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the ‘‘Secretary’’) shall provide for the transfer from 
the Federal Supplementary Medical Insurance Trust 
Fund under section 1841 of the Social Security Act 
(42 U.S.C. 1395t) to the Centers for Medicare & 
Medicaid Services Program Management Account 
of— 
(A) $20,000,000 for each of fiscal years 
2020 through 2024 for purposes of imple-
menting the amendments made by this section; 
and 
(B) such sums as determined appropriate 
by the Secretary for each subsequent fiscal year 
for purposes of administering the provisions of 
such amendments. 
(2) AVAILABILITY
AND
ADDITIONAL
USE
OF 
FUNDS.—Funds transferred pursuant to paragraph 
(1) shall remain available until expended and may be 
used, in addition to the purpose specified in para-
graph (1)(A), to implement the amendments made 
by sections 601 and 602. 
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TITLE VII—NIH, FDA, AND 
OPIOIDS FUNDING 
Subtitle A—Biomedical Innovation 
Expansion 
SEC. 701. NIH INNOVATION INITIATIVES. 
(a) NIH INNOVATION ACCOUNT.— 
(1) IN GENERAL.—Section 1001(b) of the 21st 
Century Cures Act (Public Law 114–255) is amend-
ed by adding at the end the following: 
‘‘(5) SUPPLEMENTAL
FUNDING
AND
ADDI-
TIONAL ACTIVITIES.— 
‘‘(A) IN
GENERAL.—In addition to the 
funds made available under paragraph (2), 
there are authorized to be appropriated, and 
are hereby appropriated, to the Account, out of 
any monies in the Treasury not otherwise ap-
propriated, to be available until expended with-
out further appropriation, the following: 
‘‘(i) 
For 
fiscal 
year 
2021, 
$255,400,000. 
‘‘(ii) 
For 
fiscal 
year 
2022, 
$260,400,000. 
‘‘(iii) 
For 
fiscal 
year 
2023, 
$163,400,000. 
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‘‘(iv) 
For 
fiscal 
year 
2024, 
$547,000,000. 
‘‘(v) 
For 
fiscal 
year 
2025, 
$848,000,000. 
‘‘(vi) 
For 
fiscal 
year 
2026, 
$842,400,000. 
‘‘(vii) 
For 
fiscal 
year 
2027, 
$1,089,600,000. 
‘‘(viii) 
For 
fiscal 
year 
2028, 
$1,115,600,000. 
‘‘(ix) 
For 
fiscal 
year 
2029, 
$1,170,600,000. 
‘‘(x) 
For 
fiscal 
year 
2030, 
$1,207,600,000. 
‘‘(B) SUPPLEMENTAL FUNDING FOR CER-
TAIN PROJECTS.—Of the total amounts made 
available under subparagraph (A) for each of 
fiscal years 2021 through 2030, a total amount 
not to exceed the following shall be made avail-
able for the following categories of NIH Innova-
tion Projects: 
‘‘(i) For projects described in para-
graph (4)(A), an amount not to exceed a 
total of $2,070,600,000 as follows: 
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‘‘(I) For each of fiscal years 
2021 and 2022, $50,000,000. 
‘‘(II) 
For 
fiscal 
year 
2024, 
$100,000,000. 
‘‘(III) For each of fiscal years 
2025 and 2026, $300,000,000. 
‘‘(IV) For each of fiscal years 
2027 through 2029, $317,000,000. 
‘‘(V) 
For 
fiscal 
year 
2030, 
$319,600,000. 
‘‘(ii) For projects described in para-
graph (4)(B), an amount not to exceed a 
total of $2,041,900,000 as follows: 
‘‘(I) For each of fiscal years 
2021 and 2022, $50,000,000. 
‘‘(II) 
For 
fiscal 
year 
2024, 
$128,000,000. 
‘‘(III) For fiscal year 2025, 
$209,000,000. 
‘‘(IV) For fiscal year 2026, 
$100,000,000. 
‘‘(V) 
For 
fiscal 
year 
2027, 
$325,000,000. 
‘‘(VI) For fiscal year 2028, 
$350,000,000. 
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‘‘(VII) For fiscal year 2029, 
$400,000,000. 
‘‘(VIII) For fiscal year 2030, 
$429,900,000. 
‘‘(iii) For projects described in para-
graph (4)(C), an amount not to exceed a 
total of $1,558,400,000 as follows: 
‘‘(I) For each of fiscal years 
2024 and 2025, $151,200,000. 
‘‘(II) For each of fiscal years 
2026 through 2030, $251,200,000. 
‘‘(iv) For projects described in para-
graph (4)(D), an amount not to exceed 
$15,400,000 for each of fiscal years 2021 
through 2030. 
‘‘(C) 
ADDITIONAL
NIH
INNOVATION 
PROJECTS.—In addition to funding NIH Inno-
vation Projects pursuant to subparagraph (B), 
of the total amounts made available under sub-
paragraph (A), a total amount not to exceed 
the following shall be made available for the fol-
lowing categories of NIH Innovation Projects: 
‘‘(i) To support research related to 
combating antimicrobial resistance and an-
tibiotic resistant bacteria, including re-
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search into new treatments, diagnostics, 
and vaccines, research, in consultation with 
the Centers for Disease Control and Pre-
vention, into stewardship, and the develop-
ment of strategies, in coordination with the 
Biomedical Advanced Research and Devel-
opment Authority under section 319L of 
the Public Health Service Act, to support 
commercialization of new antibiotics, not 
to exceed a total of 1,144,500,000, as fol-
lows: 
‘‘(I) For each of fiscal years 
2021 through 2024, $100,000,000. 
‘‘(II) For each of fiscal years 
2025 and 2026, $120,000,000. 
‘‘(III) For each of fiscal years 
2027 through 2029, $125,000,000. 
‘‘(IV) For fiscal year 2030, 
$129,500,000. 
‘‘(ii) To support research and re-
search activities related to rare diseases or 
conditions, including studies or analyses 
that help to better understand the natural 
history of a rare disease or condition and 
translational studies related to rare dis-
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eases or conditions, not to exceed a total of 
$530,600,000, as follows: 
‘‘(I) 
For 
fiscal 
year 
2021, 
$40,000,000. 
‘‘(II) 
For 
fiscal 
year 
2022, 
$45,000,000. 
