H. R. 5371—153
submitted under this section by the holder of an approved 
application for a prescription drug seeking approval to 
market such drug as a nonprescription drug, including 
for—
‘‘(i) a full Rx-to-nonprescription switch, under 
which a drug previously approved for prescription use 
only is—
‘‘(I) approved for nonprescription use under 
the same conditions as applied to the drug when 
approved for prescription use; or 
‘‘(II) approved for nonprescription use subject 
to one or more additional conditions for non-
prescription use; and 
‘‘(ii) a partial Rx-to-nonprescription switch, under 
which the drug is approved for nonprescription use 
only under certain conditions described in the approved 
labeling, while the drug otherwise remains approved 
for prescription use only. 
‘‘(E) RULE OF CONSTRUCTION.—Nothing in this para-
graph shall be construed to—
‘‘(i) supersede or modify the authority of the Sec-
retary under section 505G with respect to the regula-
tion of OTC monograph drugs; or 
‘‘(ii) authorize the disclosure by the Secretary of 
confidential commercial information or trade secrets.’’. 
(b) GAO REPORT.—
(1) IN
GENERAL.—Not later than 1 year after the date 
of enactment of this Act, the Comptroller General of the United 
States shall submit to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives a report 
that evaluates—
(A) the number of applications for an Rx-to-non-
prescription switch approved during the period beginning 
on October 1, 2022, and ending on the date of the report; 
(B) the number of drugs for which an application for 
an Rx-to-nonprescription switch was approved during such 
period subject to an additional condition for nonprescription 
use; 
(C) among the drugs for which an application for a 
full or partial Rx-to-nonprescription switch was approved 
during such period, the average length of time from receipt 
by the Food and Drug Administration of the application 
to the approval of such application; 
(D) the number of partial Rx-to-nonprescription switch 
applications approved during such period, and the number 
of applications for such a partial switch not approved; 
(E) any barriers to timely and predictable review of 
applications for an Rx-to-nonprescription switch; 
(F) engagement by the Food and Drug Administration 
with public stakeholders, including public meetings or addi-
tional activities to support review of applications for an 
Rx-to-nonprescription switch; and 
(G) opportunities for collaboration between the Center 
for Drug Evaluation and Research and the Centers for 
Medicare & Medicaid Services for the purpose of analyzing 
health insurance claims data for commonly prescribed
H. R. 5371—154
drugs that appear to be suitable for an Rx-to-nonprescrip-
tion switch. 
(2) DEFINITION.—In this subsection, the term ‘‘Rx-to-non-
prescription switch’’ has the meaning given such term in para-
graph (7) of section 505(b) of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 244(b)), as added by subsection (a). 
SEC. 6508. REGULATION OF CERTAIN NONPRESCRIPTION DRUGS THAT 
ARE MARKETED WITHOUT AN APPROVED DRUG APPLICA-
TION. 
(a) DEVELOPMENT ADVICE TO SPONSORS OR REQUESTORS.—Sec-
tion 505G(h) of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 355h(h)) is amended by striking ‘‘sponsors or requestors’’ 
and inserting ‘‘sponsors, requestors, or organizations nominated 
by sponsors or requestors to represent their interests in a pro-
ceeding’’. 
(b) TECHNICAL CORRECTION.—Section 505G(b)(2)(A)(iv)(III) of 
the 
Federal 
Food, 
Drug, 
and 
Cosmetic 
Act 
(21 
U.S.C. 
355h(b)(2)(A)(iv)(III)) is amended by striking ‘‘requestors’’ and 
inserting ‘‘sponsors or requestors’’. 
SEC. 6509. SUNSET DATES. 
(a) AUTHORIZATION.—Sections 744L and 744M of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j–71; 379j–72) shall 
cease to be effective October 1, 2030. 
(b) REPORTING REQUIREMENTS.—Section 744N of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j–73) shall cease to 
be effective January 31, 2031. 
SEC. 6510. EFFECTIVE DATE. 
The amendments made by this title shall take effect on October 
1, 2025, or the date of the enactment of this Act, whichever is 
later, except that fees under part 10 of subchapter C of chapter 
VII of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j–
71 et seq.) shall be assessed beginning October 1, 2025, regardless 
of the date of the enactment of this Act. 
SEC. 6511. SAVINGS CLAUSE. 
Notwithstanding the amendments made by this title, part 10 
of subchapter C of chapter VII of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 379j–71 et seq.), as in effect on the day 
before the date of enactment of this Act, shall continue to be 
in effect with respect to assessing and collecting any fee required 
by such part for a fiscal year prior to fiscal year 2026. 
