(3) incorporate the evidence and testing stand-
ards for sunscreen active ingredients detailed in sec-
tion 505G(r) of the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 355h) (as added by subsection 
(a)). 
SEC. 507. INCREASING THE CLARITY AND PREDICTABILITY 
OF THE PROCESS FOR DEVELOPING APPLI-
CATIONS 
FOR 
RX-TO-NONPRESCRIPTION 
SWITCHES. 
(a) IN GENERAL.—Section 505(b) of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 355(b)) is 
amended by adding at the end the following: 
‘‘(7) RX-TO-NONPRESCRIPTION SWITCHES.—
‘‘(A) MEETINGS.—Any person planning to 
submit an application for an Rx-to-nonprescrip-
tion switch may submit to the Secretary a writ-
ten request for a meeting, for purposes of devel-
oping a plan for such application that addresses 
the potential risks to public health of such 
switch and the evidence necessary to support 
such application, including the design of any 
necessary studies, and the format and content 
of the planned application. The Secretary may 
grant such a meeting, as appropriate, consistent 
with established procedures for granting meet-
ings with, and providing written responses to, 
applications under this section. Each such 
meeting shall be documented in meeting min-
utes. 
‘‘(B) GUIDANCE.—
‘‘(i) IN GENERAL.—Not later than 18 
months after the date of enactment of this 
paragraph, the Secretary shall issue guid-
ance to increase the clarity and predict-
ability of the process and standards for ap-
proval of applications for nonprescription 
drugs under this section, including in the 
case of applications for an Rx-to-non-
prescription switch, especially with respect 
to prescription drugs with well-established 
safety profiles for which an applicant may 
seek approval for nonprescription use. 
‘‘(ii) 
CONTENTS.—The 
guidance 
under clause (i) shall—
‘‘(I) describe how published re-
ports in medical literature, any pre-
vious finding of safety or effectiveness 
for the drug under this section, the 
results of significant human experi-
ence with the drug, unpublished stud-
ies and other data, and other sources 
of information may be used to support 
an application for a nonprescription 
drug, including in the context of an 
application for an Rx-to-nonprescrip-
tion switch; 
‘‘(II) set forth procedures for 
sponsors to request meetings de-
scribed in subparagraph (A) and doc-
ument the recommendations made in 
such meetings; 
‘‘(III) describe evidentiary expec-
tations to support approval of an ap-
plication for a nonprescription drug, 
including in the context of an applica-
tion 
for 
an 
Rx-to-nonprescription 
switch, including how sponsors can 
demonstrate that consumers can ap-
propriately self-select and use the 
drug 
and 
comprehend 
the 
non-
prescription drug label; and 
‘‘(IV) provide recommendations 
for how mechanisms, in addition to 
the required Drug Facts Label, such 
as mobile applications and decisions
aids, can be incorporated into the in-
formation submitted in support of an 
application for an Rx-to-nonprescrip-
tion switch. 
‘‘(C) PLAN
TO
ENGAGE
WITH
STAKE-
HOLDERS.—Not later than 1 year after the 
date of enactment of this paragraph, the Sec-
retary shall develop and make publicly available 
on the website of the Food and Drug Adminis-
tration a plan to engage stakeholders on steps 
and factors for application holders and other 
stakeholders to consider in identifying approved 
prescription drugs that may be promising can-
didates for applications for an Rx-to-non-
prescription switch. 
‘‘(D) DEFINITION.—For purposes of this 
paragraph, the term ‘Rx-to-nonprescription 
switch’ means the approval of an application, or 
supplemental application, as applicable, sub-
mitted under this section by the holder of an 
approved application for a prescription drug 
seeking approval to market such drug as a non-
prescription drug, including for—
‘‘(i) 
a 
full 
Rx-to-nonprescription 
switch, under which a drug previously ap-
proved for prescription use only is—
‘‘(I) approved for nonprescription 
use under the same conditions as ap-
plied to the drug when approved for 
prescription use; or 
‘‘(II) approved for nonprescrip-
tion use subject to one or more addi-
tional conditions for nonprescription 
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 label-
ing, while the drug otherwise remains ap-
proved for prescription use only. 
