II 
Calendar No. 248 
118TH CONGRESS 
1ST SESSION H. R. 6363 
IN THE SENATE OF THE UNITED STATES 
NOVEMBER 14 (legislative day, NOVEMBER 13), 2023 
Received; read the first time 
NOVEMBER 14, 2023 
Read the second time and placed on the calendar 
AN ACT 
Making further continuing appropriations for fiscal year 
2024, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Further Continuing 
Appropriations and Other Extensions Act, 2024’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents of this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of Contents. 
Sec. 3. References. 
DIVISION A—FURTHER CONTINUING APPROPRIATIONS ACT, 2024 
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DIVISION B—OTHER MATTERS 
Title I—Extensions and Other Matters 
Title II—Health and Human Services 
Title III—Miscellaneous Extensions 
Title IV—Budgetary Effects 
SEC. 3. REFERENCES. 
Except as expressly provided otherwise, any reference 
to ‘‘this Act’’ contained in any division of this Act shall 
be treated as referring only to the provisions of that divi-
sion. 
DIVISION A—FURTHER CONTINUING 
APPROPRIATIONS ACT, 2024 
SEC. 101. Division A of the Continuing Appropria-
tions Act, 2024 and Other Extensions Act (Public Law 
118–15) is amended— 
(1) by striking the date specified in section 
106(3) and inserting ‘‘February 2, 2024, except as 
provided in paragraph (4)’’; 
(2) by inserting after paragraph (3) of section 
106 the following: 
‘‘(4) In the case of appropriations and funds 
made available and authority granted pursuant to 
sections 101(1), 101(4), 101(10), 101(12), 134, and 
137, January 19, 2024.’’; 
(3) in section 101(1) by inserting after ‘‘except 
section 729,’’ the following: ‘‘and except that the 
language under the heading ‘Rural Utilities Serv-
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ice—Rural Water and Waste Disposal Program Ac-
count’ in title III shall be applied by inserting ‘direct 
loans and,’ before ‘loan guarantees’ at the beginning 
of the first sentence of the second paragraph,’’; 
(4) in section 101(10), by inserting before the 
period ‘‘, except section 123 as well as the provisions 
carrying the same restriction in prior Acts’’; 
(5) in section 123, by striking ‘‘17 days’’ and 
inserting ‘‘94 days’’ and by striking ‘‘17-day’’ and 
inserting ‘‘94-day’’; 
(6) in section 124, by striking ‘‘$621,270,000’’ 
and inserting ‘‘$663,070,000’’; 
(7) in section 125, by striking ‘‘During the pe-
riod covered by this Act’’ and inserting ‘‘Through 
the date specified in section 106(3) of this Act’’; and 
(8) by adding after section 137 the following 
new sections: 
‘‘SEC. 138. Section 2(f)(2) of the Undetectable Fire-
arms Act of 1988 (18 U.S.C. 922 note) shall be applied 
through the date specified in section 106(3) of this Act 
by substituting ‘36’ for ‘35’. 
‘‘SEC. 139. Through the date specified in section 
106(3) of this Act, amounts appropriated in section 124 
of the Continuing Appropriations Act, 2023 (division A 
of Public Law 117–180) may be charged for any proper 
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expense pursuant to section 1553(b)(1) of title 31, United 
States Code, notwithstanding the limitation in section 
1553(b)(2) of such title. 
‘‘SEC. 140. Notwithstanding sections 102 and 104, 
amounts made available by section 101 to the Department 
of Defense for ‘Procurement—Shipbuilding and Conver-
sion, Navy’ may be apportioned up to the rate for oper-
ations necessary for ‘Columbia Class Submarine (AP)’ in 
an amount not to exceed $3,338,413,000. 
‘‘SEC. 141. (a) Notwithstanding section 101, section 
747 of title VII of division E of Public Law 117–328 shall 
be applied through the date specified in section 106(3) of 
this Act by— 
‘‘(1) substituting ‘2025’ for ‘2024’; 
‘‘(2) substituting ‘2024’ for ‘2023’ each place it ap-
pears; 
‘‘(3) substituting ‘2023’ for ‘2022’ each place it ap-
pears; and 
‘‘(4) substituting ‘section 747 of division E of Public 
Law 117–328, as in effect on September 30, 2023’ for 
‘section 747 of division E of Public Law 117–103’ each 
place it appears. 
‘‘(b) Subsection (a) shall not take effect until the first 
day of the first applicable pay period beginning on or after 
January 1, 2024. 
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‘‘SEC. 142. Section 302 of title III of Public Law 
108–494 shall be applied by substituting the date specified 
in section 106(3) of this Act for ‘December 31, 2023’ each 
place it appears. 
‘‘SEC. 143. Amounts made available by section 101 
to the Department of Homeland Security under the head-
ing ‘United States Secret Service—Operations and Sup-
port’ may be apportioned up to the rate for operations 
necessary to carry out activities related to National Spe-
cial Security Events and the 2024 Presidential Campaign. 
