I 

116TH CONGRESS 

1ST SESSION H. R. 4378 

Making continuing appropriations for fiscal year 2020, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 18, 2019 

Mrs. LOWEY introduced the following bill; which was referred to the Committee on Appropriations, and in addition to the Committee on the Budget, for a period to be subsequently determined by the Speaker, in each 

case for consideration of such provisions as fall within the jurisdiction of 

the committee concerned 

A BILL 

Making continuing appropriations for fiscal year 2020, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Continuing Appropria5 tions Act, 2020, and Health Extenders Act of 2019’’. 

6 SEC. 2. TABLE OF CONTENTS. 

7 The table of contents of this Act is as follows: 

Sec. 1. Short title. 

Sec. 2. Table of Contents. 

Sec. 3. References. 

DIVISION A—CONTINUING APPROPRIATIONS ACT, 2020 


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DIVISION B—HEALTH AND HUMAN SERVICES EXTENDERS AND 

OTHER MATTERS 

TITLE I—PUBLIC HEALTH EXTENDERS 

TITLE II—OTHER HEALTH EXTENDERS 

TITLE III—MEDICAID EXTENDERS 

TITLE IV—MEDICARE EXTENDERS 

TITLE V—HUMAN SERVICES EXTENDERS 

TITLE VI—MISCELLANEOUS POLICIES 

TITLE VII—BUDGETARY EFFECTS 

1 SEC. 3. REFERENCES. 

2 Except as expressly provided otherwise, any reference 

3 to ‘‘this Act’’ contained in any division of this Act shall 

4 be treated as referring only to the provisions of that divi5 sion. 


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1 DIVISION A—CONTINUING 

2 APPROPRIATIONS ACT, 2020 

3 The following sums are hereby appropriated, out of 

4 any money in the Treasury not otherwise appropriated, 

5 and out of applicable corporate or other revenues, receipts, 

6 and funds, for the several departments, agencies, corpora7 tions, and other organizational units of Government for 

8 fiscal year 2020, and for other purposes, namely: 

9 SEC. 101. Such amounts as may be necessary, at a 

10 rate for operations as provided in the applicable appro11 priations Acts for fiscal year 2019 and under the authority 

12 and conditions provided in such Acts, for continuing 

13 projects or activities (including the costs of direct loans 

14 and loan guarantees) that are not otherwise specifically 

15 provided for in this Act, that were conducted in fiscal year 

16 2019, and for which appropriations, funds, or other au17 thority were made available in the following appropriations 

18 Acts: 

19 (1) The Agriculture, Rural Development, Food 

20 and Drug Administration, and Related Agencies Ap21 propriations Act, 2019 (division B of Public Law 

22 116–6), except that the language under the heading 

23 ‘‘Rural Utilities Service—Rural Water and Waste 

24 Disposal Program Account’’ in title III shall be ap25 plied by inserting ‘‘the cost of direct loans,’’ before 


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1 ‘‘loan guarantees’’ at the beginning of the second 

2 sentence in the matter preceding the first proviso. 

3 (2) The Commerce, Justice, Science, and Re4 lated Agencies Appropriations Act, 2019 (division C 

5 of Public Law 116–6), except section 523(b)(6). 

6 (3) The Department of Defense Appropriations 

7 Act, 2019 (division A of Public Law 115–245). 

8 (4) The Energy and Water Development and 

9 Related Agencies Appropriations Act, 2019 (division 

10 A of Public Law 115–244), except section 505. 

11 (5) The Financial Services and General Govern12 ment Appropriations Act, 2019 (division D of Public 

13 Law 116–6). 

14 (6) The Department of Homeland Security Ap15 propriations Act, 2019 (division A of Public Law 

16 116–6) as amended, and title I of division H of Pub17 lic Law 116–6. 

18 (7) The Department of the Interior, Environ19 ment, and Related Agencies Appropriations Act, 

20 2019 (division E of Public Law 116–6). 

21 (8) The Departments of Labor, Health and 

22 Human Services, and Education, and Related Agen23 cies Appropriations Act, 2019 (division B of Public 

24 Law 115–245). 


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1 (9) The Legislative Branch Appropriations Act, 

2 2019 (division B of Public Law 115–244). 

3 (10) The Military Construction, Veterans Af4 fairs, and Related Agencies Appropriations Act, 

5 2019 (division C of Public Law 115–244). 

6 (11) The Department of State, Foreign Oper7 ations, and Related Programs Appropriations Act, 

8 2019 (division F of Public Law 116–6), except sec9 tion 7058(d). 

10 (12) The Transportation, Housing and Urban 

11 Development, and Related Agencies Appropriations 

12 Act, 2019 (division G of Public Law 116–6). 

13 SEC. 102. (a) No appropriation or funds made avail14 able or authority granted pursuant to section 101 for the 

15 Department of Defense shall be used for: 

16 (1) the new production of items not funded for 

17 production in fiscal year 2019 or prior years; 

18 (2) the increase in production rates above those 

19 sustained with fiscal year 2019 funds; or 

20 (3) the initiation, resumption, or continuation 

21 of any project, activity, operation, or organization 

22 (defined as any project, subproject, activity, budget 

23 activity, program element, and subprogram within a 

24 program element, and for any investment items de25 fined as a P–1 line item in a budget activity within 


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1 an appropriation account and an R–1 line item that 

2 includes a program element and subprogram element 

3 within an appropriation account) for which appro4 priations, funds, or other authority were not avail5 able during fiscal year 2019. 

6 (b) No appropriation or funds made available or au7 thority granted pursuant to section 101 for the Depart8 ment of Defense shall be used to initiate multi-year pro9 curements utilizing advance procurement funding for eco10 nomic order quantity procurement unless specifically ap11 propriated later. 

12 SEC. 103. Appropriations made by section 101 shall 

13 be available to the extent and in the manner that would 

14 be provided by the pertinent appropriations Act. 

15 SEC. 104. Except as otherwise provided in section 

16 102, no appropriation or funds made available or author17 ity granted pursuant to section 101 shall be used to ini18 tiate or resume any project or activity for which appro19 priations, funds, or other authority were not available dur20 ing fiscal year 2019. 

21 SEC. 105. Appropriations made and authority grant22 ed pursuant to this Act shall cover all obligations or ex23 penditures incurred for any project or activity during the 

24 period for which funds or authority for such project or 

25 activity are available under this Act. 


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1 SEC. 106. Unless otherwise provided for in this Act 

2 or in the applicable appropriations Act for fiscal year 

3 2020, appropriations and funds made available and au4 thority granted pursuant to this Act shall be available 

5 until whichever of the following first occurs: 

6 (1) The enactment into law of an appropriation 

7 for any project or activity provided for in this Act. 

