(2) in subsection (b)(2)(C), by striking ‘‘Sep-
tember 30, 2024’’ and inserting ‘‘December 20, 
2024’’; and 
(3) by adding at the end the following: 
‘‘(e) COMPTROLLER GENERAL.— 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this subsection, the Comp-
troller General of the United States shall submit to 
the Committee on Agriculture of the House of Rep-
resentatives and the Committee on Agriculture, Nu-
trition, and Forestry of the Senate a report that ex-
amines risks related to supplemental nutrition as-
sistance program electronic benefit transfer payment 
system security, including the risk of stolen benefits 
through card skimming, card cloning, and other 
similar methods. 
‘‘(2) CONTENTS.—The report under paragraph 
(1) shall include an assessment of— 
‘‘(A) the extent to which the Department 
of Agriculture manages payment system secu-
rity, including risks related to stolen benefits, 
compared to leading industry practices; 
‘‘(B) the manner in which States, retailers, 
and other relevant entities manage risks related 
to stolen benefits;
‘‘(C) the oversight of and guidance pro-
vided by the Secretary to States regarding sto-
len benefits; and 
‘‘(D) recommendations and policy options 
for— 
‘‘(i) improving how the Department of 
Agriculture and other relevant entities 
manage payment system security risks, in-
cluding those related to stolen benefits; 
and 
‘‘(ii) how the Department of Agri-
culture may best share those improvements 
with States, retailers, and other relevant 
entities.’’. 
SEC. 106. EXTENSION OF FOREST SERVICE PARTICIPATION 
IN ACES PROGRAM. 
Section 8302(b) of the Agricultural Act of 2014 (16 
U.S.C. 3851a(b)) shall be applied by substituting ‘‘1 day 
after December 20, 2024’’ for ‘‘October 1, 2023’’. 
SEC. 107. EXTENSION OF GOOD NEIGHBOR AUTHORITY. 
Section 8206(b)(2)(C)(ii) of the Agricultural Act of 
2014 (16 U.S.C. 2113a(b)(2)(C)(ii)) shall be applied by 
substituting ‘‘1 day after December 20, 2024’’ for ‘‘Octo-
ber 1, 2024’’.
SEC. 108. TEMPORARY EXTENSION OF FOOD FOR PEACE 
ACT. 
The authorities provided by each provision of the 
Food for Peace Act (7 U.S.C. 1691 et seq.), as in effect 
on September 30, 2024, shall remain in effect through De-
cember 20, 2024. 
SEC. 109. OVERSEAS PAY COMPARABILITY AND LIMITA-
TION. 
(a) IN GENERAL.—The authority provided under sec-
tion 1113 of the Supplemental Appropriations Act, 2009 
(Public Law 111–32; 123 Stat. 1904) shall remain in ef-
fect through December 20, 2024. 
(b) LIMITATION.—The authority described in sub-
section (a) may not be used to pay an eligible member 
of the Foreign Service (as defined in section 1113(b) of 
the Supplemental Appropriations Act, 2009 (Public Law 
111–32; 123 Stat. 1904)) a locality-based comparability 
payment (stated as a percentage) that exceeds two-thirds 
of the amount of the locality-based comparability payment 
(stated as a percentage) that would be payable to such 
member under section 5304 of title 5, United States Code, 
if such member’s official duty station were in the District 
of Columbia.
SEC. 110. PROVISIONS RELATED TO THE COMPACT OF 
FREE ASSOCIATION WITH THE REPUBLIC OF 
PALAU. 
(a) FEDERAL PROGRAMS
AND SERVICES AGREE-
MENT WITH THE GOVERNMENT OF THE REPUBLIC OF 
PALAU.—During the period beginning on October 1, 
2024, and ending on the date on which a new Federal 
programs and services agreement with the Government of 
the Republic of Palau enters into force, any activities de-
scribed in sections 132 and 221(a) of the Compact of Free 
Association between the Government of the United States 
of America and the Government of the Republic of Palau 
set forth in section 201 of Public Law 99–658 (48 U.S.C. 
1931 note) shall, with the mutual consent of the Govern-
ment of the Republic of Palau, continue in the manner 
authorized and required for fiscal year 2024 under the 
amended agreements described in subsections (b) and (f) 
of section 462 of that Compact. 
(b) AMENDMENTS RELATED TO THE 2024 FEDERAL 
PROGRAMS AND SERVICES AGREEMENT WITH THE RE-
PUBLIC OF PALAU.— 
(1) Section 204(e) of the Compact of Free As-
sociation Amendments Act of 2024 (48 U.S.C. 
