H. R. 4851 
One Hundred Eleventh Congress 
of the 
United States of America 
AT THE SECOND SESSION 
Begun and held at the City of Washington on Tuesday, 
the fifth day of January, two thousand and ten 
An Act 
To provide a temporary extension of certain programs, and for other purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Continuing Extension Act of 
2010’’. 
SEC. 2. EXTENSION OF UNEMPLOYMENT INSURANCE PROVISIONS. 
(a) IN GENERAL.—(1) Section 4007 of the Supplemental Appro-
priations Act, 2008 (Public Law 110–252; 26 U.S.C. 3304 note) 
is amended— 
(A) by striking ‘‘April 5, 2010’’ each place it appears and 
inserting ‘‘June 2, 2010’’; 
(B) in the heading for subsection (b)(2), by striking ‘‘APRIL 
5, 2010’’ and inserting ‘‘JUNE 2, 2010’’; and 
(C) in subsection (b)(3), by striking ‘‘September 4, 2010’’ 
and inserting ‘‘November 6, 2010’’. 
(2) Section 2002(e) of the Assistance for Unemployed Workers 
and Struggling Families Act, as contained in Public Law 111– 
5 (26 U.S.C. 3304 note; 123 Stat. 438), is amended— 
(A) in paragraph (1)(B), by striking ‘‘April 5, 2010’’ and 
inserting ‘‘June 2, 2010’’; 
(B) in the heading for paragraph (2), by striking ‘‘APRIL 
5, 2010’’ and inserting ‘‘JUNE 2, 2010’’; and 
(C) in paragraph (3), by striking ‘‘October 5, 2010’’ and 
inserting ‘‘December 7, 2010’’. 
(3) Section 2005 of the Assistance for Unemployed Workers 
and Struggling Families Act, as contained in Public Law 111– 
5 (26 U.S.C. 3304 note; 123 Stat. 444), is amended— 
(A) by striking ‘‘April 5, 2010’’ each place it appears and 
inserting ‘‘June 2, 2010’’; and 
(B) in subsection (c), by striking ‘‘September 4, 2010’’ and 
inserting ‘‘November 6, 2010’’. 
(4) Section 5 of the Unemployment Compensation Extension 
Act of 2008 (Public Law 110–449; 26 U.S.C. 3304 note) is amended 
by striking ‘‘September 4, 2010’’ and inserting ‘‘November 6, 2010’’. 
(b) FUNDING.—Section 4004(e)(1) of the Supplemental Appro-
priations Act, 2008 (Public Law 110–252; 26 U.S.C. 3304 note) 
is amended— 
(1) in subparagraph (C), by striking ‘‘and’’ at the end; 
(2) by inserting after subparagraph (D) the following new 
subparagraph:
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‘‘(E) the amendments made by section 2(a)(1) of the 
Continuing Extension Act of 2010; and’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall take effect as if included in the enactment of the Temporary 
Extension Act of 2010 (Public Law 111–144). 
SEC. 3. EXTENSION AND IMPROVEMENT OF PREMIUM ASSISTANCE 
FOR COBRA BENEFITS. 
(a) EXTENSION OF ELIGIBILITY PERIOD.—Subsection (a)(3)(A) of 
section 3001 of division B of the American Recovery and Reinvest-
ment Act of 2009 (Public Law 111–5), as amended by section 3(a) 
of the Temporary Extension Act of 2010 (Public Law 111–144), 
is amended by striking ‘‘March 31, 2010’’ and inserting ‘‘May 31, 
2010’’. 
(b) RULES RELATING TO 2010 EXTENSION.—Subsection (a) of 
section 3001 of division B of the American Recovery and Reinvest-
ment Act of 2009 (Public Law 111–5), as amended by section 3(b) 
of the Temporary Extension Act of 2010 (Public Law 111–144), 
is amended by adding at the end the following: 
‘‘(18) RULES RELATED TO APRIL AND MAY 2010 EXTENSION.— 
In the case of an individual who, with regard to coverage 
described in paragraph (10)(B), experiences a qualifying event 
related to a termination of employment on or after April 1, 
2010 and prior to the date of the enactment of this paragraph, 
rules similar to those in paragraphs (4)(A) and (7)(C) shall 
apply with respect to all continuation coverage, including State 
continuation coverage programs.’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall take effect as if included in the provisions of section 3001 
of division B of the American Recovery and Reinvestment Act 
of 2009. 