8 (2) The enactment into law of the applicable 

9 appropriations Act for fiscal year 2020 without any 

10 provision for such project or activity. 

11 (3) November 21, 2019. 

12 SEC. 107. Expenditures made pursuant to this Act 

13 shall be charged to the applicable appropriation, fund, or 

14 authorization whenever a bill in which such applicable ap15 propriation, fund, or authorization is contained is enacted 

16 into law. 

17 SEC. 108. Appropriations made and funds made 

18 available by or authority granted pursuant to this Act may 

19 be used without regard to the time limitations for submis20 sion and approval of apportionments set forth in section 

21 1513 of title 31, United States Code, but nothing in this 

22 Act may be construed to waive any other provision of law 

23 governing the apportionment of funds. 

24 SEC. 109. Notwithstanding any other provision of 

25 this Act, except section 106, for those programs that 


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1 would otherwise have high initial rates of operation or 

2 complete distribution of appropriations at the beginning 

3 of fiscal year 2020 because of distributions of funding to 

4 States, foreign countries, grantees, or others, such high 

5 initial rates of operation or complete distribution shall not 

6 be made, and no grants shall be awarded for such pro7 grams funded by this Act that would impinge on final 

8 funding prerogatives. 

9 SEC. 110. This Act shall be implemented so that only 

10 the most limited funding action of that permitted in the 

11 Act shall be taken in order to provide for continuation of 

12 projects and activities. 

13 SEC. 111. (a) For entitlements and other mandatory 

14 payments whose budget authority was provided in appro15 priations Acts for fiscal year 2019, and for activities under 

16 the Food and Nutrition Act of 2008, activities shall be 

17 continued at the rate to maintain program levels under 

18 current law, under the authority and conditions provided 

19 in the applicable appropriations Act for fiscal year 2019, 

20 to be continued through the date specified in section 

21 106(3). 

22 (b) Notwithstanding section 106, obligations for man23 datory payments due on or about the first day of any 

24 month that begins after October 2019 but not later than 

25 30 days after the date specified in section 106(3) may conVerDate Sep 11 2014 23:40 Sep 18, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H4378.IH H4378

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1 tinue to be made, and funds shall be available for such 

2 payments. 

3 SEC. 112. Amounts made available under section 101 

4 for civilian personnel compensation and benefits in each 

5 department and agency may be apportioned up to the rate 

6 for operations necessary to avoid furloughs within such de7 partment or agency, consistent with the applicable appro8 priations Act for fiscal year 2019, except that such author9 ity provided under this section shall not be used until after 

10 the department or agency has taken all necessary actions 

11 to reduce or defer non-personnel-related administrative ex12 penses. 

13 SEC. 113. Funds appropriated by this Act may be 

14 obligated and expended notwithstanding section 10 of 

15 Public Law 91–672 (22 U.S.C. 2412), section 15 of the 

16 State Department Basic Authorities Act of 1956 (22 

17 U.S.C. 2680), section 313 of the Foreign Relations Au18 thorization Act, Fiscal Years 1994 and 1995 (22 U.S.C. 

19 6212), and section 504(a)(1) of the National Security Act 

20 of 1947 (50 U.S.C. 3094(a)(1)). 

21 SEC. 114. (a) Each amount incorporated by reference 

22 in this Act that was previously designated by the Congress 

23 for Overseas Contingency Operations/Global War on Ter24 rorism or as an emergency requirement pursuant to sec25 tion 251(b)(2)(A) of the Balanced Budget and Emergency 


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1 Deficit Control Act of 1985 or as being for disaster relief 

2 pursuant to section 251(b)(2)(D) of such Act is des3 ignated by the Congress for Overseas Contingency Oper4 ations/Global War on Terrorism or as an emergency re5 quirement pursuant to section 251(b)(2)(A) of such Act 

6 or as being for disaster relief pursuant to section 

7 251(b)(2)(D) of such Act, respectively. 

8 (b) Section 5 of Public Law 116–6 shall apply to 

9 amounts designated in subsection (a) and section 124 of 

10 this Act for Overseas Contingency Operations/Global War 

11 on Terrorism. 

12 (c) This section shall become effective immediately 

13 upon enactment of this Act, and shall remain in effect 

14 through the date in section 106(3). 

15 SEC. 115. (a) Rescissions or cancellations of discre16 tionary budget authority that continue pursuant to section 

17 101 in Treasury Appropriations Fund Symbols (TAFS)— 

18 (1) to which other appropriations are not pro19 vided by this Act, but for which there is a current 

20 applicable TAFS that does receive an appropriation 

21 in this Act; or 

22 (2) which are no-year TAFS and receive other 

23 appropriations in this Act, 

24 may be continued instead by reducing the rate for oper25 ations otherwise provided by section 101 for such current 


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1 applicable TAFS, as long as doing so does not impinge 

2 on the final funding prerogatives of the Congress. 

3 (b) Rescissions or cancellations described in sub4 section (a) shall continue in an amount equal to the lesser 

5 of— 

6 (1) the amount specified for rescission or can7 cellation in the applicable appropriations Act ref8 erenced in section 101 of this Act; or 

9 (2) the amount of balances available, as of Oc10 tober 1, 2019, from the funds specified for rescission 

11 or cancellation in the applicable appropriations Act 

12 referenced in section 101 of this Act. 

13 (c) No later than November 11, 2019, the Director 

14 of the Office of Management and Budget shall provide to 

15 the Committees on Appropriations of the House of Rep16 resentatives and the Senate a comprehensive list of the 

17 rescissions or cancellations that will continue pursuant to 

18 section 101: Provided, That the information in such com19 prehensive list shall be periodically updated to reflect any 

20 subsequent changes in the amount of balances available, 

21 as of October 1, 2019, from the funds specified for rescis22 sion or cancellation in the applicable appropriations Act 

23 referenced in section 101, and such updates shall be trans24 mitted to the Committees on Appropriations of the House 

25 of Representatives and the Senate upon request. 


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1 SEC. 116. Title I of the Additional Supplemental Ap2 propriations for Disaster Relief Act, 2019 (Public Law 

3 116–20) is amended in the matter under the heading ‘‘De4 partment of Agriculture—Office of the Secretary’’ by in5 serting ‘‘to cooperative processors for reduced quantity 

6 and quality sugar beets,’’ after ‘‘planting in 2019,’’: Pro7 vided, That amounts repurposed pursuant to this section 

8 that were previously designated by the Congress as an 

9 emergency requirement pursuant to the Balanced Budget 

10 and Emergency Deficit Control Act of 1985 are des11 ignated by the Congress as an emergency requirement 

12 pursuant to section 251(b)(2)(A)(i) of the Balanced Budg13 et and Emergency Deficit Control Act of 1985 and shall 

14 be available only if the President subsequently so des15 ignates all such amounts and transmits such designations 

16 to the Congress. 