TITLE VI—NO SURPRISES ACT 
IMPLEMENTATION 
SEC. 6601. EXTENDING AVAILABILITY OF FUNDING FOR NO SURPRISES 
ACT IMPLEMENTATION. 
Section 118(a) of division BB of the Consolidated Appropriations 
Act, 2021 (Public Law 116–260) is amended—
(1) by striking ‘‘otherwise appropriated, to the Secretary 
of Health and Human Services’’ and inserting the following: 
‘‘otherwise appropriated—
‘‘(1) to the Secretary of Health and Human Services’’;
H. R. 5371—155
(2) in paragraph (1), as so inserted, by striking ‘‘September 
30, 2025.’’ and inserting ‘‘January 30, 2026; and’’; and 
(3) by adding at the end the following new paragraph: 
‘‘(2) to the Secretary of Health and Human Services, in 
addition to amounts otherwise appropriated under paragraph 
(1), $14,000,000 for the period beginning on October 1, 2025, 
and ending on January 30, 2026.’’. 
DIVISION G—DEPARTMENT OF 
VETERANS AFFAIRS EXTENDERS 
TITLE I—HEALTH CARE MATTERS 
SEC. 7101. EXTENSION OF AUTHORITY FOR COLLECTION OF COPAY-
MENTS FOR HOSPITAL CARE AND NURSING HOME CARE. 
Section 1710(f)(2)(B) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
SEC. 7102. EXTENSION OF REQUIREMENT TO PROVIDE NURSING HOME 
CARE TO CERTAIN VETERANS WITH SERVICE-CONNECTED 
DISABILITIES. 
Section 1710A(d) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
SEC. 7103. EXTENSION OF STAFF SERGEANT PARKER GORDON FOX 
SUICIDE PREVENTION GRANT PROGRAM. 
Section 201(j) of the Commander John Scott Hannon Veterans 
Mental Health Care Improvement Act of 2019 (Public Law 116–
171; 38 U.S.C. 1720F note) is amended by striking ‘‘the date that 
is three years after the date on which the first grant is awarded 
under this section’’ and inserting ‘‘September 30, 2026’’. 
SEC. 7104. EXTENSION OF FUNDING FOR EXPANSION OF RURAL 
ACCESS NETWORK FOR GROWTH ENHANCEMENT PRO-
GRAM. 
Section 2(d) of the Sgt. Ketchum Rural Veterans Mental Health 
Act of 2021 (Public Law 117–21; 38 U.S.C. 1712A note) is amended 
by striking ‘‘2025’’ and inserting ‘‘2026’’. 
TITLE II—BENEFITS 
SEC. 7201. EXTENSION OF REQUIREMENT FOR QUARTERLY BRIEFINGS 
ON ADMINISTRATION OF AUTHORITIES RELATING TO 
DETERMINATIONS 
REGARDING 
PRESUMPTIONS 
OF 
SERVICE CONNECTION BASED ON TOXIC EXPOSURE. 
Section 202(b)(2) of the Sergeant First Class Heath Robinson 
Honoring our Promise to Address Comprehensive Toxics Act of 
2022 (Public Law 117–168) is amended by striking ‘‘On a quarterly 
basis during the two-year period beginning on the date of the 
enactment of this Act,’’ and inserting ‘‘On a quarterly basis during 
the period beginning on the date of the enactment of this Act 
and ending on December 31, 2026,’’.
H. R. 5371—156
SEC. 7202. EXTENSION OF REQUIREMENT RELATING TO RESTORATION 
OF ENTITLEMENT TO EDUCATIONAL ASSISTANCE IN 
CASES OF CLOSURE OR DISAPPROVAL OF EDUCATIONAL 
INSTITUTIONS. 
Section 3699(c)(2)(C) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
SEC. 7203. EXTENSION OF TEMPORARY CLARIFICATION OF LICENSURE 
REQUIREMENTS FOR CONTRACTOR MEDICAL PROFES-
SIONALS TO PERFORM MEDICAL DISABILITY EXAMINA-
TIONS FOR THE DEPARTMENT OF VETERANS AFFAIRS 
UNDER PILOT PROGRAM FOR USE OF CONTRACT PHYSI-
CIANS FOR DISABILITY EXAMINATIONS. 