SEC. 4. INCREASE IN THE MEDICARE PHYSICIAN PAYMENT UPDATE. 
Paragraph (10) of section 1848(d) of the Social Security Act, 
as added by section 1011(a) of the Department of Defense Appro-
priations Act, 2010 (Public Law 111–118) and as amended by section 
5 of the Temporary Extension Act of 2010 (Public Law 111–144), 
is amended— 
(1) in subparagraph (A), by striking ‘‘March 31, 2010’’ and 
inserting ‘‘May 31, 2010’’; and 
(2) in subparagraph (B), by striking ‘‘April 1, 2010’’ and 
inserting ‘‘June 1, 2010’’. 
SEC. 5. EHR CLARIFICATION. 
(a) QUALIFICATION FOR CLINIC-BASED PHYSICIANS.— 
(1) MEDICARE.—Section 1848(o)(1)(C)(ii) of the Social Secu-
rity Act (42 U.S.C. 1395w–4(o)(1)(C)(ii)) is amended by striking 
‘‘setting (whether inpatient or outpatient)’’ and inserting 
‘‘inpatient or emergency room setting’’. 
(2) MEDICAID.—Section 1903(t)(3)(D) of the Social Security 
Act (42 U.S.C. 1396b(t)(3)(D)) is amended by striking ‘‘setting 
(whether inpatient or outpatient)’’ and inserting ‘‘inpatient or 
emergency room setting’’. 
(b) EFFECTIVE DATE.—The amendments made by subsection 
(a) shall be effective as if included in the enactment of the HITECH 
Act (included in the American Recovery and Reinvestment Act 
of 2009 (Public Law 111–5)).
H. R. 4851—3 
(c) IMPLEMENTATION.—Notwithstanding any other provision of 
law, the Secretary of Health and Human Services may implement 
the amendments made by this section by program instruction or 
otherwise. 
SEC. 6. EXTENSION OF USE OF 2009 POVERTY GUIDELINES. 
Section 1012 of the Department of Defense Appropriations Act, 
2010 (Public Law 111–118), as amended by section 7 of the Tem-
porary Extension Act of 2010 (Public Law 111–144), is amended 
by striking ‘‘March 31, 2010’’ and inserting ‘‘May 31, 2010’’. 
SEC. 7. EXTENSION OF NATIONAL FLOOD INSURANCE PROGRAM. 
(a) EXTENSION.—Section 129 of the Continuing Appropriations 
Resolution, 2010 (Public Law 111–68), as amended by section 8 
of Public Law 111–144, is amended by striking ‘‘by substituting’’ 
and all that follows through the period at the end and inserting 
‘‘by substituting May 31, 2010, for the date specified in each such 
section.’’. 
(b) EFFECTIVE DATE.—The amendments made by subsection 
(a) shall be considered to have taken effect on February 28, 2010. 
SEC. 8. COMPENSATION AND RATIFICATION OF AUTHORITY RELATED 
TO LAPSE IN HIGHWAY PROGRAMS. 
(a) COMPENSATION
FOR FEDERAL EMPLOYEES.—Any Federal 
employees furloughed as a result of the lapse in expenditure 
authority from the Highway Trust Fund after 11:59 p.m. on Feb-
ruary 28, 2010, through March 2, 2010, shall be compensated for 
the period of that lapse at their standard rates of compensation, 
as determined under policies established by the Secretary of 
Transportation. 
(b) RATIFICATION OF ESSENTIAL ACTIONS.—All actions taken 
by Federal employees, contractors, and grantees for the purposes 
of maintaining the essential level of Government operations, serv-
ices, and activities to protect life and property and to bring about 
orderly termination of Government functions during the lapse in 
expenditure authority from the Highway Trust Fund after 11:59 
p.m. on February 28, 2010, through March 2, 2010, are hereby 
ratified and approved if otherwise in accord with the provisions 
of the Continuing Appropriations Resolution, 2010 (division B of 
Public Law 111–68). 