‘‘SEC. 144. Section 1901(e) of the Homeland Secu-
rity Act of 2002 (6 U.S.C. 591(e)) shall be applied by 
substituting the date that is 1 day after the date specified 
in section 106(3) of this Act for ‘the date that is 5 years 
after the date of the enactment of the Countering Weap-
ons of Mass Destruction Act of 2018’. 
‘‘SEC. 145. (a) Amounts made available by section 
101 for ‘Department of Education—Student Aid Adminis-
tration’ may be apportioned up to the rate for operations 
necessary to ensure the continuation of student loan serv-
icing activities, including supporting borrowers reentering 
repayment. 
‘‘(b) The limitation in section 302 of division H of 
Public Law 117–328 regarding transfers increasing any 
appropriation shall be applied to transfers to appropria-
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tions under the heading ‘Department of Education—Stu-
dent Aid Administration’ through the date specified in sec-
tion 106(3) of this Act by substituting ‘10 percent’ for 
‘3 percent’ for the purposes of the continuation of basic 
operations, including student loan servicing, business 
process operations, digital customer care, common origina-
tion and disbursement, cybersecurity activities, and infor-
mation technology systems. 
‘‘SEC. 146. Notwithstanding any other provision of 
this Act, there is hereby appropriated for fiscal year 2024, 
out of any money in the Treasury not otherwise appro-
priated, for payment to Katherine Anne Feinstein, bene-
ficiary of Dianne Feinstein, late a Senator from the State 
of California, $174,000. 
‘‘This division may be cited as the ‘Continuing Ap-
propriations Act, 2024’.’’. 
This division may be cited as the ‘‘Further Con-
tinuing Appropriations Act, 2024’’. 
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DIVISION B—OTHER MATTERS 
TITLE I—EXTENSIONS AND 
OTHER MATTERS 
SEC. 101. EXTENSION OF CERTAIN PROVISIONS OF THE 
COMPACTS OF FREE ASSOCIATION WITH THE 
FEDERATED STATES OF MICRONESIA AND 
THE REPUBLIC OF THE MARSHALL ISLANDS. 
Section 2101 of the Continuing Appropriations Act, 
2024 and Other Extensions Act (Public Law 118–15; 137 
Stat. 81) is amended— 
(1) in the section heading, by striking ‘‘COM-
PACT OF FREE ASSOCIATION WITH THE FED-
ERATED STATES OF MICRONESIA’’ and inserting 
‘‘COMPACTS OF FREE ASSOCIATION WITH THE 
FEDERATED STATES OF MICRONESIA AND THE 
REPUBLIC OF THE MARSHALL ISLANDS’’; and 
(2) in subsection (a)(1)— 
(A) by striking ‘‘November 17, 2023’’ and 
inserting ‘‘February 2, 2024’’ ; 
(B) by inserting ‘‘, section 103(f)(2) of the 
Compact of Free Association Amendments Act 
of 2003 (48 U.S.C. 1921b(f)(2)), and sections 
211, 213, and 216 of the Compact of Free As-
sociation between the Government of the United 
States of America and the Government of the 
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Republic of the Marshall Islands set forth in 
section 201(b) of that Act (48 U.S.C. 1921 
note; Public Law 108–188)’’ before ‘‘shall,’’; 
(C) by inserting ‘‘or the Republic of the 
Marshall Islands, as applicable’’ before ‘‘, con-
tinue’’; and 
(D) by striking ‘‘of that Compact’’ and in-
serting ‘‘of the applicable Compact’’. 
SEC. 102. EXTENSION OF AGRICULTURAL PROGRAMS. 
(a) EXTENSION.—Except as otherwise provided in 
this section and the amendments made by this section, 
notwithstanding any other provision of law, the authorities 
(including any limitations on the authorities) provided by 
each provision of the Agriculture Improvement Act of 
2018 (Public Law 115–334; 132 Stat. 4490) and each 
provision of law amended by that Act (and for mandatory 
programs at such funding levels), as in effect on Sep-
tember 30, 2023, shall continue, and the authorities shall 
be carried out, until the later of— 
(1) September 30, 2024; or 
(2) the date specified in the provision of that 
Act or the provision of law amended by that Act. 
(b) DISCRETIONARY PROGRAMS.—Programs carried 
out using the authorities described in subsection (a) that 
are funded by discretionary appropriations (as defined in 
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section 250(c) of the Balanced Budget and Emergency 
Deficit Control Act of 1985 (2 U.S.C. 900(c))) shall be 
subject to the availability of appropriations. 
(c) COMMODITY PROGRAMS.— 
(1) IN GENERAL.—The provisions of law appli-
cable to a covered commodity (as defined in section 
1111 of the Agricultural Act of 2014 (7 U.S.C. 
9011)), a loan commodity (as defined in section 
1201 of that Act (7 U.S.C. 9031)), sugarcane, or 
sugar beets for the 2023 crop year pursuant to title 
I of that Act (7 U.S.C. 9011 et seq.) and each 
amendment made by subtitle C of title I of the Agri-
culture Improvement Act of 2018 (Public Law 115– 
334; 132 Stat. 4511) shall be applicable to the 2024 
crop year for that covered commodity, loan com-
modity, sugarcane, or sugar beets. 
