I 
116TH CONGRESS 
1ST SESSION H. R. 1183 
To amend title 10, United States Code, to ensure access to qualified 
acupuncturist services for military members and military dependents, 
to amend title 38, United States Code, to ensure access to acupuncturist 
services through the Department of Veterans Affairs, to amend title 
XVIII of the Social Security Act to provide for coverage of qualified 
acupuncturist services under the Medicare program; to amend the Public 
Health Service Act to authorize the appointment of qualified 
acupuncturists as officers in the commissioned Regular Corps and the 
Ready Reserve Corps of the Public Health Service, and for other pur-
poses. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 13, 2019 
Ms. JUDY CHU of California introduced the following bill; which was referred 
to the Committee on Energy and Commerce, and in addition to the Com-
mittees on Armed Services, Veterans’ Affairs, and Ways and Means, 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 com-
mittee concerned 
A BILL 
To amend title 10, United States Code, to ensure access 
to qualified acupuncturist services for military members 
and military dependents, to amend title 38, United 
States Code, to ensure access to acupuncturist services 
through the Department of Veterans Affairs, to amend 
title XVIII of the Social Security Act to provide for 
coverage of qualified acupuncturist services under the 
Medicare program; to amend the Public Health Service 
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Act 
to 
authorize 
the 
appointment 
of 
qualified 
acupuncturists as officers in the commissioned Regular 
Corps and the Ready Reserve Corps of the Public Health 
Service, 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; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Acupuncture for Heroes and Seniors Act of 2019’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Definitions. 
Sec. 3. Inclusion of acupuncture services through military health care system 
and TRICARE program. 
Sec. 4. Acupuncture health services for TRICARE program beneficiaries. 
Sec. 5. Appointment of acupuncturists as commissioned officers in the Armed 
Forces. 
Sec. 6. Inclusion of acupuncturist services at veterans health facilities. 
Sec. 7. Coverage for acupuncturist services under the Medicare program. 
Sec. 8. Acupuncturists in the Regular Corps and the Ready Reserve Corps of 
the Public Health Service. 
SEC. 2. DEFINITIONS. 
In this Act, except as otherwise provided: 
(1) The term ‘‘qualified acupuncturist services’’ 
means— 
(A) acupuncturist services— 
(i) that are furnished by a qualified 
acupuncturist; and 
(ii) which the qualified acupuncturist 
is legally authorized to perform under 
State law; and 
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(B) services and supplies that are fur-
nished by a qualified acupuncturist incident to 
the services described in subparagraph (A). 
(2) The term ‘‘qualified acupuncturist’’ means 
an individual who is licensed or certified as an 
acupuncturist by a State or, in the case of an indi-
vidual in a State that does not provide for such li-
censure or certification, meets such criteria (such as 
accreditation through an appropriate nationally rec-
ognized certification authority for acupuncturists) as 
the Secretary of Health and Human Services may 
specify. In specifying such requirements, the Sec-
retary may use the same requirements as those es-
tablished by such a certification authority. 
(3) The term ‘‘State’’ means the 50 States, the 
District of Columbia, Puerto Rico, the United States 
Virgin Islands, Guam, American Samoa, and the 
Northern Mariana Islands. 
SEC. 3. INCLUSION OF ACUPUNCTURE SERVICES THROUGH 
MILITARY 
HEALTH 
CARE 
SYSTEM 
AND 
TRICARE PROGRAM. 
(a) MEMBERS OF THE UNIFORMED SERVICES.— 
(1) IN
GENERAL.—Chapter 55 of title 10, 
United States Code, is amended by inserting after 
section 1074o the following new section: 
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‘‘§ 1074p. Provision of acupuncturist services 
‘‘In accordance with section 1074(c) of this title, and 
under regulations prescribed by the Secretary, members 
of the uniformed services entitled to medical care under 
section 1074 shall be entitled to qualified acupuncturist 
services (without the requirement of a referral) provided 
in a military medical treatment facility or a private facility 
by an acupuncturist who is licensed or certified in the 
State in which the facility is located, or, in the case of 
a facility in a State that does not provide for such licen-
sure or certification, meets such criteria (such as accredi-
tation through an appropriate nationally recognized cer-
tification authority for acupuncturists) as the Secretary 
may specify. In specifying such requirements, the Sec-
retary may use the same requirements as those established 
by such a certification authority.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by inserting after the item relating to section 1074o 
the following new item: 
‘‘1074p. Provision of acupuncturist services.’’. 