17 SEC. 117. The Secretary of Agriculture may waive 

18 the matching funds requirement under Section 412(g) of 

19 the Agricultural Research, Extension, and Education Re20 form Act of 1998 (7 U.S.C. 7632(g)). 

21 SEC. 118. Amounts made available by section 101 for 

22 ‘‘Department of Agriculture—Food and Nutrition Serv23 ice—Child Nutrition Programs’’ to carry out section 

24 749(g) of the Agriculture, Rural Development, Food and 

25 Drug Administration, and Related Agencies AppropriaVerDate Sep 11 2014 23:40 Sep 18, 2019 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H4378.IH H4378

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1 tions Act, 2010 (Public Law 111–80) may be apportioned 

2 up to the rate for operations necessary to ensure that the 

3 program can be fully operational by May 2020. 

4 SEC. 119. Amounts provided by section 111 to the 

5 Department of Agriculture for ‘‘Corporations—Com6 modity Credit Corporation Fund—Reimbursement for Net 

7 Realized Losses’’ may be used, prior to the completion of 

8 the report described in section 2 of the Act of August 17, 

9 1961 (15 U.S.C. 713a–11), to reimburse the Commodity 

10 Credit Corporation for net realized losses sustained, but 

11 not previously reimbursed, as of September 17, 2019: Pro12 vided, That the Secretary of Agriculture shall submit a 

13 report, no later than October 31, 2019, to the Committees 

14 on Appropriations and Agriculture of both Houses of Con15 gress, including estimates for all Market Facilitation Pro16 gram payments, in calendar year 2018 and 2019 and pro17 jected payments in calendar year 2020 resulting from the 

18 calendar year 2019 program that include State-by-State, 

19 commodity-by-commodity, including specialty crops, anal20 ysis of the trade damage caused by retaliatory tariffs and 

21 separately by non-tariff trade barriers, including dumping, 

22 on U.S. agricultural producers, and an accounting of any 

23 commodity purchases made from substantially foreign24 owned companies or their subsidiaries. 


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1 SEC. 120. In addition to amounts provided by section 

2 101, amounts are provided for ‘‘Department of Agri3 culture—Agricultural Marketing Service—Marketing 

4 Services’’ at a rate for operations of $16,496,000 to con5 tinue the implementation of the Hemp Production Pro6 gram (section 10113 of Public Law 115–334). 

7 SEC. 121. Amounts made available by section 101 for 

8 ‘‘International Trade Commission—Salaries and Ex9 penses’’ may be apportioned up to the rate for operations 

10 necessary to carry out responsibilities under the American 

11 Manufacturing Competitiveness Act of 2016 (Public Law 

12 114–159). 

13 SEC. 122. Amounts made available by section 101 to 

14 the Department of Commerce for ‘‘Bureau of the Cen15 sus—Periodic Censuses and Programs’’ may be appor16 tioned up to the rate for operations necessary to maintain 

17 the schedule and deliver the required data according to 

18 the statutory deadlines in the 2020 Decennial Census Pro19 gram. 

20 SEC. 123. Notwithstanding section 2208(l)(3) of title 

21 10, United States Code, during the period covered by this 

22 Act, any advanced billing for background investigation 

23 services and related services purchased from activities fi24 nanced using Defense Working Capital Funds shall be ex25 cluded from the calculation of cumulative advance billings 


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1 under section 2208(l)(3) of such title. In the preceding 

2 sentence, the term ‘‘advance billing’’ has the meaning 

3 given the term in section 2208(l)(4) of such title. 

4 SEC. 124. (a) The remaining unobligated balances of 

5 funds as of September 30, 2019, from amounts provided 

6 by section 9013 of division A of Public Law 115–245 are 

7 hereby rescinded: Provided, That such amounts that were 

8 previously designated by the Congress as being for Over9 seas Contingency Operations/Global War on Terrorism 

10 pursuant to section 251(b)(2)(A)(ii) of the Balanced 

11 Budget and Emergency Deficit Control Act of 1985 are 

12 designated by the Congress as being for Overseas Contin13 gency Operations/Global War on Terrorism pursuant to 

14 that section of that Act. 

15 (b) In addition to the amount otherwise provided by 

16 section 101 for the ‘‘Ukraine Security Assistance Initia17 tive’’, there is appropriated on September 30, 2019, for 

18 an additional amount for fiscal year 2019, an amount 

19 equal to the unobligated balances rescinded pursuant to 

20 subsection (a) of this section: Provided, That amounts 

21 made available pursuant to this subsection shall remain 

22 available until September 30, 2020, and shall be available 

23 for the same purposes and under the same authorities for 

24 which they were originally provided in Public Law 115– 

25 245: Provided further, That such amount is designated by 


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1 the Congress as being for Overseas Contingency Oper2 ations/Global War on Terrorism pursuant to section 

3 251(b)(2)(A)(ii) of the Balanced Budget and Emergency 

4 Deficit Control Act of 1985. 

5 (c) This section shall become effective immediately 

6 upon enactment of this Act. 

7 (d) If this Act is enacted after September 30, 2019, 

8 or if the designation in subsection 114(b) occurs after Sep9 tember 30, 2019, this section shall be applied as if it were 

10 in effect on September 30, 2019. 

11 SEC. 125. (a) No funds shall be transferred directly 

12 from ‘‘Department of Energy—Power Marketing Admin13 istration—Colorado River Basins Power Marketing Fund, 

14 Western Area Power Administration’’ to the general fund 

15 of the Treasury in fiscal year 2019. 

16 (b) This section shall become effective immediately 

17 upon enactment of this Act. 

18 SEC. 126. During the period covered by this Act, title 

19 I of Public Law 108–361, as amended (the Calfed Bay20 Delta Authorization Act) (118 Stat. 1681), shall be ap21 plied by substituting ‘‘2020’’ for ‘‘2019’’ each place it ap22 pears. 

23 SEC. 127. Notwithstanding section 101, title I of divi24 sion D of Public Law 116–6 shall be applied by adding 

25 the following new heading and appropriation language 


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1 under the heading ‘‘Department of the Treasury—Depart2 mental Offices’’: 

3 ‘‘COMMITTEE ON FOREIGN INVESTMENT IN 

4 THE UNITED STATES FUND 

5 ‘‘For necessary expenses of the Committee on For6 eign Investment in the United States, $15,000,000, to re7 main available until expended: Provided, That the chair8 person of the Committee may transfer such amounts to 

9 any department or agency represented on the Committee 

10 (including the Department of the Treasury) subject to ad11 vance notification to the Committees on Appropriations of 

12 the House of Representatives and the Senate: Provided 

13 further, That amounts so transferred shall remain avail14 able until expended for expenses of implementing section 

15 721 of the Defense Production Act of 1950, as amended 

16 (50 U.S.C. 4565), and shall be available in addition to 

17 any other funds available to any department or agency: 

18 Provided further, That fees authorized by section 721(p) 

19 of such Act shall be credited to this appropriation as off20 setting collections: Provided further, That the total amount 

21 appropriated pursuant to this section from the general 

22 fund shall be reduced as such offsetting collections are re23 ceived during this fiscal year, so as to result in a total 

24 appropriation from the general fund estimated at not more 

25 than $5,000,000.’’. 