(2) DAIRY.— 
(A) BASE PRODUCTION HISTORY ADJUST-
MENT FOR PARTICIPATING DAIRY OPERATIONS 
WITH
PRODUCTION
OF
LESS
THAN
5,000,000 
POUNDS.—Section 1405(a) of the Agricultural 
Act of 2014 (7 U.S.C. 9055(a)) is amended— 
(i) in paragraph (1), by inserting 
‘‘paragraph (4) and’’ before ‘‘subsection 
(b)’’; and 
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(ii) by adding at the end the fol-
lowing: 
‘‘(4) BASE PRODUCTION HISTORY ADJUSTMENT 
FOR PARTICIPATING DAIRY OPERATIONS WITH PRO-
DUCTION OF LESS THAN 5,000,000 POUNDS.— 
‘‘(A) IN GENERAL.—If the amount deter-
mined under paragraph (1) is less than 
5,000,000 pounds, the production history of the 
dairy operation for dairy margin coverage shall 
be equal to— 
‘‘(i) the amount determined under 
paragraph (1); plus 
‘‘(ii) 75 percent of the amount de-
scribed in subparagraph (B). 
‘‘(B) AMOUNT.—The amount referred to in 
subparagraph (A)(ii) is, with respect to a dairy 
operation, the amount equal to— 
‘‘(i) the production volume of such 
dairy operation for the 2019 milk mar-
keting year; minus 
‘‘(ii) the amount determined under 
paragraph (1).’’. 
(B) DAIRY MARGIN COVERAGE.— 
(i) DURATION.—Section 1409 of the 
Agricultural Act of 2014 (7 U.S.C. 9059) 
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is amended by striking ‘‘2023’’ and insert-
ing ‘‘2024’’. 
(ii) AVAILABILITY OF PREMIUM DIS-
COUNT.—With respect to coverage for cal-
endar year 2024, section 1407(g) of the 
Agricultural Act of 2014 (7 U.S.C. 
9057(g)) shall only apply to a participating 
dairy operation with respect to which the 
premium was reduced in accordance with 
that section for calendar year 2023. 
(C) DAIRY FORWARD PRICING PROGRAM.— 
Section 1502(e)(2) of the Food, Conservation, 
and Energy Act of 2008 (7 U.S.C. 8772(e)(2)) 
is amended by striking ‘‘2026’’ and inserting 
‘‘2027’’. 
(3) EXTENSION OF PAYMENT AMOUNT.—Sec-
tion 1116(d) of the Agricultural Act of 2014 (7 
U.S.C. 9016(d)) is amended, in the matter pre-
ceding paragraph (1), by striking ‘‘2018’’ and in-
serting ‘‘2024’’. 
(4) SUSPENSION OF PERMANENT PRICE SUP-
PORT AUTHORITIES.—The provisions of law specified 
in— 
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(A) subsections (a) and (b) of section 1602 
of the Agricultural Act of 2014 (7 U.S.C. 
9092)— 
(i) shall not be applicable to the 2024 
crops of covered commodities (as defined 
in section 1111 of that Act (7 U.S.C. 
9011)), cotton, and sugar; and 
(ii) shall not be applicable to milk 
through December 31, 2024; and 
(B) section 1602(c) of that Act (7 U.S.C. 
9092(c)) shall not be applicable to the crops of 
wheat planted for harvest in calendar year 
2024. 
(d) OTHER PROGRAMS.— 
(1) CONSERVATION.— 
(A) GRASSROOTS SOURCE WATER PROTEC-
TION
PROGRAM.—Section 1240O(b)(3) of the 
Food Security Act of 1985 (16 U.S.C. 3839bb– 
2(b)(3)) is amended— 
(i) by striking the period at the end 
and inserting ‘‘; and’’; 
(ii) by striking ‘‘use $5,000,000’’ and 
inserting the following: ‘‘use— 
‘‘(A) $5,000,000’’; and 
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(iii) by adding at the end the fol-
lowing: 
‘‘(B) $1,000,000 beginning in fiscal year 
2024, to remain available until expended.’’. 
(B) VOLUNTARY
PUBLIC
ACCESS
AND 
HABITAT
INCENTIVE
PROGRAM.—Section 
1240R(f)(1) of the Food Security Act of 1985 
(16 U.S.C. 3839bb–5(f)(1)) is amended— 
(i) by striking ‘‘and’’ after ‘‘2018,’’; 
and 
(ii) by inserting ‘‘, and $10,000,000 
for fiscal year 2024’’ before the period at 
the end. 
(C) FERAL SWINE ERADICATION AND CON-
TROL PILOT PROGRAM.—Section 2408(g)(1) of 
the Agriculture Improvement Act of 2018 (7 
U.S.C. 8351 note; Public Law 115–334) is 
amended by inserting ‘‘and $15,000,000 for fis-
cal year 2024’’ before the period at the end. 