(b) TRICARE PROGRAM.—Section 1079(a) of title 
10, United States Code, is amended— 
(1) in paragraph (12), by inserting ‘‘or para-
graph (18)’’ after ‘‘except as authorized in para-
graph (4)’’; and 
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(2) by adding at the end the following new 
paragraph: 
‘‘(18) Acupuncturist services may be provided 
without the requirement of a referral if performed 
by an acupuncturist who is licensed or certified in 
the State in which the services are furnished, or, in 
the case of services furnished in a State that does 
not provide for such licensure or certification, meets 
such criteria (such as accreditation through an ap-
propriate nationally recognized certification author-
ity for acupuncturists) as the Secretary may specify. 
In specifying such requirements, the Secretary may 
use the same requirements as those established by 
such a certification authority.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date that is 180 days 
after the date of the enactment of this Act. 
SEC. 4. ACUPUNCTURE HEALTH SERVICES FOR TRICARE 
PROGRAM BENEFICIARIES. 
(a) PLAN REQUIRED.—Not later than 90 days after 
the date of the enactment of this Act, the Secretary of 
Defense shall develop a plan to provide qualified 
acupuncturist services, as a permanent part of the 
TRICARE program pursuant to the amendments made by 
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section 3, for covered beneficiaries (as defined in section 
1072 of title 10, United States Code). 
(b) CONTENTS OF PLAN.—The plan shall require 
that a contract entered into under section 1097 of title 
10, United States Code, for the delivery of health care 
services shall— 
(1) include the delivery of qualified acupunctur-
ist services; 
(2) require that qualified acupuncturist services 
may be provided only by a qualified acupuncturist; 
and 
(3) provide clarity on the process that a covered 
beneficiary must use to select and have direct access 
to a qualified acupuncturist (without the require-
ment of a referral). 
(c) IMPLEMENTATION OF PLAN.—The plan developed 
under subsection (a) shall provide for implementation of 
the plan to begin not later than 270 days after the date 
of enactment of this Act. 
(d) SUBMISSION.—The Secretary shall submit to 
Congress the plan developed under subsection (a). 
SEC. 5. APPOINTMENT OF ACUPUNCTURISTS AS COMMIS-
SIONED OFFICERS IN THE ARMED FORCES. 
(a) ARMY.—Section 7068 of title 10, United States 
Code, is amended— 
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(1) by inserting ‘‘(a) MEDICAL
SERVICE 
CORPS.—’’ before ‘‘There is’’; 
(2) in paragraph (5)— 
(A) in subparagraph (D), by striking 
‘‘and’’; 
(B) by redesignating subparagraph (E) as 
subparagraph (F); and 
(C) by inserting after subparagraph (D) 
the following new subparagraph: 
‘‘(E) the Acupuncture Section; and’’; and 
(3) by adding at the end the following new sub-
section: 
‘‘(b) 
APPOINTMENT
OF
ACUPUNCTURISTS.— 
Acupuncturists who are qualified under regulations pre-
scribed by the Secretary of the Army may be appointed 
as commissioned officers in the Acupuncture Section of 
the Medical Service Corps of the Army. Such regulations 
shall require such acupuncturists to be licensed or certified 
in the State in which the services are furnished, or, in 
the case of services furnished in a State that does not pro-
vide for such licensure or certification, meets such criteria 
(such as accreditation through an appropriate nationally 
recognized certification authority for acupuncturists) as 
the Secretary of the Army may specify. In specifying such 
requirements, the Secretary may use the same require-
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ments as those established by such a certification author-
ity.’’. 
(b) NAVY.— 
(1) IN GENERAL.—Chapter 809 of such title is 
amended by inserting after section 8079 the fol-
lowing new section: 
‘‘§ 8080. Appointment of acupuncturists in the Med-
ical Service Corps 
‘‘Acupuncturists who are qualified under regulations 
prescribed by the Secretary of the Navy may be appointed 
as commissioned officers in the Medical Service Corps of 
the 
Navy. 
Such 
regulations 
shall 
require 
such 
acupuncturists to be licensed or certified in the State in 
which the services are furnished, or, in the case of services 
furnished in a State that does not provide for such licen-
sure or certification, meets such criteria (such as accredi-
tation through an appropriate nationally recognized cer-
tification authority for acupuncturists) as the Secretary 
of the Navy may specify. In specifying such requirements, 
the Secretary may use the same requirements as those es-
tablished by such a certification authority.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by inserting after the item relating to section 8079 
the following new item: 
‘‘8080. Appointment of acupuncturists in the Medical Service Corps.’’. 