‘‘(E) RULE OF CONSTRUCTION.—Nothing 
in this paragraph shall be construed to—
‘‘(i) supersede or modify the authority 
of the Secretary under section 505G with 
respect to the regulation of OTC mono-
graph drugs; or
‘‘(ii) authorize the disclosure by the 
Secretary of confidential commercial infor-
mation 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 Pen-
sions of the Senate and the Committee on Energy 
and Commerce of the House of Representatives a re-
port that evaluates—
(A) the number of applications for an Rx-
to-nonprescription switch approved during the 
period beginning on October 1, 2022, and end-
ing on the date of the report; 
(B) the number of drugs for which an ap-
plication 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 applica-
tion for a full or partial Rx-to-nonprescription 
switch was approved during such period, the av-
erage length of time from receipt by the Food 
and Drug Administration of the application to 
the approval of such application;
SEC. 508. REGULATION OF CERTAIN NONPRESCRIPTION 
DRUGS THAT ARE MARKETED WITHOUT AN 
APPROVED DRUG APPLICATION. 
(a) DEVELOPMENT ADVICE TO SPONSORS OR RE-
QUESTORS.—Section 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 re-
questors to represent their interests in a proceeding’’. 
(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. 509. 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. 510. 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. 511. 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. 601. 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 in-
serting the following: ‘‘otherwise appropriated—
‘‘(1) to the Secretary of Health and Human 
Services’’;
(2) in paragraph (1), as so inserted, by striking 
‘‘September 30, 2025.’’ and inserting ‘‘November 
21, 2025; 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 appro-
priated under paragraph (1), $15,000,000 for the 
period beginning on October 1, 2025, and ending on 
November 21, 2025.’’. 
DIVISION D—DEPARTMENT OF 
VETERANS AFFAIRS EXTENDERS 
TITLE I—HEALTH CARE 
MATTERS 
SEC. 101. EXTENSION OF AUTHORITY FOR COLLECTION OF 
COPAYMENTS 
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 ‘‘November 21, 2025’’.
SEC. 102. EXTENSION OF REQUIREMENT TO PROVIDE 
NURSING HOME CARE TO CERTAIN VET-
ERANS WITH SERVICE-CONNECTED DISABIL-
ITIES. 
Section 1710A(d) of title 38, United States Code, is 
amended by striking ‘‘September 30, 2025’’ and inserting 
‘‘November 21, 2025’’. 
SEC. 103. EXTENSION OF STAFF SERGEANT PARKER GOR-
DON FOX SUICIDE PREVENTION GRANT PRO-
GRAM. 
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 ‘‘November 21, 2025’’. 
SEC. 104. EXTENSION OF FUNDING FOR EXPANSION OF 
RURAL ACCESS NETWORK FOR GROWTH EN-
HANCEMENT PROGRAM. 
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. 201. EXTENSION OF REQUIREMENT FOR QUARTERLY 
BRIEFINGS 
ON 
ADMINISTRATION 
OF 
AU-
THORITIES 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 Comprehen-
sive Toxics Act of 2022 (Public Law 117–168) is amended 
by striking ‘‘On a quarterly basis during the two-year pe-
riod beginning on the date of the enactment of this Act,’’ 
and inserting ‘‘On a quarterly basis during the period be-
ginning on the date of the enactment of this Act and end-
ing on December 31, 2026,’’. 
SEC. 202. EXTENSION OF REQUIREMENT RELATING TO RES-
TORATION 
OF 
ENTITLEMENT 
TO 
EDU-
CATIONAL ASSISTANCE IN CASES OF CLO-
SURE OR DISAPPROVAL OF EDUCATIONAL IN-
STITUTIONS. 
Section 3699(c)(2)(C) of title 38, United States 
Code, is amended by striking ‘‘September 30, 2025’’ and 
inserting ‘‘November 21, 2025’’.
SEC. 203. EXTENSION OF TEMPORARY CLARIFICATION OF 
LICENSURE 
REQUIREMENTS 
FOR 
CON-
TRACTOR MEDICAL PROFESSIONALS TO PER-
FORM MEDICAL DISABILITY EXAMINATIONS 
FOR THE DEPARTMENT OF VETERANS AF-
FAIRS UNDER PILOT PROGRAM FOR USE OF 
CONTRACT PHYSICIANS FOR DISABILITY EX-
AMINATIONS. 
