1254 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, may award grants and 
enter into cooperative agreements with entities for 
the purpose of expanding and supporting— 
‘‘(A) prevention activities (including pro-
viding screenings, vaccinations, or other pre-
ventative interventions) for conditions known to 
increase an individual’s risk of developing a 
major liver disease, such as liver cancer, hepa-
titis B, hepatitis C, nonalcoholic fatty liver dis-
ease, nonalcoholic steatohepatitis, and cirrhosis 
of the liver; 
‘‘(B) activities relating to detection and 
provision of guidance for individuals at high 
risk for contracting liver cancer and other liver 
diseases; and 
‘‘(C) viral hepatitis surveillance to provide 
for timely and accurate information regarding 
progress to eliminate viral hepatitis. 
‘‘(2) REPORT.—An entity that receives a grant 
or cooperative agreement under paragraph (1) shall 
submit to the Secretary, at a time specified by the 
Secretary, a report describing each activity carried 
out pursuant to such paragraph and evaluating the 
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effectiveness of such activity in promoting prevention 
and treatment of liver cancer and other liver dis-
eases. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
For purposes of carrying out this subsection, there 
is authorized to be appropriated $90,000,000 for 
each of fiscal years 2023 through 2027. 
‘‘(b) AWARENESS INITIATIVE GRANT PROGRAM.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, may award grants to eligi-
ble entities for the purpose of raising awareness for 
liver cancer and other liver diseases, which may in-
clude the production, dissemination, and distribution 
of informational materials targeted towards commu-
nities and populations with a higher risk for devel-
oping liver cancer and other liver diseases. 
‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re-
ceive a grant under paragraph (1), an entity shall 
submit to the Secretary an application, at such time, 
in such manner, and containing such information as 
the Secretary may require, including a description of 
how the entity, in disseminating information on liver 
cancer and other liver diseases pursuant to para-
graph (1), will— 
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‘‘(A) with respect to any community or 
population, consult with members of such com-
munity or population and provide such informa-
tion in a manner that is culturally and linguis-
tically appropriate for such community or popu-
lation; 
‘‘(B) highlight the range of preventative 
measures and treatments available for liver can-
cer and other liver diseases; 
‘‘(C) integrate information on available 
hepatitis B and hepatitis C testing programs 
into any liver cancer presentations carried out 
by the entity; and 
‘‘(D) address communities and populations 
with a higher risk for contracting liver cancer 
and other liver diseases. 
‘‘(3) PREFERENCE.—In awarding grants under 
paragraph (1), the Secretary shall give preference to 
entities that— 
‘‘(A) work with a Federally qualified 
health center; 
‘‘(B) are community-based organizations; 
or 
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‘‘(C) serve communities and populations 
with a higher risk for contracting liver cancer 
and other liver diseases. 
‘‘(4) REPORT.—An entity that receives a grant 
under paragraph (1) shall submit to the Secretary, 
at a time specified by the Secretary, a report de-
scribing each activity carried out pursuant to such 
paragraph and evaluating the effectiveness of such 
activity in raising awareness for liver cancer and 
other liver diseases. 
‘‘(5) AUTHORIZATION
OF
APPROPRIATIONS.— 
For purposes of carrying out this subsection, there 
is authorized to be appropriated $10,000,000 for 
each of fiscal years 2023 through 2027.’’. 
Subtitle C—Acquired Bone Marrow 
Failure Diseases 
SEC. 7101. ACQUIRED BONE MARROW FAILURE DISEASES. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Bone Marrow Failure Disease Research and Treatment 
Act of 2020’’. 
(b) FINDINGS.—The Congress finds the following: 
(1) Between 20,000 and 30,000 people in the 
United States are diagnosed each year with 
myelodysplastic syndromes, aplastic anemia, parox-
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ysmal nocturnal hemoglobinuria, and other acquired 
bone marrow failure diseases. 
(2) Acquired bone marrow failure diseases have 
a debilitating and often fatal impact on those diag-
nosed with these diseases. 
(3) While some treatments for acquired bone 
marrow failure diseases can prolong and improve the 
quality of patients’ lives, there is no single cure for 
these diseases. 
(4) The prevalence of acquired bone marrow 
failure diseases in the United States will continue to 
grow as the general public ages. 
(5) Evidence exists suggesting that acquired 
bone marrow failure diseases occur more often in 
minority populations, particularly in Asian-American 
and Latino or Hispanic populations. 