‘‘(III) For fiscal year 2023, 
$48,000,000. 
‘‘(IV) For each of fiscal years 
2024 and 2025, $52,400,000. 
‘‘(V) 
For 
fiscal 
year 
2026, 
$55,800,000. 
‘‘(VI) For fiscal year 2027, 
$56,000,000. 
‘‘(VII) For fiscal year 2028, 
$57,000,000. 
‘‘(VIII) For each of fiscal years 
2029 and 2030, $62,000,000.’’. 
(2) CONFORMING AMENDMENTS.—Section 1001 
of the 21st Century Cures Act (Public Law 114– 
255) is amended— 
(A) in subsection (a), by striking ‘‘sub-
section (b)(4)’’ and inserting ‘‘subsections 
(b)(4) and (b)(5)’’; 
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(B) in subsection (b)(1), by striking ‘‘para-
graph (4)’’ and inserting ‘‘paragraphs (4) and 
(5)’’; and 
(C) in subsection (c)(2)(A)(ii), by inserting 
‘‘or pursuant to subsection (b)(5)’’ after ‘‘sub-
section (b)(3)’’; and 
(D) in subsection (d), by inserting ‘‘or pur-
suant to subsection (b)(5)’’ after ‘‘subsection 
(b)(3)’’. 
(b) WORKPLAN.—Section 1001(c)(1) of the 21st 
Century Cures Act (Public Law 114–255) is amended by 
adding at the end the following: 
‘‘(D) UPDATES.—The Director of NIH 
shall , after seeking recommendations in accord-
ance with the process described in subpara-
graph (C), update the work plan submitted 
under this subsection for each of fiscal years 
2021 through 2030 to reflect the amendments 
made to this section by the Elijah E. Cum-
mings Lower Drug Costs Now Act.’’. 
(c) ANNUAL REPORTS.—Section 1001(c)(2)(A) of the 
21st Century Cures Act (Public Law 114–255) is amend-
ed by striking ‘‘2027’’ and inserting ‘‘2030’’. 
(d) SUNSET.—Section 1001(e) of the 21st Century 
Cures Act (Public Law 114–255) is amended by striking 
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‘‘September 30, 2026’’ and inserting ‘‘September 30, 
2030’’. 
SEC. 702. NIH CLINICAL TRIAL. 
Part A of title IV of the Public Health Service Act 
(42 U.S.C. 281 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 404O. CLINICAL TRIAL ACCELERATION PILOT INITIA-
TIVE. 
‘‘(a) ESTABLISHMENT
OF PILOT PROGRAM.—The 
Secretary, acting through the Director of the National In-
stitutes of Health, shall, not later than 2 years after the 
date of enactment of this Act, establish and implement 
a pilot program to award multi-year contracts to eligible 
entities to support phase II clinical trials and phase III 
clinical trials— 
‘‘(1) to promote innovation in treatments and 
technologies supporting the advanced research and 
development and production of high need cures; and 
‘‘(2) to provide support for the development of 
medical products and therapies. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
assistance under the pilot program established under sub-
section (a), an entity shall— 
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‘‘(1) be seeking to market a medical product or 
therapy that is the subject of clinical trial or trials 
to be supported using such assistance; 
‘‘(2) be a public or private entity, which may 
include a private or public research institution, a 
contract research organization, an institution of 
higher education (as defined in section 101 of the 
Higher Education Act of 1965 (20 U.S.C. 1001)), a 
medical center, a biotechnology company, or an aca-
demic research institution; and 
‘‘(3) comply with requirements of the Federal 
Food, Drug, and Cosmetic Act or section 351 of this 
Act at all stages of development, manufacturing, re-
view, approval, and safety surveillance of a medical 
product. 
‘‘(c) DUTIES.—The Secretary, acting through the Di-
rector of National Institutes of Health, shall— 
‘‘(1) in establishing the pilot program under 
subsection (a), consult with— 
‘‘(A) the Director of the National Center 
for Advancing Translational Sciences and the 
other national research institutes in considering 
their requests for new or expanded clinical trial 
support efforts; and 
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‘‘(B) the Commissioner of Food and Drugs 
and any other head of a Federal agency as the 
Secretary determines to be appropriate to en-
sure coordination and efficiently advance clin-
ical trial activities; 
‘‘(2) in implementing the pilot program under 
subsection (a), consider consulting with patients and 
patient advocates; and 
‘‘(3) in awarding contracts under the pilot pro-
gram under subsection (a), consider— 
‘‘(A) the expected health impacts of the 
clinical trial or trials to be supported under the 
contract; and 
‘‘(B) the degree to which the medical prod-
uct or therapy that is the subject of such clin-
ical trial or trials is a high need cure. 
‘‘(d) EXCLUSION.—A contract may not be awarded 
under the pilot program under subsection (a) if the drug 
that is the subject of the clinical trial or trials to be sup-
ported under the contract is a drug designated under sec-
tion 526 of the Federal Food, Drug, and Cosmetic Act 
as a drug for a rare disease or condition. 
‘‘(e) NIH CLINICAL
TRIAL
ACCELERATOR
AC-
COUNT.— 
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‘‘(1) ESTABLISHMENT.—There is established in 
the Treasury an account, to be known as the ‘NIH 
Clinical Trial Accelerator Account’ (referred to in 
this section as the ‘Account’), for purposes of car-
rying out this section. 
‘‘(2) TRANSFER
OF
DIRECT
SPENDING
SAV-
INGS.—There shall be transferred to the Account 
from 
the 
general 
fund 
of 
the 
Treasury, 
$680,000,000 for each of fiscal years 2021 through 
2025, to be available until expended without further 
appropriation. 
‘‘(3) WORK PLAN.—Not later than 180 days 
after the date of enactment of this Act, the Sec-
retary shall submit to the Committee on Energy and 
Commerce of the House of Representatives and the 
Committee on Health, Education, Labor and Pen-
sions of the Senate a work plan that includes the 
proposed implementation of this section and the pro-
posed allocation of funds in the Account. 