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(c) AIR FORCE.—Section 9067(f) of such title is 
amended— 
(1) by striking ‘‘physician assistant functions 
and chiropractic functions’’ and inserting ‘‘physician 
assistant functions, chiropractic functions, and 
acupuncturist functions’’; and 
(2) by adding at the end the following new sen-
tence: ‘‘Biomedical service officers may be referred 
to as the specific career designation, including chiro-
practic services officer and acupuncturist services of-
ficer.’’. 
(d) REGULATIONS.—The regulations required to be 
prescribed by the amendments made by this section shall 
be prescribed not later than 120 days after the date of 
the enactment of this Act. 
SEC. 6. INCLUSION OF ACUPUNCTURIST SERVICES AT VET-
ERANS HEALTH FACILITIES. 
(a) ACUPUNCTURIST SERVICES.— 
(1) IN GENERAL.—Subchapter II of chapter 17 
of title 38, United States Code, is amended by add-
ing at the end the following new section: 
‘‘§ 1720J. Provision of acupuncturist services 
‘‘(a) IN GENERAL.—The Secretary shall carry out a 
program to provide acupuncturist services to veterans en-
rolled in the health care system established under section 
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1705(a) of this title (without the requirement of a refer-
ral). 
‘‘(b) LOCATIONS.—The program under subsection (a) 
shall be carried out at in at least one facility of the De-
partment in each Veterans Integrated Service Network. In 
selecting such facilities, the Secretary shall ensure that the 
program is carried out in both urban and rural areas. 
‘‘(c) SERVICES AVAILABLE.—The Secretary shall en-
sure that the acupuncturist services available under the 
program are able to address, at a minimum, the following: 
‘‘(1) Chronic and acute pain. 
‘‘(2) Cancer pain. 
‘‘(3) Postoperative nausea and vomiting. 
‘‘(4) Postsurgical gastroparesis syndrome. 
‘‘(5) Opioid-induced constipation. 
‘‘(6) Opioid-induced pruritus. 
‘‘(7) Chemotherapy-induced neuropathy. 
‘‘(8) Aromatase inhibitor-associated joint pain. 
‘‘(9) Neck dissection-related pain and dysfunc-
tion. 
‘‘(10) Stress management. 
‘‘(11) Mental health conditions. 
‘‘(12) Substance abuse. 
‘‘(13) Symptoms relating to traumatic brain in-
jury and post-traumatic stress. 
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‘‘(d) ADMINISTRATION.—(1) The Secretary shall 
carry out the program through— 
‘‘(A) qualified acupuncturists appointed as em-
ployees of the Department located at medical centers 
and clinics of the Department; and 
‘‘(B) through contract qualified acupuncturists 
if— 
‘‘(i) the Secretary is unable to make ap-
pointments described in subparagraph (A); 
‘‘(ii) a patient requires specialty care that 
an employee under such subparagraph is not 
able to provide to the patient; or 
‘‘(iii) there is an emergency that requires 
the use of such a contract acupuncturist. 
‘‘(2) The Secretary shall provide training and mate-
rials to health care providers of the Department who pro-
vide primary care to veterans to explain the benefits of 
acupuncturist services. 
‘‘(3) 
In 
this 
section, 
the 
term 
‘qualified 
acupuncturist’ means, with respect to the furnishing of 
services in a State, an individual who licensed or certified 
in the State in which the services are furnished, or, in 
the case of services furnished in a State that does not pro-
vide for such licensure or certification, meets such criteria 
(such as accreditation through an appropriate nationally 
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recognized certification authority for acupuncturists) as 
the Secretary may specify. In specifying such require-
ments, the Secretary may use the same requirements as 
those established by such a certification authority. 
‘‘(e) REGULATIONS.—The Secretary shall prescribe 
regulations to carry out this section.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by inserting after the item relating to section 1720I 
the following new section: 
‘‘1720J. Provision of acupuncturist services.’’. 
(3) 
CONFORMING
AMENDMENT.—Section 
1701(6) of such title is amended by adding at the 
end the following new subparagraph: 
‘‘(H) Acupuncturist services in accordance 
with section 1720J of this title.’’. 
(b) ADVISORY COMMITTEE.— 
(1) IN GENERAL.—Subchapter III of chapter 5 
of such title is amended by adding at the end the 
following new section: 
‘‘§ 547. Advisory committee on acupuncturist services 
‘‘(a) ACUPUNCTURE
ADVISORY
COMMITTEE.—(1) 
The Secretary shall establish an advisory committee to be 
known as the ‘Advisory Committee on Acupuncturist Serv-
ices’ (in this section referred to as the ‘Committee’) to 
provide the Secretary with assistance and advice in the 
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development and implementation of the program estab-
lished by section 1720J of this title. 