(2) TRADE.—Section 302(h)(2) of the Bill 
Emerson Humanitarian Trust Act (7 U.S.C. 1736f– 
1(h)(2)) is amended by striking ‘‘2023’’ and insert-
ing ‘‘2024’’. 
(3) NUTRITION.—Section 203D(d)(5) of the 
Emergency Food Assistance Act of 1983 (7 U.S.C. 
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7507(d)(5)) is amended by striking ‘‘2023’’ and in-
serting ‘‘2024’’. 
(4) RURAL
ECONOMIC
DEVELOPMENT
PRO-
GRAM.—Section 313B(e)(2) of the Rural Electrifica-
tion Act of 1936 (7 U.S.C. 940c–2(e)(2)) is amend-
ed by striking ‘‘and 2023’’ and inserting ‘‘through 
2024’’. 
(5) RESEARCH.— 
(A) SCHOLARSHIPS FOR STUDENTS.—Sec-
tion 1446 of the National Agricultural Re-
search, Extension, and Teaching Policy Act of 
1977 (7 U.S.C. 3222a) is amended— 
(i) in subsection (a)(3), by striking 
‘‘three’’ and inserting ‘‘4’’; and 
(ii) in subsection (b)(1)— 
(I) by striking ‘‘Of’’ and insert-
ing the following: 
‘‘(A) FUNDING.—Of’’; and 
(II) by adding at the end the fol-
lowing: 
‘‘(B) ADDITIONAL
FUNDING.—Not later 
than 30 days after the date of enactment of 
this subparagraph, of the funds of the Com-
modity Credit Corporation, the Secretary shall 
make available to carry out this section 
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$10,000,000, to remain available until ex-
pended.’’. 
(B) URBAN, INDOOR, AND OTHER EMERG-
ING
AGRICULTURAL
PRODUCTION
RESEARCH, 
EDUCATION, AND EXTENSION INITIATIVE.—Sec-
tion 1672E(d)(1) of the Food, Agriculture, 
Conservation, and Trade Act of 1990 (7 U.S.C. 
5925g(d)(1)) is amended— 
(i) by striking the period at the end 
and inserting ‘‘; and’’; 
(ii) by striking ‘‘section $10,000,000’’ 
and inserting the following: ‘‘section— 
‘‘(A) $10,000,000’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(B) $2,000,000 for fiscal year 2024, to 
remain available until expended.’’. 
(C) FOUNDATION
FOR
FOOD
AND
AGRI-
CULTURE
RESEARCH.—Section 7601(g)(1)(A) 
of the Agricultural Act of 2014 (7 U.S.C. 
5939(g)(1)(A)) is amended by adding at the 
end the following: 
‘‘(iii) 
ADDITIONAL
FUNDING.—Not 
later than 30 days after the date of enact-
ment of this clause, of the funds of the 
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Commodity Credit Corporation, the Sec-
retary shall transfer to the Foundation to 
carry out this section $37,000,000, to re-
main available until expended.’’. 
(D) GRAZINGLANDS
RESEARCH
LABORA-
TORY.—Section 7502 of the Food, Conserva-
tion, and Energy Act of 2008 (Public Law 
110–246; 122 Stat. 2019; 132 Stat. 4817) shall 
be applied by substituting ‘‘the period begin-
ning on the date of enactment of this Act and 
ending on September 30, 2024’’ for ‘‘the 15- 
year period beginning on the date of enactment 
of this Act’’. 
(6) ENERGY.— 
(A) BIOBASED MARKETS PROGRAM.—Sec-
tion 9002(k)(1) of the Farm Security and 
Rural Investment Act of 2002 (7 U.S.C. 
8102(k)(1)) is amended by striking ‘‘2023’’ and 
inserting ‘‘2024’’. 
(B) BIOENERGY PROGRAM FOR ADVANCED 
BIOFUELS.—Section 9005(g)(1)(F) of the Farm 
Security and Rural Investment Act of 2002 (7 
U.S.C. 8105(g)(1)(F)) is amended by striking 
‘‘2023’’ and inserting ‘‘2024’’. 
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(C) FEEDSTOCK FLEXIBILITY PROGRAM.— 
Section 9010(b) of the Farm Security and 
Rural Investment Act of 2002 (7 U.S.C. 
8110(b)) is amended in paragraphs (1)(A) and 
(2)(A) by striking ‘‘2023’’ each place it appears 
and inserting ‘‘2024’’. 
(7) HORTICULTURE.— 
(A) ORGANIC PRODUCTION AND MARKET 
DATA INITIATIVES.—Section 7407(d)(1) of the 
Farm Security and Rural Investment Act of 
2002 (7 U.S.C. 5925c(d)(1)) is amended— 
(i) in subparagraph (A), by striking 
‘‘and’’ at the end; 
(ii) in subparagraph (B), by striking 
the period at the end and inserting ‘‘; 
and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(C) $1,000,000 for fiscal year 2024.’’. 