‘‘(f) REPORTS TO CONGRESS.—Not later than Octo-
ber 1 of each fiscal year, the Secretary shall submit to 
the Committee on Energy and Commerce of the House 
of Representatives and the Committee on Health, Edu-
cation, Labor and Pensions of the Senate a report on— 
‘‘(1) the implementation of this section; 
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‘‘(2) any available results on phase II clinical 
trials and phase III clinical trials supported under 
this section during such fiscal year; and 
‘‘(3) the extent to which Federal funds are obli-
gated to support such clinical trials, including the 
specific amount of such support and awards pursu-
ant to an allocation from the Account under sub-
section (e). 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) PHASE
II
CLINICAL
TRIAL.—The term 
‘phase II clinical trial’ means a phase II clinical in-
vestigation, as described in section 312.21 of title 
21, Code of Federal Regulations (or any successor 
regulations). 
‘‘(2) PHASE III CLINICAL TRIALS.—The term 
‘phase III clinical trial’ means a phase III clinical 
investigation, as described in section 312.21 of title 
21, Code of Federal Regulations (or any successor 
regulations). 
‘‘(3) HIGH NEED CURE.—The term ‘high need 
cure’ has the meaning given such term in section 
480(a)(3).’’. 
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SEC. 703. INNOVATION NETWORK. 
Part A of title IV of the Public Health Service Act 
(42 U.S.C. 281 et seq.), as amended by section 702, is 
further amended by adding at the end the following: 
‘‘SEC. 404P. INNOVATION NETWORK. 
‘‘(a) FUNDS.—The Director of NIH shall award 
grants or contracts to eligible entities to develop, expand, 
and enhance the commercialization of biomedical products. 
‘‘(b) ELIGIBLE ENTITY.—In this section, the term 
‘eligible entity’ means an entity receiving funding under— 
‘‘(1) the Small Business Innovation Research 
program of the National Institutes of Health; or 
‘‘(2) the Small Business Technology Transfer 
program of the National Institutes of Health. 
‘‘(c) USE OF FUNDS.—An eligible entity shall use the 
funds received through such grant or contract to sup-
port— 
‘‘(1) the Commercialization Readiness Pilot 
program of the National Institutes of Health; 
‘‘(2) the Innovation Corps program of the Na-
tional Institutes of Health; 
‘‘(3) the Commercialization Accelerator pro-
gram of the National Institutes of Health; 
‘‘(4) the Commercialization Assistance program 
of the National Institutes of Health; and 
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‘‘(5) such other programs and activities as the 
Director of NIH determines to be appropriate, to 
support the commercialization stage of research, 
later stage research and development, technology 
transfer, and commercialization technical assistance. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$100,000,000 for each of fiscal years 2021 through 2025, 
to be available until expended.’’. 
Subtitle B—Investing in Safety and 
Innovation 
SEC. 711. FOOD AND DRUG ADMINISTRATION. 
(a) FDA INNOVATION ACCOUNT.— 
(1) IN GENERAL.—Section 1002(b) of the 21st 
Century Cures Act (Public Law 114–255) is amend-
ed— 
(A) in paragraph (1), by striking ‘‘para-
graph (4)’’ and inserting ‘‘paragraphs (4) and 
(5)’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(5) SUPPLEMENTAL
FUNDING
AND
ADDI-
TIONAL ACTIVITIES.— 
‘‘(A) IN
GENERAL.—In addition to the 
funds made available under paragraph (2), 
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there are authorized to be appropriated, and 
are hereby appropriated, to the Account, out of 
any monies in the Treasury not otherwise ap-
propriated, to be available until expended with-
out further appropriation, the following: 
‘‘(i) 
For 
fiscal 
year 
2020, 
$417,500,000. 
‘‘(ii) For each of fiscal years 2021 
and 2022, $157,500,000. 
‘‘(iii) For each of fiscal years 2023 
through 2025, $152,500,000. 
‘‘(iv) For each of fiscal years 2026 
through 2029, $202,500,000. 
‘‘(B) SUPPLEMENTAL FUNDING FOR CER-
TAIN ACTIVITIES.—Of the total amounts made 
available under subparagraph (A) for each of 
fiscal years 2026 through 2029, a total amount 
not to exceed $50,000,000 for each such fiscal 
year, shall be made available for the activities 
under subtitles A through F (including the 
amendments made by such subtitles) of title III 
of this Act and section 1014 of the Federal 
Food, Drug, and Cosmetic Act, as added by 
section 3073 of this Act. 
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‘‘(C) ADDITIONAL
FDA
ACTIVITIES.—In 
addition to funding activities pursuant to sub-
paragraph (B), of the total amounts made 
available under subparagraph (A), a total 
amount not to exceed the following shall be 
made available for the following categories of 
activities: 
‘‘(i) For modernization of the tech-
nical infrastructure of the Food and Drug 
Administration, including enhancements 
such as interoperability across the agency, 
and additional capabilities to develop an 
advanced information technology infra-
structure to support the agency’s regu-
latory mission: 
‘‘(I) 
For 
fiscal 
year 
2020, 
$180,000,000. 
‘‘(II) For each of fiscal years 
2021 through 2029, $60,000. 
‘‘(ii) For support for continuous man-
ufacturing of drugs and biological prod-
ucts, including complex biological products 
such as regenerative medicine therapies, 
through grants to institutions of higher 
education and nonprofit organizations and 
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other appropriate mechanisms, for each of 
fiscal 
years 
2020 
through 
2029, 
$20,000,000. 
‘‘(iii) For support for the Commis-
sioner of Food and Drugs to engage ex-
perts, such as through the formation and 
operation of public-private partnerships or 
other appropriate collaborative efforts, to 
advance the development and delivery of 
individualized human gene therapy prod-
ucts: 
‘‘(I) 
For 
fiscal 
year 
2020, 
$50,000,000. 
‘‘(II) For each of fiscal years 
2021 through 2029, $10,000,000. 
‘‘(iv) For support for inspections, en-
forcement, and quality surveillance activi-
ties across the Food and Drug Administra-
tion, including foreign and domestic in-
spections across products, for each of fiscal 
years 2020 through 2029, $20,000,000. 
‘‘(v) For support for activities of the 
Food and Drug Administration related to 
customs and border protection to provide 
improvements to technologies, inspection 
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capacity, and sites of import (including 
international mail facilities) in which the 
Food and Drug Administration operates, 
for each of fiscal years 2020 through 
2029, $10,000,000. 
