periods. 

Time period. 

Effective date. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 115 

(A) beginning on the date on which the trade or business described in paragraph (1) first became inoperable 

at the principal place of employment of the employee immediately before the wildfires to which the declaration of 

the California wildfire disaster area relates, and 

(B) ending on the date on which such trade or business 

has resumed significant operations at such principal place 

of employment. 

Such term shall include wages paid without regard to whether 

the employee performs no services, performs services at a different place of employment than such principal place of employment, or performs services at such principal place of employment before significant operations have resumed. 

(c) CERTAIN RULES TO APPLY.—For purposes of this section, 

rules similar to the rules of sections 51(i)(1), 52, and 280C(a) of 

the Internal Revenue Code of 1986, shall apply. 

(d) EMPLOYEE NOT TAKEN INTO ACCOUNT MORE THAN ONCE.— 

An employee shall not be treated as an eligible employee for purposes of this section for any period with respect to any employer 

if such employer is allowed a credit under section 51 of the Internal 

Revenue Code of 1986 with respect to such employee for such 

period. 

SEC. 20104. ADDITIONAL DISASTER-RELATED TAX RELIEF PROVISIONS. 

(a) TEMPORARY SUSPENSION OF LIMITATIONS ON CHARITABLE

CONTRIBUTIONS.— 

(1) IN GENERAL.—Except as otherwise provided in paragraph (2), subsection (b) of section 170 of the Internal Revenue 

Code of 1986 shall not apply to qualified contributions and 

such contributions shall not be taken into account for purposes 

of applying subsections (b) and (d) of such section to other 

contributions. 

(2) TREATMENT OF EXCESS CONTRIBUTIONS.—For purposes 

of section 170 of the Internal Revenue Code of 1986— 

(A) INDIVIDUALS.—In the case of an individual— 

(i) LIMITATION.—Any qualified contribution shall 

be allowed only to the extent that the aggregate of 

such contributions does not exceed the excess of the 

taxpayer’s contribution base (as defined in subparagraph (H) of section 170(b)(1) of such Code) over the 

amount of all other charitable contributions allowed 

under section 170(b)(1) of such Code. 

(ii) CARRYOVER.—If the aggregate amount of qualified contributions made in the contribution year 

(within the meaning of section 170(d)(1) of such Code) 

exceeds the limitation of clause (i), such excess shall 

be added to the excess described in the portion of 

subparagraph (A) of such section which precedes clause 

(i) thereof for purposes of applying such section. 

(B) CORPORATIONS.—In the case of a corporation— 

(i) LIMITATION.—Any qualified contribution shall 

be allowed only to the extent that the aggregate of 

such contributions does not exceed the excess of the 

taxpayer’s taxable income (as determined under paragraph (2) of section 170(b) of such Code) over the 

amount of all other charitable contributions allowed 

under such paragraph. 

Applicability. 

Definitions. 

Time periods. 


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132 STAT. 116 PUBLIC LAW 115–123—FEB. 9, 2018 

(ii) CARRYOVER.—Rules similar to the rules of 

subparagraph (A)(ii) shall apply for purposes of this 

subparagraph. 

(3) EXCEPTION TO OVERALL LIMITATION ON ITEMIZED DEDUCTIONS.—So much of any deduction allowed under section 170 

of the Internal Revenue Code of 1986 as does not exceed the 

qualified contributions paid during the taxable year shall not 

be treated as an itemized deduction for purposes of section 

68 of such Code. 

(4) QUALIFIED CONTRIBUTIONS.— 

(A) IN GENERAL.—For purposes of this subsection, the 

term ‘‘qualified contribution’’ means any charitable contribution (as defined in section 170(c) of the Internal Revenue Code of 1986) if— 

(i) such contribution— 

(I) is paid during the period beginning on 

October 8, 2017, and ending on December 31, 2018, 

in cash to an organization described in section 

170(b)(1)(A) of such Code, and 

(II) is made for relief efforts in the California 

wildfire disaster area, 

(ii) the taxpayer obtains from such organization 

contemporaneous written acknowledgment (within the 

meaning of section 170(f)(8) of such Code) that such 

contribution was used (or is to be used) for relief efforts 

described in clause (i)(II), and 

(iii) the taxpayer has elected the application of 

this subsection with respect to such contribution. 

(B) EXCEPTION.—Such term shall not include a contribution by a donor if the contribution is— 

(i) to an organization described in section 509(a)(3) 

of the Internal Revenue Code of 1986, or 

(ii) for the establishment of a new, or maintenance 

of an existing, donor advised fund (as defined in section 

4966(d)(2) of such Code). 

(C) APPLICATION OF ELECTION TO PARTNERSHIPS AND

S CORPORATIONS.—In the case of a partnership or S corporation, the election under subparagraph (A)(iii) shall be made 

separately by each partner or shareholder. 

(b) SPECIAL RULES FOR QUALIFIED DISASTER-RELATED PERSONAL CASUALTY LOSSES.— 

(1) IN GENERAL.—If an individual has a net disaster loss 

for any taxable year— 

(A) the amount determined under section 

165(h)(2)(A)(ii) of the Internal Revenue Code of 1986 shall 

be equal to the sum of— 

(i) such net disaster loss, and 

(ii) so much of the excess referred to in the matter 

preceding clause (i) of section 165(h)(2)(A) of such Code 

(reduced by the amount in clause (i) of this subparagraph) as exceeds 10 percent of the adjusted gross 

income of the individual, 

(B) section 165(h)(1) of such Code shall be applied 

by substituting ‘‘$500’’ for ‘‘$500 ($100 for taxable years 

beginning after December 31, 2009)’’, 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 117 

(C) the standard deduction determined under section 

63(c) of such Code shall be increased by the net disaster 

loss, and 

(D) section 56(b)(1)(E) of such Code shall not apply 

to so much of the standard deduction as is attributable 

to the increase under subparagraph (C) of this paragraph. 

(2) NET DISASTER LOSS.—For purposes of this subsection, 

the term ‘‘net disaster loss’’ means the excess of qualified disaster-related personal casualty losses over personal casualty 

gains (as defined in section 165(h)(3)(A) of the Internal Revenue 

Code of 1986). 

(3) QUALIFIED DISASTER-RELATED PERSONAL CASUALTY

LOSSES.—For purposes of this subsection, the term ‘‘qualified 

disaster-related personal casualty losses’’ means losses 

described in section 165(c)(3) of the Internal Revenue Code 

of 1986 which arise in the California wildfire disaster area 

on or after October 8, 2017, and which are attributable to 

the wildfires to which the declaration of such area relates. 

(c) SPECIAL RULE FOR DETERMINING EARNED INCOME.— 

(1) IN GENERAL.—In the case of a qualified individual, 

if the earned income of the taxpayer for the taxable year 

which includes any portion of the period from October 8, 2017, 

to December 31, 2017, is less than the earned income of the 

taxpayer for the preceding taxable year, the credits allowed 

under sections 24(d) and 32 of the Internal Revenue Code 

of 1986 may, at the election of the taxpayer, be determined 

by substituting— 

(A) such earned income for the preceding taxable year, 

for 

(B) such earned income for the taxable year which 

includes any portion of the period from October 8, 2017, 

to December 31, 2017. 

(2) QUALIFIED INDIVIDUAL.—For purposes of this subsection, 

the term ‘‘qualified individual’’ means any individual whose 

principal place of abode during any portion of the period from 

October 8, 2017, to December 31, 2017, was located— 

(A) in the California wildfire disaster zone, or 

(B) in the California wildfire disaster area (but outside 

the California wildfire disaster zone) and such individual 

was displaced from such principal place of abode by reason 

of the wildfires to which the declaration of such area 

relates. 

(3) EARNED INCOME.—For purposes of this subsection, the 

term ‘‘earned income’’ has the meaning given such term under 

section 32(c) of the Internal Revenue Code of 1986. 

(4) SPECIAL RULES.— 

(A) APPLICATION TO JOINT RETURNS.—For purposes of 

paragraph (1), in the case of a joint return for a taxable 

year which includes any portion of the period from October 

8, 2017, to December 31, 2017— 

(i) such paragraph shall apply if either spouse 

is a qualified individual, and 

(ii) the earned income of the taxpayer for the preceding taxable year shall be the sum of the earned 

income of each spouse for such preceding taxable year. 

(B) UNIFORM APPLICATION OF ELECTION.—Any election 

made under paragraph (1) shall apply with respect to both 


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132 STAT. 118 PUBLIC LAW 115–123—FEB. 9, 2018 

sections 24(d) and 32, of the Internal Revenue Code of 

1986. 

(C) ERRORS TREATED AS MATHEMATICAL ERROR.—For 

purposes of section 6213 of the Internal Revenue Code 

of 1986, an incorrect use on a return of earned income 

pursuant to paragraph (1) shall be treated as a mathematical or clerical error. 

(D) NO EFFECT ON DETERMINATION OF GROSS INCOME, ETC.—Except as otherwise provided in this subsection, the 

Internal Revenue Code of 1986 shall be applied without 

regard to any substitution under paragraph (1). 

TITLE II—TAX RELIEF FOR HURRICANES HARVEY, IRMA, AND MARIA 

SEC. 20201. TAX RELIEF FOR HURRICANES HARVEY, IRMA, AND MARIA. 

(a) MODIFICATION OF HURRICANES HARVEY AND IRMA DISASTER

AREAS.—Subsections (a)(2) and (b)(2) of section 501 of the Disaster 

Tax Relief and Airport and Airway Extension Act of 2017 (Public 

Law 115–63; 131 Stat. 1173) are both amended by striking ‘‘September 21, 2017’’ and inserting ‘‘October 17, 2017’’. 

(b) EMPLOYEE RETENTION CREDIT.—Subsections (a)(3), (b)(3), 

and (c)(3) of section 503 of the Disaster Tax Relief and Airport 

and Airway Extension Act of 2017 (Public Law 115–63; 131 Stat. 

1181) are each amended by striking ‘‘sections 51(i)(1) and 52’’ and 

inserting ‘‘sections 51(i)(1), 52, and 280C(a)’’. 

(c) EFFECTIVE DATE.—The amendments made by this section 

shall take effect as if included in the provisions of title V of the 

Disaster Tax Relief and Airport and Airway Extension Act of 2017 

to which such amendments relate. 

TITLE III—HURRICANE MARIA RELIEF 

FOR PUERTO RICO AND THE VIRGIN 

ISLANDS MEDICAID PROGRAMS 

SEC. 20301. HURRICANE MARIA RELIEF FOR PUERTO RICO AND THE 

VIRGIN ISLANDS MEDICAID PROGRAMS. 

(a) INCREASED CAPS.—Section 1108(g)(5) of the Social Security 

Act (42 U.S.C. 1308(g)(5)) is amended— 

(1) in subparagraph (A), by striking ‘‘subparagraph (B)’’ 

and inserting ‘‘subparagraphs (B), (C), (D), and (E)’’; and 

(2) by adding at the end the following new subparagraphs: 

‘‘(C) Subject to subparagraphs (D) and (E), for the period 

beginning January 1, 2018, and ending September 30, 2019— 

‘‘(i) the amount of the increase otherwise provided 

under subparagraphs (A) and (B) for Puerto Rico shall 

be further increased by $3,600,000,000; and 

‘‘(ii) the amount of the increase otherwise provided 

under subparagraph (A) for the Virgin Islands shall be 

further increased by $106,931,000. 

‘‘(D) For the period described in subparagraph (C), the 

amount of the increase otherwise provided under subparagraph 

(A)— 

Certifications. 

Time period. 


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‘‘(i) for Puerto Rico shall be further increased by $1,200,000,000 if the Secretary certifies that Puerto Rico 

has taken reasonable and appropriate steps during such 

period, in accordance with a timeline established by the 

Secretary, to— 

‘‘(I) implement methods, satisfactory to the Secretary, for the collection and reporting of reliable data 

to the Transformed Medicaid Statistical Information 

System (T–MSIS) (or a successor system); and 

‘‘(II) demonstrate progress in establishing a State 

medicaid fraud control unit described in section 

1903(q); and 

‘‘(ii) for the Virgin Islands shall be further increased 

by $35,644,000 if the Secretary certifies that the Virgin 

Islands has taken reasonable and appropriate steps during 

such period, in accordance with a timeline established by 

the Secretary, to meet the conditions for certification specified in subclauses (I) and (II) of clause (i). 

‘‘(E) Notwithstanding any other provision of title XIX, 

during the period in which the additional funds provided under 

subparagraphs (C) and (D) are available for Puerto Rico and 

the Virgin Islands, respectively, with respect to payments from 

such additional funds for amounts expended by Puerto Rico 

and the Virgin Islands under such title, the Secretary shall 

increase the Federal medical assistance percentage or other 

rate that would otherwise apply to such payments to 100 percent.’’. 

(b) DISREGARD OF CERTAIN EXPENDITURES FROM SPENDING

CAP.—Section 1108(g)(4) of the Social Security Act (42 U.S.C. 

1308(g)(4)) is amended— 

(1) by inserting ‘‘for a calendar quarter of such fiscal year,’’ 

after ‘‘section 1903(a)(3)’’; and 

(2) by striking ‘‘of such fiscal year for a calendar quarter 

of such fiscal year,’’ and inserting ‘‘of such fiscal year, and 

with respect to fiscal years beginning with fiscal year 2018, 

if the Virgin Islands qualifies for a payment under section 

1903(a)(6) for a calendar quarter (beginning on or after January 

1, 2018) of such fiscal year,’’. 

(c) REPORT TO CONGRESS.—Not later than July 1, 2018, the 

Secretary of Health and Human Services shall submit a report 

to the Committee on Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate that— 

(1) describes the steps taken by Puerto Rico and the Virgin 

Islands to meet the conditions for certification specified in 

clauses (i) and (ii), respectively, of section 1108(g)(5)(D) of the 

Social Security Act (42 U.S.C. 1308(g)(5)(D)) (as amended by 

subsection (a) of this section); and 

(2) specifies timelines for each such territory to, as a condition of eligibility for any additional increases in the amounts 

determined for Puerto Rico or the Virgin Islands, respectively, 

under subsection (g) of section 1108 of such Act (42 U.S.C. 

1308) for purposes of payments under title XIX of such Act 

for fiscal year 2019, complete— 

(A) implementation of methods, satisfactory to the Secretary, for the collection and reporting of reliable data 

to the Transformed Medicaid Statistical Information 

System (T–MSIS) (or a successor system); and 


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132 STAT. 120 PUBLIC LAW 115–123—FEB. 9, 2018 

(B) the establishment of a State medicaid fraud control 

unit described in section 1903(q) of the Social Security 

Act (42 U.S.C. 1396d(q)). 

TITLE IV—BUDGETARY EFFECTS 

SEC. 20401. EMERGENCY DESIGNATION. 

This subdivision is designated as an emergency requirement 

pursuant to section 4(g) of the Statutory Pay-As-You-Go Act of 

2010 (2 U.S.C. 933(g)). 

SEC. 20402. DESIGNATION IN SENATE. 

In the Senate, this subdivision is designated as an emergency 

requirement pursuant to section 4112(a) of H. Con. Res. 71 (115th 

Congress), the concurrent resolution on the budget for fiscal year 

2018. 

Subdivision 3—Further Extension of Continuing 

Appropriations Act, 2018 

SEC. 20101. The Continuing Appropriations Act, 2018 (division 

D of Public Law 115–56) is further amended by— 

(1) striking the date specified in section 106(3) and 

inserting ‘‘March 23, 2018’’; and 

(2) inserting after section 155 the following new sections: 

‘‘SEC. 156. In addition to amounts provided by section 101, 

amounts are provided for ‘Department of Commerce—Bureau of 

the Census—Periodic Census and Programs’ at a rate for operations 

of $182,000,000 for an additional amount for the 2020 Decennial 

Census Program; and such amounts may be apportioned up to 

the rate for operations necessary to maintain the schedule and 

deliver the required data according to statutory deadlines in the 

2020 Decennial Census Program. 

‘‘SEC. 157. Notwithstanding section 101, the matter preceding 

the first proviso and the first proviso under the heading ‘Power 

Marketing Administrations—Operation and Maintenance, Southeastern Power Administration’ in division D of Public Law 115– 

31 shall be applied by substituting ‘$6,379,000’ for ‘$1,000,000’ 

each place it appears. 

‘‘SEC. 158. As authorized by section 404 of the Bipartisan 

Budget Act of 2015 (Public Law 114–74; 42 U.S.C. 6239 note), 

the Secretary of Energy shall draw down and sell not to exceed 

$350,000,000 of crude oil from the Strategic Petroleum Reserve 

in fiscal year 2018: Provided, That the proceeds from such drawdown and sale shall be deposited into the ‘Energy Security and 

Infrastructure Modernization Fund’ (in this section referred to as 

the ‘Fund’) during fiscal year 2018: Provided further, That in addition to amounts otherwise made available by section 101, any 

amounts deposited in the Fund shall be made available and shall 

remain available until expended at a rate for operations of 

$350,000,000, for necessary expenses in carrying out the Life Extension II project for the Strategic Petroleum Reserve. 

‘‘SEC. 159. Amounts made available by section 101 for ‘The 

Judiciary—Courts of Appeals, District Courts, and Other Judicial 

Services—Fees of Jurors and Commissioners’ may be apportioned 

up to the rate for operations necessary to accommodate increased 

juror usage. 

42 USC 6241 

note. 

Applicability. 

Ante, p. 30. 

131 Stat. 1141. 

Further 

Extension of 

Continuing 

Appropriations 

Act, 2018. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 121 

‘‘SEC. 160. Section 144 of the Continuing Appropriations Act, 

2018 (division D of Public Law 115–56), as amended by the Further 

Additional Continuing Appropriations Act, 2018 (division A of Public 

Law 115–96), is amended by (1) striking ‘$11,761,000’ and inserting 

‘$22,247,000’, and (2) striking ‘$1,104,000’ and inserting 

‘$1,987,000’. 

‘‘SEC. 161. Section 458(a)(4) of the Higher Education Act of 

1965 (20 U.S.C. 1087h(a)(4)) shall be applied by substituting ‘2018’ 

for ‘2017’. 

‘‘SEC. 162. For the purpose of carrying out section 435(a)(2) 

of the Higher Education Act of 1965 (HEA) (20 U.S.C. 1085(a)(2)), 

during the period covered by this Act the Secretary of Education 

may waive the requirement under section 435(a)(5)(A)(ii) of the 

HEA (20 U.S.C. 1085(a)(5)(A)(ii)) for an institution of higher education that offers an associate degree, is a public institution, and 

is located in an economically distressed county, defined as a county 

that ranks in the lowest 5 percent of all counties in the United 

States based on a national index of county economic status: Provided, That this section shall apply to an institution of higher 

education that otherwise would be ineligible to participate in a 

program under part A of title IV of the HEA on or after the 

date of enactment of this Act due to the application of section 

435(a)(2) of the HEA. 

‘‘SEC. 163. Notwithstanding any other provision of law, funds 

made available by this Act for military construction, land acquisition, and family housing projects and activities may be obligated 

and expended to carry out planning and design and military 

construction projects authorized by law: Provided, That funds and 

authority provided by this section may be used notwithstanding 

sections 102 and 104: Provided further, That such funds may be 

used only for projects identified by the Department of the Air 

Force in its January 29, 2018, letter sent to the Committees on 

Appropriations of both Houses of Congress detailing urgently 

needed fiscal year 2018 construction requirements. 

‘‘SEC. 164. (a) Section 116(h)(3)(D) of title 49, United States 

Code, is amended— 

‘‘(1) in clause (i), by striking ‘During the 2-year period 

beginning on the date of enactment of this section, the’; 

inserting ‘The’; and inserting the following after the first sentence: ‘Any such funds or limitation of obligations or portions 

thereof transferred to the Bureau may be transferred back 

to and merged with the original account.’; and 

‘‘(2) in clause (ii) by striking ‘During the 2-year period 

beginning on the date of enactment of this section, the’; 

inserting ‘The’; and inserting the following after the first sentence: ‘Any such funds or limitation of obligations or portions 

thereof transferred to the Bureau may be transferred back 

to and merged with the original account.’. 

‘‘(b) Section 503(l)(4) of the Railroad Revitalization and Regulatory Reform Act of 1976 (45 U.S.C. 823(l)(4)) is amended— 

‘‘(1) in the heading by striking ‘Safety and operations 

account’ and inserting ‘National Surface Transportation and 

Innovative Finance Bureau account’; and 

‘‘(2) in subparagraph (A) by striking ‘Safety and Operations 

account of the Federal Railroad Administration’ and inserting 

‘National Surface Transportation and Innovative Finance 

Bureau account’. 

Applicability. 

Waiver authority. 

Applicability. 

131 Stat. 2044. 


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132 STAT. 122 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘SEC. 165. Section 24(o) of the United States Housing Act 

of 1937 (42 U.S.C. 1437v) shall be applied by substituting the 

date specified in section 106(3) for ‘September 30, 2017’.’’. 

This subdivision may be cited as the ‘‘Further Extension of 

Continuing Appropriations Act, 2018’’. 

DIVISION C—BUDGETARY AND OTHER 

MATTERS 

SEC. 30001. TABLE OF CONTENTS. 

The table of contents for this division is as follows: 

DIVISION C—BUDGETARY AND OTHER MATTERS 

Sec. 30001. Table of contents. 

TITLE I—BUDGET ENFORCEMENT 

Sec. 30101. Amendments to the Balanced Budget and Emergency Deficit Control 

Act of 1985. 

Sec. 30102. Balances on the PAYGO Scorecards. 

Sec. 30103. Authority for fiscal year 2019 budget resolution in the Senate. 

Sec. 30104. Authority for fiscal year 2019 budget resolution in the House of Representatives. 

Sec. 30105. Exercise of rulemaking powers. 

TITLE II—OFFSETS 

Sec. 30201. Customs user fees. 

Sec. 30202. Aviation security service fees. 

Sec. 30203. Extension of certain immigration fees. 

Sec. 30204. Strategic Petroleum Reserve drawdown. 

Sec. 30205. Elimination of surplus funds of Federal reserve banks. 

Sec. 30206. Reemployment services and eligibility assessments. 

TITLE III—TEMPORARY EXTENSION OF PUBLIC DEBT LIMIT 

Sec. 30301. Temporary extension of public debt limit. 

TITLE IV—JOINT SELECT COMMITTEES 

Subtitle A—Joint Select Committee on Solvency of Multiemployer Pension Plans 

Sec. 30421. Definitions. 

Sec. 30422. Establishment of Joint Select Committee. 

Sec. 30423. Funding. 

Sec. 30424. Consideration of joint committee bill in the Senate. 

Subtitle B—Joint Select Committee on Budget and Appropriations Process Reform 

Sec. 30441. Definitions. 

Sec. 30442. Establishment of Joint Select Committee. 

Sec. 30443. Funding. 

Sec. 30444. Consideration of joint committee bill in the Senate. 

TITLE I—BUDGET ENFORCEMENT 

SEC. 30101. AMENDMENTS TO THE BALANCED BUDGET AND EMERGENCY DEFICIT CONTROL ACT OF 1985. 

(a) REVISED DISCRETIONARY SPENDING LIMITS.—Section 251(c) 

of the Balanced Budget and Emergency Deficit Control Act of 1985 

(2 U.S.C. 901(c)) is amended by striking paragraphs (5) and (6) 

and inserting the following: 

‘‘(5) for fiscal year 2018— 

‘‘(A) for the revised security category, $629,000,000,000 

in new budget authority; and 

‘‘(B) for the revised nonsecurity category 

$579,000,000,000 in new budget authority; 

Time periods. 

Applicability. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 123 

‘‘(6) for fiscal year 2019— ‘‘(A) for the revised security category, $647,000,000,000 

in new budget authority; and 

‘‘(B) for the revised nonsecurity category, $597,000,000,000 in new budget authority;’’. 

(b) DIRECT SPENDING ADJUSTMENTS FOR FISCAL YEARS 2018 

AND 2019.—Section 251A of the Balanced Budget and Emergency 

Deficit Control Act of 1985 (2 U.S.C. 901a), is amended— 

(1) in paragraph (5)(B), in the matter preceding clause 

(i), by striking ‘‘and (11)’’ and inserting ‘‘, (11), and (12)’’; 

and 

(2) by adding at the end the following: 

‘‘(12) IMPLEMENTING DIRECT SPENDING REDUCTIONS FOR

FISCAL YEARS 2018 AND 2019.—(A) OMB shall make the calculations necessary to implement the direct spending reductions 

calculated pursuant to paragraphs (3) and (4) without regard 

to the amendment made to section 251(c) revising the discretionary spending limits for fiscal years 2018 and 2019 by the 

Bipartisan Budget Act of 2018. 

‘‘(B) Paragraph (5)(B) shall not be implemented for fiscal 

years 2018 and 2019.’’. 

(c) EXTENSION OF DIRECT SPENDING REDUCTIONS THROUGH

FISCAL YEAR 2027.—Section 251A(6) of the Balanced Budget and 

Emergency Deficit Control Act of 1985 (2 U.S.C. 901a(6)) is 

amended— 

(1) in subparagraph (B), in the matter preceding clause 

(i), by striking ‘‘for fiscal year 2022, for fiscal year 2023, for 

fiscal year 2024, and for fiscal year 2025’’ and inserting ‘‘for 

each of fiscal years 2022 through 2027’’; and 

(2) in subparagraph (C), in the matter preceding clause 

(i), by striking ‘‘fiscal year 2025’’ and inserting ‘‘fiscal year 

2027’’. 

SEC. 30102. BALANCES ON THE PAYGO SCORECARDS. 

Effective on the date of enactment of this Act, the balances 

on the PAYGO scorecards established pursuant to paragraphs (4) 

and (5) of section 4(d) of the Statutory Pay-As-You-Go Act of 2010 

(2 U.S.C. 933(d)) shall be zero. 

SEC. 30103. AUTHORITY FOR FISCAL YEAR 2019 BUDGET RESOLUTION 

IN THE SENATE. 

(a) FISCAL YEAR 2019.—For purposes of enforcing the Congressional Budget Act of 1974 (2 U.S.C. 621 et seq.) after April 15, 

2018, and enforcing budgetary points of order in prior concurrent 

resolutions on the budget, the allocations, aggregates, and levels 

provided for in subsection (b) shall apply in the Senate in the 

same manner as for a concurrent resolution on the budget for 

fiscal year 2019 with appropriate budgetary levels for fiscal years 

2020 through 2028. 

(b) COMMITTEE ALLOCATIONS, AGGREGATES, AND LEVELS.—After 

April 15, 2018, but not later than May 15, 2018, the Chairman 

of the Committee on the Budget of the Senate shall file— 

(1) for the Committee on Appropriations, committee allocations for fiscal year 2019 consistent with discretionary spending 

limits set forth in section 251(c)(6) of the Balanced Budget 

and Emergency Deficit Control Act of 1985, as amended by 

this Act, for the purposes of enforcing section 302 of the 

Congressional Budget Act of 1974 (2 U.S.C. 633); 

Time periods. 

Deadline. 

Effective date. 

Applicability. 

Effective date. 


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132 STAT. 124 PUBLIC LAW 115–123—FEB. 9, 2018 

(2) for all committees other than the Committee on Appropriations, committee allocations for fiscal years 2019, 2019 

through 2023, and 2019 through 2028 consistent with the most 

recent baseline of the Congressional Budget Office, as adjusted 

for the budgetary effects of any provision of law enacted during 

the period beginning on the date such baseline is issued and 

ending on the date of submission of such statement, for the 

purposes of enforcing section 302 of the Congressional Budget 

Act of 1974 (2 U.S.C. 633); 

(3) aggregate spending levels for fiscal year 2019 in accordance with the allocations established under paragraphs (1) 

and (2), for the purpose of enforcing section 311 of the Congressional Budget Act of 1974 (2 U.S.C. 642); 

(4) aggregate revenue levels for fiscal years 2019, 2019 

through 2023, and 2019 through 2028 consistent with the most 

recent baseline of the Congressional Budget Office, as adjusted 

for the budgetary effects of any provision of law enacted during 

the period beginning on the date such baseline is issued and 

ending on the date of submission of such statement, for the 

purpose of enforcing section 311 of the Congressional Budget 

Act of 1974 (2 U.S.C. 642); and 

(5) levels of Social Security revenues and outlays for fiscal 

years 2019, 2019 through 2023, and 2019 through 2028 consistent with the most recent baseline of the Congressional 

Budget Office, as adjusted for the budgetary effects of any 

provision of law enacted during the period beginning on the 

date such baseline is issued and ending on the date of submission of such statement, for the purpose of enforcing sections 

302 and 311 of the Congressional Budget Act of 1974 (2 U.S.C. 

633 and 642). 

(c) ADDITIONAL MATTER.—The filing referred to in subsection 

(b) may also include for fiscal year 2019 the deficit-neutral reserve 

funds contained in title III of H. Con. Res. 71 (115th Congress) 

updated by one fiscal year. 

(d) EXPIRATION.—This section shall expire if a concurrent resolution on the budget for fiscal year 2019 is agreed to by the Senate 

and the House of Representatives pursuant to section 301 of the 

Congressional Budget Act of 1974 (2 U.S.C. 632). 

SEC. 30104. AUTHORITY FOR FISCAL YEAR 2019 BUDGET RESOLUTION 

IN THE HOUSE OF REPRESENTATIVES. 

(a) FISCAL YEAR 2019.—If a concurrent resolution on the budget 

for fiscal year 2019 has not been adopted by April 15, 2018, for 

the purpose of enforcing the Congressional Budget Act of 1974, 

the allocations, aggregates, and levels provided for in subsection 

(b) shall apply in the House of Representatives after April 15, 

2018, in the same manner as for a concurrent resolution on the 

budget for fiscal year 2019 with appropriate budgetary levels for 

fiscal year 2019 and for fiscal years 2020 through 2028. 

(b) COMMITTEE ALLOCATIONS, AGGREGATES, AND LEVELS.—In 

the House of Representatives, the Chair of the Committee on the 

Budget shall submit a statement for publication in the Congressional Record after April 15, 2018, but not later than May 15, 

2018, containing— 

(1) for the Committee on Appropriations, committee allocations for fiscal year 2019 for discretionary budget authority 

at the total level set forth in section 251(c)(6) of the Balanced 

Congressional 

Record, 

publication. 

Time periods. 

Deadline. 

Applicability. 

Effective date. 

Deadline. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 125 

Budget and Emergency Deficit Control Act of 1985, as amended 

by this Act, and the outlays flowing therefrom, and committee 

allocations for fiscal year 2019 for current law mandatory 

budget authority and outlays, for the purpose of enforcing section 302 of the Congressional Budget Act of 1974; 

(2) for all committees other than the Committee on Appropriations, committee allocations for fiscal year 2019 and for 

the period of fiscal years 2019 through 2028 at the levels 

included in the most recent baseline of the Congressional 

Budget Office, as adjusted for the budgetary effects of any 

provision of law enacted during the period beginning on the 

date such baseline is issued and ending on the date of submission of such statement, for the purpose of enforcing section 

302 of the Congressional Budget Act of 1974; and 

(3) aggregate spending levels for fiscal year 2019 and aggregate revenue levels for fiscal year 2019 and for the period 

of fiscal years 2019 through 2028, at the levels included in 

the most recent baseline of the Congressional Budget Office, 

as adjusted for the budgetary effects of any provision of law 

enacted during the period beginning on the date such baseline 

is issued and ending on the date of submission of such statement, for the purpose of enforcing section 311 of the Congressional Budget Act of 1974. 

(c) ADDITIONAL MATTER.—The statement referred to in subsection (b) may also include for fiscal year 2019, the matter contained in the provisions referred to in subsection (f)(1). 

(d) FISCAL YEAR 2019 ALLOCATION TO THE COMMITTEE ON

APPROPRIATIONS.—If the statement referred to in subsection (b) 

is not filed by May 15, 2018, then the matter referred to in subsection (b)(1) shall be submitted by the Chair of the Committee 

on the Budget for publication in the Congressional Record on the 

next day that the House of Representatives is in session. 

(e) ADJUSTMENTS.—The chair of the Committee on the Budget 

of the House of Representatives may adjust the levels included 

in the statement referred to in subsection (b) to reflect the budgetary 

effects of any legislation enacted during the 115th Congress that 

reduces the deficit or as otherwise necessary. 

(f) APPLICATION.—Upon submission of the statement referred 

to in subsection (b)— 

(1) all references in sections 5101 through 5112, sections 

5201 through 5205, section 5301, and section 5401 of House 

Concurrent Resolution 71 (115th Congress) to a fiscal year 

shall be considered for all purposes in the House to be references to the succeeding fiscal year; and 

(2) all references in the provisions referred to in paragraph 

(1) to allocations, aggregates, or other appropriate levels in 

‘‘this concurrent resolution’’, ‘‘the most recently agreed to 

concurrent resolution on the budget’’, or ‘‘this resolution’’ shall 

be considered for all purposes in the House to be references 

to the allocations, aggregates, or other appropriate levels contained in the statement referred to in subsection (b), as 

adjusted. 

(g) EXPIRATION.—Subsections (a) through (f) shall no longer 

apply if a concurrent resolution on the budget for fiscal year 2019 

is agreed to by the Senate and House of Representatives. 

Deadline. 

Congressional 

Record, 

publication. 


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132 STAT. 126 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 30105. EXERCISE OF RULEMAKING POWERS. 

Sections 30103 and 30104 are enacted by the Congress— 

(1) as an exercise of the rulemaking power of the Senate 

and the House of Representatives, respectively, and as such 

they shall be considered as part of the rules of each House, 

respectively, or of that House to which they specifically apply, 

and such rules shall supersede other rules only to the extent 

that they are inconsistent therewith; and 

(2) with full recognition of the constitutional right of either 

House to change such rules (so far as relating to such House) 

at any time, in the same manner, and to the same extent 

as in the case of any other rule of such House. 

TITLE II—OFFSETS 

SEC. 30201. CUSTOMS USER FEES. 

(a) IN GENERAL.—Section 13031(j)(3) of the Consolidated Omnibus Budget Reconciliation Act of 1985 (19 U.S.C. 58c(j)(3)) is 

amended— 

(1) in subparagraph (A), by striking ‘‘January 14, 2026’’ 

and inserting ‘‘February 24, 2027’’; and 

(2) in subparagraph (B)(i), by striking ‘‘September 30, 2025’’ 

and inserting ‘‘September 30, 2027’’. 

(b) RATE FOR MERCHANDISE PROCESSING FEES.—Section 503 

of the United States–Korea Free Trade Agreement Implementation 

Act (Public Law 112–41; 19 U.S.C. 3805 note) is amended by 

striking ‘‘January 14, 2026’’ and inserting ‘‘February 24, 2027’’. 

SEC. 30202. AVIATION SECURITY SERVICE FEES. 

Paragraph (4) of section 44940(i) of title 49, United States 

Code, is amended by adding at the end the following new subparagraphs: 

‘‘(M) $1,640,000,000 for fiscal year 2026. 

‘‘(N) $1,680,000,000 for fiscal year 2027.’’. 

SEC. 30203. EXTENSION OF CERTAIN IMMIGRATION FEES. 

(a) VISA WAIVER PROGRAM.—Section 217(h)(3)(B)(iii) of the 

Immigration and Nationality Act (8 U.S.C. 1187(h)(3)(B)(iii)) is 

amended by striking ‘‘September 30, 2020’’ and inserting ‘‘September 30, 2027’’. 

(b) L–1 AND H–1B VISAS.—Section 411 of the Air Transportation 

Safety and System Stabilization Act (49 U.S.C. 40101 note) is 

amended by striking ‘‘September 30, 2025’’ each place it appears 

and inserting ‘‘September 30, 2027’’. 

SEC. 30204. STRATEGIC PETROLEUM RESERVE DRAWDOWN. 

(a) DRAWDOWN AND SALE.— 

(1) IN GENERAL.—Notwithstanding section 161 of the 

Energy Policy and Conservation Act (42 U.S.C. 6241), except 

as provided in subsection (b), the Secretary of Energy shall 

draw down and sell from the Strategic Petroleum Reserve— 

(A) 30,000,000 barrels of crude oil during the period 

of fiscal years 2022 through 2025; 

(B) 35,000,000 barrels of crude oil during fiscal year 

2026; and 

(C) 35,000,000 barrels of crude oil during fiscal year 

2027. 

42 USC 6241 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 127 

(2) DEPOSIT OF AMOUNTS RECEIVED FROM SALE.—Amounts 

received from a sale under paragraph (1) shall be deposited 

in the general fund of the Treasury during the fiscal year 

in which the sale occurs. 

(b) EMERGENCY PROTECTION.—The Secretary of Energy may 

not draw down and sell crude oil under this section in quantities 

that would limit the authority to sell petroleum products under 

subsection (h) of section 161 of the Energy Policy and Conservation 

Act (42 U.S.C. 6241) in the full quantity authorized by that subsection. 

(c) STRATEGIC PETROLEUM DRAWDOWN CONDITIONS AND LIMITA- TIONS.— (1) CONDITIONS.—Section 161(h)(1) of the Energy Policy 

and Conservation Act (42 U.S.C. 6241(h)(1)) is amended in 

subparagraph (B) by striking ‘‘shortage; and’’ and all that follows through ‘‘Secretary of’’ in subparagraph (C) and inserting 

the following: ‘‘shortage; 

‘‘(C) the Secretary has found that action taken under 

this subsection will not impair the ability of the United 

States to carry out obligations of the United States under 

the international energy program; and 

‘‘(D) the Secretary of’’. 

(2) LIMITATIONS.—Section 161(h)(2) of the Energy Policy 

and Conservation Act (42 U.S.C. 6241(h)(2)) is amended by 

striking ‘‘450,000,000’’ each place it appears and inserting 

‘‘350,000,000’’. 

SEC. 30205. ELIMINATION OF SURPLUS FUNDS OF FEDERAL RESERVE 

BANKS. 

Section 7(a)(3)(A) of the Federal Reserve Act (12 U.S.C. 

289(a)(3)(A)) is amended by striking ‘‘$10,000,000,000’’ and inserting 

‘‘$7,500,000,000’’. 

SEC. 30206. REEMPLOYMENT SERVICES AND ELIGIBILITY ASSESSMENTS. 

(a) IN GENERAL.—Title III of the Social Security Act (42 U.S.C. 

501 et seq.) is amended by adding at the end the following: 

‘‘SEC. 306. GRANTS TO STATES FOR REEMPLOYMENT SERVICES AND 

ELIGIBILITY ASSESSMENTS. 

‘‘(a) IN GENERAL.—The Secretary of Labor (in this section 

referred to as the ‘Secretary’) shall award grants under this section 

for a fiscal year to eligible States to conduct a program of reemployment services and eligibility assessments for individuals referred 

to reemployment services as described in section 303(j) for weeks 

in such fiscal year for which such individuals receive unemployment 

compensation. 

‘‘(b) PURPOSES.—The purposes of this section are to accomplish 

the following goals: 

‘‘(1) To improve employment outcomes of individuals that 

receive unemployment compensation and to reduce the average 

duration of receipt of such compensation through employment. 

‘‘(2) To strengthen program integrity and reduce improper 

payments of unemployment compensation by States through 

the detection and prevention of such payments to individuals 

who are not eligible for such compensation. 

‘‘(3) To promote alignment with the broader vision of the 

Workforce Innovation and Opportunity Act (29 U.S.C. 3101 

42 USC 506. 

42 USC 6241 

note. 


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132 STAT. 128 PUBLIC LAW 115–123—FEB. 9, 2018 

et seq.) of increased program integration and service delivery 

for job seekers, including claimants for unemployment compensation. 

‘‘(4) To establish reemployment services and eligibility 

assessments as an entry point for individuals receiving 

unemployment compensation into other workforce system 

partner programs. 

‘‘(c) EVIDENCE-BASED STANDARDS.— 

‘‘(1) IN GENERAL.—In carrying out a State program of 

reemployment services and eligibility assessments using grant 

funds awarded to the State under this section, a State shall 

use such funds only for interventions demonstrated to reduce 

the number of weeks for which program participants receive 

unemployment compensation by improving employment outcomes for program participants. 

‘‘(2) EXPANDING EVIDENCE-BASED INTERVENTIONS.—In addition to the requirement imposed by paragraph (1), a State 

shall— 

‘‘(A) for fiscal years 2023 and 2024, use no less than 

25 percent of the grant funds awarded to the State under 

this section for interventions with a high or moderate 

causal evidence rating that show a demonstrated capacity 

to improve employment and earnings outcomes for program 

participants; 

‘‘(B) for fiscal years 2025 and 2026, use no less than 

40 percent of such grant funds for interventions described 

in subparagraph (A); and 

‘‘(C) for fiscal years beginning after fiscal year 2026, 

use no less than 50 percent of such grant funds for interventions described in subparagraph (A). 

‘‘(d) EVALUATIONS.— 

‘‘(1) REQUIRED EVALUATIONS.—Any intervention without a 

high or moderate causal evidence rating used by a State in 

carrying out a State program of reemployment services and 

eligibility assessments under this section shall be under evaluation at the time of use. 

‘‘(2) FUNDING LIMITATION.—A State shall use not more than 

10 percent of grant funds awarded to the State under this 

section to conduct or cause to be conducted evaluations of 

interventions used in carrying out a program under this section 

(including evaluations conducted pursuant to paragraph (1)). 

‘‘(e) STATE PLAN.— 

‘‘(1) IN GENERAL.—As a condition of eligibility to receive 

a grant under this section for a fiscal year, a State shall 

submit to the Secretary, at such time and in such manner 

as the Secretary may require, a State plan that outlines how 

the State intends to conduct a program of reemployment services and eligibility assessments under this section, including— 

‘‘(A) assurances that, and a description of how, the 

program will provide— 

‘‘(i) proper notification to participating individuals 

of the program’s eligibility conditions, requirements, 

and benefits, including the issuance of warnings and 

simple, clear notifications to ensure that participating 

individuals are fully aware of the consequences of 

Effective date. 

Time period. 


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failing to adhere to such requirements, including policies related to non-attendance or non-fulfillment of 

work search requirements; and 

‘‘(ii) reasonable scheduling accommodations to 

maximize participation for eligible individuals; 

‘‘(B) assurances that, and a description of how, the 

program will conform with the purposes outlined in subsection (b) and satisfy the requirement to use evidencebased standards under subsection (c), including— 

‘‘(i) a description of the evidence-based interventions the State plans to use to speed reemployment; 

‘‘(ii) an explanation of how such interventions are 

appropriate to the population served; and 

‘‘(iii) if applicable, a description of the evaluation 

structure the State plans to use for interventions without at least a moderate or high causal evidence rating, 

which may include national evaluations conducted by 

the Department of Labor or by other entities; and 

‘‘(C) a description of any reemployment activities and 

evaluations conducted in the prior fiscal year, and any 

data collected on— 

‘‘(i) characteristics of program participants; 

‘‘(ii) the number of weeks for which program 

participants receive unemployment compensation; and 

‘‘(iii) employment and other outcomes for program 

participants consistent with State performance 

accountability measures provided by the State 

unemployment compensation program and in section 

116(b) of the Workforce Innovation and Opportunity 

Act (29 U.S.C. 3141(b)). 

‘‘(2) APPROVAL.—The Secretary shall approve any State 

plan, that is timely submitted to the Secretary, in such manner 

as the Secretary may require, that satisfies the conditions 

described in paragraph (1). 

‘‘(3) DISAPPROVAL AND REVISION.—If the Secretary determines that a State plan submitted pursuant to this subsection 

fails to satisfy the conditions described in paragraph (1), the 

Secretary shall— 

‘‘(A) disapprove such plan; 

‘‘(B) provide to the State, not later than 30 days after 

the date of receipt of the State plan, a written notice 

of such disapproval that includes a description of any portion of the plan that was not approved and the reason 

for the disapproval of each such portion; and 

‘‘(C) provide the State with an opportunity to correct 

any such failure and submit a revised State plan. 

‘‘(f) ALLOCATION OF FUNDS.— 

‘‘(1) BASE FUNDING.— 

‘‘(A) IN GENERAL.—For each fiscal year after fiscal year 

2020, the Secretary shall allocate a percentage equal to 

the base funding percentage for such fiscal year of the 

funds made available for grants under this section among 

the States awarded such a grant for such fiscal year using 

a formula prescribed by the Secretary based on the rate 

of insured unemployment (as defined in section 203(e)(1) 

of the Federal-State Extended Unemployment Compensation Act of 1970 (26 U.S.C. 3304 note)) in the State for 

Time periods. 

Determination. 

Deadline. 

Notice. 

Determination. 


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132 STAT. 130 PUBLIC LAW 115–123—FEB. 9, 2018 

a period to be determined by the Secretary. In developing 

such formula with respect to a State, the Secretary shall 

consider the importance of avoiding sharp reductions in 

grant funding to a State over time. 

‘‘(B) BASE FUNDING PERCENTAGE.—For purposes of 

subparagraph (A), the term ‘base funding percentage’ 

means— 

‘‘(i) for fiscal years 2021 through 2026, 89 percent; 

and 

‘‘(ii) for fiscal years after 2026, 84 percent. 

‘‘(2) RESERVATION FOR OUTCOME PAYMENTS.— ‘‘(A) IN GENERAL.—Of the amounts made available for 

grants under this section for each fiscal year after 2020, 

the Secretary shall reserve a percentage equal to the outcome reservation percentage for such fiscal year for outcome payments to increase the amount otherwise awarded 

to a State under paragraph (1). Such outcome payments 

shall be paid to States conducting reemployment services 

and eligibility assessments under this section that, during 

the previous fiscal year, met or exceeded the outcome goals 

provided in subsection (b)(1) related to reducing the average 

duration of receipt of unemployment compensation by 

improving employment outcomes. 

‘‘(B) OUTCOME RESERVATION PERCENTAGE.—For purposes of subparagraph (A), the term ‘outcome reservation 

percentage’ means— 

‘‘(i) for fiscal years 2021 through 2026, 10 percent; 

and 

‘‘(ii) for fiscal years after 2026, 15 percent. 

‘‘(3) RESERVATION FOR RESEARCH AND TECHNICAL ASSISTANCE.—Of the amounts made available for grants under this 

section for each fiscal year after 2020, the Secretary may 

reserve not more than 1 percent to conduct research and provide 

technical assistance to States. 

‘‘(4) CONSULTATION AND PUBLIC COMMENT.—Not later than 

September 30, 2019, the Secretary shall— 

‘‘(A) consult with the States and seek public comment 

in developing the allocation formula under paragraph (1) 

and the criteria for carrying out the reservations under 

paragraph (2); and 

‘‘(B) make publicly available the allocation formula 

and criteria developed pursuant to subclause (A). 

‘‘(g) NOTIFICATION TO CONGRESS.—Not later than 90 days prior 

to making any changes to the allocation formula or the criteria 

developed pursuant to subsection (f)(5)(A), the Secretary shall 

submit to Congress, including to the Committee on Ways and Means 

and the Committee on Appropriations of the House of Representatives and the Committee on Finance and the Committee on Appropriations of the Senate, a notification of any such change. 

‘‘(h) SUPPLEMENT NOT SUPPLANT.—Funds made available to 

carry out this section shall be used to supplement the level of 

Federal, State, and local public funds that, in the absence of such 

availability, would be expended to provide reemployment services 

and eligibility assessments to individuals receiving unemployment 

compensation, and in no case to supplant such Federal, State, 

or local public funds. 

‘‘(i) DEFINITIONS.—In this section: 

Deadline. 

Criteria. 

Deadline. 

Definition. 

Definition. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 131 

‘‘(1) CAUSAL EVIDENCE RATING.—The terms ‘high causal 

evidence rating’ and ‘moderate causal evidence rating’ shall 

have the meaning given such terms by the Secretary of Labor. 

‘‘(2) ELIGIBLE STATE.—The term ‘eligible State’ means a 

State that has in effect a State plan approved by the Secretary 

in accordance with subsection (e). 

‘‘(3) INTERVENTION.—The term ‘intervention’ means a 

service delivery strategy for the provision of State reemployment services and eligibility assessment activities under this 

section. 

‘‘(4) STATE.—The term ‘State’ has the meaning given the 

term in section 205 of the Federal-State Extended Unemployment Compensation Act of 1970 (26 U.S.C. 3304 note). 

‘‘(5) UNEMPLOYMENT COMPENSATION.—The term unemployment compensation means ‘regular compensation’, ‘extended 

compensation’, and ‘additional compensation’ (as such terms 

are defined by section 205 of the Federal-State Extended 

Unemployment Compensation Act of 1970 (26 U.S.C. 3304 

note)).’’. 

(b) REPORT.—Not later than 3 years after the date of enactment 

of this Act, the Secretary of Labor shall submit to Congress a 

report to describe promising interventions used by States to provide 

reemployment assistance. 

(c) ADJUSTMENT TO DISCRETIONARY SPENDING LIMITS.—Section 

251(b)(2) of the Balanced Budget and Emergency Deficit Control 

Act of 1985 (2 U.S.C. 901(b)(2)) is amended by adding at the 

end the following: 

‘‘(E) REEMPLOYMENT SERVICES AND ELIGIBILITY ASSESSMENTS.— 

‘‘(i) IN GENERAL.—If a bill or joint resolution 

making appropriations for a fiscal year is enacted that 

specifies an amount for grants to States under section 

306 of the Social Security Act, then the adjustment 

for that fiscal year shall be the additional new budget 

authority provided in that Act for such grants for that 

fiscal year, but shall not exceed— 

‘‘(I) for fiscal year 2018, $0; 

‘‘(II) for fiscal year 2019, $33,000,000; 

‘‘(III) for fiscal year 2020, $58,000,000; and 

‘‘(IV) for fiscal year 2021, $83,000,000. 

‘‘(ii) DEFINITION.—As used in this subparagraph, 

the term ‘additional new budget authority’ means the 

amount provided for a fiscal year, in excess of 

$117,000,000, in an appropriation Act and specified 

to pay for grants to States under section 306 of the 

Social Security Act.’’. 

(d) OTHER BUDGETARY ADJUSTMENTS.—Section 314 of the 

Congressional Budget Act of 1974 (2 U.S.C. 645) is amended by 

adding at the end the following: 

‘‘(g) ADJUSTMENT FOR REEMPLOYMENT SERVICES AND ELIGIBILITY ASSESSMENTS.— 

‘‘(1) IN GENERAL.— 

‘‘(A) ADJUSTMENTS.—If the Committee on Appropriations of either House reports an appropriation measure 

for any of fiscal years 2022 through 2027 that provides 

budget authority for grants under section 306 of the Social 


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132 STAT. 132 PUBLIC LAW 115–123—FEB. 9, 2018 

Security Act, or if a conference committee submits a conference report thereon, the chairman of the Committee 

on the Budget of the House of Representatives or the 

Senate shall make the adjustments referred to in subparagraph (B) to reflect the additional new budget authority 

provided for such grants in that measure or conference 

report and the outlays resulting therefrom, consistent with 

subparagraph (D). 

‘‘(B) TYPES OF ADJUSTMENTS.—The adjustments 

referred to in this subparagraph consist of adjustments 

to— 

‘‘(i) the discretionary spending limits for that fiscal 

year as set forth in the most recently adopted concurrent resolution on the budget; 

‘‘(ii) the allocations to the Committees on Appropriations of the Senate and the House of Representatives for that fiscal year under section 302(a); and 

‘‘(iii) the appropriate budget aggregates for that 

fiscal year in the most recently adopted concurrent 

resolution on the budget. 

‘‘(C) ENFORCEMENT.—The adjusted discretionary 

spending limits, allocations, and aggregates under this 

paragraph shall be considered the appropriate limits, 

allocations, and aggregates for purposes of congressional 

enforcement of this Act and concurrent budget resolutions 

under this Act. 

‘‘(D) LIMITATION.—No adjustment may be made under 

this subsection in excess of— 

‘‘(i) for fiscal year 2022, $133,000,000; 

‘‘(ii) for fiscal year 2023, $258,000,000; 

‘‘(iii) for fiscal year 2024, $433,000,000; 

‘‘(iv) for fiscal year 2025, $533,000,000; 

‘‘(v) for fiscal year 2026, $608,000,000; and 

‘‘(vi) for fiscal year 2027, $633,000,000. 

‘‘(E) DEFINITION.—As used in this subsection, the term 

‘additional new budget authority’ means the amount provided 

for a fiscal year, in excess of $117,000,000, in an appropriation 

measure or conference report (as the case may be) and specified 

to pay for grants to States under section 306 of the Social 

Security Act. 

‘‘(2) REPORT ON 302(B) LEVEL.—Following any adjustment 

made under paragraph (1), the Committees on Appropriations 

of the Senate and the House of Representatives may report 

appropriately revised suballocations pursuant to section 302(b) 

to carry out this subsection.’’. 

TITLE III—TEMPORARY EXTENSION OF 

PUBLIC DEBT LIMIT 

SEC. 30301. TEMPORARY EXTENSION OF PUBLIC DEBT LIMIT. 

(a) IN GENERAL.—Section 3101(b) of title 31, United States 

Code, shall not apply for the period beginning on the date of 

the enactment of this Act and ending on March 1, 2019. 

(b) SPECIAL RULE RELATING TO OBLIGATIONS ISSUED DURING

EXTENSION PERIOD.—Effective on March 2, 2019, the limitation 

Effective date. 

31 USC 3101 

note. 

Time period. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 133 

in effect under section 3101(b) of title 31, United States Code, 

shall be increased to the extent that— 

(1) the face amount of obligations issued under chapter 

31 of such title and the face amount of obligations whose 

principal and interest are guaranteed by the United States 

Government (except guaranteed obligations held by the Secretary of the Treasury) outstanding on March 2, 2019, exceeds 

(2) the face amount of such obligations outstanding on 

the date of the enactment of this Act. 

(c) RESTORING CONGRESSIONAL AUTHORITY OVER THE NATIONAL

DEBT.— (1) EXTENSION LIMITED TO NECESSARY OBLIGATIONS.—An 

obligation shall not be taken into account under subsection 

(b)(1) unless the issuance of such obligation was necessary 

to fund a commitment incurred pursuant to law by the Federal 

Government that required payment before March 2, 2019. 

(2) PROHIBITION ON CREATION OF CASH RESERVE DURING

EXTENSION PERIOD.—The Secretary of the Treasury shall not 

issue obligations during the period specified in subsection (a) 

for the purpose of increasing the cash balance above normal 

operating balances in anticipation of the expiration of such 

period. 

TITLE IV—JOINT SELECT COMMITTEES 

Subtitle A—Joint Select Committee on 

Solvency of Multiemployer Pension Plans 

SEC. 30421. DEFINITIONS. 

In this subtitle— 

(1) the term ‘‘joint committee’’ means the Joint Select Committee on Solvency of Multiemployer Pension Plans established 

under section 30422(a); and 

(2) the term ‘‘joint committee bill’’ means a bill consisting 

of the proposed legislative language of the joint committee 

recommended in accordance with section 30422(b)(2)(B)(ii) and 

introduced under section 30424(a). 

SEC. 30422. ESTABLISHMENT OF JOINT SELECT COMMITTEE. 

(a) ESTABLISHMENT OF JOINT SELECT COMMITTEE.—There is 

established a joint select committee of Congress to be known as 

the ‘‘Joint Select Committee on Solvency of Multiemployer Pension 

Plans’’. 

(b) IMPLEMENTATION.— 

(1) GOAL.—The goal of the joint committee is to improve 

the solvency of multiemployer pension plans and the Pension 

Benefit Guaranty Corporation. 

(2) DUTIES.— 

(A) IN GENERAL.—The joint committee shall provide 

recommendations and legislative language that will significantly improve the solvency of multiemployer pension plans 

and the Pension Benefit Guaranty Corporation. 

(B) REPORT, RECOMMENDATIONS, AND LEGISLATIVE LANGUAGE.— 

Recommendations. 


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132 STAT. 134 PUBLIC LAW 115–123—FEB. 9, 2018 

(i) IN GENERAL.—Not later than November 30, 

2018, the joint committee shall vote on— 

(I) a report that contains a detailed statement 

of the findings, conclusions, and recommendations 

of the joint committee; and 

(II) proposed legislative language to carry out 

the recommendations described in subclause (I). 

(ii) APPROVAL OF REPORT AND LEGISLATIVE LANGUAGE.— 

(I) IN GENERAL.—The report of the joint committee and the proposed legislative language 

described in clause (i) shall only be approved upon 

receiving the votes of— 

(aa) a majority of joint committee members appointed by the Speaker of the House 

of Representatives and the Majority Leader 

of the Senate; and 

(bb) a majority of joint committee members appointed by the Minority Leader of the 

House of Representatives and the Minority 

Leader of the Senate. 

(II) AVAILABILITY.—The text of any report and 

proposed legislative language shall be publicly 

available in electronic form at least 24 hours prior 

to its consideration. 

(iii) ADDITIONAL VIEWS.—A member of the joint 

committee who gives notice of an intention to file 

supplemental, minority, or additional views at the time 

of the final joint committee vote on the approval of 

the report and legislative language under clause (ii) 

shall be entitled to 2 calendar days after the day 

of such notice in which to file such views in writing 

with the co-chairs. Such views shall then be included 

in the joint committee report and printed in the same 

volume, or part thereof, and their inclusion shall be 

noted on the cover of the report. In the absence of 

timely notice, the joint committee report may be 

printed and transmitted immediately without such 

views. 

(iv) TRANSMISSION OF REPORT AND LEGISLATIVE

LANGUAGE.—If the report and legislative language are 

approved by the joint committee pursuant to clause 

(ii), the joint committee shall submit the joint committee report and legislative language described in 

clause (i) to the President, the Vice President, the 

Speaker of the House of Representatives, and the 

majority and minority leaders of each House of Congress not later than 15 calendar days after such 

approval. 

(v) REPORT AND LEGISLATIVE LANGUAGE TO BE

MADE PUBLIC.—Upon the approval of the joint committee report and legislative language pursuant to 

clause (ii), the joint committee shall promptly make 

the full report and legislative language, and a record 

of any vote, available to the public. 

(3) MEMBERSHIP.— 

Records. 

Public 

information. 

Web posting. 

Deadline. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 135 

(A) IN GENERAL.—The joint committee shall be composed of 16 members appointed pursuant to subparagraph 

(B). 

(B) APPOINTMENT.—Members of the joint committee 

shall be appointed as follows: 

(i) The Speaker of the House of Representatives 

shall appoint 4 members from among Members of the 

House of Representatives. 

(ii) The Minority Leader of the House of Representatives shall appoint 4 members from among Members 

of the House of Representatives. 

(iii) The Majority Leader of the Senate shall 

appoint 4 members from among Members of the 

Senate. 

(iv) The Minority Leader of the Senate shall 

appoint 4 members from among Members of the 

Senate. 

(C) CO-CHAIRS.—Two of the appointed members of the 

joint committee will serve as co-chairs. The Speaker of 

the House of Representatives and the Majority Leader of 

the Senate shall jointly appoint one co-chair, and the 

Minority Leader of the House of Representatives and the 

Minority Leader of the Senate shall jointly appoint the 

second co-chair. The co-chairs shall be appointed not later 

than 14 calendar days after the date of enactment of this 

Act. 

(D) DATE.—Members of the joint committee shall be 

appointed not later than 14 calendar days after the date 

of enactment of this Act. 

(E) PERIOD OF APPOINTMENT.—Members shall be 

appointed for the life of the joint committee. Any vacancy 

in the joint committee shall not affect its powers, but 

shall be filled not later than 14 calendar days after the 

date on which the vacancy occurs, in the same manner 

as the original appointment was made. If a member of 

the joint committee ceases to be a Member of the House 

of Representatives or the Senate, as the case may be, 

the member is no longer a member of the joint committee 

and a vacancy shall exist. 

(4) ADMINISTRATION.— 

(A) GENERAL AUTHORITY.—For purposes of enabling 

the joint committee to exercise its powers, functions, and 

duties under this subtitle, and consistent with the Standing 

Rules of the Senate, there is authorized from the date 

of enactment of this Act through February 28, 2019, 

$500,000 to be allocated— 

(i) in total during the period October 1, 2017 

through September 30, 2018; and 

(ii) any remaining amounts shall be carried forward for the period October 1, 2018 through February 

28, 2019. 

(B) EXPENSES.—Expenses of the joint committee shall 

be paid from the contingent fund of the Senate upon 

vouchers approved by the co-chairs, subject to the rules 

and regulations of the Senate. 

(C) QUORUM.—Nine members of the joint committee 

shall constitute a quorum for purposes of voting and 

Time periods. 

Deadline. 

Deadline. 

Deadline. 


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132 STAT. 136 PUBLIC LAW 115–123—FEB. 9, 2018 

meeting, and 5 members of the joint committee shall constitute a quorum for holding hearings. 

(D) VOTING.—No proxy voting shall be allowed on 

behalf of the members of the joint committee. 

(E) MEETINGS.— 

(i) INITIAL MEETING.—Not later than 30 calendar 

days after the date of enactment of this Act, the joint 

committee shall hold its first meeting. 

(ii) AGENDA.—The co-chairs of the joint committee 

shall provide an agenda to the joint committee members not less than 48 hours in advance of any meeting. 

(F) HEARINGS.— 

(i) IN GENERAL.—The joint committee may, for the 

purpose of carrying out this section, hold such hearings, 

sit and act at such times and places, require attendance 

of witnesses and production of books, papers, and documents, take such testimony, receive such evidence, and 

administer such oaths as the joint committee considers 

advisable. 

(ii) HEARING PROCEDURES AND RESPONSIBILITIES OF

CO-CHAIRS.— 

(I) ANNOUNCEMENT.—The co-chairs of the joint 

committee shall make a public announcement of 

the date, place, time, and subject matter of any 

hearing to be conducted, not less than 7 days 

in advance of such hearing, unless the co-chairs 

determine that there is good cause to begin such 

hearing at an earlier date. 

(II) EQUAL REPRESENTATION OF WITNESSES.— 

Each co-chair shall be entitled to select an equal 

number of witnesses for each hearing held by the 

joint committee. 

(III) WRITTEN STATEMENT.—A witness 

appearing before the joint committee shall file a 

written statement of proposed testimony at least 

2 calendar days before the appearance of the witness, unless the requirement is waived by the cochairs, following their determination that there 

is good cause for failure to comply with such 

requirement. 

(G) MINIMUM NUMBER OF PUBLIC MEETINGS AND

HEARINGS.—The joint committee shall hold— 

(i) not less than a total of 5 public meetings or 

public hearings; and 

(ii) not less than 3 public hearings, which may 

include field hearings. 

(H) TECHNICAL ASSISTANCE.—Upon written request of 

the co-chairs, a Federal agency, including legislative branch 

agencies, shall provide technical assistance to the joint 

committee in order for the joint committee to carry out 

its duties. 

(I) STAFFING.— 

(i) DETAILS.—Employees of the legislative branch 

may be detailed to the joint committee on a nonreimbursable basis, consistent with the rules and regulations of the Senate. 

Time period. 

Time period. 

Deadlines. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 137 

(ii) STAFF DIRECTOR.—The co-chairs, acting jointly, 

may designate one such employee as staff director 

of the joint committee. 

(c) ETHICAL STANDARDS.—Members on the joint committee who 

serve in the House of Representatives shall be governed by the 

ethics rules and requirements of the House. Members of the Senate 

who serve on the joint committee shall comply with the ethics 

rules of the Senate. 

(d) TERMINATION.—The joint committee shall terminate on 

December 31, 2018 or 30 days after submission of its report and 

legislative recommendations pursuant to this section whichever 

occurs first. 

SEC. 30423. FUNDING. 

(a) SPECIAL RESERVE.—To enable the joint committee to exercise 

its powers, functions, and duties under this subtitle, within the 

funds in the account for ‘‘Expenses of Inquiries and Investigations’’ 

of the Senate, not more than $500,000 shall be allocated from 

the special reserve established in S. Res. 62, agreed to February 

28, 2017 (115th Congress), for use by the joint committee. 

(b) EXPIRATION.—None of the funds made available by this 

section may be available for obligation by the joint committee after 

January 2, 2019. 

(c) AVAILABILITY REQUIREMENTS.—For purposes of the joint 

committee, section 20(b) of S. Res. 62, agreed to February 28, 

2017 (115th Congress), shall not apply. 

SEC. 30424. CONSIDERATION OF JOINT COMMITTEE BILL IN THE 

SENATE. 

(a) INTRODUCTION.—Upon receipt of proposed legislative language approved in accordance with section 30422(b)(2)(B)(ii), the 

language shall be introduced in the Senate (by request) on the 

next day on which the Senate is in session by the Majority Leader 

of the Senate or by a Member of the Senate designated by the 

Majority Leader of the Senate. 

(b) COMMITTEE CONSIDERATION.—A joint committee bill introduced in the Senate under subsection (a) shall be jointly referred 

to the Committee on Finance and the Committee on Health, Education, Labor, and Pensions, which committees shall report the 

bill without any revision and with a favorable recommendation, 

an unfavorable recommendation, or without recommendation, no 

later than 7 session days after introduction of the bill. If either 

committee fails to report the bill within that period, that committee 

shall be automatically discharged from consideration of the bill, 

and the bill shall be placed on the appropriate calendar. 

(c) MOTION TO PROCEED TO CONSIDERATION.— 

(1) IN GENERAL.—Notwithstanding rule XXII of the 

Standing Rules of the Senate, it is in order, not later than 

2 days of session after the date on which a joint committee 

bill is reported or discharged from the Committee on Finance 

and the Committee on Health, Education, Labor, and Pensions, 

for the Majority Leader of the Senate or the Majority Leader’s 

designee to move to proceed to the consideration of the joint 

committee bill. It shall also be in order for any Member of 

the Senate to move to proceed to the consideration of the 

joint committee bill at any time after the conclusion of such 

2-day period. 

Deadline. 

Deadline. 


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132 STAT. 138 PUBLIC LAW 115–123—FEB. 9, 2018 

(2) CONSIDERATION OF MOTION.—Consideration of the 

motion to proceed to the consideration of the joint committee 

bill and all debatable motions and appeals in connection therewith shall not exceed 10 hours, which shall be divided equally 

between the Majority and Minority Leaders or their designees. 

A motion to further limit debate is in order, shall require 

an affirmative vote of three-fifths of Members duly chosen 

and sworn, and is not debatable. 

(3) VOTE THRESHOLD.—The motion to proceed to the consideration of the joint committee bill shall only be agreed to 

upon an affirmative vote of three-fifths of Members duly chosen 

and sworn. 

(4) LIMITATIONS.—The motion is not subject to a motion 

to postpone. All points of order against the motion to proceed 

to the joint committee bill are waived. A motion to reconsider 

the vote by which the motion is agreed to or disagreed to 

shall not be in order. 

(5) DEADLINE.—Not later than the last day of the 115th 

Congress, the Senate shall vote on a motion to proceed to 

the joint committee bill. 

(6) COMPANION MEASURES.—For purposes of this subsection, the term ‘‘joint committee bill’’ includes a bill of the 

House of Representatives that is a companion measure to the 

joint committee bill introduced in the Senate. 

(d) RULES OF SENATE.—This section is enacted by Congress— 

(1) as an exercise of the rulemaking power of the Senate, 

and as such is deemed a part of the rules of the Senate, 

but applicable only with respect to the procedure to be followed 

in the Senate in the case of a joint committee bill, and supersede 

other rules only to the extent that they are inconsistent with 

such rules; and 

(2) with full recognition of the constitutional right of the 

Senate to change the rules (so far as relating to the procedure 

of the Senate) at any time, in the same manner, and to the 

same extent as in the case of any other rule of the Senate. 

Subtitle B—Joint Select Committee on 

Budget and Appropriations Process Reform 

SEC. 30441. DEFINITIONS. 

In this subtitle— 

(1) the term ‘‘joint committee’’ means the Joint Select Committee on Budget and Appropriations Process Reform established under section 30442(a); and 

(2) the term ‘‘joint committee bill’’ means a bill consisting 

of the proposed legislative language of the joint committee 

recommended in accordance with section 30442(b)(2)(B)(ii) and 

introduced under section 30444(a). 

SEC. 30442. ESTABLISHMENT OF JOINT SELECT COMMITTEE. 

(a) ESTABLISHMENT OF JOINT SELECT COMMITTEE.—There is 

established a joint select committee of Congress to be known as 

the ‘‘Joint Select Committee on Budget and Appropriations Process 

Reform’’. 

Definition. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 139 

(b) IMPLEMENTATION.— 

(1) GOAL.—The goal of the joint committee is to reform 

the budget and appropriations process. 

(2) DUTIES.— 

(A) IN GENERAL.—The joint committee shall provide 

recommendations and legislative language that will significantly reform the budget and appropriations process. 

(B) REPORT, RECOMMENDATIONS, AND LEGISLATIVE LANGUAGE.— 

(i) IN GENERAL.—Not later than November 30, 

2018, the joint committee shall vote on— 

(I) a report that contains a detailed statement 

of the findings, conclusions, and recommendations 

of the joint committee; and 

(II) proposed legislative language to carry out 

the recommendations described in subclause (I). 