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1 SEC. 128. Notwithstanding any other provision of 

2 this Act, except section 106, the District of Columbia may 

3 expend local funds made available under the heading ‘‘Dis4 trict of Columbia—District of Columbia Funds’’ for such 

5 programs and activities under the District of Columbia 

6 Appropriations Act, 2019 (title IV of division D of Public 

7 Law 116–6) at the rate set forth in the Fiscal Year 2020 

8 Local Budget Act of 2019 (D.C. Act 23–78), as modified 

9 as of the date of enactment of this Act. 

10 SEC. 129. In addition to amounts provided by section 

11 101, amounts are provided to the Office of Personnel 

12 Management for ‘‘Salaries and Expenses’’ at a rate for 

13 operations of $48,000,000, for an additional amount for 

14 administrative expenses: Provided, That of such amounts, 

15 $29,760,000 shall be transferred from the appropriate 

16 trust funds of the Office without regard to any other pro17 vision of law: Provided further, That such amounts may 

18 be apportioned up to the rate for operations necessary to 

19 maintain agency operations. 

20 SEC. 130. Notwithstanding section 101, the matter 

21 preceding the first proviso under the heading ‘‘Small Busi22 ness Administration—Business Loans Program Account’’ 

23 in title V of division D of Public Law 116–6 shall be ap24 plied as if the following were inserted before the colon: 

25 ‘‘, and for the cost of guaranteed loans as authorized by 


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1 section 7(a) of the Small Business Act (Public Law 83– 

2 163), $99,000,000, to remain available until expended’’: 

3 Provided, That amounts made available under such head4 ing by this Act may be apportioned up to the rate for oper5 ations necessary to accommodate increased demand for 

6 commitments for general business loans authorized under 

7 section 7(a) of the Small Business Act (15 U.S.C. 636(a)). 

8 SEC. 131. Notwithstanding section 101, amounts are 

9 provided for ‘‘Small Business Administration—Disaster 

10 Loans Program Account’’ at a rate for operations of 

11 $177,136,000: Provided, That amounts made available 

12 under such heading by this Act may be apportioned up 

13 to the rate for operations necessary to accommodate in14 creased demand for commitments for disaster administra15 tive expenses authorized under section 20(a) of the Small 

16 Business Act (15 U.S.C. 631): Provided further, That the 

17 language under such heading in title V of division D of 

18 Public Law 116–6 shall be applied by— 

19 (1) substituting ‘‘$1,600,000’’ for 

20 ‘‘$1,000,000’’; 

21 (2) substituting ‘‘$8,400,000’’ for 

22 ‘‘$9,000,000’’; and 

23 (3) inserting the following before the period: ‘‘; 

24 and of which $167,136,000 is for direct administra25 tive expenses of loan making and servicing to carry 


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1 out the direct loan program, which may be trans2 ferred to and merged with the appropriations for 

3 Salaries and Expenses: Provided, That, of the funds 

4 provided under this heading, $150,888,000 shall be 

5 for major disasters declared pursuant to the Robert 

6 T. Stafford Disaster Relief and Emergency Assist7 ance Act (42 U.S.C. 5122(2)): Provided further, 

8 That the amount for major disasters under this 

9 heading is designated by Congress as being for dis10 aster relief pursuant to section 251(b)(2)(D) of the 

11 Balanced Budget and Emergency Deficit Control 

12 Act of 1985 (Public Law 99–177)’’. 

13 SEC. 132. Amounts made available by section 101 to 

14 the Department of Homeland Security for ‘‘United States 

15 Secret Service—Operations and Support’’ may be appor16 tioned up to the rate for operations necessary to support 

17 hiring and operations required for protective activities as18 sociated with the 2020 presidential election campaign. 

19 SEC. 133. Amounts made available by section 101 to 

20 the Department of Homeland Security for ‘‘Federal Emer21 gency Management Agency—Disaster Relief Fund’’ may 

22 be apportioned up to the rate for operations necessary to 

23 carry out response and recovery activities under the Rob24 ert T. Stafford Disaster Relief and Emergency Assistance 

25 Act (42 U.S.C. 5121 et seq.). 


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1 SEC. 134. (a) Sections 1309(a) and 1319 of the Na2 tional Flood Insurance Act of 1968 (42 U.S.C. 4016(a) 

3 and 4026) shall be applied by substituting the date speci4 fied in section 106(3) of this Act for ‘‘September 30, 

5 2019’’. 

6 (b) If this Act is enacted after September 30, 2019, 

7 this section shall be applied as if it were in effect on Sep8 tember 30, 2019. 

9 SEC. 135. Amounts made available by section 101 to 

10 the Department of Homeland Security for ‘‘Office of the 

11 Secretary and Executive Management—Operations and 

12 Support’’, ‘‘Management Directorate—Operations and 

13 Support’’, and ‘‘Intelligence, Analysis, and Operations Co14 ordination—Operations and Support’’ may be apportioned 

15 up to the rate for operations necessary to carry out activi16 ties previously funded by the Working Capital Fund of 

17 the Department of Homeland Security, consistent with the 

18 fiscal year 2020 President’s Budget. 

19 SEC. 136. (a) In addition to amounts provided by sec20 tion 101, amounts are provided to the ‘‘Department of 

21 Health and Human Services—Indian Health Service—In22 dian Health Services’’ at a rate for operations of 

23 $18,397,500, for an additional amount for costs of staff24 ing and operating facilities that were opened, renovated, 

25 or expanded in fiscal years 2019 and 2020, and such 


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1 amounts may be apportioned up to the rate for operations 

2 necessary to staff and operate such facilities. 

3 (b) In addition to amounts provided by section 101, 

4 amounts are provided for ‘‘Department of Health and 

5 Human Services—Indian Health Service—Indian Health 

6 Facilities’’ at a rate for operations of $631,000, for an 

7 additional amount for costs of staffing and operating fa8 cilities that were opened, renovated, or expanded in fiscal 

9 years 2019 and 2020, and such amounts may be appor10 tioned up to the rate for operations necessary to staff and 

11 operate such facilities. 