1983(e)) is amended—
(A) in paragraph (4), by redesignating 
subparagraphs (A) and (B) as clauses (i) and 
(ii), respectively, and indenting appropriately; 
(B) 
by 
redesignating 
paragraphs 
(1) 
through (4) as subparagraphs (A) through (D), 
respectively, and indenting appropriately; 
(C) in the matter preceding subparagraph 
(A) (as so redesignated), by striking ‘‘An agree-
ment’’ and inserting the following: 
‘‘(1) IN GENERAL.—An agreement’’; and 
(D) by adding at the end the following: 
‘‘(2) FEDERAL
PROGRAMS
AND
SERVICES 
AGREEMENT WITH THE REPUBLIC OF PALAU.—Sub-
paragraphs (A) and (D)(iii) of section 101(c)(2) of 
Public Law 99–658 (48 U.S.C. 1931(c)(2)) and sub-
section (d)(2)(A) shall not apply to an agreement 
that would amend, change, or terminate the agree-
ment described in section 462(f) of the U.S.-Palau 
Compact.’’. 
(2) Section 210(a)(2) of the Compact of Free 
Association Amendments Act of 2024 (48 U.S.C. 
1989(a)(2)) is amended— 
(A) in subparagraph (D), by striking 
‘‘and’’ at the end;
(B) by redesignating subparagraph (E) as 
subparagraph (F); and 
(C) by inserting after subparagraph (D) 
the following: 
‘‘(E) with respect to the Federal Deposit 
Insurance Corporation, any applicable Federal 
programs and services agreement between the 
United States and the Republic of Palau; and’’. 
SEC. 111. UNITED STATES AGENCY FOR INTERNATIONAL 
DEVELOPMENT CIVIL SERVICE ANNUITANT 
WAIVER. 
Section 625(j)(1)(B) of the Foreign Assistance Act 
of 1961 (22 U.S.C. 2385(j)(1)(B)) shall be applied by 
striking ‘‘October 1, 2010’’ and inserting ‘‘December 20, 
2024’’. 
SEC. 112. UNITED STATES AGENCY FOR INTERNATIONAL 
DEVELOPMENT INSPECTOR GENERAL ANNU-
ITANT WAIVER. 
The authorities provided under section 1015(b) of the 
Supplemental Appropriations Act, 2010 (Public Law 111– 
212; 124 Stat. 2332)— 
(1) shall remain in effect through December 20, 
2024; and 
(2) may be used to facilitate the assignment of 
persons for oversight of programs in countries with
a humanitarian disaster or complex emergency dec-
laration. 
SEC. 113. EXTENSION OF HONG KONG HUMAN RIGHTS AND 
DEMOCRACY ACT OF 2019. 
Section 7(h) of the Hong Kong Human Rights and 
Democracy Act of 2019 (Public Law 116–76; 22 U.S.C. 
5701 note) is amended by striking ‘‘the date that is 5 
years after the date of the enactment of this Act’’ and 
inserting ‘‘December 20, 2024’’. 
SEC. 114. EXTENSION OF TRANSFERS OF AIR TRAFFIC SYS-
TEMS ACQUIRED WITH AIP FUNDING. 
Section 728(b) of the FAA Reauthorization Act of 
2024 (Public Law 118–63) is amended by striking ‘‘Octo-
ber 1, 2024’’ and inserting ‘‘December 20, 2024’’. 
TITLE II—HEALTH EXTENDERS 
Subtitle A—Public Health 
SEC. 201. EXTENSION OF PROGRAMS RELATING TO AUTISM. 
(a) DEVELOPMENTAL DISABILITIES SURVEILLANCE 
AND RESEARCH PROGRAM.—Section 399AA(e) of the 
Public Health Service Act (42 U.S.C. 280i(e)) is amended 
by striking ‘‘September 30, 2024’’ and inserting ‘‘Decem-
ber 20, 2024’’. 
(b) AUTISM EDUCATION, EARLY DETECTION, AND 
INTERVENTION.—Section 399BB(g) of the Public Health 
Service Act (42 U.S.C. 280i–1(g)) is amended by striking
‘‘September 30, 2024’’ and inserting ‘‘December 20, 
2024’’. 
(c) INTERAGENCY
AUTISM
COORDINATING
COM-
MITTEE.—Section 399CC(f) of the Public Health Service 
Act (42 U.S.C. 280i–2(f)) is amended by striking ‘‘Sep-
tember 30, 2024’’ and inserting ‘‘December 20, 2024’’. 
SEC. 202. EXTENSION OF AUTHORITY TO ISSUE PRIORITY 
REVIEW VOUCHERS TO ENCOURAGE TREAT-
MENTS FOR RARE PEDIATRIC DISEASES. 
Section 529(b)(5) of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 360ff(b)(5)) is amended by strik-
ing ‘‘September 30, 2024’’ each place it appears and in-
serting ‘‘December 20, 2024’’. 