(ii) APPROVAL OF REPORT AND LEGISLATIVE LANGUAGE.— 

(I) IN GENERAL.—The report of the joint committee and the proposed legislative language 

described in clause (i) shall only be approved upon 

receiving the votes of— 

(aa) a majority of joint committee members appointed by the Speaker of the House 

of Representatives and the Majority Leader 

of the Senate; and 

(bb) a majority of joint committee members appointed by the Minority Leader of the 

House of Representatives and the Minority 

Leader of the Senate. 

(II) AVAILABILITY.—The text of any report and 

proposed legislative language shall be publicly 

available in electronic form at least 24 hours prior 

to its consideration. 

(iii) ADDITIONAL VIEWS.—A member of the joint 

committee who gives notice of an intention to file 

supplemental, minority, or additional views at the time 

of the final joint committee vote on the approval of 

the report and legislative language under clause (ii) 

shall be entitled to 2 calendar days after the day 

of such notice in which to file such views in writing 

with the co-chairs. Such views shall then be included 

in the joint committee report and printed in the same 

volume, or part thereof, and their inclusion shall be 

noted on the cover of the report. In the absence of 

timely notice, the joint committee report may be 

printed and transmitted immediately without such 

views. 

(iv) TRANSMISSION OF REPORT AND LEGISLATIVE

LANGUAGE.—If the report and legislative language are 

approved by the joint committee pursuant to clause 

(ii), the joint committee shall submit the joint committee report and legislative language described in 

clause (i) to the President, the Vice President, the 

Speaker of the House of Representatives, and the 

Time period. 

Public 

information. 

Web posting. 


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132 STAT. 140 PUBLIC LAW 115–123—FEB. 9, 2018 

majority and minority leaders of each House of Congress not later than 15 calendar days after such 

approval. 

(v) REPORT AND LEGISLATIVE LANGUAGE TO BE

MADE PUBLIC.—Upon the approval of the joint committee report and legislative language pursuant to 

clause (ii), the joint committee shall promptly make 

the full report and legislative language, and a record 

of any vote, available to the public. 

(3) MEMBERSHIP.— 

(A) IN GENERAL.—The joint committee shall be composed of 16 members appointed pursuant to subparagraph 

(B). 

(B) APPOINTMENT.—Members of the joint committee 

shall be appointed as follows: 

(i) The Speaker of the House of Representatives 

shall appoint 4 members from among Members of the 

House of Representatives. 

(ii) The Minority Leader of the House of Representatives shall appoint 4 members from among Members 

of the House of Representatives. 

(iii) The Majority Leader of the Senate shall 

appoint 4 members from among Members of the 

Senate. 

(iv) The Minority Leader of the Senate shall 

appoint 4 members from among Members of the 

Senate. 

(C) CO-CHAIRS.—Two of the appointed members of the 

joint committee will serve as co-chairs. The Speaker of 

the House of Representatives and the Majority Leader of 

the Senate shall jointly appoint one co-chair, and the 

Minority Leader of the House of Representatives and the 

Minority Leader of the Senate shall jointly appoint the 

second co-chair. The co-chairs shall be appointed not later 

than 14 calendar days after the date of enactment of this 

Act. 

(D) DATE.—Members of the joint committee shall be 

appointed not later than 14 calendar days after the date 

of enactment of this Act. 

(E) PERIOD OF APPOINTMENT.—Members shall be 

appointed for the life of the joint committee. Any vacancy 

in the joint committee shall not affect its powers, but 

shall be filled not later than 14 calendar days after the 

date on which the vacancy occurs, in the same manner 

as the original appointment was made. If a member of 

the joint committee ceases to be a Member of the House 

of Representatives or the Senate, as the case may be, 

the member is no longer a member of the joint committee 

and a vacancy shall exist. 

(4) ADMINISTRATION.— 

(A) GENERAL AUTHORITY.—For purposes of enabling 

the joint committee to exercise its powers, functions, and 

duties under this subtitle, and consistent with the Standing 

Rules of the Senate, there is authorized from the date 

of enactment of this Act through February 28, 2019, 

$500,000 to be allocated— 

Time periods. 

Deadline. 

Deadline. 

Deadline. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 141 

(i) in total during the period October 1, 2017 

through September 30, 2018; and 

(ii) any remaining amounts shall be carried forward for the period October 1, 2018 through February 

28, 2019. 

(B) EXPENSES.—Expenses of the joint committee shall 

be paid from the contingent fund of the Senate upon 

vouchers approved by the co-chairs, subject to the rules 

and regulations of the Senate. 

(C) QUORUM.—Nine members of the joint committee 

shall constitute a quorum for purposes of voting and 

meeting, and 5 members of the joint committee shall constitute a quorum for holding hearings. 

(D) VOTING.—No proxy voting shall be allowed on 

behalf of the members of the joint committee. 

(E) MEETINGS.— (i) INITIAL MEETING.—Not later than 30 calendar 

days after the date of enactment of this Act, the joint 

committee shall hold its first meeting. 

(ii) AGENDA.—The co-chairs of the joint committee 

shall provide an agenda to the joint committee members not less than 48 hours in advance of any meeting. 

(F) HEARINGS.— 

(i) IN GENERAL.—The joint committee may, for the 

purpose of carrying out this section, hold such hearings, 

sit and act at such times and places, require attendance 

of witnesses and production of books, papers, and documents, take such testimony, receive such evidence, and 

administer such oaths as the joint committee considers 

advisable. 

(ii) HEARING PROCEDURES AND RESPONSIBILITIES OF

CO-CHAIRS.— 

(I) ANNOUNCEMENT.—The co-chairs of the joint 

committee shall make a public announcement of 

the date, place, time, and subject matter of any 

hearing to be conducted, not less than 7 days 

in advance of such hearing, unless the co-chairs 

determine that there is good cause to begin such 

hearing at an earlier date. 

(II) EQUAL REPRESENTATION OF WITNESSES.— 

Each co-chair shall be entitled to select an equal 

number of witnesses for each hearing held by the 

joint committee. 

(III) WRITTEN STATEMENT.—A witness 

appearing before the joint committee shall file a 

written statement of proposed testimony at least 

2 calendar days before the appearance of the witness, unless the requirement is waived by the cochairs, following their determination that there 

is good cause for failure to comply with such 

requirement. 

(G) MINIMUM NUMBER OF PUBLIC MEETINGS AND

HEARINGS.—The joint committee shall hold— 

(i) not less than a total of 5 public meetings or 

public hearings; and 

(ii) not less than 3 public hearings, which may 

include field hearings. 

Public 

information. 

Time periods. 

Time period. 

Deadline. 


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132 STAT. 142 PUBLIC LAW 115–123—FEB. 9, 2018 

(H) TECHNICAL ASSISTANCE.—Upon written request of 

the co-chairs, a Federal agency, including legislative branch 

agencies, shall provide technical assistance to the joint 

committee in order for the joint committee to carry out 

its duties. 

(I) STAFFING.— (i) DETAILS.—Employees of the legislative branch 

may be detailed to the joint committee on a nonreimbursable basis, consistent with the rules and regulations of the Senate. 

(ii) STAFF DIRECTOR.—The co-chairs, acting jointly, 

may designate one such employee as staff director 

of the joint committee. 

(c) ETHICAL STANDARDS.—Members on the joint committee who 

serve in the House of Representatives shall be governed by the 

ethics rules and requirements of the House. Members of the Senate 

who serve on the joint committee shall comply with the ethics 

rules of the Senate. 

(d) TERMINATION.—The joint committee shall terminate on 

December 31, 2018 or 30 days after submission of its report and 

legislative recommendations pursuant to this section whichever 

occurs first. 

SEC. 30443. FUNDING. 

(a) SPECIAL RESERVE.—To enable the joint committee to exercise 

its powers, functions, and duties under this subtitle, within the 

funds in the account for ‘‘Expenses of Inquiries and Investigations’’ 

of the Senate, not more than $500,000 shall be allocated from 

the special reserve established in S. Res. 62, agreed to February 

28, 2017 (115th Congress), for use by the joint committee. 

(b) EXPIRATION.—None of the funds made available by this 

section may be available for obligation by the joint committee after 

January 2, 2019. 

(c) AVAILABILITY REQUIREMENTS.—For purposes of the joint 

committee, section 20(b) of S. Res. 62, agreed to February 28, 

2017 (115th Congress), shall not apply. 

SEC. 30444. CONSIDERATION OF JOINT COMMITTEE BILL IN THE 

SENATE. 

(a) INTRODUCTION.—Upon receipt of proposed legislative language approved in accordance with section 30442(b)(2)(B)(ii), the 

language shall be introduced in the Senate (by request) on the 

next day on which the Senate is in session by the Majority Leader 

of the Senate or by a Member of the Senate designated by the 

Majority Leader of the Senate. 

(b) COMMITTEE CONSIDERATION.—A joint committee bill introduced in the Senate under subsection (a) shall be referred to the 

Committee on the Budget, which shall report the bill without any 

revision and with a favorable recommendation, an unfavorable recommendation, or without recommendation, no later than 7 session 

days after introduction of the bill. If the Committee on the Budget 

fails to report the bill within that period, the committee shall 

be automatically discharged from consideration of the bill, and 

the bill shall be placed on the appropriate calendar. 

(c) MOTION TO PROCEED TO CONSIDERATION.— 

(1) IN GENERAL.—Notwithstanding rule XXII of the 

Standing Rules of the Senate, it is in order, not later than 

2 days of session after the date on which a joint committee 

Deadline. 

Deadline. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 143 

bill is reported or discharged from the Committee on the 

Budget, for the Majority Leader of the Senate or the Majority 

Leader’s designee to move to proceed to the consideration of 

the joint committee bill. It shall also be in order for any Member 

of the Senate to move to proceed to the consideration of the 

joint committee bill at any time after the conclusion of such 

2-day period. 

(2) CONSIDERATION OF MOTION.—Consideration of the 

motion to proceed to the consideration of the joint committee 

bill and all debatable motions and appeals in connection therewith shall not exceed 10 hours, which shall be divided equally 

between the Majority and Minority Leaders or their designees. 

A motion to further limit debate is in order, shall require 

an affirmative vote of three-fifths of Members duly chosen 

and sworn, and is not debatable. 

(3) VOTE THRESHOLD.—The motion to proceed to the consideration of the joint committee bill shall only be agreed to 

upon an affirmative vote of three-fifths of Members duly chosen 

and sworn. 

(4) LIMITATIONS.—The motion is not subject to a motion 

to postpone. All points of order against the motion to proceed 

to the joint committee bill are waived. A motion to reconsider 

the vote by which the motion is agreed to or disagreed to 

shall not be in order. 

(5) DEADLINE.—Not later than the last day of the 115th 

Congress, the Senate shall vote on a motion to proceed to 

the joint committee bill. 

(d) RULES OF SENATE.—This section is enacted by Congress— 

(1) as an exercise of the rulemaking power of the Senate, 

and as such is deemed a part of the rules of the Senate, 

but applicable only with respect to the procedure to be followed 

in the Senate in the case of a joint committee bill, and supersede 

other rules only to the extent that they are inconsistent with 

such rules; and 

(2) with full recognition of the constitutional right of the 

Senate to change the rules (so far as relating to the procedure 

of the Senate) at any time, in the same manner, and to the 

same extent as in the case of any other rule of the Senate. 

DIVISION D—REVENUE MEASURES 

SECTION 40001. TABLE OF CONTENTS. 

The table of contents for this division is as follows: 

DIVISION D—REVENUE MEASURES 

Sec. 40001. Table of contents. 

TITLE I—EXTENSION OF EXPIRING PROVISIONS 

Sec. 40101. Amendment of Internal Revenue Code of 1986. 

Subtitle A—Tax Relief for Families and Individuals 

Sec. 40201. Extension of exclusion from gross income of discharge of qualified principal residence indebtedness. 

Sec. 40202. Extension of mortgage insurance premiums treated as qualified residence interest. 

Sec. 40203. Extension of above-the-line deduction for qualified tuition and related 

expenses. 

Waiver. 

Time period. 


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132 STAT. 144 PUBLIC LAW 115–123—FEB. 9, 2018 

Subtitle B—Incentives for Growth, Jobs, Investment, and Innovation 

Sec. 40301. Extension of Indian employment tax credit. 

Sec. 40302. Extension of railroad track maintenance credit. 

Sec. 40303. Extension of mine rescue team training credit. 

Sec. 40304. Extension of classification of certain race horses as 3-year property. 

Sec. 40305. Extension of 7-year recovery period for motorsports entertainment complexes. 

Sec. 40306. Extension of accelerated depreciation for business property on an Indian reservation. 

Sec. 40307. Extension of election to expense mine safety equipment. 

Sec. 40308. Extension of special expensing rules for certain productions. 

Sec. 40309. Extension of deduction allowable with respect to income attributable to 

domestic production activities in Puerto Rico. 

Sec. 40310. Extension of special rule relating to qualified timber gain. 

Sec. 40311. Extension of empowerment zone tax incentives. 

Sec. 40312. Extension of American Samoa economic development credit. 

Subtitle C—Incentives for Energy Production and Conservation 

Sec. 40401. Extension of credit for nonbusiness energy property. 

Sec. 40402. Extension and modification of credit for residential energy property. 

Sec. 40403. Extension of credit for new qualified fuel cell motor vehicles. 

Sec. 40404. Extension of credit for alternative fuel vehicle refueling property. 

Sec. 40405. Extension of credit for 2-wheeled plug-in electric vehicles. 

Sec. 40406. Extension of second generation biofuel producer credit. 

Sec. 40407. Extension of biodiesel and renewable diesel incentives. 

Sec. 40408. Extension of production credit for Indian coal facilities. 

Sec. 40409. Extension of credits with respect to facilities producing energy from 

certain renewable resources. 

Sec. 40410. Extension of credit for energy-efficient new homes. 

Sec. 40411. Extension and phaseout of energy credit. 

Sec. 40412. Extension of special allowance for second generation biofuel plant property. 

Sec. 40413. Extension of energy efficient commercial buildings deduction. 

Sec. 40414. Extension of special rule for sales or dispositions to implement FERC 

or State electric restructuring policy for qualified electric utilities. 

Sec. 40415. Extension of excise tax credits relating to alternative fuels. 

Sec. 40416. Extension of Oil Spill Liability Trust Fund financing rate. 

Subtitle D—Modifications of Energy Incentives 

Sec. 40501. Modifications of credit for production from advanced nuclear power facilities. 

TITLE II—MISCELLANEOUS PROVISIONS 

Sec. 41101. Amendment of Internal Revenue Code of 1986. 

Sec. 41102. Modifications to rum cover over. 

Sec. 41103. Extension of waiver of limitations with respect to excluding from gross 

income amounts received by wrongfully incarcerated individuals. 

Sec. 41104. Individuals held harmless on improper levy on retirement plans. 

Sec. 41105. Modification of user fee requirements for installment agreements. 

Sec. 41106. Form 1040SR for seniors. 

Sec. 41107. Attorneys fees relating to awards to whistleblowers. 

Sec. 41108. Clarification of whistleblower awards. 

Sec. 41109. Clarification regarding excise tax based on investment income of private colleges and universities. 

Sec. 41110. Exception from private foundation excess business holding tax for independently-operated philanthropic business holdings. 

Sec. 41111. Rule of construction for Craft Beverage Modernization and Tax Reform. 

Sec. 41112. Simplification of rules regarding records, statements, and returns. 

Sec. 41113. Modification of rules governing hardship distributions. 

Sec. 41114. Modification of rules relating to hardship withdrawals from cash or deferred arrangements. 

Sec. 41115. Opportunity Zones rule for Puerto Rico. 

Sec. 41116. Tax home of certain citizens or residents of the United States living 

abroad. 

Sec. 41117. Treatment of foreign persons for returns relating to payments made in 

settlement of payment card and third party network transactions. 

Sec. 41118. Repeal of shift in time of payment of corporate estimated taxes. 

Sec. 41119. Enhancement of carbon dioxide sequestration credit. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 145 

TITLE I—EXTENSION OF EXPIRING 

PROVISIONS 

SEC. 40101. AMENDMENT OF INTERNAL REVENUE CODE OF 1986. 

Except as otherwise expressly provided, whenever in this title 

an amendment or repeal is expressed in terms of an amendment 

to, or repeal of, a section or other provision, the reference shall 

be considered to be made to a section or other provision of the 

Internal Revenue Code of 1986. 

Subtitle A—Tax Relief for Families and 

Individuals 

SEC. 40201. EXTENSION OF EXCLUSION FROM GROSS INCOME OF DISCHARGE OF QUALIFIED PRINCIPAL RESIDENCE INDEBTEDNESS. 

(a) IN GENERAL.—Section 108(a)(1)(E) is amended by striking 

‘‘January 1, 2017’’ each place it appears and inserting ‘‘January 

1, 2018’’. 

(b) EFFECTIVE DATE.—The amendments made by this section 

shall apply to discharges of indebtedness after December 31, 2016. 

SEC. 40202. EXTENSION OF MORTGAGE INSURANCE PREMIUMS 

TREATED AS QUALIFIED RESIDENCE INTEREST. 

(a) IN GENERAL.—Subclause (I) of section 163(h)(3)(E)(iv) is 

amended by striking ‘‘December 31, 2016’’ and inserting ‘‘December 

31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to amounts paid or accrued after December 31, 2016. 

SEC. 40203. EXTENSION OF ABOVE-THE-LINE DEDUCTION FOR QUALIFIED TUITION AND RELATED EXPENSES. 

(a) IN GENERAL.—Section 222(e) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to taxable years beginning after December 31, 2016. 

Subtitle B—Incentives for Growth, Jobs, 

Investment, and Innovation 

SEC. 40301. EXTENSION OF INDIAN EMPLOYMENT TAX CREDIT. 

(a) IN GENERAL.—Section 45A(f) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to taxable years beginning after December 31, 2016. 

SEC. 40302. EXTENSION OF RAILROAD TRACK MAINTENANCE CREDIT. 

(a) IN GENERAL.—Section 45G(f) is amended by striking 

‘‘January 1, 2017’’ and inserting ‘‘January 1, 2018’’. 

(b) EFFECTIVE DATE.— 

(1) IN GENERAL.—The amendment made by this section 

shall apply to expenditures paid or incurred in taxable years 

beginning after December 31, 2016. 

26 USC 45G 

note. 

26 USC 45A note. 

26 USC 222 note. 

26 USC 163 note. 

26 USC 108 note. 

26 USC 108. 

Applicability. 


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132 STAT. 146 PUBLIC LAW 115–123—FEB. 9, 2018 

(2) SAFE HARBOR ASSIGNMENTS.—Assignments, including 

related expenditures paid or incurred, under paragraph (2) 

of section 45G(b) of the Internal Revenue Code of 1986 for 

taxable years ending after January 1, 2017, and before January 

1, 2018, shall be treated as effective as of the close of such 

taxable year if made pursuant to a written agreement entered 

into no later than 90 days following the date of the enactment 

of this Act. 

SEC. 40303. EXTENSION OF MINE RESCUE TEAM TRAINING CREDIT. 

(a) IN GENERAL.—Section 45N(e) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to taxable years beginning after December 31, 2016. 

SEC. 40304. EXTENSION OF CLASSIFICATION OF CERTAIN RACE 

HORSES AS 3-YEAR PROPERTY. 

(a) IN GENERAL.—Section 168(e)(3)(A)(i) is amended— 

(1) by striking ‘‘January 1, 2017’’ in subclause (I) and 

inserting ‘‘January 1, 2018’’, and 

(2) by striking ‘‘December 31, 2016’’ in subclause (II) and 

inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendments made by this section 

shall apply to property placed in service after December 31, 2016. 

SEC. 40305. EXTENSION OF 7-YEAR RECOVERY PERIOD FOR MOTORSPORTS ENTERTAINMENT COMPLEXES. 

(a) IN GENERAL.—Section 168(i)(15)(D) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property placed in service after December 31, 2016. 

SEC. 40306. EXTENSION OF ACCELERATED DEPRECIATION FOR BUSINESS PROPERTY ON AN INDIAN RESERVATION. 

(a) IN GENERAL.—Section 168(j)(9) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property placed in service after December 31, 2016. 

SEC. 40307. EXTENSION OF ELECTION TO EXPENSE MINE SAFETY 

EQUIPMENT. 

(a) IN GENERAL.—Section 179E(g) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property placed in service after December 31, 2016. 

SEC. 40308. EXTENSION OF SPECIAL EXPENSING RULES FOR CERTAIN 

PRODUCTIONS. 

(a) IN GENERAL.—Section 181(g) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to productions commencing after December 31, 2016. 

SEC. 40309. EXTENSION OF DEDUCTION ALLOWABLE WITH RESPECT 

TO INCOME ATTRIBUTABLE TO DOMESTIC PRODUCTION 

ACTIVITIES IN PUERTO RICO. 

For purposes of applying section 199(d)(8)(C) of the Internal 

Revenue Code of 1986 with respect to taxable years beginning 

during 2017, such section shall be applied— 

26 USC 199 note. 

26 USC 181 note. 

26 USC 179E 

note. 

26 USC 168 note. 

26 USC 168 note. 

26 USC 168 note. 

26 USC 45N 

note. 

26 USC 45N. 

Time period. 

Deadline. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 147 

(1) by substituting ‘‘first 12 taxable years’’ for ‘‘first 11 

taxable years’’, and 

(2) by substituting ‘‘January 1, 2018’’ for ‘‘January 1, 2017’’. 

SEC. 40310. EXTENSION OF SPECIAL RULE RELATING TO QUALIFIED 

TIMBER GAIN. 

For purposes of applying section 1201(b) of the Internal Revenue Code of 1986 with respect to taxable years beginning during 

2017, such section shall be applied by substituting ‘‘2016 or 2017’’ 

for ‘‘2016’’. 

SEC. 40311. EXTENSION OF EMPOWERMENT ZONE TAX INCENTIVES. 

(a) IN GENERAL.— 

(1) EXTENSION.—Section 1391(d)(1)(A)(i) is amended by 

striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

2017’’. 

(2) TREATMENT OF CERTAIN TERMINATION DATES SPECIFIED

IN NOMINATIONS.—In the case of a designation of an empowerment zone the nomination for which included a termination 

date which is contemporaneous with the date specified in 

subparagraph (A)(i) of section 1391(d)(1) of the Internal Revenue Code of 1986 (as in effect before the enactment of this 

Act), subparagraph (B) of such section shall not apply with 

respect to such designation if, after the date of the enactment 

of this section, the entity which made such nomination amends 

the nomination to provide for a new termination date in such 

manner as the Secretary of the Treasury (or the Secretary’s 

designee) may provide. 

(b) EFFECTIVE DATE.—The amendment made by subsection 

(a)(1) shall apply to taxable years beginning after December 31, 

2016. 

SEC. 40312. EXTENSION OF AMERICAN SAMOA ECONOMIC DEVELOPMENT CREDIT. 

(a) IN GENERAL.—Section 119 of division A of the Tax Relief 

and Health Care Act of 2006 is amended— 

(1) in subsection (d)— 

(A) by striking ‘‘January 1, 2017’’ each place it appears 

and inserting ‘‘January 1, 2018’’, 

(B) by striking ‘‘first 11 taxable years’’ in paragraph 

(1) and inserting ‘‘first 12 taxable years’’, and 

(C) by striking ‘‘first 5 taxable years’’ in paragraph 

(2) and inserting ‘‘first 6 taxable years’’, and 

(2) in subsection (e), by adding at the end the following: 

‘‘References in this subsection to section 199 of the Internal 

Revenue Code of 1986 shall be treated as references to such 

section as in effect before its repeal.’’. 

(b) EFFECTIVE DATE.—The amendments made by this section 

shall apply to taxable years beginning after December 31, 2016. 

26 USC 30A note. 

26 USC 30A note. 

26 USC 1391 

note. 

26 USC 1391 

note. 

26 USC 1391. 

26 USC 1201 

note. 


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132 STAT. 148 PUBLIC LAW 115–123—FEB. 9, 2018 

Subtitle C—Incentives for Energy 

Production and Conservation 

SEC. 40401. EXTENSION OF CREDIT FOR NONBUSINESS ENERGY PROPERTY. 

(a) IN GENERAL.—Section 25C(g)(2) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property placed in service after December 31, 2016. 

SEC. 40402. EXTENSION AND MODIFICATION OF CREDIT FOR RESIDENTIAL ENERGY PROPERTY. 

(a) IN GENERAL.—Section 25D(h) is amended by striking 

‘‘December 31, 2016’’ and all that follows and inserting ‘‘December 

31, 2021.’’. 

(b) PHASEOUT.— 

(1) IN GENERAL.—Section 25D(a) is amended by striking 

‘‘the sum of—’’ and all that follows and inserting ‘‘the sum 

of the applicable percentages of— 

‘‘(1) the qualified solar electric property expenditures, 

‘‘(2) the qualified solar water heating property expenditures, 

‘‘(3) the qualified fuel cell property expenditures, 

‘‘(4) the qualified small wind energy property expenditures, 

and 

‘‘(5) the qualified geothermal heat pump property expenditures, 

made by the taxpayer during such year.’’. 

(2) CONFORMING AMENDMENT.—Section 25D(g) is amended 

by striking ‘‘paragraphs (1) and (2) of’’. 

(c) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property placed in service after December 31, 2016. 

SEC. 40403. EXTENSION OF CREDIT FOR NEW QUALIFIED FUEL CELL 

MOTOR VEHICLES. 

(a) IN GENERAL.—Section 30B(k)(1) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property purchased after December 31, 2016. 

SEC. 40404. EXTENSION OF CREDIT FOR ALTERNATIVE FUEL VEHICLE 

REFUELING PROPERTY. 

(a) IN GENERAL.—Section 30C(g) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property placed in service after December 31, 2016. 

SEC. 40405. EXTENSION OF CREDIT FOR 2-WHEELED PLUG-IN ELECTRIC VEHICLES. 

(a) IN GENERAL.—Section 30D(g)(3)(E)(ii) is amended by 

striking ‘‘January 1, 2017’’ and inserting ‘‘January 1, 2018’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to vehicles acquired after December 31, 2016. 

26 USC 30D 

note. 

26 USC 30C note. 

26 USC 30B note. 

26 USC 25D 

note. 

26 USC 25C note. 

26 USC 25C. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 149 

SEC. 40406. EXTENSION OF SECOND GENERATION BIOFUEL PRODUCER 

CREDIT. 

(a) IN GENERAL.—Section 40(b)(6)(J)(i) is amended by striking 

‘‘January 1, 2017’’ and inserting ‘‘January 1, 2018’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to qualified second generation biofuel production after 

December 31, 2016. 

SEC. 40407. EXTENSION OF BIODIESEL AND RENEWABLE DIESEL 

INCENTIVES. 

(a) INCOME TAX CREDIT.— 

(1) IN GENERAL.—Subsection (g) of section 40A is amended 

by striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

2017’’. 

(2) EFFECTIVE DATE.—The amendment made by this subsection shall apply to fuel sold or used after December 31, 

2016. 

(b) EXCISE TAX INCENTIVES.— 

(1) IN GENERAL.—Section 6426(c)(6) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(2) PAYMENTS.—Section 6427(e)(6)(B) is amended by 

striking ‘‘December 31, 2016’’ and inserting ‘‘December 31, 

2017’’. 

(3) EFFECTIVE DATE.—The amendments made by this subsection shall apply to fuel sold or used after December 31, 

2016. 

(4) SPECIAL RULE FOR 2017.—Notwithstanding any other 

provision of law, in the case of any biodiesel mixture credit 

properly determined under section 6426(c) of the Internal Revenue Code of 1986 for the period beginning on January 1, 

2017, and ending on December 31, 2017, such credit shall 

be allowed, and any refund or payment attributable to such 

credit (including any payment under section 6427(e) of such 

Code) shall be made, only in such manner as the Secretary 

of the Treasury (or the Secretary’s delegate) shall provide. 

Such Secretary shall issue guidance within 30 days after the 

date of the enactment of this Act providing for a one-time 

submission of claims covering periods described in the preceding 

sentence. Such guidance shall provide for a 180-day period 

for the submission of such claims (in such manner as prescribed 

by such Secretary) to begin not later than 30 days after such 

guidance is issued. Such claims shall be paid by such Secretary 

not later than 60 days after receipt. If such Secretary has 

not paid pursuant to a claim filed under this subsection within 

60 days after the date of the filing of such claim, the claim 

shall be paid with interest from such date determined by using 

the overpayment rate and method under section 6621 of such 

Code. 

SEC. 40408. EXTENSION OF PRODUCTION CREDIT FOR INDIAN COAL 

FACILITIES. 

(a) IN GENERAL.—Section 45(e)(10)(A) is amended by striking 

‘‘11-year period’’ each place it appears and inserting ‘‘12-year 

period’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to coal produced after December 31, 2016. 

26 USC 45 note. 

Guidance. 

Claims. 

Time periods. 

Deadlines. 

26 USC 6426 

note. 

26 USC 6426 

note. 

26 USC 40A note. 

26 USC 40 note. 

26 USC 40. 


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132 STAT. 150 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 40409. EXTENSION OF CREDITS WITH RESPECT TO FACILITIES 

PRODUCING ENERGY FROM CERTAIN RENEWABLE 

RESOURCES. 

(a) IN GENERAL.—The following provisions of section 45(d) are 

each amended by striking ‘‘January 1, 2017’’ each place it appears 

and inserting ‘‘January 1, 2018’’: 

(1) Paragraph (2)(A). 

(2) Paragraph (3)(A). 

(3) Paragraph (4)(B). 

(4) Paragraph (6). 

(5) Paragraph (7). 

(6) Paragraph (9). 

(7) Paragraph (11)(B). 

(b) EXTENSION OF ELECTION TO TREAT QUALIFIED FACILITIES

AS ENERGY PROPERTY.—Section 48(a)(5)(C)(ii) is amended by 

striking ‘‘January 1, 2017’’ and inserting ‘‘January 1, 2018’’. 

(c) EFFECTIVE DATE.—The amendments made by this section 

shall take effect on January 1, 2017. 

SEC. 40410. EXTENSION OF CREDIT FOR ENERGY-EFFICIENT NEW 

HOMES. 

(a) IN GENERAL.—Section 45L(g) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to homes acquired after December 31, 2016. 

SEC. 40411. EXTENSION AND PHASEOUT OF ENERGY CREDIT. 

(a) EXTENSION OF SOLAR AND THERMAL ENERGY PROPERTY.— 

Section 48(a)(3)(A) is amended— 

(1) by striking ‘‘periods ending before January 1, 2017’’ 

in clause (ii) and inserting ‘‘property the construction of which 

begins before January 1, 2022’’, and 

(2) by striking ‘‘periods ending before January 1, 2017’’ 

in clause (vii) and inserting ‘‘property the construction of which 

begins before January 1, 2022’’. 

(b) PHASEOUT OF 30-PERCENT CREDIT RATE FOR FIBER-OPTIC

SOLAR, QUALIFIED FUEL CELL, AND QUALIFIED SMALL WIND ENERGY

PROPERTY.— 

(1) IN GENERAL.—Section 48(a) is amended by adding at 

the end the following new paragraph: 

‘‘(7) PHASEOUT FOR FIBER-OPTIC SOLAR, QUALIFIED FUEL

CELL, AND QUALIFIED SMALL WIND ENERGY PROPERTY.— 

‘‘(A) IN GENERAL.—Subject to subparagraph (B), in the 

case of any qualified fuel cell property, qualified small 

wind property, or energy property described in paragraph 

(3)(A)(ii), the energy percentage determined under paragraph (2) shall be equal to— 

‘‘(i) in the case of any property the construction 

of which begins after December 31, 2019, and before 

January 1, 2021, 26 percent, and 

‘‘(ii) in the case of any property the construction 

of which begins after December 31, 2020, and before 

January 1, 2022, 22 percent. 

‘‘(B) PLACED IN SERVICE DEADLINE.—In the case of any 

energy property described in subparagraph (A) which is 

not placed in service before January 1, 2024, the energy 

Time periods. 

26 USC 45L note. 

26 USC 45 note. 

26 USC 45. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 151 

percentage determined under paragraph (2) shall be equal 

to 0 percent.’’. 

(2) CONFORMING AMENDMENT.—Section 48(a)(2)(A) is 

amended by striking ‘‘paragraph (6)’’ and inserting ‘‘paragraphs 

(6) and (7)’’. 

(3) CLARIFICATION RELATING TO PHASEOUT FOR WIND FACILITIES.—Section 48(a)(5)(E) is amended by inserting ‘‘which is 

treated as energy property by reason of this paragraph’’ after 

‘‘using wind to produce electricity’’. 

(c) EXTENSION OF QUALIFIED FUEL CELL PROPERTY.—Section 

48(c)(1)(D) is amended by striking ‘‘for any period after December 

31, 2016’’ and inserting ‘‘the construction of which does not begin 

before January 1, 2022’’. 

(d) EXTENSION OF QUALIFIED MICROTURBINE PROPERTY.—Section 48(c)(2)(D) is amended by striking ‘‘for any period after 

December 31, 2016’’ and inserting ‘‘the construction of which does 

not begin before January 1, 2022’’. 

(e) EXTENSION OF COMBINED HEAT AND POWER SYSTEM PROPERTY.—Section 48(c)(3)(A)(iv) is amended by striking ‘‘which is 

placed in service before January 1, 2017’’ and inserting ‘‘the 

construction of which begins before January 1, 2022’’. 

(f) EXTENSION OF QUALIFIED SMALL WIND ENERGY PROPERTY.— 

Section 48(c)(4)(C) is amended by striking ‘‘for any period after 

December 31, 2016’’ and inserting ‘‘the construction of which does 

not begin before January 1, 2022’’. 

(g) EFFECTIVE DATE.— 

(1) IN GENERAL.—Except as otherwise provided in this subsection, the amendments made by this section shall apply to 

periods after December 31, 2016, under rules similar to the 

rules of section 48(m) of the Internal Revenue Code of 1986 

(as in effect on the day before the date of the enactment 

of the Revenue Reconciliation Act of 1990). 

(2) EXTENSION OF COMBINED HEAT AND POWER SYSTEM PROPERTY.—The amendment made by subsection (e) shall apply 

to property placed in service after December 31, 2016. 

(3) PHASEOUTS AND TERMINATIONS.—The amendments 

made by subsection (b) shall take effect on the date of the 

enactment of this Act. 

SEC. 40412. EXTENSION OF SPECIAL ALLOWANCE FOR SECOND 

GENERATION BIOFUEL PLANT PROPERTY. 

(a) IN GENERAL.—Section 168(l)(2)(D) is amended by striking 

‘‘January 1, 2017’’ and inserting ‘‘January 1, 2018’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property placed in service after December 31, 2016. 

SEC. 40413. EXTENSION OF ENERGY EFFICIENT COMMERCIAL 

BUILDINGS DEDUCTION. 

(a) IN GENERAL.—Section 179D(h) is amended by striking 

‘‘December 31, 2016’’ and inserting ‘‘December 31, 2017’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to property placed in service after December 31, 2016. 

26 USC 179D 

note. 

26 USC 168 note. 

26 USC 48 note. 

26 USC 48. 


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132 STAT. 152 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 40414. EXTENSION OF SPECIAL RULE FOR SALES OR DISPOSITIONS TO IMPLEMENT FERC OR STATE ELECTRIC 

RESTRUCTURING POLICY FOR QUALIFIED ELECTRIC 

UTILITIES. 

(a) IN GENERAL.—Section 451(k)(3), as amended by section 

13221 of Public Law 115–97, is amended by striking ‘‘January 

1, 2017’’ and inserting ‘‘January 1, 2018’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to dispositions after December 31, 2016. 

SEC. 40415. EXTENSION OF EXCISE TAX CREDITS RELATING TO ALTERNATIVE FUELS. 

(a) EXTENSION OF ALTERNATIVE FUELS EXCISE TAX CREDITS.— 

(1) IN GENERAL.—Sections 6426(d)(5) and 6426(e)(3) are 

each amended by striking ‘‘December 31, 2016’’ and inserting 

‘‘December 31, 2017’’. 

(2) OUTLAY PAYMENTS FOR ALTERNATIVE FUELS.—Section 

6427(e)(6)(C) is amended by striking ‘‘December 31, 2016’’ and 

inserting ‘‘December 31, 2017’’. 

(3) EFFECTIVE DATE.—The amendments made by this subsection shall apply to fuel sold or used after December 31, 

2016. 

(b) SPECIAL RULE FOR 2017.—Notwithstanding any other provision of law, in the case of any alternative fuel credit properly 

determined under section 6426(d) of the Internal Revenue Code 

of 1986 for the period beginning on January 1, 2017, and ending 

on December 31, 2017, such credit shall be allowed, and any refund 

or payment attributable to such credit (including any payment 

under section 6427(e) of such Code) shall be made, only in such 

manner as the Secretary of the Treasury (or the Secretary’s delegate) shall provide. Such Secretary shall issue guidance within 

30 days after the date of the enactment of this Act providing 

for a one-time submission of claims covering periods described in 

the preceding sentence. Such guidance shall provide for a 180- 

day period for the submission of such claims (in such manner 

as prescribed by such Secretary) to begin not later than 30 days 

after such guidance is issued. Such claims shall be paid by such 

Secretary not later than 60 days after receipt. If such Secretary 

has not paid pursuant to a claim filed under this subsection within 

60 days after the date of the filing of such claim, the claim shall 

be paid with interest from such date determined by using the 

overpayment rate and method under section 6621 of such Code. 

SEC. 40416. EXTENSION OF OIL SPILL LIABILITY TRUST FUND 

FINANCING RATE. 

(a) IN GENERAL.—Section 4611(f)(2) is amended by striking 

‘‘December 31, 2017’’ and inserting ‘‘December 31, 2018’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply on and after the first day of the first calendar month 

beginning after the date of the enactment of this Act. 

26 USC 4611 

note. 

Guidance. 

Claims. 

Time periods. 

Deadlines. 

26 USC 6426 

note. 

26 USC 6426 

note. 

26 USC 451 note. 

26 USC 451. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 153 

Subtitle D—Modifications of Energy 

Incentives 

SEC. 40501. MODIFICATIONS OF CREDIT FOR PRODUCTION FROM 

ADVANCED NUCLEAR POWER FACILITIES. 

(a) TREATMENT OF UNUTILIZED LIMITATION AMOUNTS.—Section 

45J(b) is amended— 

(1) by inserting ‘‘or any amendment to’’ after ‘‘enactment 

of’’ in paragraph (4), and 

(2) by adding at the end the following new paragraph: 

‘‘(5) ALLOCATION OF UNUTILIZED LIMITATION.— ‘‘(A) IN GENERAL.—Any unutilized national megawatt 

capacity limitation shall be allocated by the Secretary 

under paragraph (3) as rapidly as is practicable after 

December 31, 2020— 

‘‘(i) first to facilities placed in service on or before 

such date to the extent that such facilities did not 

receive an allocation equal to their full nameplate 

capacity, and 

‘‘(ii) then to facilities placed in service after such 

date in the order in which such facilities are placed 

in service. 

‘‘(B) UNUTILIZED NATIONAL MEGAWATT CAPACITY LIMITA- TION.—The term ‘unutilized national megawatt capacity 

limitation’ means the excess (if any) of— 

‘‘(i) 6,000 megawatts, over 

‘‘(ii) the aggregate amount of national megawatt 

capacity limitation allocated by the Secretary before 

January 1, 2021, reduced by any amount of such limitation which was allocated to a facility which was not 

placed in service before such date. 

‘‘(C) COORDINATION WITH OTHER PROVISIONS.—In the 

case of any unutilized national megawatt capacity limitation allocated by the Secretary pursuant to this paragraph— 

‘‘(i) such allocation shall be treated for purposes 

of this section in the same manner as an allocation 

of national megawatt capacity limitation, and 

‘‘(ii) subsection (d)(1)(B) shall not apply to any 

facility which receives such allocation.’’. 

(b) TRANSFER OF CREDIT BY CERTAIN PUBLIC ENTITIES.— (1) IN GENERAL.—Section 45J is amended— 

(A) by redesignating subsection (e) as subsection (f), 

and 

(B) by inserting after subsection (d) the following new 

subsection: 

‘‘(e) TRANSFER OF CREDIT BY CERTAIN PUBLIC ENTITIES.— ‘‘(1) IN GENERAL.—If, with respect to a credit under subsection (a) for any taxable year— 

‘‘(A) a qualified public entity would be the taxpayer 

(but for this paragraph), and 

‘‘(B) such entity elects the application of this paragraph 

for such taxable year with respect to all (or any portion 

specified in such election) of such credit, 

the eligible project partner specified in such election, and not 

the qualified public entity, shall be treated as the taxpayer 

Definition. 

26 USC 45J. 


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132 STAT. 154 PUBLIC LAW 115–123—FEB. 9, 2018 

for purposes of this title with respect to such credit (or such 

portion thereof). 

‘‘(2) DEFINITIONS.—For purposes of this subsection— 

‘‘(A) QUALIFIED PUBLIC ENTITY.—The term ‘qualified 

public entity’ means— 

‘‘(i) a Federal, State, or local government entity, 

or any political subdivision, agency, or instrumentality 

thereof, 

‘‘(ii) a mutual or cooperative electric company 

described in section 501(c)(12) or 1381(a)(2), or 

‘‘(iii) a not-for-profit electric utility which had or 

has received a loan or loan guarantee under the Rural 

Electrification Act of 1936. 

‘‘(B) ELIGIBLE PROJECT PARTNER.—The term ‘eligible 

project partner’ means any person who— 

‘‘(i) is responsible for, or participates in, the design 

or construction of the advanced nuclear power facility 

to which the credit under subsection (a) relates, 

‘‘(ii) participates in the provision of the nuclear 

steam supply system to such facility, 

‘‘(iii) participates in the provision of nuclear fuel 

to such facility, 

‘‘(iv) is a financial institution providing financing 

for the construction or operation of such facility, or 

‘‘(v) has an ownership interest in such facility. 

‘‘(3) SPECIAL RULES.— 

‘‘(A) APPLICATION TO PARTNERSHIPS.—In the case of 

a credit under subsection (a) which is determined at the 

partnership level— 

‘‘(i) for purposes of paragraph (1)(A), a qualified 

public entity shall be treated as the taxpayer with 

respect to such entity’s distributive share of such 

credit, and 

‘‘(ii) the term ‘eligible project partner’ shall include 

any partner of the partnership. 

‘‘(B) TAXABLE YEAR IN WHICH CREDIT TAKEN INTO

ACCOUNT.—In the case of any credit (or portion thereof) 

with respect to which an election is made under paragraph 

(1), such credit shall be taken into account in the first 

taxable year of the eligible project partner ending with, 

or after, the qualified public entity’s taxable year with 

respect to which the credit was determined. 

‘‘(C) TREATMENT OF TRANSFER UNDER PRIVATE USE

RULES.—For purposes of section 141(b)(1), any benefit 

derived by an eligible project partner in connection with 

an election under this subsection shall not be taken into 

account as a private business use.’’. 

(2) SPECIAL RULE FOR PROCEEDS OF TRANSFERS FOR MUTUAL

OR COOPERATIVE ELECTRIC COMPANIES.—Section 501(c)(12) is 

amended by adding at the end the following new subparagraph: 

‘‘(I) In the case of a mutual or cooperative electric 

company described in this paragraph or an organization 

described in section 1381(a)(2), income received or accrued 

in connection with an election under section 45J(e)(1) shall 

be treated as an amount collected from members for the 

sole purpose of meeting losses and expenses.’’. 

26 USC 45J note. (c) EFFECTIVE DATES.— 

26 USC 501. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 155 

(1) TREATMENT OF UNUTILIZED LIMITATION AMOUNTS.—The 

amendment made by subsection (a) shall take effect on the 

date of the enactment of this Act. 

(2) TRANSFER OF CREDIT BY CERTAIN PUBLIC ENTITIES.— The amendments made by subsection (b) shall apply to taxable 

years beginning after the date of the enactment of this Act. 

TITLE II—MISCELLANEOUS 

PROVISIONS 

SEC. 41101. AMENDMENT OF INTERNAL REVENUE CODE OF 1986. 

Except as otherwise expressly provided, whenever in this title 

an amendment or repeal is expressed in terms of an amendment 

to, or repeal of, a section or other provision, the reference shall 

be considered to be made to a section or other provision of the 

Internal Revenue Code of 1986. 

SEC. 41102. MODIFICATIONS TO RUM COVER OVER. 

(a) EXTENSION.— 

(1) IN GENERAL.—Section 7652(f)(1) is amended by striking 

‘‘January 1, 2017’’ and inserting ‘‘January 1, 2022’’. 

(2) EFFECTIVE DATE.—The amendment made by this subsection shall apply to distilled spirits brought into the United 

States after December 31, 2016. 

(b) DETERMINATION OF TAXES ON RUM.— 

(1) IN GENERAL.—Section 7652(e) is amended by adding 

at the end the following new paragraph: 

‘‘(5) DETERMINATION OF AMOUNT OF TAXES COLLECTED.— 

For purposes of this subsection, the amount of taxes collected 

under section 5001(a)(1) shall be determined without regard 

to section 5001(c).’’. 

(2) EFFECTIVE DATE.—The amendment made by this subsection shall apply to distilled spirits brought into the United 

States after December 31, 2017. 

SEC. 41103. EXTENSION OF WAIVER OF LIMITATIONS WITH RESPECT 

TO EXCLUDING FROM GROSS INCOME AMOUNTS 

RECEIVED BY WRONGFULLY INCARCERATED INDIVIDUALS. 

(a) IN GENERAL.—Section 304(d) of the Protecting Americans 

from Tax Hikes Act of 2015 (26 U.S.C. 139F note) is amended 

by striking ‘‘1-year’’ and inserting ‘‘3-year’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall take effect on the date of the enactment of this Act. 

SEC. 41104. INDIVIDUALS HELD HARMLESS ON IMPROPER LEVY ON 

RETIREMENT PLANS. 

(a) IN GENERAL.—Section 6343 is amended by adding at the 

end the following new subsection: 

‘‘(f) INDIVIDUALS HELD HARMLESS ON WRONGFUL LEVY, ETC. ON RETIREMENT PLAN.— 

‘‘(1) IN GENERAL.—If the Secretary determines that an 

individual’s account or benefit under an eligible retirement 

plan (as defined in section 402(c)(8)(B)) has been levied upon 

in a case to which subsection (b) or (d)(2)(A) applies and property or an amount of money is returned to the individual— 

Determination. 

26 USC 139F 

note. 

26 USC 7652 

note. 

26 USC 7652 

note. 

26 USC 7652. 

Applicability. 


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132 STAT. 156 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(A) the individual may contribute such property or 

an amount equal to the sum of— 

‘‘(i) the amount of money so returned by the Secretary, and 

‘‘(ii) interest paid under subsection (c) on such 

amount of money, 

into such eligible retirement plan if such contribution is 

permitted by the plan, or into an individual retirement 

plan (other than an endowment contract) to which a rollover contribution of a distribution from such eligible retirement plan is permitted, but only if such contribution is 

made not later than the due date (not including extensions) 

for filing the return of tax for the taxable year in which 

such property or amount of money is returned, and 

‘‘(B) the Secretary shall, at the time such property 

or amount of money is returned, notify such individual 

that a contribution described in subparagraph (A) may 

be made. 

‘‘(2) TREATMENT AS ROLLOVER.—The distribution on account 

of the levy and any contribution under paragraph (1) with 

respect to the return of such distribution shall be treated for 

purposes of this title as if such distribution and contribution 

were described in section 402(c), 402A(c)(3), 403(a)(4), 403(b)(8), 

408(d)(3), 408A(d)(3), or 457(e)(16), whichever is applicable; 

except that— 

‘‘(A) the contribution shall be treated as having been 

made for the taxable year in which the distribution on 

account of the levy occurred, and the interest paid under 

subsection (c) shall be treated as earnings within the plan 

after the contribution and shall not be included in gross 

income, and 

‘‘(B) such contribution shall not be taken into account 

under section 408(d)(3)(B). 

‘‘(3) REFUND, ETC., OF INCOME TAX ON LEVY.— 

‘‘(A) IN GENERAL.—If any amount is includible in gross 

income for a taxable year by reason of a distribution on 

account of a levy referred to in paragraph (1) and any 

portion of such amount is treated as a rollover contribution 

under paragraph (2), any tax imposed by chapter 1 on 

such portion shall not be assessed, and if assessed shall 

be abated, and if collected shall be credited or refunded 

as an overpayment made on the due date for filing the 

return of tax for such taxable year. 

‘‘(B) EXCEPTION.—Subparagraph (A) shall not apply 

to a rollover contribution under this subsection which is 

made from an eligible retirement plan which is not a Roth 

IRA or a designated Roth account (within the meaning 

of section 402A) to a Roth IRA or a designated Roth account 

under an eligible retirement plan. 

‘‘(4) INTEREST.—Notwithstanding subsection (d), interest 

shall be allowed under subsection (c) in a case in which the 

Secretary makes a determination described in subsection 

(d)(2)(A) with respect to a levy upon an individual retirement 

plan. 

‘‘(5) TREATMENT OF INHERITED ACCOUNTS.—For purposes 

of paragraph (1)(A), section 408(d)(3)(C) shall be disregarded 

in determining whether an individual retirement plan is a 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 157 

plan to which a rollover contribution of a distribution from 

the plan levied upon is permitted.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to amounts paid under subsections (b), (c), and (d)(2)(A) 

of section 6343 of the Internal Revenue Code of 1986 in taxable 

years beginning after December 31, 2017. 

SEC. 41105. MODIFICATION OF USER FEE REQUIREMENTS FOR 

INSTALLMENT AGREEMENTS. 

(a) IN GENERAL.—Section 6159 is amended by redesignating 

subsection (f) as subsection (g) and by inserting after subsection 

(e) the following new subsection: 

‘‘(f) INSTALLMENT AGREEMENT FEES.— ‘‘(1) LIMITATION ON FEE AMOUNT.—The amount of any fee 

imposed on an installment agreement under this section may 

not exceed the amount of such fee as in effect on the date 

of the enactment of this subsection. 

‘‘(2) WAIVER OR REIMBURSEMENT.—In the case of any taxpayer with an adjusted gross income, as determined for the 

most recent year for which such information is available, which 

does not exceed 250 percent of the applicable poverty level 

(as determined by the Secretary)— 

‘‘(A) if the taxpayer has agreed to make payments 

under the installment agreement by electronic payment 

through a debit instrument, no fee shall be imposed on 

an installment agreement under this section, and 

‘‘(B) if the taxpayer is unable to make payments under 

the installment agreement by electronic payment through 

a debit instrument, the Secretary shall, upon completion 

of the installment agreement, pay the taxpayer an amount 

equal to any such fees imposed.’’. 

(b) EFFECTIVE DATE.—The amendments made by this section 

shall apply to agreements entered into on or after the date which 

is 60 days after the date of the enactment of this Act. 

SEC. 41106. FORM 1040SR FOR SENIORS. 

(a) IN GENERAL.—The Secretary of the Treasury (or the Secretary’s delegate) shall make available a form, to be known as 

‘‘Form 1040SR’’, for use by individuals to file the return of tax 

imposed by chapter 1 of the Internal Revenue Code of 1986. Such 

form shall be as similar as practicable to Form 1040EZ, except 

that— 

(1) the form shall be available only to individuals who 

have attained age 65 as of the close of the taxable year, 

(2) the form may be used even if income for the taxable 

year includes— 

(A) social security benefits (as defined in section 86(d) 

of the Internal Revenue Code of 1986), 

(B) distributions from qualified retirement plans (as 

defined in section 4974(c) of such Code), annuities or other 

such deferred payment arrangements, 

(C) interest and dividends, or 

(D) capital gains and losses taken into account in determining adjusted net capital gain (as defined in section 

1(h)(3) of such Code), and 

(3) the form shall be available without regard to the amount 

of any item of taxable income or the total amount of taxable 

income for the taxable year. 

26 USC 7805 

note. 

26 USC 6159 

note. 

26 USC 6159. 

26 USC 6343 

note. 


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132 STAT. 158 PUBLIC LAW 115–123—FEB. 9, 2018 

(b) EFFECTIVE DATE.—The form required by subsection (a) shall 

be made available for taxable years beginning after the date of 

the enactment of this Act. 

SEC. 41107. ATTORNEYS FEES RELATING TO AWARDS TO WHISTLEBLOWERS. 

(a) IN GENERAL.—Paragraph (21) of section 62(a) is amended 

to read as follows: 

‘‘(21) ATTORNEYS’ FEES RELATING TO AWARDS TO WHISTLE- BLOWERS.— 

‘‘(A) IN GENERAL.—Any deduction allowable under this 

chapter for attorney fees and court costs paid by, or on 

behalf of, the taxpayer in connection with any award 

under— 

‘‘(i) section 7623(b), or 

‘‘(ii) in the case of taxable years beginning after 

December 31, 2017, any action brought under— 

‘‘(I) section 21F of the Securities Exchange 

Act of 1934 (15 U.S.C. 78u–6), 

‘‘(II) a State false claims act, including a State 

false claims act with qui tam provisions, or 

‘‘(III) section 23 of the Commodity Exchange 

Act (7 U.S.C. 26). 

‘‘(B) MAY NOT EXCEED AWARD.—Subparagraph (A) shall 

not apply to any deduction in excess of the amount includible in the taxpayer’s gross income for the taxable year 

on account of such award.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to taxable years beginning after December 31, 2017. 

SEC. 41108. CLARIFICATION OF WHISTLEBLOWER AWARDS. 

(a) DEFINITION OF PROCEEDS.— (1) IN GENERAL.—Section 7623 is amended by adding at 

the end the following new subsection: 

‘‘(c) PROCEEDS.—For purposes of this section, the term ‘proceeds’ 

includes— 

‘‘(1) penalties, interest, additions to tax, and additional 

amounts provided under the internal revenue laws, and 

‘‘(2) any proceeds arising from laws for which the Internal 

Revenue Service is authorized to administer, enforce, or investigate, including— 

‘‘(A) criminal fines and civil forfeitures, and 

‘‘(B) violations of reporting requirements.’’. 

(2) CONFORMING AMENDMENTS.—Paragraphs (1) and (2)(A) 

of section 7623(b) are each amended by striking ‘‘collected proceeds (including penalties, interest, additions to tax, and additional amounts) resulting from the action’’ and inserting ‘‘proceeds collected as a result of the action’’. 

(b) AMOUNT OF PROCEEDS DETERMINED WITHOUT REGARD TO

AVAILABILITY.—Paragraphs (1) and (2)(A) of section 7623(b) are 

each amended by inserting ‘‘(determined without regard to whether 

such proceeds are available to the Secretary)’’ after ‘‘in response 

to such action’’. 

(c) DISPUTED AMOUNT THRESHOLD.—Section 7623(b)(5)(B) is 

amended by striking ‘‘tax, penalties, interest, additions to tax, and 

additional amounts’’ and inserting ‘‘proceeds’’. 

(d) EFFECTIVE DATE.—The amendments made by this section 

shall apply to information provided before, on, or after the date 

26 USC 7623 

note. 

26 USC 62 note. 

26 USC 62. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 159 

of the enactment of this Act with respect to which a final determination for an award has not been made before such date of enactment. 

SEC. 41109. CLARIFICATION REGARDING EXCISE TAX BASED ON 

INVESTMENT INCOME OF PRIVATE COLLEGES AND 

UNIVERSITIES. 

(a) IN GENERAL.—Subsection (b)(1) of section 4968, as added 

by section 13701(a) of Public Law 115–97, is amended— 

(1) by inserting ‘‘tuition-paying’’ after ‘‘500’’ in subparagraph (A), and 

(2) by inserting ‘‘tuition-paying’’ after ‘‘50 percent of the’’ 

in subparagraph (B). 

(b) EFFECTIVE DATE.—The amendments made by this section 

shall apply to taxable years beginning after December 31, 2017. 

SEC. 41110. EXCEPTION FROM PRIVATE FOUNDATION EXCESS BUSINESS HOLDING TAX FOR INDEPENDENTLY-OPERATED 

PHILANTHROPIC BUSINESS HOLDINGS. 

(a) IN GENERAL.—Section 4943 is amended by adding at the 

end the following new subsection: 

‘‘(g) EXCEPTION FOR CERTAIN HOLDINGS LIMITED TO INDEPENDENTLY-OPERATED PHILANTHROPIC BUSINESS.— 

‘‘(1) IN GENERAL.—Subsection (a) shall not apply with 

respect to the holdings of a private foundation in any business 

enterprise which meets the requirements of paragraphs (2), 

(3), and (4) for the taxable year. 

‘‘(2) OWNERSHIP.—The requirements of this paragraph are 

met if— 

‘‘(A) 100 percent of the voting stock in the business 

enterprise is held by the private foundation at all times 

during the taxable year, and 

‘‘(B) all the private foundation’s ownership interests 

in the business enterprise were acquired by means other 

than by purchase. 

‘‘(3) ALL PROFITS TO CHARITY.— 

‘‘(A) IN GENERAL.—The requirements of this paragraph 

are met if the business enterprise, not later than 120 

days after the close of the taxable year, distributes an 

amount equal to its net operating income for such taxable 

year to the private foundation. 

‘‘(B) NET OPERATING INCOME.—For purposes of this 

paragraph, the net operating income of any business enterprise for any taxable year is an amount equal to the gross 

income of the business enterprise for the taxable year, 

reduced by the sum of— 

‘‘(i) the deductions allowed by chapter 1 for the 

taxable year which are directly connected with the 

production of such income, 

‘‘(ii) the tax imposed by chapter 1 on the business 

enterprise for the taxable year, and 

‘‘(iii) an amount for a reasonable reserve for 

working capital and other business needs of the business enterprise. 

‘‘(4) INDEPENDENT OPERATION.—The requirements of this 

paragraph are met if, at all times during the taxable year— 

‘‘(A) no substantial contributor (as defined in section 

4958(c)(3)(C)) to the private foundation or family member 

26 USC 4968 

note. 

26 USC 4968. 


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132 STAT. 160 PUBLIC LAW 115–123—FEB. 9, 2018 

(as determined under section 4958(f)(4)) of such a contributor is a director, officer, trustee, manager, employee, or 

contractor of the business enterprise (or an individual 

having powers or responsibilities similar to any of the 

foregoing), 

‘‘(B) at least a majority of the board of directors of 

the private foundation are persons who are not— 

‘‘(i) directors or officers of the business enterprise, 

or 

‘‘(ii) family members (as so determined) of a 

substantial contributor (as so defined) to the private 

foundation, and 

‘‘(C) there is no loan outstanding from the business 

enterprise to a substantial contributor (as so defined) to 

the private foundation or to any family member of such 

a contributor (as so determined). 

‘‘(5) CERTAIN DEEMED PRIVATE FOUNDATIONS EXCLUDED.— 

This subsection shall not apply to— 

‘‘(A) any fund or organization treated as a private 

foundation for purposes of this section by reason of subsection (e) or (f), 

‘‘(B) any trust described in section 4947(a)(1) (relating 

to charitable trusts), and 

‘‘(C) any trust described in section 4947(a)(2) (relating 

to split-interest trusts).’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to taxable years beginning after December 31, 2017. 

SEC. 41111. RULE OF CONSTRUCTION FOR CRAFT BEVERAGE MODERNIZATION AND TAX REFORM. 

(a) IN GENERAL.—Subpart A of part IX of subtitle C of title 

I of Public Law 115–97 is amended by adding at the end the 

following new section: 

‘‘SEC. 13809. RULE OF CONSTRUCTION. 

‘‘Nothing in this subpart, the amendments made by this subpart, or any regulation promulgated under this subpart or the 

amendments made by this subpart, shall be construed to preempt, 

supersede, or otherwise limit or restrict any State, local, or tribal 

law that prohibits or regulates the production or sale of distilled 

spirits, wine, or malt beverages.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall take effect as if included in Public Law 115–97. 

SEC. 41112. SIMPLIFICATION OF RULES REGARDING RECORDS, STATEMENTS, AND RETURNS. 

(a) IN GENERAL.—Subsection (a) of section 5555 is amended 

by adding at the end the following: ‘‘For calendar quarters beginning 

after the date of the enactment of this sentence, and before January 

1, 2020, the Secretary shall permit a person to employ a unified 

system for any records, statements, and returns required to be 

kept, rendered, or made under this section for any beer produced 

in the brewery for which the tax imposed by section 5051 has 

been determined, including any beer which has been removed for 

consumption on the premises of the brewery.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to calendar quarters beginning after the date of the 

enactment of this Act. 

26 USC 5555 

note. 

Time period. 

26 USC 263A 

note. 

26 USC 263A 

note. 

26 USC 4943 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 161 

SEC. 41113. MODIFICATION OF RULES GOVERNING HARDSHIP DISTRIBUTIONS. 

(a) IN GENERAL.—Not later than 1 year after the date of the 

enactment of this Act, the Secretary of the Treasury shall modify 

Treasury Regulation section 1.401(k)–1(d)(3)(iv)(E) to— 

(1) delete the 6-month prohibition on contributions imposed 

by paragraph (2) thereof, and 

(2) make any other modifications necessary to carry out 

the purposes of section 401(k)(2)(B)(i)(IV) of the Internal Revenue Code of 1986. 

(b) EFFECTIVE DATE.—The revised regulations under this section shall apply to plan years beginning after December 31, 2018. 

SEC. 41114. MODIFICATION OF RULES RELATING TO HARDSHIP WITHDRAWALS FROM CASH OR DEFERRED ARRANGEMENTS. 

(a) IN GENERAL.—Section 401(k) is amended by adding at the 

end the following: 

‘‘(14) SPECIAL RULES RELATING TO HARDSHIP WITH- DRAWALS.—For purposes of paragraph (2)(B)(i)(IV)— 

‘‘(A) AMOUNTS WHICH MAY BE WITHDRAWN.—The following amounts may be distributed upon hardship of the 

employee: 

‘‘(i) Contributions to a profit-sharing or stock bonus 

plan to which section 402(e)(3) applies. 

‘‘(ii) Qualified nonelective contributions (as defined 

in subsection (m)(4)(C)). 

‘‘(iii) Qualified matching contributions described 

in paragraph (3)(D)(ii)(I). 

‘‘(iv) Earnings on any contributions described in 

clause (i), (ii), or (iii). 

‘‘(B) NO REQUIREMENT TO TAKE AVAILABLE LOAN.—A 

distribution shall not be treated as failing to be made 

upon the hardship of an employee solely because the 

employee does not take any available loan under the plan.’’. 

(b) CONFORMING AMENDMENT.—Section 401(k)(2)(B)(i)(IV) is 

amended to read as follows: 

‘‘(IV) subject to the provisions of paragraph 

(14), upon hardship of the employee, or’’. 

(c) EFFECTIVE DATE.—The amendments made by this section 

shall apply to plan years beginning after December 31, 2018. 

SEC. 41115. OPPORTUNITY ZONES RULE FOR PUERTO RICO. 

(a) IN GENERAL.—Subsection (b) of section 1400Z–1 is amended 

by adding at the end the following new paragraph: 

‘‘(3) SPECIAL RULE FOR PUERTO RICO.—Each population 

census tract in Puerto Rico that is a low- income community 

shall be deemed to be certified and designated as a qualified 

opportunity zone, effective on the date of the enactment of 

Public Law 115–97.’’. 

(b) CONFORMING AMENDMENT.—Section 1400Z–1(d)(1) is 

amended by inserting ‘‘and subsection (b)(3)’’ after ‘‘paragraph (2)’’. 

SEC. 41116. TAX HOME OF CERTAIN CITIZENS OR RESIDENTS OF THE 

UNITED STATES LIVING ABROAD. 

(a) IN GENERAL.—Paragraph (3) of section 911(d) is amended 

by inserting before the period at the end of the second sentence 

the following: ‘‘, unless such individual is serving in an area designated by the President of the United States by Executive order 

Certification. 

Effective date. 

26 USC 401 note. 

26 USC 401. 

Deadline. 

26 USC 401 note. 


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132 STAT. 162 PUBLIC LAW 115–123—FEB. 9, 2018 

as a combat zone for purposes of section 112 in support of the 

Armed Forces of the United States’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to taxable years beginning after December 31, 2017. 

SEC. 41117. TREATMENT OF FOREIGN PERSONS FOR RETURNS 

RELATING TO PAYMENTS MADE IN SETTLEMENT OF PAYMENT CARD AND THIRD PARTY NETWORK TRANSACTIONS. 

(a) IN GENERAL.—Section 6050W(d)(1)(B) is amended by adding 

at the end the following: ‘‘Notwithstanding the preceding sentence, 

a person with only a foreign address shall not be treated as a 

participating payee with respect to any payment settlement entity 

solely because such person receives payments from such payment 

settlement entity in dollars.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to returns for calendar years beginning after December 

31, 2017. 

SEC. 41118. REPEAL OF SHIFT IN TIME OF PAYMENT OF CORPORATE 

ESTIMATED TAXES. 

The Trade Preferences Extension Act of 2015 is amended by 

striking section 803 (relating to time for payment of corporate 

estimated taxes). 

SEC. 41119. ENHANCEMENT OF CARBON DIOXIDE SEQUESTRATION 

CREDIT. 

(a) IN GENERAL.—Section 45Q is amended to read as follows: 

‘‘SEC. 45Q. CREDIT FOR CARBON OXIDE SEQUESTRATION. 

‘‘(a) GENERAL RULE.—For purposes of section 38, the carbon 

oxide sequestration credit for any taxable year is an amount equal 

to the sum of— 

‘‘(1) $20 per metric ton of qualified carbon oxide which 

is— 

‘‘(A) captured by the taxpayer using carbon capture 

equipment which is originally placed in service at a qualified facility before the date of the enactment of the Bipartisan Budget Act of 2018, and 

‘‘(B) disposed of by the taxpayer in secure geological 

storage and not used by the taxpayer as described in paragraph (2)(B), 

‘‘(2) $10 per metric ton of qualified carbon oxide which 

is— 

‘‘(A) captured by the taxpayer using carbon capture 

equipment which is originally placed in service at a qualified facility before the date of the enactment of the Bipartisan Budget Act of 2018, and 

‘‘(B)(i) used by the taxpayer as a tertiary injectant 

in a qualified enhanced oil or natural gas recovery project 

and disposed of by the taxpayer in secure geological storage, 

or 

‘‘(ii) utilized by the taxpayer in a manner described 

in subsection (f)(5), 

‘‘(3) the applicable dollar amount (as determined under 

subsection (b)(1)) per metric ton of qualified carbon oxide which 

is— 

Time period. 

26 USC 6655 

note. 

26 USC 6050W 

note. 

26 USC 6050W. 

26 USC 911 note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 163 

‘‘(A) captured by the taxpayer using carbon capture 

equipment which is originally placed in service at a qualified facility on or after the date of the enactment of the 

Bipartisan Budget Act of 2018, during the 12-year period 

beginning on the date the equipment was originally placed 

in service, and 

‘‘(B) disposed of by the taxpayer in secure geological 

storage and not used by the taxpayer as described in paragraph (4)(B), and 

‘‘(4) the applicable dollar amount (as determined under 

subsection (b)(1)) per metric ton of qualified carbon oxide which 

is— 

‘‘(A) captured by the taxpayer using carbon capture 

equipment which is originally placed in service at a qualified facility on or after the date of the enactment of the 

Bipartisan Budget Act of 2018, during the 12-year period 

beginning on the date the equipment was originally placed 

in service, and 

‘‘(B)(i) used by the taxpayer as a tertiary injectant 

in a qualified enhanced oil or natural gas recovery project 

and disposed of by the taxpayer in secure geological storage, 

or 

‘‘(ii) utilized by the taxpayer in a manner described 

in subsection (f)(5). 

‘‘(b) APPLICABLE DOLLAR AMOUNT; ADDITIONAL EQUIPMENT; 

ELECTION.— 

‘‘(1) APPLICABLE DOLLAR AMOUNT.— 

‘‘(A) IN GENERAL.—The applicable dollar amount shall 

be an amount equal to— 

‘‘(i) for any taxable year beginning in a calendar 

year after 2016 and before 2027— 

‘‘(I) for purposes of paragraph (3) of subsection 

(a), the dollar amount established by linear interpolation between $22.66 and $50 for each calendar 

year during such period, and 

‘‘(II) for purposes of paragraph (4) of such subsection, the dollar amount established by linear 

interpolation between $12.83 and $35 for each calendar year during such period, and 

‘‘(ii) for any taxable year beginning in a calendar 

year after 2026— 

‘‘(I) for purposes of paragraph (3) of subsection 

(a), an amount equal to the product of $50 and 

the inflation adjustment factor for such calendar 

year determined under section 43(b)(3)(B) for such 

calendar year, determined by substituting ‘2025’ 

for ‘1990’, and 

‘‘(II) for purposes of paragraph (4) of such subsection, an amount equal to the product of $35 

and the inflation adjustment factor for such calendar year determined under section 43(b)(3)(B) 

for such calendar year, determined by substituting 

‘2025’ for ‘1990’. 