Section 2002(a)(4) of the Johnny Isakson and David 
P. Roe, M.D. Veterans Health Care and Benefits Improve-
ment Act of 2020 (Public Law 116–315; 38 U.S.C. 5101 
note) is amended by striking ‘‘five years’’ and inserting 
‘‘six years’’. 
SEC. 204. EXTENSION OF AUTHORITY TO MAINTAIN RE-
GIONAL 
OFFICE 
IN 
REPUBLIC 
OF 
PHIL-
IPPINES. 
Section 315(b) of title 38, United States Code, is 
amended by striking ‘‘September 30, 2025’’ and inserting 
‘‘November 21, 2025’’. 
TITLE III—HOUSING 
SEC. 301. EXTENSION OF AUTHORIZATION OF APPROPRIA-
TIONS FOR HOMELESS WOMEN VETERANS 
AND HOMELESS VETERANS WITH CHILDREN 
REINTEGRATION GRANT PROGRAM. 
Section 2021A(f)(1) of title 38, United States Code, 
is amended by striking ‘‘2025’’ and inserting ‘‘2026’’.
(2) by amending paragraph (2) to read as fol-
lows: 
‘‘(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-judi-
cial sale and distributes the sale proceeds, if any, in ac-
cordance with the State or local law where such property 
is situated.’’. 
(e) GUIDANCE IN ADVANCE OF REGULATIONS.—Sub-
section (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 Partial Claim Program under 
this section and the loss mitigation options prescribed 
under section 3732(d) of this title, including any addi-
tional terms, conditions, and requirements the Secretary 
determines necessary.’’. 
SEC. 308. GOVERNMENT ACCOUNTABILITY OFFICE RE-
PORTS ON PARTIAL CLAIM PROGRAM OF THE 
DEPARTMENT OF VETERANS 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 Pro-
gram terminates, the Comptroller General of the 
United States shall submit to the Committee on Vet-
erans’ Affairs of the Senate and the Committee on 
Veterans’ Affairs of the House of Representatives a 
report. 
(2) ELEMENTS.—Each report required by para-
graph (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 Vet-
erans Affairs under chapter 37 of title 38, 
United States Code. 
(D) The number of applications for hous-
ing loan benefits 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. 
(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 be-
fore the Partial Claim Program terminates, the 
Comptroller General shall—
(A) conduct an assessment of the benefits 
and challenges 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 Representa-
tives a report on the findings of the Comptroller 
General with respect to that assessment. 
(2) CONSIDERATIONS.—In conducting the as-
sessment required by paragraph (1), the Comptroller 
General shall consider the following: 
(A) The characteristics of borrowers for 
whom a partial claim was made compared to 
the characteristics of borrowers 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 con-
sidered in determining whether a borrower 
would benefit from a partial 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 provided by the Depart-
ment. 
(E) Any similarities and differences in the 
Department’s administration and use of the 
Partial Claim Program compared to the De-
partment’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 Assist-
ance Partial Claim Payment program and the 
extent to which those lessons learned were ap-
plied to the Partial Claim Program. 
(G) The types of information the Depart-
ment 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 program. 
(H) How the use by the Department of 
partial claims compares to the use of partial 
claims by other Federal housing agencies, in-
cluding, for each partial claim program—
(i) the volume of loans for which par-
tial claims have been made; 
(ii) the results for borrowers (includ-
ing 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 of the Department of Veterans Af-
fairs carried out under section 3737 of title 38, United 
States Code. 
TITLE IV—OTHER MATTERS 
SEC. 401. EXTENSION OF SUBPOENA AUTHORITY OF IN-
SPECTOR GENERAL OF DEPARTMENT OF 
VETERANS AFFAIRS. 
Section 312(d)(7)(A) of title 38, United States Code, 
is amended by striking ‘‘September 30, 2025’’ and insert-
ing ‘‘November 21, 2025’’. 
SEC. 402. EXTENSION OF AUTHORITY FOR SECRETARY OF 
VETERANS AFFAIRS TO TRANSPORT INDIVID-
UALS TO AND FROM FACILITIES OF DEPART-
MENT OF VETERANS AFFAIRS. 
Section 111A(a)(2) of title 38, United States Code, 
is amended by striking ‘‘September 30, 2025’’ and insert-
ing ‘‘November 21, 2025’’. 
SEC. 403. EXTENSION OF AUTHORITY RELATING TO VEND-
EE 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 
‘‘November 21, 2025’’; and