‘‘(vi) To further advance the develop-
ment of a coordinated postmarket surveil-
lance system for all medical products, in-
cluding drugs, biological products, and de-
vices, linked to electronic health records in 
furtherance of the Food and Drug Admin-
istration’s postmarket surveillance capabili-
ties: 
‘‘(I) 
For 
fiscal 
year 
2020, 
$112,500,000. 
‘‘(II) For each of fiscal years 
2021 through 2029, $12,500,000. 
‘‘(vii) For support for Food and Drug 
Administration activities to keep pace with 
the projected product development of re-
generative therapies, including cellular and 
somatic cell gene therapy products: 
‘‘(I) For each of fiscal years 
2020 through 2022, $10,000,000. 
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‘‘(II) For each of fiscal years 
2023 through 2029, $5,000,000. 
‘‘(viii) For carrying out section 714A 
of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 379d–3a; relating to hiring 
authority for scientific, technical, and pro-
fessional personnel), for each of fiscal 
years 2020 through 2029, $2,500,000. 
‘‘(ix) For the Food and Drug Admin-
istration to support improvements to the 
technological infrastructure for reporting 
and analysis of adverse events associated 
with the use of drugs and biological prod-
ucts, for each of fiscal years 2020 through 
2029, $12,500,000.’’. 
(2) CONFORMING AMENDMENTS.—Section 1002 
of the 21st Century Cures Act (Public Law 114– 
255) is amended— 
(A) in subsection (a), by inserting before 
the period at the end the following: ‘‘or pursu-
ant to subparagraph (A) of subsection (b)(5) to 
carry out the activities described in subpara-
graphs (B) and (C) of such subsection’’; and 
(B) in subsection (d)— 
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(i) by inserting ‘‘or pursuant to sub-
paragraph (A) of subsection (b)(5)’’ after 
‘‘subsection (b)(3)’’; and 
(ii) by striking ‘‘subsection (b)(4)’’ 
and inserting ‘‘subsections (b)(4) and 
(b)(5)’’. 
(b) ANNUAL REPORT.—Section 1002(c)(2)(A) of the 
21st Century Cures Act (Public Law 114–255) is amend-
ed, in the matter preceding clause (i), by striking ‘‘2026’’ 
and inserting ‘‘2030’’. 
(c) SUNSET.—Section 1002(e) of the 21st Century 
Cures Act (Public Law 114–255) is amended by striking 
‘‘September 30, 2025’’ and inserting ‘‘September 30, 
2030’’. 
SEC. 712. STUDY ON HIGH-RISK, HIGH-REWARD DRUGS. 
(a) IN GENERAL.—Not later than 180 days after the 
date of enactment of this Act, the Secretary of Health and 
Human Services shall conduct a study to identify— 
(1) diseases or conditions that lack a treatment 
approved by the Food and Drug Administration and 
instances in which development of a treatment for 
such diseases or conditions could fill an unmet med-
ical need for the treatment of a serious or life- 
threatening disease or condition or a rare disease or 
condition; and 
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(2) appropriate incentives that would lead to 
the development, approval, and marketing of such 
treatments. 
(b) REPORT TO CONGRESS; RECOMMENDATIONS.— 
Not later than one year after the date of enactment of 
this Act, the Secretary shall submit to the Congress a re-
port that includes— 
(1) findings from the study under subsection 
(a); and 
(2) recommendations regarding legislation nec-
essary to create appropriate incentives identified 
pursuant to subsection (a)(2). 
Subtitle C—Opioid Epidemic 
Response 
SEC. 721. OPIOID EPIDEMIC RESPONSE FUND. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’) shall use any funds made available pursuant to 
subsection (b) to carry out the programs and activities de-
scribed in subsection (c) to address the opioid and sub-
stance use disorder epidemic. Such funds shall be in addi-
tion to any funds which are otherwise available to carry 
out such programs and activities. 
(b) OPIOID EPIDEMIC RESPONSE FUND.— 
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(1) ESTABLISHMENT OF ACCOUNT.—There is 
established in the Treasury an account, to be known 
as the Opioid Epidemic Response Fund (referred to 
in this section as the ‘‘Fund’’), for purposes of fund-
ing the programs and activities described in sub-
section (c). 
(2) FUNDING.—There is authorized to be ap-
propriated, and there is appropriated, to the Fund, 
out of any monies in the Treasury not otherwise ap-
propriated $1,980,000,000 for each of fiscal years 
2021 through 2025. 
(3) AVAILABILITY.—Amounts made available by 
paragraph (2) shall be made available to the agen-
cies specified in subsection (c) in accordance with 
such subsection. Amounts made available to an 
agency pursuant to the preceding sentence for a fis-
cal year shall remain available until expended. 
(c) PROGRAMS
AND
ACTIVITIES.—Of the total 
amount in the Fund for each of fiscal years 2021 through 
2025, such amount shall be allocated as follows: 
(1) SAMHSA.—For the Substance Abuse and 
Mental Health Services Administration to carry out 
programs and activities pursuant to section 722, 
$1,500,000,000 for each of fiscal years 2021 
through 2025. 
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(2) CDC.—For the Centers for Disease Control 
and Prevention to carry out programs and activities 
pursuant to section 723, $120,000,000 for each of 
fiscal years 2021 through 2025. 
(3) FDA.—For the Food and Drug Adminis-
tration to carry out programs and activities pursu-
ant to section 724, $10,000,000 for each of fiscal 
years 2021 through 2025. 
(4) NIH.—For the National Institutes of 
Health to carry out programs and activities pursu-
ant to section 725, $240,000,000 for each of fiscal 
years 2021 through 2025. 
(5) HRSA.—For the Health Resources and 
Services Administration to carry out programs and 
activities pursuant to section 726, $90,000,000 for 
each of fiscal years 2021 through 2025. 
(6) ACF.—For the Administration for Children 
and Families to carry out programs and activities 
pursuant to section 727, $20,000,000 for each of 
fiscal years 2021 through 2025. 
(d) ACCOUNTABILITY AND OVERSIGHT.— 
(1) WORK PLAN.— 
(A) IN
GENERAL.—Not later than 180 
days after the date of enactment of this Act, 
the Secretary of Health and Human Services 
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shall submit to the Committee on Health, Edu-
cation, Labor, and Pensions and the Committee 
on Appropriations of the Senate and the Com-
mittee on Energy and Commerce, the Com-
mittee on Appropriations, and the Committee 
on Education and Labor of the House of Rep-
resentatives, a work plan including the proposed 
allocation of funds made available pursuant to 
subsection (b) for each of fiscal years 2021 
through 2025 and the contents described in 
subparagraph (B). 