(B) MODERNIZATION AND IMPROVEMENT 
OF INTERNATIONAL TRADE TECHNOLOGY SYS-
TEMS
AND
DATA
COLLECTION.—Section 
2123(c)(4) of the Organic Foods Production 
Act of 1990 (7 U.S.C. 6522(c)(4)) is amended, 
in the matter preceding subparagraph (A), by 
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inserting ‘‘and $1,000,000 for fiscal year 2024’’ 
after ‘‘2019’’. 
(C) NATIONAL
ORGANIC
CERTIFICATION 
COST-SHARE
PROGRAM.—Section 
10606(d)(1)(C) of the Farm Security and 
Rural Investment Act of 2002 (7 U.S.C. 
6523(d)(1)(C)) is amended by striking ‘‘and 
2023’’ and inserting ‘‘through 2024’’. 
(D) MULTIPLE CROP AND PESTICIDE USE 
SURVEY.—Section 10109(c)(1) of the Agri-
culture Improvement Act of 2018 (Public Law 
115–334; 132 Stat. 4906) is amended by in-
serting ‘‘and $100,000 for fiscal year 2024’’ 
after ‘‘2019’’. 
(8) MISCELLANEOUS.— 
(A) PIMA
AGRICULTURE
COTTON
TRUST 
FUND.—Section 12314 of the Agricultural Act 
of 2014 (7 U.S.C. 2101 note; Public Law 113– 
79) is amended— 
(i) in subsection (b), in the matter 
preceding paragraph (1), by striking 
‘‘2023’’ and inserting ‘‘2024’’; and 
(ii) in subsection (h), by striking 
‘‘2023’’ and inserting ‘‘2024’’. 
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(B) AGRICULTURE WOOL APPAREL MANU-
FACTURERS
TRUST
FUND.—Section 12315 of 
the Agricultural Act of 2014 (7 U.S.C. 7101 
note; Public Law 113–79) is amended by strik-
ing ‘‘2023’’ each place it appears and inserting 
‘‘2024’’. 
(C) WOOL RESEARCH AND PROMOTION.— 
Section 12316(a) of the Agricultural Act of 
2014 (7 U.S.C. 7101 note; Public Law 113–79) 
is amended by striking ‘‘2023’’ and inserting 
‘‘2024’’. 
(D) EMERGENCY
CITRUS
DISEASE
RE-
SEARCH
AND
DEVELOPMENT
TRUST
FUND.— 
Section 12605(d) of the Agriculture Improve-
ment Act of 2018 (7 U.S.C. 7632 note; Public 
Law 115–334) is amended by striking ‘‘2023’’ 
and inserting ‘‘2024’’. 
(E) SHEEP PRODUCTION AND MARKETING 
GRANT PROGRAM.—Section 209(c) of the Agri-
cultural Marketing Act of 1946 (7 U.S.C. 
1627a(c)) is amended by inserting ‘‘and 
$400,000 for fiscal year 2024,’’ after ‘‘2019,’’. 
(9) EXCEPTIONS.—Subsection (a) shall not 
apply with respect to mandatory funding under the 
following provisions of law: 
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(A) Section 1614(c)(4) of the Agricultural 
Act of 2014 (7 U.S.C. 9097(c)(4)). 
(B) Subparagraphs (A) and (B) of section 
1241(a)(1) of the Food Security Act of 1985 
(16 U.S.C. 3841(a)(1)). 
(e) REPORTS.— 
(1) IN GENERAL.—Subject to paragraph (2), 
any requirement under a provision of law described 
in subsection (a) to submit a report on a recurring 
basis, and the final report under which was required 
to be submitted during fiscal year 2023, shall con-
tinue, and the requirement shall be carried out, on 
the same recurring basis, until the later of the dates 
specified in paragraphs (1) and (2) of that sub-
section. 
(2) APPROPRIATIONS
REQUIRED.—If discre-
tionary appropriations (as defined in section 250(c) 
of the Balanced Budget and Emergency Deficit Con-
trol Act of 1985 (2 U.S.C. 900(c))) are required to 
carry out a reporting requirement described in para-
graph (1), the application of that paragraph to that 
reporting requirement shall be subject to the avail-
ability of appropriations. 
(f) RESCISSION.—Of the unobligated balances of 
amounts made available under section 9003(g)(1)(A) of 
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the Farm Security and Rural Investment Act of 2002 (7 
U.S.C. 8103(g)(1)(A)), $177,350,000 is rescinded. 
(g) EFFECTIVE DATE.—This section and the amend-
ments made by this section (except subsection (f) and the 
amendments made by subparagraphs (A) and (C) of sub-
section (d)(5)) shall be applied and administered as if this 
section and those amendments had been enacted on Sep-
tember 30, 2023. 
TITLE II—HEALTH AND HUMAN 
SERVICES 
Subtitle A—Public Health 
Extenders 
SEC. 201. EXTENSION FOR COMMUNITY HEALTH CENTERS, 
NATIONAL HEALTH SERVICE CORPS, AND 
TEACHING HEALTH CENTERS THAT OPERATE 
GME PROGRAMS. 