‘‘(2) The Committee shall consist of members ap-
pointed by the Secretary from the general public, includ-
ing— 
‘‘(A) not fewer than five practicing acupunctur-
ists, of which at least four shall be State licensed 
acupuncturists; 
‘‘(B) one veteran from each of the Armed 
Forces; 
‘‘(C) not fewer than two representatives from 
veterans service organizations; and 
‘‘(D) a representative of the Department of De-
fense. 
‘‘(b) DUTIES.—The Committee shall— 
‘‘(1) review and evaluate the ability of a veteran 
to access an acupuncturist at facilities of the De-
partment; 
‘‘(2) advise the Secretary with respect to— 
‘‘(A) protocols governing direct access to 
acupuncture care; 
‘‘(B) protocols governing the scope of prac-
tice of acupuncture practitioners; 
‘‘(C) the definitions of services to be pro-
vided by acupuncturists; and 
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‘‘(D) such other matters the Secretary de-
termines appropriate; and 
‘‘(3) upon the determination of the Secretary 
that the program of acupuncturist services under 
section 1720H of this title has been fully imple-
mented, submit to the Secretary a report containing 
the evaluation of the Committee of the implementa-
tion of such program. 
‘‘(c) CHAIRMAN.—The Secretary shall designate one 
member of the Committee to serve as the chairman of the 
Committee. 
‘‘(d) MEETINGS.—The Committee shall meet at the 
call of the Chairman, but not fewer than three times dur-
ing each fiscal year, beginning in the fiscal year following 
the fiscal year in which this section is enacted. 
‘‘(e) REPORT.—Following the date on which the 
Committee submits to the Secretary the report under sub-
section (b)(4), the Secretary shall submit to the Commit-
tees on Veterans’ Affairs of the Senate and the House of 
Representatives a report containing the following: 
‘‘(1) A copy of the Committee report, together 
with the comments of the Secretary on the report. 
‘‘(2) An explanation of the criteria and ration-
ale that the Secretary used to determine that the 
program of acupuncturist services under section 
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1720J of this title was fully implemented, as de-
scribed in such subsection (b)(4). 
‘‘(3) The views of the Secretary regarding the 
future implementation of such program.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by inserting after the item relating to section 546 
the following new item: 
‘‘547. Advisory committee on acupuncturist services.’’. 
(c) CONFORMING AMENDMENTS.— 
(1) AUTHORITY FOR APPOINTMENTS.—Section 
7401(1) of title 38, United States Code, is amended 
by inserting ‘‘acupuncturists,’’ after ‘‘chiroprac-
tors,’’. 
(2) PERIOD OF APPOINTMENTS.—Section 7403 
of such title is amended by adding at the end the 
following new subparagraph: 
‘‘(I) Acupuncturists.’’. 
(3) PAY.— 
(A) SCALE.—Section 7404 of such title is 
amended— 
(i) in subsection (a)(2), by inserting 
‘‘, acupuncturists,’’ after ‘‘physicians’’; and 
(ii) in the list in subsection (b), by in-
serting ‘‘, ACUPUNCTURIST,’’ after 
‘‘PHYSICIAN’’. 
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(B) TREATMENT.—Section 7431 of title 
38, United States Code, is amended by adding 
at the end the following new subsection: 
‘‘(i) TREATMENT OF ACUPUNCTURISTS.—For pur-
poses of this subchapter, an acupuncturist is deemed to 
be a physician.’’. 
(4) MALPRACTICE AND NEGLIGENCE SUITS.— 
Section 7316(a)(2) of such title is amended by in-
serting ‘‘acupuncturist,’’ after ‘‘chiropractor,’’. 
(5) HOURS AND CONDITIONS.—Section 7421(b) 
of such title is amended by adding at the end the 
following new paragraph: 
‘‘(9) Acupuncturists.’’. 
(6) EFFECTIVE DATE.—The amendments made 
by paragraph (4) apply with respect to services pro-
vided on or after the date that is 270 days after the 
date of enactment of this Act. 
SEC. 7. COVERAGE FOR ACUPUNCTURIST SERVICES UNDER 
THE MEDICARE PROGRAM. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (GG); 
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(B) by adding ‘‘and’’ at the end of sub-
paragraph (HH); and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(II) qualified acupuncturist services (as de-
fined in subsection (jjj)(1));’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘Qualified Acupuncturist Services 
‘‘(jjj)(1) The term ‘qualified acupuncturist services’ 
means such services furnished by a qualified acupuncturist 
(as defined in paragraph (2)), and such services and sup-
plies furnished as an incident to services furnished by the 
qualified acupuncturist, as the qualified acupuncturist is 
legally authorized to perform under State law. 