‘‘(B) ROUNDING.—The applicable dollar amount determined under subparagraph (A) shall be rounded to the 

nearest cent. 

Time periods. 


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132 STAT. 164 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(2) INSTALLATION OF ADDITIONAL CARBON CAPTURE EQUIPMENT ON EXISTING QUALIFIED FACILITY.—In the case of a qualified facility placed in service before the date of the enactment 

of the Bipartisan Budget Act of 2018, for which additional 

carbon capture equipment is placed in service on or after the 

date of the enactment of such Act, the amount of qualified 

carbon oxide which is captured by the taxpayer shall be equal 

to— 

‘‘(A) for purposes of paragraphs (1)(A) and (2)(A) of 

subsection (a), the lesser of— 

‘‘(i) the total amount of qualified carbon oxide captured at such facility for the taxable year, or 

‘‘(ii) the total amount of the carbon dioxide capture 

capacity of the carbon capture equipment in service 

at such facility on the day before the date of the 

enactment of the Bipartisan Budget Act of 2018, and 

‘‘(B) for purposes of paragraphs (3)(A) and (4)(A) of 

such subsection, an amount (not less than zero) equal to 

the excess of— 

‘‘(i) the amount described in clause (i) of subparagraph (A), over 

‘‘(ii) the amount described in clause (ii) of such 

subparagraph. 

‘‘(3) ELECTION.—For purposes of determining the carbon 

oxide sequestration credit under this section, a taxpayer may 

elect to have the dollar amounts applicable under paragraph 

(1) or (2) of subsection (a) apply in lieu of the dollar amounts 

applicable under paragraph (3) or (4) of such subsection for 

each metric ton of qualified carbon oxide which is captured 

by the taxpayer using carbon capture equipment which is originally placed in service at a qualified facility on or after the 

date of the enactment of the Bipartisan Budget Act of 2018. 

‘‘(c) QUALIFIED CARBON OXIDE.—For purposes of this section— 

‘‘(1) IN GENERAL.—The term ‘qualified carbon oxide’ 

means— 

‘‘(A) any carbon dioxide which— 

‘‘(i) is captured from an industrial source by carbon 

capture equipment which is originally placed in service 

before the date of the enactment of the Bipartisan 

Budget Act of 2018, 

‘‘(ii) would otherwise be released into the 

atmosphere as industrial emission of greenhouse gas 

or lead to such release, and 

‘‘(iii) is measured at the source of capture and 

verified at the point of disposal, injection, or utilization, 

‘‘(B) any carbon dioxide or other carbon oxide which— 

‘‘(i) is captured from an industrial source by carbon 

capture equipment which is originally placed in service 

on or after the date of the enactment of the Bipartisan 

Budget Act of 2018, 

‘‘(ii) would otherwise be released into the 

atmosphere as industrial emission of greenhouse gas 

or lead to such release, and 

‘‘(iii) is measured at the source of capture and 

verified at the point of disposal, injection, or utilization, 

or 

Definition. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 165 

‘‘(C) in the case of a direct air capture facility, any 

carbon dioxide which— 

‘‘(i) is captured directly from the ambient air, and 

‘‘(ii) is measured at the source of capture and 

verified at the point of disposal, injection, or utilization. 

‘‘(2) RECYCLED CARBON OXIDE.—The term ‘qualified carbon 

oxide’ includes the initial deposit of captured carbon oxide 

used as a tertiary injectant. Such term does not include carbon 

oxide that is recaptured, recycled, and re-injected as part of 

the enhanced oil and natural gas recovery process. 

‘‘(d) QUALIFIED FACILITY.—For purposes of this section, the 

term ‘qualified facility’ means any industrial facility or direct air 

capture facility— 

‘‘(1) the construction of which begins before January 1, 

2024, and— 

‘‘(A) construction of carbon capture equipment begins 

before such date, or 

‘‘(B) the original planning and design for such facility 

includes installation of carbon capture equipment, and 

‘‘(2) which captures— 

‘‘(A) in the case of a facility which emits not more 

than 500,000 metric tons of carbon oxide into the 

atmosphere during the taxable year, not less than 25,000 

metric tons of qualified carbon oxide during the taxable 

year which is utilized in a manner described in subsection 

(f)(5), 

‘‘(B) in the case of an electricity generating facility 

which is not described in subparagraph (A), not less than 

500,000 metric tons of qualified carbon oxide during the 

taxable year, or 

‘‘(C) in the case of a direct air capture facility or 

any facility not described in subparagraph (A) or (B), not 

less than 100,000 metric tons of qualified carbon oxide 

during the taxable year. 

‘‘(e) DEFINITIONS.—For purposes of this section— 

‘‘(1) DIRECT AIR CAPTURE FACILITY.— 

‘‘(A) IN GENERAL.—Subject to subparagraph (B), the 

term ‘direct air capture facility’ means any facility which 

uses carbon capture equipment to capture carbon dioxide 

directly from the ambient air. 

‘‘(B) EXCEPTION.—The term ‘direct air capture facility’ 

shall not include any facility which captures carbon 

dioxide— 

‘‘(i) which is deliberately released from naturally 

occurring subsurface springs, or 

‘‘(ii) using natural photosynthesis. 

‘‘(2) QUALIFIED ENHANCED OIL OR NATURAL GAS RECOVERY

PROJECT.—The term ‘qualified enhanced oil or natural gas 

recovery project’ has the meaning given the term ‘qualified 

enhanced oil recovery project’ by section 43(c)(2), by substituting 

‘crude oil or natural gas’ for ‘crude oil’ in subparagraph (A)(i) 

thereof. 

‘‘(3) TERTIARY INJECTANT.—The term ‘tertiary injectant’ has 

the same meaning as when used within section 193(b)(1). 

‘‘(f) SPECIAL RULES.— ‘‘(1) ONLY QUALIFIED CARBON OXIDE CAPTURED AND DIS- POSED OF OR USED WITHIN THE UNITED STATES TAKEN INTO

Definition. 

Definition. 


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132 STAT. 166 PUBLIC LAW 115–123—FEB. 9, 2018 

ACCOUNT.—The credit under this section shall apply only with 

respect to qualified carbon oxide the capture and disposal, 

use, or utilization of which is within— 

‘‘(A) the United States (within the meaning of section 

638(1)), or 

‘‘(B) a possession of the United States (within the 

meaning of section 638(2)). 

‘‘(2) SECURE GEOLOGICAL STORAGE.—The Secretary, in consultation with the Administrator of the Environmental Protection Agency, the Secretary of Energy, and the Secretary of 

the Interior, shall establish regulations for determining adequate security measures for the geological storage of qualified 

carbon oxide under subsection (a) such that the qualified carbon 

oxide does not escape into the atmosphere. Such term shall 

include storage at deep saline formations, oil and gas reservoirs, 

and unminable coal seams under such conditions as the Secretary may determine under such regulations. 

‘‘(3) CREDIT ATTRIBUTABLE TO TAXPAYER.— 

‘‘(A) IN GENERAL.—Except as provided in subparagraph 

(B) or in any regulations prescribed by the Secretary, any 

credit under this section shall be attributable to— 

‘‘(i) in the case of qualified carbon oxide captured 

using carbon capture equipment which is originally 

placed in service at a qualified facility before the date 

of the enactment of the Bipartisan Budget Act of 2018, 

the person that captures and physically or contractually ensures the disposal, utilization, or use as a 

tertiary injectant of such qualified carbon oxide, and 

‘‘(ii) in the case of qualified carbon oxide captured 

using carbon capture equipment which is originally 

placed in service at a qualified facility on or after 

the date of the enactment of the Bipartisan Budget 

Act of 2018, the person that owns the carbon capture 

equipment and physically or contractually ensures the 

capture and disposal, utilization, or use as a tertiary 

injectant of such qualified carbon oxide. 

‘‘(B) ELECTION.—If the person described in subparagraph (A) makes an election under this subparagraph in 

such time and manner as the Secretary may prescribe 

by regulations, the credit under this section— 

‘‘(i) shall be allowable to the person that disposes 

of the qualified carbon oxide, utilizes the qualified 

carbon oxide, or uses the qualified carbon oxide as 

a tertiary injectant, and 

‘‘(ii) shall not be allowable to the person described 

in subparagraph (A). 

‘‘(4) RECAPTURE.—The Secretary shall, by regulations, provide for recapturing the benefit of any credit allowable under 

subsection (a) with respect to any qualified carbon oxide which 

ceases to be captured, disposed of, or used as a tertiary injectant 

in a manner consistent with the requirements of this section. 

‘‘(5) UTILIZATION OF QUALIFIED CARBON OXIDE.— 

‘‘(A) IN GENERAL.—For purposes of this section, utilization of qualified carbon oxide means— 

‘‘(i) the fixation of such qualified carbon oxide 

through photosynthesis or chemosynthesis, such as 

through the growing of algae or bacteria, 

Definition. 

Consultation. 

Applicability. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 167 

‘‘(ii) the chemical conversion of such qualified 

carbon oxide to a material or chemical compound in 

which such qualified carbon oxide is securely stored, 

or 

‘‘(iii) the use of such qualified carbon oxide for 

any other purpose for which a commercial market 

exists (with the exception of use as a tertiary injectant 

in a qualified enhanced oil or natural gas recovery 

project), as determined by the Secretary. 

‘‘(B) MEASUREMENT.— ‘‘(i) IN GENERAL.—For purposes of determining the 

amount of qualified carbon oxide utilized by the taxpayer under paragraph (2)(B)(ii) or (4)(B)(ii) of subsection (a), such amount shall be equal to the metric 

tons of qualified carbon oxide which the taxpayer demonstrates, based upon an analysis of lifecycle greenhouse gas emissions and subject to such requirements 

as the Secretary, in consultation with the Secretary 

of Energy and the Administrator of the Environmental 

Protection Agency, determines appropriate, were— 

‘‘(I) captured and permanently isolated from 

the atmosphere, or 

‘‘(II) displaced from being emitted into the 

atmosphere, 

through use of a process described in subparagraph 

(A). 

‘‘(ii) LIFECYCLE GREENHOUSE GAS EMISSIONS.—For 

purposes of clause (i), the term ‘lifecycle greenhouse 

gas emissions’ has the same meaning given such term 

under subparagraph (H) of section 211(o)(1) of the 

Clean Air Act (42 U.S.C. 7545(o)(1)), as in effect on 

the date of the enactment of the Bipartisan Budget 

Act of 2018, except that ‘product’ shall be substituted 

for ‘fuel’ each place it appears in such subparagraph. 

‘‘(6) ELECTION FOR APPLICABLE FACILITIES.— ‘‘(A) IN GENERAL.—For purposes of this section, in the 

case of an applicable facility, for any taxable year in which 

such facility captures not less than 500,000 metric tons 

of qualified carbon oxide during the taxable year, the person described in paragraph (3)(A)(ii) may elect to have 

such facility, and any carbon capture equipment placed 

in service at such facility, deemed as having been placed 

in service on the date of the enactment of the Bipartisan 

Budget Act of 2018. 

‘‘(B) APPLICABLE FACILITY.—For purposes of this paragraph, the term ‘applicable facility’ means a qualified 

facility— 

‘‘(i) which was placed in service before the date 

of the enactment of the Bipartisan Budget Act of 2018, 

and 

‘‘(ii) for which no taxpayer claimed a credit under 

this section in regards to such facility for any taxable 

year ending before the date of the enactment of such 

Act. 

‘‘(7) INFLATION ADJUSTMENT.—In the case of any taxable 

year beginning in a calendar year after 2009, there shall be 

substituted for each dollar amount contained in paragraphs 

Definition. 

Definition. 

Determination. 

Consultation. 


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132 STAT. 168 PUBLIC LAW 115–123—FEB. 9, 2018 

(1) and (2) of subsection (a) an amount equal to the product 

of— 

‘‘(A) such dollar amount, multiplied by 

‘‘(B) the inflation adjustment factor for such calendar 

year determined under section 43(b)(3)(B) for such calendar 

year, determined by substituting ‘2008’ for ‘1990’. 

‘‘(g) APPLICATION OF SECTION FOR CERTAIN CARBON CAPTURE

EQUIPMENT.—In the case of any carbon capture equipment placed 

in service before the date of the enactment of the Bipartisan Budget 

Act of 2018, the credit under this section shall apply with respect 

to qualified carbon oxide captured using such equipment before 

the end of the calendar year in which the Secretary, in consultation 

with the Administrator of the Environmental Protection Agency, 

certifies that, during the period beginning after October 3, 2008, 

a total of 75,000,000 metric tons of qualified carbon oxide have 

been taken into account in accordance with— 

‘‘(1) subsection (a) of this section, as in effect on the day 

before the date of the enactment of the Bipartisan Budget 

Act of 2018, and 

‘‘(2) paragraphs (1) and (2) of subsection (a) of this section. 

‘‘(h) REGULATIONS.—The Secretary may prescribe such regulations and other guidance as may be necessary or appropriate to 

carry out this section, including regulations or other guidance to— 

‘‘(1) ensure proper allocation under subsection (a) for qualified carbon oxide captured by a taxpayer during the taxable 

year ending after the date of the enactment of the Bipartisan 

Budget Act of 2018, and 

‘‘(2) determine whether a facility satisfies the requirements 

under subsection (d)(1) during such taxable year.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall apply to taxable years beginning after December 31, 2017. 

DIVISION E—HEALTH AND HUMAN 

SERVICES EXTENDERS 

SEC. 50100. SHORT TITLE; TABLE OF CONTENTS. 

(a) SHORT TITLE.—This division may be cited as the ‘‘Advancing 

Chronic Care, Extenders, and Social Services (ACCESS) Act’’ 

(b) TABLE OF CONTENTS.—The table of contents for this division 

is as follows: 

DIVISION E—HEALTH AND HUMAN SERVICES EXTENDERS 

Sec. 50100. Short title; table of contents. 

TITLE I—CHIP 

Sec. 50101. Funding extension of the Children’s Health Insurance Program through 

fiscal year 2027. Sec. 50102. Extension of pediatric quality measures program. 

Sec. 50103. Extension of outreach and enrollment program. 

TITLE II—MEDICARE EXTENDERS 

Sec. 50201. Extension of work GPCI floor. 

Sec. 50202. Repeal of Medicare payment cap for therapy services; limitation to ensure appropriate therapy. Sec. 50203. Medicare ambulance services. 

Sec. 50204. Extension of increased inpatient hospital payment adjustment for certain low-volume hospitals. Sec. 50205. Extension of the Medicare-dependent hospital (MDH) program. 

Sec. 50206. Extension of funding for quality measure endorsement, input, and selection; reporting requirements. 

42 USC 1305 

note. 

Advancing 

Chronic Care, 

Extenders, and 

Social Services 

(ACCESS) Act. 

Applicability. 

26 USC 45Q 

note. 

Determination. 

Consultation. 

Certification. 

Time period. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 169 

Sec. 50207. Extension of funding outreach and assistance for low-income programs; 

State health insurance assistance program reporting requirements. 

Sec. 50208. Extension of home health rural add-on. 

TITLE III—CREATING HIGH-QUALITY RESULTS AND OUTCOMES 

NECESSARY TO IMPROVE CHRONIC (CHRONIC) CARE 

Subtitle A—Receiving High Quality Care in the Home 

Sec. 50301. Extending the Independence at Home Demonstration Program. 

Sec. 50302. Expanding access to home dialysis therapy. 

Subtitle B—Advancing Team-Based Care 

Sec. 50311. Providing continued access to Medicare Advantage special needs plans 

for vulnerable populations. 

Subtitle C—Expanding Innovation and Technology 

Sec. 50321. Adapting benefits to meet the needs of chronically ill Medicare Advantage enrollees. 

Sec. 50322. Expanding supplemental benefits to meet the needs of chronically ill 

Medicare Advantage enrollees. 

Sec. 50323. Increasing convenience for Medicare Advantage enrollees through telehealth. 

Sec. 50324. Providing accountable care organizations the ability to expand the use 

of telehealth. 

Sec. 50325. Expanding the use of telehealth for individuals with stroke. 

Subtitle D—Identifying the Chronically Ill Population 

Sec. 50331. Providing flexibility for beneficiaries to be part of an accountable care 

organization. 

Subtitle E—Empowering Individuals and Caregivers in Care Delivery 

Sec. 50341. Eliminating barriers to care coordination under accountable care organizations. 

Sec. 50342. GAO study and report on longitudinal comprehensive care planning 

services under Medicare part B. 

Subtitle F—Other Policies to Improve Care for the Chronically Ill 

Sec. 50351. GAO study and report on improving medication synchronization. 

Sec. 50352. GAO study and report on impact of obesity drugs on patient health and 

spending. 

Sec. 50353. HHS study and report on long-term risk factors for chronic conditions 

among Medicare beneficiaries. 

Sec. 50354. Providing prescription drug plans with parts A and B claims data to 

promote the appropriate use of medications and improve health outcomes. 

TITLE IV—PART B IMPROVEMENT ACT AND OTHER PART B 

ENHANCEMENTS 

Subtitle A—Medicare Part B Improvement Act 

Sec. 50401. Home infusion therapy services temporary transitional payment. 

Sec. 50402. Orthotist’s and prosthetist’s clinical notes as part of the patient’s medical record. 

Sec. 50403. Independent accreditation for dialysis facilities and assurance of high 

quality surveys. 

Sec. 50404. Modernizing the application of the Stark rule under Medicare. 

Subtitle B—Additional Medicare Provisions 

Sec. 50411. Making permanent the removal of the rental cap for durable medical 

equipment under Medicare with respect to speech generating devices. 

Sec. 50412. Increased civil and criminal penalties and increased sentences for Federal health care program fraud and abuse. 

Sec. 50413. Reducing the volume of future EHR-related significant hardship requests. 

Sec. 50414. Strengthening rules in case of competition for diabetic testing strips. 

TITLE V—OTHER HEALTH EXTENDERS 

Sec. 50501. Extension for family-to-family health information centers. 

Sec. 50502. Extension for sexual risk avoidance education. 


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132 STAT. 170 PUBLIC LAW 115–123—FEB. 9, 2018 

Sec. 50503. Extension for personal responsibility education. 

TITLE VI—CHILD AND FAMILY SERVICES AND SUPPORTS EXTENDERS 

Subtitle A—Continuing the Maternal, Infant, and Early Childhood Home Visiting 

Program 

Sec. 50601. Continuing evidence-based home visiting program. 

Sec. 50602. Continuing to demonstrate results to help families. 

Sec. 50603. Reviewing statewide needs to target resources. 

Sec. 50604. Improving the likelihood of success in high-risk communities. 

Sec. 50605. Option to fund evidence-based home visiting on a pay for outcome 

basis. 

Sec. 50606. Data exchange standards for improved interoperability. 

Sec. 50607. Allocation of funds. 

Subtitle B—Extension of Health Professions Workforce Demonstration Projects 

Sec. 50611. Extension of health workforce demonstration projects for low-income individuals. 

TITLE VII—FAMILY FIRST PREVENTION SERVICES ACT 

Subtitle A—Investing in Prevention and Supporting Families 

Sec. 50701. Short title. 

Sec. 50702. Purpose. 

PART I—PREVENTION ACTIVITIES UNDER TITLE IV–E 

Sec. 50711. Foster care prevention services and programs. 

Sec. 50712. Foster care maintenance payments for children with parents in a licensed residential family-based treatment facility for substance abuse. 

Sec. 50713. Title IV–E payments for evidence-based kinship navigator programs. 

PART II—ENHANCED SUPPORT UNDER TITLE IV–B 

Sec. 50721. Elimination of time limit for family reunification services while in foster care and permitting time-limited family reunification services when 

a child returns home from foster care. 

Sec. 50722. Reducing bureaucracy and unnecessary delays when placing children in 

homes across State lines. 

Sec. 50723. Enhancements to grants to improve well-being of families affected by 

substance abuse. 

PART III—MISCELLANEOUS

Sec. 50731. Reviewing and improving licensing standards for placement in a relative foster family home. 

Sec. 50732. Development of a statewide plan to prevent child abuse and neglect fatalities. 

Sec. 50733. Modernizing the title and purpose of title IV–E. 

Sec. 50734. Effective dates. 

PART IV—ENSURING THE NECESSITY OF A PLACEMENT THAT IS NOT IN A FOSTER

FAMILY HOME

Sec. 50741. Limitation on Federal financial participation for placements that are 

not in foster family homes. 

Sec. 50742. Assessment and documentation of the need for placement in a qualified 

residential treatment program. 

Sec. 50743. Protocols to prevent inappropriate diagnoses. 

Sec. 50744. Additional data and reports regarding children placed in a setting that 

is not a foster family home. 

Sec. 50745. Criminal records checks and checks of child abuse and neglect registries for adults working in child-care institutions and other group care 

settings. 

Sec. 50746. Effective dates; application to waivers. 

PART V—CONTINUING SUPPORT FOR CHILD AND FAMILY SERVICES

Sec. 50751. Supporting and retaining foster families for children. 

Sec. 50752. Extension of child and family services programs. 

Sec. 50753. Improvements to the John H. Chafee foster care independence program 

and related provisions. 

PART VI—CONTINUING INCENTIVES TO STATES TO PROMOTE ADOPTION AND LEGAL

GUARDIANSHIP

Sec. 50761. Reauthorizing adoption and legal guardianship incentive programs. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 171 

PART VII—TECHNICAL CORRECTIONS

Sec. 50771. Technical corrections to data exchange standards to improve program 

coordination. 

Sec. 50772. Technical corrections to State requirement to address the developmental needs of young children. 

PART VIII—ENSURING STATES REINVEST SAVINGS RESULTING FROM INCREASE IN

ADOPTION ASSISTANCE

Sec. 50781. Delay of adoption assistance phase-in. 

Sec. 50782. GAO study and report on State reinvestment of savings resulting from 

increase in adoption assistance. 

TITLE VIII—SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO PAY FOR 

RESULTS 

Sec. 50801. Short title. 

Sec. 50802. Social impact partnerships to pay for results. 

TITLE IX—PUBLIC HEALTH PROGRAMS 

Sec. 50901. Extension for community health centers, the National Health Service 

Corps, and teaching health centers that operate GME programs. 

Sec. 50902. Extension for special diabetes programs. 

TITLE X—MISCELLANEOUS HEALTH CARE POLICIES 

Sec. 51001. Home health payment reform. 

Sec. 51002. Information to satisfy documentation of Medicare eligibility for home 

health services. 

Sec. 51003. Technical amendments to Public Law 114–10. 

Sec. 51004. Expanded access to Medicare intensive cardiac rehabilitation programs. 

Sec. 51005. Extension of blended site neutral payment rate for certain long-term 

care hospital discharges; temporary adjustment to site neutral payment 

rates. 

Sec. 51006. Recognition of attending physician assistants as attending physicians 

to serve hospice patients. 

Sec. 51007. Extension of enforcement instruction on supervision requirements for 

outpatient therapeutic services in critical access and small rural hospitals through 2017. 

Sec. 51008. Allowing physician assistants, nurse practitioners, and clinical nurse 

specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. 

Sec. 51009. Transitional payment rules for certain radiation therapy services under 

the physician fee schedule. 

TITLE XI—PROTECTING SENIORS’ ACCESS TO MEDICARE ACT 

Sec. 52001. Repeal of the Independent Payment Advisory Board. 

TITLE XII—OFFSETS 

Sec. 53101. Modifying reductions in Medicaid DSH allotments. 

Sec. 53102. Third party liability in Medicaid and CHIP. 

Sec. 53103. Treatment of lottery winnings and other lump-sum income for purposes 

of income eligibility under Medicaid. 

Sec. 53104. Rebate obligation with respect to line extension drugs. 

Sec. 53105. Medicaid Improvement Fund. 

Sec. 53106. Physician fee schedule update. 

Sec. 53107. Payment for outpatient physical therapy services and outpatient occupational therapy services furnished by a therapy assistant. 

Sec. 53108. Reduction for non-emergency ESRD ambulance transports. 

Sec. 53109. Hospital transfer policy for early discharges to hospice care. 

Sec. 53110. Medicare payment update for home health services. 

Sec. 53111. Medicare payment update for skilled nursing facilities. 

Sec. 53112. Preventing the artificial inflation of star ratings after the consolidation 

of Medicare Advantage plans offered by the same organization. 

Sec. 53113. Sunsetting exclusion of biosimilars from Medicare part D coverage gap 

discount program. 

Sec. 53114. Adjustments to Medicare part B and part D premium subsidies for 

higher income individuals. 

Sec. 53115. Medicare Improvement Fund. 

Sec. 53116. Closing the Donut Hole for Seniors. 

Sec. 53117. Modernizing child support enforcement fees. 

Sec. 53118. Increasing efficiency of prison data reporting. 

Sec. 53119. Prevention and Public Health Fund. 


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132 STAT. 172 PUBLIC LAW 115–123—FEB. 9, 2018 

TITLE I—CHIP 

SEC. 50101. FUNDING EXTENSION OF THE CHILDREN’S HEALTH INSURANCE PROGRAM THROUGH FISCAL YEAR 2027. 

(a) IN GENERAL.—Section 2104(a) of the Social Security Act 

(42 U.S.C. 1397dd(a)), as amended by section 3002(a) of the 

HEALTHY KIDS Act (division C of Public Law 115–120), is 

amended— 

(1) in paragraph (25), by striking ‘‘; and’’ and inserting 

a semicolon; 

(2) in paragraph (26), by striking the period at the end 

and inserting a semicolon; and 

(3) by adding at the end the following new paragraphs: 

‘‘(27) for each of fiscal years 2024 through 2026, such 

sums as are necessary to fund allotments to States under 

subsections (c) and (m); and 

‘‘(28) for fiscal year 2027, for purposes of making two semiannual allotments— 

‘‘(A) $7,650,000,000 for the period beginning on October 

1, 2026, and ending on March 31, 2027; and 

‘‘(B) $7,650,000,000 for the period beginning on April 

1, 2027, and ending on September 30, 2027.’’. 

(b) ALLOTMENTS.— 

(1) IN GENERAL.—Section 2104(m) of the Social Security 

Act (42 U.S.C. 1397dd(m)), as amended by section 3002(b) of 

the HEALTHY KIDS Act (division C of Public Law 115–120), 

is amended— 

(A) in paragraph (2)(B)— 

(i) in the matter preceding clause (i), by striking 

‘‘(25)’’ and inserting ‘‘(27)’’; 

(ii) in clause (i), by striking ‘‘and 2023’’ and 

inserting ‘‘, 2023, and 2027’’; and 

(iii) in clause (ii)(I), by striking ‘‘(or, in the case 

of fiscal year 2018, under paragraph (4))’’ and inserting 

‘‘(or, in the case of fiscal year 2018 or 2024, under 

paragraph (4) or (10), respectively)’’; 

(B) in paragraph (5)— 

(i) by striking ‘‘or (10)’’ and inserting ‘‘(10), or 

(11)’’; and 

(ii) by striking ‘‘or 2023,’’ and inserting ‘‘2023, or 

2027,’’; 

(C) in paragraph (7)— 

(i) in subparagraph (A), by striking ‘‘2023’’ and 

inserting ‘‘2027,’’; and 

(ii) in the matter following subparagraph (B), by 

striking ‘‘or fiscal year 2022’’ and inserting ‘‘fiscal year 

2022, fiscal year 2024, or fiscal year 2026’’; 

(D) in paragraph (9)— 

(i) by striking ‘‘or (10)’’ and inserting ‘‘(10), or 

(11)’’; and 

(ii) by striking ‘‘or 2023,’’ and inserting ‘‘2023, or 

2027,’’; and 

(E) by adding at the end the following: 

‘‘(11) FOR FISCAL YEAR 2027.— 

‘‘(A) FIRST HALF.—Subject to paragraphs (5) and (7), 

from the amount made available under subparagraph (A) 

Computations. 

States. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 173 

of paragraph (28) of subsection (a) for the semi-annual 

period described in such subparagraph, increased by the 

amount of the appropriation for such period under section 

50101(b)(2) of the Advancing Chronic Care, Extenders, and 

Social Services Act, the Secretary shall compute a State 

allotment for each State (including the District of Columbia 

and each commonwealth and territory) for such semiannual period in an amount equal to the first half ratio 

(described in subparagraph (D)) of the amount described 

in subparagraph (C). 

‘‘(B) SECOND HALF.—Subject to paragraphs (5) and (7), 

from the amount made available under subparagraph (B) 

of paragraph (28) of subsection (a) for the semi-annual 

period described in such subparagraph, the Secretary shall 

compute a State allotment for each State (including the 

District of Columbia and each commonwealth and territory) 

for such semi-annual period in an amount equal to the 

amount made available under such subparagraph, multiplied by the ratio of— 

‘‘(i) the amount of the allotment to such State 

under subparagraph (A); to 

‘‘(ii) the total of the amount of all of the allotments 

made available under such subparagraph. 

‘‘(C) FULL YEAR AMOUNT BASED ON REBASED AMOUNT.— 

The amount described in this subparagraph for a State 

is equal to the Federal payments to the State that are 

attributable to (and countable towards) the total amount 

of allotments available under this section to the State 

in fiscal year 2026 (including payments made to the State 

under subsection (n) for fiscal year 2026 as well as amounts 

redistributed to the State in fiscal year 2026), multiplied 

by the allotment increase factor under paragraph (6) for 

fiscal year 2027. 

‘‘(D) FIRST HALF RATIO.—The first half ratio described 

in this subparagraph is the ratio of— 

‘‘(i) the sum of— 

‘‘(I) the amount made available under subsection (a)(28)(A); and 

‘‘(II) the amount of the appropriation for such 

period under section 50101(b)(2) of the Advancing 

Chronic Care, Extenders, and Social Services Act; 

to 

‘‘(ii) the sum of— 

‘‘(I) the amount described in clause (i); and 

‘‘(II) the amount made available under subsection (a)(28)(B).’’. 

(2) ONE-TIME APPROPRIATION FOR FISCAL YEAR 2027.—There 

is appropriated to the Secretary of Health and Human Services, 

out of any money in the Treasury not otherwise appropriated, 

such sums as are necessary to fund allotments to States under 

subsections (c) and (m) of section 2104 of the Social Security 

Act (42 U.S.C. 1397dd) for fiscal year 2027, taking into account 

the full year amounts calculated for States under paragraph 

(11)(C) of subsection (m) of such section (as added by paragraph 

(1)) and the amounts appropriated under subparagraphs (A) 

and (B) of subsection (a)(28) of such section (as added by 

subsection (a)). Such amount shall accompany the allotment 


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132 STAT. 174 PUBLIC LAW 115–123—FEB. 9, 2018 

made for the period beginning on October 1, 2026, and ending 

on March 31, 2027, under paragraph (28)(A) of section 2104(a) 

of such Act (42 U.S.C. 1397dd(a)), to remain available until 

expended. Such amount shall be used to provide allotments 

to States under paragraph (11) of section 2104(m) of such 

Act for the first 6 months of fiscal year 2027 in the same 

manner as allotments are provided under subsection (a)(28)(A) 

of such section 2104 and subject to the same terms and conditions as apply to the allotments provided from such subsection 

(a)(28)(A). 

(c) EXTENSION OF THE CHILD ENROLLMENT CONTINGENCY

FUND.—Section 2104(n) of the Social Security Act (42 U.S.C. 

1397dd(n)), as amended by section 3002(c) of the HEALTHY KIDS 

Act (division C of Public Law 115–120), is amended— 

(1) in paragraph (2)— 

(A) in subparagraph (A)(ii)— 

(i) by striking ‘‘and 2018 through 2022’’ and 

inserting ‘‘2018 through 2022, and 2024 through 2026’’; 

and 

(ii) by striking ‘‘and 2023’’ and inserting ‘‘2023, 

and 2027’’; and 

(B) in subparagraph (B)— 

(i) by striking ‘‘and 2018 through 2022’’ and 

inserting ‘‘2018 through 2022, and 2024 through 2026’’; 

and 

(ii) by striking ‘‘and 2023’’ and inserting ‘‘2023, 

and 2027’’; and 

(2) in paragraph (3)(A), in the matter preceding clause 

(i)— 

(A) by striking ‘‘or in any of fiscal years 2018 through 

2022’’ and inserting ‘‘fiscal years 2018 through 2022, or 

fiscal years 2024 through 2026’’; and 

(B) by striking ‘‘or 2023’’ and inserting ‘‘2023, or 2027’’. 

(d) EXTENSION OF QUALIFYING STATES OPTION.—Section 

2105(g)(4) of the Social Security Act (42 U.S.C. 1397ee(g)(4)), as 

amended by section 3002(d) of the HEALTHY KIDS Act (division 

C of Public Law 115–120), is amended— 

(1) in the paragraph heading, by striking ‘‘THROUGH 2023’’ 

and inserting ‘‘THROUGH 2027’’; and 

(2) in subparagraph (A), by striking ‘‘2023’’ and inserting 

‘‘2027’’. 

(e) EXTENSION OF EXPRESS LANE ELIGIBILITY OPTION.—Section 

1902(e)(13)(I) of the Social Security Act (42 U.S.C. 1396a(e)(13)(I)), 

as amended by section 3002(e) of the HEALTHY KIDS Act (division 

C of Public Law 115–120), is amended by striking ‘‘2023’’ and 

inserting ‘‘2027’’. 

(f) ASSURANCE OF ELIGIBILITY STANDARD FOR CHILDREN AND

FAMILIES.— 

(1) IN GENERAL.—Section 2105(d)(3) of the Social Security 

Act (42 U.S.C. 1397ee(d)(3)), as amended by section 3002(f)(1) 

of the HEALTHY KIDS Act (division C of Public Law 115– 

120), is amended— 

(A) in the paragraph heading, by striking ‘‘THROUGH

SEPTEMBER 30, 2023’’ and inserting ‘‘THROUGH SEPTEMBER

30, 2027’’; and 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 175 

(B) in subparagraph (A), in the matter preceding clause 

(i), by striking ‘‘2023’’ each place it appears and inserting 

‘‘2027’’. 

(2) CONFORMING AMENDMENTS.—Section 1902(gg)(2) of the 

Social Security Act (42 U.S.C. 1396a(gg)(2)), as amended by 

section 3002(f)(2) of the HEALTHY KIDS Act (division C of 

Public Law 115–120), is amended— 

(A) in the paragraph heading, by striking ‘‘THROUGH

SEPTEMBER 30, 2023’’ and inserting ‘‘THROUGH SEPTEMBER

30, 2027’’; and 

(B) by striking ‘‘2023,’’ each place it appears and 

inserting ‘‘2027’’. 

SEC. 50102. EXTENSION OF PEDIATRIC QUALITY MEASURES PROGRAM. 

(a) IN GENERAL.—Section 1139A(i)(1) of the Social Security 

Act (42 U.S.C. 1320b–9a(i)(1)), as amended by section 3003(b) of 

the HEALTHY KIDS Act (division C of Public Law 115–120), is 

amended— 

(1) in subparagraph (B), by striking ‘‘; and’’ and inserting 

a semicolon; 

(2) in subparagraph (C), by striking the period at the 

end and inserting ‘‘; and’’; and 

(3) by adding at the end the following new subparagraph: 

‘‘(D) for the period of fiscal years 2024 through 2027, 

$60,000,000 for the purpose of carrying out this section 

(other than subsections (e), (f), and (g)).’’. 

(b) MAKING REPORTING MANDATORY.—Section 1139A of the 

Social Security Act (42 U.S.C. 1320b–9a) is amended— 

(1) in subsection (a)— 

(A) in the heading for paragraph (4), by inserting ‘‘AND

MANDATORY REPORTING’’ after ‘‘REPORTING’’; 

(B) in paragraph (4)— 

(i) by striking ‘‘Not later than’’ and inserting the 

following: 

‘‘(A) VOLUNTARY REPORTING.—Not later than’’; and 

(ii) by adding at the end the following: 

‘‘(B) MANDATORY REPORTING.—Beginning with the 

annual State report on fiscal year 2024 required under 

subsection (c)(1), the Secretary shall require States to use 

the initial core measurement set and any updates or 

changes to that set to report information regarding the 

quality of pediatric health care under titles XIX and XXI 

using the standardized format for reporting information 

and procedures developed under subparagraph (A).’’; and 

(C) in paragraph (6)(B), by inserting ‘‘and, beginning 

with the report required on January 1, 2025, and for each 

annual report thereafter, the status of mandatory reporting 

by States under titles XIX and XXI, utilizing the initial 

core quality measurement set and any updates or changes 

to that set’’ before the semicolon; and 

(2) in subsection (c)(1)(A), by inserting ‘‘and, beginning 

with the annual report on fiscal year 2024, all of the core 

measures described in subsection (a) and any updates or 

changes to those measures’’ before the semicolon. 

Effective date. 

Effective dates. 

Time period. 


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132 STAT. 176 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 50103. EXTENSION OF OUTREACH AND ENROLLMENT PROGRAM. 

(a) IN GENERAL.—Section 2113 of the Social Security Act (42 

U.S.C. 1397mm), as amended by section 3004(a) of the HEALTHY 

KIDS Act (division C of Public Law 115–120), is amended— 

(1) in subsection (a)(1), by striking ‘‘2023’’ and inserting 

‘‘2027’’; and 

(2) in subsection (g)— 

(A) by striking ‘‘and $120,000,000’’ and inserting ‘‘, 

$120,000,000’’; and 

(B) by inserting ‘‘, and $48,000,000 for the period of 

fiscal years 2024 through 2027’’ after ‘‘2023’’. 

(b) ADDITIONAL RESERVED FUNDS.—Section 2113(a) of the Social 

Security Act (42 U.S.C. 1397mm(a)) is amended— 

(1) in paragraph (1), by striking ‘‘paragraph (2)’’ and 

inserting ‘‘paragraphs (2) and (3)’’; and 

(2) by adding at the end the following new paragraph: 

‘‘(3) TEN PERCENT SET ASIDE FOR EVALUATING AND PROVIDING TECHNICAL ASSISTANCE TO GRANTEES.—For the period 

of fiscal years 2024 through 2027, an amount equal to 10 

percent of such amounts shall be used by the Secretary for 

the purpose of evaluating and providing technical assistance 

to eligible entities awarded grants under this section.’’. 

(c) USE OF RESERVED FUNDS FOR NATIONAL ENROLLMENT AND

RETENTION STRATEGIES.—Section 2113(h) of the Social Security Act 

(42 U.S.C. 1397mm(h)) is amended— 

(1) in paragraph (5), by striking ‘‘; and’’ and inserting 

a semicolon; 

(2) by redesignating paragraph (6) as paragraph (7); and 

(3) by inserting after paragraph (5) the following new paragraph: 

‘‘(6) the development of materials and toolkits and the 

provision of technical assistance to States regarding enrollment 

and retention strategies for eligible children under this title 

and title XIX; and’’. 

TITLE II—MEDICARE EXTENDERS 

SEC. 50201. EXTENSION OF WORK GPCI FLOOR. 

Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 

1395w–4(e)(1)(E)) is amended by striking ‘‘January 1, 2018’’ and 

inserting ‘‘January 1, 2020’’. 

SEC. 50202. REPEAL OF MEDICARE PAYMENT CAP FOR THERAPY SERVICES; LIMITATION TO ENSURE APPROPRIATE THERAPY. 

Section 1833(g) of the Social Security Act (42 U.S.C. 1395l(g)) 

is amended— 

(1) in paragraph (1)— 

(A) by striking ‘‘Subject to paragraphs (4) and (5)’’ 

and inserting ‘‘(A) Subject to paragraphs (4) and (5)’’; 

(B) in the subparagraph (A), as inserted and designated 

by subparagraph (A) of this paragraph, by adding at the 

end the following new sentence: ‘‘The preceding sentence 

shall not apply to expenses incurred with respect to services 

furnished after December 31, 2017.’’; and 

(C) by adding at the end the following new subparagraph: 

Time periods. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 177 

‘‘(B) With respect to services furnished during 2018 or a subsequent year, in the case of physical therapy services of the type 

described in section 1861(p), speech-language pathology services 

of the type described in such section through the application of 

section 1861(ll)(2), and physical therapy services and speech-language pathology services of such type which are furnished by a 

physician or as incident to physicians’ services, with respect to 

expenses incurred in any calendar year, any amount that is more 

than the amount specified in paragraph (2) for the year shall 

not be considered as incurred expenses for purposes of subsections 

(a) and (b) unless the applicable requirements of paragraph (7) 

are met.’’; 

(2) in paragraph (3)— 

(A) by striking ‘‘Subject to paragraphs (4) and (5)’’ 

and inserting ‘‘(A) Subject to paragraphs (4) and (5)’’; 

(B) in the subparagraph (A), as inserted and designated 

by subparagraph (A) of this paragraph, by adding at the 

end the following new sentence: ‘‘The preceding sentence 

shall not apply to expenses incurred with respect to services 

furnished after December 31, 2017.’’; and 

(C) by adding at the end the following new subparagraph:. 

‘‘(B) With respect to services furnished during 2018 or a subsequent year, in the case of occupational therapy services (of the 

type that are described in section 1861(p) through the operation 

of section 1861(g) and of such type which are furnished by a 

physician or as incident to physicians’ services), with respect to 

expenses incurred in any calendar year, any amount that is more 

than the amount specified in paragraph (2) for the year shall 

not be considered as incurred expenses for purposes of subsections 

(a) and (b) unless the applicable requirements of paragraph (7) 

are met.’’; 

(3) in paragraph (5)— 

(A) by redesignating subparagraph (D) as paragraph 

(8) and moving such paragraph to immediately follow paragraph (7), as added by paragraph (4) of this section; and 

(B) in subparagraph (E)(iv), by inserting ‘‘, except as 

such process is applied under paragraph (7)(B)’’ before the 

period at the end; and 

(4) by adding at the end the following new paragraph: 

‘‘(7) For purposes of paragraphs (1)(B) and (3)(B), with respect 

to services described in such paragraphs, the requirements 

described in this paragraph are as follows: 

‘‘(A) INCLUSION OF APPROPRIATE MODIFIER.—The claim for 

such services contains an appropriate modifier (such as the 

KX modifier described in paragraph (5)(B)) indicating that such 

services are medically necessary as justified by appropriate 

documentation in the medical record involved. 

‘‘(B) TARGETED MEDICAL REVIEW FOR CERTAIN SERVICES

ABOVE THRESHOLD.— 

‘‘(i) IN GENERAL.—In the case where expenses that 

would be incurred for such services would exceed the 

threshold described in clause (ii) for the year, such services 

shall be subject to the process for medical review implemented under paragraph (5)(E). 

‘‘(ii) THRESHOLD.—The threshold under this clause 

for— 


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132 STAT. 178 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(I) a year before 2028, is $3,000; 

‘‘(II) 2028, is the amount specified in subclause 

(I) increased by the percentage increase in the MEI 

(as defined in section 1842(i)(3)) for 2028; and 

‘‘(III) a subsequent year, is the amount specified 

in this clause for the preceding year increased by the 

percentage increase in the MEI (as defined in section 

1842(i)(3)) for such subsequent year; 

except that if an increase under subclause (II) or (III) 

for a year is not a multiple of $10, it shall be rounded 

to the nearest multiple of $10. 

‘‘(iii) APPLICATION.—The threshold under clause (ii) 

shall be applied separately— 

‘‘(I) for physical therapy services and speech-language pathology services; and 

‘‘(II) for occupational therapy services. 

‘‘(iv) FUNDING.—For purposes of carrying out this 

subparagraph, the Secretary shall provide for the transfer, 

from the Federal Supplementary Medical Insurance Trust 

Fund under section 1841 to the Centers for Medicare & 

Medicaid Services Program Management Account, of 

$5,000,000 for each fiscal year beginning with fiscal year 

2018, to remain available until expended. Such funds may 

not be used by a contractor under section 1893(h) for medical reviews under this subparagraph.’’. 

SEC. 50203. MEDICARE AMBULANCE SERVICES. 

(a) EXTENSION OF CERTAIN GROUND AMBULANCE ADD-ON PAYMENTS.— 

(1) GROUND AMBULANCE.—Section 1834(l)(13)(A) of the 

Social Security Act (42 U.S.C. 1395m(l)(13)(A)) is amended 

by striking ‘‘2018’’ and inserting ‘‘2023’’ each place it appears. 

(2) SUPER RURAL AMBULANCE.—Section 1834(l)(12)(A) of the 

Social Security Act (42 U.S.C. 1395m(l)(12)(A)) is amended, 

in the first sentence, by striking ‘‘2018’’ and inserting ‘‘2023’’. 

(b) REQUIRING GROUND AMBULANCE PROVIDERS OF SERVICES

AND SUPPLIERS TO SUBMIT COST AND OTHER INFORMATION.—Section 

1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) is amended 

by adding at the end the following new paragraph: 

‘‘(17) SUBMISSION OF COST AND OTHER INFORMATION.— 

‘‘(A) DEVELOPMENT OF DATA COLLECTION SYSTEM.—The 

Secretary shall develop a data collection system (which 

may include use of a cost survey) to collect cost, revenue, 

utilization, and other information determined appropriate 

by the Secretary with respect to providers of services (in 

this paragraph referred to as ‘providers’) and suppliers 

of ground ambulance services. Such system shall be 

designed to collect information— 

‘‘(i) needed to evaluate the extent to which reported 

costs relate to payment rates under this subsection; 

‘‘(ii) on the utilization of capital equipment and 

ambulance capacity, including information consistent 

with the type of information described in section 

1121(a); and 

‘‘(iii) on different types of ground ambulance services furnished in different geographic locations, 

Evaluation. 

Time period. 


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including rural areas and low population density areas 

described in paragraph (12). 

‘‘(B) SPECIFICATION OF DATA COLLECTION SYSTEM.— 

‘‘(i) IN GENERAL.—The Secretary shall— 

‘‘(I) not later than December 31, 2019, specify 

the data collection system under subparagraph (A); 

and 

‘‘(II) identify the providers and suppliers of 

ground ambulance services that would be required 

to submit information under such data collection 

system, including the representative sample 

described in clause (ii). 

‘‘(ii) DETERMINATION OF REPRESENTATIVE

SAMPLE.— 

‘‘(I) IN GENERAL.—Not later than December 

31, 2019, with respect to the data collection for 

the first year under such system, and for each 

subsequent year through 2024, the Secretary shall 

determine a representative sample to submit 

information under the data collection system. 

‘‘(II) REQUIREMENTS.—The sample under subclause (I) shall be representative of the different 

types of providers and suppliers of ground ambulance services (such as those providers and suppliers that are part of an emergency service or 

part of a government organization) and the 

geographic locations in which ground ambulance 

services are furnished (such as urban, rural, and 

low population density areas). 

‘‘(III) LIMITATION.—The Secretary shall not 

include an individual provider or supplier of 

ground ambulance services in the sample under 

subclause (I) in 2 consecutive years, to the extent 

practicable. 

‘‘(C) REPORTING OF COST INFORMATION.—For each year, 

a provider or supplier of ground ambulance services identified by the Secretary under subparagraph (B)(i)(II) as being 

required to submit information under the data collection 

system with respect to a period for the year shall submit 

to the Secretary information specified under the system. 

Such information shall be submitted in a form and manner, 

and at a time, specified by the Secretary for purposes 

of this subparagraph. 

‘‘(D) PAYMENT REDUCTION FOR FAILURE TO REPORT.— 

‘‘(i) IN GENERAL.—Beginning January 1, 2022, subject to clause (ii), a 10 percent reduction to payments 

under this subsection shall be made for the applicable 

period (as defined in clause (ii)) to a provider or supplier of ground ambulance services that— 

‘‘(I) is required to submit information under 

the data collection system with respect to a period 

under subparagraph (C); and 

‘‘(II) does not sufficiently submit such information, as determined by the Secretary. 

‘‘(ii) APPLICABLE PERIOD DEFINED.—For purposes 

of clause (i), the term ‘applicable period’ means, with 

respect to a provider or supplier of ground ambulance 

Effective date. 

Deadlines. 

Deadline. 


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services, a year specified by the Secretary not more 

than 2 years after the end of the period with respect 

to which the Secretary has made a determination 

under clause (i)(II) that the provider or supplier of 

ground ambulance services failed to sufficiently submit 

information under the data collection system. 

‘‘(iii) HARDSHIP EXEMPTION.—The Secretary may 

exempt a provider or supplier from the payment reduction under clause (i) with respect to an applicable 

period in the event of significant hardship, such as 

a natural disaster, bankruptcy, or other similar situation that the Secretary determines interfered with the 

ability of the provider or supplier of ground ambulance 

services to submit such information in a timely manner 

for the specified period. 

‘‘(iv) INFORMAL REVIEW.—The Secretary shall 

establish a process under which a provider or supplier 

of ground ambulance services may seek an informal 

review of a determination that the provider or supplier 

is subject to the payment reduction under clause (i). 

‘‘(E) ONGOING DATA COLLECTION.— 

‘‘(i) REVISION OF DATA COLLECTION SYSTEM.—The 

Secretary may, as the Secretary determines appropriate and, if available, taking into consideration the 

report (or reports) under subparagraph (F), revise the 

data collection system under subparagraph (A). 

‘‘(ii) SUBSEQUENT DATA COLLECTION.—In order to 

continue to evaluate the extent to which reported costs 

relate to payment rates under this subsection and for 

other purposes the Secretary deems appropriate, the 

Secretary shall require providers and suppliers of 

ground ambulance services to submit information for 

years after 2024 as the Secretary determines appropriate, but in no case less often than once every 3 

years. 

‘‘(F) GROUND AMBULANCE DATA COLLECTION SYSTEM

STUDY.— 

‘‘(i) IN GENERAL.—Not later than March 15, 2023, 

and as determined necessary by the Medicare Payment 

Advisory Commission thereafter, such Commission 

shall assess, and submit to Congress a report on, 

information submitted by providers and suppliers of 

ground ambulance services through the data collection 

system under subparagraph (A), the adequacy of payments for ground ambulance services under this subsection, and geographic variations in the cost of furnishing such services. 

‘‘(ii) CONTENTS.—A report under clause (i) shall 

contain the following: 

‘‘(I) An analysis of information submitted 

through the data collection system. 

‘‘(II) An analysis of any burden on providers 

and suppliers of ground ambulance services associated with the data collection system. 

‘‘(III) A recommendation as to whether 

information should continue to be submitted 

through such data collection system or if such 

Recommendation. 

Analysis. 

Deadline. 

Assessment. 

Reports. 

Time period. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 181 

system should be revised under subparagraph 

(E)(i). 

‘‘(IV) Other information determined appropriate by the Commission. 

‘‘(G) PUBLIC AVAILABILITY.—The Secretary shall post 

information on the results of the data collection under 

this paragraph on the Internet website of the Centers 

for Medicare & Medicaid Services, as determined appropriate by the Secretary. 

‘‘(H) IMPLEMENTATION.—The Secretary shall implement 

this paragraph through notice and comment rulemaking. 

‘‘(I) ADMINISTRATION.—Chapter 35 of title 44, United 

States Code, shall not apply to the collection of information 

required under this subsection. 

‘‘(J) LIMITATIONS ON REVIEW.—There shall be no 

administrative or judicial review under section 1869, section 1878, or otherwise of the data collection system or 

identification of respondents under this paragraph. 

‘‘(K) FUNDING FOR IMPLEMENTATION.—For purposes of 

carrying out subparagraph (A), the Secretary shall provide 

for the transfer, from the Federal Supplementary Medical 

Insurance Trust Fund under section 1841, of $15,000,000 

to the Centers for Medicare & Medicaid Services Program 

Management Account for fiscal year 2018. Amounts transferred under this subparagraph shall remain available until 

expended.’’. 

SEC. 50204. EXTENSION OF INCREASED INPATIENT HOSPITAL PAYMENT ADJUSTMENT FOR CERTAIN LOW-VOLUME HOSPITALS. 

(a) IN GENERAL.—Section 1886(d)(12) of the Social Security 

Act (42 U.S.C. 1395ww(d)(12)) is amended— 

(1) in subparagraph (B), in the matter preceding clause 

(i), by striking ‘‘fiscal year 2018’’ and inserting ‘‘fiscal year 

2023’’; 

(2) in subparagraph (C)— 

(A) in clause (i)— 

(i) by striking ‘‘through 2017’’ the first place it 

appears and inserting ‘‘through 2022’’; and 

(ii) by striking ‘‘ and has less than 800 discharges’’ 

and all that follows through the period at the end 

and inserting the following ‘‘and has— 

‘‘(I) with respect to each of fiscal years 2005 

through 2010, less than 800 discharges during the 

fiscal year; 

‘‘(II) with respect to each of fiscal years 2011 

through 2018, less than 1,600 discharges of 

individuals entitled to, or enrolled for, benefits 

under part A during the fiscal year or portion 

of fiscal year; 

‘‘(III) with respect to each of fiscal years 2019 

through 2022, less than 3,800 discharges during 

the fiscal year; and 

‘‘(IV) with respect to fiscal year 2023 and each 

subsequent fiscal year, less than 800 discharges 

during the fiscal year.’’; and 

(B) in clause (ii)— 

Notice. 

Web posting. 


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(i) by striking ‘‘subparagraph (B)’’ and inserting 

‘‘subparagraphs (B) and (D)’’; and 

(ii) by inserting ‘‘(except as provided in clause (i)(II) 

and subparagraph (D)(i))’’ after ‘‘regardless’’; and 

(3) in subparagraph (D)— 

(A) by striking ‘‘through 2017’’ and inserting ‘‘through 

2022’’; 

(B) by striking ‘‘hospitals with 200 or fewer’’ and 

inserting the following: ‘‘hospitals— 

‘‘(i) with respect to each of fiscal years 2011 

through 2018, with 200 or fewer’’; 

(C) by striking the period at the end and inserting 

‘‘or portion of fiscal year; and’’; and 

(D) by adding at the end the following new clause: 

‘‘(ii) with respect to each of fiscal years 2019 

through 2022, with 500 or fewer discharges in the 

fiscal year to 0 percent for low-volume hospitals with 

greater than 3,800 discharges in the fiscal year.’’. 

(b) MEDPAC REPORT ON EXTENSION OF INCREASED INPATIENT

HOSPITAL PAYMENT ADJUSTMENT FOR CERTAIN LOW-VOLUME HOSPITALS.— 

(1) IN GENERAL.—Not later than March 15, 2022, the Medicare Payment Advisory Commission shall submit to Congress 

a report on the extension of the increased inpatient hospital 

payment adjustment for certain low-volume hospitals under 

section 1886(d)(12) of the Social Security Act (42 U.S.C. 

1395ww(d)(12)) under the provisions of, and amendments made 

by, this section. 

(2) CONTENTS.—The report under paragraph (1) shall 

include an evaluation of the effects of such extension on the 

following: 

(A) Beneficiary utilization of inpatient hospital services 

under title XVIII of the Social Security Act (42 U.S.C. 

1395 et seq.). 

(B) The financial status of hospitals with a low volume 

of Medicare or total inpatient admissions. 

(C) Program spending under such title XVIII. 

(D) Other matters relevant to evaluating the effects 

of such extension. 

SEC. 50205. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL 

(MDH) PROGRAM. 

(a) IN GENERAL.—Section 1886(d)(5)(G) of the Social Security 

Act (42 U.S.C. 1395ww(d)(5)(G)) is amended— 

(1) in clause (i), by striking ‘‘October 1, 2017’’ and inserting 

‘‘October 1, 2022’’; 

(2) in clause (ii)(II), by striking ‘‘October 1, 2017’’ and 

inserting ‘‘October 1, 2022’’; and 

(3) in clause (iv), by striking subclause (I) and inserting 

the following new subclause: 

‘‘(I) that is located in— 

‘‘(aa) a rural area; or 

‘‘(bb) a State with no rural area (as defined in paragraph (2)(D)) and satisfies any of the criteria in subclause 

(I), (II), or (III) of paragraph (8)(E)(ii),’’; and 

(4) by inserting after subclause (IV) the following new 

flush sentences: 

Time period. 


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‘‘Subclause (I)(bb) shall apply for purposes of payment under clause 

(ii) only for discharges of a hospital occurring on or after the 

effective date of a determination of medicare-dependent small rural 

hospital status made by the Secretary with respect to the hospital 

after the date of the enactment of this sentence. For purposes 

of applying subclause (II) of paragraph (8)(E)(ii) under subclause 

(I)(bb), such subclause (II) shall be applied by inserting ‘as of 

January 1, 2018,’ after ‘such State’ each place it appears.’’. 

(b) CONFORMING AMENDMENTS.— (1) EXTENSION OF TARGET AMOUNT.—Section 1886(b)(3)(D) 

of the Social Security Act (42 U.S.C. 1395ww(b)(3)(D)) is 

amended— 

(A) in the matter preceding clause (i), by striking 

‘‘October 1, 2017’’ and inserting ‘‘October 1, 2022’’; and 

(B) in clause (iv), by striking ‘‘through fiscal year 2017’’ 

and inserting ‘‘through fiscal year 2022’’. 

(2) PERMITTING HOSPITALS TO DECLINE RECLASSIFICATION.— 

Section 13501(e)(2) of the Omnibus Budget Reconciliation Act 

of 1993 (42 U.S.C. 1395ww note) is amended by striking 

‘‘through fiscal year 2017’’ and inserting ‘‘through fiscal year 

2022’’. 

(c) GAO STUDY AND REPORT.— 

(1) STUDY.—The Comptroller General of the United States 

(in this subsection referred to as the ‘‘Comptroller General’’) 

shall conduct a study on the medicare-dependent, small rural 

hospital program under section 1886(d) of the Social Security 

Act (42 U.S.C. 1395x(d)). Such study shall include an analysis 

of the following: 

(A) The payor mix of medicare-dependent, small rural 

hospitals (as defined in paragraph (5)(G)(iv) of such section 

1886(d)), how such mix will trend in future years (based 

on current trends and projections), and whether or not 

the requirement under subclause (IV) of such paragraph 

should be revised. 

(B) The characteristics of medicare-dependent, small 

rural hospitals that meet the requirement of such subclause 

(IV) through the application of paragraph (a)(iii)(A) or 

(a)(iii)(B) of section 412.108 of title 42, Code of Federal 

Regulations, including Medicare inpatient and outpatient 

utilization, payor mix, and financial status (including Medicare and total margins), and whether or not Medicare 

payments for such hospitals should be revised. 

(C) Such other items related to medicare-dependent, 

small rural hospitals as the Comptroller General determines appropriate. 

(2) REPORT.—Not later than 2 years after the date of the 

enactment of this Act, the Comptroller General shall submit 

to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations 

for such legislation and administrative action as the Comptroller General determines appropriate. 

SEC. 50206. EXTENSION OF FUNDING FOR QUALITY MEASURE 

ENDORSEMENT, INPUT, AND SELECTION; REPORTING 

REQUIREMENTS. 

(a) EXTENSION OF FUNDING.—Section 1890(d)(2) of the Social 

Security Act (42 U.S.C. 1395aaa(d)(2)) is amended— 

Recommendations. 

Analysis. 

Applicability. 


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132 STAT. 184 PUBLIC LAW 115–123—FEB. 9, 2018 

(1) in the first sentence— 

(A) by striking ‘‘2014 and’’ and inserting ‘‘2014,’’; and 

(B) by inserting the following before the period: ‘‘, 

and $7,500,000 for each of fiscal years 2018 and 2019’’; 

and 

(2) by adding at the end the following new sentence: 

‘‘Amounts transferred for each of fiscal years 2018 and 2019 

shall be in addition to any unobligated funds transferred for 

a preceding fiscal year that are available under the preceding 

sentence.’’ 

(b) ANNUAL REPORT BY SECRETARY TO CONGRESS.—Section 1890 

of the Social Security Act (42 U.S.C. 1395aaa) is amended by 

adding at the end the following new subsection: 

‘‘(e) ANNUAL REPORT BY SECRETARY TO CONGRESS.—By not 

later than March 1 of each year (beginning with 2019), the Secretary 

shall submit to Congress a report containing the following: 

‘‘(1) A comprehensive plan that identifies the quality 

measurement needs of programs and initiatives of the Secretary 

and provides a strategy for using the entity with a contract 

under subsection (a) and any other entity the Secretary has 

contracted with or may contract with to perform work associated with section 1890A to help meet those needs, specifically 

with respect to the programs under this title and title XIX. 

In years after the first plan under this paragraph is submitted, 

the requirements of this paragraph may be met by providing 

an update to the plan. 

‘‘(2) The amount of funding provided under subsection (d) 

for purposes of carrying out this section and section 1890A 

that has been obligated by the Secretary, the amount of funding 

provided that has been expended, and the amount of funding 

provided that remains unobligated. 

‘‘(3) With respect to the activities described under this 

section or section 1890A, a description of how the funds 

described in paragraph (2) have been obligated or expended, 

including how much of that funding has been obligated or 

expended for work performed by the Secretary, the entity with 

a contract under subsection (a), and any other entity the Secretary has contracted with to perform work. 

‘‘(4) A description of the activities for which the funds 

described in paragraph (2) were used, including task orders 

and activities assigned to the entity with a contract under 

subsection (a), activities performed by the Secretary, and task 

orders and activities assigned to any other entity the Secretary 

has contracted with to perform work related to carrying out 

section 1890A. 

‘‘(5) The amount of funding described in paragraph (2) 

that has been obligated or expended for each of the activities 

described in paragraph (4). 

‘‘(6) Estimates for, and descriptions of, obligations and 

expenditures that the Secretary anticipates will be needed in 

the succeeding two year period to carry out each of the quality 

measurement activities required under this section and section 

1890A, including any obligations that will require funds to 

be expended in a future year.’’. 

(c) REVISIONS TO ANNUAL REPORT FROM CONSENSUS-BASED

ENTITY TO CONGRESS AND THE SECRETARY.— 

Estimate. 

Time period. 

Updates. 

Plan. 

Contracts. 

Effective date. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 185 

(1) IN GENERAL.—Section 1890(b)(5)(A) of the Social Security Act (42 U.S.C. 1395aaa(b)(5)(A)) is amended— 

(A) by redesignating clauses (i) through (vi) as subclauses (I) through (VI), respectively, and moving the margins accordingly; 

(B) in the matter preceding subclause (I), as redesignated by subparagraph (A), by striking ‘‘containing a 

description of—’’ and inserting ‘‘containing the following: 

‘‘(i) A description of—’’; and 

(C) by adding at the end the following new clauses: 

‘‘(ii) An itemization of financial information for 

the fiscal year ending September 30 of the preceding 

year, including— 

‘‘(I) annual revenues of the entity (including 

any government funding, private sector contributions, grants, membership revenues, and investment revenue); 

‘‘(II) annual expenses of the entity (including 

grants paid, benefits paid, salaries or other compensation, fundraising expenses, and overhead 

costs); and 

‘‘(III) a breakdown of the amount awarded per 

contracted task order and the specific projects 

funded in each task order assigned to the entity. 

‘‘(iii) Any updates or modifications of internal policies and procedures of the entity as they relate to 

the duties of the entity under this section, including— 

‘‘(I) specifically identifying any modifications 

to the disclosure of interests and conflicts of 

interests for committees, work groups, task forces, 

and advisory panels of the entity; and 

‘‘(II) information on external stakeholder 

participation in the duties of the entity under this 

section (including complete rosters for all committees, work groups, task forces, and advisory panels 

funded through government contracts, descriptions 

of relevant interests and any conflicts of interest 

for members of all committees, work groups, task 

forces, and advisory panels, and the total percentage by health care sector of all convened committees, work groups, task forces, and advisory 

panels.’’. 

(2) EFFECTIVE DATE.—The amendments made by this subsection shall apply to reports submitted for years beginning 

with 2019. 

(d) GAO STUDY AND REPORT.— 

(1) STUDY.—The Comptroller General of the United States 

shall conduct a study on health care quality measurement 

efforts funded under sections 1890 and 1890A of the Social 

Security Act (42 U.S.C. 1395aaa; 1395aaa–1). Such study shall 

include an examination of the following: 

(A) The extent to which the Secretary of Health and 

Human Services (in this subsection referred to as the ‘‘Secretary’’) has set and prioritized objectives to be achieved 

for each of the quality measurement activities required 

under such sections 1890 and 1890A. 

Contracts. 

Applicability. 

42 USC 1395aaa 

note. 


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132 STAT. 186 PUBLIC LAW 115–123—FEB. 9, 2018 

(B) The efforts that the Secretary has undertaken to 

meet quality measurement objectives associated with such 

sections 1890 and 1890A, including division of responsibilities for those efforts within the Department of Health 

and Human Services and through contracts with a consensus-based entity under subsection (a) of such section 

1890 (in this subsection referred to as the ‘‘consensusbased entity’’) and other entities, and the extent of any 

overlap among the work performed by the Secretary, the 

consensus-based entity, the Measure Applications Partnership (MAP) convened by such entity to provide input to 

the Secretary on the selection of quality and efficiency 

measures, and any other entities the Secretary has contracted with to perform work related to carrying out such 

sections 1890 and 1890A. 

(C) The total amount of funding provided to the Secretary for purposes of carrying out such sections 1890 

and 1890A, the amount of such funding that has been 

obligated or expended by the Secretary, and the amount 

of such funding that remains unobligated. 

(D) How the funds described in subparagraph (C) have 

been allocated, including how much of the funding has 

been allocated for work performed by the Secretary, the 

consensus-based entity, and any other entity the Secretary 

has contracted with to perform work related to carrying 

out such sections 1890 and 1890A, respectively, and 

descriptions of such work. 

(E) The extent to which the Secretary has developed 

a comprehensive and long-term plan to ensure that it can 

achieve quality measurement objectives related to carrying 

out such sections 1890 and 1890A in a timely manner 

and with efficient use of available resources, including the 

roles of the consensus-based entity, the Measure Applications Partnership (MAP), and any other entity the Secretary has contracted with to perform work related to such 

sections 1890 and 1890A in helping the Secretary achieve 

those objectives. 

(2) REPORT.—Not later than 18 months after the date of 

enactment of this Act, the Comptroller General of the United 

States shall submit to Congress a report containing the results 

of the study conducted under paragraph (1), together with 

recommendations for such legislation and administrative action 

as the Comptroller General determines appropriate. 

SEC. 50207. EXTENSION OF FUNDING OUTREACH AND ASSISTANCE FOR 

LOW-INCOME PROGRAMS; STATE HEALTH INSURANCE 

ASSISTANCE PROGRAM REPORTING REQUIREMENTS. 

(a) FUNDING EXTENSIONS.— 

(1) ADDITIONAL FUNDING FOR STATE HEALTH INSURANCE

PROGRAMS.—Subsection (a)(1)(B) of section 119 of the Medicare 

Improvements for Patients and Providers Act of 2008 (42 U.S.C. 

1395b–3 note), as amended by section 3306 of the Patient 

Protection and Affordable Care Act (Public Law 111–148), section 610 of the American Taxpayer Relief Act of 2012 (Public 

Law 112–240), section 1110 of the Pathway for SGR Reform 

Act of 2013 (Public Law 113–67), section 110 of the Protecting 

Access to Medicare Act of 2014 (Public Law 113–93), and section 

Recommendations. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 187 

208 of the Medicare Access and CHIP Reauthorization Act 

of 2015 (Public Law 114–10) is amended— 

(A) in clause (vi), by striking ‘‘and’’ at the end; 

(B) in clause (vii), by striking the period at the end 

and inserting ‘‘; and’’; and 

(C) by adding at the end the following new clauses: 

‘‘(viii) for fiscal year 2018, of $13,000,000; and 

‘‘(ix) for fiscal year 2019, of $13,000,000.’’. 

(2) ADDITIONAL FUNDING FOR AREA AGENCIES ON AGING.— 

Subsection (b)(1)(B) of such section 119, as so amended, is 

amended— 

(A) in clause (vi), by striking ‘‘and’’ at the end; 

(B) in clause (vii), by striking the period at the end 

and inserting ‘‘; and’’; and 

(C) by inserting after clause (vii) the following new 

clauses: 

‘‘(viii) for fiscal year 2018, of $7,500,000; and 

‘‘(ix) for fiscal year 2019, of $7,500,000.’’. 

(3) ADDITIONAL FUNDING FOR AGING AND DISABILITY

RESOURCE CENTERS.—Subsection (c)(1)(B) of such section 119, 

as so amended, is amended— 

(A) in clause (vi), by striking ‘‘and’’ at the end; 

(B) in clause (vii), by striking the period at the end 

and inserting ‘‘; and’’; and 

(C) by inserting after clause (vii) the following new 

clauses: 

‘‘(viii) for fiscal year 2018, of $5,000,000; and 

‘‘(ix) for fiscal year 2019, of $5,000,000.’’. 

(4) ADDITIONAL FUNDING FOR CONTRACT WITH THE NATIONAL

CENTER FOR BENEFITS AND OUTREACH ENROLLMENT.—Subsection (d)(2) of such section 119, as so amended, is amended— 

(A) in clause (vi), by striking ‘‘and’’ at the end; 

(B) in clause (vii), by striking the period at the end 

and inserting ‘‘; and’’; and 

(C) by inserting after clause (vii) the following new 

clauses: 

‘‘(viii) for fiscal year 2018, of $12,000,000; and 

‘‘(ix) for fiscal year 2019, of $12,000,000.’’. 