(a) TEACHING HEALTH CENTERS THAT OPERATE 
GRADUATE MEDICAL EDUCATION PROGRAMS.—Section 
340H(g)(1) of the Public Health Service Act (42 U.S.C. 
256h(g)) is amended by striking ‘‘and $16,635,616 for the 
period beginning on October 1, 2023, and ending on No-
vember 17, 2023’’ and inserting ‘‘$16,635,616 for the pe-
riod beginning on October 1, 2023, and ending on Novem-
ber 17, 2023, and $21,834,247 for the period beginning 
on November 18, 2023, and ending on January 19, 2024’’. 
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(b) EXTENSION
FOR COMMUNITY HEALTH CEN-
TERS.—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 the Continuing Appropriations Act, 2024 and 
Other Extensions Act, is further amended by striking 
‘‘and $526,027,397 for the period beginning on October 
1, 2023, and ending on November 17, 2023’’ and inserting 
‘‘$526,027,397 for the period beginning on October 1, 
2023, and ending on November 17, 2023, and 
$690,410,959 for the period beginning on November 18, 
2023, and ending on January 19, 2024’’. 
(c) EXTENSION FOR THE NATIONAL HEALTH SERV-
ICE CORPS.—Section 10503(b)(2)(I) of the Patient Pro-
tection and Affordable Care Act (42 U.S.C. 254b– 
2(b)(2)(I)), as amended by the Continuing Appropriations 
Act, 2024 and Other Extensions Act, is further amended 
by striking ‘‘$40,767,123 for the period beginning on Oc-
tober 1, 2023, and ending on November 17, 2023’’ and 
inserting ‘‘$40,767,123 for the period beginning on Octo-
ber 1, 2023, and ending on November 17, 2023, and 
$53,506,849 for the period beginning on November 18, 
2023, and ending on January 19, 2024’’. 
(d) APPLICATION OF PROVISIONS.—Amounts appro-
priated pursuant to the amendments made by this section 
shall be subject to the requirements contained in Public 
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Law 117–328 for funds for programs authorized under 
sections 330 through 340 of the Public Health Service Act 
(42 U.S.C. 254b et seq.). 
(e) CONFORMING AMENDMENT.—Section 3014(h)(4) 
of title 18, United States Code, is amended by striking 
‘‘and section 2321(d) of the Continuing Appropriations 
Act, 2024 and Other Extensions Act’’ and inserting ‘‘sec-
tion 2321(d) of the Continuing Appropriations Act, 2024 
and Other Extensions Act, and section 201(d) of the Fur-
ther Continuing Appropriations and Other Extensions 
Act, 2024’’. 
SEC. 202. EXTENSION OF SPECIAL DIABETES PROGRAMS. 
(a) EXTENSION OF SPECIAL DIABETES PROGRAMS 
FOR TYPE I DIABETES.—Section 330B(b)(2)(E) of the 
Public Health Service Act (42 U.S.C. 254c–2(b)(2)(E)), 
as amended by the Continuing Appropriations Act, 2024 
and Other Extensions Act, is further amended by striking 
‘‘$19,726,027 for the period beginning on October 1, 
2023, and ending on November 17, 2023’’ and inserting 
‘‘$19,726,027 for the period beginning on October 1, 
2023, and ending on November 17, 2023, and 
$25,890,411 for the period beginning on November 18, 
2023, and ending on January 19, 2024’’. 
(b) EXTENDING FUNDING FOR SPECIAL DIABETES 
PROGRAMS FOR INDIANS.—Section 330C(c)(2)(E) of the 
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Public Health Service Act (42 U.S.C. 254c–3(c)(2)(E)), 
as amended by the Continuing Appropriations Act, 2024 
and Other Extensions Act, is further amended by striking 
‘‘$19,726,027 for the period beginning on October 1, 
2023, and ending on November 17, 2023’’ and inserting 
‘‘$19,726,027 for the period beginning on October 1, 
2023, and ending on November 17, 2023, and 
$25,890,411 for the period beginning on November 18, 
2023, and ending on January 19, 2024’’. 
SEC. 203. NATIONAL HEALTH SECURITY EXTENSIONS. 
(a) Section 319(e)(8) of the Public Health Service 
Act (42 U.S.C. 247d(e)(8)) is amended by striking ‘‘No-
vember 17, 2023’’ and inserting ‘‘January 19, 2024’’. 
(b) Section 319L(e)(1)(D) of the Public Health Serv-
ice Act (42 U.S.C. 247d–7e(e)(1)(D)) is amended by strik-
ing ‘‘on the date that is 17 years after the date of enact-
ment of the Pandemic and All-Hazards Preparedness Act’’ 
and inserting ‘‘after January 19, 2024’’. 
(c) Section 319L–1(b) of the Public Health Service 
Act (42 U.S.C. 247d–7f(b)) is amended by striking ‘‘at 
the end of the 17-year period that begins on the date of 
enactment of this Act’’ and inserting ‘‘after January 19, 
2024’’. 
