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520E(b)(2) of the PHS Act shall not apply to funds ap-
propriated under this Act for fiscal year 2009. 
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY 
HEALTHCARE RESEARCH AND QUALITY 
For carrying out titles III and IX of the Public 
Health Service Act (‘‘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, 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 available until expended: Provided, That the 
amount made available pursuant to section 937(c) of the 
PHS Act shall not exceed $372,053,000. 
CENTERS FOR MEDICARE AND MEDICAID SERVICES 
GRANTS TO STATES FOR MEDICAID 
For carrying out, except as otherwise provided, titles 
XI and XIX of the Social Security Act, $149,335,031,000, 
to remain available until expended. 
For making, after May 31, 2009, payments to States 
under title XIX of the Social Security Act for the last 
quarter of fiscal year 2009 for unanticipated costs, in-
curred for the current fiscal year, such sums as may be 
necessary. 
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For making payments to States or in the case of sec-
tion 1928 on behalf of States under title XIX of the Social 
Security Act for the first quarter of fiscal year 2010, 
$71,700,038,000, to remain available until expended. 
Payment under title XIX may be made for any quar-
ter 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 HEALTH CARE TRUST FUNDS 
For payment to the Federal Hospital Insurance 
Trust Fund and the Federal Supplementary Medical In-
surance 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) of Public Law 97–248, and for ad-
ministrative expenses incurred pursuant to section 201(g) 
of the Social Security Act, $195,383,000,000. 
In addition, for making matching payments under 
section 1844, and benefit payments under section 1860D– 
16 of the Social Security Act, 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 Public Health Service Act (‘‘PHS 
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Act’’), and the Clinical Laboratory Improvement Amend-
ments of 1988, not to exceed $3,305,386,000, to be trans-
ferred from the Federal Hospital Insurance Trust Fund 
and the Federal Supplementary Medical Insurance Trust 
Fund, as authorized by section 201(g) of the Social Secu-
rity 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 
of Health and Human Services pursuant to section 302 
of the Tax Relief and Health Care Act of 2006; 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 pur-
poses of this appropriation: Provided further, That 
$35,700,000, to remain available through September 30, 
2010, shall be for contract costs for the Healthcare Inte-
grated General Ledger Accounting System: Provided fur-
ther, That $108,900,000, to remain available through Sep-
tember 30, 2010, shall be for the Centers for Medicare 
and Medicaid Services (‘‘CMS’’) Medicare contracting re-
form activities: Provided further, That funds appropriated 
under this heading shall be available for the Healthy 
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Start, Grow Smart program under which the CMS may, 
directly or through grants, contracts, or cooperative agree-
ments, produce and distribute informational materials in-
cluding, but not limited to, pamphlets and brochures on 
infant and toddler health care to expectant parents en-
rolled in the Medicaid program and to parents and guard-
ians enrolled in such program with infants and children: 
Provided further, That the Secretary is directed to collect 
fees in fiscal year 2009 from Medicare Advantage organi-
zations pursuant to section 1857(e)(2) of the Social Secu-
rity Act and from eligible organizations with risk-sharing 
contracts under section 1876 of that Act pursuant to sec-
tion 1876(k)(4)(D) of that Act: Provided further, That 
$4,542,000 shall be used for the projects, and in the 
amounts, specified under the heading ‘‘Program Manage-
ment’’ in the explanatory statement described in section 
4 (in the matter preceding division A of this consolidated 
Act): Provided further, That $75,000,000 is available for 
the State high risk health insurance pool program as au-
thorized by the State High Risk Pool Funding Extension 
Act of 2006. 
HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT 
In addition to amounts otherwise available for pro-
gram integrity and program management, $198,000,000, 
to be transferred from the Federal Hospital Insurance 
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