(b) STATE HEALTH INSURANCE ASSISTANCE PROGRAM REPORTING

REQUIREMENTS.—Beginning not later than April 1, 2019, and 

biennially thereafter, the Agency for Community Living shall electronically post on its website the following information, with respect 

to grants to States for State health insurance assistance programs, 

(such information to be presented by State and by entity receiving 

funds from the State to carry out such a program funded by such 

grant): 

(1) The amount of Federal funding provided to each such 

State for such program for the period involved and the amount 

of Federal funding provided by each such State for such program to each such entity for the period involved. 

(2) Information as the Secretary may specify, with respect 

to such programs carried out through such grants, consistent 

with the terms and conditions for receipt of such grants. 

SEC. 50208. EXTENSION OF HOME HEALTH RURAL ADD-ON. 

(a) EXTENSION.— 

Effective date. 

Web posting. 

Grants. 

42 USC 1395b–3 

note. 


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132 STAT. 188 PUBLIC LAW 115–123—FEB. 9, 2018 

(1) IN GENERAL.—Section 421 of the Medicare Prescription 

Drug, Improvement, and Modernization Act of 2003 (Public 

Law 108–173; 117 Stat. 2283; 42 U.S.C. 1395fff note), as 

amended by section 5201(b) of the Deficit Reduction Act of 

2005 (Public Law 109–171; 120 Stat. 46), section 3131(c) of 

the Patient Protection and Affordable Care Act (Public Law 

111–148; 124 Stat. 428), and section 210 of the Medicare Access 

and CHIP Reauthorization Act of 2015 (Public Law 114–10; 

129 Stat. 151) is amended— 

(A) in subsection (a), by striking ‘‘January 1, 2018’’ 

and inserting ‘‘January 1, 2019’’ each place it appears; 

(B) by redesignating subsections (b) and (c) as subsections (c) and (d), respectively; 

(C) in each of subsections (c) and (d), as so redesignated, by striking ‘‘subsection (a)’’ and inserting ‘‘subsection 

(a) or (b)’’; and 

(D) by inserting after subsection (a) the following new 

subsection: 

‘‘(b) SUBSEQUENT TEMPORARY INCREASE.— 

‘‘(1) IN GENERAL.—The Secretary shall increase the payment amount otherwise made under such section 1895 for 

home health services furnished in a county (or equivalent area) 

in a rural area (as defined in such section 1886(d)(2)(D)) that, 

as determined by the Secretary— 

‘‘(A) is in the highest quartile of all counties (or equivalent areas) based on the number of Medicare home health 

episodes furnished per 100 individuals who are entitled 

to, or enrolled for, benefits under part A of title XVIII 

of the Social Security Act or enrolled for benefits under 

part B of such title (but not enrolled in a plan under 

part C of such title)— 

‘‘(i) in the case of episodes and visits ending during 

2019, by 1.5 percent; and 

‘‘(ii) in the case of episodes and visits ending during 

2020, by 0.5 percent; 

‘‘(B) has a population density of 6 individuals or fewer 

per square mile of land area and is not described in 

subparagraph (A)— 

‘‘(i) in the case of episodes and visits ending during 

2019, by 4 percent; 

‘‘(ii) in the case of episodes and visits ending during 

2020, by 3 percent; 

‘‘(iii) in the case of episodes and visits ending 

during 2021, by 2 percent; and 

‘‘(iv) in the case of episodes and visits ending 

during 2022, by 1 percent; and 

‘‘(C) is not described in either subparagraph (A) or 

(B)— 

‘‘(i) in the case of episodes and visits ending during 

2019, by 3 percent; 

‘‘(ii) in the case of episodes and visits ending during 

2020, by 2 percent; and 

‘‘(iii) in the case of episodes and visits ending 

during 2021, by 1 percent. 

Applicability. ‘‘(2) RULES FOR DETERMINATIONS.— 

Determination. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 189 

‘‘(A) NO SWITCHING.—For purposes of this subsection, 

the determination by the Secretary as to which subparagraph of paragraph (1) applies to a county (or equivalent 

area) shall be made a single time and shall apply for 

the duration of the period to which this subsection applies. 

‘‘(B) UTILIZATION.—In determining which counties (or 

equivalent areas) are in the highest quartile under paragraph (1)(A), the following rules shall apply: 

‘‘(i) The Secretary shall use data from 2015. 

‘‘(ii) The Secretary shall exclude data from the 

territories (and the territories shall not be described 

in such paragraph). 

‘‘(iii) The Secretary may exclude data from counties 

(or equivalent areas) in rural areas with a low volume 

of home health episodes (and if data is so excluded 

with respect to a county (or equivalent area), such 

county (or equivalent area) shall not be described in 

such paragraph). 

‘‘(C) POPULATION DENSITY.—In determining population 

density under paragraph (1)(B), the Secretary shall use 

data from the 2010 decennial Census. 

‘‘(3) LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review under section 1869, section 1878, 

or otherwise of determinations under paragraph (1).’’. 

(2) REQUIREMENT TO SUBMIT COUNTY DATA ON CLAIM

FORM.—Section 1895(c) of the Social Security Act (42 U.S.C. 

1395fff(c)) is amended— 

(A) in paragraph (1), by striking ‘‘and’’ at the end; 

(B) in paragraph (2), by striking the period at the 

end and inserting ‘‘; and’’; and 

(C) by adding at the end the following new paragraph: 

‘‘(3) in the case of home health services furnished on or 

after January 1, 2019, the claim contains the code for the 

county (or equivalent area) in which the home health service 

was furnished.’’. 

(b) HHS OIG ANALYSIS.—Not later than January 1, 2023, the 

Inspector General of the Department of Health and Human Services 

shall submit to Congress— 

(1) an analysis of the home health claims and utilization 

of home health services by county (or equivalent area) under 

the Medicare program; and 

(2) recommendations the Inspector General determines 

appropriate based on such analysis. 

Recommendations. 

Deadline. 


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132 STAT. 190 PUBLIC LAW 115–123—FEB. 9, 2018 

TITLE III—CREATING HIGH-QUALITY 

RESULTS AND OUTCOMES NECESSARY TO IMPROVE CHRONIC 

(CHRONIC) CARE 

Subtitle A—Receiving High Quality Care in 

the Home 

SEC. 50301. EXTENDING THE INDEPENDENCE AT HOME DEMONSTRATION PROGRAM. 

(a) IN GENERAL.—Section 1866E of the Social Security Act 

(42 U.S.C. 1395cc–5) is amended— 

(1) in subsection (e)— 

(A) in paragraph (1)— 

(i) by striking ‘‘An agreement’’ and inserting 

‘‘Agreements’’; and 

(ii) by striking ‘‘5-year’’ and inserting ‘‘7-year’’; and 

(B) in paragraph (5)— 

(i) by striking ‘‘10,000’’ and inserting ‘‘15,000’’; and 

(ii) by adding at the end the following new sentence: ‘‘An applicable beneficiary that participates in 

the demonstration program by reason of the increase 

from 10,000 to 15,000 in the preceding sentence pursuant to the amendment made by section 

50301(a)(1)(B)(i) of the Advancing Chronic Care, 

Extenders, and Social Services Act shall be considered 

in the spending target estimates under paragraph (1) 

of subsection (c) and the incentive payment calculations 

under paragraph (2) of such subsection for the sixth 

and seventh years of such program.’’; 

(2) in subsection (g), in the first sentence, by inserting 

‘‘, including, to the extent practicable, with respect to the use 

of electronic health information systems, as described in subsection (b)(1)(A)(vi)’’ after ‘‘under the demonstration program’’; 

and 

(3) in subsection (i)(1)(A), by striking ‘‘will not receive an 

incentive payment for the second of 2’’ and inserting ‘‘did not 

achieve savings for the third of 3’’. 

(b) EFFECTIVE DATE.—The amendment made by subsection 

(a)(3) shall take effect as if included in the enactment of Public 

Law 111–148. 

SEC. 50302. EXPANDING ACCESS TO HOME DIALYSIS THERAPY. 

(a) IN GENERAL.—Section 1881(b)(3) of the Social Security Act 

(42 U.S.C. 1395rr(b)(3)) is amended— 

(1) by redesignating subparagraphs (A) and (B) as clauses 

(i) and (ii), respectively; 

(2) in clause (ii), as redesignated by paragraph (1), by 

striking ‘‘on a comprehensive’’ and insert ‘‘subject to subparagraph (B), on a comprehensive’’; 

(3) by striking ‘‘With respect to’’ and inserting ‘‘(A) With 

respect to’’; and 

(4) by adding at the end the following new subparagraph: 

42 USC 1395cc–5 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 191 

‘‘(B)(i) For purposes of subparagraph (A)(ii), subject to clause 

(ii), an individual determined to have end stage renal disease 

receiving home dialysis may choose to receive monthly end stage 

renal disease-related clinical assessments furnished on or after 

January 1, 2019, via telehealth. 

‘‘(ii) Clause (i) shall apply to an individual only if the individual 

receives a face-to-face clinical assessment, without the use of telehealth— 

‘‘(I) in the case of the initial 3 months of home dialysis 

of such individual, at least monthly; and 

‘‘(II) after such initial 3 months, at least once every 3 

consecutive months.’’. 

(b) ORIGINATING SITE REQUIREMENTS.— (1) IN GENERAL.—Section 1834(m) of the Social Security 

Act (42 U.S.C. 1395m(m)) is amended— 

(A) in paragraph (4)(C)(ii), by adding at the end the 

following new subclauses: 

‘‘(IX) A renal dialysis facility, but only for purposes of section 1881(b)(3)(B). 

‘‘(X) The home of an individual, but only for 

purposes of section 1881(b)(3)(B).’’; and 

(B) by adding at the end the following new paragraph: 

‘‘(5) TREATMENT OF HOME DIALYSIS MONTHLY ESRD-RELATED

VISIT.—The geographic requirements described in paragraph 

(4)(C)(i) shall not apply with respect to telehealth services 

furnished on or after January 1, 2019, for purposes of section 

1881(b)(3)(B), at an originating site described in subclause (VI), 

(IX), or (X) of paragraph (4)(C)(ii).’’. 

(2) NO FACILITY FEE IF ORIGINATING SITE FOR HOME DIALYSIS

THERAPY IS THE HOME.—Section 1834(m)(2)(B) of the Social 

Security (42 U.S.C. 1395m(m)(2)(B)) is amended— 

(A) by redesignating clauses (i) and (ii) as subclauses 

(I) and (II), and indenting appropriately; 

(B) in subclause (II), as redesignated by subparagraph 

(A), by striking ‘‘clause (i) or this clause’’ and inserting 

‘‘subclause (I) or this subclause’’; 

(C) by striking ‘‘SITE.—With respect to’’ and inserting 

‘‘SITE.— 

‘‘(i) IN GENERAL.—Subject to clause (ii), with 

respect to’’; and 

(D) by adding at the end the following new clause: 

‘‘(ii) NO FACILITY FEE IF ORIGINATING SITE FOR

HOME DIALYSIS THERAPY IS THE HOME.—No facility fee 

shall be paid under this subparagraph to an originating 

site described in paragraph (4)(C)(ii)(X).’’. 

(c) CLARIFICATION REGARDING TELEHEALTH PROVIDED TO BENEFICIARIES.—Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 

1320a–7a(i)(6)) is amended— 

(1) in subparagraph (H), by striking ‘‘or’’ at the end; 

(2) in subparagraph (I), by striking the period at the end 

and inserting ‘‘; or’’; and 

(3) by adding at the end the following new subparagraph: 

‘‘(J) the provision of telehealth technologies (as defined 

by the Secretary) on or after January 1, 2019, by a provider 

of services or a renal dialysis facility (as such terms are 

defined for purposes of title XVIII) to an individual with 

end stage renal disease who is receiving home dialysis 

Applicability. 

Time periods. 


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132 STAT. 192 PUBLIC LAW 115–123—FEB. 9, 2018 

for which payment is being made under part B of such 

title, if— 

‘‘(i) the telehealth technologies are not offered as 

part of any advertisement or solicitation; 

‘‘(ii) the telehealth technologies are provided for 

the purpose of furnishing telehealth services related 

to the individual’s end stage renal disease; and 

‘‘(iii) the provision of the telehealth technologies 

meets any other requirements set forth in regulations 

promulgated by the Secretary.’’. 

(d) CONFORMING AMENDMENT.—Section 1881(b)(1) of the Social 

Security Act (42 U.S.C. 1395rr(b)(1)) is amended by striking ‘‘paragraph (3)(A)’’ and inserting ‘‘paragraph (3)(A)(i)’’. 

Subtitle B—Advancing Team-Based Care 

SEC. 50311. PROVIDING CONTINUED ACCESS TO MEDICARE ADVANTAGE SPECIAL NEEDS PLANS FOR VULNERABLE POPULATIONS. 

(a) EXTENSION.—Section 1859(f)(1) of the Social Security Act 

(42 U.S.C. 1395w–28(f)(1)) is amended by striking ‘‘and for periods 

before January 1, 2019’’. 

(b) INCREASED INTEGRATION OF DUAL SNPS.— 

(1) IN GENERAL.—Section 1859(f) of the Social Security 

Act (42 U.S.C. 1395w–28(f)) is amended— 

(A) in paragraph (3), by adding at the end the following 

new subparagraph: 

‘‘(F) The plan meets the requirements applicable under 

paragraph (8).’’; and 

(B) by adding at the end the following new paragraph: 

‘‘(8) INCREASED INTEGRATION OF DUAL SNPS.— 

‘‘(A) DESIGNATED CONTACT.—The Secretary, acting 

through the Federal Coordinated Health Care Office established under section 2602 of Public Law 111–148, shall 

serve as a dedicated point of contact for States to address 

misalignments that arise with the integration of specialized 

MA plans for special needs individuals described in subsection (b)(6)(B)(ii) under this paragraph and, consistent 

with such role, shall establish— 

‘‘(i) a uniform process for disseminating to State 

Medicaid agencies information under this title 

impacting contracts between such agencies and such 

plans under this subsection; and 

‘‘(ii) basic resources for States interested in 

exploring such plans as a platform for integration, 

such as a model contract or other tools to achieve 

those goals. 

‘‘(B) UNIFIED GRIEVANCES AND APPEALS PROCESS.— 

‘‘(i) IN GENERAL.—Not later than April 1, 2020, 

the Secretary shall establish procedures, to the extent 

feasible as determined by the Secretary, unifying grievances and appeals procedures under sections 1852(f), 

1852(g), 1902(a)(3), 1902(a)(5), and 1932(b)(4) for items 

and services provided by specialized MA plans for special needs individuals described in subsection 

Applicability. (b)(6)(B)(ii) under this title and title XIX. With respect 

Deadline. 

Procedures. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 193 

to items and services described in the preceding sentence, procedures established under this clause shall 

apply in place of otherwise applicable grievances and 

appeals procedures. The Secretary shall solicit comment in developing such procedures from States, plans, 

beneficiaries and their representatives, and other relevant stakeholders. 

‘‘(ii) PROCEDURES.—The procedures established 

under clause (i) shall be included in the plan contract 

under paragraph (3)(D) and shall— 

‘‘(I) adopt the provisions for the enrollee that 

are most protective for the enrollee and, to the 

extent feasible as determined by the Secretary, 

are compatible with unified timeframes and 

consolidated access to external review under an 

integrated process; 

‘‘(II) take into account differences in State 

plans under title XIX to the extent necessary; 

‘‘(III) be easily navigable by an enrollee; and 

‘‘(IV) include the elements described in clause 

(iii), as applicable. 

‘‘(iii) ELEMENTS DESCRIBED.—Both unified appeals 

and unified grievance procedures shall include, as 

applicable, the following elements described in this 

clause: 

‘‘(I) Single written notification of all applicable 

grievances and appeal rights under this title and 

title XIX. For purposes of this subparagraph, the 

Secretary may waive the requirements under section 1852(g)(1)(B) when the specialized MA plan 

covers items or services under this part or under 

title XIX. 

‘‘(II) Single pathways for resolution of any 

grievance or appeal related to a particular item 

or service provided by specialized MA plans for 

special needs individuals described in subsection 

(b)(6)(B)(ii) under this title and title XIX. 

‘‘(III) Notices written in plain language and 

available in a language and format that is accessible to the enrollee, including in non-English languages that are prevalent in the service area of 

the specialized MA plan. 

‘‘(IV) Unified timeframes for grievances and 

appeals processes, such as an individual’s filing 

of a grievance or appeal, a plan’s acknowledgment 

and resolution of a grievance or appeal, and 

notification of decisions with respect to a grievance 

or appeal. 

‘‘(V) Requirements for how the plan must 

process, track, and resolve grievances and appeals, 

to ensure beneficiaries are notified on a timely 

basis of decisions that are made throughout the 

grievance or appeals process and are able to easily 

determine the status of a grievance or appeal. 

‘‘(iv) CONTINUATION OF BENEFITS PENDING

APPEAL.—The unified procedures under clause (i) shall, 

with respect to all benefits under parts A and B and 

Notices. 

Waiver authority. 

Notification. 


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132 STAT. 194 PUBLIC LAW 115–123—FEB. 9, 2018 

title XIX subject to appeal under such procedures, 

incorporate provisions under current law and implementing regulations that provide continuation of benefits pending appeal under this title and title XIX. 

‘‘(C) REQUIREMENT FOR UNIFIED GRIEVANCES AND

APPEALS.—For 2021 and subsequent years, the contract 

of a specialized MA plan for special needs individuals 

described in subsection (b)(6)(B)(ii) with a State Medicaid 

agency under paragraph (3)(D) shall require the use of 

unified grievances and appeals procedures as described 

in subparagraph (B). 

‘‘(D) REQUIREMENTS FOR INTEGRATION.— 

‘‘(i) IN GENERAL.—For 2021 and subsequent years, 

a specialized MA plan for special needs individuals 

described in subsection (b)(6)(B)(ii) shall meet one or 

more of the following requirements, to the extent permitted under State law, for integration of benefits 

under this title and title XIX: 

‘‘(I) The specialized MA plan must meet the 

requirements of contracting with the State Medicaid agency described in paragraph (3)(D) in addition to coordinating long-term services and supports or behavioral health services, or both, by 

meeting an additional minimum set of requirements determined by the Secretary through the 

Federal Coordinated Health Care Office established under section 2602 of the Patient Protection 

and Affordable Care Act based on input from stakeholders, such as notifying the State in a timely 

manner of hospitalizations, emergency room visits, 

and hospital or nursing home discharges of 

enrollees, assigning one primary care provider for 

each enrollee, or sharing data that would benefit 

the coordination of items and services under this 

title and the State plan under title XIX. Such 

minimum set of requirements must be included 

in the contract of the specialized MA plan with 

the State Medicaid agency under such paragraph. 

‘‘(II) The specialized MA plan must meet the 

requirements of a fully integrated plan described 

in section 1853(a)(1)(B)(iv)(II) (other than the 

requirement that the plan have similar average 

levels of frailty, as determined by the Secretary, 

as the PACE program), or enter into a capitated 

contract with the State Medicaid agency to provide 

long-term services and supports or behavioral 

health services, or both. 

‘‘(III) In the case of a specialized MA plan 

that is offered by a parent organization that is 

also the parent organization of a Medicaid managed care organization providing long term services and supports or behavioral services under a 

contract under section 1903(m), the parent 

organization must assume clinical and financial 

responsibility for benefits provided under this title 

and title XIX with respect to any individual who 

Contracts. 

Determinations. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 195 

is enrolled in both the specialized MA plan and 

the Medicaid managed care organization. 

‘‘(ii) SUSPENSION OF ENROLLMENT FOR FAILURE TO

MEET REQUIREMENTS DURING INITIAL PERIOD.—During 

the period of plan years 2021 through 2025, if the 

Secretary determines that a specialized MA plan for 

special needs individuals described in subsection 

(b)(6)(B)(ii) has failed to comply with clause (i), the 

Secretary may provide for the application against the 

Medicare Advantage organization offering the plan of 

the remedy described in section 1857(g)(2)(B) in the 

same manner as the Secretary may apply such remedy, 

and in accordance with the same procedures as would 

apply, in the case of an MA organization determined 

by the Secretary to have engaged in conduct described 

in section 1857(g)(1). If the Secretary applies such 

remedy to a Medicare Advantage organization under 

the preceding sentence, the organization shall submit 

to the Secretary (at a time, and in a form and manner, 

specified by the Secretary) information describing how 

the plan will come into compliance with clause (i). 

‘‘(E) STUDY AND REPORT TO CONGRESS.— 

‘‘(i) IN GENERAL.—Not later than March 15, 2022, 

and, subject to clause (iii), biennially thereafter 

through 2032, the Medicare Payment Advisory 

Commission established under section 1805, in consultation with the Medicaid and CHIP Payment and 

Access Commission established under section 1900, 

shall conduct (and submit to the Secretary and the 

Committees on Ways and Means and Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate a report on) a study 

to determine how specialized MA plans for special 

needs individuals described in subsection (b)(6)(B)(ii) 

perform among each other based on data from 

Healthcare Effectiveness Data and Information Set 

(HEDIS) quality measures, reported on the plan level, 

as required under section 1852(e)(3) (or such other 

measures or data sources that are available and appropriate, such as encounter data and Consumer Assessment of Healthcare Providers and Systems data, as 

specified by such Commissions as enabling an accurate 

evaluation under this subparagraph). Such study shall 

include, as feasible, the following comparison groups 

of specialized MA plans for special needs individuals 

described in subsection (b)(6)(B)(ii): 

‘‘(I) A comparison group of such plans that 

are described in subparagraph (D)(i)(I). 

‘‘(II) A comparison group of such plans that 

are described in subparagraph (D)(i)(II). 

‘‘(III) A comparison group of such plans operating within the Financial Alignment Initiative 

demonstration for the period for which such plan 

is so operating and the demonstration is in effect, 

and, in the case that an integration option that 

is not with respect to specialized MA plans for 

Time period. 

Consultation. 

Determination. 

Evaluation. 

Compliance. 

Determination. 


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132 STAT. 196 PUBLIC LAW 115–123—FEB. 9, 2018 

special needs individuals is established after the 

conclusion of the demonstration involved. 

‘‘(IV) A comparison group of such plans that 

are described in subparagraph (D)(i)(III). 

‘‘(V) A comparison group of MA plans, as feasible, not described in a previous subclause of this 

clause, with respect to the performance of such 

plans for enrollees who are special needs individuals described in subsection (b)(6)(B)(ii). 

‘‘(ii) ADDITIONAL REPORTS.—Beginning with 2033 

and every five years thereafter, the Medicare Payment 

Advisory Commission, in consultation with the Medicaid and CHIP Payment and Access Commission, shall 

conduct a study described in clause (i).’’. 

(2) CONFORMING AMENDMENT TO RESPONSIBILITIES OF FED- ERAL COORDINATED HEALTH CARE OFFICE.—Section 2602(d) of 

Public Law 111–148 (42 U.S.C. 1315b(d)) is amended by adding 

at the end the following new paragraphs: 

‘‘(6) To act as a designated contact for States under subsection (f)(8)(A) of section 1859 of the Social Security Act (42 

U.S.C. 1395w–28) with respect to the integration of specialized 

MA plans for special needs individuals described in subsection 

(b)(6)(B)(ii) of such section. 

‘‘(7) To be responsible, subject to the final approval of 

the Secretary, for developing regulations and guidance related 

to the implementation of a unified grievance and appeals 

process as described in subparagraphs (B) and (C) of section 

1859(f)(8) of the Social Security Act (42 U.S.C. 1395w–28(f)(8)). 

‘‘(8) To be responsible, subject to the final approval of 

the Secretary, for developing regulations and guidance related 

to the integration or alignment of policy and oversight under 

the Medicare program under title XVIII of such Act and the 

Medicaid program under title XIX of such Act regarding specialized MA plans for special needs individuals described in subsection (b)(6)(B)(ii) of such section 1859.’’. 

(c) IMPROVEMENTS TO SEVERE OR DISABLING CHRONIC CONDITION SNPS.— 

(1) CARE MANAGEMENT REQUIREMENTS.—Section 1859(f)(5) 

of the Social Security Act (42 U.S.C. 1395w–28(f)(5)) is 

amended— 

(A) by striking ‘‘ALL SNPS.—The requirements’’ and 

inserting ‘‘ALL SNPS.— 

‘‘(A) IN GENERAL.—Subject to subparagraph (B), the 

requirements’’; 

(B) by redesignating subparagraphs (A) and (B) as 

clauses (i) and (ii), respectively, and indenting appropriately; and 

(C) in clause (ii), as redesignated by subparagraph 

(B), by redesignating clauses (i) through (iii) as subclauses 

(I) through (III), respectively, and indenting appropriately; 

and 

(D) by adding at the end the following new subparagraph: 

‘‘(B) IMPROVEMENTS TO CARE MANAGEMENT REQUIREMENTS FOR SEVERE OR DISABLING CHRONIC CONDITION

SNPS.—For 2020 and subsequent years, in the case of a 

specialized MA plan for special needs individuals described 

Effective dates. 

Consultation. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 197 

in subsection (b)(6)(B)(iii), the requirements described in 

this paragraph include the following: 

‘‘(i) The interdisciplinary team under subparagraph (A)(ii)(III) includes a team of providers with 

demonstrated expertise, including training in an 

applicable specialty, in treating individuals similar to 

the targeted population of the plan. 

‘‘(ii) Requirements developed by the Secretary to 

provide face-to-face encounters with individuals 

enrolled in the plan not less frequently than on an 

annual basis. 

‘‘(iii) As part of the model of care under clause 

(i) of subparagraph (A), the results of the initial assessment and annual reassessment under clause (ii)(I) of 

such subparagraph of each individual enrolled in the 

plan are addressed in the individual’s individualized 

care plan under clause (ii)(II) of such subparagraph. 

‘‘(iv) As part of the annual evaluation and approval 

of such model of care, the Secretary shall take into 

account whether the plan fulfilled the previous year’s 

goals (as required under the model of care). 

‘‘(v) The Secretary shall establish a minimum 

benchmark for each element of the model of care of 

a plan. The Secretary shall only approve a plan’s model 

of care under this paragraph if each element of the 

model of care meets the minimum benchmark 

applicable under the preceding sentence.’’. 

(2) REVISIONS TO THE DEFINITION OF A SEVERE OR DISABLING

CHRONIC CONDITIONS SPECIALIZED NEEDS INDIVIDUAL.— 

(A) IN GENERAL.—Section 1859(b)(6)(B)(iii) of the Social 

Security Act (42 U.S.C. 1395w–28(b)(6)(B)(iii)) is 

amended— 

(i) by striking ‘‘who have’’ and inserting ‘‘who— 

‘‘(I) before January 1, 2022, have’’; 

(ii) in subclause (I), as added by clause (i), by 

striking the period at the end and inserting ‘‘; and’’; 

and 

(iii) by adding at the end the following new subclause: 

‘‘(II) on or after January 1, 2022, have one 

or more comorbid and medically complex chronic 

conditions that is life threatening or significantly 

limits overall health or function, have a high risk 

of hospitalization or other adverse health outcomes, and require intensive care coordination and 

that is listed under subsection (f)(9)(A).’’. 

(B) PANEL OF CLINICAL ADVISORS.—Section 1859(f) of 

the Social Security Act (42 U.S.C. 1395w–28(f)), as 

amended by subsection (b), is amended by adding at the 

end the following new paragraph: 

‘‘(9) LIST OF CONDITIONS FOR CLARIFICATION OF THE DEFINITION OF A SEVERE OR DISABLING CHRONIC CONDITIONS SPECIALIZED NEEDS INDIVIDUAL.— 

‘‘(A) IN GENERAL.—Not later than December 31, 2020, 

and every 5 years thereafter, subject to subparagraphs 

(B) and (C), the Secretary shall convene a panel of clinical 

Deadlines. 


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advisors to establish and update a list of conditions that 

meet each of the following criteria: 

‘‘(i) Conditions that meet the definition of a severe 

or disabling chronic condition under subsection 

(b)(6)(B)(iii) on or after January 1, 2022. 

‘‘(ii) Conditions that require prescription drugs, 

providers, and models of care that are unique to the 

specific population of enrollees in a specialized MA 

plan for special needs individuals described in such 

subsection on or after such date and— 

‘‘(I) as a result of access to, and enrollment 

in, such a specialized MA plan for special needs 

individuals, individuals with such condition would 

have a reasonable expectation of slowing or halting 

the progression of the disease, improving health 

outcomes and decreasing overall costs for individuals diagnosed with such condition compared to 

available options of care other than through such 

a specialized MA plan for special needs individuals; 

or 

‘‘(II) have a low prevalence in the general 

population of beneficiaries under this title or a 

disproportionally high per-beneficiary cost under 

this title. 

‘‘(B) INCLUSION OF CERTAIN CONDITIONS.—The conditions listed under subparagraph (A) shall include HIV/ 

AIDS, end stage renal disease, and chronic and disabling 

mental illness. 

‘‘(C) REQUIREMENT.—In establishing and updating the 

list under subparagraph (A), the panel shall take into 

account the availability of varied benefits, cost-sharing, 

and supplemental benefits under the model described in 

paragraph (2) of section 1859(h), including the expansion 

under paragraph (1) of such section.’’. 

(d) QUALITY MEASUREMENT AT THE PLAN LEVEL FOR SNPS

AND DETERMINATION OF FEASABILITY OF QUALITY MEASUREMENT

AT THE PLAN LEVEL FOR ALL MA PLANS.—Section 1853(o) of the 

Social Security Act (42 U.S.C. 1395w–23(o)) is amended by adding 

at the end the following new paragraphs: 

‘‘(6) QUALITY MEASUREMENT AT THE PLAN LEVEL FOR SNPS.— 

‘‘(A) IN GENERAL.—Subject to subparagraph (B), the 

Secretary may require reporting of data under section 

1852(e) for, and apply under this subsection, quality measures at the plan level for specialized MA plans for special 

needs individuals instead of at the contract level. 

‘‘(B) CONSIDERATIONS.—Prior to applying quality 

measurement at the plan level under this paragraph, the 

Secretary shall— 

‘‘(i) take into consideration the minimum number 

of enrollees in a specialized MA plan for special needs 

individuals in order to determine if a statistically 

significant or valid measurement of quality at the plan 

level is possible under this paragraph; 

‘‘(ii) take into consideration the impact of such 

application on plans that serve a disproportionate 

number of individuals dually eligible for benefits under 

this title and under title XIX; 


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‘‘(iii) if quality measures are reported at the plan 

level, ensure that MA plans are not required to provide 

duplicative information; and 

‘‘(iv) ensure that such reporting does not interfere 

with the collection of encounter data submitted by 

MA organizations or the administration of any changes 

to the program under this part as a result of the 

collection of such data. 

‘‘(C) APPLICATION.—If the Secretary applies quality 

measurement at the plan level under this paragraph— 

‘‘(i) such quality measurement may include Medicare Health Outcomes Survey (HOS), Healthcare 

Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures and quality measures under 

part D; and 

‘‘(ii) the Secretary shall consider applying administrative actions, such as remedies described in section 

1857(g)(2), at the plan level. 

‘‘(7) DETERMINATION OF FEASIBILITY OF QUALITY MEASUREMENT AT THE PLAN LEVEL FOR ALL MA PLANS.— 

‘‘(A) DETERMINATION OF FEASIBILITY.—The Secretary 

shall determine the feasibility of requiring reporting of 

data under section 1852(e) for, and applying under this 

subsection, quality measures at the plan level for all MA 

plans under this part. 

‘‘(B) CONSIDERATION OF CHANGE.—After making a 

determination under subparagraph (A), the Secretary shall 

consider requiring such reporting and applying such quality 

measures at the plan level as described in such subparagraph’’. 

(e) GAO STUDY AND REPORT ON STATE-LEVEL INTEGRATION

BETWEEN DUAL SNPS AND MEDICAID.— 

(1) STUDY.—The Comptroller General of the United States 

(in this subsection referred to as the ‘‘Comptroller General’’) 

shall conduct a study on State-level integration between specialized MA plans for special needs individuals described in subsection (b)(6) (B)(ii) of section 1859 of the Social Security Act 

(42 U.S.C. 1395w–28) and the Medicaid program under title 

XIX of such Act (42 U.S.C. 1396 et seq.). Such study shall 

include an analysis of the following: 

(A) The characteristics of States in which the State 

agency responsible for administering the State plan under 

such title XIX has a contract with such a specialized MA 

plan and that delivers long-term services and supports 

under the State plan under such title XIX through a managed care program, including the requirements under such 

State plan with respect to long-term services and supports. 

(B) The types of such specialized MA plans, which 

may include the following: 

(i) A plan described in section 1853(a)(1)(B)(iv)(II) 

of such Act (42 U.S.C. 1395w–23(a)(1)(B)(iv)(II)). 

(ii) A plan that meets the requirements described 

in subsection (f)(3)(D) of such section 1859. 

(iii) A plan described in clause (ii) that also meets 

additional requirements established by the State. 

Analysis. 


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(C) The characteristics of individuals enrolled in such 

specialized MA plans. 

(D) As practicable, the following with respect to State 

programs for the delivery of long-term services and supports under such title XIX through a managed care program: 

(i) Which populations of individuals are eligible 

to receive such services and supports. 

(ii) Whether all such services and supports are 

provided on a capitated basis or if any of such services 

and supports are carved out and provided through 

fee-for service. 

(E) As practicable, how the availability and variation 

of integration arrangements of such specialized MA plans 

offered in States affects spending, service delivery options, 

access to community-based care, and utilization of care. 

(F) The efforts of State Medicaid programs to transition 

dually-eligible beneficiaries receiving long-term services 

and supports (LTSS) from institutional settings to home 

and community-based settings and related financial 

impacts of such transitions. 

(G) Barriers and opportunities for making further 

progress on dual integration, as well as recommendations 

for legislation or administrative action to expedite or refine 

pathways toward fully integrated care. 

(2) REPORT.—Not later than 2 years after the date of the 

enactment of this Act, the Comptroller General shall submit 

to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations 

for such legislation and administrative action as the Comptroller General determines appropriate. 

Subtitle C—Expanding Innovation and 

Technology 

SEC. 50321. ADAPTING BENEFITS TO MEET THE NEEDS OF CHRONICALLY ILL MEDICARE ADVANTAGE ENROLLEES. 

Section 1859 of the Social Security Act (42 U.S.C. 1395w– 

28) is amended by adding at the end the following new subsection: 

‘‘(h) NATIONAL TESTING OF MEDICARE ADVANTAGE VALUE-BASED

INSURANCE DESIGN MODEL.— ‘‘(1) IN GENERAL.—In implementing the Medicare Advantage Value-Based Insurance Design model that is being tested 

under section 1115A(b), the Secretary shall revise the testing 

of the model under such section to cover, effective not later 

than January 1, 2020, all States. 

‘‘(2) TERMINATION AND MODIFICATION PROVISION NOT

APPLICABLE UNTIL JANUARY 1, 2022.—The provisions of section 

1115A(b)(3)(B) shall apply to the Medicare Advantage ValueBased Insurance Design model, including such model as revised 

under paragraph (1), beginning January 1, 2022, but shall 

not apply to such model, as so revised, prior to such date. 

‘‘(3) FUNDING.—The Secretary shall allocate funds made 

available under section 1115A(f)(1) to design, implement, and 

evaluate the Medicare Advantage Value-Based Insurance 

Design model, as revised under paragraph (1).’’. 

Revision. 

Deadline. 

Recommendations. 

Recommendations. 


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SEC. 50322. EXPANDING SUPPLEMENTAL BENEFITS TO MEET THE 

NEEDS OF CHRONICALLY ILL MEDICARE ADVANTAGE 

ENROLLEES. 

(a) IN GENERAL.—Section 1852(a)(3) of the Social Security Act 

(42 U.S.C. 1395w–22(a)(3)) is amended— 

(1) in subparagraph (A), by striking ‘‘Each’’ and inserting 

‘‘Subject to subparagraph (D), each’’; and 

(2) by adding at the end the following new subparagraph: 

‘‘(D) EXPANDING SUPPLEMENTAL BENEFITS TO MEET THE

NEEDS OF CHRONICALLY ILL ENROLLEES.— 

‘‘(i) IN GENERAL.—For plan year 2020 and subsequent plan years, in addition to any supplemental 

health care benefits otherwise provided under this 

paragraph, an MA plan, including a specialized MA 

plan for special needs individuals (as defined in section 

1859(b)(6)), may provide supplemental benefits 

described in clause (ii) to a chronically ill enrollee 

(as defined in clause (iii)). 

‘‘(ii) SUPPLEMENTAL BENEFITS DESCRIBED.— 

‘‘(I) IN GENERAL.—Supplemental benefits 

described in this clause are supplemental benefits 

that, with respect to a chronically ill enrollee, have 

a reasonable expectation of improving or 

maintaining the health or overall function of the 

chronically ill enrollee and may not be limited 

to being primarily health related benefits. 

‘‘(II) AUTHORITY TO WAIVE UNIFORMITY

REQUIREMENTS.—The Secretary may, only with 

respect to supplemental benefits provided to a 

chronically ill enrollee under this subparagraph, 

waive the uniformity requirements under this part, 

as determined appropriate by the Secretary. 

‘‘(iii) CHRONICALLY ILL ENROLLEE DEFINED.—In this 

subparagraph, the term ‘chronically ill enrollee’ means 

an enrollee in an MA plan that the Secretary determines— 

‘‘(I) has one or more comorbid and medically 

complex chronic conditions that is life threatening 

or significantly limits the overall health or function 

of the enrollee; 

‘‘(II) has a high risk of hospitalization or other 

adverse health outcomes; and 

‘‘(III) requires intensive care coordination.’’. 

(b) GAO STUDY AND REPORT.— 

(1) STUDY.—The Comptroller General of the United States 

(in this subsection referred to as the ‘‘Comptroller General’’) 

shall conduct a study on supplemental benefits provided to 

enrollees in Medicare Advantage plans under part C of title 

XVIII of the Social Security Act, including specialized MA plans 

for special needs individuals (as defined in section 1859(b)(6) 

of such Act (42 U.S.C. 1395w–28(b)(6))). To the extend data 

are available, such study shall include an analysis of the following: 

(A) The type of supplemental benefits provided to such 

enrollees, the total number of enrollees receiving each 

Analysis. 

Determination. 


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supplemental benefit, and whether the supplemental benefit is covered by the standard benchmark cost of the 

benefit or with an additional premium. 

(B) The frequency in which supplemental benefits are 

utilized by such enrollees. 

(C) The impact supplemental benefits have on— 

(i) indicators of the quality of care received by 

such enrollees, including overall health and function 

of the enrollees; 

(ii) the utilization of items and services for which 

benefits are available under the original Medicare feefor-service program option under parts A and B of 

such title XVIII by such enrollees; and 

(iii) the amount of the bids submitted by Medicare 

Advantage Organizations for Medicare Advantage 

plans under such part C. 

(2) CONSULTATION.—In conducting the study under paragraph (1), the Comptroller General shall, as necessary, consult 

with the Centers for Medicare & Medicaid Services and Medicare Advantage organizations offering Medicare Advantage 

plans. 

(3) REPORT.—Not later than 5 years after the date of the 

enactment of this Act, the Comptroller General shall submit 

to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations 

for such legislation and administrative action as the Comptroller General determines appropriate. 

SEC. 50323. INCREASING CONVENIENCE FOR MEDICARE ADVANTAGE 

ENROLLEES THROUGH TELEHEALTH. 

(a) IN GENERAL.—Section 1852 of the Social Security Act (42 

U.S.C. 1395w–22) is amended— 

(1) in subsection (a)(1)(B)(i), by inserting ‘‘, subject to subsection (m),’’ after ‘‘means’’; and 

(2) by adding at the end the following new subsection: 

‘‘(m) PROVISION OF ADDITIONAL TELEHEALTH BENEFITS.— 

‘‘(1) MA PLAN OPTION.—For plan year 2020 and subsequent 

plan years, subject to the requirements of paragraph (3), an 

MA plan may provide additional telehealth benefits (as defined 

in paragraph (2)) to individuals enrolled under this part. 

‘‘(2) ADDITIONAL TELEHEALTH BENEFITS DEFINED.— 

‘‘(A) IN GENERAL.—For purposes of this subsection and 

section 1854: 

‘‘(i) DEFINITION.—The term ‘additional telehealth 

benefits’ means services— 

‘‘(I) for which benefits are available under part 

B, including services for which payment is not 

made under section 1834(m) due to the conditions 

for payment under such section; and 

‘‘(II) that are identified for such year as clinically appropriate to furnish using electronic 

information and telecommunications technology 

when a physician (as defined in section 1861(r)) 

or practitioner (described in section 1842(b)(18)(C)) 

providing the service is not at the same location 

as the plan enrollee. 

Recommendations. 


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‘‘(ii) EXCLUSION OF CAPITAL AND INFRASTRUCTURE

COSTS AND INVESTMENTS.—The term ‘additional telehealth benefits’ does not include capital and infrastructure costs and investments relating to such benefits. 

‘‘(B) PUBLIC COMMENT.—Not later than November 30, 

2018, the Secretary shall solicit comments on— 

‘‘(i) what types of items and services (including 

those provided through supplemental health care benefits, such as remote patient monitoring, secure messaging, store and forward technologies, and other nonface-to-face communication) should be considered to 

be additional telehealth benefits; and 

‘‘(ii) the requirements for the provision or furnishing of such benefits (such as training and coordination requirements). 

‘‘(3) REQUIREMENTS FOR ADDITIONAL TELEHEALTH BENEFITS.—The Secretary shall specify requirements for the provision or furnishing of additional telehealth benefits, including 

with respect to the following: 

‘‘(A) Physician or practitioner qualifications (other than 

licensure) and other requirements such as specific training. 

‘‘(B) Factors necessary for the coordination of such 

benefits with other items and services including those furnished in-person. 

‘‘(C) Such other areas as determined by the Secretary. 

‘‘(4) ENROLLEE CHOICE.—If an MA plan provides a service 

as an additional telehealth benefit (as defined in paragraph 

(2))— 

‘‘(A) the MA plan shall also provide access to such 

benefit through an in-person visit (and not only as an 

additional telehealth benefit); and 

‘‘(B) an individual enrollee shall have discretion as 

to whether to receive such service through the in-person 

visit or as an additional telehealth benefit. 

‘‘(5) TREATMENT UNDER MA.—For purposes of this subsection and section 1854, if a plan provides additional telehealth 

benefits, such additional telehealth benefits shall be treated 

as if they were benefits under the original Medicare fee-forservice program option. 

‘‘(6) CONSTRUCTION.—Nothing in this subsection shall be 

construed as affecting the requirement under subsection (a)(1) 

that MA plans provide enrollees with items and services (other 

than hospice care) for which benefits are available under parts 

A and B, including benefits available under section 1834(m).’’. 

(b) CLARIFICATION REGARDING INCLUSION IN BID AMOUNT.— 

Section 1854(a)(6)(A)(ii)(I) of the Social Security Act (42 U.S.C. 

1395w–24(a)(6)(A)(ii)(I)) is amended by inserting ‘‘, including, for 

plan year 2020 and subsequent plan years, the provision of additional telehealth benefits as described in section 1852(m)’’ before 

the semicolon at the end. 

SEC. 50324. PROVIDING ACCOUNTABLE CARE ORGANIZATIONS THE 

ABILITY TO EXPAND THE USE OF TELEHEALTH. 

(a) IN GENERAL.—Section 1899 of the Social Security Act (42 

U.S.C. 1395jjj) is amended by adding at the end the following 

new subsection: 

Determination. 

Deadline. 


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‘‘(l) PROVIDING ACOS THE ABILITY TO EXPAND THE USE OF

TELEHEALTH SERVICES.— 

‘‘(1) IN GENERAL.—In the case of telehealth services for 

which payment would otherwise be made under this title furnished on or after January 1, 2020, for purposes of this subsection only, the following shall apply with respect to such 

services furnished by a physician or practitioner participating 

in an applicable ACO (as defined in paragraph (2)) to a Medicare fee-for-service beneficiary assigned to the applicable ACO: 

‘‘(A) INCLUSION OF HOME AS ORIGINATING SITE.—Subject 

to paragraph (3), the home of a beneficiary shall be treated 

as an originating site described in section 1834(m)(4)(C)(ii). 

‘‘(B) NO APPLICATION OF GEOGRAPHIC LIMITATION.—The 

geographic limitation under section 1834(m)(4)(C)(i) shall 

not apply with respect to an originating site described 

in section 1834(m)(4)(C)(ii) (including the home of a beneficiary under subparagraph (A)), subject to State licensing 

requirements. 

‘‘(2) DEFINITIONS.—In this subsection: 

‘‘(A) APPLICABLE ACO.—The term ‘applicable ACO’ 

means an ACO participating in a model tested or expanded 

under section 1115A or under this section— 

‘‘(i) that operates under a two-sided model— 

‘‘(I) described in section 425.600(a) of title 42, 

Code of Federal Regulations; or 

‘‘(II) tested or expanded under section 1115A; 

and 

‘‘(ii) for which Medicare fee-for-service beneficiaries 

are assigned to the ACO using a prospective assignment method, as determined appropriate by the Secretary. 

‘‘(B) HOME.—The term ‘home’ means, with respect to 

a Medicare fee-for-service beneficiary, the place of residence 

used as the home of the beneficiary. 

‘‘(3) TELEHEALTH SERVICES RECEIVED IN THE HOME.—In 

the case of telehealth services described in paragraph (1) where 

the home of a Medicare fee-for-service beneficiary is the originating site, the following shall apply: 

‘‘(A) NO FACILITY FEE.—There shall be no facility fee 

paid to the originating site under section 1834(m)(2)(B). 

‘‘(B) EXCLUSION OF CERTAIN SERVICES.—No payment 

may be made for such services that are inappropriate to 

furnish in the home setting such as services that are typically furnished in inpatient settings such as a hospital.’’. 

(b) STUDY AND REPORT.— 

(1) STUDY.— 

(A) IN GENERAL.—The Secretary of Health and Human 

Services (in this subsection referred to as the ‘‘Secretary’’) 

shall conduct a study on the implementation of section 

1899(l) of the Social Security Act, as added by subsection 

(a). Such study shall include an analysis of the utilization 

of, and expenditures for, telehealth services under such 

section. 

(B) COLLECTION OF DATA.—The Secretary may collect 

such data as the Secretary determines necessary to carry 

out the study under this paragraph. 

Analysis. 

42 USC 1395jjj 

note. 

Applicability. 


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(2) REPORT.—Not later than January 1, 2026, the Secretary 

shall submit to Congress a report containing the results of 

the study conducted under paragraph (1), together with recommendations for such legislation and administrative action 

as the Secretary determines appropriate. 

SEC. 50325. EXPANDING THE USE OF TELEHEALTH FOR INDIVIDUALS 

WITH STROKE. 

Section 1834(m) of the Social Security Act (42 U.S.C. 

1395m(m)), as amended by section 50302(b)(1), is amended— 

(1) in paragraph (4)(C)(i), in the matter preceding subclause 

(I), by striking ‘‘The term’’ and inserting ‘‘Except as provided 

in paragraph (6), the term’’; and 

(2) by adding at the end the following new paragraph: 

‘‘(6) TREATMENT OF STROKE TELEHEALTH SERVICES.— ‘‘(A) NON-APPLICATION OF ORIGINATING SITE REQUIRE- MENTS.—The requirements described in paragraph (4)(C) 

shall not apply with respect to telehealth services furnished 

on or after January 1, 2019, for purposes of diagnosis, 

evaluation, or treatment of symptoms of an acute stroke, 

as determined by the Secretary. 

‘‘(B) INCLUSION OF CERTAIN SITES.—With respect to 

telehealth services described in subparagraph (A), the term 

‘originating site’ shall include any hospital (as defined in 

section 1861(e)) or critical access hospital (as defined in 

section 1861(mm)(1)), any mobile stroke unit (as defined 

by the Secretary), or any other site determined appropriate 

by the Secretary, at which the eligible telehealth individual 

is located at the time the service is furnished via a telecommunications system. 

‘‘(C) NO ORIGINATING SITE FACILITY FEE FOR NEW

SITES.—No facility fee shall be paid under paragraph (2)(B) 

to an originating site with respect to a telehealth service 

described in subparagraph (A) if the originating site does 

not otherwise meet the requirements for an originating 

site under paragraph (4)(C).’’. 

Subtitle D—Identifying the Chronically Ill 

Population 

SEC. 50331. PROVIDING FLEXIBILITY FOR BENEFICIARIES TO BE PART 

OF AN ACCOUNTABLE CARE ORGANIZATION. 

Section 1899(c) of the Social Security Act (42 U.S.C. 1395jjj(c)) 

is amended— 

(1) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively, and indenting appropriately; 

(2) by striking ‘‘ACOS.—The Secretary’’ and inserting 

‘‘ACOS.— 

‘‘(1) IN GENERAL.—Subject to paragraph (2), the Secretary’’; 

and 

(3) by adding at the end the following new paragraph: 

‘‘(2) PROVIDING FLEXIBILITY.— 

‘‘(A) CHOICE OF PROSPECTIVE ASSIGNMENT.—For each 

agreement period (effective for agreements entered into 

or renewed on or after January 1, 2020), in the case where 

an ACO established under the program is in a Track that 

Contracts. 

Definition. 

Determination. 

Recommendations. 

42 USC 1395jjj 

note. 


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provides for the retrospective assignment of Medicare feefor-service beneficiaries to the ACO, the Secretary shall 

permit the ACO to choose to have Medicare fee-for-service 

beneficiaries assigned prospectively, rather than retrospectively, to the ACO for an agreement period. 

‘‘(B) ASSIGNMENT BASED ON VOLUNTARY IDENTIFICATION

BY MEDICARE FEE-FOR-SERVICE BENEFICIARIES.— ‘‘(i) IN GENERAL.—For performance year 2018 and 

each subsequent performance year, if a system is available for electronic designation, the Secretary shall 

permit a Medicare fee-for-service beneficiary to voluntarily identify an ACO professional as the primary 

care provider of the beneficiary for purposes of 

assigning such beneficiary to an ACO, as determined 

by the Secretary. 

‘‘(ii) NOTIFICATION PROCESS.—The Secretary shall 

establish a process under which a Medicare fee-forservice beneficiary is— 

‘‘(I) notified of their ability to make an identification described in clause (i); and 

‘‘(II) informed of the process by which they 

may make and change such identification. 

‘‘(iii) SUPERSEDING CLAIMS-BASED ASSIGNMENT.—A 

voluntary identification by a Medicare fee-for-service 

beneficiary under this subparagraph shall supersede 

any claims-based assignment otherwise determined by 

the Secretary.’’. 

Subtitle E—Empowering Individuals and 

Caregivers in Care Delivery 

SEC. 50341. ELIMINATING BARRIERS TO CARE COORDINATION UNDER 

ACCOUNTABLE CARE ORGANIZATIONS. 

(a) IN GENERAL.—Section 1899 of the Social Security Act (42 

U.S.C. 1395jjj), as amended by section 50324(a), is amended— 

(1) in subsection (b)(2), by adding at the end the following 

new subparagraph: 

‘‘(I) An ACO that seeks to operate an ACO Beneficiary 

Incentive Program pursuant to subsection (m) shall apply 

to the Secretary at such time, in such manner, and with 

such information as the Secretary may require.’’; 

(2) by adding at the end the following new subsection: 

‘‘(m) AUTHORITY TO PROVIDE INCENTIVE PAYMENTS TO BENEFICIARIES WITH RESPECT TO QUALIFYING PRIMARY CARE SERVICES.— 

‘‘(1) PROGRAM.— 

‘‘(A) IN GENERAL.—In order to encourage Medicare feefor-service beneficiaries to obtain medically necessary primary care services, an ACO participating under this section 

under a payment model described in clause (i) or (ii) of 

paragraph (2)(B) may apply to establish an ACO Beneficiary Incentive Program to provide incentive payments 

to such beneficiaries who are furnished qualifying services 

in accordance with this subsection. The Secretary shall 

permit such an ACO to establish such a program at the 

Secretary’s discretion and subject to such requirements, 

Application. 

Determination. 

Determination. 


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including program integrity requirements, as the Secretary 

determines necessary. 

‘‘(B) IMPLEMENTATION.—The Secretary shall implement 

this subsection on a date determined appropriate by the 

Secretary. Such date shall be no earlier than January 

1, 2019, and no later than January 1, 2020. 

‘‘(2) CONDUCT OF PROGRAM.— ‘‘(A) DURATION.—Subject to subparagraph (H), an ACO 

Beneficiary Incentive Program established under this subsection shall be conducted for such period (of not less 

than 1 year) as the Secretary may approve. 

‘‘(B) SCOPE.—An ACO Beneficiary Incentive Program 

established under this subsection shall provide incentive 

payments to all of the following Medicare fee-for-service 

beneficiaries who are furnished qualifying services by the 

ACO: 

‘‘(i) With respect to the Track 2 and Track 3 payment models described in section 425.600(a) of title 

42, Code of Federal Regulations (or in any successor 

regulation), Medicare fee-for-service beneficiaries who 

are preliminarily prospectively or prospectively 

assigned (or otherwise assigned, as determined by the 

Secretary) to the ACO. 

‘‘(ii) With respect to any future payment models 

involving two-sided risk, Medicare fee-for-service beneficiaries who are assigned to the ACO, as determined 

by the Secretary. 

‘‘(C) QUALIFYING SERVICE.—For purposes of this subsection, a qualifying service is a primary care service, as 

defined in section 425.20 of title 42, Code of Federal Regulations (or in any successor regulation), with respect to which 

coinsurance applies under part B, furnished through an 

ACO by— 

‘‘(i) an ACO professional described in subsection 

(h)(1)(A) who has a primary care specialty designation 

included in the definition of primary care physician 

under section 425.20 of title 42, Code of Federal Regulations (or any successor regulation); 

‘‘(ii) an ACO professional described in subsection 

(h)(1)(B); or 

‘‘(iii) a Federally qualified health center or rural 

health clinic (as such terms are defined in section 

1861(aa)). 

‘‘(D) INCENTIVE PAYMENTS.—An incentive payment 

made by an ACO pursuant to an ACO Beneficiary Incentive 

Program established under this subsection shall be— 

‘‘(i) in an amount up to $20, with such maximum 

amount updated annually by the percentage increase 

in the consumer price index for all urban consumers 

(United States city average) for the 12-month period 

ending with June of the previous year; 

‘‘(ii) in the same amount for each Medicare feefor-service beneficiary described in clause (i) or (ii) 

of subparagraph (B) without regard to enrollment of 

such a beneficiary in a medicare supplemental policy 

(described in section 1882(g)(1)), in a State Medicaid 

plan under title XIX or a waiver of such a plan, or 

Time period. 

Determinations. 

Time period. 

Determination. 


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in any other health insurance policy or health benefit 

plan; 

‘‘(iii) made for each qualifying service furnished 

to such a beneficiary described in clause (i) or (ii) 

of subparagraph (B) during a period specified by the 

Secretary; and 

‘‘(iv) made no later than 30 days after a qualifying 

service is furnished to such a beneficiary described 

in clause (i) or (ii) of subparagraph (B). 

‘‘(E) NO SEPARATE PAYMENTS FROM THE SECRETARY.— 

The Secretary shall not make any separate payment to 

an ACO for the costs, including incentive payments, of 

carrying out an ACO Beneficiary Incentive Program established under this subsection. Nothing in this subparagraph 

shall be construed as prohibiting an ACO from using shared 

savings received under this section to carry out an ACO 

Beneficiary Incentive Program. 

‘‘(F) NO APPLICATION TO SHARED SAVINGS CALCULATION.—Incentive payments made by an ACO under this 

subsection shall be disregarded for purposes of calculating 

benchmarks, estimated average per capita Medicare 

expenditures, and shared savings under this section. 

‘‘(G) REPORTING REQUIREMENTS.—An ACO conducting 

an ACO Beneficiary Incentive Program under this subsection shall, at such times and in such format as the 

Secretary may require, report to the Secretary such 

information and retain such documentation as the Secretary may require, including the amount and frequency 

of incentive payments made and the number of Medicare 

fee-for-service beneficiaries receiving such payments. 

‘‘(H) TERMINATION.—The Secretary may terminate an 

ACO Beneficiary Incentive Program established under this 

subsection at any time for reasons determined appropriate 

by the Secretary. 

‘‘(3) EXCLUSION OF INCENTIVE PAYMENTS.—Any payment 

made under an ACO Beneficiary Incentive Program established 

under this subsection shall not be considered income or 

resources or otherwise taken into account for purposes of— 

‘‘(A) determining eligibility for benefits or assistance 

(or the amount or extent of benefits or assistance) under 

any Federal program or under any State or local program 

financed in whole or in part with Federal funds; or 

‘‘(B) any Federal or State laws relating to taxation.’’; 

(3) in subsection (e), by inserting ‘‘, including an ACO 

Beneficiary Incentive Program under subsections (b)(2)(I) and 

(m)’’ after ‘‘the program’’; and 

(4) in subsection (g)(6), by inserting ‘‘or of an ACO Beneficiary Incentive Program under subsections (b)(2)(I) and (m)’’ 

after ‘‘under subsection (d)(4)’’. 

(b) AMENDMENT TO SECTION 1128B.—Section 1128B(b)(3) of 

the Social Security Act (42 U.S.C. 1320a–7b(b)(3)) is amended— 

(1) by striking ‘‘and’’ at the end of subparagraph (I); 

(2) by striking the period at the end of subparagraph (J) 

and inserting ‘‘; and’’; and 

(3) by adding at the end the following new subparagraph: 

Deadline. 


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‘‘(K) an incentive payment made to a Medicare feefor-service beneficiary by an ACO under an ACO Beneficiary Incentive Program established under subsection (m) 

of section 1899, if the payment is made in accordance 

with the requirements of such subsection and meets such 

other conditions as the Secretary may establish.’’. 

(c) EVALUATION AND REPORT.— (1) EVALUATION.—The Secretary of Health and Human 

Services (in this subsection referred to as the ‘‘Secretary’’) shall 

conduct an evaluation of the ACO Beneficiary Incentive Program established under subsections (b)(2)(I) and (m) of section 

1899 of the Social Security Act (42 U.S.C. 1395jjj), as added 

by subsection (a). The evaluation shall include an analysis 

of the impact of the implementation of the Program on expenditures and beneficiary health outcomes under title XVIII of 

the Social Security Act (42 U.S.C. 1395 et seq.). 

(2) REPORT.—Not later than October 1, 2023, the Secretary 

shall submit to Congress a report containing the results of 

the evaluation under paragraph (1), together with recommendations for such legislation and administrative action as the Secretary determines appropriate. 

SEC. 50342. GAO STUDY AND REPORT ON LONGITUDINAL COMPREHENSIVE CARE PLANNING SERVICES UNDER MEDICARE 

PART B. 

(a) STUDY.—The Comptroller General shall conduct a study 

on the establishment under part B of the Medicare program under 

title XVIII of the Social Security Act of a payment code for a 

visit for longitudinal comprehensive care planning services. Such 

study shall include an analysis of the following to the extent such 

information is available: 

(1) The frequency with which services similar to longitudinal comprehensive care planning services are furnished to 

Medicare beneficiaries, which providers of services and suppliers are furnishing those services, whether Medicare 

reimbursement is being received for those services, and, if 

so, through which codes those services are being reimbursed. 

(2) Whether, and the extent to which, longitudinal comprehensive care planning services would overlap, and could 

therefore result in duplicative payment, with services covered 

under the hospice benefit as well as the chronic care management code, evaluation and management codes, or other codes 

that already exist under part B of the Medicare program. 

(3) Any barriers to hospitals, skilled nursing facilities, hospice programs, home health agencies, and other applicable providers working with a Medicare beneficiary to engage in the 

care planning process and complete the necessary documentation to support the treatment and care plan of the beneficiary 

and provide such documentation to other providers and the 

beneficiary or the beneficiary’s representative. 

(4) Any barriers to providers, other than the provider furnishing longitudinal comprehensive care planning services, 

accessing the care plan and associated documentation for use 

related to the care of the Medicare beneficiary. 

(5) Potential options for ensuring that applicable providers 

are notified of a patient’s existing longitudinal care plan and 

that applicable providers consider that plan in making their 

Analysis. 

Recommendations. 

Analysis. 


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treatment decisions, and what the challenges might be in implementing such options. 

(6) Stakeholder’s views on the need for the development 

of quality metrics with respect to longitudinal comprehensive 

care planning services, such as measures related to— 

(A) the process of eliciting input from the Medicare 

beneficiary or from a legally authorized representative and 

documenting in the medical record the patient-directed care 

plan; 

(B) the effectiveness and patient-centeredness of the 

care plan in organizing delivery of services consistent with 

the plan; 

(C) the availability of the care plan and associated 

documentation to other providers that care for the beneficiary; and 

(D) the extent to which the beneficiary received services 

and support that is free from discrimination based on 

advanced age, disability status, or advanced illness. 

(7) Stakeholder’s views on how such quality metrics would 

provide information on— 

(A) the goals, values, and preferences of the beneficiary; 

(B) the documentation of the care plan; 

(C) services furnished to the beneficiary; and 

(D) outcomes of treatment. 

(8) Stakeholder’s views on— 

(A) the type of training and education needed for 

applicable providers, individuals, and caregivers in order 

to facilitate longitudinal comprehensive care planning services; 

(B) the types of providers of services and suppliers 

that should be included in the interdisciplinary team of 

an applicable provider; and 

(C) the characteristics of Medicare beneficiaries that 

would be most appropriate to receive longitudinal comprehensive care planning services, such as individuals with 

advanced disease and individuals who need assistance with 

multiple activities of daily living. 

(9) Stakeholder’s views on the frequency with which 

longitudinal comprehensive care planning services should be 

furnished. 

(b) REPORT.—Not later than 18 months after the date of the 

enactment of this Act, the Comptroller General shall submit to 

Congress a report containing the results of the study conducted 

under subsection (a), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate. 

(c) DEFINITIONS.—In this section: 

(1) APPLICABLE PROVIDER.—The term ‘‘applicable provider’’ 

means a hospice program (as defined in subsection (dd)(2) of 

section 1861 of the Social Security Act (42 U.S.C. 1395ww)) 

or other provider of services (as defined in subsection (u) of 

such section) or supplier (as defined in subsection (d) of such 

section) that— 

(A) furnishes longitudinal comprehensive care planning 

services through an interdisciplinary team; and 

(B) meets such other requirements as the Secretary 

may determine to be appropriate. 

Recommendations. 


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(2) COMPTROLLER GENERAL.—The term ‘‘Comptroller General’’ means the Comptroller General of the United States. 

(3) INTERDISCIPLINARY TEAM.—The term ‘‘interdisciplinary 

team’’ means a group that— 

(A) includes the personnel described in subsection 

(dd)(2)(B)(i) of such section 1861; 

(B) may include a chaplain, minister, or other clergy; 

and 

(C) may include other direct care personnel. 

(4) LONGITUDINAL COMPREHENSIVE CARE PLANNING SERV- ICES.—The term ‘‘longitudinal comprehensive care planning 

services’’ means a voluntary shared decisionmaking process 

that is furnished by an applicable provider through an interdisciplinary team and includes a conversation with Medicare 

beneficiaries who have received a diagnosis of a serious or 

life-threatening illness. The purpose of such services is to discuss a longitudinal care plan that addresses the progression 

of the disease, treatment options, the goals, values, and preferences of the beneficiary, and the availability of other resources 

and social supports that may reduce the beneficiary’s health 

risks and promote self-management and shared decisionmaking. 

(5) SECRETARY.—The term ‘‘Secretary’’ means the Secretary 

of Health and Human Services. 

Subtitle F—Other Policies to Improve Care 

for the Chronically Ill 

SEC. 50351. GAO STUDY AND REPORT ON IMPROVING MEDICATION 

SYNCHRONIZATION. 

(a) STUDY.—The Comptroller General of the United States (in 

this section referred to as the ‘‘Comptroller General’’) shall conduct 

a study on the extent to which Medicare prescription drug plans 

(MA–PD plans and stand alone prescription drug plans) under 

part D of title XVIII of the Social Security Act and private payors 

use programs that synchronize pharmacy dispensing so that individuals may receive multiple prescriptions on the same day to facilitate 

comprehensive counseling and promote medication adherence. The 

study shall include a analysis of the following: 

(1) The extent to which pharmacies have adopted such 

programs. 

(2) The common characteristics of such programs, including 

how pharmacies structure counseling sessions under such programs and the types of payment and other arrangements that 

Medicare prescription drug plans and private payors employ 

under such programs to support the efforts of pharmacies. 

(3) How such programs compare for Medicare prescription 

drug plans and private payors. 

(4) What is known about how such programs affect patient 

medication adherence and overall patient health outcomes, 

including if adherence and outcomes vary by patient subpopulations, such as disease state and socioeconomic status. 

(5) What is known about overall patient satisfaction with 

such programs and satisfaction with such programs, including 

within patient subpopulations, such as disease state and socioeconomic status. 

Analysis. 


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(6) The extent to which laws and regulations of the Medicare program support such programs. 

(7) Barriers to the use of medication synchronization programs by Medicare prescription drug plans. 

(b) REPORT.—Not later than 18 months after the date of the 

enactment of this Act, the Comptroller General shall submit to 

Congress a report containing the results of the study under subsection (a), together with recommendations for such legislation and 

administrative action as the Comptroller General determines appropriate. 

SEC. 50352. GAO STUDY AND REPORT ON IMPACT OF OBESITY DRUGS 

ON PATIENT HEALTH AND SPENDING. 

(a) STUDY.—The Comptroller General of the United States (in 

this section referred to as the ‘‘Comptroller General’’) shall, to 

the extent data are available, conduct a study on the use of prescription drugs to manage the weight of obese patients and the impact 

of coverage of such drugs on patient health and on health care 

spending. Such study shall examine the use and impact of these 

obesity drugs in the non-Medicare population and for Medicare 

beneficiaries who have such drugs covered through an MA–PD 

plan (as defined in section 1860D–1(a)(3)(C) of the Social Security 

Act (42 U.S.C. 1395w–101(a)(3)(C))) as a supplemental health care 

benefit. The study shall include an analysis of the following: 

(1) The prevalence of obesity in the Medicare and nonMedicare population. 

(2) The utilization of obesity drugs. 

(3) The distribution of Body Mass Index by individuals 

taking obesity drugs, to the extent practicable. 

(4) What is known about the use of obesity drugs in 

conjunction with the receipt of other items or services, such 

as behavioral counseling, and how these compare to items 

and services received by obese individuals who do not take 

obesity drugs. 

(5) Physician considerations and attitudes related to prescribing obesity drugs. 

(6) The extent to which coverage policies cease or limit 

coverage for individuals who fail to receive clinical benefit. 

(7) What is known about the extent to which individuals 

who take obesity drugs adhere to the prescribed regimen. 

(8) What is known about the extent to which individuals 

who take obesity drugs maintain weight loss over time. 

(9) What is known about the subsequent impact such drugs 

have on medical services that are directly related to obesity, 

including with respect to subpopulations determined based on 

the extent of obesity. 

(10) What is known about the spending associated with 

the care of individuals who take obesity drugs, compared to 

the spending associated with the care of individuals who do 

not take such drugs. 

(b) REPORT.—Not later than 18 months after the date of the 

enactment of this Act, the Comptroller General shall submit to 

Congress a report containing the results of the study under subsection (a), together with recommendations for such legislation and 

administrative action as the Comptroller General determines appropriate. 

Recommendations. 

Analysis. 

Recommendations. 


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SEC. 50353. HHS STUDY AND REPORT ON LONG-TERM RISK FACTORS 

FOR CHRONIC CONDITIONS AMONG MEDICARE BENEFICIARIES. 

(a) STUDY.—The Secretary of Health and Human Services (in 

this section referred to as the ‘‘Secretary’’) shall conduct a study 

on long-term cost drivers to the Medicare program, including obesity, tobacco use, mental health conditions, and other factors that 

may contribute to the deterioration of health conditions among 

individuals with chronic conditions in the Medicare population. 

The study shall include an analysis of any barriers to collecting 

and analyzing such information and how to remove any such barriers (including through legislation and administrative actions). 

(b) REPORT.—Not later than 18 months after the date of the 

enactment of this Act, the Secretary shall submit to Congress 

a report containing the results of the study under subsection (a), 

together with recommendations for such legislation and administrative action as the Secretary determines appropriate. The Secretary 

shall also post such report on the Internet website of the Department of Health and Human Services. 

SEC. 50354. PROVIDING PRESCRIPTION DRUG PLANS WITH PARTS A 

AND B CLAIMS DATA TO PROMOTE THE APPROPRIATE 

USE OF MEDICATIONS AND IMPROVE HEALTH OUTCOMES. 