SEC. 203. NO SURPRISES ACT IMPLEMENTATION FUNDING. 
Section 118(a) of title I of division BB of the Consoli-
dated Appropriations Act, 2021 (Public Law 116–260) is 
amended by striking ‘‘through 2024’’ and inserting 
‘‘through September 30, 2025’’. 
Subtitle B—Medicaid 
SEC. 211. MEDICAID FUNDING FOR THE NORTHERN MAR-
IANA ISLANDS. 
Section 1108(g) of the Social Security Act (42 U.S.C. 
1308) is amended—
(1) in paragraph (2), in the matter preceding 
subparagraph (A), by striking ‘‘and (5)’’ and insert-
ing ‘‘, (5), and (14)’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(14) ADDITIONAL INCREASE FOR THE NORTH-
ERN MARIANA ISLANDS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
increase the total amount otherwise determined 
under this subsection for the Northern Mariana 
Islands for the period beginning on October 1, 
2022, and ending on September 30, 2024, by 
$27,100,000. 
‘‘(B) SPECIAL RULES.—The increase de-
scribed in subparagraph (A)— 
‘‘(i) shall apply to the total amount 
certified by the Secretary under title XIX 
for payment to the Northern Mariana Is-
lands for services attributable to fiscal year 
2023 or 2024, notwithstanding that pay-
ments for any such services are made by 
the Northern Mariana Islands in fiscal 
year 2025; and 
‘‘(ii) shall be in addition to the 
amount calculated under paragraph (2) for
the Northern Mariana Islands for fiscal 
years 2023 and 2024 and shall not be 
taken into account in calculating an 
amount under paragraph (2) for the 
Northern Mariana Islands for fiscal year 
2025 or a subsequent fiscal year.’’. 
Subtitle C—Medicare 
SEC. 221. REVISING PHASE-IN OF MEDICARE CLINICAL LAB-
ORATORY TEST PAYMENT CHANGES. 
(a) REVISED PHASE-IN OF REDUCTIONS FROM PRI-
VATE
PAYOR
RATE
IMPLEMENTATION.—Section 
1834A(b)(3) of the Social Security Act (42 U.S.C. 
1395m–1(b)(3)) is amended— 
(1) in subparagraph (A), by striking ‘‘2027’’ 
and inserting ‘‘2028’’; and 
(2) in subparagraph (B)— 
(A) in clause (ii), by striking ‘‘2024’’ and 
inserting ‘‘2025’’; and 
(B) in clause (iii), by striking ‘‘2025 
through 2027’’ and inserting ‘‘2026 through 
2028’’. 
(b) REVISED REPORTING PERIOD FOR REPORTING 
OF PRIVATE SECTOR PAYMENT RATES FOR ESTABLISH-
MENT
OF
MEDICARE
PAYMENT
RATES.—Section
1834A(a)(1)(B) of the Social Security Act (42 U.S.C. 
1395m–1(a)(1)(B)) is amended— 
(1) in clause (i), by striking ‘‘2024’’ and insert-
ing ‘‘2025’’; and 
(2) in clause (ii), by striking ‘‘2025’’ each place 
it appears and inserting ‘‘2026’’. 
SEC. 222. MEDICARE IMPROVEMENT FUND. 
Section 1898(b)(1) of the Social Security Act (42 
U.S.C. 1395iii(b)(1)) is amended by striking ‘‘2022, $0’’ 
and inserting ‘‘2026, $3,197,000,000’’. 
TITLE III—VETERANS 
EXTENDERS 
Subtitle A—Health Care 
SEC. 301. 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, 2024’’ and 
inserting ‘‘September 30, 2025’’.
SEC. 302. 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, 2024’’ and inserting 
‘‘September 30, 2025’’. 
SEC. 303. EXTENSION OF EXPANSION OF RURAL ACCESS 
NETWORK 
FOR 
GROWTH 
ENHANCEMENT 
PROGRAM OF THE DEPARTMENT OF VET-
ERANS AFFAIRS. 
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 ‘‘2024’’ and 
inserting ‘‘2025’’. 
SEC. 304. EXTENSION OF PILOT PROGRAM TO PROVIDE 
VETERANS 
ACCESS 
TO 
COMPLEMENTARY 
AND 
INTEGRATIVE 
HEALTH 
PROGRAMS 
THROUGH ANIMAL THERAPY, AGRITHERAPY, 
SPORTS AND RECREATION THERAPY, ART 
THERAPY, AND POSTTRAUMATIC GROWTH 
PROGRAMS. 
Section 203(d)(1) of the Scott Hannon Veterans 
Mental Health Care Improvement Act of 2019 (Public 
Law 116–171; 38 U.S.C. 1712A note) is amended by 
striking ‘‘for a three-year period beginning on the com-