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(d)(1) Section 2811A(g) of the Public Health Service 
Act (42 U.S.C. 300hh–10b(g)) is amended by striking 
‘‘November 17, 2023’’ and inserting ‘‘January 19, 2024’’. 
(2) Section 2811B(g)(1) of the Public Health Service 
Act (42 U.S.C. 300hh–10c(g)(1)) is amended by striking 
‘‘November 17, 2023’’ and inserting ‘‘January 19, 2024’’. 
(3) Section 2811C(g)(1) of the Public Health Service 
Act (42 U.S.C. 300hh–10d(g)(1)) is amended by striking 
‘‘November 17, 2023’’ and inserting ‘‘January 19, 2024’’. 
(e) Section 2812(c)(4)(B) of the Public Health Serv-
ice Act (42 U.S.C. 300hh–11(c)(4)(B)) is amended by 
striking ‘‘November 17, 2023’’ and inserting ‘‘January 19, 
2024’’. 
Subtitle B—Medicaid 
SEC. 301. DELAYING CERTAIN DISPROPORTIONATE SHARE 
PAYMENT CUTS. 
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), by striking ‘‘November 18, 
2023’’ and inserting ‘‘January 20, 2024’’; and 
(2) in clause (ii), by striking ‘‘November 18, 
2023’’ and inserting ‘‘January 20, 2024’’. 
SEC. 302. MEDICAID IMPROVEMENT FUND REDUCTION. 
Section 1941(b)(3)(A) of the Social Security Act (42 
U.S.C. 1396w–1(b)(3)(A)), as amended by the Continuing 
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Appropriations Act, 2024 and Other Extensions Act, is 
further amended by striking ‘‘$6,357,117,810’’ and insert-
ing ‘‘5,796,117,810’’. 
Subtitle C—Human Services 
SEC. 401. EXTENSION OF CHILD AND FAMILY SERVICES 
PROGRAMS. 
Activities authorized by part B of title IV of the So-
cial Security Act shall continue through January 19, 
2024, in the manner authorized for fiscal year 2023, and 
out of any money in the Treasury of the United States 
not otherwise appropriated, there are hereby appropriated 
such sums as may be necessary for such purpose. 
SEC. 402. SEXUAL RISK AVOIDANCE EDUCATION EXTEN-
SION. 
Section 510 of the Social Security Act (42 U.S.C. 
710), as amended by the Continuing Appropriations Act, 
2024 and Other Extensions Act, is further amended— 
(1) in subsection (a)— 
(A) in paragraph (1)— 
(i) by striking ‘‘and for the period be-
ginning on October 1, 2023, and ending on 
November 17, 2023’’ and inserting ‘‘, for 
the period beginning on October 1, 2023, 
and ending on November 17, 2023, and for 
the period beginning on November 18, 
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2023, and ending on January 19, 2024’’; 
and 
(ii) by striking ‘‘with respect to such 
period’’ and inserting ‘‘with respect to the 
applicable period’’; 
(B) in paragraphs (2)(A), by striking ‘‘for 
the period’’ and inserting ‘‘for the applicable 
period’’; and 
(C) in paragraphs (2)(B), by striking ‘‘for 
the period’’ and inserting ‘‘for the applicable 
period’’; and 
(2) in subsection (f)— 
(A) in paragraph (1), by striking ‘‘and for 
the period beginning on October 1, 2023, and 
ending on November 17, 2023, an amount 
equal to the pro rata portion of the amount ap-
propriated for the corresponding period for fis-
cal year 2023’’ and inserting ‘‘for the period be-
ginning on October 1, 2023, and ending on No-
vember 17, 2023, an amount equal to the pro 
rata portion of the amount appropriated for the 
corresponding period for fiscal year 2023, and 
for the period beginning on November 18, 
2023, and ending on January 19, 2024, an 
amount equal to the pro rata portion of the 
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amount appropriated for the corresponding pe-
riod for fiscal year 2023’’; and 
(B) in paragraph (2), by striking ‘‘for the 
period’’ and inserting ‘‘for the applicable pe-
riod’’. 
SEC. 403. PERSONAL RESPONSIBILITY EDUCATION EXTEN-
SION. 
Section 513 of the Social Security Act (42 U.S.C. 