Section 2002(a)(4) of the Johnny Isakson and David P. Roe, 
M.D. Veterans Health Care and Benefits Improvement Act of 2020 
(Public Law 116–315; 38 U.S.C. 5101 note) is amended by striking 
‘‘five years’’ and inserting ‘‘six years’’. 
SEC. 7204. EXTENSION OF AUTHORITY TO MAINTAIN REGIONAL OFFICE 
IN REPUBLIC OF PHILIPPINES. 
Section 315(b) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
TITLE III—HOUSING 
SEC. 7301. EXTENSION OF AUTHORIZATION OF APPROPRIATIONS FOR 
HOMELESS WOMEN VETERANS AND HOMELESS VET-
ERANS WITH CHILDREN REINTEGRATION GRANT PRO-
GRAM. 
Section 2021A(f)(1) of title 38, United States Code, is amended 
by striking ‘‘2025’’ and inserting ‘‘2026’’. 
SEC. 
7302. 
EXTENSION 
OF 
AUTHORITY 
FOR 
TREATMENT 
AND 
REHABILITATION FOR SERIOUSLY MENTALLY ILL AND 
HOMELESS VETERANS. 
(a) GENERAL TREATMENT.—Section 2031(b) of title 38, United 
States Code, is amended by striking ‘‘September 30, 2025’’ and 
inserting ‘‘September 30, 2026’’. 
(b) ADDITIONAL SERVICES
AT CERTAIN LOCATIONS.—Section 
2033(d) of title 38, United States Code, is amended by striking 
‘‘September 30, 2025’’ and inserting ‘‘September 30, 2026’’. 
SEC. 7303. EXTENSION OF FUNDING FOR FINANCIAL ASSISTANCE FOR 
SUPPORTIVE SERVICES FOR VERY LOW-INCOME VETERAN 
FAMILIES IN PERMANENT HOUSING. 
Section 2044(e) of title 38, United States Code, is amended 
by adding at the end the following new paragraph: 
‘‘(9) $660,000,000 for fiscal year 2026.’’. 
SEC. 7304. EXTENSION OF FUNDING FOR GRANT PROGRAM FOR HOME-
LESS VETERANS WITH SPECIAL NEEDS. 
Section 2061(d)(1) of title 38, United States Code, is amended 
by striking ‘‘2025’’ and inserting ‘‘2026’’.
H. R. 5371—157
SEC. 7305. EXTENSION OF AUTHORITY TO PROVIDE ASSISTANCE FOR 
SPECIALLY ADAPTED HOUSING FOR DISABLED VETERANS 
RESIDING TEMPORARILY IN HOUSING OWNED BY A 
FAMILY MEMBER. 
Section 2102A(e) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
SEC. 7306. EXTENSION OF AUTHORITY FOR SPECIALLY ADAPTED 
HOUSING ASSISTIVE TECHNOLOGY GRANT PROGRAM. 
Section 2108(g) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
SEC. 7307. IMPROVEMENTS TO PARTIAL CLAIM PROGRAM OF THE 
DEPARTMENT OF VETERANS AFFAIRS. 
(a) CLARIFICATION OF RELATIONSHIP TO OTHER POWERS OF SEC-
RETARY.—Section 3720(h) of title 38, United States Code, is 
amended by striking ‘‘of subsection (a)’’ and all that follows through 
the period at the end and inserting ‘‘of subsection (a) in conjunction 
with the purchase of a loan under section 3732(a)(2) of this title 
unless the Secretary determines the purchase would be made con-
sistent with section 3732(d) of this title.’’. 
(b) ADMINISTRATION OF PARTIAL CLAIM PROGRAM.—Section 3737 
of such title is amended—
(1) in subsection (b)(2), by striking ‘‘first lien guaranteed 
loan for such property’’ and inserting ‘‘amount of indebtedness 
under the guaranteed loan that the Secretary does not pur-
chase’’; and 
(2) in subsection (c)—
(A) in paragraph (2)(B)(ii), by striking ‘‘120 days’’ and 
inserting ‘‘180 days’’; and 
(B) by amending paragraph (3) to read as follows: 
‘‘(3) An amount paid to the holder of a loan as a partial 
claim—
‘‘(A) shall not alter the guaranty calculation specified by 
section 3703 of this title; 
‘‘(B) shall be included, for the purpose of a liquidation 
sale, in the same manner as any other advance allowed by 
the Secretary; and 
‘‘(C) shall not be claimed under the guaranty or increase 
the Secretary’s cost of acquisition of the property securing 
the defaulted loan.’’. 