12 SEC. 137. Amounts made available by section 101 to 

13 the Department of Health and Human Services for ‘‘Cen14 ters for Disease Control and Prevention—Public Health 

15 Preparedness and Response’’ and ‘‘Office of the Sec16 retary—Public Health and Social Services Emergency 

17 Fund’’ may be obligated in the account and budget struc18 ture, and under the authorities and conditions, set forth 

19 in H.R. 2740, as passed by the U.S. House of Representa20 tives on June 19, 2019. 

21 SEC. 138. During the period covered by this Act, up 

22 to $20,000,000 of the unobligated amounts in the Infec23 tious Diseases Rapid Response Reserve Fund established 

24 by section 231 of division B of Public Law 115–245 may 

25 be transferred to ‘‘Department of Health and Human 


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1 Services—Centers for Disease Control and Prevention— 

2 CDC–Wide Activities and Program Support’’ and shall be 

3 available until expended for Ebola preparedness and re4 sponse activities without regard to the limitations in the 

5 third proviso in such section 231: Provided, That the Di6 rector of the Centers for Disease Control and Prevention 

7 may transfer such amounts to any of the appropriations 

8 accounts under the heading ‘‘Centers for Disease Control 

9 and Prevention’’ for Ebola response activities: Provided 

10 further, That such transfer authority shall be in addition 

11 to any other transfer authority provided to the Depart12 ment of Health and Human Services. 

13 SEC. 139. Section 114(f) of the Higher Education 

14 Act of 1965 (20 U.S.C. 1011c(f)) shall be applied by sub15 stituting the date specified in section 106(3) of this Act 

16 for ‘‘September 30, 2019’’. 

17 SEC. 140. Amounts made available by section 101 for 

18 ‘‘Department of Veterans Affairs—Veterans Benefits Ad19 ministration—General Operating Expenses, Veterans 

20 Benefits Administration’’ and ‘‘Department of Veterans 

21 Affairs—Departmental Administration—Information 

22 Technology Systems’’ may be apportioned up to the rate 

23 for operations necessary to support projects and activities 

24 created by the Blue Water Navy Vietnam Veterans Act 

25 of 2019 (Public Law 116–23). 


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1 SEC. 141. Section 7 of the Export-Import Bank Act 

2 of 1945 (12 U.S.C. 635f) shall be applied by substituting 

3 the date specified in section 106(3) of this Act for ‘‘Sep4 tember 30, 2019’’. 

5 SEC. 142. Section 209 of the International Religious 

6 Freedom Act of 1998 (22 U.S.C. 6436) shall be applied 

7 by substituting the date specified in section 106(3) of this 

8 Act for ‘‘September 30, 2019’’. 

9 SEC. 143. Title I of division L of Public Law 115– 

10 141 and title I of division G of Public Law 116–6 shall 

11 be amended in the first provisos in each Act under the 

12 headings ‘‘Department of Transportation—Federal Tran13 sit Administration—Capital Investment Grants’’ by strik14 ing ‘‘obligated’’ and inserting ‘‘allocated’’. 

15 SEC. 144. Section 9503(e)(4) of the Internal Revenue 

16 Code of 1986 shall not apply during the period covered 

17 by this Act. 

18 SEC. 145. Amounts made available by section 101 to 

19 the Department of Housing and Urban Development for 

20 ‘‘Housing Programs—Housing for the Elderly’’ may be 

21 apportioned up to the rate for operations necessary to 

22 maintain project rental assistance for the elderly under 

23 section 202(c)(2) of the Housing Act of 1959 (12 U.S.C. 

24 1701q(c)(2)), including making amendments to contracts 


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1 for such assistance and renewing expiring contracts for 

2 such assistance for up to a 1-year term. 

3 This division may be cited as the ‘‘Continuing Appro4 priations Act, 2020’’. 


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1 DIVISION B—HEALTH AND 

2 HUMAN SERVICES EXTEND3 ERS AND OTHER MATTERS 

4 TITLE I—PUBLIC HEALTH 

5 EXTENDERS 

6 SEC. 1101. EXTENSION FOR COMMUNITY HEALTH CENTERS, 

7 THE NATIONAL HEALTH SERVICE CORPS, 

8 AND TEACHING HEALTH CENTERS THAT OP9 ERATE GME PROGRAMS. 

10 (a) COMMUNITY HEALTH CENTERS.—Section 

11 10503(b)(1)(F) of the Patient Protection and Affordable 

12 Care Act (42 U.S.C. 254b–2(b)(1)(F)) is amended by 

13 striking ‘‘2018 and $4,000,000,000 for fiscal year 2019.’’ 

14 and inserting ‘‘2018, $4,000,000,000 for fiscal year 2019, 

15 and $569,863,014 for the period beginning on October 1, 

16 2019, and ending on November 21, 2019; and’’. 

17 (b) NATIONAL HEALTH SERVICE CORPS.—Section 

18 10503(b)(2) of the Patient Protection and Affordable 

19 Care Act (42 U.S.C. 254b–2(b)(2)) is amended— 

20 (1) in subparagraph (E), by striking ‘‘; and’’ 

21 and inserting a semicolon; 

22 (2) in subparagraph (F), by striking the period 

23 at the end and inserting ‘‘; and’’; and 

24 (3) by adding at the end the following: 


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1 ‘‘(G) $44,164,384 for the period beginning 

2 on October 1, 2019, and ending on November 

3 21, 2019.’’. 

4 (c) TEACHING HEALTH CENTERS THAT OPERATE

5 GRADUATE MEDICAL EDUCATION PROGRAMS.—Section 

6 340H(g)(1) of the Public Health Service Act (42 U.S.C. 

7 256h(g)(1)) is amended— 

8 (1) by striking ‘‘and $126,500,000’’ and insert9 ing ‘‘$126,500,000’’; and 

10 (2) by inserting ‘‘and $18,021,918 for the pe11 riod beginning on October 1, 2019, and ending on 

12 November 21, 2019,’’ before ‘‘to remain available’’. 

13 (d) APPLICATION OF PROVISIONS.—Amounts appro14 priated pursuant to this section for the period beginning 

15 on October 1, 2019, and ending on November 21, 2019, 

16 shall be subject to the requirements contained in Public 

17 Law 115–245 for funds for programs authorized under 

18 sections 330 through 340 of the Public Health Service Act 

19 (42 U.S.C. 254 through 256). 