713), as amended by the Continuing Appropriations Act, 
2024 and Other Extensions Act, is further amended— 
(1) in subsection (a)— 
(A) in paragraph (1)— 
(i) in subparagraph (A), by striking 
‘‘and for the period beginning on October 
1, 2023, and ending on November 17, 
2023,’’ and inserting ‘‘, for the period be-
ginning on October 1, 2023, and ending on 
November 17, 2023, and for the period be-
ginning on November 18, 2023, and end-
ing on January 19, 2024,’’; and 
(ii) in subparagraph (B)(i), by insert-
ing after ‘‘November 17, 2023’’ the fol-
lowing: ‘‘, and for the period beginning on 
November 18, 2023, and ending on Janu-
ary 19, 2024’’; 
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(iii) in subparagraph (C)(i), by strik-
ing ‘‘for a fiscal year or the period’’ and 
inserting ‘‘for a fiscal year or period’’; and 
(B) in paragraph (3), by striking ‘‘for a 
fiscal year or the period’’ and inserting ‘‘for a 
fiscal year or period’’; and 
(C) in paragraph (4)(A)— 
(i) by striking ‘‘for the period’’ each 
place it appears and inserting ‘‘for each 
period’’; and 
(ii) by striking ‘‘for a fiscal year or 
the period’’ and inserting ‘‘for a fiscal year 
or period’’; 
(D) in paragraph (4)(B)(i), by striking 
‘‘the period described in paragraph (1)(A)’’ and 
inserting ‘‘each period described in paragraph 
(1)(A)’’; 
(2) in subsection (c), by striking ‘‘for the period 
described in subsection (a)(1)(A)’’ and inserting ‘‘for 
a period described in subsection (a)(1)(A) for fiscal 
year 2024’’; and 
(3) in subsection (f)(1), by striking ‘‘2023, and 
for the period beginning on October 1, 2023, and 
ending on November 17, 2023, an amount equal to 
the pro rata portion of the amount appropriated for 
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the corresponding period for fiscal year 2023’’ and 
inserting ‘‘2023, for the period beginning on October 
1, 2023, and ending on November 17, 2023, an 
amount equal to the pro rata portion of the amount 
appropriated for the corresponding period for fiscal 
year 2023, and for the period beginning on Novem-
ber 18, 2023, and ending on January 19, 2024, an 
amount equal to the pro rata portion of the amount 
appropriated for the corresponding period for fiscal 
year 2023’’. 
Subtitle D—Medicare 
SEC. 501. EXTENDING FLOOR FOR WORK GEOGRAPHIC 
INDEX. 
Section 1848(e)(1)(E) of the Social Security Act (42 
U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘Janu-
ary 1, 2024’’ and inserting ‘‘January 20, 2024’’. 
SEC. 502. REVISING PHASE-IN OF MEDICARE CLINICAL LAB-
ORATORY TEST PAYMENT CHANGES. 
(a) REVISED PHASE-IN OF REDUCTIONS FROM PRI-
VATE
PAYOR
RATE
IMPLEMENTATION.—Section 
1834A(b)(3) of the Social Security Act (42 U.S.C. 
1395m–1(b)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘2026’’ 
and inserting ‘‘2027’’; and 
(2) in subparagraph (B)— 
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(A) in clause (ii), by striking ‘‘2023’’ and 
inserting ‘‘2024’’; and 
(B) in clause (iii), by striking ‘‘2024 
through 2026’’ and inserting ‘‘2025 through 
2027’’. 
(b) REVISED REPORTING PERIOD FOR REPORTING 
OF PRIVATE SECTOR PAYMENT RATES FOR ESTABLISH-
MENT
OF
MEDICARE
PAYMENT
RATES.—Section 
1834A(a)(1)(B) of the Social Security Act (42 U.S.C. 
1395m–1(a)(1)(B)) is amended— 
(1) in clause (i), by striking ‘‘2023’’ and insert-
ing ‘‘2024’’; and 
(2) in clause (ii), by striking ‘‘2024’’ each place 
it appears and inserting ‘‘2025’’. 
SEC. 503. MEDICARE IMPROVEMENT FUND. 
Section 1898(b)(1) of the Social Security Act (42 
U.S.C. 
1395iii(b)(1)) 
is 
amended 
by 
striking 
‘‘$180,000,000’’ and inserting ‘‘$466,795,056’’. 
TITLE III—MISCELLANEOUS 
EXTENSIONS 
SEC. 601. COUNTER-UAS AUTHORITIES. 
Section 210G(i) of the Homeland Security Act of 
2002 (6 U.S.C. 124n(i)) is amended by striking ‘‘Novem-
ber 18, 2023’’ and inserting ‘‘February 3, 2024’’. 
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TITLE IV—BUDGETARY EFFECTS 
SEC. 701. BUDGETARY EFFECTS. 
(a) STATUTORY PAYGO SCORECARDS.—The budg-
etary effects of this 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 this 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 Re-
port 105–217 and section 250(c)(8) of the Balanced 
Budget and Emergency Deficit Control Act of 1985, the 
budgetary effects of this division shall not be estimated— 
(1) for purposes of section 251 of such Act; 
(2) for purposes of an allocation to the Com-
mittee on Appropriations pursuant to section 302(a) 
of the Congressional Budget Act of 1974; and 
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(3) 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. 
Passed the House of Representatives November 14, 
2023. 
Attest: 
KEVIN F. MCCUMBER, 
Clerk. 
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Calendar No. 248 
118TH CONGRESS 
1ST SESSION 
H. R. 6363 
AN ACT 
Making further continuing appropriations for fiscal 
year 2024, and for other purposes. 
NOVEMBER 14, 2023 
Read the second time and placed on the calendar 
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