H. R. 2471—418 
Appropriations of the House of Representatives and the Senate 
shall be notified at least 15 days in advance of any transfer pursuant 
to the preceding proviso. 
GENERAL PROVISIONS 
SEC. 201. Funds appropriated in this title shall be available 
for not to exceed $50,000 for official reception and representation 
expenses when specifically approved by the Secretary. 
SEC. 202. None of the funds appropriated in this title shall 
be used to pay the salary of an individual, through a grant or 
other extramural mechanism, at a rate in excess of Executive Level 
II: Provided, That none of the funds appropriated in this title 
shall be used to prevent the NIH from paying up to 100 percent 
of the salary of an individual at this rate. 
SEC. 203. None of the funds appropriated in this Act may 
be expended pursuant to section 241 of the PHS Act, except for 
funds specifically provided for in this Act, or for other taps and 
assessments made by any office located in HHS, prior to the 
preparation and submission of a report by the Secretary to the 
Committees on Appropriations of the House of Representatives and 
the Senate detailing the planned uses of such funds. 
SEC. 204. Notwithstanding section 241(a) of the PHS Act, such 
portion as the Secretary shall determine, but not more than 2.5 
percent, of any amounts appropriated for programs authorized 
under such Act shall be made available for the evaluation (directly, 
or by grants or contracts) and the implementation and effectiveness 
of programs funded in this title. 
(TRANSFER OF FUNDS) 
SEC. 205. Not to exceed 1 percent of any discretionary funds 
(pursuant to the Balanced Budget and Emergency Deficit Control 
Act of 1985) which are appropriated for the current fiscal year 
for HHS in this Act may be transferred between appropriations, 
but no such appropriation shall be increased by more than 3 percent 
by any such transfer: Provided, That the transfer authority granted 
by this section shall not be used to create any new program or 
to fund any project or activity for which no funds are provided 
in this Act: Provided further, That the Committees on Appropria-
tions of the House of Representatives and the Senate are notified 
at least 15 days in advance of any transfer. 
SEC. 206. In lieu of the timeframe specified in section 338E(c)(2) 
of the PHS Act, terminations described in such section may occur 
up to 60 days after the effective date of a contract awarded in 
fiscal year 2022 under section 338B of such Act, or at any time 
if the individual who has been awarded such contract has not 
received funds due under the contract. 
SEC. 207. None of the funds appropriated in this Act may 
be made available to any entity under title X of the PHS Act 
unless the applicant for the award certifies to the Secretary that 
it encourages family participation in the decision of minors to 
seek family planning services and that it provides counseling to 
minors on how to resist attempts to coerce minors into engaging 
in sexual activities. 
SEC. 208. Notwithstanding any other provision of law, no pro-
vider of services under title X of the PHS Act shall be exempt
H. R. 2471—419 
from any State law requiring notification or the reporting of child 
abuse, child molestation, sexual abuse, rape, or incest. 
SEC. 209. None of the funds appropriated by this Act (including 
funds appropriated to any trust fund) may be used to carry out 
the Medicare Advantage program if the Secretary denies participa-
tion in such program to an otherwise eligible entity (including 
a Provider Sponsored Organization) because the entity informs 
the Secretary that it will not provide, pay for, provide coverage 
of, or provide referrals for abortions: Provided, That the Secretary 
shall make appropriate prospective adjustments to the capitation 
payment to such an entity (based on an actuarially sound estimate 
of the expected costs of providing the service to such entity’s 
enrollees): Provided further, That nothing in this section shall be 
construed to change the Medicare program’s coverage for such serv-
ices and a Medicare Advantage organization described in this sec-
tion shall be responsible for informing enrollees where to obtain 
information about all Medicare covered services. 
SEC. 210. None of the funds made available in this title may 
be used, in whole or in part, to advocate or promote gun control. 
SEC. 211. The Secretary shall make available through assign-
ment not more than 60 employees of the Public Health Service 
to assist in child survival activities and to work in AIDS programs 
through and with funds provided by the Agency for International 
Development, the United Nations International Children’s Emer-
gency Fund or the World Health Organization. 
SEC. 212. In order for HHS to carry out international health 
activities, including HIV/AIDS and other infectious disease, chronic 
and environmental disease, and other health activities abroad 
during fiscal year 2022: 
(1) The Secretary may exercise authority equivalent to 
that available to the Secretary of State in section 2(c) of the 
State Department Basic Authorities Act of 1956. The Secretary 
shall consult with the Secretary of State and relevant Chief 
of Mission to ensure that the authority provided in this section 
is exercised in a manner consistent with section 207 of the 
Foreign Service Act of 1980 and other applicable statutes 
administered by the Department of State. 
(2) The Secretary is authorized to provide such funds by 
advance or reimbursement to the Secretary of State as may 
be necessary to pay the costs of acquisition, lease, alteration, 
renovation, and management of facilities outside of the United 
States for the use of HHS. The Department of State shall 
cooperate fully with the Secretary to ensure that HHS has 
secure, safe, functional facilities that comply with applicable 
regulation governing location, setback, and other facilities 
requirements and serve the purposes established by this Act. 
The Secretary is authorized, in consultation with the Secretary 
of State, through grant or cooperative agreement, to make 
available to public or nonprofit private institutions or agencies 
in participating foreign countries, funds to acquire, lease, alter, 
or renovate facilities in those countries as necessary to conduct 
programs of assistance for international health activities, 
including activities relating to HIV/AIDS and other infectious 
diseases, chronic and environmental diseases, and other health 
activities abroad.