20 (e) CONFORMING AMENDMENT.—Paragraph (4) of 

21 section 3014(h) of title 18, United States Code, as amend22 ed by section 50901 of Public Law 115–123, is amended 

23 by striking ‘‘and section 50901(e) of the Advancing 

24 Chronic Care, Extenders, and Social Services Act’’ and in25 serting ‘‘, section 50901(e) of the Advancing Chronic 


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1 Care, Extenders, and Social Services Act, and section 

2 1101(d) of division B of the Continuing Appropriations 

3 Act, 2020, and Health Extenders Act of 2019’’. 

4 SEC. 1102. DIABETES PROGRAMS. 

5 (a) TYPE I.—Section 330B(b)(2)(D) of the Public 

6 Health Service Act (42 U.S.C. 254c–2(b)(2)(D)) is 

7 amended by inserting ‘‘and $21,369,863 for the period be8 ginning on October 1, 2019, and ending on November 21, 

9 2019,’’ before ‘‘to remain available’’. 

10 (b) INDIANS.—Section 330C(c)(2)(D) of the Public 

11 Health Service Act (42 U.S.C. 254c–3(c)(2)(D)) is 

12 amended by inserting ‘‘and $21,369,863 for the period be13 ginning on October 1, 2019, and ending on November 21, 

14 2019,’’ before ‘‘to remain available’’. 

15 TITLE II—OTHER HEALTH 

16 EXTENDERS 

17 SEC. 1201. EXTENSION OF SEXUAL RISK AVOIDANCE EDU18 CATION PROGRAM. 

19 Section 510 of the Social Security Act (42 U.S.C. 

20 710) is amended— 

21 (1) in subsection (a)— 

22 (A) in paragraph (1)— 

23 (i) in the matter preceding subpara24 graph (A)— 


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1 (I) by inserting after ‘‘for each of 

2 fiscal years 2018 and 2019’’ the fol3 lowing: ‘‘and for the period beginning 

4 October 1, 2019, and ending Novem5 ber 21, 2019’’; and 

6 (II) by inserting after ‘‘for the 

7 fiscal year’’ the following: ‘‘(or, with 

8 respect to such period, for fiscal year 

9 2020)’’; and 

10 (ii) in subparagraph (A), by striking 

11 ‘‘for the fiscal year’’ each place it appears 

12 and inserting ‘‘for the fiscal year or pe13 riod’’ in each such place; and 

14 (B) in paragraph (2)— 

15 (i) in subparagraph (A)— 

16 (I) by inserting after ‘‘for each of 

17 fiscal years 2018 and 2019’’ the fol18 lowing: ‘‘and for the period beginning 

19 October 1, 2019, and ending Novem20 ber 21, 2019’’; and 

21 (II) by inserting after ‘‘for the 

22 fiscal year’’ the following: ‘‘(or, with 

23 respect to such period, for fiscal year 

24 2020)’’; and 


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1 (ii) in subparagraph (B)(i), by insert2 ing after ‘‘for the fiscal year’’ the fol3 lowing: ‘‘(or, with respect to such period, 

4 for fiscal year 2020)’’; and 

5 (2) in subsection (f)— 

6 (A) in paragraph (1), by inserting after 

7 ‘‘for each of fiscal years 2018 and 2019’’ the 

8 following: ‘‘and $10,684,931 for the period be9 ginning October 1, 2019, and ending November 

10 21, 2019’’; and 

11 (B) in paragraph (2), by inserting after 

12 ‘‘for each of fiscal years 2018 and 2019’’ the 

13 following: ‘‘and for the period described in para14 graph (1)’’. 

15 SEC. 1202. EXTENSION OF PERSONAL RESPONSIBILITY 

16 EDUCATION PROGRAM. 

17 Section 513 of the Social Security Act (42 U.S.C. 

18 713) is amended— 

19 (1) in subsection (a)— 

20 (A) in paragraph (1)— 

21 (i) in subparagraph (A)— 

22 (I) in the matter preceding clause 

23 (i), by inserting after ‘‘for each of fis24 cal years 2010 through 2019’’ the fol25 lowing: ‘‘and for the period beginning 


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1 October 1, 2019, and ending Novem2 ber 21, 2019’’; and 

3 (II) in clause (i), by inserting 

4 after ‘‘for the fiscal year’’ the fol5 lowing: ‘‘or period’’; 

6 (ii) in subparagraph (B)(i), by adding 

7 at the end the following new sentence: 

8 ‘‘The previous sentence shall not apply 

9 with respect to State allotments under this 

10 paragraph for the period beginning Octo11 ber 1, 2019, and ending November 21, 

12 2019.’’; and 

13 (iii) in subparagraph (C)(i)— 

14 (I) by inserting after ‘‘for a fiscal 

15 year’’ the following: ‘‘or the period de16 scribed in subparagraph (A)’’; and 

17 (II) by inserting after ‘‘for the 

18 fiscal year’’ the following: ‘‘or period’’; 

19 (B) in paragraph (3)— 

20 (i) by inserting after ‘‘for a fiscal 

21 year’’ the following: ‘‘or the period de22 scribed in paragraph (1)(A)’’; and 

23 (ii) by striking ‘‘the end of the second 

24 succeeding fiscal year’’ and inserting ‘‘the 


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1 end of the second fiscal year following such 

2 fiscal year or period’’; and 

3 (C) in paragraph (4)— 

4 (i) in subparagraph (A)— 

5 (I) by inserting after ‘‘for each of 

6 fiscal years 2010 through 2019’’ the 

7 following: ‘‘and for the period de8 scribed in paragraph (1)(A)’’; 

9 (II) by inserting after ‘‘for each 

10 of fiscal years 2012 through 2019’’ 

11 the following: ‘‘and for the period so 

12 described’’; and 

13 (III) by inserting after ‘‘for a fis14 cal year’’ the following: ‘‘or the period 

15 so described’’; and 

16 (ii) in subparagraph (B)(i), by strik17 ing ‘‘continue through fiscal year 2019’’ 

18 and inserting ‘‘continue through the period 

19 described in paragraph (1)(A)’’; 

20 (2) in subsection (c)— 

21 (A) in paragraph (1), by striking ‘‘From 

22 the amount’’ and inserting ‘‘Subject to para23 graph (3), from the amount’’; 


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1 (B) in paragraph (2), by striking ‘‘From 

2 the amount’’ and inserting ‘‘Subject to para3 graph (3), from the amount’’; and 

4 (C) by adding at the end the following new 

5 paragraph: 

6 ‘‘(3) EXCEPTION.—Paragraphs (1) and (2) 

7 shall not apply with respect to any amount appro8 priated under subsection (f) for the period described 

9 in subsection (a)(1)(A).’’; and 

10 (3) in subsection (f), by inserting after ‘‘for 

11 each of fiscal years 2010 through 2019’’ the fol12 lowing: ‘‘and $10,684,931 for the period beginning 

13 October 1, 2019, and ending November 21, 2019’’. 

14 TITLE III—MEDICAID 

15 EXTENDERS 

16 SEC. 1301. EXTENSION OF COMMUNITY MENTAL HEALTH 

17 SERVICES DEMONSTRATION PROGRAM. 

18 Section 223(d)(3) of the Protecting Access to Medi19 care Act of 2014 (42 U.S.C. 1396a note) is amended by 

20 striking ‘‘September 13, 2019’’ and inserting ‘‘November 

21 21, 2019’’. 