Section 1860D–4(c) of the Social Security Act (42 U.S.C. 1395w– 

104(c)) is amended by adding at the end the following new paragraph: 

‘‘(6) PROVIDING PRESCRIPTION DRUG PLANS WITH PARTS A

AND B CLAIMS DATA TO PROMOTE THE APPROPRIATE USE OF

MEDICATIONS AND IMPROVE HEALTH OUTCOMES.— 

‘‘(A) PROCESS.—Subject to subparagraph (B), the Secretary shall establish a process under which a PDP sponsor 

of a prescription drug plan may submit a request for the 

Secretary to provide the sponsor, on a periodic basis and 

in an electronic format, beginning in plan year 2020, data 

described in subparagraph (D) with respect to enrollees 

in such plan. Such data shall be provided without regard 

to whether such enrollees are described in clause (ii) of 

paragraph (2)(A). 

‘‘(B) PURPOSES.—A PDP sponsor may use the data 

provided to the sponsor pursuant to subparagraph (A) for 

any of the following purposes: 

‘‘(i) To optimize therapeutic outcomes through 

improved medication use, as such phrase is used in 

clause (i) of paragraph (2)(A). 

‘‘(ii) To improving care coordination so as to prevent adverse health outcomes, such as preventable 

emergency department visits and hospital readmissions. 

‘‘(iii) For any other purpose determined appropriate by the Secretary. 

‘‘(C) LIMITATIONS ON DATA USE.—A PDP sponsor shall 

not use data provided to the sponsor pursuant to subparagraph (A) for any of the following purposes: 

‘‘(i) To inform coverage determinations under this 

part. 

Determination. 

Web posting. 

Recommendations. 

Analysis. 


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‘‘(ii) To conduct retroactive reviews of medically 

accepted indications determinations. 

‘‘(iii) To facilitate enrollment changes to a different 

prescription drug plan or an MA–PD plan offered by 

the same parent organization. 

‘‘(iv) To inform marketing of benefits. 

‘‘(v) For any other purpose that the Secretary 

determines is necessary to include in order to protect 

the identity of individuals entitled to, or enrolled for, 

benefits under this title and to protect the security 

of personal health information. 

‘‘(D) DATA DESCRIBED.—The data described in this 

clause are standardized extracts (as determined by the 

Secretary) of claims data under parts A and B for items 

and services furnished under such parts for time periods 

specified by the Secretary. Such data shall include data 

as current as practicable.’’. 

TITLE IV—PART B IMPROVEMENT ACT 

AND OTHER PART B ENHANCEMENTS 

Subtitle A—Medicare Part B Improvement 

Act 

SEC. 50401. HOME INFUSION THERAPY SERVICES TEMPORARY TRANSITIONAL PAYMENT. 

(a) IN GENERAL.—Section 1834(u) of the Social Security Act 

(42 U.S.C. 1395m(u)) is amended, by adding at the end the following 

new paragraph: 

‘‘(7) HOME INFUSION THERAPY SERVICES TEMPORARY TRANSITIONAL PAYMENT.— 

‘‘(A) TEMPORARY TRANSITIONAL PAYMENT.— ‘‘(i) IN GENERAL.—The Secretary shall, in accordance with the payment methodology described in 

subparagraph (B) and subject to the provisions of this 

paragraph, provide a home infusion therapy services 

temporary transitional payment under this part to an 

eligible home infusion supplier (as defined in subparagraph (F)) for items and services described in subparagraphs (A) and (B) of section 1861(iii)(2)) furnished 

during the period specified in clause (ii) by such supplier in coordination with the furnishing of transitional 

home infusion drugs (as defined in clause (iii)). 

‘‘(ii) PERIOD SPECIFIED.—For purposes of clause (i), 

the period specified in this clause is the period beginning on January 1, 2019, and ending on the day before 

the date of the implementation of the payment system 

under paragraph (1)(A). 

‘‘(iii) TRANSITIONAL HOME INFUSION DRUG

DEFINED.—For purposes of this paragraph, the term 

‘transitional home infusion drug’ has the meaning 

given to the term ‘home infusion drug’ under section 

1861(iii)(3)(C)), except that clause (ii) of such section 

shall not apply if a drug described in such clause 

Determination. 

Determination. 


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is identified in clauses (i), (ii), (iii) or (iv) of subparagraph (C) as of the date of the enactment of this 

paragraph. 

‘‘(B) PAYMENT METHODOLOGY.—For purposes of this 

paragraph, the Secretary shall establish a payment methodology, with respect to items and services described in 

subparagraph (A)(i). Under such payment methodology the 

Secretary shall— 

‘‘(i) create the three payment categories described 

in clauses (i), (ii), and (iii) of subparagraph (C); 

‘‘(ii) assign drugs to such categories, in accordance 

with such clauses; 

‘‘(iii) assign appropriate Healthcare Common 

Procedure Coding System (HCPCS) codes to each payment category; and 

‘‘(iv) establish a single payment amount for each 

such payment category, in accordance with subparagraph (D), for each infusion drug administration calendar day in the individual’s home for drugs assigned 

to such category. 

‘‘(C) PAYMENT CATEGORIES.— 

‘‘(i) PAYMENT CATEGORY 1.—The Secretary shall 

create a payment category 1 and assign to such category drugs which are covered under the Local Coverage Determination on External Infusion Pumps (LCD 

number L33794) and billed with the following HCPCS 

codes (as identified as of January 1, 2018, and as 

subsequently modified by the Secretary): J0133, J0285, 

J0287, J0288, J0289, J0895, J1170, J1250, J1265, 

J1325, J1455, J1457, J1570, J2175, J2260, J2270, 

J2274, J2278, J3010, or J3285. 

‘‘(ii) PAYMENT CATEGORY 2.—The Secretary shall 

create a payment category 2 and assign to such category drugs which are covered under such local coverage determination and billed with the following 

HCPCS codes (as identified as of January 1, 2018, 

and as subsequently modified by the Secretary): J1555 

JB, J1559 JB, J1561 JB, J1562 JB, J1569 JB, or J1575 

JB. 

‘‘(iii) PAYMENT CATEGORY 3.—The Secretary shall 

create a payment category 3 and assign to such category drugs which are covered under such local coverage determination and billed with the following 

HCPCS codes (as identified as of January 1, 2018, 

and as subsequently modified by the Secretary): J9000, 

J9039, J9040, J9065, J9100, J9190, J9200, J9360, or 

J9370. 

‘‘(iv) INFUSION DRUGS NOT OTHERWISE INCLUDED.— 

With respect to drugs that are not included in payment 

category 1, 2, or 3 under clause (i), (ii), or (iii), respectively, the Secretary shall assign to the most appropriate of such categories, as determined by the Secretary, drugs which are— 

‘‘(I) covered under such local coverage determination and billed under HCPCS codes J7799 

or J7999 (as identified as of July 1, 2017, and 

as subsequently modified by the Secretary); or 

Determination. 


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‘‘(II) billed under any code that is implemented 

after the date of the enactment of this paragraph 

and included in such local coverage determination 

or included in subregulatory guidance as a home 

infusion drug described in subparagraph (A)(i). 

‘‘(D) PAYMENT AMOUNTS.— 

‘‘(i) IN GENERAL.—Under the payment methodology, the Secretary shall pay eligible home infusion 

suppliers, with respect to items and services described 

in subparagraph (A)(i) furnished during the period 

described in subparagraph (A)(ii) by such supplier to 

an individual, at amounts equal to the amounts determined under the physician fee schedule established 

under section 1848 for services furnished during the 

year for codes and units of such codes described in 

clauses (ii), (iii), and (iv) with respect to drugs included 

in the payment category under subparagraph (C) specified in the respective clause, determined without 

application of the geographic adjustment under subsection (e) of such section. 

‘‘(ii) PAYMENT AMOUNT FOR CATEGORY 1.—For purposes of clause (i), the codes and units described in 

this clause, with respect to drugs included in payment 

category 1 described in subparagraph (C)(i), are one 

unit of HCPCS code 96365 plus three units of HCPCS 

code 96366 (as identified as of January 1, 2018, and 

as subsequently modified by the Secretary). 

‘‘(iii) PAYMENT AMOUNT FOR CATEGORY 2.—For purposes of clause (i), the codes and units described in 

this clause, with respect to drugs included in payment 

category 2 described in subparagraph (C)(i), are one 

unit of HCPCS code 96369 plus three units of HCPCS 

code 96370 (as identified as of January 1, 2018, and 

as subsequently modified by the Secretary). 

‘‘(iv) PAYMENT AMOUNT FOR CATEGORY 3.—For purposes of clause (i), the codes and units described in 

this clause, with respect to drugs included in payment 

category 3 described in subparagraph (C)(i), are one 

unit of HCPCS code 96413 plus three units of HCPCS 

code 96415 (as identified as of January 1, 2018, and 

as subsequently modified by the Secretary). 

‘‘(E) CLARIFICATIONS.— 

‘‘(i) INFUSION DRUG ADMINISTRATION DAY.—For purposes of this subsection, with respect to the furnishing 

of transitional home infusion drugs or home infusion 

drugs to an individual by an eligible home infusion 

supplier or a qualified home infusion therapy supplier, 

a reference to payment to such supplier for an infusion 

drug administration calendar day in the individual’s 

home shall refer to payment only for the date on which 

professional services (as described in section 

1861(iii)(2)(A)) were furnished to administer such 

drugs to such individual. For purposes of the previous 

sentence, an infusion drug administration calendar day 

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‘‘(ii) TREATMENT OF MULTIPLE DRUGS ADMINISTERED

ON SAME INFUSION DRUG ADMINISTRATION DAY.—In the 

case that an eligible home infusion supplier, with 

respect to an infusion drug administration calendar 

day in an individual’s home, furnishes to such individual transitional home infusion drugs which are not 

all assigned to the same payment category under 

subparagraph (C), payment to such supplier for such 

infusion drug administration calendar day in the 

individual’s home shall be a single payment equal to 

the amount of payment under this paragraph for the 

drug, among all such drugs so furnished to such individual during such calendar day, for which the highest 

payment would be made under this paragraph. 

‘‘(F) ELIGIBLE HOME INFUSION SUPPLIERS.—In this paragraph, the term ‘eligible home infusion supplier’ means 

a supplier that is enrolled under this part as a pharmacy 

that provides external infusion pumps and external infusion pump supplies and that maintains all pharmacy licensure requirements in the State in which the applicable 

infusion drugs are administered. 

‘‘(G) IMPLEMENTATION.—Notwithstanding any other 

provision of law, the Secretary may implement this paragraph by program instruction or otherwise.’’. 

(b) CONFORMING AMENDMENTS.—(1) Section 1842(b)(6)(I) of the 

Social Security Act (42 U.S.C. 1395u(b)(6)(I)) is amended by 

inserting ‘‘or, in the case of items and services described in clause 

(i) of section 1834(u)(7)(A) furnished to an individual during the 

period described in clause (ii) of such section, payment shall be 

made to the eligible home infusion therapy supplier’’ after ‘‘payment 

shall be made to the qualified home infusion therapy supplier’’. 

(2) Section 5012(d) of the 21st Century Cures Act is amended 

by inserting the following before the period at the end: ‘‘, except 

that the amendments made by paragraphs (1) and (2) of subsection 

(c) shall apply to items and services furnished on or after January 

1, 2019’’. 

SEC. 50402. ORTHOTIST’S AND PROSTHETIST’S CLINICAL NOTES AS 

PART OF THE PATIENT’S MEDICAL RECORD. 

Section 1834(h) of the Social Security Act (42 U.S.C. 1395m(h)) 

is amended by adding at the end the following new paragraph: 

‘‘(5) DOCUMENTATION CREATED BY ORTHOTISTS AND

PROSTHETISTS.—For purposes of determining the reasonableness and medical necessity of orthotics and prosthetics, documentation created by an orthotist or prosthetist shall be considered part of the individual’s medical record to support documentation created by eligible professionals described in section 

1848(k)(3)(B).’’ 

SEC. 50403. INDEPENDENT ACCREDITATION FOR DIALYSIS FACILITIES 

AND ASSURANCE OF HIGH QUALITY SURVEYS. 

(a) ACCREDITATION AND SURVEYS.— 

(1) IN GENERAL.—Section 1865 of the Social Security Act 

(42 U.S.C. 1395bb) is amended— 

(A) in subsection (a)— 

(i) in paragraph (1), in the matter preceding 

subparagraph (A), by striking ‘‘or the conditions and 

requirements under section 1881(b)’’; and 

Determination. 

Applicability. 

42 USC 1395l 

note. 

Definition. 


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(ii) in paragraph (4), by inserting ‘‘(including a 

renal dialysis facility)’’ after ‘‘facility’’; and 

(B) by adding at the end the following new subsection: 

‘‘(e) With respect to an accreditation body that has received 

approval from the Secretary under subsection (a)(3)(A) for accreditation of provider entities that are required to meet the conditions 

and requirements under section 1881(b), in addition to review and 

oversight authorities otherwise applicable under this title, the Secretary shall (as the Secretary determines appropriate) conduct, 

with respect to such accreditation body and provider entities, any 

or all of the following as frequently as is otherwise required to 

be conducted under this title with respect to other accreditation 

bodies or other provider entities: 

‘‘(1) Validation surveys referred to in subsection (d). 

‘‘(2) Accreditation program reviews (as defined in section 

488.8(c) of title 42 of the Code of Federal Regulations, or 

a successor regulation). 

‘‘(3) Performance reviews (as defined in section 488.8(a) 

of title 42 of the Code of Federal Regulations, or a successor 

regulation).’’. 

(2) TIMING FOR ACCEPTANCE OF REQUESTS FROM ACCREDITATION ORGANIZATIONS.—Not later than 90 days after the date 

of enactment of this Act, the Secretary of Health and Human 

Services shall begin accepting requests from national accreditation bodies for a finding described in section 1865(a)(3)(A) of 

the Social Security Act (42 U.S.C. 1395bb(a)(3)(A)) for purposes 

of accrediting provider entities that are required to meet the 

conditions and requirements under section 1881(b) of such Act 

(42 U.S.C. 1395rr(b)). 

(b) REQUIREMENT FOR TIMING OF SURVEYS OF NEW DIALYSIS

FACILITIES.—Section 1881(b)(1) of the Social Security Act (42 U.S.C. 

1395rr(b)(1)) is amended by adding at the end the following new 

sentence: ‘‘Beginning 180 days after the date of the enactment 

of this sentence, an initial survey of a provider of services or 

a renal dialysis facility to determine if the conditions and requirements under this paragraph are met shall be initiated not later 

than 90 days after such date on which both the provider enrollment 

form (without regard to whether such form is submitted prior 

to or after such date of enactment) has been determined by the 

Secretary to be complete and the provider’s enrollment status 

indicates approval is pending the results of such survey.’’. 

SEC. 50404. MODERNIZING THE APPLICATION OF THE STARK RULE 

UNDER MEDICARE. 

(a) CLARIFICATION OF THE WRITING REQUIREMENT AND SIGNATURE REQUIREMENT FOR ARRANGEMENTS PURSUANT TO THE STARK

RULE.— 

(1) WRITING REQUIREMENT.—Section 1877(h)(1) of the Social 

Security Act (42 U.S.C. 1395nn(h)(1)) is amended by adding 

at the end the following new subparagraph: 

‘‘(D) WRITTEN REQUIREMENT CLARIFIED.—In the case of any 

requirement pursuant to this section for a compensation 

arrangement to be in writing, such requirement shall be satisfied by such means as determined by the Secretary, including 

by a collection of documents, including contemporaneous documents evidencing the course of conduct between the parties 

involved.’’. 

Determination. 

Effective date. 

Survey. 

Determination. 

Deadline. 

Deadline. 

42 USC 1395bb 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 219 

(2) SIGNATURE REQUIREMENT.—Section 1877(h)(1) of the 

Social Security Act (42 U.S.C. 1395nn(h)(1)), as amended by 

paragraph (1), is further amended by adding at the end the 

following new subparagraph: 

‘‘(E) SPECIAL RULE FOR SIGNATURE REQUIREMENTS.— 

In the case of any requirement pursuant to this section 

for a compensation arrangement to be in writing and signed 

by the parties, such signature requirement shall be met 

if— 

‘‘(i) not later than 90 consecutive calendar days 

immediately following the date on which the compensation arrangement became noncompliant, the parties 

obtain the required signatures; and 

‘‘(ii) the compensation arrangement otherwise complies with all criteria of the applicable exception.’’. 

(b) INDEFINITE HOLDOVER FOR LEASE ARRANGEMENTS AND PERSONAL SERVICES ARRANGEMENTS PURSUANT TO THE STARK RULE.— 

Section 1877(e) of the Social Security Act (42 U.S.C. 1395nn(e)) 

is amended— 

(1) in paragraph (1), by adding at the end the following 

new subparagraph: 

‘‘(C) HOLDOVER LEASE ARRANGEMENTS.—In the case of 

a holdover lease arrangement for the lease of office space 

or equipment, which immediately follows a lease arrangement described in subparagraph (A) for the use of such 

office space or subparagraph (B) for the use of such equipment and that expired after a term of at least 1 year, 

payments made by the lessee to the lessor pursuant to 

such holdover lease arrangement, if— 

‘‘(i) the lease arrangement met the conditions of 

subparagraph (A) for the lease of office space or 

subparagraph (B) for the use of equipment when the 

arrangement expired; 

‘‘(ii) the holdover lease arrangement is on the same 

terms and conditions as the immediately preceding 

arrangement; and 

‘‘(iii) the holdover arrangement continues to satisfy 

the conditions of subparagraph (A) for the lease of 

office space or subparagraph (B) for the use of equipment.’’; and 

(2) in paragraph (3), by adding at the end the following 

new subparagraph: 

‘‘(C) HOLDOVER PERSONAL SERVICE ARRANGEMENT.—In 

the case of a holdover personal service arrangement, which 

immediately follows an arrangement described in subparagraph (A) that expired after a term of at least 1 year, 

remuneration from an entity pursuant to such holdover 

personal service arrangement, if— 

‘‘(i) the personal service arrangement met the 

conditions of subparagraph (A) when the arrangement 

expired; 

‘‘(ii) the holdover personal service arrangement is 

on the same terms and conditions as the immediately 

preceding arrangement; and 

‘‘(iii) the holdover arrangement continues to satisfy 

the conditions of subparagraph (A).’’. 

Time period. 

Time period. 

Time period. 


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132 STAT. 220 PUBLIC LAW 115–123—FEB. 9, 2018 

Subtitle B—Additional Medicare 

Provisions 

SEC. 50411. MAKING PERMANENT THE REMOVAL OF THE RENTAL CAP 

FOR DURABLE MEDICAL EQUIPMENT UNDER MEDICARE 

WITH RESPECT TO SPEECH GENERATING DEVICES. 

Section 1834(a)(2)(A)(iv) of the Social Security Act (42 U.S.C. 

1395m(a)(2)(A)(iv)) is amended by striking ‘‘and before October 1, 

2018,’’. 

SEC. 50412. INCREASED CIVIL AND CRIMINAL PENALTIES AND 

INCREASED SENTENCES FOR FEDERAL HEALTH CARE 

PROGRAM FRAUD AND ABUSE. 

(a) INCREASED CIVIL MONEY PENALTIES AND CRIMINAL FINES.— 

(1) INCREASED CIVIL MONEY PENALTIES.—Section 1128A of 

the Social Security Act (42 U.S.C. 1320a–7a) is amended— 

(A) in subsection (a), in the matter following paragraph 

(10)— 

(i) by striking ‘‘$10,000’’ and inserting ‘‘$20,000’’ 

each place it appears; 

(ii) by striking ‘‘$15,000’’ and inserting ‘‘$30,000’’; 

and 

(iii) by striking ‘‘$50,000’’ and inserting ‘‘$100,000’’ 

each place it appears; and 

(B) in subsection (b)— 

(i) in paragraph (1), in the flush text following 

subparagraph (B), by striking ‘‘$2,000’’ and inserting 

‘‘$5,000’’; 

(ii) in paragraph (2), by striking ‘‘$2,000’’ and 

inserting ‘‘$5,000’’; and 

(iii) in paragraph (3)(A)(i), by striking ‘‘$5,000’’ 

and inserting ‘‘$10,000’’. 

(2) INCREASED CRIMINAL FINES.—Section 1128B of such Act 

(42 U.S.C. 1320a–7b) is amended— 

(A) in subsection (a), in the matter following paragraph 

(6)— 

(i) by striking ‘‘$25,000’’ and inserting ‘‘$100,000’’; 

and 

(ii) by striking ‘‘$10,000’’ and inserting ‘‘$20,000’’; 

(B) in subsection (b)— 

(i) in paragraph (1), in the flush text following 

subparagraph (B), by striking ‘‘$25,000’’ and inserting 

‘‘$100,000’’; and 

(ii) in paragraph (2), in the flush text following 

subparagraph (B), by striking ‘‘$25,000’’ and inserting 

‘‘$100,000’’; 

(C) in subsection (c), by striking ‘‘$25,000’’ and 

inserting ‘‘$100,000’’; 

(D) in subsection (d), in the flush text following paragraph (2), by striking ‘‘$25,000’’ and inserting ‘‘$100,000’’; 

and 

(E) in subsection (e), by striking ‘‘$2,000’’ and inserting 

‘‘$4,000’’. 

(b) INCREASED SENTENCES FOR FELONIES INVOLVING FEDERAL

HEALTH CARE PROGRAM FRAUD AND ABUSE.— 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 221 

(1) FALSE STATEMENTS AND REPRESENTATIONS.—Section 

1128B(a) of the Social Security Act (42 U.S.C. 1320a–7b(a)) 

is amended, in the matter following paragraph (6), by striking 

‘‘not more than five years or both, or (ii)’’ and inserting ‘‘not 

more than 10 years or both, or (ii)’’. 

(2) ANTIKICKBACK.—Section 1128B(b) of such Act (42 U.S.C. 

1320a–7b(b)) is amended— 

(A) in paragraph (1), in the flush text following 

subparagraph (B), by striking ‘‘not more than five years’’ 

and inserting ‘‘not more than 10 years’’; and 

(B) in paragraph (2), in the flush text following 

subparagraph (B), by striking ‘‘not more than five years’’ 

and inserting ‘‘not more than 10 years’’. 

(3) FALSE STATEMENT OR REPRESENTATION WITH RESPECT

TO CONDITIONS OR OPERATIONS OF FACILITIES.—Section 1128B(c) 

of such Act (42 U.S.C. 1320a–7b(c)) is amended by striking 

‘‘not more than five years’’ and inserting ‘‘not more than 10 

years’’. 

(4) EXCESS CHARGES.—Section 1128B(d) of such Act (42 

U.S.C. 1320a–7b(d)) is amended, in the flush text following 

paragraph (2), by striking ‘‘not more than five years’’ and 

inserting ‘‘not more than 10 years’’. 

(c) EFFECTIVE DATE.—The amendments made by this section 

shall apply to acts committed after the date of the enactment 

of this Act. 

SEC. 50413. REDUCING THE VOLUME OF FUTURE EHR-RELATED 

SIGNIFICANT HARDSHIP REQUESTS. 

Section 1848(o)(2)(A) of the Social Security Act (42 U.S.C. 

1395w–4(o)(2)(A)) and section 1886(n)(3)(A) of such Act (42 U.S.C. 

1395ww(n)(3)(A)) are each amended in the last sentence by striking 

‘‘by requiring’’ and all that follows through ‘‘this paragraph’’. 

SEC. 50414. STRENGTHENING RULES IN CASE OF COMPETITION FOR 

DIABETIC TESTING STRIPS. 

(a) SPECIAL RULE IN CASE OF COMPETITION FOR DIABETIC

TESTING STRIPS.— 

(1) IN GENERAL.—Paragraph (10) of section 1847(b) of the 

Social Security Act (42 U.S.C. 1395w–3(b)) is amended— 

(A) in subparagraph (A), by striking the second sentence and inserting the following new sentence: ‘‘With 

respect to bids to furnish such types of products on or 

after January 1, 2019, the volume for such types of products 

shall be determined by the Secretary through the use of 

multiple sources of data (from mail order and non-mail 

order Medicare markets), including market-based data 

measuring sales of diabetic testing strip products that are 

not exclusively sold by a single retailer from such markets.’’; and 

(B) by adding at the end the following new subparagraphs: 

‘‘(C) DEMONSTRATION OF ABILITY TO FURNISH TYPES

OF DIABETIC TESTING STRIP PRODUCTS.—With respect to 

bids to furnish diabetic testing strip products on or after 

January 1, 2019, an entity shall attest to the Secretary 

that the entity has the ability to obtain an inventory of 

the types and quantities of diabetic testing strip products 

Determination. 

Applicability. 

42 USC 

1320a–7a note. 


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132 STAT. 222 PUBLIC LAW 115–123—FEB. 9, 2018 

that will allow the entity to furnish such products in a 

manner consistent with its bid and— 

‘‘(i) demonstrate to the Secretary, through letters 

of intent with manufacturers, wholesalers, or other 

suppliers, or other evidence as the Secretary may 

specify, such ability; or 

‘‘(ii) demonstrate to the Secretary that it made 

a good faith attempt to obtain such a letter of intent 

or such other evidence. 

‘‘(D) USE OF UNLISTED TYPES IN CALCULATION OF

PERCENTAGE.—With respect to bids to furnish diabetic 

testing strip products on or after January 1, 2019, in determining under subparagraph (A) whether a bid submitted 

by an entity under such subparagraph covers 50 percent 

(or such higher percentage as the Secretary may specify) 

of all types of diabetic testing strip products, the Secretary 

may not attribute a percentage to types of diabetic testing 

strip products that the Secretary does not identify by brand, 

model, and market share volume. 

‘‘(E) ADHERENCE TO DEMONSTRATION.— 

‘‘(i) IN GENERAL.—In the case of an entity that 

is furnishing diabetic testing strip products on or after 

January 1, 2019, under a contract entered into under 

the competition conducted pursuant to paragraph (1), 

the Secretary shall establish a process to monitor, on 

an ongoing basis, the extent to which such entity continues to cover the product types included in the 

entity’s bid. 

‘‘(ii) TERMINATION.—If the Secretary determines 

that an entity described in clause (i) fails to maintain 

in inventory, or otherwise maintain ready access to 

(through requirements, contracts, or otherwise) a type 

of product included in the entity’s bid, the Secretary 

may terminate such contract unless the Secretary finds 

that the failure of the entity to maintain inventory 

of, or ready access to, the product is the result of 

the discontinuation of the product by the product 

manufacturer, a market-wide shortage of the product, 

or the introduction of a newer model or version of 

the product in the market involved.’’. 

(b) CODIFYING AND EXPANDING ANTI-SWITCHING RULE.—Section 

1847(b) of the Social Security Act (42 U.S.C. 1395w–3(b)), as 

amended by subsection (a)(1), is further amended— 

(1) by redesignating paragraph (11) as paragraph (12); 

and 

(2) by inserting after paragraph (10) the following new 

paragraph: 

‘‘(11) ADDITIONAL SPECIAL RULES IN CASE OF COMPETITION

FOR DIABETIC TESTING STRIPS.— 

‘‘(A) IN GENERAL.—With respect to an entity that is 

furnishing diabetic testing strip products to individuals 

under a contract entered into under the competitive acquisition program established under this section, the entity 

shall furnish to each individual a brand of such products 

that is compatible with the home blood glucose monitor 

selected by the individual. 

Determination. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 223 

‘‘(B) PROHIBITION ON INFLUENCING AND

INCENTIVIZING.—An entity described in subparagraph (A) 

may not attempt to influence or incentivize an individual 

to switch the brand of glucose monitor or diabetic testing 

strip product selected by the individual, including by— 

‘‘(i) persuading, pressuring, or advising the individual to switch; or 

‘‘(ii) furnishing information about alternative 

brands to the individual where the individual has not 

requested such information. 

‘‘(C) PROVISION OF INFORMATION.— 

‘‘(i) STANDARDIZED INFORMATION.—Not later than 

January 1, 2019, the Secretary shall develop and make 

available to entities described in subparagraph (A) 

standardized information that describes the rights of 

an individual with respect to such an entity. The 

information described in the preceding sentence shall 

include information regarding— 

‘‘(I) the requirements established under subparagraphs (A) and (B); 

‘‘(II) the right of the individual to purchase 

diabetic testing strip products from another mail 

order supplier of such products or a retail pharmacy if the entity is not able to furnish the brand 

of such product that is compatible with the home 

blood glucose monitor selected by the individual; 

and 

‘‘(III) the right of the individual to return 

diabetic testing strip products furnished to the 

individual by the entity. 

‘‘(ii) REQUIREMENT.—With respect to diabetic 

testing strip products furnished on or after the date 

on which the Secretary develops the standardized 

information under clause (i), an entity described in 

subparagraph (A) may not communicate directly to 

an individual until the entity has verbally provided 

the individual with such standardized information. 

‘‘(D) ORDER REFILLS.—With respect to diabetic testing 

strip products furnished on or after January 1, 2019, the 

Secretary shall require an entity furnishing diabetic testing 

strip products to an individual to contact and receive a 

request from the individual for such products not more 

than 14 days prior to dispensing a refill of such products 

to the individual.’’. 

(c) IMPLEMENTATION; NON-APPLICATION OF THE PAPERWORK

REDUCTION ACT.— 

(1) IMPLEMENTATION.—Notwithstanding any other provision of law, the Secretary of Health and Human Services may 

implement the provisions of, and amendments made by, this 

section by program instruction or otherwise. 

(2) NON-APPLICATION OF THE PAPERWORK REDUCTION ACT.— 

Chapter 35 of title 44, United States Code (commonly referred 

to as the ‘‘Paperwork Reduction Act of 1995’’), shall not apply 

to this section or the amendments made by this section. 

42 USC 1395w–3 

note. 

Requirement. 

Time period. 

Deadline. 


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132 STAT. 224 PUBLIC LAW 115–123—FEB. 9, 2018 

TITLE V—OTHER HEALTH EXTENDERS 

SEC. 50501. EXTENSION FOR FAMILY-TO-FAMILY HEALTH INFORMATION CENTERS. 

Section 501(c) of the Social Security Act (42 U.S.C. 701(c)) 

is amended— 

(1) in paragraph (1)(A)— 

(A) in clause (v), by striking ‘‘and’’ at the end; 

(B) in clause (vi), by striking the period at the end 

and inserting ‘‘; and’’; and 

(C) by adding at the end the following new clause: 

‘‘(vii) $6,000,000 for each of fiscal years 2018 and 2019.’’; 

(2) in paragraph (3)(C), by inserting before the period the 

following: ‘‘, and with respect to fiscal years 2018 and 2019, 

such centers shall also be developed in all territories and at 

least one such center shall be developed for Indian tribes’’; 

and 

(3) by amending paragraph (5) to read as follows: 

‘‘(5) For purposes of this subsection— 

‘‘(A) the term ‘Indian tribe’ has the meaning given such 

term in section 4 of the Indian Health Care Improvement 

Act (25 U.S.C. 1603); 

‘‘(B) the term ‘State’ means each of the 50 States and 

the District of Columbia; and 

‘‘(C) the term ‘territory’ means Puerto Rico, Guam, American Samoa, the Virgin Islands, and the Northern Mariana 

Islands.’’. 

SEC. 50502. EXTENSION FOR SEXUAL RISK AVOIDANCE EDUCATION. 

(a) IN GENERAL.—Section 510 of the Social Security Act (42 

U.S.C. 710) is amended to read as follows: 

‘‘SEC. 510. SEXUAL RISK AVOIDANCE EDUCATION. 

‘‘(a) IN GENERAL.— 

‘‘(1) ALLOTMENTS TO STATES.—For the purpose described 

in subsection (b), the Secretary shall, for each of fiscal years 

2018 and 2019, allot to each State which has transmitted 

an application for the fiscal year under section 505(a) an 

amount equal to the product of— 

‘‘(A) the amount appropriated pursuant to subsection 

(e)(1) for the fiscal year, minus the amount reserved under 

subsection (e)(2) for the fiscal year; and 

‘‘(B) the proportion that the number of low-income 

children in the State bears to the total of such numbers 

of children for all the States. 

‘‘(2) OTHER ALLOTMENTS.— 

‘‘(A) OTHER ENTITIES.—For the purpose described in 

subsection (b), the Secretary shall, for each of fiscal years 

2018 and 2019, for any State which has not transmitted 

an application for the fiscal year under section 505(a), 

allot to one or more entities in the State the amount 

that would have been allotted to the State under paragraph 

(1) if the State had submitted such an application. 

‘‘(B) PROCESS.—The Secretary shall select the recipients of allotments under subparagraph (A) by means of 

a competitive grant process under which— 

Deadlines. 

Definitions. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 225 

‘‘(i) not later than 30 days after the deadline for 

the State involved to submit an application for the 

fiscal year under section 505(a), the Secretary publishes a notice soliciting grant applications; and 

‘‘(ii) not later than 120 days after such deadline, 

all such applications must be submitted. 

‘‘(b) PURPOSE.— ‘‘(1) IN GENERAL.—Except for research under paragraph 

(5) and information collection and reporting under paragraph 

(6), the purpose of an allotment under subsection (a) to a 

State (or to another entity in the State pursuant to subsection 

(a)(2)) is to enable the State or other entity to implement 

education exclusively on sexual risk avoidance (meaning voluntarily refraining from sexual activity). 

‘‘(2) REQUIRED COMPONENTS.—Education on sexual risk 

avoidance pursuant to an allotment under this section shall— 

‘‘(A) ensure that the unambiguous and primary 

emphasis and context for each topic described in paragraph 

(3) is a message to youth that normalizes the optimal 

health behavior of avoiding nonmarital sexual activity; 

‘‘(B) be medically accurate and complete; 

‘‘(C) be age-appropriate; 

‘‘(D) be based on adolescent learning and developmental theories for the age group receiving the education; 

and 

‘‘(E) be culturally appropriate, recognizing the experiences of youth from diverse communities, backgrounds, 

and experiences. 

‘‘(3) TOPICS.—Education on sexual risk avoidance pursuant 

to an allotment under this section shall address each of the 

following topics: 

‘‘(A) The holistic individual and societal benefits associated with personal responsibility, self-regulation, goal setting, healthy decisionmaking, and a focus on the future. 

‘‘(B) The advantage of refraining from nonmarital 

sexual activity in order to improve the future prospects 

and physical and emotional health of youth. 

‘‘(C) The increased likelihood of avoiding poverty when 

youth attain self-sufficiency and emotional maturity before 

engaging in sexual activity. 

‘‘(D) The foundational components of healthy relationships and their impact on the formation of healthy marriages and safe and stable families. 

‘‘(E) How other youth risk behaviors, such as drug 

and alcohol usage, increase the risk for teen sex. 

‘‘(F) How to resist and avoid, and receive help 

regarding, sexual coercion and dating violence, recognizing 

that even with consent teen sex remains a youth risk 

behavior. 

‘‘(4) CONTRACEPTION.—Education on sexual risk avoidance 

pursuant to an allotment under this section shall ensure that— 

‘‘(A) any information provided on contraception is medically accurate and complete and ensures that students 

understand that contraception offers physical risk reduction, but not risk elimination; and 

‘‘(B) the education does not include demonstrations, 

simulations, or distribution of contraceptive devices. 

Notice. 


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132 STAT. 226 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(5) RESEARCH.— 

‘‘(A) IN GENERAL.—A State or other entity receiving 

an allotment pursuant to subsection (a) may use up to 

20 percent of such allotment to build the evidence base 

for sexual risk avoidance education by conducting or supporting research. 

‘‘(B) REQUIREMENTS.—Any research conducted or supported pursuant to subparagraph (A) shall be— 

‘‘(i) rigorous; 

‘‘(ii) evidence-based; and 

‘‘(iii) designed and conducted by independent 

researchers who have experience in conducting and 

publishing research in peer-reviewed outlets. 

‘‘(6) INFORMATION COLLECTION AND REPORTING.—A State 

or other entity receiving an allotment pursuant to subsection 

(a) shall, as specified by the Secretary— 

‘‘(A) collect information on the programs and activities 

funded through the allotment; and 

‘‘(B) submit reports to the Secretary on the data from 

such programs and activities. 

‘‘(c) NATIONAL EVALUATION.— 

‘‘(1) IN GENERAL.—The Secretary shall— 

‘‘(A) in consultation with appropriate State and local 

agencies, conduct one or more rigorous evaluations of the 

education funded through this section and associated data; 

and 

‘‘(B) submit a report to the Congress on the results 

of such evaluations, together with a summary of the 

information collected pursuant to subsection (b)(6). 

‘‘(2) CONSULTATION.—In conducting the evaluations 

required by paragraph (1), including the establishment of rigorous evaluation methodologies, the Secretary shall consult 

with relevant stakeholders and evaluation experts. 

‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.— 

‘‘(1) Sections 503, 507, and 508 apply to allotments under 

subsection (a) to the same extent and in the same manner 

as such sections apply to allotments under section 502(c). 

‘‘(2) Sections 505 and 506 apply to allotments under subsection (a) to the extent determined by the Secretary to be 

appropriate. 

‘‘(e) DEFINITIONS.—In this section: 

‘‘(1) The term ‘age-appropriate’ means suitable (in terms 

of topics, messages, and teaching methods) to the developmental 

and social maturity of the particular age or age group of children or adolescents, based on developing cognitive, emotional, 

and behavioral capacity typical for the age or age group. 

‘‘(2) The term ‘medically accurate and complete’ means 

verified or supported by the weight of research conducted in 

compliance with accepted scientific methods and— 

‘‘(A) published in peer-reviewed journals, where 

applicable; or 

‘‘(B) comprising information that leading professional 

organizations and agencies with relevant expertise in the 

field recognize as accurate, objective, and complete. 

‘‘(3) The term ‘rigorous’, with respect to research or evaluation, means using— 

Reports. 

Consultation. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 227 

‘‘(A) established scientific methods for measuring the 

impact of an intervention or program model in changing 

behavior (specifically sexual activity or other sexual risk 

behaviors), or reducing pregnancy, among youth; or 

‘‘(B) other evidence-based methodologies established by 

the Secretary for purposes of this section. 

‘‘(4) The term ‘youth’ refers to one or more individuals 

who have attained age 10 but not age 20. 

‘‘(f) FUNDING.— 

‘‘(1) IN GENERAL.—To carry out this section, there is appropriated, out of any money in the Treasury not otherwise appropriated, $75,000,000 for each of fiscal years 2018 and 2019. 

‘‘(2) RESERVATION.—The Secretary shall reserve, for each 

of fiscal years 2018 and 2019, not more than 20 percent of 

the amount appropriated pursuant to paragraph (1) for administering the program under this section, including the conducting of national evaluations and the provision of technical 

assistance to the recipients of allotments.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall take effect as if enacted on October 1, 2017. 

SEC. 50503. EXTENSION FOR PERSONAL RESPONSIBILITY EDUCATION. 

(a) IN GENERAL.—Section 513 of the Social Security Act (42 

U.S.C. 713) is amended— 

(1) in subsection (a)(1)(A), by striking ‘‘2017’’ and inserting 

‘‘2019’’; and 

(2) in subsection (a)(4)— 

(A) in subparagraph (A), by striking ‘‘2017’’ each place 

it appears and inserting ‘‘2019’’; and 

(B) in subparagraph (B)— 

(i) in the subparagraph heading, by striking ‘‘3- 

YEAR GRANTS’’ and inserting ‘‘COMPETITIVE PREP

GRANTS’’; and 

(ii) in clause (i), by striking ‘‘solicit applications 

to award 3-year grants in each of fiscal years 2012 

through 2017’’ and inserting ‘‘continue through fiscal 

year 2019 grants awarded for any of fiscal years 2015 

through 2017’’; 

(3) in subsection (c)(1), by inserting after ‘‘youth with HIV/ 

AIDS,’’ the following: ‘‘victims of human trafficking,’’; and 

(4) in subsection (f), by striking ‘‘2017’’ and inserting ‘‘2019’’. 

(b) EFFECTIVE DATE.—The amendments made by this section 

shall take effect as if enacted on October 1, 2017. 

42 USC 713 note. 

42 USC 710 note. 


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132 STAT. 228 PUBLIC LAW 115–123—FEB. 9, 2018 

TITLE VI—CHILD AND FAMILY 

SERVICES AND SUPPORTS EXTENDERS 

Subtitle A—Continuing the Maternal, Infant, and Early Childhood Home Visiting 

Program 

SEC. 50601. CONTINUING EVIDENCE-BASED HOME VISITING PROGRAM. 

Section 511(j)(1)(H) of the Social Security Act (42 U.S.C. 

711(j)(1)(H)) is amended by striking ‘‘fiscal year 2017’’ and inserting 

‘‘each of fiscal years 2017 through 2022’’. 

SEC. 50602. CONTINUING TO DEMONSTRATE RESULTS TO HELP FAMILIES. 

(a) REQUIRE SERVICE DELIVERY MODELS TO DEMONSTRATE

IMPROVEMENT IN APPLICABLE BENCHMARK AREAS.—Section 511 of 

the Social Security Act (42 U.S.C. 711) is amended in each of 

subsections (d)(1)(A) and (h)(4)(A) by striking ‘‘each of’’. 

(b) DEMONSTRATION OF IMPROVEMENTS IN SUBSEQUENT

YEARS.—Section 511(d)(1) of such Act (42 U.S.C. 711(d)(1)) is 

amended by adding at the end the following: 

‘‘(D) DEMONSTRATION OF IMPROVEMENTS IN SUBSE- QUENT YEARS.— 

‘‘(i) CONTINUED MEASUREMENT OF IMPROVEMENT IN

APPLICABLE BENCHMARK AREAS.—The eligible entity, 

after demonstrating improvements for eligible families 

as specified in subparagraphs (A) and (B), shall continue to track and report, not later than 30 days after 

the end of fiscal year 2020 and every 3 years thereafter, 

information demonstrating that the program results 

in improvements for the eligible families participating 

in the program in at least 4 of the areas specified 

in subparagraph (A) that the service delivery model 

or models selected by the entity are intended to 

improve. 

‘‘(ii) CORRECTIVE ACTION PLAN.—If the eligible 

entity fails to demonstrate improvement in at least 

4 of the areas specified in subparagraph (A), as compared to eligible families who do not receive services 

under an early childhood home visitation program, the 

entity shall develop and implement a plan to improve 

outcomes in each of the areas specified in subparagraph 

(A) that the service delivery model or models selected 

by the entity are intended to improve, subject to 

approval by the Secretary. The plan shall include provisions for the Secretary to monitor implementation of 

the plan and conduct continued oversight of the program, including through submission by the entity of 

regular reports to the Secretary. 

‘‘(iii) TECHNICAL ASSISTANCE.—The Secretary shall 

provide an eligible entity required to develop and 

implement an improvement plan under clause (ii) with 

technical assistance to develop and implement the 

Deadline. 

Time period. 

Reports. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 229 

plan. The Secretary may provide the technical assistance directly or through grants, contracts, or cooperative agreements. 

‘‘(iv) NO IMPROVEMENT OR FAILURE TO SUBMIT

REPORT.—If the Secretary determines after a period 

of time specified by the Secretary that an eligible entity 

implementing an improvement plan under clause (ii) 

has failed to demonstrate any improvement in at least 

4 of the areas specified in subparagraph (A), or if 

the Secretary determines that an eligible entity has 

failed to submit the report required by clause (i), the 

Secretary shall terminate the grant made to the entity 

under this section and may include any unexpended 

grant funds in grants made to nonprofit organizations 

under subsection (h)(2)(B).’’. 

(c) INCLUDING INFORMATION ON APPLICABLE BENCHMARKS IN

APPLICATION.—Section 511(e)(5) of such Act (42 U.S.C. 711(e)(5)) 

is amended by inserting ‘‘that the service delivery model or models 

selected by the entity are intended to improve’’ before the period 

at the end. 

SEC. 50603. REVIEWING STATEWIDE NEEDS TO TARGET RESOURCES. 

Section 511(b)(1) of the Social Security Act (42 U.S.C. 711(b)(1)) 

is amended by striking ‘‘Not later than’’ and all that follows through 

‘‘section 505(a))’’ and inserting ‘‘Each State shall, as a condition 

of receiving payments from an allotment for the State under section 

502, conduct a statewide needs assessment (which may be separate 

from but in coordination with the statewide needs assessment 

required under section 505(a) and which shall be reviewed and 

updated by the State not later than October 1, 2020)’’. 

SEC. 50604. IMPROVING THE LIKELIHOOD OF SUCCESS IN HIGH-RISK 

COMMUNITIES. 

Section 511(d)(4)(A) of the Social Security Act (42 U.S.C. 

711(d)(4)(A)) is amended by inserting ‘‘, taking into account the 

staffing, community resource, and other requirements to operate 

at least one approved model of home visiting and demonstrate 

improvements for eligible families’’ before the period. 

SEC. 50605. OPTION TO FUND EVIDENCE-BASED HOME VISITING ON 

A PAY FOR OUTCOME BASIS. 

(a) IN GENERAL.—Section 511(c) of the Social Security Act (42 

U.S.C. 711(c)) is amended by redesignating paragraphs (3) and 

(4) as paragraphs (4) and (5), respectively, and by inserting after 

paragraph (2) the following: 

‘‘(3) AUTHORITY TO USE GRANT FOR A PAY FOR OUTCOMES

INITIATIVE.—An eligible entity to which a grant is made under 

paragraph (1) may use up to 25 percent of the grant for outcomes or success payments related to a pay for outcomes initiative that will not result in a reduction of funding for services 

delivered by the entity under a childhood home visitation program under this section while the eligible entity develops or 

operates such an initiative.’’. 

(b) DEFINITION OF PAY FOR OUTCOMES INITIATIVE.—Section 

511(k) of such Act (42 U.S.C. 711(k)) is amended by adding at 

the end the following: 

‘‘(4) PAY FOR OUTCOMES INITIATIVE.—The term ‘pay for 

outcomes initiative’ means a performance-based grant, contract, 

Updates. 

Deadline. 

Determinations. 


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132 STAT. 230 PUBLIC LAW 115–123—FEB. 9, 2018 

cooperative agreement, or other agreement awarded by a public 

entity in which a commitment is made to pay for improved 

outcomes achieved as a result of the intervention that result 

in social benefit and direct cost savings or cost avoidance to 

the public sector. Such an initiative shall include— 

‘‘(A) a feasibility study that describes how the proposed 

intervention is based on evidence of effectiveness; 

‘‘(B) a rigorous, third-party evaluation that uses experimental or quasi-experimental design or other research 

methodologies that allow for the strongest possible causal 

inferences to determine whether the initiative has met 

its proposed outcomes as a result of the intervention; 

‘‘(C) an annual, publicly available report on the 

progress of the initiative; and 

‘‘(D) a requirement that payments are made to the 

recipient of a grant, contract, or cooperative agreement 

only when agreed upon outcomes are achieved, except that 

this requirement shall not apply with respect to payments 

to a third party conducting the evaluation described in 

subparagraph (B).’’. 

(c) EXTENDED AVAILABILITY OF FUNDS.—Section 511(j)(3) of 

such Act (42 U.S.C. 711(j)(3)) is amended— 

(1) by striking ‘‘(3) AVAILABILITY.—Funds’’ and inserting 

the following: 

‘‘(3) AVAILABILITY.— 

‘‘(A) IN GENERAL.—Except as provided in subparagraph 

(B), funds’’; and 

(2) by adding at the end the following: 

‘‘(B) FUNDS FOR PAY FOR OUTCOMES INITIATIVES.— 

Funds made available to an eligible entity under this section for a fiscal year (or portion of a fiscal year) for a 

pay for outcomes initiative shall remain available for 

expenditure by the eligible entity for not more than 10 

years after the funds are so made available.’’. 

SEC. 50606. DATA EXCHANGE STANDARDS FOR IMPROVED INTEROPERABILITY. 

(a) IN GENERAL.—Section 511(h) of the Social Security Act 

(42 U.S.C. 711(h)) is amended by adding at the end the following: 

‘‘(5) DATA EXCHANGE STANDARDS FOR IMPROVED INTEROPERABILITY.— 

‘‘(A) DESIGNATION AND USE OF DATA EXCHANGE STANDARDS.— 

‘‘(i) DESIGNATION.—The head of the department 

or agency responsible for administering a program 

funded under this section shall, in consultation with 

an interagency work group established by the Office 

of Management and Budget and considering State 

government perspectives, designate data exchange 

standards for necessary categories of information that 

a State agency operating the program is required to 

electronically exchange with another State agency 

under applicable Federal law. 

‘‘(ii) DATA EXCHANGE STANDARDS MUST BE NONPROPRIETARY AND INTEROPERABLE.—The data exchange 

standards designated under clause (i) shall, to the 

Consultation. 

Time period. 

Deadline. 

Public 

information. 

Reports. 

Requirement. 

Evaluation. 

Determination. 

Study. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 231 

extent practicable, be nonproprietary and interoperable. 

‘‘(iii) OTHER REQUIREMENTS.—In designating data 

exchange standards under this paragraph, the Secretary shall, to the extent practicable, incorporate— 

‘‘(I) interoperable standards developed and 

maintained by an international voluntary consensus standards body, as defined by the Office 

of Management and Budget; 

‘‘(II) interoperable standards developed and 

maintained by intergovernmental partnerships, 

such as the National Information Exchange Model; 

and 

‘‘(III) interoperable standards developed and 

maintained by Federal entities with authority over 

contracting and financial assistance. 

‘‘(B) DATA EXCHANGE STANDARDS FOR FEDERAL

REPORTING.— 

‘‘(i) DESIGNATION.—The head of the department 

or agency responsible for administering a program 

referred to in this section shall, in consultation with 

an interagency work group established by the Office 

of Management and Budget, and considering State 

government perspectives, designate data exchange 

standards to govern Federal reporting and exchange 

requirements under applicable Federal law. 

‘‘(ii) REQUIREMENTS.—The data exchange reporting 

standards required by clause (i) shall, to the extent 

practicable— 

‘‘(I) incorporate a widely accepted, nonproprietary, searchable, computer-readable format; 

‘‘(II) be consistent with and implement 

applicable accounting principles; 

‘‘(III) be implemented in a manner that is 

cost-effective and improves program efficiency and 

effectiveness; and 

‘‘(IV) be capable of being continually upgraded 

as necessary. 

‘‘(iii) INCORPORATION OF NONPROPRIETARY STANDARDS.—In designating data exchange standards under 

this paragraph, the Secretary shall, to the extent practicable, incorporate existing nonproprietary standards, 

such as the eXtensible Mark up Language. 

‘‘(iv) RULE OF CONSTRUCTION.—Nothing in this 

paragraph shall be construed to require a change to 

existing data exchange standards for Federal reporting 

about a program referred to in this section, if the 

head of the department or agency responsible for 

administering the program finds the standards to be 

effective and efficient.’’. 

(b) EFFECTIVE DATE.—The amendment made by subsection (a) 

shall take effect on the date that is 2 years after the date of 

enactment of this Act. 

SEC. 50607. ALLOCATION OF FUNDS. 

Section 511(j) of the Social Security Act (42 U.S.C. 711(j)) 

is amended by adding at the end the following: 

42 USC 711 note. 

Consultation. 


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132 STAT. 232 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(4) ALLOCATION OF FUNDS.—To the extent that the grant 

amount awarded under this section to an eligible entity is 

determined on the basis of relative population or poverty considerations, the Secretary shall make the determination using 

the most accurate Federal data available for the eligible 

entity.’’. 

Subtitle B—Extension of Health Professions Workforce Demonstration Projects 

SEC. 50611. EXTENSION OF HEALTH WORKFORCE DEMONSTRATION 

PROJECTS FOR LOW-INCOME INDIVIDUALS. 

Section 2008(c)(1) of the Social Security Act (42 U.S.C. 

1397g(c)(1)) is amended by striking ‘‘2017’’ and inserting ‘‘2019’’. 

TITLE VII—FAMILY FIRST PREVENTION 

SERVICES ACT 

Subtitle A—Investing in Prevention and 

Supporting Families 

SEC. 50701. SHORT TITLE. 

This subtitle may be cited as the ‘‘Bipartisan Budget Act of 

2018’’. 

SEC. 50702. PURPOSE. 

The purpose of this subtitle is to enable States to use Federal 

funds available under parts B and E of title IV of the Social 

Security Act to provide enhanced support to children and families 

and prevent foster care placements through the provision of mental 

health and substance abuse prevention and treatment services, 

in-home parent skill-based programs, and kinship navigator services. 

PART I—PREVENTION ACTIVITIES UNDER 

TITLE IV–E 

SEC. 50711. FOSTER CARE PREVENTION SERVICES AND PROGRAMS. 

(a) STATE OPTION.—Section 471 of the Social Security Act (42 

U.S.C. 671) is amended— 

(1) in subsection (a)(1), by striking ‘‘and’’ and all that 

follows through the semicolon and inserting ‘‘, adoption assistance in accordance with section 473, and, at the option of 

the State, services or programs specified in subsection (e)(1) 

of this section for children who are candidates for foster care 

or who are pregnant or parenting foster youth and the parents 

or kin caregivers of the children, in accordance with the requirements of that subsection;’’; and 

(2) by adding at the end the following: 

‘‘(e) PREVENTION AND FAMILY SERVICES AND PROGRAMS.— 

‘‘(1) IN GENERAL.—Subject to the succeeding provisions of 

this subsection, the Secretary may make a payment to a State 

for providing the following services or programs for a child 

Time period. 

42 USC 622 note. 

42 USC 1305 

note. 

Bipartisan 

Budget Act of 

2018. 

Determination. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 233 

described in paragraph (2) and the parents or kin caregivers 

of the child when the need of the child, such a parent, or 

such a caregiver for the services or programs are directly related 

to the safety, permanence, or well-being of the child or to 

preventing the child from entering foster care: 

‘‘(A) MENTAL HEALTH AND SUBSTANCE ABUSE PREVENTION AND TREATMENT SERVICES.—Mental health and substance abuse prevention and treatment services provided 

by a qualified clinician for not more than a 12-month 

period that begins on any date described in paragraph 

(3) with respect to the child. 

‘‘(B) IN-HOME PARENT SKILL-BASED PROGRAMS.—Inhome parent skill-based programs for not more than a 

12-month period that begins on any date described in paragraph (3) with respect to the child and that include parenting skills training, parent education, and individual and 

family counseling. 

‘‘(2) CHILD DESCRIBED.—For purposes of paragraph (1), a 

child described in this paragraph is the following: 

‘‘(A) A child who is a candidate for foster care (as 

defined in section 475(13)) but can remain safely at home 

or in a kinship placement with receipt of services or programs specified in paragraph (1). 

‘‘(B) A child in foster care who is a pregnant or parenting foster youth. 

‘‘(3) DATE DESCRIBED.—For purposes of paragraph (1), the 

dates described in this paragraph are the following: 

‘‘(A) The date on which a child is identified in a prevention plan maintained under paragraph (4) as a child who 

is a candidate for foster care (as defined in section 475(13)). 

‘‘(B) The date on which a child is identified in a prevention plan maintained under paragraph (4) as a pregnant 

or parenting foster youth in need of services or programs 

specified in paragraph (1). 

‘‘(4) REQUIREMENTS RELATED TO PROVIDING SERVICES AND

PROGRAMS.—Services and programs specified in paragraph (1) 

may be provided under this subsection only if specified in 

advance in the child’s prevention plan described in subparagraph (A) and the requirements in subparagraphs (B) through 

(E) are met: 

‘‘(A) PREVENTION PLAN.—The State maintains a written 

prevention plan for the child that meets the following 

requirements (as applicable): 

‘‘(i) CANDIDATES.—In the case of a child who is 

a candidate for foster care described in paragraph 

(2)(A), the prevention plan shall— 

‘‘(I) identify the foster care prevention strategy 

for the child so that the child may remain safely 

at home, live temporarily with a kin caregiver 

until reunification can be safely achieved, or live 

permanently with a kin caregiver; 

‘‘(II) list the services or programs to be provided to or on behalf of the child to ensure the 

success of that prevention strategy; and 

‘‘(III) comply with such other requirements as 

the Secretary shall establish. 

Compliance. 


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132 STAT. 234 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(ii) PREGNANT OR PARENTING FOSTER YOUTH.—In 

the case of a child who is a pregnant or parenting 

foster youth described in paragraph (2)(B), the prevention plan shall— 

‘‘(I) be included in the child’s case plan 

required under section 475(1); 

‘‘(II) list the services or programs to be provided to or on behalf of the youth to ensure that 

the youth is prepared (in the case of a pregnant 

foster youth) or able (in the case of a parenting 

foster youth) to be a parent; 

‘‘(III) describe the foster care prevention 

strategy for any child born to the youth; and 

‘‘(IV) comply with such other requirements as 

the Secretary shall establish. 

‘‘(B) TRAUMA-INFORMED.—The services or programs to 

be provided to or on behalf of a child are provided under 

an organizational structure and treatment framework that 

involves understanding, recognizing, and responding to the 

effects of all types of trauma and in accordance with recognized principles of a trauma-informed approach and 

trauma-specific interventions to address trauma’s consequences and facilitate healing. 

‘‘(C) ONLY SERVICES AND PROGRAMS PROVIDED IN

ACCORDANCE WITH PROMISING, SUPPORTED, OR WELL-SUPPORTED PRACTICES PERMITTED.— 

‘‘(i) IN GENERAL.—Only State expenditures for services or programs specified in subparagraph (A) or (B) 

of paragraph (1) that are provided in accordance with 

practices that meet the requirements specified in 

clause (ii) of this subparagraph and that meet the 

requirements specified in clause (iii), (iv), or (v), respectively, for being a promising, supported, or well-supported practice, shall be eligible for a Federal matching 

payment under section 474(a)(6)(A). 

‘‘(ii) GENERAL PRACTICE REQUIREMENTS.—The general practice requirements specified in this clause are 

the following: 

‘‘(I) The practice has a book, manual, or other 

available writings that specify the components of 

the practice protocol and describe how to administer the practice. 

‘‘(II) There is no empirical basis suggesting 

that, compared to its likely benefits, the practice 

constitutes a risk of harm to those receiving it. 

‘‘(III) If multiple outcome studies have been 

conducted, the overall weight of evidence supports 

the benefits of the practice. 

‘‘(IV) Outcome measures are reliable and valid, 

and are administrated consistently and accurately 

across all those receiving the practice. 

‘‘(V) There is no case data suggesting a risk 

of harm that was probably caused by the treatment 

and that was severe or frequent. 

‘‘(iii) PROMISING PRACTICE.—A practice shall be 

considered to be a ‘promising practice’ if the practice 

is superior to an appropriate comparison practice using 

Study. 

Compliance. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 235 

conventional standards of statistical significance (in 

terms of demonstrated meaningful improvements in 

validated measures of important child and parent outcomes, such as mental health, substance abuse, and 

child safety and well-being), as established by the 

results or outcomes of at least one study that— 

‘‘(I) was rated by an independent systematic 

review for the quality of the study design and 

execution and determined to be well-designed and 

well-executed; and 

‘‘(II) utilized some form of control (such as 

an untreated group, a placebo group, or a wait 

list study). 

‘‘(iv) SUPPORTED PRACTICE.—A practice shall be 

considered to be a ‘supported practice’ if— 

‘‘(I) the practice is superior to an appropriate 

comparison practice using conventional standards 

of statistical significance (in terms of demonstrated 

meaningful improvements in validated measures 

of important child and parent outcomes, such as 

mental health, substance abuse, and child safety 

and well-being), as established by the results or 

outcomes of at least one study that— 

‘‘(aa) was rated by an independent systematic review for the quality of the study design 

and execution and determined to be welldesigned and well-executed; 

‘‘(bb) was a rigorous random-controlled 

trial (or, if not available, a study using a rigorous quasi-experimental research design); 

and 

‘‘(cc) was carried out in a usual care or 

practice setting; and 

‘‘(II) the study described in subclause (I) established that the practice has a sustained effect 

(when compared to a control group) for at least 

6 months beyond the end of the treatment. 

‘‘(v) WELL-SUPPORTED PRACTICE.—A practice shall 

be considered to be a ‘well-supported practice’ if— 

‘‘(I) the practice is superior to an appropriate 

comparison practice using conventional standards 

of statistical significance (in terms of demonstrated 

meaningful improvements in validated measures 

of important child and parent outcomes, such as 

mental health, substance abuse, and child safety 

and well-being), as established by the results or 

outcomes of at least two studies that— 

‘‘(aa) were rated by an independent 

systematic review for the quality of the study 

design and execution and determined to be 

well-designed and well-executed; 

‘‘(bb) were rigorous random-controlled 

trials (or, if not available, studies using a rigorous quasi-experimental research design); 

and 

‘‘(cc) were carried out in a usual care or 

practice setting; and 

Studies. 

Time period. 

Study. 


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132 STAT. 236 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(II) at least one of the studies described in 

subclause (I) established that the practice has a 

sustained effect (when compared to a control 

group) for at least 1 year beyond the end of treatment. 

‘‘(D) GUIDANCE ON PRACTICES CRITERIA AND PRE- APPROVED SERVICES AND PROGRAMS.— ‘‘(i) IN GENERAL.—Not later than October 1, 2018, 

the Secretary shall issue guidance to States regarding 

the practices criteria required for services or programs 

to satisfy the requirements of subparagraph (C). The 

guidance shall include a pre-approved list of services 

and programs that satisfy the requirements. 

‘‘(ii) UPDATES.—The Secretary shall issue updates 

to the guidance required by clause (i) as often as the 

Secretary determines necessary. 

‘‘(E) OUTCOME ASSESSMENT AND REPORTING.—The State 

shall collect and report to the Secretary the following 

information with respect to each child for whom, or on 

whose behalf mental health and substance abuse prevention and treatment services or in-home parent skill-based 

programs are provided during a 12-month period beginning 

on the date the child is determined by the State to be 

a child described in paragraph (2): 

‘‘(i) The specific services or programs provided and 

the total expenditures for each of the services or programs. 

‘‘(ii) The duration of the services or programs provided. 

‘‘(iii) In the case of a child described in paragraph 

(2)(A), the child’s placement status at the beginning, 

and at the end, of the 1-year period, respectively, and 

whether the child entered foster care within 2 years 

after being determined a candidate for foster care. 

‘‘(5) STATE PLAN COMPONENT.— ‘‘(A) IN GENERAL.—A State electing to provide services 

or programs specified in paragraph (1) shall submit as 

part of the State plan required by subsection (a) a prevention services and programs plan component that meets 

the requirements of subparagraph (B). 

‘‘(B) PREVENTION SERVICES AND PROGRAMS PLAN COMPONENT.—In order to meet the requirements of this subparagraph, a prevention services and programs plan component, 

with respect to each 5-year period for which the plan 

component is in operation in the State, shall include the 

following: 

‘‘(i) How providing services and programs specified 

in paragraph (1) is expected to improve specific outcomes for children and families. 

‘‘(ii) How the State will monitor and oversee the 

safety of children who receive services and programs 

specified in paragraph (1), including through periodic 

risk assessments throughout the period in which the 

services and programs are provided on behalf of a 

child and reexamination of the prevention plan maintained for the child under paragraph (4) for the provision of the services or programs if the State determines 

Assessments. 

Determination. 

Time period. 

Plan. 

Deadline. 

Time periods. 

Determination. 

Deadlines. 

Time period. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 237 

the risk of the child entering foster care remains high 

despite the provision of the services or programs. 

‘‘(iii) With respect to the services and programs 

specified in subparagraphs (A) and (B) of paragraph 

(1), information on the specific promising, supported, 

or well-supported practices the State plans to use to 

provide the services or programs, including a description of— 

‘‘(I) the services or programs and whether the 

practices used are promising, supported, or wellsupported; 

‘‘(II) how the State plans to implement the 

services or programs, including how implementation of the services or programs will be continuously monitored to ensure fidelity to the practice 

model and to determine outcomes achieved and 

how information learned from the monitoring will 

be used to refine and improve practices; 

‘‘(III) how the State selected the services or 

programs; 

‘‘(IV) the target population for the services 

or programs; and 

‘‘(V) how each service or program provided 

will be evaluated through a well-designed and rigorous process, which may consist of an ongoing, 

cross-site evaluation approved by the Secretary. 

‘‘(iv) A description of the consultation that the 

State agencies responsible for administering the State 

plans under this part and part B engage in with other 

State agencies responsible for administering health 

programs, including mental health and substance 

abuse prevention and treatment services, and with 

other public and private agencies with experience in 

administering child and family services, including 

community-based organizations, in order to foster a 

continuum of care for children described in paragraph 

(2) and their parents or kin caregivers. 

‘‘(v) A description of how the State shall assess 

children and their parents or kin caregivers to determine eligibility for services or programs specified in 

paragraph (1). 

‘‘(vi) A description of how the services or programs 

specified in paragraph (1) that are provided for or 

on behalf of a child and the parents or kin caregivers 

of the child will be coordinated with other child and 

family services provided to the child and the parents 

or kin caregivers of the child under the State plans 

in effect under subparts 1 and 2 of part B. 

‘‘(vii) Descriptions of steps the State is taking to 

support and enhance a competent, skilled, and professional child welfare workforce to deliver traumainformed and evidence-based services, including— 

‘‘(I) ensuring that staff is qualified to provide 

services or programs that are consistent with the 

promising, supported, or well-supported practice 

models selected; and 

Assessment. 

Consultation. 

Evaluation. 


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132 STAT. 238 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(II) developing appropriate prevention plans, 

and conducting the risk assessments required 

under clause (iii). 

‘‘(viii) A description of how the State will provide 

training and support for caseworkers in assessing what 

children and their families need, connecting to the 

families served, knowing how to access and deliver 

the needed trauma-informed and evidence-based services, and overseeing and evaluating the continuing 

appropriateness of the services. 

‘‘(ix) A description of how caseload size and type 

for prevention caseworkers will be determined, managed, and overseen. 

‘‘(x) An assurance that the State will report to 

the Secretary such information and data as the Secretary may require with respect to the provision of 

services and programs specified in paragraph (1), 

including information and data necessary to determine 

the performance measures for the State under paragraph (6) and compliance with paragraph (7). 

‘‘(C) REIMBURSEMENT FOR SERVICES UNDER THE

PREVENTION PLAN COMPONENT.— 

‘‘(i) LIMITATION.—Except as provided in subclause 

(ii), a State may not receive a Federal payment under 

this part for a given promising, supported, or wellsupported practice unless (in accordance with subparagraph (B)(iii)(V)) the plan includes a well-designed and 

rigorous evaluation strategy for that practice. 

‘‘(ii) WAIVER OF LIMITATION.—The Secretary may 

waive the requirement for a well-designed and rigorous 

evaluation of any well-supported practice if the Secretary deems the evidence of the effectiveness of the 

practice to be compelling and the State meets the 

continuous quality improvement requirements included 

in subparagraph (B)(iii)(II) with regard to the practice. 

‘‘(6) PREVENTION SERVICES MEASURES.— 

‘‘(A) ESTABLISHMENT; ANNUAL UPDATES.—Beginning 

with fiscal year 2021, and annually thereafter, the Secretary shall establish the following prevention services 

measures based on information and data reported by States 

that elect to provide services and programs specified in 

paragraph (1): 

‘‘(i) PERCENTAGE OF CANDIDATES FOR FOSTER CARE

WHO DO NOT ENTER FOSTER CARE.—The percentage of 

candidates for foster care for whom, or on whose behalf, 

the services or programs are provided who do not enter 

foster care, including those placed with a kin caregiver 

outside of foster care, during the 12-month period in 

which the services or programs are provided and 

through the end of the succeeding 12-month period. 

‘‘(ii) PER-CHILD SPENDING.—The total amount of 

expenditures made for mental health and substance 

abuse prevention and treatment services or in-home 

parent skill-based programs, respectively, for, or on 

behalf of, each child described in paragraph (2). 

‘‘(B) DATA.—The Secretary shall establish and annually 

update the prevention services measures— 

Deadline. 

Updates. 

Time period. 

Time period. 

Evaluation. 

Assessment. 

Evaluation. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 239 

‘‘(i) based on the median State values of the 

information reported under each clause of subparagraph (A) for the 3 then most recent years; and 

‘‘(ii) taking into account State differences in the 

price levels of consumption goods and services using 

the most recent regional price parities published by 

the Bureau of Economic Analysis of the Department 

of Commerce or such other data as the Secretary determines appropriate. 

‘‘(C) PUBLICATION OF STATE PREVENTION SERVICES

MEASURES.—The Secretary shall annually make available 

to the public the prevention services measures of each 

State. 

‘‘(7) MAINTENANCE OF EFFORT FOR STATE FOSTER CARE

PREVENTION EXPENDITURES.— ‘‘(A) IN GENERAL.—If a State elects to provide services 

and programs specified in paragraph (1) for a fiscal year, 

the State foster care prevention expenditures for the fiscal 

year shall not be less than the amount of the expenditures 

for fiscal year 2014 (or, at the option of a State described 

in subparagraph (E), fiscal year 2015 or fiscal year 2016 

(whichever the State elects)). 