‘‘(2) The term ‘qualified acupuncturist’ has the 
meaning given such term in section 2 of the Acupuncture 
for Heroes and Seniors Act of 2019.’’. 
(b) PAYMENT RULES.— 
(1) PAYMENT UNDER PHYSICIAN FEE SCHED-
ULE.—Section 1848(j)(3) of the Social Security Act 
(42 U.S.C. 1395w–4(j)(3)) is amended by inserting 
‘‘(2)(GG),’’ before ‘‘(3),’’. 
(2) SEPARATE PAYMENT FOR SERVICES OF IN-
STITUTIONAL
PROVIDERS.—Section 1833(a)(2)(B) 
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of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395l(a)(2)(B)) is amended— 
(A) in clause (i), by inserting ‘‘and in the 
case of qualified acupuncturist services,’’ after 
‘‘1999,’’; 
(B) in clause (ii), by inserting ‘‘or in the 
case of qualified acupuncturist services,’’ after 
‘‘1999,’’; and 
(C) in clause (iii), by inserting ‘‘(other 
than qualified acupuncturist services)’’ after 
‘‘such services’’. 
(3) QUALIFIED
ACUPUNCTURIST
TREATMENT 
AS A PRACTITIONER.—Section 1842(b)(18)(C) of the 
Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is 
amended by adding at the end the following new 
clause: 
‘‘(vii) A qualified acupuncturist (as defined in 
section 1861(jjj)(2)).’’. 
(4) SEPARATE
BILLING
FOR
ACUPUNCTURIST 
SERVICES FURNISHED IN AN INPATIENT HOSPITAL 
SETTING.—Section 1861(b)(4) of the Social Security 
Act (42 U.S.C. 1395x(b)(4)) is amended by insert-
ing ‘‘qualified acupuncturist services,’’ after ‘‘quali-
fied psychologist services,’’. 
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(c) EFFECTIVE DATE.—The amendments made by 
this section apply with respect to services furnished on or 
after the date that is 270 days after the date of enactment 
of this Act. 
SEC. 8. ACUPUNCTURISTS IN THE REGULAR CORPS AND 
THE READY RESERVE CORPS OF THE PUBLIC 
HEALTH SERVICE. 
(a) AUTHORIZATION
OF
APPOINTMENT.—Section 
207 of the Public Health Service Act (42 U.S.C. 209) is 
amended— 
(1) in subsection (a)(1), by inserting ‘‘acupunc-
ture,’’ after ‘‘nursing,’’; and 
(2) by adding at the end the following: 
‘‘(j) 
APPOINTMENT
OF
QUALIFIED 
ACUPUNCTURISTS.— 
‘‘(1) ELIGIBILITY.—Acupuncturists shall be eli-
gible for appointment as officers in the commis-
sioned Regular Corps and the Ready Reserve Corps 
of the Public Health Service. 
‘‘(2) QUALIFICATION; TRAINING, EQUIPMENT, 
AND
PREPARATION.—The Secretary shall ensure 
that acupuncturists in the commissioned Regular 
Corps and in the Ready Reserve Corps— 
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‘‘(A) are qualified acupuncturists (as de-
fined in section 2 of the Acupuncture for He-
roes and Seniors Act of 2019); and 
‘‘(B) are trained, equipped, and otherwise 
prepared to fulfill applicable public health and 
emergency response service responsibilities in 
the Commissioned Corps.’’. 
(b) REQUIRED PLACEMENT.— 
(1) IN GENERAL.—Not later than 90 days after 
the date of enactment of this Act, the Secretary of 
Health and Human Services shall ensure the ap-
pointment of no fewer than 6 acupuncturists into 
the commissioned Regular Corps and the Ready Re-
serve Corps of the Public Health Service. 
(2) REPORTS.—Not later than 120 days after 
the date of enactment of this Act, and quarterly 
thereafter, the Surgeon General of the Public Health 
Service shall submit to the Committee on Energy 
and Commerce of the House of Representatives and 
the Committee on Health, Education, Labor, and 
Pensions of the Senate a report on all measures 
taken by the President, the Surgeon General, and 
the Secretary of Health and Human Services to 
VerDate Sep 11 2014 
20:17 Feb 26, 2019
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