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1 SEC. 1302. TEMPORARY INCREASE IN FEDERAL MEDICAL 

2 ASSISTANCE PERCENTAGE FOR TERRITORIES 

3 UNDER MEDICAID PROGRAM. 

4 Section 1905 of the Social Security Act (42 U.S.C. 

5 1396d) is amended— 

6 (1) in subsection (b), by striking ‘‘and (aa)’’ 

7 and inserting ‘‘(aa), and (ff)’’; and 

8 (2) by adding at the end the following new sub9 section: 

10 ‘‘(ff) TEMPORARY INCREASE IN FMAP FOR TERRI11 TORIES.—Notwithstanding subsection (b) or (z)(2), the 

12 Federal medical assistance percentage for Puerto Rico, the 

13 Virgin Islands, Guam, the Northern Mariana Islands, and 

14 American Samoa shall be equal to 100 percent for the pe15 riod beginning October 1, 2019, and ending November 21, 

16 2019.’’. 

17 SEC. 1303. DELAY OF REDUCTIONS IN MEDICAID DSH AL18 LOTMENTS. 

19 Section 1923(f)(7)(A) of the Social Security Act (42 

20 U.S.C. 1396r–4(f)(7)(A)) is amended— 

21 (1) in clause (i), in the matter preceding sub22 clause (I), by striking ‘‘For each of fiscal years 2020 

23 through 2025’’ and inserting ‘‘For the period begin24 ning November 22, 2019, and ending September 30, 

25 2020, and for each of fiscal years 2021 through 

26 2025’’; and 


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1 (2) in clause (ii)(I), by striking ‘‘for fiscal year 

2 2020’’ and inserting ‘‘for the period beginning No3 vember 22, 2019, and ending September 30, 2020’’. 

4 TITLE IV—MEDICARE 

5 EXTENDERS 

6 SEC. 1401. EXTENSION OF FUNDING FOR QUALITY MEAS7 URE ENDORSEMENT, INPUT, AND SELECTION. 

8 Section 1890(d)(2) of the Social Security Act (42 

9 U.S.C. 1395aaa(d)(2)) is amended— 

10 (1) in the first sentence— 

11 (A) by striking ‘‘and $7,500,000’’ and in12 serting ‘‘$7,500,000’’; and 

13 (B) by inserting before the period at the 

14 end the following: ‘‘, and $1,069,000 for the pe15 riod beginning on October 1, 2019, and ending 

16 on November 21, 2019’’; and 

17 (2) in the third sentence, by inserting ‘‘and for 

18 the period beginning on October 1, 2019, and ending 

19 on November 21, 2019,’’ after ‘‘2019’’. 

20 SEC. 1402. EXTENSION OF FUNDING OUTREACH AND AS21 SISTANCE FOR LOW-INCOME PROGRAMS. 

22 (a) ADDITIONAL FUNDING FOR STATE HEALTH IN23 SURANCE PROGRAMS.—Subsection (a)(1)(B) of section 

24 119 of the Medicare Improvements for Patients and Pro25 viders Act of 2008 (42 U.S.C. 1395b–3 note), as amended 


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1 by section 3306 of the Patient Protection and Affordable 

2 Care Act (Public Law 111–148), section 610 of the Amer3 ican Taxpayer Relief Act of 2012 (Public Law 112–240), 

4 section 1110 of the Pathway for SGR Reform Act of 2013 

5 (Public Law 113–67), section 110 of the Protecting Ac6 cess to Medicare Act of 2014 (Public Law 113–93), sec7 tion 208 of the Medicare Access and CHIP Reauthoriza8 tion Act of 2015 (Public Law 114–10), and section 50207 

9 of division E of the Bipartisan Budget Act of 2018 (Public 

10 Law 115–123), is amended— 

11 (1) in clause (vii), by striking ‘‘and’’ at the end; 

12 (2) in clause (viii), by striking ‘‘and’’ at the 

13 end; 

14 (3) in clause (ix), by striking the period at the 

15 end and inserting ‘‘; and’’; and 

16 (4) by inserting after clause (ix) the following 

17 new clause: 

18 ‘‘(x) for the period beginning on Octo19 ber 1, 2019, and ending on November 21, 

20 2019, of $1,852,000.’’. 

21 (b) ADDITIONAL FUNDING FOR AREA AGENCIES ON

22 AGING.—Subsection (b)(1)(B) of such section 119, as so 

23 amended, is amended— 

24 (1) in clause (vii), by striking ‘‘and’’ at the end; 


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1 (2) in clause (viii), by striking ‘‘and’’ at the 

2 end; 

3 (3) in clause (ix), by striking the period at the 

4 end and inserting ‘‘; and’’; and 

5 (4) by inserting after clause (ix) the following 

6 new clause: 

7 ‘‘(x) for the period beginning on Octo8 ber 1, 2019, and ending on November 21, 

9 2019, of $1,069,000.’’. 

10 (c) ADDITIONAL FUNDING FOR AGING AND DIS11 ABILITY RESOURCE CENTERS.—Subsection (c)(1)(B) of 

12 such section 119, as so amended, is amended— 

13 (1) in clause (vii), by striking ‘‘and’’ at the end; 

14 (2) in clause (viii), by striking ‘‘and’’ at the 

15 end; 

16 (3) in clause (ix), by striking the period at the 

17 end and inserting ‘‘; and’’; and 

18 (4) by inserting after clause (ix) the following 

19 new clause: 

20 ‘‘(x) for the period beginning on Octo21 ber 1, 2019, and ending on November 21, 

22 2019, of $712,000.’’. 

23 (d) ADDITIONAL FUNDING FOR CONTRACT WITH

24 THE NATIONAL CENTER FOR BENEFITS AND OUTREACH


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1 ENROLLMENT.—Subsection (d)(2) of such section 119, as 

2 so amended, is amended— 

3 (1) in clause (vii), by striking ‘‘and’’ at the end; 

4 (2) in clause (viii), by striking ‘‘and’’ at the 

5 end; 

6 (3) in clause (ix), by striking the period at the 

7 end and inserting ‘‘; and’’; and 

8 (4) by inserting after clause (ix) the following 

9 new clause: 

10 ‘‘(x) for the period beginning on Octo11 ber 1, 2019, and ending on November 21, 

12 2019, of $1,710,000.’’. 