(c) REQUIREMENTS OF LOAN HOLDER.—Section (d)(1) of such 
section is amending by inserting ‘‘and servicing the loan’’ after 
‘‘documents’’. 
(d) DEFAULT AND FORECLOSURE.—Subsection (e) of such section 
is amended—
(1) in paragraph (1)—
(A) in subparagraph (A), by striking ‘‘an individual 
who’’ and all that follows through the period at the end 
and inserting the following: ‘‘a borrower who defaults on 
a partial claim shall be liable to the Secretary for any 
loss suffered by the Secretary with respect to such default, 
and such loss may be recovered in the same manner as 
any other debt due the United States. The Secretary shall
H. R. 5371—158
not restore housing loan entitlement under section 3702(b) 
of this title until such loss is repaid in full.’’; and 
(B) by amending subparagraph (B) to read as follows: 
‘‘(B) The Secretary may charge administrative costs, fees, and 
interest, as appropriate, with respect to any default under a partial 
claim in a manner similar to the interest and administrative costs 
charged under section 5315 of this title.’’; and 
(2) by amending paragraph (2) to read as follows: 
‘‘(2) Notwithstanding section 2410 of title 28, a non-judicial 
sale of real property to satisfy a loan guaranteed under this chapter 
shall discharge the property from a partial claim interest held 
by the Secretary, provided that the holder of the guaranteed loan 
conducts the non-judicial sale and distributes the sale proceeds, 
if any, in accordance with the State or local law where such property 
is situated.’’. 
(e) GUIDANCE IN ADVANCE OF REGULATIONS.—Subsection (h) 
of such section is amended to read as follows: 
‘‘(h) GUIDANCE IN ADVANCE OF REGULATIONS.—Notwithstanding 
any other provision of law, the Secretary may, before prescribing 
regulations, issue administrative guidance with respect to the Par-
tial Claim Program under this section and the loss mitigation 
options prescribed under section 3732(d) of this title, including 
any additional terms, conditions, and requirements the Secretary 
determines necessary.’’. 
SEC. 7308. GOVERNMENT ACCOUNTABILITY OFFICE REPORTS ON PAR-
TIAL CLAIM PROGRAM OF THE DEPARTMENT OF VET-
ERANS AFFAIRS AND OTHER MATTERS. 
(a) ANNUAL REPORTS.—
(1) IN GENERAL.—Not later than one year after the date 
of the enactment of this Act, and every year thereafter until 
the Partial Claim Program terminates, the Comptroller General 
of the United States shall submit to the Committee on Veterans’ 
Affairs of the Senate and the Committee on Veterans’ Affairs 
of the House of Representatives a report. 
(2) ELEMENTS.—Each report required by paragraph (1) 
shall include, for the period covered by the report and 
disaggregated by quarter, the following: 
(A) Key data on the performance of the Partial Claim 
Program, including—
(i) the number of partial claims filed and approved; 
and 
(ii) the redefault and foreclosure rates of loans 
for which a partial claim was made. 
(B) A comparison of the data described in subparagraph 
(A) with data on the performance of other loss mitigation 
options provided by the Department of Veterans Affairs. 
(C) The number of housing loans insured, guaranteed, 
or made by the Secretary of Veterans Affairs under chapter 
37 of title 38, United States Code. 
(D) The number of applications for housing loan bene-
fits under such chapter denied. 
(E) The number of housing loans insured, guaranteed, 
or made by the Secretary under such chapter refinanced 
under section 3710(a)(8) or 3712 of title 38, United States 
Code.
H. R. 5371—159
(F) The number of veterans who owe a payment on 
a mortgage associated with a loan insured, guaranteed, 
or made by the Secretary under such chapter that is at 
least—
(i) 60 days late; and 
(ii) 90 days late. 
(b) ASSESSMENT.—
(1) IN GENERAL.—Not later than one year before the Partial 
Claim Program terminates, the Comptroller General shall—
(A) conduct an assessment of the benefits and chal-
lenges of the Partial Claim Program; and 
(B) submit to the Committee on Veterans’ Affairs of 
the Senate and the Committee on Veterans’ Affairs of the 
House of Representatives a report on the findings of the 
Comptroller General with respect to that assessment. 
(2) 
CONSIDERATIONS.—In 
conducting 
the 
assessment 
required by paragraph (1), the Comptroller General shall con-
sider the following: 
(A) The characteristics of borrowers for whom a partial 
claim was made compared to the characteristics of bor-
rowers provided other loss mitigation options by the 
Department of Veterans Affairs. 