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(3) The Secretary is authorized to provide to personnel 
appointed or assigned by the Secretary to serve abroad, allow-
ances and benefits similar to those provided under chapter 
9 of title I of the Foreign Service Act of 1980, and 22 U.S.C. 
4081 through 4086 and subject to such regulations prescribed 
by the Secretary. The Secretary is further authorized to provide 
locality-based comparability payments (stated as a percentage) 
up to the amount of the locality-based comparability payment 
(stated as a percentage) that would be payable to such per-
sonnel under section 5304 of title 5, United States Code if 
such personnel’s official duty station were in the District of 
Columbia. Leaves of absence for personnel under this subsection 
shall be on the same basis as that provided under subchapter 
I of chapter 63 of title 5, United States Code, or section 903 
of the Foreign Service Act of 1980, to individuals serving in 
the Foreign Service. 
(TRANSFER OF FUNDS) 
SEC. 213. The Director of the NIH, jointly with the Director 
of the Office of AIDS Research, may transfer up to 3 percent 
among institutes and centers from the total amounts identified 
by these two Directors as funding for research pertaining to the 
human immunodeficiency virus: Provided, That the Committees 
on Appropriations of the House of Representatives and the Senate 
are notified at least 15 days in advance of any transfer. 
(TRANSFER OF FUNDS) 
SEC. 214. Of the amounts made available in this Act for NIH, 
the amount for research related to the human immunodeficiency 
virus, as jointly determined by the Director of NIH and the Director 
of the Office of AIDS Research, shall be made available to the 
‘‘Office of AIDS Research’’ account. The Director of the Office of 
AIDS Research shall transfer from such account amounts necessary 
to carry out section 2353(d)(3) of the PHS Act. 
SEC. 215. (a) AUTHORITY.—Notwithstanding any other provision 
of law, the Director of NIH (‘‘Director’’) may use funds authorized 
under section 402(b)(12) of the PHS Act to enter into transactions 
(other than contracts, cooperative agreements, or grants) to carry 
out research identified pursuant to or research and activities 
described in such section 402(b)(12). 
(b) PEER REVIEW.—In entering into transactions under sub-
section (a), the Director may utilize such peer review procedures 
(including consultation with appropriate scientific experts) as the 
Director determines to be appropriate to obtain assessments of 
scientific and technical merit. Such procedures shall apply to such 
transactions in lieu of the peer review and advisory council review 
procedures that would otherwise be required under sections 
301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494 of the 
PHS Act. 
SEC. 216. Not to exceed $100,000,000 of funds appropriated 
by this Act to the institutes and centers of the National Institutes 
of Health may be used for alteration, repair, or improvement of 
facilities, as necessary for the proper and efficient conduct of the 
activities authorized herein, at not to exceed $5,000,000 per project.
H. R. 2471—421 
(TRANSFER OF FUNDS) 
SEC. 217. Of the amounts made available for NIH, 1 percent 
of the amount made available for National Research Service Awards 
(‘‘NRSA’’) shall be made available to the Administrator of the Health 
Resources and Services Administration to make NRSA awards for 
research in primary medical care to individuals affiliated with 
entities who have received grants or contracts under sections 736, 
739, or 747 of the PHS Act, and 1 percent of the amount made 
available for NRSA shall be made available to the Director of 
the Agency for Healthcare Research and Quality to make NRSA 
awards for health service research. 
SEC. 218. (a) The Biomedical Advanced Research and Develop-
ment Authority (‘‘BARDA’’) may enter into a contract, for more 
than one but no more than 10 program years, for purchase of 
research services or of security countermeasures, as that term is 
defined in section 319F–2(c)(1)(B) of the PHS Act (42 U.S.C. 247d– 
6b(c)(1)(B)), if— 
(1) funds are available and obligated— 
(A) for the full period of the contract or for the first 
fiscal year in which the contract is in effect; and 
(B) for the estimated costs associated with a necessary 
termination of the contract; and 
(2) the Secretary determines that a multi-year contract 
will serve the best interests of the Federal Government by 
encouraging full and open competition or promoting economy 
in administration, performance, and operation of BARDA’s pro-
grams. 
(b) A contract entered into under this section— 
(1) shall include a termination clause as described by sub-
section (c) of section 3903 of title 41, United States Code; 
and 
(2) shall be subject to the congressional notice requirement 
stated in subsection (d) of such section. 
SEC. 219. (a) The Secretary shall publish in the fiscal year 
2023 budget justification and on Departmental Web sites informa-
tion concerning the employment of full-time equivalent Federal 
employees or contractors for the purposes of implementing, admin-
istering, enforcing, or otherwise carrying out the provisions of the 
ACA, and the amendments made by that Act, in the proposed 
fiscal year and each fiscal year since the enactment of the ACA. 
(b) With respect to employees or contractors supported by all 
funds appropriated for purposes of carrying out the ACA (and 
the amendments made by that Act), the Secretary shall include, 
at a minimum, the following information: 
(1) For each such fiscal year, the section of such Act under 
which such funds were appropriated, a statement indicating 
the program, project, or activity receiving such funds, the Fed-
eral operating division or office that administers such program, 
and the amount of funding received in discretionary or manda-
tory appropriations. 
(2) For each such fiscal year, the number of full-time 
equivalent employees or contracted employees assigned to each 
authorized and funded provision detailed in accordance with 
paragraph (1). 
(c) In carrying out this section, the Secretary may exclude 
from the report employees or contractors who—