(B) CONTENTS.—The work plan submitted 
under subparagraph (A) shall include— 
(i) the amount of money to be obli-
gated or expended out of the Fund in each 
fiscal year for each program and activity 
described in subsection (c); and 
(ii) a description and justification of 
each such program and activity. 
(2) ANNUAL REPORTS.—Not later than October 
1 of each of fiscal years 2022 through 2026, the 
Secretary of Health and Human Services shall sub-
mit to the Committee on Health, Education, Labor, 
and Pensions and the Committee on Appropriations 
of the Senate and the Committee on Energy and 
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Commerce, the Committee on Appropriations, and 
the Committee on Education and Labor of the 
House of Representatives, a report including— 
(A) the amount of money obligated or ex-
pended out of the Fund in the prior fiscal year 
for each program and activity described in sub-
section (c); 
(B) a description of all programs and ac-
tivities using funds made available pursuant to 
subsection (b); and 
(C) how the programs and activities are re-
sponding to the opioid and substance use dis-
order epidemic. 
(e) LIMITATIONS.—Notwithstanding any authority in 
this subtitle or any appropriations Act, any funds made 
available pursuant to subsection (b) may not be used for 
any purpose other than the programs and activities de-
scribed in subsection (c). 
SEC. 722. SUBSTANCE ABUSE AND MENTAL HEALTH SERV-
ICES ADMINISTRATION. 
(a) IN GENERAL.—The entirety of the funds made 
available pursuant to section 721(c)(1) shall be for the As-
sistant Secretary for Mental Health and Substance Use 
to continue to award the State Opioid Response Grants 
funded by the heading ‘‘Substance Abuse And Mental 
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Health Services Administration—Substance Abuse Treat-
ment’’ in title II of the Departments of Labor, Health and 
Human Services, and Education, and Related Agencies 
Appropriations Act, 2018 (Public Law 115–141). Subject 
to subsections (b) and (c), such grants shall be awarded 
in the same manner and subject to the same conditions 
as were applicable to such grants for fiscal year 2018. 
(b) REQUIREMENT
THAT
TREATMENT
BE
EVI-
DENCE-BASED.—As a condition on receipt of a grant pur-
suant to subsection (a), a grantee shall agree that— 
(1) treatments, practices, or interventions fund-
ed through the grant will be evidence-based; and 
(2) such treatments, practices, and interven-
tions will include medication-assisted treatment for 
individuals diagnosed with opioid use disorder, using 
drugs only if the drugs have been approved or li-
censed by the Food and Drug Administration under 
section 505 of the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 355) or section 351 of the 
Public Health Service Act (42 U.S.C. 262). 
(c) RESERVATIONS.—Of the amount made available 
pursuant to section 731(c)(1) for a fiscal year— 
(1) not less than $75,000,000 shall be reserved 
to make grants under subsection (a) to Indian 
Tribes or Tribal organizations; and 
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(2) not less than $50,000,000 shall be reserved 
to make grants under subsection (a) to political sub-
divisions of States, such as counties, cities, or towns. 
SEC. 723. CENTERS FOR DISEASE CONTROL AND PREVEN-
TION. 
(a) ADDRESSING OPIOID USE DISORDER.—The en-
tirety of the funds made available pursuant to section 
721(c)(2) shall be for the Director of the Centers for Dis-
ease Control and Prevention, pursuant to applicable au-
thorities in the Public Health Service Act (42 U.S.C. 201 
et seq.), to continue and expand programs of the Centers 
for Disease Control and Prevention to address opioid and 
substance use disorder, including by— 
(1) improving the timeliness and quality of data 
on the opioid use disorder epidemic, including im-
provement of— 
(A) data on fatal and nonfatal overdoses; 
(B) syndromic surveillance; 
(C) data on long-term sequelae (including 
neonatal abstinence syndrome); and 
(D) cause of death reporting related to 
substance abuse or opioid overdose; 
(2) expanding and strengthening evidence-based 
prevention and education strategies; 
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(3) supporting responsible prescribing practices, 
including through development and dissemination of 
prescriber guidelines; 
(4) improving access to and use of effective pre-
vention, treatment, and recovery support, including 
through grants and the provision of technical assist-
ance to States and localities; 
(5) strengthening partnerships with first re-
sponders, including to protect their safety; 
(6) considering the needs of vulnerable popu-
lations; 
(7) addressing infectious diseases linked to the 
opioid crisis; 
(8) strengthening prescription drug monitoring 
programs; and 
(9) providing financial and technical assistance 
to State and local health department efforts to treat 
and prevent substance use disorder. 
(b) LIMITATION.—Of the funds made available pur-
suant to section 721(c)(2) for carrying out this section, 
not more than 20 percent may be used for intramural pur-
poses. 
SEC. 724. FOOD AND DRUG ADMINISTRATION. 
The entirety of the funds made available pursuant to 
section 721(c)(3) shall be for the Commissioner of Food 
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and Drugs, pursuant to applicable authorities in the Pub-
lic Health Service Act (42 U.S.C. 201 et seq.) or the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 301 et 
seq.) and other applicable law, to support widespread inno-
vation in non-opioid and non-addictive medical products 
for pain treatment, access to opioid addiction treatments, 
appropriate use of approved opioids, and efforts to reduce 
illicit importation of opioids. Such support may include the 
following: 
(1) Facilitating the development of non-opioid 
and non-addictive pain treatments. 
(2) Advancing guidance documents for sponsors 
of non-opioid pain products. 
(3) Developing evidence to inform the potential 
for nonprescription overdose therapies. 
(4) Examining expanded labeling indications for 
medication-assisted treatment. 
(5) Conducting public education and outreach, 
including public workshops or public meetings, re-
garding the benefits of medication-assisted treat-
ment, including all drugs approved by the Food and 
Drug Administration, and device treatment options 
approved or cleared by the Food and Drug Adminis-
tration. 
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(6) Exploring the expansion and possible man-
datory nature of prescriber education regarding pain 
management and appropriate opioid prescribing 
through authorities under section 505–1 of the Fed-
eral Food, Drug, and Cosmetic Act (21 U.S.C. 355– 
1). 