13 SEC. 1403. EXTENSION OF TERMINATION DATE OF PATIENT14 CENTERED OUTCOMES RESEARCH TRUST 

15 FUND. 

16 Section 9511(f) of the Internal Revenue Code of 

17 1986 is amended by striking ‘‘September 30’’ and insert18 ing ‘‘November 21’’. 

19 TITLE V—HUMAN SERVICES 

20 EXTENDERS 

21 SEC. 1501. EXTENSION OF DEMONSTRATION PROJECTS TO 

22 ADDRESS HEALTH PROFESSIONS WORK23 FORCE NEEDS. 

24 Activities authorized by section 2008 of the Social Se25 curity Act shall continue through November 21, 2019, in 


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1 the manner authorized for fiscal year 2019, and out of 

2 any money in the Treasury of the United States not other3 wise appropriated, there are hereby appropriated such 

4 sums as may be necessary for such purpose. Grants and 

5 payments may be made pursuant to this authority through 

6 the date so specified at the pro rata portion of the total 

7 amount authorized for such activities in fiscal year 2019. 

8 SEC. 1502. EXTENSION OF THE TEMPORARY ASSISTANCE 

9 FOR NEEDY FAMILIES PROGRAM AND RE10 LATED PROGRAMS. 

11 Activities authorized by part A of title IV and section 

12 1108(b) of the Social Security Act shall continue through 

13 November 21, 2019, in the manner authorized for fiscal 

14 year 2019, and out of any money in the Treasury of the 

15 United States not otherwise appropriated, there are here16 by appropriated such sums as may be necessary for such 

17 purpose. 

18 TITLE VI—MISCELLANEOUS 

19 POLICIES 

20 SEC. 1601. ALASKA NATIVE REGIONAL HEALTH ENTITIES. 

21 Section 424(a) of the Consolidated Appropriations 

22 Act, 2014 (Public Law 113–76), as amended by section 

23 428 of the Consolidated Appropriations Act, 2018 (Public 

24 Law 115–141), shall be applied by substituting ‘‘Novem25 ber 21, 2019’’ for ‘‘October 1, 2019’’. 


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1 SEC. 1602. INCREASING NUMERICAL LIMITATIONS OF THE 

2 WORLD TRADE CENTER HEALTH PROGRAM. 

3 (a) WORLD TRADE CENTER RESPONDERS.—Section 

4 3311(a)(4)(A) of the Public Health Service Act (42 U.S.C. 

5 300mm–21(a)(4)(A)) is amended by striking ‘‘25,000’’ 

6 and inserting ‘‘75,000’’. 

7 (b) WORLD TRADE CENTER SURVIVORS.—Section 

8 3321(a)(3)(A) of the Public Health Service Act (42 U.S.C. 

9 300mm–31(a)(3)(A)) is amended by striking ‘‘25,000’’ 

10 and inserting ‘‘75,000’’. 

11 (c) RULE OF CONSTRUCTION REGARDING ANNUAL

12 FUNDING LIMITATIONS.—Nothing in this section, or the 

13 amendments made by this section, shall alter the annual 

14 limitations on amounts appropriated to the World Trade 

15 Center Health Program Fund under section 3351(a)(2) 

16 of the Public Health Service Act (42 U.S.C. 300mm– 

17 61(a)(2)). 

18 SEC. 1603. EXCLUDING AUTHORIZED GENERIC DRUGS 

19 FROM CALCULATION OF AVERAGE MANUFAC20 TURER PRICE FOR PURPOSES OF THE MED21 ICAID DRUG REBATE PROGRAM; EXCLUDING 

22 MANUFACTURERS FROM DEFINITION OF 

23 WHOLESALER. 

24 (a) IN GENERAL.—Subparagraph (C) of section 

25 1927(k)(1) of the Social Security Act (42 U.S.C. 1396r– 

26 8(k)(1)) is amended— 


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1 (1) in the subparagraph heading, by striking 

2 ‘‘INCLUSION’’ and inserting ‘‘EXCLUSION’’; 

3 (2) by striking ‘‘a new drug application’’ and 

4 inserting ‘‘the manufacturer’s new drug applica5 tion’’; and 

6 (3) by striking ‘‘inclusive’’ and inserting ‘‘exclu7 sive’’. 

8 (b) EXCLUDING MANUFACTURERS FROM DEFINI9 TION OF WHOLESALER.—Section 1927(k)(11) of the So10 cial Security Act (42 U.S.C. 1396r–8(k)(11)) is amend11 ed— 

12 (1) by striking ‘‘manufacturers,’’; and 

13 (2) by striking ‘‘manufacturer’s and’’. 

14 (c) EFFECTIVE DATE.—The amendments made by 

15 this section shall take effect on the first day of the first 

16 fiscal quarter that begins after the date of enactment of 

17 this Act. 

18 SEC. 1604. MEDICAID IMPROVEMENT FUND. 

19 Section 1941(b) of the Social Security Act (42 U.S.C. 

20 1396w–1(b)), as amended by section 2 of Public Law 

21 116–29, is amended— 

22 (1) in paragraph (1), by striking ‘‘$1,000,000’’ 

23 and inserting ‘‘$0’’; and 

24 (2) in paragraph (3)— 


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1 (A) by striking ‘‘2023’’ each place it ap2 pears and inserting ‘‘2025’’; and 

3 (B) in subparagraph (A), by striking ‘‘$0’’ 

4 and inserting ‘‘$2,387,000,000’’. 

5 TITLE VII—BUDGETARY 

6 EFFECTS 

7 SEC. 1701. BUDGETARY EFFECTS. 

8 (a) STATUTORY PAYGO SCORECARDS.—The budg9 etary effects of this division shall not be entered on either 

10 PAYGO scorecard maintained pursuant to section 4(d) of 

11 the Statutory Pay-As-You-Go Act of 2010. 

12 (b) SENATE PAYGO SCORECARDS.—The budgetary 

13 effects of this division shall not be entered on any PAYGO 

14 scorecard maintained for purposes of section 4106 of H. 

15 Con. Res. 71 (115th Congress). 

16 (c) CLASSIFICATION OF BUDGETARY EFFECTS.— 

17 Notwithstanding Rule 3 of the Budget Scorekeeping 

18 Guidelines set forth in the joint explanatory statement of 

19 the committee of conference accompanying Conference Re20 port 105–217 and section 250(c)(8) of the Balanced 

21 Budget and Emergency Deficit Control Act of 1985, the 

22 budgetary effects of this division shall not be estimated— 

23 (1) for purposes of section 251 of such Act; and 


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1 (2) for purposes of paragraph (4)(C) of section 

2 3 of the Statutory Pay-As-You-Go Act of 2010 as 

3 being included in an appropriation Act. 

Æ 


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