(c) FUNDING.—Funds used by the Secretary to compensate 
employees described in subsection (a) shall be derived from funds 
previously authorized out of the Highway Trust Fund and made 
available or limited to the Department of Transportation by the 
Consolidated Appropriations Act, 2010 (Public Law 111–117) and 
shall be subject to the obligation limitations established in such 
Act. 
(d) EXPENDITURES FROM HIGHWAY TRUST FUND.—To permit 
expenditures from the Highway Trust Fund to effectuate the pur-
poses of this section, this section shall be deemed to be a section 
of the Continuing Appropriations Resolution, 2010 (division B of 
Public Law 111–68), as in effect on the date of the enactment 
of the last amendment to such Resolution. 
SEC. 9. SATELLITE TELEVISION EXTENSION. 
(a) AMENDMENTS TO SECTION 119 OF TITLE 17, UNITED STATES 
CODE.—
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(1) IN GENERAL.—Section 119 of title 17, United States 
Code, is amended— 
(A) in subsection (c)(1)(E), by striking ‘‘April 30, 2010’’ 
and inserting ‘‘May 31, 2010’’; and 
(B) in subsection (e), by striking ‘‘April 30, 2010’’ and 
inserting ‘‘May 31, 2010’’. 
(2) TERMINATION
OF
LICENSE.—Section 1003(a)(2)(A) of 
Public Law 111–118 is amended by striking ‘‘April 30, 2010’’, 
and inserting ‘‘May 31, 2010’’. 
(b) AMENDMENTS TO COMMUNICATIONS ACT OF 1934.—Section 
325(b) of the Communications Act of 1934 (47 U.S.C. 325(b)) is 
amended— 
(1) in paragraph (2)(C), by striking ‘‘April 30, 2010’’ and 
inserting ‘‘May 31, 2010’’; and 
(2) in paragraph (3)(C), by striking ‘‘May 1, 2010’’ each 
place it appears in clauses (ii) and (iii) and inserting ‘‘June 
1, 2010’’. 
SEC. 10. EXTENSION OF SMALL BUSINESS LOAN GUARANTEE PRO-
GRAM. 
(a) APPROPRIATION.—There is appropriated, out of any funds 
in the Treasury not otherwise appropriated, $80,000,000, for an 
additional amount for ‘‘Small Business Administration—Business 
Loans Program Account’’, to remain available until expended, for 
the cost of fee reductions and eliminations under section 501 of 
division A of the American Recovery and Reinvestment Act of 
2009 (Public Law 111–5; 123 Stat. 151) and loan guarantees under 
section 502 of division A of the American Recovery and Reinvest-
ment Act of 2009 (Public Law 111–5; 123 Stat. 152), as amended 
by this section: Provided, That such costs shall be as defined in 
section 502 of the Congressional Budget Act of 1974. 
(b) EXTENSION
OF SUNSET DATE.—Section 502(f) of division 
A of the American Recovery and Reinvestment Act of 2009 (Public 
Law 111–5; 123 Stat. 153) is amended by striking ‘‘April 30, 2010’’ 
and inserting ‘‘May 31, 2010’’. 
SEC. 11. SENSE OF THE SENATE REGARDING A VALUE ADDED TAX. 
It is the sense of the Senate that the Value Added Tax is 
a massive tax increase that will cripple families on fixed income 
and only further push back America’s economic recovery and the 
Senate opposes a Value Added Tax. 
SEC. 12. DETERMINATION OF BUDGETARY EFFECTS. 
(a) IN GENERAL.—The budgetary effects of this Act, for the 
purpose of complying with the Statutory Pay-As-You-Go Act of 
2010, shall be determined by reference to the latest statement 
titled ‘‘Budgetary Effects of PAYGO Legislation’’ for this Act, sub-
mitted for printing in the Congressional Record by the Chairman 
of the Senate Budget Committee, provided that such statement 
has been submitted prior to the vote on passage. 
(b) EMERGENCY DESIGNATION FOR CONGRESSIONAL ENFORCE-
MENT.—This Act, with the exception of section 4, is designated 
as an emergency for purposes of pay-as-you-go principles. In the 
Senate, this Act is designated as an emergency requirement pursu-
ant to section 403(a) of S. Con. Res. 13 (111th Congress), the 
concurrent resolution on the budget for fiscal year 2010.