(B) The performance of loans guaranteed under chapter 
37 of title 38, United States Code, following various loss 
mitigation actions. 
(C) The information the Department considered in 
determining whether a borrower would benefit from a par-
tial claim compared to other loss mitigation options. 
(D) The costs to taxpayers of the Partial Claim Program 
compared to the costs of other loss mitigation options pro-
vided by the Department. 
(E) Any similarities and differences in the Depart-
ment’s administration and use of the Partial Claim Pro-
gram compared to the Department’s administration and 
use of the COVID–19 Veterans Assistance Partial Claim 
Payment program established under subpart F of part 36 
of title 38, Code of Regulations. 
(F) The information the Department learned from the 
COVID–19 Veterans Assistance Partial Claim Payment 
program and the extent to which those lessons learned 
were applied to the Partial Claim Program. 
(G) The types of information the Department collected 
to monitor the performance and effectiveness of the Partial 
Claim Program and how the Department used that 
information to make any needed adjustments to the pro-
gram. 
(H) How the use by the Department of partial claims 
compares to the use of partial claims by other Federal 
housing agencies, including, for each partial claim pro-
gram—
(i) the volume of loans for which partial claims 
have been made; 
(ii) the results for borrowers (including redefault 
and foreclosure rates); and 
(iii) the costs to taxpayers. 
(c) PARTIAL CLAIM PROGRAM DEFINED.—In this section, the 
term ‘‘Partial Claim Program’’ means the Partial Claim Program
H. R. 5371—160
of the Department of Veterans Affairs carried out under section 
3737 of title 38, United States Code. 
TITLE IV—OTHER MATTERS 
SEC. 7401. EXTENSION OF SUBPOENA AUTHORITY OF INSPECTOR GEN-
ERAL OF DEPARTMENT OF VETERANS AFFAIRS. 
Section 312(d)(7)(A) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
SEC. 7402. EXTENSION OF REQUIREMENT FOR ANNUAL REPORT ON 
USE OF AUTHORITY TO PROVIDE EQUITABLE RELIEF. 
Section 503(c) of title 38, United States Code, is amended 
by striking ‘‘December 31, 2025’’ and inserting ‘‘December 31, 2026’’. 
SEC. 7403. EXTENSION OF AUTHORITY FOR SECRETARY OF VETERANS 
AFFAIRS TO TRANSPORT INDIVIDUALS TO AND FROM 
FACILITIES OF DEPARTMENT OF VETERANS AFFAIRS. 
Section 111A(a)(2) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
SEC. 7404. EXTENSION OF AUTHORITY RELATING TO VENDEE LOAN 
PROGRAM. 
Section 3733(a)(8) of title 38, United States Code, is amended—
(1) in the matter preceding subparagraph (A), by striking 
‘‘September 30, 2025’’ and inserting ‘‘September 30, 2026’’; and 
(2) in subparagraph (C), by striking ‘‘September 30, 2025’’ 
and inserting ‘‘September 30, 2026’’. 
SEC. 7405. EXTENSION OF AUTHORITY FOR TRANSFER OF REAL PROP-
ERTY. 
Section 8118(a)(5) of title 38, United States Code, is amended 
by striking ‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2026’’. 
SEC. 7406. RETROACTIVE EFFECTIVE DATE. 
The amendments made by this division, except for the amend-
ments made by section 7307, shall take effect as if enacted on 
September 30, 2025. 
DIVISION H—MISCELLANEOUS 
SEC. 8001. BUDGETARY EFFECTS. 
(a) STATUTORY PAYGO SCORECARDS.—The budgetary effects 
of this division and divisions E through G 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 and divisions E through G 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 accom-
panying Conference Report 105–217 and section 250(c)(8) of the
H. R. 5371—161
Balanced Budget and Emergency Deficit Control Act of 1985, the 
budgetary effects of this division and divisions E through G shall 
not be estimated—
(1) for purposes of section 251 of such Act; 
(2) for purposes of an allocation to the Committee on Appro-
priations pursuant to section 302(a) of the Congressional 
Budget Act of 1974; and 
(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. 
(d) BALANCES ON THE PAYGO SCORECARDS.—Effective on the 
date of the adjournment of the first session of the 119th Congress, 
and for the purposes of the annual report issued pursuant to section 
5 of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 934) after 
such adjournment and for determining whether a sequestration 
order is necessary under such section, the balances on the PAYGO 
scorecards established pursuant to paragraphs (4) and (5) of section 
4(d) of such Act shall be zero.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.