(7) Examining options to limit the duration of 
opioid prescriptions for acute pain, including 
through packaging options. 
(8) Increasing staff and infrastructure capacity 
to inspect and analyze packages at international 
mail facilities and pursue criminal investigations. 
SEC. 725. NATIONAL INSTITUTES OF HEALTH. 
The entirety of the funds made available pursuant to 
section 721(c)(4) shall be for the Director of the National 
Institutes of Health, pursuant to applicable authorities in 
the Public Health Service Act (42 U.S.C. 201 et seq.), 
to carry out activities related to— 
(1) accelerating research for addressing the 
opioid use disorder epidemic, including developing 
non-opioid medications and interventions, including 
non-addictive medications, to manage pain, as well 
as developing medications and interventions to treat 
and to prevent substance use disorders; 
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(2) conducting and supporting research on 
which treatments (in terms of pain management as 
well as treating and preventing substance use dis-
orders) are optimal for which patients; and 
(3) conducting and supporting research on cre-
ating longer-lasting or faster-acting antidotes for 
opioid overdose, particularly in response to the prev-
alence of fentanyl and carfentanyl overdoses. 
SEC. 726. HEALTH RESOURCES AND SERVICES ADMINIS-
TRATION. 
The entirety of the funds made available pursuant to 
section 721(c)(5) shall be for the Administrator of the 
Health Resources and Services Administration, pursuant 
to applicable authorities in titles III, VII, and VIII of the 
Public Health Service Act (42 U.S.C. 241 et seq.), to 
carry out activities that increase the availability and ca-
pacity of the behavioral health workforce. Such activities 
shall include providing loan repayment assistance for sub-
stance use disorder treatment providers. 
SEC. 727. ADMINISTRATION FOR CHILDREN AND FAMILIES. 
Of the funds made available pursuant to section 
721(c)(6) for each of fiscal years 2021 through 2025, 
$20,000,000 for each such fiscal year shall be for the Sec-
retary of Health and Human Services to carry out title 
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I of the Child Abuse Prevention and Treatment Act (42 
U.S.C. 5101 et seq.). 
Subtitle D—Reducing Administra-
tive 
Costs 
and 
Burdens 
in 
Health Care 
SEC. 731. REDUCING ADMINISTRATIVE COSTS AND BUR-
DENS IN HEALTH CARE. 
Title II of the Public Health Service Act (42 U.S.C. 
202 et seq.) is amended by adding at the end the fol-
lowing: 
‘‘PART E—REDUCING ADMINISTRATIVE COSTS 
AND BURDENS IN HEALTH CARE 
‘‘SEC. 281. ELIMINATING UNNECESSARY ADMINISTRATIVE 
BURDENS AND COSTS. 
‘‘(a) REDUCING ADMINISTRATIVE BURDENS
AND 
COSTS.—The Secretary, in consultation with providers of 
health services, health care suppliers of services, health 
care payers, health professional societies, health vendors 
and developers, health care standard development organi-
zations and operating rule entities, health care quality or-
ganizations, health care accreditation organizations, public 
health entities, States, patients, and other appropriate en-
tities, shall, in accordance with subsection (b)— 
‘‘(1) establish a goal of reducing unnecessary 
costs and administrative burdens across the health 
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care system, including the Medicare program under 
title XVIII of the Social Security Act, the Medicaid 
program under title XIX of such Act, and the pri-
vate health insurance market, by at least half over 
a period of 10 years from the date of enactment of 
this section; 
‘‘(2) develop strategies and benchmarks for 
meeting the goal established under paragraph (1); 
‘‘(3) develop recommendations for meeting the 
goal established under paragraph (1); and 
‘‘(4) take action to reduce unnecessary costs 
and administrative burdens based on recommenda-
tions identified in this subsection. 
‘‘(b) STRATEGIES, RECOMMENDATIONS, AND AC-
TIONS.— 
‘‘(1) IN GENERAL.—To achieve the goal estab-
lished under subsection (a)(1), the Secretary, in con-
sultation with the entities described in such sub-
section, shall not later than 1 year after the date of 
enactment of this section, develop strategies and rec-
ommendations and take actions to meet such goal in 
accordance with this subsection. No strategies, rec-
ommendation, or action shall undermine the quality 
of patient care or patient health outcomes. 
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‘‘(2) STRATEGIES.—The strategies developed 
under paragraph (1) shall address unnecessary costs 
and administrative burdens. Such strategies shall in-
clude broad public comment and shall prioritize— 
‘‘(A) recommendations identified as a re-
sult of efforts undertaken to implement section 
3001; 
‘‘(B) recommendations and best practices 
identified as a result of efforts undertaken 
under this part; 
‘‘(C) a review of regulations, rules, and re-
quirements of the Department of Health and 
Human Services that could be modified or 
eliminated to reduce unnecessary costs and ad-
ministrative burden imposed on patients, pro-
viders, payers, and other stakeholders across 
the health care system; and 
‘‘(D) feedback from stakeholders in rural 
or frontier areas on how to reduce unnecessary 
costs and administrative burdens on the health 
care system in those areas. 
‘‘(3) RECOMMENDATIONS.—The recommenda-
tions developed under paragraph (1) shall include— 
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‘‘(A) actions that improve the standardiza-
tion and automation of administrative trans-
actions; 
‘‘(B) actions that integrate clinical and ad-
ministrative functions; 
‘‘(C) actions that improve patient care and 
reduce unnecessary costs and administrative 
burdens borne by patients, their families, and 
other caretakers; 
‘‘(D) actions that advance the development 
and adoption of open application programming 
interfaces and other emerging technologies to 
increase transparency and interoperability, em-
power patients, and facilitate better integration 
of clinical and administrative functions; 
‘‘(E) actions to be taken by the Secretary 
and actions that need to be taken by other enti-
ties; and 
‘‘(F) other areas, as the Secretary deter-
mines appropriate, to reduce unnecessary costs 
and administrative burdens required of health 
care providers. 
‘‘(4) CONSISTENCY.—Any improvements in 
electronic processes proposed by the Secretary under 
this section should leverage existing information 
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technology definitions under Federal Law. Specifi-
cally, any electronic processes should not be con-
strued to include a facsimile, a proprietary payer 
portal that does not meet standards specified by the 
Secretary, or an electronic form image. 