‘‘(B) STATE FOSTER CARE PREVENTION EXPENDITURES.— 

The term ‘State foster care prevention expenditures’ means 

the following: 

‘‘(i) TANF; IV–B; SSBG.—State expenditures for 

foster care prevention services and activities under 

the State program funded under part A (including 

from amounts made available by the Federal Government), under the State plan developed under part B 

(including any such amounts), or under the Social Services Block Grant Programs under subtitle A of title 

XX (including any such amounts). 

‘‘(ii) OTHER STATE PROGRAMS.—State expenditures 

for foster care prevention services and activities under 

any State program that is not described in clause (i) 

(other than any State expenditures for foster care 

prevention services and activities under the State program under this part (including under a waiver of 

the program)). 

‘‘(C) STATE EXPENDITURES.—The term ‘State expenditures’ means all State or local funds that are expended 

by the State or a local agency including State or local 

funds that are matched or reimbursed by the Federal 

Government and State or local funds that are not matched 

or reimbursed by the Federal Government. 

‘‘(D) DETERMINATION OF PREVENTION SERVICES AND

ACTIVITIES.—The Secretary shall require each State that 

elects to provide services and programs specified in paragraph (1) to report the expenditures specified in subparagraph (B) for fiscal year 2014 and for such fiscal years 

thereafter as are necessary to determine whether the State 

is complying with the maintenance of effort requirement 

in subparagraph (A). The Secretary shall specify the specific services and activities under each program referred 

to in subparagraph (B) that are ‘prevention services and 

activities’ for purposes of the reports. 

Requirement. 

Reports. 

Definition. 

Definition. 

Deadline. 

Public 

information. 

Determination. 


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132 STAT. 240 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(E) STATE DESCRIBED.—For purposes of subparagraph 

(A), a State is described in this subparagraph if the population of children in the State in 2014 was less than 200,000 

(as determined by the United States Census Bureau). 

‘‘(8) PROHIBITION AGAINST USE OF STATE FOSTER CARE

PREVENTION EXPENDITURES AND FEDERAL IV–E PREVENTION

FUNDS FOR MATCHING OR EXPENDITURE REQUIREMENT.—A State 

that elects to provide services and programs specified in paragraph (1) shall not use any State foster care prevention expenditures for a fiscal year for the State share of expenditures 

under section 474(a)(6) for a fiscal year. 

‘‘(9) ADMINISTRATIVE COSTS.—Expenditures described in 

section 474(a)(6)(B)— 

‘‘(A) shall not be eligible for payment under subparagraph (A), (B), or (E) of section 474(a)(3); and 

‘‘(B) shall be eligible for payment under section 

474(a)(6)(B) without regard to whether the expenditures 

are incurred on behalf of a child who is, or is potentially, 

eligible for foster care maintenance payments under this 

part. 

‘‘(10) APPLICATION.— 

‘‘(A) IN GENERAL.—The provision of services or programs under this subsection to or on behalf of a child 

described in paragraph (2) shall not be considered to be 

receipt of aid or assistance under the State plan under 

this part for purposes of eligibility for any other program 

established under this Act. 

‘‘(B) CANDIDATES IN KINSHIP CARE.—A child described 

in paragraph (2) for whom such services or programs under 

this subsection are provided for more than 6 months while 

in the home of a kin caregiver, and who would satisfy 

the AFDC eligibility requirement of section 

472(a)(3)(A)(ii)(II) but for residing in the home of the caregiver for more than 6 months, is deemed to satisfy that 

requirement for purposes of determining whether the child 

is eligible for foster care maintenance payments under 

section 472.’’. 

(b) DEFINITION.—Section 475 of such Act (42 U.S.C. 675) is 

amended by adding at the end the following: 

‘‘(13) The term ‘child who is a candidate for foster care’ 

means, a child who is identified in a prevention plan under 

section 471(e)(4)(A) as being at imminent risk of entering foster 

care (without regard to whether the child would be eligible 

for foster care maintenance payments under section 472 or 

is or would be eligible for adoption assistance or kinship 

guardianship assistance payments under section 473) but who 

can remain safely in the child’s home or in a kinship placement 

as long as services or programs specified in section 471(e)(1) 

that are necessary to prevent the entry of the child into foster 

care are provided. The term includes a child whose adoption 

or guardianship arrangement is at risk of a disruption or dissolution that would result in a foster care placement.’’. 

(c) PAYMENTS UNDER TITLE IV–E.—Section 474(a) of such Act 

(42 U.S.C. 674(a)) is amended— 

(1) in paragraph (5), by striking the period at the end 

and inserting ‘‘; plus’’; and 

(2) by adding at the end the following: 

Time period. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 241 

‘‘(6) subject to section 471(e)— 

‘‘(A) for each quarter— 

‘‘(i) subject to clause (ii)— 

‘‘(I) beginning after September 30, 2019, and 

before October 1, 2026, an amount equal to 50 

percent of the total amount expended during the 

quarter for the provision of services or programs 

specified in subparagraph (A) or (B) of section 

471(e)(1) that are provided in accordance with 

promising, supported, or well-supported practices 

that meet the applicable criteria specified for the 

practices in section 471(e)(4)(C); and 

‘‘(II) beginning after September 30, 2026, an 

amount equal to the Federal medical assistance 

percentage (which shall be as defined in section 

1905(b), in the case of a State other than the 

District of Columbia, or 70 percent, in the case 

of the District of Columbia) of the total amount 

expended during the quarter for the provision of 

services or programs specified in subparagraph (A) 

or (B) of section 471(e)(1) that are provided in 

accordance with promising, supported, or well-supported practices that meet the applicable criteria 

specified for the practices in section 471(e)(4)(C) 

(or, with respect to the payments made during 

the quarter under a cooperative agreement or contract entered into by the State and an Indian 

tribe, tribal organization, or tribal consortium for 

the administration or payment of funds under this 

part, an amount equal to the Federal medical 

assistance percentage that would apply under section 479B(d) (in this paragraph referred to as the 

‘tribal FMAP’) if the Indian tribe, tribal organization, or tribal consortium made the payments 

under a program operated under that section, 

unless the tribal FMAP is less than the Federal 

medical assistance percentage that applies to the 

State); except that 

‘‘(ii) not less than 50 percent of the total amount 

expended by a State under clause (i) for a fiscal year 

shall be for the provision of services or programs specified in subparagraph (A) or (B) of section 471(e)(1) 

that are provided in accordance with well-supported 

practices; plus 

‘‘(B) for each quarter specified in subparagraph (A), 

an amount equal to the sum of the following proportions 

of the total amount expended during the quarter— 

‘‘(i) 50 percent of so much of the expenditures 

as are found necessary by the Secretary for the proper 

and efficient administration of the State plan for the 

provision of services or programs specified in section 

471(e)(1), including expenditures for activities 

approved by the Secretary that promote the development of necessary processes and procedures to establish and implement the provision of the services and 

Time periods. 


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132 STAT. 242 PUBLIC LAW 115–123—FEB. 9, 2018 

programs for individuals who are eligible for the services and programs and expenditures attributable to 

data collection and reporting; and 

‘‘(ii) 50 percent of so much of the expenditures 

with respect to the provision of services and programs 

specified in section 471(e)(1) as are for training of 

personnel employed or preparing for employment by 

the State agency or by the local agency administering 

the plan in the political subdivision and of the members 

of the staff of State-licensed or State-approved child 

welfare agencies providing services to children 

described in section 471(e)(2) and their parents or kin 

caregivers, including on how to determine who are 

individuals eligible for the services or programs, how 

to identify and provide appropriate services and programs, and how to oversee and evaluate the ongoing 

appropriateness of the services and programs.’’. 

(d) TECHNICAL ASSISTANCE AND BEST PRACTICES, CLEARINGHOUSE, AND DATA COLLECTION AND EVALUATIONS.—Section 476 of 

such Act (42 U.S.C. 676) is amended by adding at the end the 

following: 

‘‘(d) TECHNICAL ASSISTANCE AND BEST PRACTICES, CLEARINGHOUSE, DATA COLLECTION, AND EVALUATIONS RELATING TO PREVENTION SERVICES AND PROGRAMS.— 

‘‘(1) TECHNICAL ASSISTANCE AND BEST PRACTICES.—The Secretary shall provide to States and, as applicable, to Indian 

tribes, tribal organizations, and tribal consortia, technical 

assistance regarding the provision of services and programs 

described in section 471(e)(1) and shall disseminate best practices with respect to the provision of the services and programs, 

including how to plan and implement a well-designed and rigorous evaluation of a promising, supported, or well-supported 

practice. 

‘‘(2) CLEARINGHOUSE OF PROMISING, SUPPORTED, AND WELLSUPPORTED PRACTICES.—The Secretary shall, directly or through 

grants, contracts, or interagency agreements, evaluate research 

on the practices specified in clauses (iii), (iv), and (v), respectively, of section 471(e)(4)(C), and programs that meet the 

requirements described in section 427(a)(1), including culturally 

specific, or location- or population-based adaptations of the 

practices, to identify and establish a public clearinghouse of 

the practices that satisfy each category described by such 

clauses. In addition, the clearinghouse shall include information 

on the specific outcomes associated with each practice, including 

whether the practice has been shown to prevent child abuse 

and neglect and reduce the likelihood of foster care placement 

by supporting birth families and kinship families and improving 

targeted supports for pregnant and parenting youth and their 

children. 

‘‘(3) DATA COLLECTION AND EVALUATIONS.—The Secretary, 

directly or through grants, contracts, or interagency agreements, may collect data and conduct evaluations with respect 

to the provision of services and programs described in section 

471(e)(1) for purposes of assessing the extent to which the 

provision of the services and programs— 

‘‘(A) reduces the likelihood of foster care placement; 

‘‘(B) increases use of kinship care arrangements; or 

Evaluation. 

Native 

Americans. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 243 

‘‘(C) improves child well-being. 

‘‘(4) REPORTS TO CONGRESS.— 

‘‘(A) IN GENERAL.—The Secretary shall submit to the 

Committee on Finance of the Senate and the Committee 

on Ways and Means of the House of Representatives periodic reports based on the provision of services and programs 

described in section 471(e)(1) and the activities carried 

out under this subsection. 

‘‘(B) PUBLIC AVAILABILITY.—The Secretary shall make 

the reports to Congress submitted under this paragraph 

publicly available. 

‘‘(5) APPROPRIATION.—Out of any money in the Treasury 

of the United States not otherwise appropriated, there are 

appropriated to the Secretary $1,000,000 for fiscal year 2018 

and each fiscal year thereafter to carry out this subsection.’’. 

(e) APPLICATION TO PROGRAMS OPERATED BY INDIAN TRIBAL

ORGANIZATIONS.— 

(1) IN GENERAL.—Section 479B of such Act (42 U.S.C. 679c) 

is amended— 

(A) in subsection (c)(1)— 

(i) in subparagraph (C)(i)— 

(I) in subclause (II), by striking ‘‘and’’ after 

the semicolon; 

(II) in subclause (III), by striking the period 

at the end and inserting ‘‘; and’’; and 

(III) by adding at the end the following: 

‘‘(IV) at the option of the tribe, organization, 

or consortium, services and programs specified in 

section 471(e)(1) to children described in section 

471(e)(2) and their parents or kin caregivers, in 

accordance with section 471(e) and subparagraph 

(E).’’; and 

(ii) by adding at the end the following: 

‘‘(E) PREVENTION SERVICES AND PROGRAMS FOR CHILDREN AND THEIR PARENTS AND KIN CAREGIVERS.— 

‘‘(i) IN GENERAL.—In the case of a tribe, organization, or consortium that elects to provide services and 

programs specified in section 471(e)(1) to children 

described in section 471(e)(2) and their parents or kin 

caregivers under the plan, the Secretary shall specify 

the requirements applicable to the provision of the 

services and programs. The requirements shall, to the 

greatest extent practicable, be consistent with the 

requirements applicable to States under section 471(e) 

and shall permit the provision of the services and 

programs in the form of services and programs that 

are adapted to the culture and context of the tribal 

communities served. 

‘‘(ii) PERFORMANCE MEASURES.—The Secretary 

shall establish specific performance measures for each 

tribe, organization, or consortium that elects to provide 

services and programs specified in section 471(e)(1). 

The performance measures shall, to the greatest extent 

practicable, be consistent with the prevention services 

measures required for States under section 471(e)(6) 

but shall allow for consideration of factors unique to 

Requirements. 


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132 STAT. 244 PUBLIC LAW 115–123—FEB. 9, 2018 

the provision of the services by tribes, organizations, 

or consortia.’’; and 

(B) in subsection (d)(1), by striking ‘‘and (5)’’ and 

inserting ‘‘(5), and (6)(A)’’. 

(2) CONFORMING AMENDMENT.—The heading for subsection 

(d) of section 479B of such Act (42 U.S.C. 679c) is amended 

by striking ‘‘FOR FOSTER CARE MAINTENANCE AND ADOPTION

ASSISTANCE PAYMENTS’’. 

(f) APPLICATION TO PROGRAMS OPERATED BY TERRITORIES.— 

Section 1108(a)(2) of the Social Security Act (42 U.S.C. 1308(a)(2)) 

is amended by striking ‘‘or 413(f)’’ and inserting ‘‘413(f), or 

474(a)(6)’’. 

SEC. 50712. FOSTER CARE MAINTENANCE PAYMENTS FOR CHILDREN 

WITH PARENTS IN A LICENSED RESIDENTIAL FAMILYBASED TREATMENT FACILITY FOR SUBSTANCE ABUSE. 

(a) IN GENERAL.—Section 472 of the Social Security Act (42 

U.S.C. 672) is amended— 

(1) in subsection (a)(2)(C), by striking ‘‘or’’ and inserting 

‘‘, with a parent residing in a licensed residential family-based 

treatment facility, but only to the extent permitted under subsection (j), or in a’’; and 

(2) by adding at the end the following: 

‘‘(j) CHILDREN PLACED WITH A PARENT RESIDING IN A LICENSED

RESIDENTIAL FAMILY-BASED TREATMENT FACILITY FOR SUBSTANCE

ABUSE.— 

‘‘(1) IN GENERAL.—Notwithstanding the preceding provisions of this section, a child who is eligible for foster care 

maintenance payments under this section, or who would be 

eligible for the payments if the eligibility were determined 

without regard to paragraphs (1)(B) and (3) of subsection (a), 

shall be eligible for the payments for a period of not more 

than 12 months during which the child is placed with a parent 

who is in a licensed residential family-based treatment facility 

for substance abuse, but only if— 

‘‘(A) the recommendation for the placement is specified 

in the child’s case plan before the placement; 

‘‘(B) the treatment facility provides, as part of the 

treatment for substance abuse, parenting skills training, 

parent education, and individual and family counseling; 

and 

‘‘(C) the substance abuse treatment, parenting skills 

training, parent education, and individual and family counseling is provided under an organizational structure and 

treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma 

and in accordance with recognized principles of a traumainformed approach and trauma-specific interventions to 

address the consequences of trauma and facilitate healing. 

‘‘(2) APPLICATION.—With respect to children for whom foster 

care maintenance payments are made under paragraph (1), 

only the children who satisfy the requirements of paragraphs 

(1)(B) and (3) of subsection (a) shall be considered to be children 

with respect to whom foster care maintenance payments are 

made under this section for purposes of subsection (h) or section 

473(b)(3)(B).’’. 

Time period. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 245 

(b) CONFORMING AMENDMENT.—Section 474(a)(1) of such Act 

(42 U.S.C. 674(a)(1)) is amended by inserting ‘‘subject to section 

472(j),’’ before ‘‘an amount equal to the Federal’’ the first place 

it appears. 

SEC. 50713. TITLE IV–E PAYMENTS FOR EVIDENCE-BASED KINSHIP 

NAVIGATOR PROGRAMS. 

Section 474(a) of the Social Security Act (42 U.S.C. 674(a)), 

as amended by section 50711(c), is amended— 

(1) in paragraph (6), by striking the period at the end 

and inserting ‘‘; plus’’; and 

(2) by adding at the end the following: 

‘‘(7) an amount equal to 50 percent of the amounts 

expended by the State during the quarter as the Secretary 

determines are for kinship navigator programs that meet the 

requirements described in section 427(a)(1) and that the Secretary determines are operated in accordance with promising, 

supported, or well-supported practices that meet the applicable 

criteria specified for the practices in section 471(e)(4)(C), without regard to whether the expenditures are incurred on behalf 

of children who are, or are potentially, eligible for foster care 

maintenance payments under this part.’’. 

PART II—ENHANCED SUPPORT UNDER TITLE 

IV–B 

SEC. 50721. ELIMINATION OF TIME LIMIT FOR FAMILY REUNIFICATION 

SERVICES WHILE IN FOSTER CARE AND PERMITTING 

TIME-LIMITED FAMILY REUNIFICATION SERVICES WHEN 

A CHILD RETURNS HOME FROM FOSTER CARE. 

(a) IN GENERAL.—Section 431(a)(7) of the Social Security Act 

(42 U.S.C. 629a(a)(7)) is amended— 

(1) in the paragraph heading, by striking ‘‘TIME-LIMITED

FAMILY’’ and inserting ‘‘FAMILY’’; and 

(2) in subparagraph (A)— 

(A) by striking ‘‘time-limited family’’ and inserting 

‘‘family’’; 

(B) by inserting ‘‘or a child who has been returned 

home’’ after ‘‘child care institution’’; and 

(C) by striking ‘‘, but only during the 15-month period 

that begins on the date that the child, pursuant to section 

475(5)(F), is considered to have entered foster care’’ and 

inserting ‘‘and to ensure the strength and stability of the 

reunification. In the case of a child who has been returned 

home, the services and activities shall only be provided 

during the 15-month period that begins on the date that 

the child returns home’’. 

(b) CONFORMING AMENDMENTS.— 

(1) Section 430 of such Act (42 U.S.C. 629) is amended 

in the matter preceding paragraph (1), by striking ‘‘time-limited’’. 

(2) Subsections (a)(4), (a)(5)(A), and (b)(1) of section 432 

of such Act (42 U.S.C. 629b) are amended by striking ‘‘timelimited’’ each place it appears. 

Time period. 

Determination. 


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132 STAT. 246 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 50722. REDUCING BUREAUCRACY AND UNNECESSARY DELAYS 

WHEN PLACING CHILDREN IN HOMES ACROSS STATE 

LINES. 

(a) STATE PLAN REQUIREMENT.—Section 471(a)(25) of the Social 

Security Act (42 U.S.C. 671(a)(25)) is amended— 

(1) by striking ‘‘provide’’ and inserting ‘‘provides’’; and 

(2) by inserting ‘‘, which, in the case of a State other 

than the Commonwealth of Puerto Rico, the United States 

Virgin Islands, Guam, or American Samoa, not later than 

October 1, 2027, shall include the use of an electronic interstate 

case-processing system’’ before the first semicolon. 

(b) EXEMPTION OF INDIAN TRIBES.—Section 479B(c) of such 

Act (42 U.S.C. 679c(c)) is amended by adding at the end the following: 

‘‘(4) INAPPLICABILITY OF STATE PLAN REQUIREMENT TO HAVE

IN EFFECT PROCEDURES PROVIDING FOR THE USE OF AN ELEC- TRONIC INTERSTATE CASE-PROCESSING SYSTEM.—The requirement in section 471(a)(25) that a State plan provide that the 

State shall have in effect procedures providing for the use 

of an electronic interstate case-processing system shall not 

apply to an Indian tribe, tribal organization, or tribal consortium that elects to operate a program under this part.’’. 

(c) FUNDING FOR THE DEVELOPMENT OF AN ELECTRONIC INTERSTATE CASE-PROCESSING SYSTEM TO EXPEDITE THE INTERSTATE

PLACEMENT OF CHILDREN IN FOSTER CARE OR GUARDIANSHIP, OR

FOR ADOPTION.—Section 437 of such Act (42 U.S.C. 629g) is 

amended by adding at the end the following: 

‘‘(g) FUNDING FOR THE DEVELOPMENT OF AN ELECTRONIC INTERSTATE CASE-PROCESSING SYSTEM TO EXPEDITE THE INTERSTATE

PLACEMENT OF CHILDREN IN FOSTER CARE OR GUARDIANSHIP, OR

FOR ADOPTION.— 

‘‘(1) PURPOSE.—The purpose of this subsection is to facilitate the development of an electronic interstate case-processing 

system for the exchange of data and documents to expedite 

the placements of children in foster, guardianship, or adoptive 

homes across State lines. 

‘‘(2) REQUIREMENTS.—A State that seeks funding under 

this subsection shall submit to the Secretary the following: 

‘‘(A) A description of the goals and outcomes to be 

achieved, which goals and outcomes must result in— 

‘‘(i) reducing the time it takes for a child to be 

provided with a safe and appropriate permanent living 

arrangement across State lines; 

‘‘(ii) improving administrative processes and 

reducing costs in the foster care system; and 

‘‘(iii) the secure exchange of relevant case files 

and other necessary materials in real time, and timely 

communications and placement decisions regarding 

interstate placements of children. 

‘‘(B) A description of the activities to be funded in 

whole or in part with the funds, including the sequencing 

of the activities. 

‘‘(C) A description of the strategies for integrating programs and services for children who are placed across 

State lines. 

‘‘(D) Such other information as the Secretary may 

require. 

Deadline. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 247 

‘‘(3) FUNDING AUTHORITY.—The Secretary may provide 

funds to a State that complies with paragraph (2). In providing 

funds under this subsection, the Secretary shall prioritize 

States that are not yet connected with the electronic interstate 

case-processing system referred to in paragraph (1). 

‘‘(4) USE OF FUNDS.—A State to which funding is provided 

under this subsection shall use the funding to support the 

State in connecting with, or enhancing or expediting services 

provided under, the electronic interstate case-processing system 

referred to in paragraph (1). 

‘‘(5) EVALUATIONS.—Not later than 1 year after the final 

year in which funds are awarded under this subsection, the 

Secretary shall submit to the Congress, and make available 

to the general public by posting on a website, a report that 

contains the following information: 

‘‘(A) How using the electronic interstate case-processing 

system developed pursuant to paragraph (4) has changed 

the time it takes for children to be placed across State 

lines. 

‘‘(B) The number of cases subject to the Interstate 

Compact on the Placement of Children that were processed 

through the electronic interstate case-processing system, 

and the number of interstate child placement cases that 

were processed outside the electronic interstate case-processing system, by each State in each year. 

‘‘(C) The progress made by States in implementing 

the electronic interstate case-processing system. 

‘‘(D) How using the electronic interstate case-processing system has affected various metrics related to child 

safety and well-being, including the time it takes for children to be placed across State lines. 

‘‘(E) How using the electronic interstate case-processing 

system has affected administrative costs and caseworker 

time spent on placing children across State lines. 

‘‘(6) DATA INTEGRATION.—The Secretary, in consultation 

with the Secretariat for the Interstate Compact on the Placement of Children and the States, shall assess how the electronic 

interstate case-processing system developed pursuant to paragraph (4) could be used to better serve and protect children 

that come to the attention of the child welfare system, by— 

‘‘(A) connecting the system with other data systems 

(such as systems operated by State law enforcement and 

judicial agencies, systems operated by the Federal Bureau 

of Investigation for the purposes of the Innocence Lost 

National Initiative, and other systems); 

‘‘(B) simplifying and improving reporting related to 

paragraphs (34) and (35) of section 471(a) regarding children or youth who have been identified as being a sex 

trafficking victim or children missing from foster care; and 

‘‘(C) improving the ability of States to quickly comply 

with background check requirements of section 471(a)(20), 

including checks of child abuse and neglect registries as 

required by section 471(a)(20)(B).’’. 

(d) RESERVATION OF FUNDS TO IMPROVE THE INTERSTATE PLACEMENT OF CHILDREN.—Section 437(b) of such Act (42 U.S.C. 629g(b)) 

is amended by adding at the end the following: 

Consultation. 

Assessment. 

Deadline. 

Public 

information. 

Reports. 

Web posting. 


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132 STAT. 248 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(4) IMPROVING THE INTERSTATE PLACEMENT OF CHIL- DREN.—The Secretary shall reserve $5,000,000 of the amount 

made available for fiscal year 2018 for grants under subsection 

(g), and the amount so reserved shall remain available through 

fiscal year 2022.’’. 

SEC. 50723. ENHANCEMENTS TO GRANTS TO IMPROVE WELL-BEING 

OF FAMILIES AFFECTED BY SUBSTANCE ABUSE. 

Section 437(f) of the Social Security Act (42 U.S.C. 629g(f)) 

is amended— 

(1) in the subsection heading, by striking ‘‘INCREASE THE

WELL-BEING OF, AND TO IMPROVE THE PERMANENCY OUTCOMES

FOR, CHILDREN AFFECTED BY’’ and inserting ‘‘IMPLEMENT IV– 

E PREVENTION SERVICES, AND IMPROVE THE WELL-BEING OF, AND IMPROVE PERMANENCY OUTCOMES FOR, CHILDREN AND

FAMILIES AFFECTED BY HEROIN, OPIOIDS, AND OTHER’’; 

(2) by striking paragraph (2) and inserting the following: 

‘‘(2) REGIONAL PARTNERSHIP DEFINED.—In this subsection, 

the term ‘regional partnership’ means a collaborative agreement 

(which may be established on an interstate, State, or intrastate 

basis) entered into by the following: 

‘‘(A) MANDATORY PARTNERS FOR ALL PARTNERSHIP

GRANTS.— 

‘‘(i) The State child welfare agency that is responsible for the administration of the State plan under 

this part and part E. 

‘‘(ii) The State agency responsible for administering the substance abuse prevention and treatment 

block grant provided under subpart II of part B of 

title XIX of the Public Health Service Act. 

‘‘(B) MANDATORY PARTNERS FOR PARTNERSHIP GRANTS

PROPOSING TO SERVE CHILDREN IN OUT-OF-HOME PLACE- MENTS.—If the partnership proposes to serve children in 

out-of-home placements, the Juvenile Court or Administrative Office of the Court that is most appropriate to oversee 

the administration of court programs in the region to 

address the population of families who come to the attention of the court due to child abuse or neglect. 

‘‘(C) OPTIONAL PARTNERS.—At the option of the partnership, any of the following: 

‘‘(i) An Indian tribe or tribal consortium. 

‘‘(ii) Nonprofit child welfare service providers. 

‘‘(iii) For-profit child welfare service providers. 

‘‘(iv) Community health service providers, 

including substance abuse treatment providers. 

‘‘(v) Community mental health providers. 

‘‘(vi) Local law enforcement agencies. 

‘‘(vii) School personnel. 

‘‘(viii) Tribal child welfare agencies (or a consortia 

of the agencies). 

‘‘(ix) Any other providers, agencies, personnel, officials, or entities that are related to the provision of 

child and family services under a State plan approved 

under this subpart. 

‘‘(D) EXCEPTION FOR REGIONAL PARTNERSHIPS WHERE

THE LEAD APPLICANT IS AN INDIAN TRIBE OR TRIBAL CON- SORTIA.—If an Indian tribe or tribal consortium enters 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 249 

into a regional partnership for purposes of this subsection, 

the Indian tribe or tribal consortium— 

‘‘(i) may (but is not required to) include the State 

child welfare agency as a partner in the collaborative 

agreement; 

‘‘(ii) may not enter into a collaborative agreement 

only with tribal child welfare agencies (or a consortium 

of the agencies); and 

‘‘(iii) if the condition described in paragraph (2)(B) 

applies, may include tribal court organizations in lieu 

of other judicial partners.’’; 

(3) in paragraph (3)— 

(A) in subparagraph (A)— 

(i) by striking ‘‘2012 through 2016’’ and inserting 

‘‘2017 through 2021’’; and 

(ii) by striking ‘‘$500,000 and not more than 

$1,000,000’’ and inserting ‘‘$250,000 and not more than 

$1,000,000’’; 

(B) in subparagraph (B)— 

(i) in the subparagraph heading, by inserting ‘‘; 

PLANNING’’ after ‘‘APPROVAL’’; 

(ii) in clause (i), by striking ‘‘clause (ii)’’ and 

inserting ‘‘clauses (ii) and (iii)’’; and 

(iii) by adding at the end the following: 

‘‘(iii) SUFFICIENT PLANNING.—A grant awarded 

under this subsection shall be disbursed in two phases: 

a planning phase (not to exceed 2 years) and an 

implementation phase. The total disbursement to a 

grantee for the planning phase may not exceed 

$250,000, and may not exceed the total anticipated 

funding for the implementation phase.’’; and 

(C) by adding at the end the following: 

‘‘(D) LIMITATION ON PAYMENT FOR A FISCAL YEAR.— 

No payment shall be made under subparagraph (A) or 

(C) for a fiscal year until the Secretary determines that 

the eligible partnership has made sufficient progress in 

meeting the goals of the grant and that the members 

of the eligible partnership are coordinating to a reasonable 

degree with the other members of the eligible partnership.’’; 

(4) in paragraph (4)— 

(A) in subparagraph (B)— 

(i) in clause (i), by inserting ‘‘, parents, and families’’ after ‘‘children’’; 

(ii) in clause (ii), by striking ‘‘safety and permanence for such children; and’’ and inserting ‘‘safe, 

permanent caregiving relationships for the children;’’; 

(iii) in clause (iii), by striking ‘‘or’’ and inserting 

‘‘increase reunification rates for children who have 

been placed in out-of-home care, or decrease’’; and 

(iv) by redesignating clause (iii) as clause (v) and 

inserting after clause (ii) the following: 

‘‘(iii) improve the substance abuse treatment outcomes for parents including retention in treatment and 

successful completion of treatment; 

‘‘(iv) facilitate the implementation, delivery, and 

effectiveness of prevention services and programs 

under section 471(e); and’’; 

Determination. 

Time period. 


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132 STAT. 250 PUBLIC LAW 115–123—FEB. 9, 2018 

(B) in subparagraph (D), by striking ‘‘where appropriate,’’; and 

(C) by striking subparagraphs (E) and (F) and inserting 

the following: 

‘‘(E) A description of a plan for sustaining the services 

provided by or activities funded under the grant after the 

conclusion of the grant period, including through the use 

of prevention services and programs under section 471(e) 

and other funds provided to the State for child welfare 

and substance abuse prevention and treatment services. 

‘‘(F) Additional information needed by the Secretary 

to determine that the proposed activities and implementation will be consistent with research or evaluations showing 

which practices and approaches are most effective.’’; 

(5) in paragraph (5)(A), by striking ‘‘abuse treatment’’ and 

inserting ‘‘use disorder treatment including medication assisted 

treatment and in-home substance abuse disorder treatment 

and recovery’’; 

(6) in paragraph (7)— 

(A) by striking ‘‘and’’ at the end of subparagraph (C); 

and 

(B) by redesignating subparagraph (D) as subparagraph (E) and inserting after subparagraph (C) the following: 

‘‘(D) demonstrate a track record of successful collaboration among child welfare, substance abuse disorder treatment and mental health agencies; and’’; 

(7) in paragraph (8)— 

(A) in subparagraph (A)— 

(i) by striking ‘‘establish indicators that will be’’ 

and inserting ‘‘review indicators that are’’; and 

(ii) by striking ‘‘in using funds made available 

under such grants to achieve the purpose of this subsection’’ and inserting ‘‘and establish a set of core 

indicators related to child safety, parental recovery, 

parenting capacity, and family well-being. In developing the core indicators, to the extent possible, indicators shall be made consistent with the outcome measures described in section 471(e)(6)’’; and 

(B) in subparagraph (B)— 

(i) in the matter preceding clause (i), by inserting 

‘‘base the performance measures on lessons learned 

from prior rounds of regional partnership grants under 

this subsection, and’’ before ‘‘consult’’; and 

(ii) by striking clauses (iii) and (iv) and inserting 

the following: 

‘‘(iii) Other stakeholders or constituencies as determined by the Secretary.’’; 

(8) in paragraph (9)(A), by striking clause (i) and inserting 

the following: 

‘‘(i) SEMIANNUAL REPORTS.—Not later than September 30 of each fiscal year in which a recipient 

of a grant under this subsection is paid funds under 

the grant, and every 6 months thereafter, the grant 

recipient shall submit to the Secretary a report on 

the services provided and activities carried out during 

the reporting period, progress made in achieving the 

Determination. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 251 

goals of the program, the number of children, adults, 

and families receiving services, and such additional 

information as the Secretary determines is necessary. 

The report due not later than September 30 of the 

last such fiscal year shall include, at a minimum, data 

on each of the performance indicators included in the 

evaluation of the regional partnership.’’; and 

(9) in paragraph (10), by striking ‘‘2012 through 2016’’ 

and inserting ‘‘2017 through 2021’’. 

PART III—MISCELLANEOUS 

SEC. 50731.REVIEWING AND IMPROVING LICENSING STANDARDS FOR 

PLACEMENT IN A RELATIVE FOSTER FAMILY HOME. 

(a) IDENTIFICATION OF REPUTABLE MODEL LICENSING STANDARDS.—Not later than October 1, 2018, the Secretary of Health 

and Human Services shall identify reputable model licensing standards with respect to the licensing of foster family homes (as defined 

in section 472(c)(1) of the Social Security Act). 

(b) STATE PLAN REQUIREMENT.—Section 471(a) of the Social 

Security Act (42 U.S.C. 671(a)) is amended— 

(1) in paragraph (34)(B), by striking ‘‘and’’ after the semicolon; 

(2) in paragraph (35)(B), by striking the period at the 

end and inserting a semicolon; and 

(3) by adding at the end the following: 

‘‘(36) provides that, not later than April 1, 2019, the State 

shall submit to the Secretary information addressing— 

‘‘(A) whether the State licensing standards are in 

accord with model standards identified by the Secretary, 

and if not, the reason for the specific deviation and a 

description as to why having a standard that is reasonably 

in accord with the corresponding national model standards 

is not appropriate for the State; 

‘‘(B) whether the State has elected to waive standards 

established in 471(a)(10)(A) for relative foster family homes 

(pursuant to waiver authority provided by 471(a)(10)(D)), 

a description of which standards the State most commonly 

waives, and if the State has not elected to waive the 

standards, the reason for not waiving these standards; 

‘‘(C) if the State has elected to waive standards specified in subparagraph (B), how caseworkers are trained 

to use the waiver authority and whether the State has 

developed a process or provided tools to assist caseworkers 

in waiving nonsafety standards per the authority provided 

in 471(a)(10)(D) to quickly place children with relatives; 

and 

‘‘(D) a description of the steps the State is taking 

to improve caseworker training or the process, if any; and’’. 

SEC. 50732. DEVELOPMENT OF A STATEWIDE PLAN TO PREVENT CHILD 

ABUSE AND NEGLECT FATALITIES. 

Section 422(b)(19) of the Social Security Act (42 U.S.C. 

622(b)(19)) is amended to read as follows: 

‘‘(19) document steps taken to track and prevent child 

maltreatment deaths by including— 

Deadlines. 

42 USC 671 note. 


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132 STAT. 252 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(A) a description of the steps the State is taking 

to compile complete and accurate information on the deaths 

required by Federal law to be reported by the State agency 

referred to in paragraph (1), including gathering relevant 

information on the deaths from the relevant organizations 

in the State including entities such as State vital statistics 

department, child death review teams, law enforcement 

agencies, offices of medical examiners, or coroners; and 

‘‘(B) a description of the steps the State is taking 

to develop and implement a comprehensive, statewide plan 

to prevent the fatalities that involves and engages relevant 

public and private agency partners, including those in 

public health, law enforcement, and the courts.’’. 

SEC. 50733. MODERNIZING THE TITLE AND PURPOSE OF TITLE IV– 

E. 

(a) PART HEADING.—The heading for part E of title IV of 

the Social Security Act (42 U.S.C. 670 et seq.) is amended to 

read as follows: 

‘‘PART E—FEDERAL PAYMENTS FOR FOSTER 

CARE, PREVENTION, AND PERMANENCY’’. 

(b) PURPOSE.—The first sentence of section 470 of such Act 

(42 U.S.C. 670) is amended— 

(1) by striking ‘‘1995) and’’ and inserting ‘‘1995),’’; 

(2) by inserting ‘‘kinship guardianship assistance, and 

prevention services or programs specified in section 471(e)(1),’’ 

after ‘‘needs,’’; and 

(3) by striking ‘‘(commencing with the fiscal year which 

begins October 1, 1980)’’. 

SEC. 50734. EFFECTIVE DATES. 

(a) EFFECTIVE DATES.— 

(1) IN GENERAL.—Except as provided in paragraph (2), subject to subsection (b), the amendments made by parts I through 

III of this subtitle shall take effect on October 1, 2018. 

(2) EXCEPTIONS.—The amendments made by sections 

50711(d), 50731, and 50733 shall take effect on the date of 

enactment of this Act. 

(b) TRANSITION RULE.— 

(1) IN GENERAL.—In the case of a State plan under part 

B or E of title IV of the Social Security Act which the Secretary 

of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for 

the plan to meet the additional requirements imposed by the 

amendments made by parts I through III of this subtitle, the 

State plan shall not be regarded as failing to comply with 

the requirements of such part solely on the basis of the failure 

of the plan to meet such additional requirements before the 

first day of the first calendar quarter beginning after the close 

of the first regular session of the State legislature that begins 

after the date of enactment of this Act. For purposes of the 

previous sentence, in the case of a State that has a 2-year 

legislative session, each year of the session shall be deemed 

to be a separate regular session of the State legislature. 

Determination. 

42 USC 622 note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 253 

(2) APPLICATION TO PROGRAMS OPERATED BY INDIAN TRIBAL

ORGANIZATIONS.—In the case of an Indian tribe, tribal organization, or tribal consortium which the Secretary of Health and 

Human Services determines requires time to take action necessary to comply with the additional requirements imposed 

by the amendments made by parts I through III of this subtitle 

(whether the tribe, organization, or tribal consortium has a 

plan under section 479B of the Social Security Act or a cooperative agreement or contract entered into with a State), the 

Secretary shall provide the tribe, organization, or tribal consortium with such additional time as the Secretary determines 

is necessary for the tribe, organization, or tribal consortium 

to take the action to comply with the additional requirements 

before being regarded as failing to comply with the requirements. 

PART IV—ENSURING THE NECESSITY OF A 

PLACEMENT THAT IS NOT IN A FOSTER FAMILY HOME 

SEC. 50741. LIMITATION ON FEDERAL FINANCIAL PARTICIPATION FOR 

PLACEMENTS THAT ARE NOT IN FOSTER FAMILY HOMES. 

(a) LIMITATION ON FEDERAL FINANCIAL PARTICIPATION.— 

(1) IN GENERAL.—Section 472 of the Social Security Act 

(42 U.S.C. 672), as amended by section 50712(a), is amended— 

(A) in subsection (a)(2)(C), by inserting ‘‘, but only 

to the extent permitted under subsection (k)’’ after ‘‘institution’’; and 

(B) by adding at the end the following: 

‘‘(k) LIMITATION ON FEDERAL FINANCIAL PARTICIPATION.— 

‘‘(1) IN GENERAL.—Beginning with the third week for which 

foster care maintenance payments are made under this section 

on behalf of a child placed in a child-care institution, no Federal 

payment shall be made to the State under section 474(a)(1) 

for amounts expended for foster care maintenance payments 

on behalf of the child unless— 

‘‘(A) the child is placed in a child-care institution that 

is a setting specified in paragraph (2) (or is placed in 

a licensed residential family-based treatment facility consistent with subsection (j)); and 

‘‘(B) in the case of a child placed in a qualified residential treatment program (as defined in paragraph (4)), the 

requirements specified in paragraph (3) and section 475A(c) 

are met. 

‘‘(2) SPECIFIED SETTINGS FOR PLACEMENT.—The settings for 

placement specified in this paragraph are the following: 

‘‘(A) A qualified residential treatment program (as 

defined in paragraph (4)). 

‘‘(B) A setting specializing in providing prenatal, postpartum, or parenting supports for youth. 

‘‘(C) In the case of a child who has attained 18 years 

of age, a supervised setting in which the child is living 

independently. 

‘‘(D) A setting providing high-quality residential care 

and supportive services to children and youth who have 

Effective date. 

Time period. 

Determination. 


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132 STAT. 254 PUBLIC LAW 115–123—FEB. 9, 2018 

been found to be, or are at risk of becoming, sex trafficking 

victims, in accordance with section 471(a)(9)(C). 

‘‘(3) ASSESSMENT TO DETERMINE APPROPRIATENESS OF

PLACEMENT IN A QUALIFIED RESIDENTIAL TREATMENT PRO- GRAM.— ‘‘(A) DEADLINE FOR ASSESSMENT.—In the case of a child 

who is placed in a qualified residential treatment program, 

if the assessment required under section 475A(c)(1) is not 

completed within 30 days after the placement is made, 

no Federal payment shall be made to the State under 

section 474(a)(1) for any amounts expended for foster care 

maintenance payments on behalf of the child during the 

placement. 

‘‘(B) DEADLINE FOR TRANSITION OUT OF PLACEMENT.— If the assessment required under section 475A(c)(1) determines that the placement of a child in a qualified residential treatment program is not appropriate, a court disapproves such a placement under section 475A(c)(2), or 

a child who has been in an approved placement in a qualified residential treatment program is going to return home 

or be placed with a fit and willing relative, a legal guardian, 

or an adoptive parent, or in a foster family home, Federal 

payments shall be made to the State under section 474(a)(1) 

for amounts expended for foster care maintenance payments on behalf of the child while the child remains in 

the qualified residential treatment program only during 

the period necessary for the child to transition home or 

to such a placement. In no event shall a State receive 

Federal payments under section 474(a)(1) for amounts 

expended for foster care maintenance payments on behalf 

of a child who remains placed in a qualified residential 

treatment program after the end of the 30-day period that 

begins on the date a determination is made that the placement is no longer the recommended or approved placement 

for the child. 

‘‘(4) QUALIFIED RESIDENTIAL TREATMENT PROGRAM.—For 

purposes of this part, the term ‘qualified residential treatment 

program’ means a program that— 

‘‘(A) has a trauma-informed treatment model that is 

designed to address the needs, including clinical needs 

as appropriate, of children with serious emotional or behavioral disorders or disturbances and, with respect to a child, 

is able to implement the treatment identified for the child 

by the assessment of the child required under section 

475A(c); 

‘‘(B) subject to paragraphs (5) and (6), has registered 

or licensed nursing staff and other licensed clinical staff 

who— 

‘‘(i) provide care within the scope of their practice 

as defined by State law; 

‘‘(ii) are on-site according to the treatment model 

referred to in subparagraph (A); and 

‘‘(iii) are available 24 hours a day and 7 days 

a week; 

‘‘(C) to extent appropriate, and in accordance with the 

child’s best interests, facilitates participation of family 

members in the child’s treatment program; 

Definition. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 255 

‘‘(D) facilitates outreach to the family members of the 

child, including siblings, documents how the outreach is 

made (including contact information), and maintains contact information for any known biological family and fictive 

kin of the child; 

‘‘(E) documents how family members are integrated 

into the treatment process for the child, including postdischarge, and how sibling connections are maintained; 

‘‘(F) provides discharge planning and family-based 

aftercare support for at least 6 months post-discharge; and 

‘‘(G) is licensed in accordance with section 471(a)(10) 

and is accredited by any of the following independent, 

not-for-profit organizations: 

‘‘(i) The Commission on Accreditation of Rehabilitation Facilities (CARF). 

‘‘(ii) The Joint Commission on Accreditation of 

Healthcare Organizations (JCAHO). 

‘‘(iii) The Council on Accreditation (COA). 

‘‘(iv) Any other independent, not-for-profit accrediting organization approved by the Secretary. 

‘‘(5) ADMINISTRATIVE COSTS.—The prohibition in paragraph 

(1) on Federal payments under section 474(a)(1) shall not be 

construed as prohibiting Federal payments for administrative 

expenditures incurred on behalf of a child placed in a childcare institution and for which payment is available under section 474(a)(3). 

‘‘(6) RULE OF CONSTRUCTION.—The requirements in paragraph (4)(B) shall not be construed as requiring a qualified 

residential treatment program to acquire nursing and behavioral health staff solely through means of a direct employer 

to employee relationship.’’. 

(2) CONFORMING AMENDMENT.—Section 474(a)(1) of the 

Social Security Act (42 U.S.C. 674(a)(1)), as amended by section 

50712(b), is amended by striking ‘‘section 472(j)’’ and inserting 

‘‘subsections (j) and (k) of section 472’’. 

(b) DEFINITION OF FOSTER FAMILY HOME, CHILD-CARE INSTITUTION.—Section 472(c) of such Act (42 U.S.C. 672(c)(1)) is amended 

to read as follows: 

‘‘(c) DEFINITIONS.—For purposes of this part: 

‘‘(1) FOSTER FAMILY HOME.— 

‘‘(A) IN GENERAL.—The term ‘foster family home’ means 

the home of an individual or family— 

‘‘(i) that is licensed or approved by the State in 

which it is situated as a foster family home that meets 

the standards established for the licensing or approval; 

and 

‘‘(ii) in which a child in foster care has been placed 

in the care of an individual, who resides with the 

child and who has been licensed or approved by the 

State to be a foster parent— 

‘‘(I) that the State deems capable of adhering 

to the reasonable and prudent parent standard; 

‘‘(II) that provides 24-hour substitute care for 

children placed away from their parents or other 

caretakers; and 

‘‘(III) that provides the care for not more than 

six children in foster care. 


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132 STAT. 256 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(B) STATE FLEXIBILITY.—The number of foster children 

that may be cared for in a home under subparagraph 

(A) may exceed the numerical limitation in subparagraph 

(A)(ii)(III), at the option of the State, for any of the following 

reasons: 

‘‘(i) To allow a parenting youth in foster care to 

remain with the child of the parenting youth. 

‘‘(ii) To allow siblings to remain together. 

‘‘(iii) To allow a child with an established meaningful relationship with the family to remain with the 

family. 

‘‘(iv) To allow a family with special training or 

skills to provide care to a child who has a severe 

disability. 

‘‘(C) RULE OF CONSTRUCTION.—Subparagraph (A) shall 

not be construed as prohibiting a foster parent from renting 

the home in which the parent cares for a foster child 

placed in the parent’s care. 

‘‘(2) CHILD-CARE INSTITUTION.— 

‘‘(A) IN GENERAL.—The term ‘child-care institution’ 

means a private child-care institution, or a public childcare institution which accommodates no more than 25 children, which is licensed by the State in which it is situated 

or has been approved by the agency of the State responsible 

for licensing or approval of institutions of this type as 

meeting the standards established for the licensing. 

‘‘(B) SUPERVISED SETTINGS.—In the case of a child who 

has attained 18 years of age, the term shall include a 

supervised setting in which the individual is living 

independently, in accordance with such conditions as the 

Secretary shall establish in regulations. 

‘‘(C) EXCLUSIONS.—The term shall not include detention facilities, forestry camps, training schools, or any other 

facility operated primarily for the detention of children 

who are determined to be delinquent.’’. 

(c) TRAINING FOR STATE JUDGES, ATTORNEYS, AND OTHER LEGAL

PERSONNEL IN CHILD WELFARE CASES.—Section 438(b)(1) of such 

Act (42 U.S.C. 629h(b)(1)) is amended in the matter preceding 

subparagraph (A) by inserting ‘‘shall provide for the training of 

judges, attorneys, and other legal personnel in child welfare cases 

on Federal child welfare policies and payment limitations with 

respect to children in foster care who are placed in settings that 

are not a foster family home,’’ after ‘‘with respect to the child,’’. 

(d) ASSURANCE OF NONIMPACT ON JUVENILE JUSTICE SYSTEM.— 

(1) STATE PLAN REQUIREMENT.—Section 471(a) of such Act 

(42 U.S.C. 671(a)), as amended by section 50731, is further 

amended by adding at the end the following: 

‘‘(37) includes a certification that, in response to the limitation imposed under section 472(k) with respect to foster care 

maintenance payments made on behalf of any child who is 

placed in a setting that is not a foster family home, the State 

will not enact or advance policies or practices that would result 

in a significant increase in the population of youth in the 

State’s juvenile justice system.’’. 

(2) GAO STUDY AND REPORT.—The Comptroller General 

of the United States shall evaluate the impact, if any, on 

State juvenile justice systems of the limitation imposed under 

Evaluations. 

Certification. 

Definition. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 257 

section 472(k) of the Social Security Act (as added by section 

50741(a)(1)) on foster care maintenance payments made on 

behalf of any child who is placed in a setting that is not 

a foster family home, in accordance with the amendments made 

by subsections (a) and (b) of this section. In particular, the 

Comptroller General shall evaluate the extent to which children 

in foster care who also are subject to the juvenile justice system 

of the State are placed in a facility under the jurisdiction 

of the juvenile justice system and whether the lack of available 

congregate care placements under the jurisdiction of the child 

welfare systems is a contributing factor to that result. Not 

later than December 31, 2025, the Comptroller General shall 

submit to Congress a report on the results of the evaluation. 

SEC. 50742. ASSESSMENT AND DOCUMENTATION OF THE NEED FOR 

PLACEMENT IN A QUALIFIED RESIDENTIAL TREATMENT 

PROGRAM. 

Section 475A of the Social Security Act (42 U.S.C. 675a) is 

amended by adding at the end the following: 

‘‘(c) ASSESSMENT, DOCUMENTATION, AND JUDICIAL DETERMINATION REQUIREMENTS FOR PLACEMENT IN A QUALIFIED RESIDENTIAL

TREATMENT PROGRAM.—In the case of any child who is placed 

in a qualified residential treatment program (as defined in section 

472(k)(4)), the following requirements shall apply for purposes of 

approving the case plan for the child and the case system review 

procedure for the child: 

‘‘(1)(A) Within 30 days of the start of each placement in 

such a setting, a qualified individual (as defined in subparagraph (D)) shall— 

‘‘(i) assess the strengths and needs of the child using 

an age-appropriate, evidence-based, validated, functional 

assessment tool approved by the Secretary; 

‘‘(ii) determine whether the needs of the child can 

be met with family members or through placement in a 

foster family home or, if not, which setting from among 

the settings specified in section 472(k)(2) would provide 

the most effective and appropriate level of care for the 

child in the least restrictive environment and be consistent 

with the short- and long-term goals for the child, as specified in the permanency plan for the child; and 

‘‘(iii) develop a list of child-specific short- and longterm mental and behavioral health goals. 

‘‘(B)(i) The State shall assemble a family and permanency 

team for the child in accordance with the requirements of 

clauses (ii) and (iii). The qualified individual conducting the 

assessment required under subparagraph (A) shall work in 

conjunction with the family of, and permanency team for, the 

child while conducting and making the assessment. 

‘‘(ii) The family and permanency team shall consist of all 

appropriate biological family members, relative, and fictive kin 

of the child, as well as, as appropriate, professionals who are 

a resource to the family of the child, such as teachers, medical 

or mental health providers who have treated the child, or 

clergy. In the case of a child who has attained age 14, the 

family and permanency team shall include the members of 

the permanency planning team for the child that are selected 

by the child in accordance with section 475(5)(C)(iv). 

Lists. 

Determination. 

Deadline. 

Applicability. 


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132 STAT. 258 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(iii) The State shall document in the child’s case plan— 

‘‘(I) the reasonable and good faith effort of the State 

to identify and include all the individuals described in 

clause (ii) on the child’s family and permanency team; 

‘‘(II) all contact information for members of the family 

and permanency team, as well as contact information for 

other family members and fictive kin who are not part 

of the family and permanency team; 

‘‘(III) evidence that meetings of the family and permanency team, including meetings relating to the assessment 

required under subparagraph (A), are held at a time and 

place convenient for family; 

‘‘(IV) if reunification is the goal, evidence demonstrating that the parent from whom the child was 

removed provided input on the members of the family 

and permanency team; 

‘‘(V) evidence that the assessment required under 

subparagraph (A) is determined in conjunction with the 

family and permanency team; 

‘‘(VI) the placement preferences of the family and 

permanency team relative to the assessment that recognizes children should be placed with their siblings unless 

there is a finding by the court that such placement is 

contrary to their best interest; and 

‘‘(VII) if the placement preferences of the family and 

permanency team and child are not the placement setting 

recommended by the qualified individual conducting the 

assessment under subparagraph (A), the reasons why the 

preferences of the team and of the child were not recommended. 

‘‘(C) In the case of a child who the qualified individual 

conducting the assessment under subparagraph (A) determines 

should not be placed in a foster family home, the qualified 

individual shall specify in writing the reasons why the needs 

of the child cannot be met by the family of the child or in 

a foster family home. A shortage or lack of foster family homes 

shall not be an acceptable reason for determining that the 

needs of the child cannot be met in a foster family home. 

The qualified individual also shall specify in writing why the 

recommended placement in a qualified residential treatment 

program is the setting that will provide the child with the 

most effective and appropriate level of care in the least restrictive environment and how that placement is consistent with 

the short- and long-term goals for the child, as specified in 

the permanency plan for the child. 

‘‘(D)(i) Subject to clause (ii), in this subsection, the term 

‘qualified individual’ means a trained professional or licensed 

clinician who is not an employee of the State agency and 

who is not connected to, or affiliated with, any placement 

setting in which children are placed by the State. 

‘‘(ii) The Secretary may approve a request of a State to 

waive any requirement in clause (i) upon a submission by 

the State, in accordance with criteria established by the Secretary, that certifies that the trained professionals or licensed 

clinicians with responsibility for performing the assessments 

described in subparagraph (A) shall maintain objectivity with 

Certification. 

Definition. 

Determination. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 259 

respect to determining the most effective and appropriate placement for a child. 

‘‘(2) Within 60 days of the start of each placement in 

a qualified residential treatment program, a family or juvenile 

court or another court (including a tribal court) of competent 

jurisdiction, or an administrative body appointed or approved 

by the court, independently, shall— 

‘‘(A) consider the assessment, determination, and documentation made by the qualified individual conducting the 

assessment under paragraph (1); 

‘‘(B) determine whether the needs of the child can 

be met through placement in a foster family home or, 

if not, whether placement of the child in a qualified residential treatment program provides the most effective and 

appropriate level of care for the child in the least restrictive 

environment and whether that placement is consistent with 

the short- and long-term goals for the child, as specified 

in the permanency plan for the child; and 

‘‘(C) approve or disapprove the placement. 

‘‘(3) The written documentation made under paragraph 

(1)(C) and documentation of the determination and approval 

or disapproval of the placement in a qualified residential treatment program by a court or administrative body under paragraph (2) shall be included in and made part of the case 

plan for the child. 

‘‘(4) As long as a child remains placed in a qualified residential treatment program, the State agency shall submit evidence 

at each status review and each permanency hearing held with 

respect to the child— 

‘‘(A) demonstrating that ongoing assessment of the 

strengths and needs of the child continues to support the 

determination that the needs of the child cannot be met 

through placement in a foster family home, that the placement in a qualified residential treatment program provides 

the most effective and appropriate level of care for the 

child in the least restrictive environment, and that the 

placement is consistent with the short- and long-term goals 

for the child, as specified in the permanency plan for the 

child; 

‘‘(B) documenting the specific treatment or service 

needs that will be met for the child in the placement 

and the length of time the child is expected to need the 

treatment or services; and 

‘‘(C) documenting the efforts made by the State agency 

to prepare the child to return home or to be placed with 

a fit and willing relative, a legal guardian, or an adoptive 

parent, or in a foster family home. 

‘‘(5) In the case of any child who is placed in a qualified 

residential treatment program for more than 12 consecutive 

months or 18 nonconsecutive months (or, in the case of a 

child who has not attained age 13, for more than 6 consecutive 

or nonconsecutive months), the State agency shall submit to 

the Secretary— 

‘‘(A) the most recent versions of the evidence and documentation specified in paragraph (4); and 

‘‘(B) the signed approval of the head of the State agency 

for the continued placement of the child in that setting.’’. 

Time periods. 

Determination. 

Deadline. 


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132 STAT. 260 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 50743. PROTOCOLS TO PREVENT INAPPROPRIATE DIAGNOSES. 

(a) STATE PLAN REQUIREMENT.—Section 422(b)(15)(A) of the 

Social Security Act (42 U.S.C. 622(b)(15)(A)) is amended— 

(1) in clause (vi), by striking ‘‘and’’ after the semicolon; 

(2) by redesignating clause (vii) as clause (viii); and 

(3) by inserting after clause (vi) the following: 

‘‘(vii) the procedures and protocols the State has 

established to ensure that children in foster care placements are not inappropriately diagnosed with mental 

illness, other emotional or behavioral disorders, medically fragile conditions, or developmental disabilities, 

and placed in settings that are not foster family homes 

as a result of the inappropriate diagnoses; and’’. 

(b) EVALUATION.—Section 476 of such Act (42 U.S.C. 676), 

as amended by section 50711(d), is further amended by adding 

at the end the following: 

‘‘(e) EVALUATION OF STATE PROCEDURES AND PROTOCOLS TO

PREVENT INAPPROPRIATE DIAGNOSES OF MENTAL ILLNESS OR OTHER

CONDITIONS.—The Secretary shall conduct an evaluation of the 

procedures and protocols established by States in accordance with 

the requirements of section 422(b)(15)(A)(vii). The evaluation shall 

analyze the extent to which States comply with and enforce the 

procedures and protocols and the effectiveness of various State 

procedures and protocols and shall identify best practices. Not later 

than January 1, 2020, the Secretary shall submit a report on 

the results of the evaluation to Congress.’’. 

SEC. 50744. ADDITIONAL DATA AND REPORTS REGARDING CHILDREN 

PLACED IN A SETTING THAT IS NOT A FOSTER FAMILY 

HOME. 

Section 479A(a)(7)(A) of the Social Security Act (42 U.S.C. 

679b(a)(7)(A)) is amended by striking clauses (i) through (vi) and 

inserting the following: 

‘‘(i) with respect to each such placement— 

‘‘(I) the type of the placement setting, 

including whether the placement is shelter care, 

a group home and if so, the range of the child 

population in the home, a residential treatment 

facility, a hospital or institution providing medical, 

rehabilitative, or psychiatric care, a setting specializing in providing prenatal, post-partum, or parenting supports, or some other kind of child-care 

institution and if so, what kind; 

‘‘(II) the number of children in the placement 

setting and the age, race, ethnicity, and gender 

of each of the children; 

‘‘(III) for each child in the placement setting, 

the length of the placement of the child in the 

setting, whether the placement of the child in the 

setting is the first placement of the child and 

if not, the number and type of previous placements 

of the child, and whether the child has special 

needs or another diagnosed mental or physical 

illness or condition; and 

‘‘(IV) the extent of any specialized education, 

treatment, counseling, or other services provided 

in the setting; and 

Deadline. 

Reports. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 261 

‘‘(ii) separately, the number and ages of children 

in the placements who have a permanency plan of 

another planned permanent living arrangement; and’’. 

SEC. 50745. CRIMINAL RECORDS CHECKS AND CHECKS OF CHILD 

ABUSE AND NEGLECT REGISTRIES FOR ADULTS 

WORKING IN CHILD-CARE INSTITUTIONS AND OTHER 

GROUP CARE SETTINGS. 

(a) STATE PLAN REQUIREMENT.—Section 471(a)(20) of the Social 

Security Act (42 U.S.C. 671(a)(20)) is amended— 

(1) in subparagraph (A)(ii), by striking ‘‘and’’ after the 

semicolon; 

(2) in subparagraph (B)(iii), by striking ‘‘and’’after the semicolon; 

(3) in subparagraph (C), by adding ‘‘and’’ after the semicolon; and 

(4) by inserting after subparagraph (C), the following new 

subparagraph: 

‘‘(D) provides procedures for any child-care institution, 

including a group home, residential treatment center, 

shelter, or other congregate care setting, to conduct 

criminal records checks, including fingerprint-based checks 

of national crime information databases (as defined in section 534(f)(3)(A) of title 28, United States Code), and checks 

described in subparagraph (B) of this paragraph, on any 

adult working in a child-care institution, including a group 

home, residential treatment center, shelter, or other congregate care setting, unless the State reports to the Secretary the alternative criminal records checks and child 

abuse registry checks the State conducts on any adult 

working in a child-care institution, including a group home, 

residential treatment center, shelter, or other congregate 

care setting, and why the checks specified in this subparagraph are not appropriate for the State;’’. 

(b) TECHNICAL AMENDMENTS.—Subparagraphs (A) and (C) of 

section 471(a)(20) of the Social Security Act (42 U.S.C. 671(a)(20)) 

are each amended by striking ‘‘section 534(e)(3)(A)’’ and inserting 

‘‘section 534(f)(3)(A)’’. 

SEC. 50746. EFFECTIVE DATES; APPLICATION TO WAIVERS. 

(a) EFFECTIVE DATES.— (1) IN GENERAL.—Subject to paragraph (2) and subsections 

(b), (c), and (d), the amendments made by this part shall 

take effect as if enacted on January 1, 2018. 

(2) TRANSITION RULE.—In the case of a State plan under 

part B or E of title IV of the Social Security Act which the 

Secretary of Health and Human Services determines requires 

State legislation (other than legislation appropriating funds) 

in order for the plan to meet the additional requirements 

imposed by the amendments made by this part, the State 

plan shall not be regarded as failing to comply with the requirements of part B or E of title IV of such Act solely on the 

basis of the failure of the plan to meet the additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State 

legislature that begins after the date of enactment of this 

Act. For purposes of the previous sentence, in the case of 

a State that has a 2-year legislative session, each year of 

Determination. 

42 USC 622 note. 


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132 STAT. 262 PUBLIC LAW 115–123—FEB. 9, 2018 

the session shall be deemed to be a separate regular session 

of the State legislature. 

(b) LIMITATION ON FEDERAL FINANCIAL PARTICIPATION FOR

PLACEMENTS THAT ARE NOT IN FOSTER FAMILY HOMES AND

RELATED PROVISIONS.— (1) IN GENERAL.—The amendments made by sections 

50741(a), 50741(b), 50741(d), and 50742 shall take effect on 

October 1, 2019. 

(2) STATE OPTION TO DELAY EFFECTIVE DATE FOR NOT MORE

THAN 2 YEARS.—If a State requests a delay in the effective 

date, the Secretary of Health and Human Services shall delay 

the effective date provided for in paragraph (1) with respect 

to the State for the amount of time requested by the State, 

not to exceed 2 years. If the effective date is so delayed for 

a period with respect to a State under the preceding sentence, 

then— 

(A) notwithstanding section 50734, the date that the 

amendments made by section 50711(c) take effect with 

respect to the State shall be delayed for the period; and 

(B) in applying section 474(a)(6) of the Social Security 

Act with respect to the State, ‘‘on or after the date this 

paragraph takes effect with respect to the State’’ is deemed 

to be substituted for ‘‘after September 30, 2019’’ in subparagraph (A)(i)(I) of such section. 

(c) CRIMINAL RECORDS CHECKS AND CHECKS OF CHILD ABUSE

AND NEGLECT REGISTRIES FOR ADULTS WORKING IN CHILD-CARE

INSTITUTIONS AND OTHER GROUP CARE SETTINGS.—Subject to subsection (a)(2), the amendments made by section 50745 shall take 

effect on October 1, 2018. 

(d) APPLICATION TO STATES WITH WAIVERS.—In the case of 

a State that, on the date of enactment of this Act, has in effect 

a waiver approved under section 1130 of the Social Security Act 

(42 U.S.C. 1320a–9), the amendments made by this part shall 

not apply with respect to the State before the expiration (determined 

without regard to any extensions) of the waiver to the extent 

the amendments are inconsistent with the terms of the waiver. 

PART V—CONTINUING SUPPORT FOR CHILD 

AND FAMILY SERVICES 

SEC. 50751. SUPPORTING AND RETAINING FOSTER FAMILIES FOR CHILDREN. 

(a) SUPPORTING AND RETAINING FOSTER PARENTS AS A FAMILY

SUPPORT SERVICE.—Section 431(a)(2)(B) of the Social Security Act 

(42 U.S.C. 631(a)(2)(B)) is amended by redesignating clauses (iii) 

through (vi) as clauses (iv) through (vii), respectively, and inserting 

after clause (ii) the following: 

‘‘(iii) To support and retain foster families so they 

can provide quality family-based settings for children 

in foster care.’’. 

(b) SUPPORT FOR FOSTER FAMILY HOMES.—Section 436 of such 

Act (42 U.S.C. 629f) is amended by adding at the end the following: 

‘‘(c) SUPPORT FOR FOSTER FAMILY HOMES.—Out of any money 

in the Treasury of the United States not otherwise appropriated, 

there are appropriated to the Secretary for fiscal year 2018, 

$8,000,000 for the Secretary to make competitive grants to States, 

Indian tribes, or tribal consortia to support the recruitment and 

Appropriation 

authorization. 

Effective date. 

Applicability. 

Effective date. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 263 

retention of high-quality foster families to increase their capacity 

to place more children in family settings, focused on States, Indian 

tribes, or tribal consortia with the highest percentage of children 

in non-family settings. The amount appropriated under this 

subparagraph shall remain available through fiscal year 2022.’’. 

SEC. 50752. EXTENSION OF CHILD AND FAMILY SERVICES PROGRAMS. 

(a) EXTENSION OF STEPHANIE TUBBS JONES CHILD WELFARE

SERVICES PROGRAM.—Section 425 of the Social Security Act (42 

U.S.C. 625) is amended by striking ‘‘2012 through 2016’’ and 

inserting ‘‘2017 through 2021’’. 

(b) EXTENSION OF PROMOTING SAFE AND STABLE FAMILIES PRO- GRAM AUTHORIZATIONS.— (1) IN GENERAL.—Section 436(a) of such Act (42 U.S.C. 

629f(a)) is amended by striking all that follows ‘‘$345,000,000’’ 

and inserting ‘‘for each of fiscal years 2017 through 2021.’’. 

(2) DISCRETIONARY GRANTS.—Section 437(a) of such Act 

(42 U.S.C. 629g(a)) is amended by striking ‘‘2012 through 2016’’ 

and inserting ‘‘2017 through 2021’’. 

(c) EXTENSION OF FUNDING RESERVATIONS FOR MONTHLY CASE- WORKER VISITS AND REGIONAL PARTNERSHIP GRANTS.—Section 

436(b) of such Act (42 U.S.C. 629f(b)) is amended— 

(1) in paragraph (4)(A), by striking ‘‘2012 through 2016’’ 

and inserting ‘‘2017 through 2021’’; and 

(2) in paragraph (5), by striking ‘‘2012 through 2016’’ and 

inserting ‘‘2017 through 2021’’. 

(d) REAUTHORIZATION OF FUNDING FOR STATE COURTS.— (1) EXTENSION OF PROGRAM.—Section 438(c)(1) of such Act 

(42 U.S.C. 629h(c)(1)) is amended by striking ‘‘2012 through 

2016’’ and inserting ‘‘2017 through 2021’’. 

(2) EXTENSION OF FEDERAL SHARE.—Section 438(d) of such 

Act (42 U.S.C. 629h(d)) is amended by striking ‘‘2012 through 

2016’’ and inserting ‘‘2017 through 2021’’. 

(e) REPEAL OF EXPIRED PROVISIONS.—Section 438(e) of such 

Act (42 U.S.C. 629h(e)) is repealed. 

SEC. 50753. IMPROVEMENTS TO THE JOHN H. CHAFEE FOSTER CARE 

INDEPENDENCE PROGRAM AND RELATED PROVISIONS. 

(a) AUTHORITY TO SERVE FORMER FOSTER YOUTH UP TO AGE

23.—Section 477 of the Social Security Act (42 U.S.C. 677) is 

amended— 

(1) in subsection (a)(5), by inserting ‘‘(or 23 years of age, 

in the case of a State with a certification under subsection 

(b)(3)(A)(ii) to provide assistance and services to youths who 

have aged out of foster care and have not attained such age, 

in accordance with such subsection)’’ after ‘‘21 years of age’’; 

(2) in subsection (b)(3)(A)— 

(A) by inserting ‘‘(i)’’ before ‘‘A certification’’; 

(B) by striking ‘‘children who have left foster care’’ 

and all that follows through the period and inserting 

‘‘youths who have aged out of foster care and have not 

attained 21 years of age.’’; and 

(C) by adding at the end the following: 

‘‘(ii) If the State has elected under section 475(8)(B) 

to extend eligibility for foster care to all children who 

have not attained 21 years of age, or if the Secretary 

determines that the State agency responsible for administering the State plans under this part and part B uses 

Determination. 


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132 STAT. 264 PUBLIC LAW 115–123—FEB. 9, 2018 

State funds or any other funds not provided under this 

part to provide services and assistance for youths who 

have aged out of foster care that are comparable to the 

services and assistance the youths would receive if the 

State had made such an election, the certification required 

under clause (i) may provide that the State will provide 

assistance and services to youths who have aged out of 

foster care and have not attained 23 years of age.’’; and 

(3) in subsection (b)(3)(B), by striking ‘‘children who have 

left foster care’’ and all that follows through the period and 

inserting ‘‘youths who have aged out of foster care and have 

not attained 21 years of age (or 23 years of age, in the case 

of a State with a certification under subparagraph (A)(i) to 

provide assistance and services to youths who have aged out 

of foster care and have not attained such age, in accordance 

with subparagraph (A)(ii)).’’. 

