H. R. 2471—406 
That 15 percent of the remaining amount shall be for the States 
with the highest mortality rate related to opioid use disorders: 
Provided further, That of the amounts provided for State Opioid 
Response Grants not more than 2 percent shall be available for 
Federal administrative expenses, training, technical assistance, and 
evaluation: Provided further, That of the amount not reserved by 
the previous three provisos, the Secretary shall make allocations 
to States, territories, and the District of Columbia according to 
a formula using national survey results that the Secretary deter-
mines are the most objective and reliable measure of drug use 
and drug-related deaths: Provided further, That the Secretary shall 
submit the formula methodology to the Committees on Appropria-
tions of the House of Representatives and the Senate not less 
than 21 days prior to publishing a Funding Opportunity Announce-
ment: Provided further, That prevention and treatment activities 
funded through such grants may include education, treatment 
(including the provision of medication), behavioral health services 
for individuals in treatment programs, referral to treatment serv-
ices, recovery support, and medical screening associated with such 
treatment: Provided further, That each State, as well as the District 
of Columbia, shall receive not less than $4,000,000: Provided fur-
ther, That in addition to amounts provided herein, the following 
amounts shall be available under section 241 of the PHS Act: 
(1) $79,200,000 to carry out subpart II of part B of title XIX 
of the PHS Act to fund section 1935(b) technical assistance, national 
data, data collection and evaluation activities, and further that 
the total available under this Act for section 1935(b) activities 
shall not exceed 5 percent of the amounts appropriated for subpart 
II of part B of title XIX; and (2) $2,000,000 to evaluate substance 
abuse treatment programs: Provided further, That none of the funds 
provided for section 1921 of the PHS Act or State Opioid Response 
Grants shall be subject to section 241 of such Act. 
SUBSTANCE ABUSE PREVENTION 
For carrying out titles III and V of the PHS Act with respect 
to substance abuse prevention, $218,219,000. 
HEALTH SURVEILLANCE AND PROGRAM SUPPORT 
For program support and cross-cutting activities that supple-
ment activities funded under the headings ‘‘Mental Health’’, ‘‘Sub-
stance Abuse Treatment’’, and ‘‘Substance Abuse Prevention’’ in 
carrying out titles III, V, and XIX of the PHS Act and the Protection 
and Advocacy for Individuals with Mental Illness Act in the Sub-
stance 
Abuse 
and 
Mental 
Health 
Services 
Administration, 
$260,230,000: Provided, That of the amount made available under 
this heading, $127,535,000 shall be used for the projects, and in 
the amounts, specified in the table titled ‘‘Community Project 
Funding/Congressionally Directed Spending’’ included for this divi-
sion in the explanatory statement described in section 4 (in the 
matter preceding division A of this consolidated Act): Provided 
further, That none of the funds made available for projects described 
in the preceding proviso shall be subject to section 241 of the 
PHS Act or section 205 of this Act: Provided further, That in 
addition to amounts provided herein, $31,428,000 shall be available 
under section 241 of the PHS Act to supplement funds available 
to carry out national surveys on drug abuse and mental health,
H. R. 2471—407 
to collect and analyze program data, and to conduct public aware-
ness and technical assistance activities: Provided further, That, 
in addition, fees may be collected for the costs of publications, 
data, data tabulations, and data analysis completed under title 
V of the PHS Act and provided to a public or private entity upon 
request, which shall be credited to this appropriation and shall 
remain available until expended for such purposes: Provided further, 
That amounts made available in this Act for carrying out section 
501(o) of the PHS Act shall remain available through September 
30, 2023: Provided further, That funds made available under this 
heading (other than amounts specified in the first proviso under 
this heading) may be used to supplement program support funding 
provided under the headings ‘‘Mental Health’’, ‘‘Substance Abuse 
Treatment’’, and ‘‘Substance Abuse Prevention’’. 