‘‘(5) ACTIONS.—The Secretary shall take action 
to achieve the goal established under subsection 
(a)(1), and, not later than 1 year after the date of 
enactment of this section, and biennially thereafter, 
submit to Congress and make publically available, a 
report describing the actions taken by the Secretary 
pursuant to goals, strategies, and recommendations 
described in this subsection. 
‘‘(6) FACA.—The Federal Advisory Committee 
Act (5 U.S.C. App.) shall not apply to the develop-
ment of the goal, strategies, recommendations, or 
actions described in this section. 
‘‘(7) RULE
OF
CONSTRUCTION.—Nothing in 
this subsection shall be construed to authorize, or be 
used by, the Federal Government to inhibit or other-
wise restrain efforts made to reduce waste, fraud, 
and abuse across the health care system. 
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‘‘SEC. 282. GRANTS TO STATES TO DEVELOP AND IMPLE-
MENT RECOMMENDATIONS TO ACCELERATE 
STATE INNOVATION TO REDUCE HEALTH 
CARE ADMINISTRATIVE COSTS. 
‘‘(a) GRANTS.— 
‘‘(1) IN GENERAL.—Not later than 6 months 
after the date of enactment of this section, the Sec-
retary shall award grants to at least 15 States, and 
one coordinating entity designated as provided for 
under subsection (e), to enable such States to estab-
lish and administer private-public multi-stakeholder 
commissions for the purpose of reducing health care 
administrative costs and burden within and across 
States. Not less than 3 of such grants shall be 
awarded to States that are primarily rural, frontier, 
or a combination thereof, in nature. 
‘‘(2) ENTITIES.—For purposes of this section, 
the term ‘State’ means a State, a State designated 
entity, or a multi-State collaborative (as defined by 
the Secretary). 
‘‘(3) PRIORITY.—In awarding grants under this 
section, the Secretary shall give priority to applica-
tions submitted by States that propose to carry out 
a pilot program or support the adoption of electronic 
health care transactions and operating rules. 
‘‘(b) APPLICATION.— 
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‘‘(1) IN GENERAL.—To be eligible to receive a 
grant under subsection (a) a State shall submit to 
the Secretary an application in such a manner and 
containing such information as the Secretary may 
reasonably require, including the information de-
scribed in paragraph (2). 
‘‘(2) REQUIRED INFORMATION.—In addition to 
any additional information required by the Secretary 
under this subsection, an application shall include a 
description of— 
‘‘(A) the size and composition of the com-
mission to be established under the grant, in-
cluding the stakeholders represented and the 
degree to which the commission reflects impor-
tant geographic and population characteristics 
of the State; 
‘‘(B) the relationship of the commission to 
the State official responsible for coordinating 
and implementing the recommendations result-
ing from the commission, and the role and re-
sponsibilities of the State with respect to the 
commission, including any participation, review, 
oversight, implementation or other related func-
tions; 
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‘‘(C) the history and experience of the 
State in addressing health care administrative 
costs, and any experience similar to the purpose 
of the commission to improve health care ad-
ministrative processes and the exchange of 
health care administrative data; 
‘‘(D) the resources and expertise that will 
be made available to the commission by com-
mission members or other possible sources, and 
how Federal funds will be used to leverage and 
complement these resources; 
‘‘(E) the governance structure and proce-
dures that the commission will follow to make, 
implement, and pilot recommendations; 
‘‘(F) the proposed objectives relating to the 
simplification of administrative transactions 
and operating rules, increased standardization, 
and the efficiency and effectiveness of the 
transmission of health information; 
‘‘(G) potential cost savings and other im-
provements in meeting the objectives described 
in subparagraph (F); and 
‘‘(H) the method or methods by which the 
recommendations described in subsection (c) 
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will be reviewed, tested, adopted, implemented, 
and updated as needed. 
‘‘(c) MULTI-STAKEHOLDER COMMISSION.— 
‘‘(1) IN
GENERAL.—Not later than 90 days 
after the date on which a grant is awarded to a 
State under this section, the State official described 
in subsection (b)(2)(B), the State insurance commis-
sioner, or other appropriate State official shall con-
vene a multi-stakeholder commission, in accordance 
with this subsection. 
‘‘(2) MEMBERSHIP.—The commission convened 
under paragraph (1) shall include representatives 
from health plans, health care providers, health ven-
dors, relevant State agencies, health care standard 
development organizations, and operating rule enti-
ties, relevant professional and trade associations, pa-
tients, and other entities determined appropriate by 
the State. 
‘‘(3) RECOMMENDATIONS.—Not later than one 
year after the date on which a grant is awarded to 
a State under this section, the commission shall 
make recommendations and plans, consistent with 
the application submitted by the State under sub-
section (b), and intended to meet the objectives de-
fined in the application. Such recommendations shall 
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comply with, and build upon, all relevant Federal re-
quirements and regulations, and may include— 
‘‘(A) common, uniform specifications, best 
practices, and conventions, for the efficient, ef-
fective exchange of administrative transactions 
adopted pursuant to the Health Insurance Port-
ability and Accountability Act of 1996 (Public 
Law 104–191); 
‘‘(B) the development of streamlined busi-
ness processes for the exchange and use of 
health care administrative data; and 
‘‘(C) specifications, incentives, require-
ments, tools, mechanisms, and resources to im-
prove— 
‘‘(i) the access, exchange, and use of 
health care administrative information 
through electronic means; 
‘‘(ii) the implementation of utilization 
management protocols; and 
‘‘(iii) compliance with Federal and 
State laws. 
‘‘(d) USE
OF FUNDS
FOR IMPLEMENTATION.—A 
State may use amounts received under a grant under this 
section for one or more of the following: 
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HR 3 PCS
‘‘(1) The development, implementation, and 
best use of shared data infrastructure that supports 
the electronic transmission of administrative data. 
‘‘(2) The development and provision of training 
and educational materials, forums, and activities as 
well as technical assistance to effectively implement, 
use, and benefit from electronic health care trans-
actions and operating rules. 
‘‘(3) To accelerate the early adoption and im-
plementation of administrative transactions and op-
erating rules designated by the Secretary and that 
have been adopted pursuant to the Health Insurance 
Portability and Accountability Act of 1996 (Public 
Law 104–191), including transactions and operating 
rules described in section 1173(a)(2) of the Social 
Security Act. 