(b) AUTHORITY TO REDISTRIBUTE UNSPENT FUNDS.—Section 

477(d) of such Act (42 U.S.C. 677(d)) is amended— 

(1) in paragraph (4), by inserting ‘‘or does not expend 

allocated funds within the time period specified under section 

477(d)(3)’’ after ‘‘provided by the Secretary’’; and 

(2) by adding at the end the following: 

‘‘(5) REDISTRIBUTION OF UNEXPENDED AMOUNTS.— 

‘‘(A) AVAILABILITY OF AMOUNTS.—To the extent that 

amounts paid to States under this section in a fiscal year 

remain unexpended by the States at the end of the succeeding fiscal year, the Secretary may make the amounts 

available for redistribution in the second succeeding fiscal 

year among the States that apply for additional funds 

under this section for that second succeeding fiscal year. 

‘‘(B) REDISTRIBUTION.— 

‘‘(i) IN GENERAL.—The Secretary shall redistribute 

the amounts made available under subparagraph (A) 

for a fiscal year among eligible applicant States. In 

this subparagraph, the term ‘eligible applicant State’ 

means a State that has applied for additional funds 

for the fiscal year under subparagraph (A) if the Secretary determines that the State will use the funds 

for the purpose for which originally allotted under 

this section. 

‘‘(ii) AMOUNT TO BE REDISTRIBUTED.—The amount 

to be redistributed to each eligible applicant State shall 

be the amount so made available multiplied by the 

State foster care ratio, (as defined in subsection (c)(4), 

except that, in such subsection, ‘all eligible applicant 

States (as defined in subsection (d)(5)(B)(i))’ shall be 

substituted for ‘all States’). 

‘‘(iii) TREATMENT OF REDISTRIBUTED AMOUNT.—Any 

amount made available to a State under this paragraph 

shall be regarded as part of the allotment of the State 

under this section for the fiscal year in which the 

redistribution is made. 

‘‘(C) TRIBES.—For purposes of this paragraph, the term 

‘State’ includes an Indian tribe, tribal organization, or 

tribal consortium that receives an allotment under this 

section.’’. 

Definition. 

Definition. 

Determination. 

Applicability. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 265 

(c) EXPANDING AND CLARIFYING THE USE OF EDUCATION AND

TRAINING VOUCHERS.— (1) IN GENERAL.—Section 477(i)(3) of such Act (42 U.S.C. 

677(i)(3)) is amended— 

(A) by striking ‘‘on the date’’ and all that follows 

through ‘‘23’’ and inserting ‘‘to remain eligible until they 

attain 26’’; and 

(B) by inserting ‘‘, but in no event may a youth participate in the program for more than 5 years (whether or 

not consecutive)’’ before the period. 

(2) CONFORMING AMENDMENT.—Section 477(i)(1) of such 

Act (42 U.S.C. 677(i)(1)) is amended by inserting ‘‘who have 

attained 14 years of age’’ before the period. 

(d) OTHER IMPROVEMENTS.—Section 477 of such Act (42 U.S.C. 

677), as amended by subsections (a), (b), and (c), is amended— 

(1) in the section heading, by striking ‘‘INDEPENDENCE

PROGRAM’’ and inserting ‘‘PROGRAM FOR SUCCESSFUL TRANSITION TO ADULTHOOD’’; 

(2) in subsection (a)— 

(A) in paragraph (1)— 

(i) by striking ‘‘identify children who are likely 

to remain in foster care until 18 years of age and 

to help these children make the transition to selfsufficiency by providing services’’ and inserting ‘‘support all youth who have experienced foster care at 

age 14 or older in their transition to adulthood through 

transitional services’’; 

(ii) by inserting ‘‘and post-secondary education’’ 

after ‘‘high school diploma’’; and 

(iii) by striking ‘‘training in daily living skills, 

training in budgeting and financial management skills’’ 

and inserting ‘‘training and opportunities to practice 

daily living skills (such as financial literacy training 

and driving instruction)’’; 

(B) in paragraph (2), by striking ‘‘who are likely to 

remain in foster care until 18 years of age receive the 

education, training, and services necessary to obtain 

employment’’ and inserting ‘‘who have experienced foster 

care at age 14 or older achieve meaningful, permanent 

connections with a caring adult’’; 

(C) in paragraph (3), by striking ‘‘who are likely to 

remain in foster care until 18 years of age prepare for 

and enter postsecondary training and education institutions’’ and inserting ‘‘who have experienced foster care 

at age 14 or older engage in age or developmentally appropriate activities, positive youth development, and experiential learning that reflects what their peers in intact families 

experience’’; and 

(D) by striking paragraph (4) and redesignating paragraphs (5) through (8) as paragraphs (4) through (7); 

(3) in subsection (b)— 

(A) in paragraph (2)(D), by striking ‘‘adolescents’’ and 

inserting ‘‘youth’’; and 

(B) in paragraph (3)— 

(i) in subparagraph (D)— 

(I) by inserting ‘‘including training on youth 

development’’ after ‘‘to provide training’’; and 


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132 STAT. 266 PUBLIC LAW 115–123—FEB. 9, 2018 

(II) by striking ‘‘adolescents preparing for independent living’’ and all that follows through the 

period and inserting ‘‘youth preparing for a 

successful transition to adulthood and making a 

permanent connection with a caring adult.’’; 

(ii) in subparagraph (H), by striking ‘‘adolescents’’ 

each place it appears and inserting ‘‘youth’’; and 

(iii) in subparagraph (K)— 

(I) by striking ‘‘an adolescent’’ and inserting 

‘‘a youth’’; and 

(II) by striking ‘‘the adolescent’’ each place 

it appears and inserting ‘‘the youth’’; and 

(4) in subsection (f), by striking paragraph (2) and inserting 

the following: 

‘‘(2) REPORT TO CONGRESS.—Not later than October 1, 2019, 

the Secretary shall submit to the Committee on Ways and 

Means of the House of Representatives and the Committee 

on Finance of the Senate a report on the National Youth 

in Transition Database and any other databases in which States 

report outcome measures relating to children in foster care 

and children who have aged out of foster care or left foster 

care for kinship guardianship or adoption. The report shall 

include the following: 

‘‘(A) A description of the reasons for entry into foster 

care and of the foster care experiences, such as length 

of stay, number of placement settings, case goal, and discharge reason of 17-year-olds who are surveyed by the 

National Youth in Transition Database and an analysis 

of the comparison of that description with the reasons 

for entry and foster care experiences of children of other 

ages who exit from foster care before attaining age 17. 

‘‘(B) A description of the characteristics of the individuals who report poor outcomes at ages 19 and 21 to the 

National Youth in Transition Database. 

‘‘(C) Benchmarks for determining what constitutes a 

poor outcome for youth who remain in or have exited 

from foster care and plans the executive branch will take 

to incorporate these benchmarks in efforts to evaluate child 

welfare agency performance in providing services to children transitioning from foster care. 

‘‘(D) An analysis of the association between types of 

placement, number of overall placements, time spent in 

foster care, and other factors, and outcomes at ages 19 

and 21. 

‘‘(E) An analysis of the differences in outcomes for 

children in and formerly in foster care at age 19 and 

21 among States.’’. 

(e) CLARIFYING DOCUMENTATION PROVIDED TO FOSTER YOUTH

LEAVING FOSTER CARE.—Section 475(5)(I) of such Act (42 U.S.C. 

675(5)(I)) is amended by inserting after ‘‘REAL ID Act of 2005’’ 

the following: ‘‘, and any official documentation necessary to prove 

that the child was previously in foster care’’. 

Determination. 

Analyses. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 267 

PART VI—CONTINUING INCENTIVES TO 

STATES TO PROMOTE ADOPTION AND LEGAL 

GUARDIANSHIP 

SEC. 50761. REAUTHORIZING ADOPTION AND LEGAL GUARDIANSHIP 

INCENTIVE PROGRAMS. 

(a) IN GENERAL.—Section 473A of the Social Security Act (42 

U.S.C. 673b) is amended— 

(1) in subsection (b)(4), by striking ‘‘2013 through 2015’’ 

and inserting ‘‘2016 through 2020’’; 

(2) in subsection (h)(1)(D), by striking ‘‘2016’’ and inserting 

‘‘2021’’; and 

(3) in subsection (h)(2), by striking ‘‘2016’’ and inserting 

‘‘2021’’. 

(b) EFFECTIVE DATE.—The amendments made by subsection 

(a) shall take effect as if enacted on October 1, 2017. 

PART VII—TECHNICAL CORRECTIONS 

SEC. 50771. TECHNICAL CORRECTIONS TO DATA EXCHANGE STANDARDS TO IMPROVE PROGRAM COORDINATION. 

(a) IN GENERAL.—Section 440 of the Social Security Act (42 

U.S.C. 629m) is amended to read as follows: 

‘‘SEC. 440. DATA EXCHANGE STANDARDS FOR IMPROVED INTEROPERABILITY. 

‘‘(a) DESIGNATION.—The Secretary shall, in consultation with 

an interagency work group established by the Office of Management 

and Budget and considering State government perspectives, by 

rule, designate data exchange standards to govern, under this part 

and part E— 

‘‘(1) necessary categories of information that State agencies 

operating programs under State plans approved under this 

part are required under applicable Federal law to electronically 

exchange with another State agency; and 

‘‘(2) Federal reporting and data exchange required under 

applicable Federal law. 

‘‘(b) REQUIREMENTS.—The data exchange standards required 

by paragraph (1) shall, to the extent practicable— 

‘‘(1) incorporate a widely accepted, non-proprietary, searchable, computer-readable format, such as the Extensible Markup 

Language; 

‘‘(2) contain interoperable standards developed and maintained by intergovernmental partnerships, such as the National 

Information Exchange Model; 

‘‘(3) incorporate interoperable standards developed and 

maintained by Federal entities with authority over contracting 

and financial assistance; 

‘‘(4) be consistent with and implement applicable 

accounting principles; 

‘‘(5) be implemented in a manner that is cost-effective 

and improves program efficiency and effectiveness; and 

‘‘(6) be capable of being continually upgraded as necessary. 

‘‘(c) RULE OF CONSTRUCTION.—Nothing in this subsection shall 

be construed to require a change to existing data exchange standards found to be effective and efficient.’’. 

Consultation. 

Establishment. 

42 USC 673b 

note. 

42 USC 673b 

note. 


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132 STAT. 268 PUBLIC LAW 115–123—FEB. 9, 2018 

(b) EFFECTIVE DATE.—Not later than the date that is 24 months 

after the date of the enactment of this section, the Secretary of 

Health and Human Services shall issue a proposed rule that— 

(1) identifies federally required data exchanges, include 

specification and timing of exchanges to be standardized, and 

address the factors used in determining whether and when 

to standardize data exchanges; and 

(2) specifies State implementation options and describes 

future milestones. 

SEC. 50772. TECHNICAL CORRECTIONS TO STATE REQUIREMENT TO 

ADDRESS THE DEVELOPMENTAL NEEDS OF YOUNG 

CHILDREN. 

Section 422(b)(18) of the Social Security Act (42 U.S.C. 

622(b)(18)) is amended by striking ‘‘such children’’ and inserting 

‘‘all vulnerable children under 5 years of age’’. 

PART VIII—ENSURING STATES REINVEST SAVINGS RESULTING FROM INCREASE IN ADOPTION ASSISTANCE 

SEC. 50781. DELAY OF ADOPTION ASSISTANCE PHASE-IN. 

(a) IN GENERAL.—The table in section 473(e)(1)(B) of the Social 

Security Act (42 U.S.C. 673(e)(1)(B)) is amended by striking the 

last 2 rows and inserting the following: 

‘‘2017 through 2023 ..................... 2 

2024 .............................................. 2 (or, in the case of a child for 

whom an adoption assistance 

agreement is entered into 

under this section on or after 

July 1, 2024, any age) 

2025 or thereafter ....................... any age.’’. 

(b) EFFECTIVE DATE.—The amendment made by this section 

shall take effect as if enacted on January 1, 2018. 

SEC. 50782. GAO STUDY AND REPORT ON STATE REINVESTMENT OF 

SAVINGS RESULTING FROM INCREASE IN ADOPTION 

ASSISTANCE. 

(a) STUDY.—The Comptroller General of the United States shall 

study the extent to which States are complying with the requirements of section 473(a)(8) of the Social Security Act (42 U.S.C. 

673(a)(8)) relating to the effects of phasing out the AFDC income 

eligibility requirements for adoption assistance payments under 

section 473 of the Social Security Act, as enacted by section 402 

of the Fostering Connections to Success and Increasing Adoptions 

Act of 2008 (Public Law 110–351; 122 Stat. 3975) and amended 

by section 206 of the Preventing Sex Trafficking and Strengthening 

Families Act (Public Law 113–183; 128 Stat. 1919). In particular, 

the Comptroller General shall analyze the extent to which States 

are complying with the following requirements under section 

473(a)(8)(D) of the Social Security Act: 

Analysis. 

42 USC 673 note. 

Determination. 

Deadline. 

Regulations. 

42 USC 629m 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 269 

(1) The requirement to spend an amount equal to the 

amount of the savings (if any) in State expenditures under 

part E of title IV of the Social Security Act resulting from 

phasing out the AFDC income eligibility requirements for adoption assistance payments under section 473 of such Act to 

provide to children of families any service that may be provided 

under part B or E of title IV of such Act. 

(2) The requirement that a State shall spend not less 

than 30 percent of the amount of any savings described in 

paragraph (1) on post-adoption services, post-guardianship services, and services to support and sustain positive permanent 

outcomes for children who otherwise might enter into foster 

care under the responsibility of the State, with at least 2⁄3

of the spending by the State to comply with the 30 percent 

requirement being spent on post-adoption and post-guardianship services. 

(b) REPORT.—The Comptroller General of the United States 

shall submit to the Committee on Finance of the Senate, the Committee on Ways and Means of the House of Representatives, and 

the Secretary of Health and Human Services a report that contains 

the results of the study required by subsection (a), including recommendations to ensure compliance with laws referred to in subsection (a). 

TITLE VIII—SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RESULTS 

SEC. 50801. SHORT TITLE. 

This subtitle may be cited as the ‘‘Social Impact Partnerships 

to Pay for Results Act’’. 

SEC. 50802. SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RESULTS. 

Title XX of the Social Security Act (42 U.S.C. 1397 et seq.) 

is amended— 

(1) in the title heading, by striking ‘‘TO STATES’’ and 

inserting ‘‘AND PROGRAMS’’; and 

(2) by adding at the end the following: 

‘‘Subtitle C—Social Impact Demonstration Projects 

‘‘PURPOSES

‘‘SEC. 2051. The purposes of this subtitle are the following: 

‘‘(1) To improve the lives of families and individuals in 

need in the United States by funding social programs that 

achieve real results. 

‘‘(2) To redirect funds away from programs that, based 

on objective data, are ineffective, and into programs that 

achieve demonstrable, measurable results. 

‘‘(3) To ensure Federal funds are used effectively on social 

services to produce positive outcomes for both service recipients 

and taxpayers. 

‘‘(4) To establish the use of social impact partnerships 

to address some of our Nation’s most pressing problems. 

42 USC 1397n 

note. 

42 USC 1305 

note. 

Social Impact 

Partnerships to 

Pay for Results 

Act. 

Recommendations. 


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‘‘(5) To facilitate the creation of public-private partnerships 

that bundle philanthropic or other private resources with 

existing public spending to scale up effective social interventions already being implemented by private organizations, nonprofits, charitable organizations, and State and local governments across the country. 

‘‘(6) To bring pay-for-performance to the social sector, 

allowing the United States to improve the impact and effectiveness of vital social services programs while redirecting inefficient or duplicative spending. 

‘‘(7) To incorporate outcomes measurement and randomized 

controlled trials or other rigorous methodologies for assessing 

program impact. 

‘‘SOCIAL IMPACT PARTNERSHIP APPLICATION

‘‘SEC. 2052. (a) NOTICE.—Not later than 1 year after the date 

of the enactment of this subtitle, the Secretary of the Treasury, 

in consultation with the Federal Interagency Council on Social 

Impact Partnerships, shall publish in the Federal Register a request 

for proposals from States or local governments for social impact 

partnership projects in accordance with this section. 

‘‘(b) REQUIRED OUTCOMES FOR SOCIAL IMPACT PARTNERSHIP

PROJECT.—To qualify as a social impact partnership project under 

this subtitle, a project must produce one or more measurable, clearly 

defined outcomes that result in social benefit and Federal, State, 

or local savings through any of the following: 

‘‘(1) Increasing work and earnings by individuals in the 

United States who are unemployed for more than 6 consecutive 

months. 

‘‘(2) Increasing employment and earnings of individuals 

who have attained 16 years of age but not 25 years of age. 

‘‘(3) Increasing employment among individuals receiving 

Federal disability benefits. 

‘‘(4) Reducing the dependence of low-income families on 

Federal means-tested benefits. 

‘‘(5) Improving rates of high school graduation. 

‘‘(6) Reducing teen and unplanned pregnancies. 

‘‘(7) Improving birth outcomes and early childhood health 

and development among low-income families and individuals. 

‘‘(8) Reducing rates of asthma, diabetes, or other preventable diseases among low-income families and individuals to 

reduce the utilization of emergency and other high-cost care. 

‘‘(9) Increasing the proportion of children living in twoparent families. 

‘‘(10) Reducing incidences and adverse consequences of child 

abuse and neglect. 

‘‘(11) Reducing the number of youth in foster care by 

increasing adoptions, permanent guardianship arrangements, 

reunifications, or placements with a fit and willing relative, 

or by avoiding placing children in foster care by ensuring they 

can be cared for safely in their own homes. 

‘‘(12) Reducing the number of children and youth in foster 

care residing in group homes, child care institutions, agencyoperated foster homes, or other non-family foster homes, unless 

it is determined that it is in the interest of the child’s longterm health, safety, or psychological well-being to not be placed 

in a family foster home. 

Deadline. 

Consultation. 

Federal Register, 

publication. 

42 USC 1397n–1 

note. 


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‘‘(13) Reducing the number of children returning to foster 

care. 

‘‘(14) Reducing recidivism among juvenile offenders, 

individuals released from prison, or other high-risk populations. 

‘‘(15) Reducing the rate of homelessness among our most 

vulnerable populations. 

‘‘(16) Improving the health and well-being of those with 

mental, emotional, and behavioral health needs. 

‘‘(17) Improving the educational outcomes of special-needs 

or low-income children. 

‘‘(18) Improving the employment and well-being of 

returning United States military members. 

‘‘(19) Increasing the financial stability of low-income families. 

‘‘(20) Increasing the independence and employability of 

individuals who are physically or mentally disabled. 

‘‘(21) Other measurable outcomes defined by the State or 

local government that result in positive social outcomes and 

Federal savings. 

‘‘(c) APPLICATION REQUIRED.—The notice described in subsection 

(a) shall require a State or local government to submit an application for the social impact partnership project that addresses the 

following: 

‘‘(1) The outcome goals of the project. 

‘‘(2) A description of each intervention in the project and 

anticipated outcomes of the intervention. 

‘‘(3) Rigorous evidence demonstrating that the intervention 

can be expected to produce the desired outcomes. 

‘‘(4) The target population that will be served by the project. 

‘‘(5) The expected social benefits to participants who receive 

the intervention and others who may be impacted. 

‘‘(6) Projected Federal, State, and local government costs 

and other costs to conduct the project. 

‘‘(7) Projected Federal, State, and local government savings 

and other savings, including an estimate of the savings to 

the Federal Government, on a program-by-program basis and 

in the aggregate, if the project is implemented and the outcomes 

are achieved as a result of the intervention. 

‘‘(8) If savings resulting from the successful completion 

of the project are estimated to accrue to the State or local 

government, the likelihood of the State or local government 

to realize those savings. 

‘‘(9) A plan for delivering the intervention through a social 

impact partnership model. 

‘‘(10) A description of the expertise of each service provider 

that will administer the intervention, including a summary 

of the experience of the service provider in delivering the proposed intervention or a similar intervention, or demonstrating 

that the service provider has the expertise necessary to deliver 

the proposed intervention. 

‘‘(11) An explanation of the experience of the State or 

local government, the intermediary, or the service provider 

in raising private and philanthropic capital to fund social 

service investments. 

‘‘(12) The detailed roles and responsibilities of each entity 

involved in the project, including any State or local government 


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132 STAT. 272 PUBLIC LAW 115–123—FEB. 9, 2018 

entity, intermediary, service provider, independent evaluator, 

investor, or other stakeholder. 

‘‘(13) A summary of the experience of the service provider 

in delivering the proposed intervention or a similar intervention, or a summary demonstrating the service provider has 

the expertise necessary to deliver the proposed intervention. 

‘‘(14) A summary of the unmet need in the area where 

the intervention will be delivered or among the target population who will receive the intervention. 

‘‘(15) The proposed payment terms, the methodology used 

to calculate outcome payments, the payment schedule, and 

performance thresholds. 

‘‘(16) The project budget. 

‘‘(17) The project timeline. 

‘‘(18) The criteria used to determine the eligibility of an 

individual for the project, including how selected populations 

will be identified, how they will be referred to the project, 

and how they will be enrolled in the project. 

‘‘(19) The evaluation design. 

‘‘(20) The metrics that will be used in the evaluation to 

determine whether the outcomes have been achieved as a result 

of the intervention and how the metrics will be measured. 

‘‘(21) An explanation of how the metrics used in the evaluation to determine whether the outcomes achieved as a result 

of the intervention are independent, objective indicators of 

impact and are not subject to manipulation by the service 

provider, intermediary, or investor. 

‘‘(22) A summary explaining the independence of the evaluator from the other entities involved in the project and the 

evaluator’s experience in conducting rigorous evaluations of 

program effectiveness including, where available, well-implemented randomized controlled trials on the intervention or 

similar interventions. 

‘‘(23) The capacity of the service provider to deliver the 

intervention to the number of participants the State or local 

government proposes to serve in the project. 

‘‘(24) A description of whether and how the State or local 

government and service providers plan to sustain the intervention, if it is timely and appropriate to do so, to ensure that 

successful interventions continue to operate after the period 

of the social impact partnership. 

‘‘(d) PROJECT INTERMEDIARY INFORMATION REQUIRED.—The 

application described in subsection (c) shall also contain the following information about any intermediary for the social impact 

partnership project (whether an intermediary is a service provider 

or other entity): 

‘‘(1) Experience and capacity for providing or facilitating 

the provision of the type of intervention proposed. 

‘‘(2) The mission and goals. 

‘‘(3) Information on whether the intermediary is already 

working with service providers that provide this intervention 

or an explanation of the capacity of the intermediary to begin 

working with service providers to provide the intervention. 

‘‘(4) Experience working in a collaborative environment 

across government and nongovernmental entities. 

‘‘(5) Previous experience collaborating with public or private 

entities to implement evidence-based programs. 


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‘‘(6) Ability to raise or provide funding to cover operating 

costs (if applicable to the project). 

‘‘(7) Capacity and infrastructure to track outcomes and 

measure results, including— 

‘‘(A) capacity to track and analyze program performance and assess program impact; and 

‘‘(B) experience with performance-based awards or 

performance-based contracting and achieving project milestones and targets. 

‘‘(8) Role in delivering the intervention. 

‘‘(9) How the intermediary would monitor program success, 

including a description of the interim benchmarks and outcome 

measures. 

‘‘(e) FEASIBILITY STUDIES FUNDED THROUGH OTHER SOURCES.— The notice described in subsection (a) shall permit a State or 

local government to submit an application for social impact partnership funding that contains information from a feasibility study 

developed for purposes other than applying for funding under this 

subtitle. 

‘‘AWARDING SOCIAL IMPACT PARTNERSHIP AGREEMENTS

‘‘SEC. 2053. (a) TIMELINE IN AWARDING AGREEMENT.—Not later 

than 6 months after receiving an application in accordance with 

section 2052, the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships, shall determine 

whether to enter into an agreement for a social impact partnership 

project with a State or local government. 

‘‘(b) CONSIDERATIONS IN AWARDING AGREEMENT.—In determining whether to enter into an agreement for a social impact 

partnership project (the application for which was submitted under 

section 2052) the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships and the head of 

any Federal agency administering a similar intervention or serving 

a population similar to that served by the project, shall consider 

each of the following: 

‘‘(1) The recommendations made by the Commission on 

Social Impact Partnerships. 

‘‘(2) The value to the Federal Government of the outcomes 

expected to be achieved if the outcomes specified in the agreement are achieved as a result of the intervention. 

‘‘(3) The likelihood, based on evidence provided in the 

application and other evidence, that the State or local government in collaboration with the intermediary and the service 

providers will achieve the outcomes. 

‘‘(4) The savings to the Federal Government if the outcomes 

specified in the agreement are achieved as a result of the 

intervention. 

‘‘(5) The savings to the State and local governments if 

the outcomes specified in the agreement are achieved as a 

result of the intervention. 

‘‘(6) The expected quality of the evaluation that would 

be conducted with respect to the agreement. 

‘‘(7) The capacity and commitment of the State or local 

government to sustain the intervention, if appropriate and 

timely and if the intervention is successful, beyond the period 

of the social impact partnership. 

‘‘(c) AGREEMENT AUTHORITY.— Determinations. 

Deadline. 

Consultation. 

Determination. 

42 USC 1397n–2 

note. 


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132 STAT. 274 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(1) AGREEMENT REQUIREMENTS.—In accordance with this 

section, the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships and the head 

of any Federal agency administering a similar intervention 

or serving a population similar to that served by the project, 

may enter into an agreement for a social impact partnership 

project with a State or local government if the Secretary, in 

consultation with the Federal Interagency Council on Social 

Impact Partnerships, determines that each of the following 

requirements are met: 

‘‘(A) The State or local government agrees to achieve 

one or more outcomes as a result of the intervention, as 

specified in the agreement and validated by independent 

evaluation, in order to receive payment. 

‘‘(B) The Federal payment to the State or local government for each specified outcome achieved as a result of 

the intervention is less than or equal to the value of the 

outcome to the Federal Government over a period not to 

exceed 10 years, as determined by the Secretary, in consultation with the State or local government. 

‘‘(C) The duration of the project does not exceed 10 

years. 

‘‘(D) The State or local government has demonstrated, 

through the application submitted under section 2052, that, 

based on prior rigorous experimental evaluations or rigorous quasi-experimental studies, the intervention can be 

expected to achieve each outcome specified in the agreement. 

‘‘(E) The State, local government, intermediary, or 

service provider has experience raising private or philanthropic capital to fund social service investments (if 

applicable to the project). 

‘‘(F) The State or local government has shown that 

each service provider has experience delivering the intervention, a similar intervention, or has otherwise demonstrated the expertise necessary to deliver the intervention. 

‘‘(2) PAYMENT.—The Secretary shall pay the State or local 

government only if the independent evaluator described in section 2055 determines that the social impact partnership project 

has met the requirements specified in the agreement and 

achieved an outcome as a result of the intervention, as specified 

in the agreement and validated by independent evaluation. 

‘‘(d) NOTICE OF AGREEMENT AWARD.—Not later than 30 days 

after entering into an agreement under this section the Secretary 

shall publish a notice in the Federal Register that includes, with 

regard to the agreement, the following: 

‘‘(1) The outcome goals of the social impact partnership 

project. 

‘‘(2) A description of each intervention in the project. 

‘‘(3) The target population that will be served by the project. 

‘‘(4) The expected social benefits to participants who receive 

the intervention and others who may be impacted. 

‘‘(5) The detailed roles, responsibilities, and purposes of 

each Federal, State, or local government entity, intermediary, 

service provider, independent evaluator, investor, or other 

stakeholder. 

Deadline. 

Federal Register, 

publication. 


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‘‘(6) The payment terms, the methodology used to calculate 

outcome payments, the payment schedule, and performance 

thresholds. 

‘‘(7) The project budget. 

‘‘(8) The project timeline. 

‘‘(9) The project eligibility criteria. 

‘‘(10) The evaluation design. 

‘‘(11) The metrics that will be used in the evaluation to 

determine whether the outcomes have been achieved as a result 

of each intervention and how these metrics will be measured. 

‘‘(12) The estimate of the savings to the Federal, State, 

and local government, on a program-by-program basis and in 

the aggregate, if the agreement is entered into and implemented 

and the outcomes are achieved as a result of each intervention. 

‘‘(e) AUTHORITY TO TRANSFER ADMINISTRATION OF AGREE- MENT.—The Secretary may transfer to the head of another Federal 

agency the authority to administer (including making payments 

under) an agreement entered into under subsection (c), and any 

funds necessary to do so. 

‘‘(f) REQUIREMENT ON FUNDING USED TO BENEFIT CHILDREN.— Not less than 50 percent of all Federal payments made to carry 

out agreements under this section shall be used for initiatives 

that directly benefit children. 

‘‘FEASIBILITY STUDY FUNDING

‘‘SEC. 2054. (a) REQUESTS FOR FUNDING FOR FEASIBILITY

STUDIES.—The Secretary shall reserve a portion of the amount 

made available to carry out this subtitle to assist States or local 

governments in developing feasibility studies to apply for social 

impact partnership funding under section 2052. To be eligible to 

receive funding to assist with completing a feasibility study, a 

State or local government shall submit an application for feasibility 

study funding addressing the following: 

‘‘(1) A description of the outcome goals of the social impact 

partnership project. 

‘‘(2) A description of the intervention, including anticipated 

program design, target population, an estimate regarding the 

number of individuals to be served, and setting for the intervention. 

‘‘(3) Evidence to support the likelihood that the intervention 

will produce the desired outcomes. 

‘‘(4) A description of the potential metrics to be used. 

‘‘(5) The expected social benefits to participants who receive 

the intervention and others who may be impacted. 

‘‘(6) Estimated costs to conduct the project. 

‘‘(7) Estimates of Federal, State, and local government 

savings and other savings if the project is implemented and 

the outcomes are achieved as a result of each intervention. 

‘‘(8) An estimated timeline for implementation and completion of the project, which shall not exceed 10 years. 

‘‘(9) With respect to a project for which the State or local 

government selects an intermediary to operate the project, any 

partnerships needed to successfully execute the project and 

the ability of the intermediary to foster the partnerships. 

‘‘(10) The expected resources needed to complete the feasibility study for the State or local government to apply for 

social impact partnership funding under section 2052. 

Time period. 

Estimates. 

Cost estimate. 

42 USC 1397n–3 

note. 

Estimate. 

Criteria. 


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132 STAT. 276 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(b) FEDERAL SELECTION OF APPLICATIONS FOR FEASIBILITY

STUDY.—Not later than 6 months after receiving an application 

for feasibility study funding under subsection (a), the Secretary, 

in consultation with the Federal Interagency Council on Social 

Impact Partnerships and the head of any Federal agency administering a similar intervention or serving a population similar to 

that served by the project, shall select State or local government 

feasibility study proposals for funding based on the following: 

‘‘(1) The recommendations made by the Commission on 

Social Impact Partnerships. 

‘‘(2) The likelihood that the proposal will achieve the 

desired outcomes. 

‘‘(3) The value of the outcomes expected to be achieved 

as a result of each intervention. 

‘‘(4) The potential savings to the Federal Government if 

the social impact partnership project is successful. 

‘‘(5) The potential savings to the State and local governments if the project is successful. 

‘‘(c) PUBLIC DISCLOSURE.—Not later than 30 days after selecting 

a State or local government for feasibility study funding under 

this section, the Secretary shall cause to be published on the website 

of the Federal Interagency Council on Social Impact Partnerships 

information explaining why a State or local government was granted 

feasibility study funding. 

‘‘(d) FUNDING RESTRICTION.— ‘‘(1) FEASIBILITY STUDY RESTRICTION.—The Secretary may 

not provide feasibility study funding under this section for 

more than 50 percent of the estimated total cost of the feasibility study reported in the State or local government application submitted under subsection (a). 

‘‘(2) AGGREGATE RESTRICTION.—Of the total amount made 

available to carry out this subtitle, the Secretary may not 

use more than $10,000,000 to provide feasibility study funding 

to States or local governments under this section. 

‘‘(3) NO GUARANTEE OF FUNDING.—The Secretary shall have 

the option to award no funding under this section. 

‘‘(e) SUBMISSION OF FEASIBILITY STUDY REQUIRED.—Not later 

than 9 months after the receipt of feasibility study funding under 

this section, a State or local government receiving the funding 

shall complete the feasibility study and submit the study to the 

Federal Interagency Council on Social Impact Partnerships. 

‘‘(f) DELEGATION OF AUTHORITY.—The Secretary may transfer 

to the head of another Federal agency the authorities provided 

in this section and any funds necessary to exercise the authorities. 

‘‘EVALUATIONS

‘‘SEC. 2055. (a) AUTHORITY TO ENTER INTO AGREEMENTS.— For each State or local government awarded a social impact partnership project approved by the Secretary under this subtitle, the 

head of the relevant agency, as recommended by the Federal Interagency Council on Social Impact Partnerships and determined by 

the Secretary, shall enter into an agreement with the State or 

local government to pay for all or part of the independent evaluation 

to determine whether the State or local government project has 

achieved a specific outcome as a result of the intervention in order 

for the State or local government to receive outcome payments 

under this subtitle. 

Determination. 

42 USC 1397n–4 

note. 

Deadline. 

Deadline. 

Web posting. 

Deadline. 

Consultation. 


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‘‘(b) EVALUATOR QUALIFICATIONS.—The head of the relevant 

agency may not enter into an agreement with a State or local 

government unless the head determines that the evaluator is independent of the other parties to the agreement and has demonstrated 

substantial experience in conducting rigorous evaluations of program effectiveness including, where available and appropriate, wellimplemented randomized controlled trials on the intervention or 

similar interventions. 

‘‘(c) METHODOLOGIES TO BE USED.—The evaluation used to 

determine whether a State or local government will receive outcome 

payments under this subtitle shall use experimental designs using 

random assignment or other reliable, evidence-based research methodologies, as certified by the Federal Interagency Council on Social 

Impact Partnerships, that allow for the strongest possible causal 

inferences when random assignment is not feasible. 

‘‘(d) PROGRESS REPORT.— ‘‘(1) SUBMISSION OF REPORT.—The independent evaluator 

shall— 

‘‘(A) not later than 2 years after a project has been 

approved by the Secretary and biannually thereafter until 

the project is concluded, submit to the head of the relevant 

agency and the Federal Interagency Council on Social 

Impact Partnerships a written report summarizing the 

progress that has been made in achieving each outcome 

specified in the agreement; and 

‘‘(B) before the scheduled time of the first outcome 

payment and before the scheduled time of each subsequent 

payment, submit to the head of the relevant agency and 

the Federal Interagency Council on Social Impact Partnerships a written report that includes the results of the 

evaluation conducted to determine whether an outcome 

payment should be made along with information on the 

unique factors that contributed to achieving or failing to 

achieve the outcome, the challenges faced in attempting 

to achieve the outcome, and information on the improved 

future delivery of this or similar interventions. 

‘‘(2) SUBMISSION TO THE SECRETARY AND CONGRESS.—Not 

later than 30 days after receipt of the written report pursuant 

to paragraph (1)(B), the Federal Interagency Council on Social 

Impact Partnerships shall submit the report to the Secretary 

and each committee of jurisdiction in the House of Representatives and the Senate. 

‘‘(e) FINAL REPORT.— 

‘‘(1) SUBMISSION OF REPORT.—Within 6 months after the 

social impact partnership project is completed, the independent 

evaluator shall— 

‘‘(A) evaluate the effects of the activities undertaken 

pursuant to the agreement with regard to each outcome 

specified in the agreement; and 

‘‘(B) submit to the head of the relevant agency and 

the Federal Interagency Council on Social Impact Partnerships a written report that includes the results of the 

evaluation and the conclusion of the evaluator as to 

whether the State or local government has fulfilled each 

obligation of the agreement, along with information on 

the unique factors that contributed to the success or failure 

of the project, the challenges faced in attempting to achieve 

Evaluation. 

Evaluation. 

Certification. 

Determination. 


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the outcome, and information on the improved future 

delivery of this or similar interventions. 

‘‘(2) SUBMISSION TO THE SECRETARY AND CONGRESS.—Not 

later than 30 days after receipt of the written report pursuant 

to paragraph (1)(B), the Federal Interagency Council on Social 

Impact Partnerships shall submit the report to the Secretary 

and each committee of jurisdiction in the House of Representatives and the Senate. 

‘‘(f) LIMITATION ON COST OF EVALUATIONS.—Of the amount 

made available under this subtitle for social impact partnership 

projects, the Secretary may not obligate more than 15 percent 

to evaluate the implementation and outcomes of the projects. 

‘‘(g) DELEGATION OF AUTHORITY.—The Secretary may transfer 

to the head of another Federal agency the authorities provided 

in this section and any funds necessary to exercise the authorities. 

‘‘FEDERAL INTERAGENCY COUNCIL ON SOCIAL IMPACT PARTNERSHIPS

‘‘SEC. 2056. (a) ESTABLISHMENT.—There is established the Federal Interagency Council on Social Impact Partnerships (in this 

section referred to as the ‘Council’) to— 

‘‘(1) coordinate with the Secretary on the efforts of social 

impact partnership projects funded under this subtitle; 

‘‘(2) advise and assist the Secretary in the development 

and implementation of the projects; 

‘‘(3) advise the Secretary on specific programmatic and 

policy matter related to the projects; 

‘‘(4) provide subject-matter expertise to the Secretary with 

regard to the projects; 

‘‘(5) certify to the Secretary that each State or local government that has entered into an agreement with the Secretary 

for a social impact partnership project under this subtitle and 

each evaluator selected by the head of the relevant agency 

under section 2055 has access to Federal administrative data 

to assist the State or local government and the evaluator in 

evaluating the performance and outcomes of the project; 

‘‘(6) address issues that will influence the future of social 

impact partnership projects in the United States; 

‘‘(7) provide guidance to the executive branch on the future 

of social impact partnership projects in the United States; 

‘‘(8) prior to approval by the Secretary, certify that each 

State and local government application for a social impact 

partnership contains rigorous, independent data and reliable, 

evidence-based research methodologies to support the conclusion that the project will yield savings to the State or local 

government or the Federal Government if the project outcomes 

are achieved; 

‘‘(9) certify to the Secretary, in the case of each approved 

social impact partnership that is expected to yield savings 

to the Federal Government, that the project will yield a projected savings to the Federal Government if the project outcomes are achieved, and coordinate with the relevant Federal 

agency to produce an after-action accounting once the project 

is complete to determine the actual Federal savings realized, 

and the extent to which actual savings aligned with projected 

savings; and 

Certification. 

Certification. 

Certification. 

42 USC 1397n–5 

note. 


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‘‘(10) provide periodic reports to the Secretary and make 

available reports periodically to Congress and the public on 

the implementation of this subtitle. 

‘‘(b) COMPOSITION OF COUNCIL.—The Council shall have 11 

members, as follows: 

‘‘(1) CHAIR.—The Chair of the Council shall be the Director 

of the Office of Management and Budget. 

‘‘(2) OTHER MEMBERS.—The head of each of the following 

entities shall designate one officer or employee of the entity 

to be a Council member: 

‘‘(A) The Department of Labor. 

‘‘(B) The Department of Health and Human Services. 

‘‘(C) The Social Security Administration. 

‘‘(D) The Department of Agriculture. 

‘‘(E) The Department of Justice. 

‘‘(F) The Department of Housing and Urban Development. 

‘‘(G) The Department of Education. 

‘‘(H) The Department of Veterans Affairs. 

‘‘(I) The Department of the Treasury. 

‘‘(J) The Corporation for National and Community 

Service. 

‘‘COMMISSION ON SOCIAL IMPACT PARTNERSHIPS

‘‘SEC. 2057. (a) ESTABLISHMENT.—There is established the 

Commission on Social Impact Partnerships (in this section referred 

to as the ‘Commission’). 

‘‘(b) DUTIES.—The duties of the Commission shall be to— 

‘‘(1) assist the Secretary and the Federal Interagency 

Council on Social Impact Partnerships in reviewing applications 

for funding under this subtitle; 

‘‘(2) make recommendations to the Secretary and the Federal Interagency Council on Social Impact Partnerships 

regarding the funding of social impact partnership agreements 

and feasibility studies; and 

‘‘(3) provide other assistance and information as requested 

by the Secretary or the Federal Interagency Council on Social 

Impact Partnerships. 

‘‘(c) COMPOSITION.—The Commission shall be composed of nine 

members, of whom— 

‘‘(1) one shall be appointed by the President, who will 

serve as the Chair of the Commission; 

‘‘(2) one shall be appointed by the Majority Leader of the 

Senate; 

‘‘(3) one shall be appointed by the Minority Leader of 

the Senate; 

‘‘(4) one shall be appointed by the Speaker of the House 

of Representatives; 

‘‘(5) one shall be appointed by the Minority Leader of 

the House of Representatives; 

‘‘(6) one shall be appointed by the Chairman of the Committee on Finance of the Senate; 

‘‘(7) one shall be appointed by the ranking member of 

the Committee on Finance of the Senate; 

‘‘(8) one member shall be appointed by the Chairman of 

the Committee on Ways and Means of the House of Representatives; and 

Recommendations. 

42 USC 1397n–6 

note. 

Reports. 

Public 

information. 


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‘‘(9) one shall be appointed by the ranking member of 

the Committee on Ways and Means of the House of Representatives. 

‘‘(d) QUALIFICATIONS OF COMMISSION MEMBERS.—The members 

of the Commission shall— 

‘‘(1) be experienced in finance, economics, pay for performance, or program evaluation; 

‘‘(2) have relevant professional or personal experience in 

a field related to one or more of the outcomes listed in this 

subtitle; or 

‘‘(3) be qualified to review applications for social impact 

partnership projects to determine whether the proposed metrics 

and evaluation methodologies are appropriately rigorous and 

reliant upon independent data and evidence-based research. 

‘‘(e) TIMING OF APPOINTMENTS.—The appointments of the members of the Commission shall be made not later than 120 days 

after the date of the enactment of this subtitle, or, in the event 

of a vacancy, not later than 90 days after the date the vacancy 

arises. If a member of Congress fails to appoint a member by 

that date, the President may select a member of the President’s 

choice on behalf of the member of Congress. Notwithstanding the 

preceding sentence, if not all appointments have been made to 

the Commission as of that date, the Commission may operate 

with no fewer than five members until all appointments have been 

made. 

‘‘(f) TERM OF APPOINTMENTS.— 

‘‘(1) IN GENERAL.—The members appointed under subsection (c) shall serve as follows: 

‘‘(A) Three members shall serve for 2 years. 

‘‘(B) Three members shall serve for 3 years. 

‘‘(C) Three members (one of which shall be Chair of 

the Commission appointed by the President) shall serve 

for 4 years. 

‘‘(2) ASSIGNMENT OF TERMS.—The Commission shall designate the term length that each member appointed under 

subsection (c) shall serve by unanimous agreement. In the 

event that unanimous agreement cannot be reached, term 

lengths shall be assigned to the members by a random process. 

‘‘(g) VACANCIES.—Subject to subsection (e), in the event of a 

vacancy in the Commission, whether due to the resignation of 

a member, the expiration of a member’s term, or any other reason, 

the vacancy shall be filled in the manner in which the original 

appointment was made and shall not affect the powers of the 

Commission. 

‘‘(h) APPOINTMENT POWER.—Members of the Commission 

appointed under subsection (c) shall not be subject to confirmation 

by the Senate. 

‘‘LIMITATION ON USE OF FUNDS

‘‘SEC. 2058. Of the amounts made available to carry out this 

subtitle, the Secretary may not use more than $2,000,000 in any 

fiscal year to support the review, approval, and oversight of social 

impact partnership projects, including activities conducted by— 

‘‘(1) the Federal Interagency Council on Social Impact Partnerships; and 

42 USC 1397n–7 

note. 

President. 

President. 

Deadlines. 


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‘‘(2) any other agency consulted by the Secretary before 

approving a social impact partnership project or a feasibility 

study under section 2054. 

‘‘NO FEDERAL FUNDING FOR CREDIT ENHANCEMENTS

‘‘SEC. 2059. No amount made available to carry out this subtitle 

may be used to provide any insurance, guarantee, or other credit 

enhancement to a State or local government under which a Federal 

payment would be made to a State or local government as the 

result of a State or local government failing to achieve an outcome 

specified in an agreement. 

‘‘AVAILABILITY OF FUNDS

‘‘SEC. 2060. Amounts made available to carry out this subtitle 

shall remain available until 10 years after the date of the enactment 

of this subtitle. 

‘‘WEBSITE

‘‘SEC. 2061. The Federal Interagency Council on Social Impact 

Partnerships shall establish and maintain a public website that 

shall display the following: 

‘‘(1) A copy of, or method of accessing, each notice published 

regarding a social impact partnership project pursuant to this 

subtitle. 

‘‘(2) A copy of each feasibility study funded under this 

subtitle. 

‘‘(3) For each State or local government that has entered 

into an agreement with the Secretary for a social impact partnership project, the website shall contain the following information: 

‘‘(A) The outcome goals of the project. 

‘‘(B) A description of each intervention in the project. 

‘‘(C) The target population that will be served by the 

project. 

‘‘(D) The expected social benefits to participants who 

receive the intervention and others who may be impacted. 

‘‘(E) The detailed roles, responsibilities, and purposes 

of each Federal, State, or local government entity, intermediary, service provider, independent evaluator, investor, 

or other stakeholder. 

‘‘(F) The payment terms, methodology used to calculate 

outcome payments, the payment schedule, and performance 

thresholds. 

‘‘(G) The project budget. 

‘‘(H) The project timeline. 

‘‘(I) The project eligibility criteria. 

‘‘(J) The evaluation design. 

‘‘(K) The metrics used to determine whether the proposed outcomes have been achieved and how these metrics 

are measured. 

‘‘(4) A copy of the progress reports and the final reports 

relating to each social impact partnership project. 

‘‘(5) An estimate of the savings to the Federal, State, and 

local government, on a program-by-program basis and in the 

Estimate. 

Records. 

42 USC 

1397n–10 note. 

Termination 

date. 

42 USC 1397n–9 

note. 

42 USC 1397n–8 

note. 


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132 STAT. 282 PUBLIC LAW 115–123—FEB. 9, 2018 

aggregate, resulting from the successful completion of the social 

impact partnership project. 

‘‘REGULATIONS

‘‘SEC. 2062. The Secretary, in consultation with the Federal 

Interagency Council on Social Impact Partnerships, may issue regulations as necessary to carry out this subtitle. 

‘‘DEFINITIONS

‘‘SEC. 2063. In this subtitle: 

‘‘(1) AGENCY.—The term ‘agency’ has the meaning given 

that term in section 551 of title 5, United States Code. 

‘‘(2) INTERVENTION.—The term ‘intervention’ means a specific service delivered to achieve an impact through a social 

impact partnership project. 

‘‘(3) SECRETARY.—The term ‘Secretary’ means the Secretary 

of the Treasury. 

‘‘(4) SOCIAL IMPACT PARTNERSHIP PROJECT.—The term 

‘social impact partnership project’ means a project that finances 

social services using a social impact partnership model. 

‘‘(5) SOCIAL IMPACT PARTNERSHIP MODEL.—The term ‘social 

impact partnership model’ means a method of financing social 

services in which— 

‘‘(A) Federal funds are awarded to a State or local 

government only if a State or local government achieves 

certain outcomes agreed on by the State or local government and the Secretary; and 

‘‘(B) the State or local government coordinates with 

service providers, investors (if applicable to the project), 

and (if necessary) an intermediary to identify— 

‘‘(i) an intervention expected to produce the outcome; 

‘‘(ii) a service provider to deliver the intervention 

to the target population; and 

‘‘(iii) investors to fund the delivery of the intervention. 

‘‘(6) STATE.—The term ‘State’ means each State of the 

United States, the District of Columbia, each commonwealth, 

territory or possession of the United States, and each federally 

recognized Indian tribe. 

‘‘FUNDING

‘‘SEC. 2064. Out of any money in the Treasury of the United 

States not otherwise appropriated, there is hereby appropriated 

$100,000,000 for fiscal year 2018 to carry out this subtitle.’’. 

TITLE IX—PUBLIC HEALTH PROGRAMS 

SEC. 50901. EXTENSION FOR COMMUNITY HEALTH CENTERS, THE 

NATIONAL HEALTH SERVICE CORPS, AND TEACHING 

HEALTH CENTERS THAT OPERATE GME PROGRAMS. 

(a) COMMUNITY HEALTH CENTERS FUNDING.—Section 

10503(b)(1)(F) of the Patient Protection and Affordable Care Act 

(42 U.S.C. 254b–2(b)(1)(F)), as amended by section 3101 of Public 

Law 115–96, is amended to read as follows: 

42 USC 

1397n–13 note. 

42 USC 

1397n–12 note. 

Consultation. 

42 USC 

1397n–11 note. 


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‘‘(F) $3,800,000,000 for fiscal year 2018 and 

$4,000,000,000 for fiscal year 2019.’’. 

(b) OTHER COMMUNITY HEALTH CENTERS PROVISIONS.—Section 

330 of the Public Health Service Act (42 U.S.C. 254b) is amended— 

(1) in subsection (b)(1)(A)(ii), by striking ‘‘abuse’’ and 

inserting ‘‘use disorder’’; 

(2) in subsection (b)(2)(A), by striking ‘‘abuse’’ and inserting 

‘‘use disorder’’; 

(3) in subsection (c)— 

(A) in paragraph (1), by striking subparagraphs (B) 

through (D); 

(B) by striking ‘‘(1) IN GENERAL’’ and all that follows 

through ‘‘The Secretary’’ and inserting the following: 

‘‘(1) CENTERS.—The Secretary’’; and 

(C) in paragraph (1), as amended, by redesignating 

clauses (i) through (v) as subparagraphs (A) through (E) 

and moving the margin of each of such redesignated 

subparagraph 2 ems to the left; 

(4) by striking subsection (d) and inserting the following: 

‘‘(d) IMPROVING QUALITY OF CARE.— 

‘‘(1) SUPPLEMENTAL AWARDS.—The Secretary may award 

supplemental grant funds to health centers funded under this 

section to implement evidence-based models for increasing 

access to high-quality primary care services, which may include 

models related to— 

‘‘(A) improving the delivery of care for individuals with 

multiple chronic conditions; 

‘‘(B) workforce configuration; 

‘‘(C) reducing the cost of care; 

‘‘(D) enhancing care coordination; 

‘‘(E) expanding the use of telehealth and technologyenabled collaborative learning and capacity building 

models; 

‘‘(F) care integration, including integration of behavioral health, mental health, or substance use disorder services; and 

‘‘(G) addressing emerging public health or substance 

use disorder issues to meet the health needs of the population served by the health center. 

‘‘(2) SUSTAINABILITY.—In making supplemental awards 

under this subsection, the Secretary may consider whether 

the health center involved has submitted a plan for continuing 

the activities funded under this subsection after supplemental 

funding is expended. 

‘‘(3) SPECIAL CONSIDERATION.—The Secretary may give special consideration to applications for supplemental funding 

under this subsection that seek to address significant barriers 

to access to care in areas with a greater shortage of health 

care providers and health services relative to the national average.’’; 

(5) in subsection (e)(1)— 

(A) in subparagraph (B)— 

(i) by striking ‘‘2 years’’ and inserting ‘‘1 year’’; 

and 

(ii) by adding at the end the following: ‘‘The Secretary shall not make a grant under this paragraph 

Grants. 

Deadline. 

Implementation 

plan. 


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unless the applicant provides assurances to the Secretary that within 120 days of receiving grant funding 

for the operation of the health center, the applicant 

will submit, for approval by the Secretary, an 

implementation plan to meet the requirements of subsection (k)(3). The Secretary may extend such 120- 

day period for achieving compliance upon a demonstration of good cause by the health center.’’; and 

(B) in subparagraph (C)— 

(i) in the subparagraph heading, by striking ‘‘AND

PLANS’’; 

(ii) by striking ‘‘or plan (as described in subparagraphs (B) and (C) of subsection (c)(1))’’; 

(iii) by striking ‘‘or plan, including the purchase’’ 

and inserting the following: ‘‘including— 

‘‘(i) the purchase’’; 

(iv) by inserting ‘‘, which may include data and 

information systems’’ after ‘‘of equipment’’; 

(v) by striking the period at the end and inserting 

a semicolon; and 

(vi) by adding at the end the following: 

‘‘(ii) the provision of training and technical assistance; and 

‘‘(iii) other activities that— 

‘‘(I) reduce costs associated with the provision 

of health services; 

‘‘(II) improve access to, and availability of, 

health services provided to individuals served by 

the centers; 

‘‘(III) enhance the quality and coordination of 

health services; or 

‘‘(IV) improve the health status of communities.’’; 

(6) in subsection (e)(5)(B)— 

(A) in the heading of subparagraph (B), by striking 

‘‘AND PLANS’’; and 

(B) by striking ‘‘and subparagraphs (B) and (C) of 

subsection (c)(1) to a health center or to a network or 

plan’’ and inserting ‘‘to a health center or to a network’’; 

(7) in subsection (e), by adding at the end the following: 

‘‘(6) NEW ACCESS POINTS AND EXPANDED SERVICES.— 

‘‘(A) APPROVAL OF NEW ACCESS POINTS.— 

‘‘(i) IN GENERAL.—The Secretary may approve 

applications for grants under subparagraph (A) or (B) 

of paragraph (1) to establish new delivery sites. 

‘‘(ii) SPECIAL CONSIDERATION.—In carrying out 

clause (i), the Secretary may give special consideration 

to applicants that have demonstrated the new delivery 

site will be located within a sparsely populated area, 

or an area which has a level of unmet need that 

is higher relative to other applicants. 

‘‘(iii) CONSIDERATION OF APPLICATIONS.—In carrying out clause (i), the Secretary shall approve 

applications for grants in such a manner that the 

ratio of the medically underserved populations in rural 

areas which may be expected to use the services provided by the applicants involved to the medically 

Time period. 


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underserved populations in urban areas which may 

be expected to use the services provided by the 

applicants is not less than two to three or greater 

than three to two. 

‘‘(iv) SERVICE AREA OVERLAP.—If in carrying out 

clause (i) the applicant proposes to serve an area that 

is currently served by another health center funded 

under this section, the Secretary may consider whether 

the award of funding to an additional health center 

in the area can be justified based on the unmet need 

for additional services within the catchment area. 

‘‘(B) APPROVAL OF EXPANDED SERVICE APPLICATIONS.— 

‘‘(i) IN GENERAL.—The Secretary may approve 

applications for grants under subparagraph (A) or (B) 

of paragraph (1) to expand the capacity of the applicant 

to provide required primary health services described 

in subsection (b)(1) or additional health services 

described in subsection (b)(2). 

‘‘(ii) PRIORITY EXPANSION PROJECTS.—In carrying 

out clause (i), the Secretary may give special consideration to expanded service applications that seek to 

address emerging public health or behavioral health, 

mental health, or substance abuse issues through 

increasing the availability of additional health services 

described in subsection (b)(2) in an area in which there 

are significant barriers to accessing care. 

‘‘(iii) CONSIDERATION OF APPLICATIONS.—In carrying out clause (i), the Secretary shall approve 

applications for grants in such a manner that the 

ratio of the medically underserved populations in rural 

areas which may be expected to use the services provided by the applicants involved to the medically 

underserved populations in urban areas which may 

be expected to use the services provided by such 

applicants is not less than two to three or greater 

than three to two.’’; 

(8) in subsection (h)— 

(A) in paragraph (1), by striking ‘‘and children and 

youth at risk of homelessness’’ and inserting ‘‘, children 

and youth at risk of homelessness, homeless veterans, and 

veterans at risk of homelessness’’; and 

(B) in paragraph (5)— 

(i) by striking subparagraph (B); 

(ii) by redesignating subparagraph (C) as subparagraph (B); and 

(iii) in subparagraph (B) (as so redesignated)— 

(I) in the subparagraph heading, by striking 

‘‘ABUSE’’ and inserting ‘‘USE DISORDER’’; and 

(II) by striking ‘‘abuse’’ and inserting ‘‘use disorder’’; 

(9) in subsection (k)— 

(A) in paragraph (2)— 

(i) in the paragraph heading, by inserting ‘‘UNMET’’ 

before ‘‘NEED’’; 

(ii) in the matter preceding subparagraph (A), by 

inserting ‘‘or subsection (e)(6)’’ after ‘‘subsection (e)(1)’’; 


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(iii) in subparagraph (A), by inserting ‘‘unmet’’ 

before ‘‘need for health services’’; 

(iv) in subparagraph (B), by striking ‘‘and’’ at the 

end; 

(v) in subparagraph (C), by striking the period 

at the end and inserting ‘‘; and’’; and 

(vi) by adding after subparagraph (C) the following: 

‘‘(D) in the case of an application for a grant pursuant 

to subsection (e)(6), a demonstration that the applicant 

has consulted with appropriate State and local government 

agencies, and health care providers regarding the need 

for the health services to be provided at the proposed 

delivery site.’’; 

(B) in paragraph (3)— 

(i) in the matter preceding subparagraph (A), by 

inserting ‘‘or subsection (e)(6)’’ after ‘‘subsection 

(e)(1)(B)’’; 

(ii) in subparagraph (B), by striking ‘‘in the 

catchment area of the center’’ and inserting ‘‘, including 

other health care providers that provide care within 

the catchment area, local hospitals, and specialty providers in the catchment area of the center, to provide 

access to services not available through the health 

center and to reduce the non-urgent use of hospital 

emergency departments’’; 

(iii) in subparagraph (H)(ii), by inserting ‘‘who 

shall be directly employed by the center’’ after 

‘‘approves the selection of a director for the center’’; 

(iv) in subparagraph (L), by striking ‘‘and’’ at the 

end; 

(v) in subparagraph (M), by striking the period 

and inserting ‘‘; and’’; and 

(vi) by inserting after subparagraph (M), the following: 

‘‘(N) the center has written policies and procedures 

in place to ensure the appropriate use of Federal funds 

in compliance with applicable Federal statutes, regulations, 

and the terms and conditions of the Federal award.’’; and 

(C) by striking paragraph (4); 

(10) in subsection (l), by adding at the end the following: 

‘‘Funds expended to carry out activities under this subsection 

and operational support activities under subsection (m) shall 

not exceed 3 percent of the amount appropriated for this section 

for the fiscal year involved.’’; 

(11) in subsection (q)(4), by adding at the end the following: 

‘‘A waiver provided by the Secretary under this paragraph 

may not remain in effect for more than 1 year and may not 

be extended after such period. An entity may not receive more 

than one waiver under this paragraph in consecutive years.’’; 

(12) in subsection (r)(3)— 

(A) by striking ‘‘appropriate committees of Congress 

a report concerning the distribution of funds under this 

section’’ and inserting the following: ‘‘Committee on Health, 

Education, Labor, and Pensions of the Senate, and the 

Committee on Energy and Commerce of the House of Representatives, a report including, at a minimum— 

Waiver. 

Time period. 


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‘‘(A) the distribution of funds for carrying out this 

section’’; 

(B) by striking ‘‘populations. Such report shall include 

an assessment’’ and inserting the following: ‘‘populations; 

‘‘(B) an assessment’’; 

(C) by striking ‘‘and the rationale for any substantial 

changes in the distribution of funds.’’ and inserting a semicolon; and 

(D) by adding at the end the following: 

‘‘(C) the distribution of awards and funding for new 

or expanded services in each of rural areas and urban 

areas; 

‘‘(D) the distribution of awards and funding for establishing new access points, and the number of new access 

points created; 

‘‘(E) the amount of unexpended funding for loan 

guarantees and loan guarantee authority under title XVI; 

‘‘(F) the rationale for any substantial changes in the 

distribution of funds; 

‘‘(G) the rate of closures for health centers and access 

points; 

‘‘(H) the number and reason for any grants awarded 

pursuant to subsection (e)(1)(B); and 

‘‘(I) the number and reason for any waivers provided 

pursuant to subsection (q)(4).’’; 

(13) in subsection (r), by adding at the end the following 

new paragraph: 

‘‘(5) FUNDING FOR PARTICIPATION OF HEALTH CENTERS IN

ALL OF US RESEARCH PROGRAM.—In addition to any amounts 

made available pursuant to paragraph (1) of this subsection, 

section 402A of this Act, or section 10503 of the Patient Protection and Affordable Care Act, there is authorized to be appropriated, and there is appropriated, out of any monies in the 

Treasury not otherwise appropriated, to the Secretary 

$25,000,000 for fiscal year 2018 to support the participation 

of health centers in the All of Us Research Program under 

the Precision Medicine Initiative under section 498E of this 

Act.’’; and 

(14) by striking subsection (s). 

(c) NATIONAL HEALTH SERVICE CORPS.—Section 10503(b)(2)(F) 

of the Patient Protection and Affordable Care Act (42 U.S.C. 254b– 

2(b)(2)(F)), as amended by section 3101 of Public Law 115–96, 

is amended to read as follows: 

‘‘(F) $310,000,000 for each of fiscal years 2018 and 

2019.’’. 

(d) TEACHING HEALTH CENTERS THAT OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS.— 

(1) PAYMENTS.—Subsection (a) of section 340H of the Public 

Health Service Act (42 U.S.C. 256h) is amended to read as 

follows: 

‘‘(a) PAYMENTS.— 

‘‘(1) IN GENERAL.—Subject to subsection (h)(2), the Secretary shall make payments under this section for direct 

expenses and indirect expenses to qualified teaching health 

centers that are listed as sponsoring institutions by the relevant 

accrediting body for, as appropriate— 

Appropriation 

authorization. 


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‘‘(A) maintenance of filled positions at existing 

approved graduate medical residency training programs; 

‘‘(B) expansion of existing approved graduate medical 

residency training programs; and 

‘‘(C) establishment of new approved graduate medical 

residency training programs. 

‘‘(2) PER RESIDENT AMOUNT.—In making payments under 

paragraph (1), the Secretary shall consider the cost of training 

residents at teaching health centers and the implications of 

the per resident amount on approved graduate medical residency training programs at teaching health centers. 

‘‘(3) PRIORITY.—In making payments under paragraph 

(1)(C), the Secretary shall give priority to qualified teaching 

health centers that— 

‘‘(A) serve a health professional shortage area with 

a designation in effect under section 332 or a medically 

underserved community (as defined in section 799B); or 

‘‘(B) are located in a rural area (as defined in section 

1886(d)(2)(D) of the Social Security Act).’’. 

(2) FUNDING.—Paragraph (1) of section 340H(g) of the 

Public Health Service Act (42 U.S.C. 256h(g)), as amended 

by section 3101 of Public Law 115–96, is amended by striking 

‘‘and $30,000,000 for the period of the first and second quarters 

of fiscal year 2018,’’ and inserting ‘‘and $126,500,000 for each 

of fiscal years 2018 and 2019,’’. 

(3) ANNUAL REPORTING.—Subsection (h)(1) of section 340H 

of the Public Health Service Act (42 U.S.C. 256h) is amended— 

(A) by redesignating subparagraph (D) as subparagraph (H); and 

(B) by inserting after subparagraph (C) the following: 

‘‘(D) The number of patients treated by residents 

described in paragraph (4). 

‘‘(E) The number of visits by patients treated by residents described in paragraph (4). 

‘‘(F) Of the number of residents described in paragraph 

(4) who completed their residency training at the end of 

such residency academic year, the number and percentage 

of such residents entering primary care practice (meaning 

any of the areas of practice listed in the definition of 

a primary care residency program in section 749A). 

‘‘(G) Of the number of residents described in paragraph 

(4) who completed their residency training at the end of 

such residency academic year, the number and percentage 

of such residents who entered practice at a health care 

facility— 

‘‘(i) primarily serving a health professional shortage area with a designation in effect under section 

332 or a medically underserved community (as defined 

in section 799B); or 

‘‘(ii) located in a rural area (as defined in section 

1886(d)(2)(D) of the Social Security Act).’’. 

(4) REPORT ON TRAINING COSTS.—Not later than March 

31, 2019, the Secretary of Health and Human Services shall 

submit to the Congress a report on the direct graduate expenses 

of approved graduate medical residency training programs, and 

the indirect expenses associated with the additional costs of 

teaching residents, of qualified teaching health centers (as such 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 289 

terms are used or defined in section 340H of the Public Health 

Service Act (42 U.S.C. 256h)). 

(5) DEFINITION.—Subsection (j) of section 340H of the Public 

Health Service Act (42 U.S.C. 256h) is amended— 

(A) by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and 

(B) by inserting after paragraph (1) the following: 

‘‘(2) NEW APPROVED GRADUATE MEDICAL RESIDENCY

TRAINING PROGRAM.—The term ‘new approved graduate medical 

residency training program’ means an approved graduate medical residency training program for which the sponsoring qualified teaching health center has not received a payment under 

this section for a previous fiscal year (other than pursuant 

to subsection (a)(1)(C)).’’. 

(6) TECHNICAL CORRECTION.—Subsection (f) of section 340H 

(42 U.S.C. 256h) is amended by striking ‘‘hospital’’ each place 

it appears and inserting ‘‘teaching health center’’. 

(7) PAYMENTS FOR PREVIOUS FISCAL YEARS.—The provisions 

of section 340H of the Public Health Service Act (42 U.S.C. 

256h), as in effect on the day before the date of enactment 

of Public Law 115–96, shall continue to apply with respect 

to payments under such section for fiscal years before fiscal 

year 2018. 

(e) APPLICATION.—Amounts appropriated pursuant to this section for fiscal year 2018 or 2019 are subject to the requirements 

contained in Public Law 115–31 for funds for programs authorized 

under sections 330 through 340 of the Public Health Service Act 

(42 U.S.C. 254b–256). 

(f) CONFORMING AMENDMENTS.—Paragraph (4) of section 

3014(h) of title 18, United States Code, as amended by section 

3101 of Public Law 115–96, is amended by striking ‘‘and section 

3101(d) of the CHIP and Public Health Funding Extension Act’’ 

and inserting ‘‘and section 50901(e) of the Advancing Chronic Care, 

Extenders, and Social Services Act’’. 

SEC. 50902. EXTENSION FOR SPECIAL DIABETES PROGRAMS. 

(a) SPECIAL DIABETES PROGRAM FOR TYPE I DIABETES.—Section 

330B(b)(2)(D) of the Public Health Service Act (42 U.S.C. 254c– 

2(b)(2)(D)), as amended by section 3102 of Public Law 115–96, 

is amended to read as follows: 

‘‘(D) $150,000,000 for each of fiscal years 2018 and 

2019, to remain available until expended.’’. 

(b) SPECIAL DIABETES PROGRAM FOR INDIANS.—Subparagraph 

(D) of section 330C(c)(2) of the Public Health Service Act (42 U.S.C. 

254c–3(c)(2)), as amended by section 3102 of Public Law 115– 

96, is amended to read as follows: 

‘‘(D) $150,000,000 for each of fiscal years 2018 and 

2019, to remain available until expended.’’. 

TITLE X—MISCELLANEOUS HEALTH 

CARE POLICIES 

SEC. 51001. HOME HEALTH PAYMENT REFORM. 

(a) BUDGET NEUTRAL TRANSITION TO A 30-DAY UNIT OF PAY- MENT FOR HOME HEALTH SERVICES.—Section 1895(b) of the Social 

Security Act (42 U.S.C. 1395fff(b)) is amended— 

Time periods. 

Applicability. 

42 USC 256h 

note. 


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(1) in paragraph (2)— 

(A) by striking ‘‘PAYMENT.—In defining’’ and inserting ‘‘PAYMENT.— 

‘‘(A) IN GENERAL.—In defining’’; and 

(B) by adding at the end the following new subparagraph: 

‘‘(B) 30-DAY UNIT OF SERVICE.—For purposes of implementing the prospective payment system with respect to 

home health units of service furnished during a year beginning with 2020, the Secretary shall apply a 30-day unit 

of service as the unit of service applied under this paragraph.’’; 

(2) in paragraph (3)— 

(A) in subparagraph (A), by adding at the end the 

following new clause: 

‘‘(iv) BUDGET NEUTRALITY FOR 2020.—With respect 

to payments for home health units of service furnished 

that end during the 12-month period beginning 

January 1, 2020, the Secretary shall calculate a 

standard prospective payment amount (or amounts) 

for 30-day units of service (as described in paragraph 

(2)(B)) for the prospective payment system under this 

subsection. Such standard prospective payment 

amount (or amounts) shall be calculated in a manner 

such that the estimated aggregate amount of expenditures under the system during such period with 

application of paragraph (2)(B) is equal to the estimated aggregate amount of expenditures that otherwise would have been made under the system during 

such period if paragraph (2)(B) had not been enacted. 

