H. R. 6157—108 
OFFICE OF MEDICARE HEARINGS AND APPEALS 
For expenses necessary for the Office of Medicare Hearings 
and Appeals, $182,381,000 shall remain available until September 
30, 2020, to be transferred in appropriate part from the Federal 
Hospital Insurance Trust Fund and the Federal Supplementary 
Medical Insurance Trust Fund. 
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION 
TECHNOLOGY 
For expenses necessary for the Office of the National Coordi-
nator for Health Information Technology, including grants, con-
tracts, and cooperative agreements for the development and 
advancement of interoperable health information technology, 
$60,367,000. 
OFFICE OF INSPECTOR GENERAL 
For expenses necessary for the Office of Inspector General, 
including the hire of passenger motor vehicles for investigations, 
in carrying out the provisions of the Inspector General Act of 
1978, $80,000,000: Provided, That of such amount, necessary sums 
shall be available for providing protective services to the Secretary 
and investigating non-payment of child support cases for which 
non-payment is a Federal offense under 18 U.S.C. 228. 
OFFICE FOR CIVIL RIGHTS 
For expenses necessary for the Office for Civil Rights, 
$38,798,000. 
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED 
OFFICERS 
For retirement pay and medical benefits of Public Health 
Service Commissioned Officers as authorized by law, for payments 
under the Retired Serviceman’s Family Protection Plan and Sur-
vivor Benefit Plan, and for medical care of dependents and retired 
personnel under the Dependents’ Medical Care Act, such amounts 
as may be required during the current fiscal year. 
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND 
For expenses necessary to support activities related to coun-
tering potential biological, nuclear, radiological, chemical, and 
cybersecurity threats to civilian populations, and for other public 
health emergencies, $1,026,458,000, of which $561,700,000 shall 
remain available through September 30, 2020, for expenses nec-
essary to support advanced research and development pursuant 
to section 319L of the PHS Act and other administrative expenses 
of the Biomedical Advanced Research and Development Authority: 
Provided, That funds provided under this heading for the purpose 
of acquisition of security countermeasures shall be in addition to 
any other funds available for such purpose: Provided further, That 
products purchased with funds provided under this heading may, 
at the discretion of the Secretary, be deposited in the Strategic 
National Stockpile pursuant to section 319F–2 of the PHS Act: 
Provided further, That $5,000,000 of the amounts made available
H. R. 6157—109 
to support emergency operations shall remain available through 
September 30, 2021. 
For expenses necessary for procuring security countermeasures 
(as defined in section 319F–2(c)(1)(B) of the PHS Act), $735,000,000, 
to remain available until expended. 
For an additional amount for expenses necessary to prepare 
for or respond to an influenza pandemic, $260,000,000; of which 
$225,000,000 shall be available until expended, for activities 
including the development and purchase of vaccine, antivirals, nec-
essary medical supplies, diagnostics, and other surveillance tools: 
Provided, That notwithstanding section 496(b) of the PHS Act, 
funds may be used for the construction or renovation of privately 
owned facilities for the production of pandemic influenza vaccines 
and other biologics, if the Secretary finds such construction or 
renovation necessary to secure sufficient supplies of such vaccines 
or biologics. 
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. 
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 execution of a contract awarded in fiscal 
year 2019 under section 338B of such Act.
H. R. 6157—110 
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 
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 2019: 
(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
H. R. 6157—111 
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. 
(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.