‘‘(4) To accelerate the early adoption and im-
plementation of additional or updated administrative 
transactions, operating rules, and related data ex-
change standards that are being considered for 
adoption under the Health Insurance Portability and 
Accountability Act of 1996 or are adopted pursuant 
to such Act, or as designated by the Secretary, in-
cluding the electronic claim attachment. 
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‘‘(5) To conduct pilot projects to test ap-
proaches to implement and use the electronic health 
care transactions and operating rules in practice 
under a variety of different settings. With respect to 
the electronic attachment transaction, priority shall 
be given to pilot projects that test and evaluate 
methods and mechanisms to most effectively incor-
porate patient health data from electronic health 
records and other electronic sources with the elec-
tronic attachment transaction. 
‘‘(6) To assess barriers to the adoption, imple-
mentation, and effective use of electronic health care 
transactions and operating rules, as well as to ex-
plore, identify, and plan options, approaches, and re-
sources to address barriers and make improvements. 
‘‘(7) The facilitation of public and private ini-
tiatives to reduce administrative costs and accelerate 
the adoption, implementation, and effective use of 
electronic health care transactions and operating 
rules for State programs. 
‘‘(8) Developing, testing, implementing, and as-
sessing additional data exchange specifications, oper-
ating rules, incentives, requirements, tools, mecha-
nisms, and resources to accelerate the adoption and 
effective use of the transactions and operating rules. 
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HR 3 PCS
‘‘(9) Ongoing needs assessments and planning 
related to the development and implementation of 
administrative simplification initiatives. 
‘‘(e) COORDINATING ENTITY.— 
‘‘(1) FUNCTIONS.—Not later than 6 months 
after the date of enactment of this section, the Sec-
retary shall designate a coordinating entity under 
this subsection for the purpose of— 
‘‘(A) providing technical assistance to 
States relating to the simplification of adminis-
trative transactions and operating rules, in-
creased standardization, and the efficiency and 
effectiveness of the transmission of health care 
information; 
‘‘(B) evaluating pilot projects and other ef-
forts conducted under this section for impact 
and best practices to inform broader national 
use; 
‘‘(C) using consistent evaluation meth-
odologies to compare return on investment 
across efforts conducted under this section; 
‘‘(D) 
compiling, 
synthesizing, 
dissemi-
nating, and adopting lessons learned to promote 
the adoption of electronic health care trans-
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actions and operating rules across the health 
care system; and 
‘‘(E) making recommendations to the Sec-
retary and the National Committee on Vital 
and Health Statistics regarding the national 
adoption of efforts conducted under this sec-
tion. 
‘‘(2) 
ELIGIBILITY.—The 
entity 
designated 
under paragraph (1) shall be a qualified nonprofit 
entity that— 
‘‘(A) focuses its mission on administrative 
simplification; 
‘‘(B) has demonstrated experience using a 
multi-stakeholder and consensus-based process 
for the development of common, uniform speci-
fications, operating rules, best practices, and 
conventions, for the efficient, effective exchange 
of administrative transactions that includes rep-
resentation by or participation from health 
plans, health care providers, vendors, States, 
relevant Federal agencies, and other health care 
standard development organizations; 
‘‘(C) has demonstrated experience pro-
viding technical assistance to health plans, 
health care providers, vendors, and States relat-
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HR 3 PCS
ing to the simplification of administrative trans-
actions and operating rules, increased standard-
ization, and the efficiency and effectiveness of 
the transmission of health care information; 
‘‘(D) has demonstrated experience evalu-
ating and measuring the adoption and return 
on investment of administrative transactions 
and operating rules; 
‘‘(E) has demonstrated experience gath-
ering, synthesizing, and adopting common, uni-
form specifications, operating rules, best prac-
tices, and conventions for national use based on 
lessons learned to promote the adoption of elec-
tronic health care transactions and operating 
rules across the health care system; 
‘‘(F) has a public set of guiding principles 
that ensure processes are open and transparent, 
and supports nondiscrimination and conflict of 
interest policies that demonstrate a commit-
ment to open, fair, and nondiscriminatory prac-
tices; 
‘‘(G) builds on the transaction standards 
issued under Health Insurance Portability and 
Accountability Act of 1996; and 
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HR 3 PCS
‘‘(H) allows for public review and updates 
of common, uniform specifications, operating 
rules, best practices, and conventions to support 
administrative simplification. 
‘‘(f) PERIOD AND AMOUNT.—A grant awarded to a 
State under this section shall be for a period of 5 years 
and shall not exceed $50,000,000 for such 5-year period. 
A grant awarded to the coordinating entity designated by 
the Secretary under subsection (e) shall be for a period 
of 5 years and shall not exceed $15,000,000 for such 5- 
year period. 
‘‘(g) REPORTS.— 
‘‘(1) STATES.—Not later than 1 year after re-
ceiving a grant under this section, and biennially 
thereafter, a State shall submit to the Secretary a 
report on the outcomes experienced by the State 
under the grant. 
‘‘(2) COORDINATING ENTITY.—Not later than 1 
year after receiving a grant under this section, and 
at least biennially thereafter, the coordinating entity 
shall submit to the Secretary and the National Com-
mittee on Vital and Health Statistics a report of 
evaluations conducted under the grant under this 
section and recommendations regarding the national 
adoption of efforts conducted under this section. 
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‘‘(3) SECRETARY.—Not later than 6 months 
after the date on which the States and coordinating 
entity submit the report required under paragraphs 
(1) and (2), the Secretary, in consultation with Na-
tional Committee on Vital and Health Statistics, 
shall submit to the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate and the 
Committee on Energy and Commerce of the House 
of Representatives, a report on the outcomes 
achieved under the grants under this section. 
‘‘(4) GAO.—Not later than 6 months after the 
date on which the Secretary submits the final report 
under paragraph (3), the Comptroller General of the 
United States shall conduct a study, and submit to 
the Committee on Health, Education, Labor, and 
Pensions of the Senate and the Committee on En-
ergy and Commerce of the House of Representa-
tives, a report on the outcomes of the activities car-
ried out under this section which shall contain a list 
of best practices and recommendations to States 
concerning administrative simplification. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$250,000,000 for the 5-fiscal-year period beginning with 
fiscal year 2020.’’. 
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