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY 
HEALTHCARE RESEARCH AND QUALITY 
For carrying out titles III and IX of the PHS Act, part A 
of title XI of the Social Security Act, and section 1013 of the 
Medicare Prescription Drug, Improvement, and Modernization Act 
of 2003, $350,400,000: Provided, That section 947(c) of the PHS 
Act shall not apply in fiscal year 2022: Provided further, That 
in addition, amounts received from Freedom of Information Act 
fees, reimbursable and interagency agreements, and the sale of 
data shall be credited to this appropriation and shall remain avail-
able until September 30, 2023. 
CENTERS FOR MEDICARE & MEDICAID SERVICES 
GRANTS TO STATES FOR MEDICAID 
For carrying out, except as otherwise provided, titles XI and 
XIX of the Social Security Act, $368,666,106,000, to remain avail-
able until expended. 
In addition, for carrying out such titles after May 31, 2022, 
for the last quarter of fiscal year 2022 for unanticipated costs 
incurred for the current fiscal year, such sums as may be necessary, 
to remain available until expended. 
In addition, for carrying out such titles for the first quarter 
of fiscal year 2023, $165,722,018,000, to remain available until 
expended. 
Payment under such title XIX may be made for any quarter 
with respect to a State plan or plan amendment in effect during 
such quarter, if submitted in or prior to such quarter and approved 
in that or any subsequent quarter. 
PAYMENTS TO THE HEALTH CARE TRUST FUNDS 
For payment to the Federal Hospital Insurance Trust Fund 
and the Federal Supplementary Medical Insurance Trust Fund, 
as provided under sections 217(g), 1844, and 1860D–16 of the Social 
Security Act, sections 103(c) and 111(d) of the Social Security 
Amendments of 1965, section 278(d)(3) of Public Law 97–248, and 
for administrative expenses incurred pursuant to section 201(g) 
of the Social Security Act, $487,862,000,000.
H. R. 2471—408 
In addition, for making matching payments under section 1844 
and benefit payments under section 1860D–16 of the Social Security 
Act that were not anticipated in budget estimates, such sums as 
may be necessary. 
PROGRAM MANAGEMENT 
For carrying out, except as otherwise provided, titles XI, XVIII, 
XIX, and XXI of the Social Security Act, titles XIII and XXVII 
of the PHS Act, the Clinical Laboratory Improvement Amendments 
of 1988, and other responsibilities of the Centers for Medicare 
& Medicaid Services, not to exceed $3,669,744,000 to be transferred 
from the Federal Hospital Insurance Trust Fund and the Federal 
Supplementary Medical Insurance Trust Fund, as authorized by 
section 201(g) of the Social Security Act; together with all funds 
collected in accordance with section 353 of the PHS Act and section 
1857(e)(2) of the Social Security Act, funds retained by the Secretary 
pursuant to section 1893(h) of the Social Security Act, and such 
sums as may be collected from authorized user fees and the sale 
of data, which shall be credited to this account and remain available 
until expended: Provided, That all funds derived in accordance 
with 31 U.S.C. 9701 from organizations established under title 
XIII of the PHS Act shall be credited to and available for carrying 
out the purposes of this appropriation: Provided further, That the 
Secretary is directed to collect fees in fiscal year 2022 from Medicare 
Advantage organizations pursuant to section 1857(e)(2) of the Social 
Security Act and from eligible organizations with risk-sharing con-
tracts under section 1876 of that Act pursuant to section 
1876(k)(4)(D) of that Act: Provided further, That of the amount 
made available under this heading, $397,334,000 shall remain avail-
able until September 30, 2023, and shall be available for the Survey 
and Certification Program: Provided further, That amounts avail-
able under this heading to support quality improvement organiza-
tions (as defined in section 1152 of the Social Security Act) shall 
not exceed the amount specifically provided for such purpose under 
this heading in division H of the Consolidated Appropriations Act, 
2018 (Public Law 115–141). 
HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT 
In addition to amounts otherwise available for program integ-
rity and program management, $873,000,000, to remain available 
through September 30, 2023, to be transferred from the Federal 
Hospital Insurance Trust Fund and the Federal Supplementary 
Medical Insurance Trust Fund, as authorized by section 201(g) 
of the Social Security Act, of which $658,648,000 shall be for the 
Centers for Medicare & Medicaid Services program integrity activi-
ties, of which $102,145,000 shall be for the Department of Health 
and Human Services Office of Inspector General to carry out fraud 
and abuse activities authorized by section 1817(k)(3) of such Act, 
and of which $112,207,000 shall be for the Department of Justice 
to carry out fraud and abuse activities authorized by section 
1817(k)(3) of such Act: Provided, That the report required by section 
1817(k)(5) of the Social Security Act for fiscal year 2022 shall 
include measures of the operational efficiency and impact on fraud, 
waste, and abuse in the Medicare, Medicaid, and CHIP programs 
for the funds provided by this appropriation: Provided further, 
That of the amount provided under this heading, $317,000,000
H. R. 2471—409 
is provided to meet the terms of section 4004(b)(3)(B) and section 
4005(c)(2) of S. Con. Res. 14 (117th Congress), the concurrent resolu-
tion on the budget for fiscal year 2022, and $556,000,000 is addi-
tional new budget authority specified for purposes of section 
4004(b)(3) and section 4005(c) of such resolution: Provided further, 
That the Secretary shall provide not less than $30,000,000 from 
amounts made available under this heading and amounts made 
available for fiscal year 2022 under section 1817(k)(3)(A) of the 
Social Security Act for the Senior Medicare Patrol program to 
combat health care fraud and abuse. 
ADMINISTRATION FOR CHILDREN AND FAMILIES 
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND 
FAMILY SUPPORT PROGRAMS 
For carrying out, except as otherwise provided, titles I, IV– 
D, X, XI, XIV, and XVI of the Social Security Act and the Act 
of July 5, 1960, $2,795,000,000, to remain available until expended; 
and for such purposes for the first quarter of fiscal year 2023, 
$1,300,000,000, to remain available until expended. 
For carrying out, after May 31 of the current fiscal year, except 
as otherwise provided, titles I, IV–D, X, XI, XIV, and XVI of the 
Social Security Act and the Act of July 5, 1960, for the last 3 
months of the current fiscal year for unanticipated costs, incurred 
for the current fiscal year, such sums as may be necessary. 
LOW INCOME HOME ENERGY ASSISTANCE 
For making payments under subsections (b) and (d) of section 
2602 of the Low-Income Home Energy Assistance Act of 1981 (42 
U.S.C. 8621 et seq.), $3,800,304,000: Provided, That notwith-
standing section 2609A(a) of such Act, not more than $4,600,000 
may be reserved by the Secretary for technical assistance, training, 
and monitoring of program activities for compliance with internal 
controls, policies and procedures, and to supplement funding other-
wise available for necessary administrative expenses to carry out 
such Act, and the Secretary may, in addition to the authorities 
provided in section 2609A(a)(1), use such funds through contracts 
with private entities that do not qualify as nonprofit organizations: 
Provided further, That all but $785,000,000 of the amount appro-
priated under this heading shall be allocated as though the total 
appropriation for such payments for fiscal year 2022 was less than 
$1,975,000,000: Provided further, That, after applying all applicable 
provisions of section 2604 of such Act and the previous proviso, 
each State or territory that would otherwise receive an allocation 
that is less than 97 percent of the amount that it received under 
this heading for fiscal year 2021 from amounts appropriated in 
Public Law 116–260 shall have its allocation increased to that 
97 percent level, with the portions of other States’ and territories’ 
allocations that would exceed 100 percent of the amounts they 
respectively received in such fashion for fiscal year 2021 being 
ratably reduced.