The previous sentence shall be applied before (and 

not affect the application of) paragraph (3)(B). In calculating such amount (or amounts), the Secretary shall 

make assumptions about behavior changes that could 

occur as a result of the implementation of paragraph 

(2)(B) and the case-mix adjustment factors established 

under paragraph (4)(B) and shall provide a description 

of such assumptions in the notice and comment rulemaking used to implement this clause.’’; and 

(B) by adding at the end the following new subparagraph: 

‘‘(D) BEHAVIOR ASSUMPTIONS AND ADJUSTMENTS.— 

‘‘(i) IN GENERAL.—The Secretary shall annually 

determine the impact of differences between assumed 

behavior changes (as described in paragraph (3)(A)(iv)) 

and actual behavior changes on estimated aggregate 

expenditures under this subsection with respect to 

years beginning with 2020 and ending with 2026. 

‘‘(ii) PERMANENT ADJUSTMENTS.—The Secretary 

shall, at a time and in a manner determined appropriate, through notice and comment rulemaking, provide for one or more permanent increases or decreases 

to the standard prospective payment amount (or 

amounts) for applicable years, on a prospective basis, 

to offset for such increases or decreases in estimated 

aggregate expenditures (as determined under clause 

(i)). 

Deadline. 

Determination. 

Notice. 

Regulations. 

Applicability. 


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‘‘(iii) TEMPORARY ADJUSTMENTS FOR RETROSPECTIVE

BEHAVIOR.—The Secretary shall, at a time and in a 

manner determined appropriate, through notice and 

comment rulemaking, provide for one or more temporary increases or decreases to the payment amount 

for a unit of home health services (as determined under 

paragraph (4)) for applicable years, on a prospective 

basis, to offset for such increases or decreases in estimated aggregate expenditures (as determined under 

clause (i)). Such a temporary increase or decrease shall 

apply only with respect to the year for which such 

temporary increase or decrease is made, and the Secretary shall not take into account such a temporary 

increase or decrease in computing such amount under 

this subsection for a subsequent year.’’; and 

(3) in paragraph (4)(B)— 

(A) by striking ‘‘FACTORS.—The Secretary’’ and 

inserting ‘‘FACTORS.— 

‘‘(i) IN GENERAL.—The Secretary’’; and 

(B) by adding at the end the following new clause: 

‘‘(ii) TREATMENT OF THERAPY THRESHOLDS.—For 

2020 and subsequent years, the Secretary shall eliminate the use of therapy thresholds (established by the 

Secretary) in case mix adjustment factors established 

under clause (i) for calculating payments under the 

prospective payment system under this subsection.’’. 

(b) TECHNICAL EXPERT PANEL.— 

(1) IN GENERAL.—During the period beginning on January 

1, 2018, and ending on December 31, 2018, the Secretary of 

Health and Human Services shall hold at least one session 

of a technical expert panel, the participants of which shall 

include home health providers, patient representatives, and 

other relevant stakeholders. The technical expert panel shall 

identify and prioritize recommendations with respect to the 

prospective payment system for home health services under 

section 1895(b) of the Social Security Act (42 U.S.C. 1395fff(b)), 

on the following: 

(A) The Home Health Groupings Model, as described 

in the proposed rule ‘‘Medicare and Medicaid Programs; 

CY 2018 Home Health Prospective Payment System Rate 

Update and Proposed CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting 

Requirements’’ (82 Fed. Reg. 35294 through 35332 (July 

28, 2017)). 

(B) Alternative case-mix models to the Home Health 

Groupings Model that were submitted during 2017 as comments in response to proposed rule making, including 

patient-focused factors that consider the risks of hospitalization and readmission to a hospital, improvement 

or maintenance of functionality of individuals to increase 

the capacity for self-care, quality of care, and resource 

utilization. 

(2) INAPPLICABILITY OF FACA.—The provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply 

to the technical expert panel under paragraph (1). 

Recommendations. 

Applicability. 


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132 STAT. 292 PUBLIC LAW 115–123—FEB. 9, 2018 

(3) REPORT.—Not later than April 1, 2019, the Secretary 

of Health and Human Services shall submit to the Committee 

on Ways and Means and the Committee on Energy and Commerce of the House of Representatives and the Committee 

on Finance of the Senate a report on the recommendations 

of such panel described in such paragraph. 

(4) NOTICE AND COMMENT RULEMAKING.—Not later than 

December 31, 2019, the Secretary of Health and Human Services shall pursue notice and comment rulemaking on a casemix system with respect to the prospective payment system 

for home health services under section 1895(b) of the Social 

Security Act (42 U.S.C. 1395fff(b)). 

(c) REPORTS.— 

(1) INTERIM REPORT.—Not later than March 15, 2022, the 

Medicare Payment Advisory Commission shall submit to Congress an interim report on the application of a 30-day unit 

of service as the unit of service applied under section 1895(b)(2) 

of the Social Security Act (42 U.S.C. 1395fff(b)(2)), as amended 

by subsection (a), including an analysis of the level of payments 

provided to home health agencies as compared to the cost 

of delivering home health services, and any unintended consequences, including with respect to behavioral changes and 

quality. 

(2) FINAL REPORT.—Not later than March 15, 2026, such 

Commission shall submit to Congress a final report on such 

application and any such consequences. 

SEC. 51002. INFORMATION TO SATISFY DOCUMENTATION OF MEDICARE ELIGIBILITY FOR HOME HEALTH SERVICES. 

(a) PART A.—Section 1814(a) of the Social Security Act (42 

U.S.C. 1395f(a)) is amended by inserting before ‘‘For purposes of 

paragraph (2)(C),’’ the following new sentence: ‘‘For purposes of 

documentation for physician certification and recertification made 

under paragraph (2) on or after January 1, 2019, and made with 

respect to home health services furnished by a home health agency, 

in addition to using documentation in the medical record of the 

physician who so certifies or the medical record of the acute or 

post-acute care facility (in the case that home health services were 

furnished to an individual who was directly admitted to the home 

health agency from such a facility), the Secretary may use documentation in the medical record of the home health agency as 

supporting material, as appropriate to the case involved.’’. 

(b) PART B.—Section 1835(a) of the Social Security Act (42 

U.S.C. 1395n(a)) is amended by inserting before ‘‘For purposes 

of paragraph (2)(A),’’ the following new sentence: ‘‘For purposes 

of documentation for physician certification and recertification made 

under paragraph (2) on or after January 1, 2019, and made with 

respect to home health services furnished by a home health agency, 

in addition to using documentation in the medical record of the 

physician who so certifies or the medical record of the acute or 

post-acute care facility (in the case that home health services were 

furnished to an individual who was directly admitted to the home 

health agency from such a facility), the Secretary may use documentation in the medical record of the home health agency as 

supporting material, as appropriate to the case involved.’’. 

Certification. 

Deadline. 


ralbany on LAP520R082 with PUB LAWS PDF
PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 293 

SEC. 51003. TECHNICAL AMENDMENTS TO PUBLIC LAW 114–10. 

(a) MIPS TRANSITION.—Section 1848 of the Social Security Act 

(42 U.S.C. 1395w–4) is amended— 

(1) in subsection (q)— 

(A) in paragraph (1)— 

(i) in subparagraph (B), by striking ‘‘items and 

services’’ and inserting ‘‘covered professional services 

(as defined in subsection (k)(3)(A))’’; and 

(ii) in subparagraph (C)(iv)— 

(I) by amending subclause (I) to read as follows: 

‘‘(I) The minimum number (as determined by 

the Secretary) of— 

‘‘(aa) for performance periods beginning 

before January 1, 2018, individuals enrolled 

under this part who are treated by the eligible 

professional for the performance period 

involved; and 

‘‘(bb) for performance periods beginning 

on or after January 1, 2018, individuals 

enrolled under this part who are furnished 

covered professional services (as defined in 

subsection (k)(3)(A)) by the eligible professional for the performance period involved.’’; 

(II) in subclause (II), by striking ‘‘items and 

services’’ and inserting ‘‘covered professional services (as defined in subsection (k)(3)(A))’’; and 

(III) by amending subclause (III) to read as 

follows: 

‘‘(III) The minimum amount (as determined 

by the Secretary) of— 

‘‘(aa) for performance periods beginning 

before January 1, 2018, allowed charges billed 

by such professional under this part for such 

performance period; and 

‘‘(bb) for performance periods beginning 

on or after January 1, 2018, allowed charges 

for covered professional services (as defined 

in subsection (k)(3)(A)) billed by such professional for such performance period.’’; 

(B) in paragraph (5)(D)— 

(i) in clause (i)(I), by inserting ‘‘subject to clause 

(iii),’’ after ‘‘clauses (i) and (ii) of paragraph (2)(A),’’; 

and 

(ii) by adding at the end the following new clause: 

‘‘(iii) TRANSITION YEARS.—For each of the second, 

third, fourth, and fifth years for which the MIPS 

applies to payments, the performance score for the 

performance category described in paragraph (2)(A)(ii) 

shall not take into account the improvement of the 

professional involved.’’; 

(C) in paragraph (5)(E)— 

(i) in clause (i)(I)(bb)— 

(I) in the heading by striking ‘‘FIRST 2 YEARS’’ 

and inserting ‘‘FIRST 5 YEARS’’; and 

(II) by striking ‘‘the first and second years’’ 

and inserting ‘‘each of the first through fifth years’’; 

Time periods. 

Time periods. 


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132 STAT. 294 PUBLIC LAW 115–123—FEB. 9, 2018 

(ii) in clause (i)(II)(bb)— 

(I) in the heading, by striking ‘‘2 YEARS’’ and 

inserting ‘‘5 YEARS’’; and 

(II) by striking the second sentence and 

inserting the following new sentences: ‘‘For each 

of the second, third, fourth, and fifth years for 

which the MIPS applies to payments, not less than 

10 percent and not more than 30 percent of such 

score shall be based on performance with respect 

to the category described in clause (ii) of paragraph 

(2)(A). Nothing in the previous sentence shall be 

construed, with respect to a performance period 

for a year described in the previous sentence, as 

preventing the Secretary from basing 30 percent 

of such score for such year with respect to the 

category described in such clause (ii), if the Secretary determines, based on information posted 

under subsection (r)(2)(I) that sufficient resource 

use measures are ready for adoption for use under 

the performance category under paragraph 

(2)(A)(ii) for such performance period.’’; 

(D) in paragraph (6)(D)— 

(i) in clause (i), in the second sentence, by striking 

‘‘Such performance threshold’’ and inserting ‘‘Subject 

to clauses (iii) and (iv), such performance threshold’’; 

(ii) in clause (ii)— 

(I) in the first sentence, by inserting ‘‘(beginning with 2019 and ending with 2024)’’ after ‘‘for 

each year of the MIPS’’; and 

(II) in the second sentence, by inserting ‘‘subject to clause (iii),’’ after ‘‘For each such year,’’; 

(iii) in clause (iii)— 

(I) in the heading, by striking ‘‘2’’ and inserting 

‘‘5’’; and 

(II) in the first sentence, by striking ‘‘two 

years’’ and inserting ‘‘five years’’; and 

(iv) by adding at the end the following new clause: 

‘‘(iv) ADDITIONAL SPECIAL RULE FOR THIRD, FOURTH

AND FIFTH YEARS OF MIPS.—For purposes of determining MIPS adjustment factors under subparagraph 

(A), in addition to the requirements specified in clause 

(iii), the Secretary shall increase the performance 

threshold with respect to each of the third, fourth, 

and fifth years to which the MIPS applies to ensure 

a gradual and incremental transition to the performance threshold described in clause (i) (as estimated 

by the Secretary) with respect to the sixth year to 

which the MIPS applies.’’; 

(E) in paragraph (6)(E)— 

(i) by striking ‘‘In the case of items and services’’ 

and inserting ‘‘In the case of covered professional services (as defined in subsection (k)(3)(A))’’; and 

(ii) by striking ‘‘under this part with respect to 

such items and services’’ and inserting ‘‘under this 

part with respect to such covered professional services’’; 

and 

Determination. 

Determination. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 295 

(F) in paragraph (7), in the first sentence, by striking 

‘‘items and services’’ and inserting ‘‘covered professional 

services (as defined in subsection (k)(3)(A))’’; 

(2) in subsection (r)(2), by adding at the end the following 

new subparagraph: 

‘‘(I) INFORMATION.—The Secretary shall, not later than 

December 31st of each year (beginning with 2018), post 

on the Internet website of the Centers for Medicare & 

Medicaid Services information on resource use measures 

in use under subsection (q), resource use measures under 

development and the time-frame for such development, 

potential future resource use measure topics, a description 

of stakeholder engagement, and the percent of expenditures 

under part A and this part that are covered by resource 

use measures.’’; and 

(3) in subsection (s)(5)(B), by striking ‘‘section 1833(z)(2)(C)’’ 

and inserting ‘‘section 1833(z)(3)(D)’’. 

(b) PHYSICIAN-FOCUSED PAYMENT MODEL TECHNICAL ADVISORY

COMMITTEE PROVISION OF INITIAL PROPOSAL FEEDBACK.—Section 

1868(c)(2)(C) of the Social Security Act (42 U.S.C. 1395ee(c)(2)(C)) 

is amended to read as follows: 

‘‘(C) COMMITTEE REVIEW OF MODELS SUBMITTED.—The 

Committee, on a periodic basis— 

‘‘(i) shall review models submitted under subparagraph (B); 

‘‘(ii) may provide individuals and stakeholder entities who submitted such models with— 

‘‘(I) initial feedback on such models regarding 

the extent to which such models meet the criteria 

described in subparagraph (A); and 

‘‘(II) an explanation of the basis for the feedback provided under subclause (I); and 

‘‘(iii) shall prepare comments and recommendations regarding whether such models meet the criteria 

described in subparagraph (A) and submit such comments and recommendations to the Secretary.’’. 

SEC. 51004. EXPANDED ACCESS TO MEDICARE INTENSIVE CARDIAC 

REHABILITATION PROGRAMS. 

Section 1861(eee)(4)(B) of the Social Security Act (42 U.S.C. 

1395x(eee)(4)(B)) is amended— 

(1) in clause (v), by striking ‘‘or’’ at the end; 

(2) in clause (vi), by striking the period at the end and 

inserting a semicolon; and 

(3) by adding at the end the following new clauses: 

‘‘(vii) stable, chronic heart failure (defined as patients 

with left ventricular ejection fraction of 35 percent or less 

and New York Heart Association (NYHA) class II to IV 

symptoms despite being on optimal heart failure therapy 

for at least 6 weeks); or 

‘‘(viii) any additional condition for which the Secretary 

has determined that a cardiac rehabilitation program shall 

be covered, unless the Secretary determines, using the 

same process used to determine that the condition is covered for a cardiac rehabilitation program, that such coverage is not supported by the clinical evidence.’’. 

Determination. 

Recommendations. 

Deadline. 

Web posting. 


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132 STAT. 296 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 51005. EXTENSION OF BLENDED SITE NEUTRAL PAYMENT RATE 

FOR CERTAIN LONG-TERM CARE HOSPITAL DISCHARGES; TEMPORARY ADJUSTMENT TO SITE NEUTRAL 

PAYMENT RATES. 

(a) EXTENSION.—Section 1886(m)(6)(B)(i) of the Social Security 

Act (42 U.S.C. 1395ww(m)(6)(B)(i)) is amended— 

(1) in subclause (I), by striking ‘‘fiscal year 2016 or fiscal 

year 2017’’ and inserting ‘‘fiscal years 2016 through 2019’’; 

and 

(2) in subclause (II), by striking ‘‘2018’’ and inserting 

‘‘2020’’. 

(b) TEMPORARY ADJUSTMENT TO SITE NEUTRAL PAYMENT

RATES.—Section 1886(m)(6)(B) of the Social Security Act (42 U.S.C. 

1395ww(m)(6)(B)) is amended— 

(1) in clause (ii), in the matter preceding subclause (I), 

by striking ‘‘In this paragraph’’ and inserting ‘‘Subject to clause 

(iv), in this paragraph’’; and 

(2) by adding at the end the following new clause: 

‘‘(iv) ADJUSTMENT.—For each of fiscal years 2018 

through 2026, the amount that would otherwise apply 

under clause (ii)(I) for the year (determined without 

regard to this clause) shall be reduced by 4.6 percent.’’. 

SEC. 51006. RECOGNITION OF ATTENDING PHYSICIAN ASSISTANTS AS 

ATTENDING PHYSICIANS TO SERVE HOSPICE PATIENTS. 

(a) RECOGNITION OF ATTENDING PHYSICIAN ASSISTANTS AS

ATTENDING PHYSICIANS TO SERVE HOSPICE PATIENTS.— 

(1) IN GENERAL.—Section 1861(dd)(3)(B) of the Social Security Act (42 U.S.C. 1395x(dd)(3)(B)) is amended— 

(A) by striking ‘‘or nurse’’ and inserting ‘‘, the nurse’’; 

and 

(B) by inserting ‘‘, or the physician assistant (as defined 

in such subsection)’’ after ‘‘subsection (aa)(5))’’. 

(2) CLARIFICATION OF HOSPICE ROLE OF PHYSICIAN ASSISTANTS.—Section 1814(a)(7)(A)(i)(I) of the Social Security Act (42 

U.S.C. 1395f(a)(7)(A)(i)(I)) is amended by inserting ‘‘or a physician assistant’’ after ‘‘a nurse practitioner’’. 

(b) EFFECTIVE DATE.—The amendments made by this section 

shall apply to items and services furnished on or after January 

1, 2019. 

SEC. 51007. EXTENSION OF ENFORCEMENT INSTRUCTION ON SUPERVISION REQUIREMENTS FOR OUTPATIENT THERAPEUTIC SERVICES IN CRITICAL ACCESS AND SMALL 

RURAL HOSPITALS THROUGH 2017. 

Section 1 of Public Law 113–198, as amended by section 1 

of Public Law 114–112 and section 16004(a) of the 21st Century 

Cures Act (Public Law 114–255), is amended— 

(1) in the section heading, by striking ‘‘2016’’ and inserting 

‘‘2017’’; and 

(2) by striking ‘‘and 2016’’ and inserting ‘‘2016, and 2017’’. 

128 Stat. 2057. 

Applicability. 

42 USC 1395f 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 297 

SEC. 51008. ALLOWING PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, AND CLINICAL NURSE SPECIALISTS TO SUPERVISE CARDIAC, INTENSIVE CARDIAC, AND PULMONARY 

REHABILITATION PROGRAMS. 

(a) CARDIAC AND INTENSIVE CARDIAC REHABILITATION PROGRAMS.—Section 1861(eee) of the Social Security Act (42 U.S.C. 

1395x(eee)) is amended— 

(1) in paragraph (1)— 

(A) by striking ‘‘physician-supervised’’; and 

(B) by inserting ‘‘under the supervision of a physician 

(as defined in subsection (r)(1)) or a physician assistant, 

nurse practitioner, or clinical nurse specialist (as those 

terms are defined in subsection (aa)(5))’’ before the period 

at the end; 

(2) in paragraph (2)— 

(A) in subparagraph (A)(iii), by striking the period 

at the end and inserting a semicolon; and 

(B) in subparagraph (B), by striking ‘‘a physician’’ and 

inserting ‘‘a physician (as defined in subsection (r)(1)) or 

a physician assistant, nurse practitioner, or clinical nurse 

specialist (as those terms are defined in subsection (aa)(5))’’; 

and 

(3) in paragraph (4)(A), in the matter preceding clause 

(i)— 

(A) by striking ‘‘physician-supervised’’; and 

(B) by inserting ‘‘under the supervision of a physician 

(as defined in subsection (r)(1)) or a physician assistant, 

nurse practitioner, or clinical nurse specialist (as those 

terms are defined in subsection (aa)(5))’’ after ‘‘paragraph 

(3)’’. 

(b) PULMONARY REHABILITATION PROGRAMS.—Section 

1861(fff)(1) of the Social Security Act (42 U.S.C. 1395x(fff)(1)) is 

amended— 

(1) by striking ‘‘physician-supervised’’; and 

(2) by inserting ‘‘under the supervision of a physician (as 

defined in subsection (r)(1)) or a physician assistant, nurse 

practitioner, or clinical nurse specialist (as those terms are 

defined in subsection (aa)(5))’’ before the period at the end. 

(c) EFFECTIVE DATE.—The amendments made by this section 

shall apply to items and services furnished on or after January 

1, 2024. 

SEC. 51009. TRANSITIONAL PAYMENT RULES FOR CERTAIN RADIATION 

THERAPY SERVICES UNDER THE PHYSICIAN FEE 

SCHEDULE. 

Section 1848 of the Social Security Act (42 U.S.C. 1395w– 

4) is amended— 

(1) in subsection (b)(11), by striking ‘‘2017 and 2018’’ and 

inserting ‘‘2017, 2018, and 2019’’; and 

(2) in subsection (c)(2)(K)(iv), by striking ‘‘2017 and 2018’’ 

and inserting ‘‘2017, 2018, and 2019’’. 

Applicability. 

42 USC 1395x 

note. 


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132 STAT. 298 PUBLIC LAW 115–123—FEB. 9, 2018 

TITLE XI—PROTECTING SENIORS’ 

ACCESS TO MEDICARE ACT 

SEC. 52001. REPEAL OF THE INDEPENDENT PAYMENT ADVISORY 

BOARD. 

(a) REPEAL.—Section 1899A of the Social Security Act (42 U.S.C. 

1395kkk) is repealed. 

(b) CONFORMING AMENDMENTS.— (1) LOBBYING COOLING-OFF PERIOD.—Paragraph (3) of section 207(c) of title 18, United States Code, is repealed. 

(2) GAO STUDY AND REPORT.—Section 3403(b) of the Patient 

Protection and Affordable Care Act (42 U.S.C. 1395kkk–1) is 

repealed. 

(3) MEDPAC REVIEW AND COMMENT.—Section 1805(b) of 

the Social Security Act (42 U.S.C. 1395b–6(b)) is amended— 

(A) by striking paragraph (4); 

(B) by redesignating paragraphs (5) through (8) as 

paragraphs (4) through (7), respectively; and 

(C) by redesignating the paragraph (9) that was 

redesignated by section 3403(c)(1) of the Patient Protection 

and Affordable Care Act (Public Law 111–148) as paragraph (8). 

(4) NAME CHANGE.—Section 10320(b) of the Patient Protection and Affordable Care Act (Public Law 111–148) is repealed. 

(5) RULE OF CONSTRUCTION.—Section 10320(c) of the 

Patient Protection and Affordable Care Act (Public Law 111– 

148) is repealed. 

TITLE XII—OFFSETS 

SEC. 53101. MODIFYING REDUCTIONS IN MEDICAID DSH ALLOTMENTS. 

Section 1923(f)(7)(A) of the Social Security Act (42 U.S.C. 

1396r–4(f)(7)(A)) is amended— 

(1) in clause (i), in the matter preceding subclause (I), 

by striking ‘‘2018’’ and inserting ‘‘2020’’; and 

(2) in clause (ii), by striking subclauses (I) through (VIII) 

and inserting the following: ‘‘(I) $4,000,000,000 for fiscal year 2020; and 

‘‘(II) $8,000,000,000 for each of fiscal years 

2021 through 2025.’’. 

SEC. 53102. THIRD PARTY LIABILITY IN MEDICAID AND CHIP. 

(a) MODIFICATION OF THIRD PARTY LIABILITY RULES RELATED

TO SPECIAL TREATMENT OF CERTAIN TYPES OF CARE AND PAYMENTS.— 

(1) IN GENERAL.—Section 1902(a)(25)(E) of the Social Security Act (42 U.S.C. 1396a(a)(25)(E)) is amended, in the matter 

preceding clause (i), by striking ‘‘prenatal or’’. 

(2) EFFECTIVE DATE.—The amendment made by paragraph 

(1) shall take effect on the date of enactment of this Act. 

(b) DELAY IN EFFECTIVE DATE AND REPEAL OF CERTAIN BIPARTISAN BUDGET ACT OF 2013 AMENDMENTS.— 

(1) REPEAL.—Effective as of September 30, 2017, subsection 

(b) of section 202 of the Bipartisan Budget Act of 2013 (Public 

Law 113–67; 127 Stat. 1177; 42 U.S.C. 1396a note) (including 

Applicability. 

42 USC 1396a 

note. 

42 USC 1395kkk 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 299 

any amendments made by such subsection) is repealed and 

the provisions amended by such subsection shall be applied 

and administered as if such amendments had never been 

enacted. 

(2) DELAY IN EFFECTIVE DATE.—Subsection (c) of section 

202 of the Bipartisan Budget Act of 2013 (Public Law 113– 

67; 127 Stat. 1177; 42 U.S.C. 1396a note) is amended to read 

as follows: 

‘‘(c) EFFECTIVE DATE.—The amendments made by subsection 

(a) shall take effect on October 1, 2019.’’. 

(3) EFFECTIVE DATE; TREATMENT.—The repeal and amendment made by this subsection shall take effect as if enacted 

on September 30, 2017, and shall apply with respect to any 

open claims, including claims pending, generated, or filed, after 

such date. The amendments made by subsections (a) and (b) 

of section 202 of the Bipartisan Budget Act of 2013 (Public 

Law 113–67; 127 Stat. 1177; 42 U.S.C. 1396a note) that took 

effect on October 1, 2017, are null and void and section 

1902(a)(25) of the Social Security Act (42 U.S.C. 1396a(a)(25)) 

shall be applied and administered as if such amendments had 

not taken effect on such date. 

(c) GAO STUDY AND REPORT.—Not later than 18 months after 

the date of enactment of this Act, the Comptroller General of 

the United States shall submit a report to the Committee on Energy 

and Commerce of the House of Representatives and the Committee 

on Finance of the Senate on the impacts of the amendments made 

by subsections (a)(1) and (b)(2), including— 

(1) the impact, or potential effect, of such amendments 

on access to prenatal and preventive pediatric care (including 

early and periodic screening, diagnostic, and treatment services) 

covered under State plans under such title (or waivers of such 

plans); 

(2) the impact, or potential effect, of such amendments 

on access to services covered under such plans or waivers 

for individuals on whose behalf child support enforcement is 

being carried out by a State agency under part D of title 

IV of such Act; and 

(3) the impact, or potential effect, on providers of services 

under such plans or waivers of delays in payment or related 

issues that result from such amendments. 

(d) APPLICATION TO CHIP.— 

(1) IN GENERAL.—Section 2107(e)(1) of the Social Security 

Act (42 U.S.C. 1397gg(e)(1)) is amended— 

(A) by redesignating subparagraphs (B) through (R) 

as subparagraphs (C) through (S), respectively; and 

(B) by inserting after subparagraph (A) the following 

new subparagraph: 

‘‘(B) Section 1902(a)(25) (relating to third party 

liability).’’. 

(2) MANDATORY REPORTING.—Section 1902(a)(25)(I)(i) of the 

Social Security Act (42 U.S.C. 1396a(a)(25)(I)(i)) is amended— 

(A) by striking ‘‘medical assistance under the State 

plan’’ and inserting ‘‘medical assistance under a State plan 

(or under a waiver of the plan)’’; 

(B) by striking ‘‘(and, at State option, child’’ and 

inserting ‘‘and child’’; and 

(C) by striking ‘‘title XXI)’’ and inserting ‘‘title XXI’’. 

Applicability. 

42 USC 1396a 

note. 

42 USC 1396a 

and note, 1396k, 

1396p. 


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132 STAT. 300 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 53103. TREATMENT OF LOTTERY WINNINGS AND OTHER LUMPSUM INCOME FOR PURPOSES OF INCOME ELIGIBILITY 

UNDER MEDICAID. 

(a) IN GENERAL.—Section 1902 of the Social Security Act (42 

U.S.C. 1396a) is amended— 

(1) in subsection (a)(17), by striking ‘‘(e)(14), (e)(14)’’ and 

inserting ‘‘(e)(14), (e)(15)’’; and 

(2) in subsection (e)(14), by adding at the end the following 

new subparagraph: 

‘‘(K) TREATMENT OF CERTAIN LOTTERY WINNINGS AND

INCOME RECEIVED AS A LUMP SUM.— ‘‘(i) IN GENERAL.—In the case of an individual who 

is the recipient of qualified lottery winnings (pursuant 

to lotteries occurring on or after January 1, 2018) 

or qualified lump sum income (received on or after 

such date) and whose eligibility for medical assistance 

is determined based on the application of modified 

adjusted gross income under subparagraph (A), a State 

shall, in determining such eligibility, include such 

winnings or income (as applicable) as income 

received— 

‘‘(I) in the month in which such winnings or 

income (as applicable) is received if the amount 

of such winnings or income is less than $80,000; 

‘‘(II) over a period of 2 months if the amount 

of such winnings or income (as applicable) is 

greater than or equal to $80,000 but less than 

$90,000; 

‘‘(III) over a period of 3 months if the amount 

of such winnings or income (as applicable) is 

greater than or equal to $90,000 but less than 

$100,000; and 

‘‘(IV) over a period of 3 months plus 1 additional month for each increment of $10,000 of such 

winnings or income (as applicable) received, not 

to exceed a period of 120 months (for winnings 

or income of $1,260,000 or more), if the amount 

of such winnings or income is greater than or 

equal to $100,000. 

‘‘(ii) COUNTING IN EQUAL INSTALLMENTS.—For purposes of subclauses (II), (III), and (IV) of clause (i), 

winnings or income to which such subclause applies 

shall be counted in equal monthly installments over 

the period of months specified under such subclause. 

‘‘(iii) HARDSHIP EXEMPTION.—An individual whose 

income, by application of clause (i), exceeds the 

applicable eligibility threshold established by the State, 

shall continue to be eligible for medical assistance to 

the extent that the State determines, under procedures 

established by the State (in accordance with standards 

specified by the Secretary), that the denial of eligibility 

of the individual would cause an undue medical or 

financial hardship as determined on the basis of criteria established by the Secretary. 

‘‘(iv) NOTIFICATIONS AND ASSISTANCE REQUIRED IN

CASE OF LOSS OF ELIGIBILITY.—A State shall, with 

respect to an individual who loses eligibility for medical 

Determination. 

Applicability. 

Determination. 

Time periods. 

42 USC 1396a 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 301 

assistance under the State plan (or a waiver of such 

plan) by reason of clause (i)— 

‘‘(I) before the date on which the individual 

loses such eligibility, inform the individual— 

‘‘(aa) of the individual’s opportunity to 

enroll in a qualified health plan offered 

through an Exchange established under title 

I of the Patient Protection and Affordable Care 

Act during the special enrollment period specified in section 9801(f)(3) of the Internal Revenue Code of 1986 (relating to loss of Medicaid 

or CHIP coverage); and 

‘‘(bb) of the date on which the individual 

would no longer be considered ineligible by 

reason of clause (i) to receive medical assistance under the State plan or under any waiver 

of such plan and be eligible to reapply to 

receive such medical assistance; and 

‘‘(II) provide technical assistance to the individual seeking to enroll in such a qualified health 

plan. 

‘‘(v) QUALIFIED LOTTERY WINNINGS DEFINED.—In 

this subparagraph, the term ‘qualified lottery winnings’ 

means winnings from a sweepstakes, lottery, or pool 

described in paragraph (3) of section 4402 of the 

Internal Revenue Code of 1986 or a lottery operated 

by a multistate or multijurisdictional lottery association, including amounts awarded as a lump sum payment. 

‘‘(vi) QUALIFIED LUMP SUM INCOME DEFINED.—In 

this subparagraph, the term ‘qualified lump sum 

income’ means income that is received as a lump sum 

from monetary winnings from gambling (as defined 

by the Secretary and including gambling activities 

described in section 1955(b)(4) of title 18, United States 

Code).’’. 

(b) RULES OF CONSTRUCTION.— 

(1) INTERCEPTION OF LOTTERY WINNINGS ALLOWED.— 

Nothing in the amendment made by subsection (a)(2) shall 

be construed as preventing a State from intercepting the State 

lottery winnings awarded to an individual in the State to 

recover amounts paid by the State under the State Medicaid 

plan under title XIX of the Social Security Act (42 U.S.C. 

1396 et seq.) for medical assistance furnished to the individual. 

(2) APPLICABILITY LIMITED TO ELIGIBILITY OF RECIPIENT OF

LOTTERY WINNINGS OR LUMP SUM INCOME.—Nothing in the 

amendment made by subsection (a)(2) shall be construed, with 

respect to a determination of household income for purposes 

of a determination of eligibility for medical assistance under 

the State plan under title XIX of the Social Security Act (42 

U.S.C. 1396 et seq.) (or a waiver of such plan) made by applying 

modified adjusted gross income under subparagraph (A) of section 1902(e)(14) of such Act (42 U.S.C. 1396a(e)(14)), as limiting 

the eligibility for such medical assistance of any individual 

that is a member of the household other than the individual 

who received qualified lottery winnings or qualified lump-sum 

42 USC 1396a 

note. 


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132 STAT. 302 PUBLIC LAW 115–123—FEB. 9, 2018 

income (as defined in subparagraph (K) of such section 

1902(e)(14), as added by subsection (a)(2) of this section). 

SEC. 53104. REBATE OBLIGATION WITH RESPECT TO LINE EXTENSION 

DRUGS. 

(a) IN GENERAL.—Section 1927(c)(2)(C) of the Social Security 

Act (42 U.S.C. 1396r–8(c)(2)(C)) is amended by striking ‘‘(C) TREATMENT OF NEW FORMULATIONS.—In the case’’ and all that follows 

through the period at the end of the first sentence and inserting 

the following: 

‘‘(C) TREATMENT OF NEW FORMULATIONS.— 

‘‘(i) IN GENERAL.—In the case of a drug that is 

a line extension of a single source drug or an innovator 

multiple source drug that is an oral solid dosage form, 

the rebate obligation for a rebate period with respect 

to such drug under this subsection shall be the greater 

of the amount described in clause (ii) for such drug 

or the amount described in clause (iii) for such drug. 

‘‘(ii) AMOUNT 1.—For purposes of clause (i), the 

amount described in this clause with respect to a drug 

described in clause (i) and rebate period is the amount 

computed under paragraph (1) for such drug, increased 

by the amount computed under subparagraph (A) and, 

as applicable, subparagraph (B) for such drug and 

rebate period. 

‘‘(iii) AMOUNT 2.—For purposes of clause (i), the 

amount described in this clause with respect to a drug 

described in clause (i) and rebate period is the amount 

computed under paragraph (1) for such drug, increased 

by the product of— 

‘‘(I) the average manufacturer price for the 

rebate period of the line extension of a single 

source drug or an innovator multiple source drug 

that is an oral solid dosage form; 

‘‘(II) the highest additional rebate (calculated 

as a percentage of average manufacturer price) 

under this paragraph for the rebate period for 

any strength of the original single source drug 

or innovator multiple source drug; and 

‘‘(III) the total number of units of each dosage 

form and strength of the line extension product 

paid for under the State plan in the rebate period 

(as reported by the State).’’. 

(b) EFFECTIVE DATE.—The amendments made subsection (a) 

shall apply with respect to rebate periods beginning on or after 

October 1, 2018. 

SEC. 53105. MEDICAID IMPROVEMENT FUND. 

Section 1941(b) of the Social Security Act (42 U.S.C. 1396w– 

1(b)) is amended— 

(1) in paragraph (1), by striking ‘‘$5,000,000’’ and inserting 

‘‘$0’’; and 

(2) in paragraph (3)(A), by striking ‘‘$980,000,000’’ and 

inserting ‘‘$0’’. 

Applicability. 

42 USC 1396r–8 

note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 303 

SEC. 53106. PHYSICIAN FEE SCHEDULE UPDATE. 

Section 1848(d)(18) of the Social Security Act (42 U.S.C. 1395w– 

4(d)(18)) is amended by striking ‘‘paragraph (1)(C)’’ and all that 

follows and inserting the following: ‘‘paragraph (1)(C)— 

‘‘(A) for 2016 and each subsequent year through 2018 

shall be 0.5 percent; and 

‘‘(B) for 2019 shall be 0.25 percent.’’. 

SEC. 53107. PAYMENT FOR OUTPATIENT PHYSICAL THERAPY SERVICES 

AND OUTPATIENT OCCUPATIONAL THERAPY SERVICES 

FURNISHED BY A THERAPY ASSISTANT. 

Section 1834 of the Social Security Act (42 U.S.C. 1395m) 

is amended by adding at the end the following new subsection: 

‘‘(v) PAYMENT FOR OUTPATIENT PHYSICAL THERAPY SERVICES

AND OUTPATIENT OCCUPATIONAL THERAPY SERVICES FURNISHED BY

A THERAPY ASSISTANT.— 

‘‘(1) IN GENERAL.—In the case of an outpatient physical 

therapy service or outpatient occupational therapy service furnished on or after January 1, 2022, for which payment is 

made under section 1848 or subsection (k), that is furnished 

in whole or in part by a therapy assistant (as defined by 

the Secretary), the amount of payment for such service shall 

be an amount equal to 85 percent of the amount of payment 

otherwise applicable for the service under this part. Nothing 

in the preceding sentence shall be construed to change 

applicable requirements with respect to such services. 

‘‘(2) USE OF MODIFIER.— 

‘‘(A) ESTABLISHMENT.—Not later than January 1, 2019, 

the Secretary shall establish a modifier to indicate (in 

a form and manner specified by the Secretary), in the 

case of an outpatient physical therapy service or outpatient 

occupational therapy service furnished in whole or in part 

by a therapy assistant (as so defined), that the service 

was furnished by a therapy assistant. 

‘‘(B) REQUIRED USE.—Each request for payment, or bill 

submitted, for an outpatient physical therapy service or 

outpatient occupational therapy service furnished in whole 

or in part by a therapy assistant (as so defined) on or 

after January 1, 2020, shall include the modifier established under subparagraph (A) for each such service. 

‘‘(3) IMPLEMENTATION.—The Secretary shall implement this 

subsection through notice and comment rulemaking.’’. 

SEC. 53108. REDUCTION FOR NON-EMERGENCY ESRD AMBULANCE 

TRANSPORTS. 

Section 1834(l)(15) of the Social Security Act (42. U.S.C. 

1395m(l)(15)) is amended by striking ‘‘on or after October 1, 2013’’ 

and inserting ‘‘during the period beginning on October 1, 2013, 

and ending on September 30, 2018, and by 23 percent for such 

services furnished on or after October 1, 2018’’. 

SEC. 53109. HOSPITAL TRANSFER POLICY FOR EARLY DISCHARGES 

TO HOSPICE CARE. 

(a) IN GENERAL.—Section 1886(d)(5)(J) of the Social Security 

Act (42 U.S.C. 1395ww(d)(5)(J)) is amended— 

(1) in clause (ii)— 

(A) in subclause (III), by striking ‘‘or’’ at the end; 

Notice. 

Regulation. 

Deadline. 

Time period. 


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132 STAT. 304 PUBLIC LAW 115–123—FEB. 9, 2018 

(B) by redesignating subclause (IV) as subclause (V); 

and 

(C) by inserting after subclause (III) the following new 

subclause: 

‘‘(IV) for discharges occurring on or after October 1, 2018, 

is provided hospice care by a hospice program; or’’; and 

(2) in clause (iv)— 

(A) by inserting after the first sentence the following 

new sentence: ‘‘The Secretary shall include in the proposed 

rule published for fiscal year 2019, a description of the 

effect of clause (ii)(IV).’’; and 

(B) in subclause (I), by striking ‘‘and (III)’’ and inserting 

‘‘(III), and, in the case of proposed and final rules for 

fiscal year 2019 and subsequent fiscal years, (IV)’’. 

(b) MEDPAC EVALUATION AND REPORT.— (1) EVALUATION.—The Medicare Payment Advisory 

Commission (in this subsection referred to as the ‘‘Commission’’) 

shall conduct an evaluation of the effects of the amendments 

made by subsection (a), including the effects on— 

(A) the numbers of discharges of patients from an 

inpatient hospital setting to a hospice program; 

(B) the lengths of stays of patients in an inpatient 

hospital setting who are discharged to a hospice program; 

(C) spending under the Medicare program under title 

XVIII of the Social Security Act; and 

(D) other areas determined appropriate by the Commission. 

(2) CONSIDERATION.—In conducting the evaluation under 

paragraph (1), the Commission shall consider factors such as 

whether the timely access to hospice care by patients admitted 

to a hospital has been affected through changes to hospital 

policies or behaviors made as a result of such amendments. 

(3) PRELIMINARY RESULTS.—Not later than March 15, 2020, 

the Commission shall provide Congress with preliminary 

results on the evaluation being conducted under paragraph 

(1). 

(4) REPORT.—Not later than March 15, 2021, the Commission shall submit to Congress a report on the evaluation conducted under paragraph (1). 

SEC. 53110. MEDICARE PAYMENT UPDATE FOR HOME HEALTH SERVICES. 

Section 1895(b)(3)(B) of the Social Security Act (42 U.S.C. 

1395fff(b)(3)(B)) is amended— 

(1) in clause (iii), in the last sentence, by inserting before 

the period at the end the following: ‘‘and for 2020 shall be 

1.5 percent’’; and 

(2) in clause (vi), by inserting ‘‘and 2020’’ after ‘‘except 

2018’’. 

SEC. 53111. MEDICARE PAYMENT UPDATE FOR SKILLED NURSING 

FACILITIES. 

Section 1888(e)(5)(B) of the Social Security Act (42 U.S.C. 

1395yy(e)(5)(B)) is amended— 

(1) in clause (i), by striking ‘‘and (iii)’’ and inserting ‘‘, 

(iii), and (iv)’’; 

(2) in clause (ii), by striking ‘‘clause (iii)’’ and inserting 

‘‘clauses (iii) and (iv)’’; and 

Deadline. 


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(3) by adding at the end the following new clause: 

‘‘(iv) SPECIAL RULE FOR FISCAL YEAR 2019.—For 

fiscal year 2019 (or other similar annual period specified in clause (i)), the skilled nursing facility market 

basket percentage, after application of clause (ii), is 

equal to 2.4 percent.’’. 

SEC. 53112. PREVENTING THE ARTIFICIAL INFLATION OF STAR 

RATINGS AFTER THE CONSOLIDATION OF MEDICARE 

ADVANTAGE PLANS OFFERED BY THE SAME ORGANIZATION. 

Section 1853(o)(4) of the Social Security Act (42 U.S.C. 1395w– 

23(o)(4)) is amended by adding at the end the following new 

subparagraph: 

‘‘(D) SPECIAL RULE TO PREVENT THE ARTIFICIAL INFLA- TION OF STAR RATINGS AFTER THE CONSOLIDATION OF MEDI- CARE ADVANTAGE PLANS OFFERED BY A SINGLE ORGANIZA- TION.— ‘‘(i) IN GENERAL.—If— 

‘‘(I) a Medicare Advantage organization has 

entered into more than one contract with the Secretary with respect to the offering of Medicare 

Advantage plans; and 

‘‘(II) on or after January 1, 2019, the Secretary 

approves a request from the organization to 

consolidate the plans under one or more contract 

(in this subparagraph referred to as a ‘closed contract’) with the plans offered under a separate 

contract (in this subparagraph referred to as the 

‘continuing contract’); 

with respect to the continuing contract, the Secretary 

shall adjust the quality rating under the 5-star rating 

system and any quality increase under this subsection 

and rebate amounts under section 1854 to reflect an 

enrollment-weighted average of scores or ratings for 

the continuing and closed contracts, as determined 

appropriate by the Secretary. 

‘‘(ii) APPLICATION.—An adjustment under clause 

(i) shall apply for any year for which the quality rating 

of the continuing contract is based primarily on a 

measurement period that is prior to the first year 

in which a closed contract is no longer offered.’’. 

SEC. 53113. SUNSETTING EXCLUSION OF BIOSIMILARS FROM MEDICARE PART D COVERAGE GAP DISCOUNT PROGRAM. 

Section 1860D–14A(g)(2)(A) of the Social Security Act (42 U.S.C. 

1395w–114a(g)(2)(A)) is amended by inserting ‘‘, with respect to 

a plan year before 2019,’’ after ‘‘other than’’. 

SEC. 53114. ADJUSTMENTS TO MEDICARE PART B AND PART D PREMIUM SUBSIDIES FOR HIGHER INCOME INDIVIDUALS. 

(a) IN GENERAL.—Section 1839(i)(3)(C)(i) of the Social Security 

Act (42 U.S.C. 1395r(i)(3)(C)(i)) is amended— 

(1) in subclause (II), in the matter preceding the table, 

by striking ‘‘years beginning with’’; and 

(2) by adding at the end the following new subclause: 

‘‘(III) Subject to paragraph (5), for years beginning with 2019: 

Effective date. 

Contracts. 


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132 STAT. 306 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘If the modified adjusted gross income 

is: ................................................................. The applicable 

percentage is:

More than $85,000 but not more than 

$107,000 ...................................................... 35 percent

More than $107,000 but not more than 

$133,500 ...................................................... 50 percent

More than $133,500 but not more than 

$160,000 ...................................................... 65 percent

More than $160,000 but less than $500,000 80 percent

At least $500,000 ........................................... 85 percent.’’. 

(b) JOINT RETURNS.—Section 1839(i)(3)(C)(ii) of the Social Security Act (42 U.S.C. 1395r(i)(3)(C)(ii)) is amended by inserting before 

the period the following: ‘‘except, with respect to the dollar amounts 

applied in the last row of the table under subclause (III) of such 

clause (and the second dollar amount specified in the second to 

last row of such table), clause (i) shall be applied by substituting 

dollar amounts which are 150 percent of such dollar amounts for 

the calendar year’’. 

(c) INFLATION ADJUSTMENT.—Section 1839(i)(5) of the Social 

Security Act (42 U.S.C. 1395r(i)(5)) is amended— 

(1) in subparagraph (A), by striking ‘‘In the case’’ and 

inserting ‘‘Subject to subparagraph (C), in the case’’; 

(2) in subparagraph (B), by striking ‘‘subparagraph (A)’’ 

and inserting ‘‘subparagraph (A) or (C)’’; and 

(3) by adding at the end the following new subparagraph: 

‘‘(C) TREATMENT OF ADJUSTMENTS FOR CERTAIN HIGHER

INCOME INDIVIDUALS.— 

‘‘(i) IN GENERAL.—Subparagraph (A) shall not 

apply with respect to each dollar amount in paragraph 

(3) of $500,000. 

‘‘(ii) ADJUSTMENT BEGINNING 2028.—In the case of 

any calendar year beginning after 2027, each dollar 

amount in paragraph (3) of $500,000 shall be increased 

by an amount equal to— 

‘‘(I) such dollar amount, multiplied by 

‘‘(II) the percentage (if any) by which the average of the Consumer Price Index for all urban 

consumers (United States city average) for the 12- 

month period ending with August of the preceding 

calendar year exceeds such average for the 12- 

month period ending with August 2026.’’. 

SEC. 53115. MEDICARE IMPROVEMENT FUND. 

Section 1898(b)(1) of the Social Security Act (42 U.S.C. 1395iii(b)(1)) is amended by striking ‘‘$220,000,000’’ and inserting 

‘‘$0’’. 

SEC. 53116. CLOSING THE DONUT HOLE FOR SENIORS. 

(a) CLOSING DONUT HOLE SOONER.—Section 1860D–2(b)(2)(D) 

of the Social Security Act (42 U.S.C. 1395w–102(b)(2)(D))— 

(1) in clause (i), by amending subclause (I) to read as 

follows: 

‘‘(I) equal to the difference between— 

Time periods. 

Applicability. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 307 

‘‘(aa) the applicable gap percentage (specified in clause (ii) for the year); and 

‘‘(bb) the discount percentage specified in 

section 1860D–14A(g)(4)(A) for such applicable 

drugs (or, in the case of a year after 2018, 

50 percent); or’’; and 

(2) in clause (ii)— 

(A) in subclause (IV), by adding ‘‘and’’ at the end; 

(B) by striking subclause (V); and 

(C) in subclause (VI)— 

(i) by striking ‘‘2020’’ and inserting ‘‘2019’’; and 

(ii) by redesignating such subclause as subclause 

(V). 

(b) LOWERING DISCOUNTED PRICE.—Section 1860D–14A(g)(4)(A) 

of the Social Security Act (42 U.S.C. 1395w–114a(g)(4)(A)) is 

amended by inserting ‘‘(or, with respect to a plan year after plan 

year 2018, 30 percent)’’ after ‘‘50 percent’’. 

SEC. 53117. MODERNIZING CHILD SUPPORT ENFORCEMENT FEES. 

(a) IN GENERAL.—Section 454(6)(B)(ii) of the Social Security 

Act (42 U.S.C. 654(6)(B)(ii)) is amended— 

(1) by striking ‘‘$25’’ and inserting ‘‘$35’’; and 

(2) by striking ‘‘$500’’ each place it appears and inserting 

‘‘$550’’. 

(b) EFFECTIVE DATE.— 

(1) IN GENERAL.—The amendments made by subsection 

(a) shall take effect on the 1st day of the 1st fiscal year 

that begins on or after the date of the enactment of this 

Act, and shall apply to payments under part D of title IV 

of the Social Security Act (42 U.S.C. 651 et seq.) for calendar 

quarters beginning on or after such 1st day. 

(2) DELAY PERMITTED IF STATE LEGISLATION REQUIRED.— 

If the Secretary of Health and Human Services determines 

that State legislation (other than legislation appropriating 

funds) is required in order for a State plan developed pursuant 

to part D of title IV of the Social Security Act (42 U.S.C. 

651 et seq.) to meet the requirements imposed by the amendment made by subsection (a), the plan shall not be regarded 

as failing to meet such requirements before the 1st day of 

the 1st calendar quarter beginning after the first regular session of the State legislature that begins after the date of the 

enactment of this Act. For purposes of the preceding sentence, 

if the State has a 2-year legislative session, each year of the 

session is deemed to be a separate regular session of the State 

legislature. 

SEC. 53118. INCREASING EFFICIENCY OF PRISON DATA REPORTING. 

(a) IN GENERAL.—Section 1611(e)(1)(I)(i)(II) of the Social Security Act (42 U.S.C. 1382(e)(1)(I)(i)(II)) is amended by striking ‘‘30 

days’’ each place it appears and inserting ‘‘15 days’’. 

(b) EFFECTIVE DATE.—The amendments made by subsection 

(a) shall apply with respect to any payment made by the Commissioner of Social Security pursuant to section 1611(e)(1)(I)(i)(II) of 

the Social Security Act (42 U.S.C. 1382(e)(1)(I)(i)(II)) (as amended 

by such subsection) on or after the date that is 6 months after 

the date of enactment of this Act. 

Applicability. 

42 USC 1382 

note. 

Time period. 

Determination. 

Applicability. 

42 USC 654 note. 


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132 STAT. 308 PUBLIC LAW 115–123—FEB. 9, 2018 

SEC. 53119. PREVENTION AND PUBLIC HEALTH FUND. 

Section 4002(b) of the Patient Protection and Affordable Care 

Act (42 U.S.C. 300u–11(b)), as amended by section 3103 of Public 

Law 115–96, is amended by striking paragraphs (4) through (9) 

and inserting the following: 

‘‘(4) for fiscal year 2019, $900,000,000; 

‘‘(5) for each of fiscal years 2020 and 2021, $950,000,000; 

‘‘(6) for each of fiscal years 2022 and 2023, $1,000,000,000; 

‘‘(7) for each of fiscal years 2024 and 2025, $1,300,000,000; 

‘‘(8) for each of fiscal years 2026 and 2027, $1,800,000,000; 

and 

‘‘(9) for fiscal year 2028 and each fiscal year thereafter, 

$2,000,000,000.’’. 

DIVISION F—IMPROVEMENTS TO AGRICULTURE 

PROGRAMS 

SEC. 60101. (a) TREATMENT OF SEED COTTON.— 

(1) DESIGNATION OF SEED COTTON AS A COVERED COMMODITY.—Section 1111(6) of the Agricultural Act of 2014 (7 

U.S.C. 9011(6)) is amended— 

(A) by striking ‘‘The term’’ and inserting the following: 

‘‘(A) IN GENERAL.—The term’’; and 

(B) by adding at the end the following: 

‘‘(B) INCLUSION.—Effective beginning with the 2018 

crop year, the term ‘covered commodity’ includes seed 

cotton.’’. 

(2) REFERENCE PRICE FOR SEED COTTON.—Section 1111(18) 

of the Agricultural Act of 2014 (7 U.S.C. 9011(18)) is amended 

by adding at the end the following: 

‘‘(O) For seed cotton, $0.367 per pound.’’. 

(3) DEFINITION OF SEED COTTON.—Section 1111 of the Agricultural Act of 2014 (7 U.S.C. 9011) is amended— 

(A) by redesignating paragraphs (20) through (24) as 

paragraphs (21) through (25), respectively; and 

(B) by inserting after paragraph (19) the following: 

‘‘(20) SEED COTTON.—The term ‘seed cotton’ means 

unginned upland cotton that includes both lint and seed.’’. 

(4) PAYMENT YIELD.—Section 1113 of the Agricultural Act 

of 2014 (7 U.S.C. 9013) is amended by adding at the end 

the following: 

‘‘(e) PAYMENT YIELD FOR SEED COTTON.— 

‘‘(1) PAYMENT YIELD.—Subject to paragraph (2), the payment yield for seed cotton for a farm shall be equal to 2.4 

times the payment yield for upland cotton for the farm established under section 1104(e)(3) of the Food, Conservation, and 

Energy Act of 2008 (7 U.S.C. 8714(e)(3)) (as in effect on September 30, 2013). 

‘‘(2) UPDATE.—At the sole discretion of the owner of a 

farm with a yield for upland cotton described in paragraph 

(1), the owner of the farm shall have a 1-time opportunity 

to update the payment yield for upland cotton for the farm, 

as provided in subsection (d), for the purpose of calculating 

the payment yield for seed cotton under paragraph (1).’’. 

(5) PAYMENT ACRES.—Section 1114(b) of the Agricultural 

Act of 2014 (7 U.S.C. 9014(b)) is amended by adding at the 

end the following: 

Effective date. 

Improvements to 

Agriculture 

Programs Act of 

2018. 

7 USC 9011 note. 


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‘‘(4) SEED COTTON.— ‘‘(A) IN GENERAL.—Not later than 90 days after the 

date of enactment of this paragraph, the Secretary shall 

require the owner of a farm to allocate all generic base 

acres on the farm under subparagraph (B) or (C), or both. 

‘‘(B) NO RECENT HISTORY OF COVERED COMMODITIES.— In the case of a farm on which no covered commodities 

(including seed cotton) were planted or were prevented 

from being planted at any time during the 2009 through 

2016 crop years, the owner of such farm shall allocate 

generic base acres on the farm to unassigned crop base 

for which no payments may be made under section 1116 

or 1117. 

‘‘(C) RECENT HISTORY OF COVERED COMMODITIES.—In 

the case of a farm not described in subparagraph (B), 

the owner of such farm shall allocate generic base acres 

on the farm— 

‘‘(i) subject to subparagraph (D), to seed cotton 

base acres in a quantity equal to the greater of— 

‘‘(I) 80 percent of the generic base acres on 

the farm; or 

‘‘(II) the average number of seed cotton acres 

planted or prevented from being planted on the 

farm during the 2009 through 2012 crop years 

(not to exceed the total generic base acres on the 

farm); or 

‘‘(ii) to base acres for covered commodities 

(including seed cotton), by applying subparagraphs (B), 

(D), (E), and (F) of section 1112(a)(3). 

‘‘(D) TREATMENT OF RESIDUAL GENERIC BASE ACRES.— 

In the case of a farm on which generic base acres are 

allocated under subparagraph (C)(i), the residual generic 

base acres shall be allocated to unassigned crop base for 

which no payments may be made under section 1116 or 

1117. 

‘‘(E) EFFECT OF FAILURE TO ALLOCATE.—In the case 

of a farm not described in subparagraph (B) for which 

the owner of the farm fails to make an election under 

subparagraph (C), the owner of the farm shall be deemed 

to have elected to allocate all generic base acres in accordance with subparagraph (C)(i).’’. 

(6) RECORDKEEPING REGARDING UNASSIGNED CROP BASE.— 

Section 1114 of the Agricultural Act of 2014 (7 U.S.C. 9014) 

is amended by adding at the end the following: 

‘‘(f) UNASSIGNED CROP BASE.—The Secretary shall maintain 

information on generic base acres on a farm allocated as unassigned 

crop base under subsection (b)(4).’’. 

(7) SPECIAL ELECTION PERIOD FOR PRICE LOSS COVERAGE

OR AGRICULTURE RISK COVERAGE.—Section 1115 of the Agricultural Act of 2014 (7 U.S.C. 9015) is amended— 

(A) in subsection (a), by striking ‘‘For’’ and inserting 

‘‘Except as provided in subsection (g), for’’; and 

(B) by adding at the end the following: 

‘‘(g) SPECIAL ELECTION.— 

‘‘(1) IN GENERAL.—In the case of acres allocated to seed 

cotton on a farm, all of the producers on the farm shall be 

given the opportunity to make a new 1-time election under 

Deadline. 


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132 STAT. 310 PUBLIC LAW 115–123—FEB. 9, 2018 

subsection (a) to reflect the designation of seed cotton as a 

covered commodity for that crop year under section 1111(6)(B). 

‘‘(2) EFFECT OF FAILURE TO MAKE UNANIMOUS ELECTION.— 

If all the producers on a farm fail to make a unanimous election 

under paragraph (1), the producers on the farm shall be deemed 

to have elected price loss coverage under section 1116 for acres 

allocated on the farm to seed cotton.’’. 

(8) EFFECTIVE PRICE.—Section 1116 of the Agricultural Act 

of 2014 (7 U.S.C. 9016) is amended by adding at the end 

the following: 

‘‘(h) EFFECTIVE PRICE FOR SEED COTTON.— 

‘‘(1) IN GENERAL.—The effective price for seed cotton under 

subsection (b) shall be equal to the marketing year average 

price for seed cotton, as calculated under paragraph (2). 

‘‘(2) CALCULATION.—The marketing year average price for 

seed cotton for a crop year shall be equal to the quotient 

obtained by dividing— 

‘‘(A) the sum obtained by adding— 

‘‘(i) the product obtained by multiplying— 

‘‘(I) the upland cotton lint marketing year 

average price; and 

‘‘(II) the total United States upland cotton lint 

production, measured in pounds; and 

‘‘(ii) the product obtained by multiplying— 

‘‘(I) the cottonseed marketing year average 

price; and 

‘‘(II) the total United States cottonseed production, measured in pounds; by 

‘‘(B) the sum obtained by adding— 

‘‘(i) the total United States upland cotton lint 

production, measured in pounds; and 

‘‘(ii) the total United States cottonseed production, 

measured in pounds.’’. 

(9) DEEMED LOAN RATE FOR SEED COTTON.—Section 1202 

of the Agricultural Act of 2014 (7 U.S.C. 9032) is amended 

by adding at the end the following: 

‘‘(c) SEED COTTON.— 

‘‘(1) IN GENERAL.—For purposes of section 1116(b)(2) and 

paragraphs (1)(B)(ii) and (2)(A)(ii)(II) of section 1117(b), the 

loan rate for seed cotton shall be deemed to be equal to $0.25 

per pound. 

‘‘(2) EFFECT.—Nothing in this subsection authorizes any 

nonrecourse marketing assistance loan under this subtitle for 

seed cotton.’’. 

(10) LIMITATION ON STACKED INCOME PROTECTION PLAN FOR

PRODUCERS OF UPLAND COTTON.—Section 508B of the Federal 

Crop Insurance Act (7 U.S.C. 1508b) is amended by adding 

at the end the following: 

‘‘(f) LIMITATION.—Effective beginning with the 2019 crop year, 

a farm shall not be eligible for the Stacked Income Protection 

Plan for upland cotton for a crop year for which the farm is enrolled 

in coverage for seed cotton under— 

‘‘(1) price loss coverage under section 1116 of the Agricultural Act of 2014 (7 U.S.C. 9016); or 

‘‘(2) agriculture risk coverage under section 1117 of that 

Act (7 U.S.C. 9017).’’. 

Effective date. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 311 

(11) TECHNICAL CORRECTION.—Section 1114(b)(2) of the 

Agricultural Act of 2014 (7 U.S.C. 9014(b)(2)) is amended by 

striking ‘‘paragraphs (1)(B) and (2)(B)’’ and inserting ‘‘paragraphs (1) and (2)’’. 

(12) ADMINISTRATION.—The Secretary of Agriculture shall 

carry out the amendments made by this subsection in accordance with section 1601 of the Agricultural Act of 2014 (7 U.S.C. 

9091). 

(13) APPLICATION.—Except as provided in paragraph (10), 

the amendments made by this subsection shall apply beginning 

with the 2018 crop year. 

(b) MARGIN PROTECTION PROGRAM FOR DAIRY PRODUCERS.— (1) MONTHLY CALCULATION OF ACTUAL DAIRY PRODUCTION

MARGIN.— 

(A) DEFINITIONS.—Section 1401 of the Agricultural Act 

of 2014 (7 U.S.C. 9051) is amended— 

(i) by striking paragraph (4); and 

(ii) by redesignating paragraphs (5) through (11) 

as paragraphs (4) through (10), respectively. 

(B) CALCULATION OF ACTUAL DAIRY PRODUCTION

MARGIN.—Section 1402(b)(1) of the Agricultural Act of 2014 

(7 U.S.C. 9052(b)(1)) is amended by striking ‘‘consecutive 

2-month period’’ each place it appears and inserting 

‘‘month’’. 

(C) MARGIN PROTECTION PAYMENTS.—Section 1406 of 

the Agricultural Act of 2014 (7 U.S.C. 9056) is amended— 

(i) by striking ‘‘consecutive 2-month period’’ each 

place it appears and inserting ‘‘month’’; and 

(ii) in subsection (c)(2)(B), by striking ‘‘6’’ and 

inserting ‘‘12’’. 

(2) PARTICIPATION OF DAIRY OPERATIONS IN MARGIN PROTECTION PROGRAM.—Section 1404 of the Agricultural Act of 2014 

(7 U.S.C. 9054) is amended— 

(A) in subsection (b)— 

(i) in paragraph (1), by inserting ‘‘, including the 

establishment of a date each calendar year by which 

a dairy operation shall register for the calendar year’’ 

before the period at the end; 

(ii) by redesignating paragraphs (2) and (3) as 

paragraphs (3) and (4), respectively; and 

(iii) by inserting after paragraph (1) the following: 

‘‘(2) EXTENSION OF ELECTION PERIOD FOR 2018 CALENDAR

YEAR.—The Secretary shall extend the election period for the 

2018 calendar year by not less than 90 days after the date 

of enactment of the Bipartisan Budget Act of 2018 or such 

additional period as the Secretary determines is necessary for 

dairy operations to make new elections to participate for that 

calendar year, including dairy operations that elected to so 

participate before that date of enactment.’’; and 

(B) in subsection (c), by adding at the end the following: 

‘‘(4) EXEMPTION.—A limited resource, beginning, veteran, 

or socially disadvantaged farmer, as defined by the Secretary, 

shall be exempt from the administrative fee under this subsection.’’. 

(3) PRODUCTION HISTORY OF PARTICIPATING DAIRY OPER- ATIONS.—Section 1405(a) of the Agricultural Act of 2014 (7 

U.S.C. 9055(a)) is amended by adding at the end the following: 

Deadline. 

Determination. 

Applicability. 

Effective date. 

7 USC 9011 note. 

7 USC 9011 note. 


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132 STAT. 312 PUBLIC LAW 115–123—FEB. 9, 2018 

‘‘(3) CONTINUED APPLICABILITY OF BASE PRODUCTION HISTORY.—A production history established for a dairy operation 

under paragraph (1) shall be the base production history for 

the dairy operation in subsequent years (as adjusted under 

paragraph (2)).’’. 

(4) PREMIUMS FOR MARGIN PROTECTION PROGRAM.—Section 

1407 of the Agricultural Act of 2014 (7 U.S.C. 9057) is 

amended— 

(A) in subsection (b)— 

(i) by striking the subsection heading and inserting 

the following: ‘‘TIER I: PREMIUM PER HUNDREDWEIGHT

FOR FIRST 5,000,000 POUNDS OF PRODUCTION.—’’; 

(ii) in paragraph (1), by striking ‘‘4,000,000’’ and 

inserting ‘‘5,000,000’’; and 

(iii) in paragraph (2)— 

(I) by striking ‘‘$0.010’’ and inserting ‘‘None’’; 

(II) by striking ‘‘$0.025’’ and inserting ‘‘None’’; 

(III) by striking ‘‘$0.040’’ and inserting 

‘‘$0.009’’; 

(IV) by striking ‘‘$0.055’’ and inserting 

‘‘$0.016’’; 

(V) by striking ‘‘$0.090’’ and inserting ‘‘$0.040’’; 

(VI) by striking ‘‘$0.217’’ and inserting 

‘‘$0.063’’; 

(VII) by striking ‘‘$0.300’’ and inserting 

‘‘$0.087’’; and 

(VIII) by striking ‘‘$0.475’’ and inserting 

‘‘$0.142’’; and 

(B) in subsection (c)— 

(i) by striking the subsection heading and inserting 

the following: ‘‘TIER II: PREMIUM PER HUNDREDWEIGHT

FOR PRODUCTION IN EXCESS OF 5,000,000 POUNDS.— 

’’; and 

(ii) in paragraph (1), by striking ‘‘4,000,000’’ and 

inserting ‘‘5,000,000’’. 

(5) APPLICATION.—The amendments made by this subsection shall apply beginning with the 2018 calendar year. 

(c) LIMITATION ON CROP INSURANCE LIVESTOCK-RELATED

EXPENDITURES.— 

(1) IN GENERAL.—Section 523(b) of the Federal Crop Insurance Act (7 U.S.C. 1523(b)) is amended by striking paragraph 

(10). 

(2) CONFORMING AMENDMENTS.—Section 516 of the Federal 

Crop Insurance Act (7 U.S.C. 1516) is amended in subsections 

(a)(2)(C) and (b)(1)(D) by striking ‘‘subsections (a)(3)(E)(ii) and 

(b)(10) of section 523’’ each place it appears and inserting 

‘‘subsection (a)(3)(E)(ii) of that section’’. 

SEC. 60102. (a) Section 1240B of the Food Security Act of 

1985 (16 U.S.C. 3839aa–2) is amended by striking subsection (a) 

and inserting the following: 

‘‘(a) ESTABLISHMENT.—During each of the 2002 through 2019 

fiscal years, the Secretary shall provide payments to producers 

that enter into contracts with the Secretary under the program.’’. 

(b) Section 1241 of the Food Security Act of 1985 (16 U.S.C. 

3841) is amended— 

(1) in subsection (a)— 

Time period. 

Payments. 

Contracts. 

7 USC 9051 note. 


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PUBLIC LAW 115–123—FEB. 9, 2018 132 STAT. 313 

LEGISLATIVE HISTORY—H.R. 1892: 

HOUSE REPORTS: No. 115–119 (Comm. on the Judiciary). 

CONGRESSIONAL RECORD: 

Vol. 163 (2017): May 16, 18, considered and passed House. 

Nov. 28, considered and passed Senate, amended. 

Vol. 164 (2018): Feb. 6, House concurred in Senate amendment with an 

amendment. 

Feb. 7, Senate considered concurring in House amendment 

with an amendment. 

Feb. 8, Senate concurred in House amendment with an 

amendment. House concurred in Senate amendment. 

Æ 

(A) in the matter preceding paragraph (1), by striking 

‘‘2018’’ and inserting ‘‘2018 (and fiscal year 2019 in the 

case of the program specified in paragraph (5))’’; and 

(B) in paragraph (5)(E), by striking ‘‘fiscal year 2018’’ 

and inserting ‘‘each of fiscal years 2018 through 2019’’; 

and 

(2) in subsection (b), by striking ‘‘2018’’ and inserting ‘‘2018 

(and fiscal year 2019 in the case of the program specified 

in subsection (a)(5))’’. 

This division may be cited as the ‘‘Improvements to Agriculture 

Programs Act of 2018’’. 

DIVISION G—BUDGETARY EFFECTS 

SEC. 70101. BUDGETARY EFFECTS. 

(a) IN GENERAL.—The budgetary effects of division A, subdivision 2 of division B, and division C and each succeeding division 

shall not be entered on either PAYGO scorecard maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010. 

(b) SENATE PAYGO SCORECARDS.—The budgetary effects of division A, subdivision 2 of division B, and division C and each succeeding division shall not be entered on any PAYGO scorecard 

maintained for purposes of section 4106 of H. Con. Res. 71 (115th 

Congress). 

(c) CLASSIFICATION OF BUDGETARY EFFECTS.—Notwithstanding 

Rule 3 of the Budget Scorekeeping Guidelines set forth in the 

joint explanatory statement of the committee of conference accompanying Conference Report 105–217 and section 250(c)(8) of the 

Balanced Budget and Emergency Deficit Control Act of 1985, the 

budgetary effects of division A, subdivision 2 of division B, and 

division C and each succeeding division shall not be estimated— 

(1) for purposes of section 251 of such Act; and 

(2) for purposes of paragraph (4)(C) of section 3 of the 

Statutory Pay-As-You-Go Act of 2010 as being included in an 

appropriation Act. 

Approved February 9, 2018. 


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