(6) The National Heart, Lung, and Blood Insti-
tute and the National Cancer Institute have con-
ducted important research into the causes of and 
treatments for acquired bone marrow failure dis-
eases. 
(7) The National Marrow Donor Program Reg-
istry has made significant contributions to the fight 
against bone marrow failure diseases by connecting 
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millions of potential marrow donors with individuals 
and families suffering from these conditions. 
(8) Despite these advances, a more comprehen-
sive Federal strategic effort among numerous Fed-
eral agencies is needed to discover a cure for ac-
quired bone marrow failure disorders. 
(9) Greater Federal surveillance of acquired 
bone marrow failure diseases is needed to gain a bet-
ter understanding of the causes of acquired bone 
marrow failure diseases. 
(10) The Federal Government should increase 
its research support for and engage with public and 
private organizations in developing a comprehensive 
approach to combat and cure acquired bone marrow 
failure diseases. 
(c) NATIONAL ACQUIRED BONE MARROW FAILURE 
DISEASE REGISTRY.—Title III of the Public Health Serv-
ice Act (42 U.S.C. 241 et seq.) is amended by inserting 
after section 317U (42 U.S.C. 247b–23) the following: 
‘‘SEC. 317V. NATIONAL ACQUIRED BONE MARROW FAILURE 
DISEASE REGISTRY. 
‘‘(a) ESTABLISHMENT OF REGISTRY.— 
‘‘(1) IN GENERAL.—Not later than 6 months 
after the date of the enactment of this section, the 
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Secretary, acting through the Director of the Cen-
ters for Disease Control and Prevention, shall— 
‘‘(A) develop a system to collect data on 
acquired bone marrow failure diseases; and 
‘‘(B) establish and maintain a national and 
publicly available registry, to be known as the 
National Acquired Bone Marrow Failure Dis-
ease Registry, in accordance with paragraph 
(3). 
‘‘(2) RECOMMENDATIONS
OF
ADVISORY
COM-
MITTEE.—In carrying out this subsection, the Sec-
retary shall take into consideration the recommenda-
tions of the Advisory Committee on Acquired Bone 
Marrow Failure Diseases established under sub-
section (b). 
‘‘(3) PURPOSES OF REGISTRY.—The National 
Acquired Bone Marrow Failure Disease Registry 
shall— 
‘‘(A) identify the incidence and prevalence 
of acquired bone marrow failure diseases in the 
United States; 
‘‘(B) be used to collect and store data on 
acquired bone marrow failure diseases, includ-
ing data concerning— 
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‘‘(i) the age, race or ethnicity, general 
geographic location, sex, and family history 
of individuals who are diagnosed with ac-
quired bone marrow failure diseases, and 
any other characteristics of such individ-
uals determined appropriate by the Sec-
retary; 
‘‘(ii) the genetic and environmental 
factors that may be associated with devel-
oping acquired bone marrow failure dis-
eases; 
‘‘(iii) treatment approaches for deal-
ing with acquired bone marrow failure dis-
eases; 
‘‘(iv) outcomes for individuals treated 
for acquired bone marrow failure diseases, 
including outcomes for recipients of stem 
cell therapeutic products as contained in 
the database established pursuant to sec-
tion 379A; and 
‘‘(v) any other factors pertaining to 
acquired bone marrow failure diseases de-
termined appropriate by the Secretary; and 
‘‘(C) be made available— 
‘‘(i) to the general public; and 
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1262 
‘‘(ii) to researchers to facilitate fur-
ther research into the causes of, and treat-
ments for, acquired bone marrow failure 
diseases in accordance with standard prac-
tices of the Centers for Disease Control 
and Prevention. 
‘‘(b) ADVISORY COMMITTEE.— 
‘‘(1) ESTABLISHMENT.—Not later than 6 
months after the date of the enactment of this sec-
tion, the Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, 
shall establish an advisory committee, to be known 
as the Advisory Committee on Acquired Bone Mar-
row Failure Diseases. 
‘‘(2) MEMBERS.—The members of the Advisory 
Committee on Acquired Bone Marrow Failure Dis-
eases shall be appointed by the Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, and shall include at least 
one representative from each of the following: 
‘‘(A) A national patient advocacy organiza-
tion with experience advocating on behalf of pa-
tients suffering from acquired bone marrow 
failure diseases. 
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‘‘(B) The National Institutes of Health, in-
cluding at least one representative from each 
of— 
‘‘(i) the National Cancer Institute; 
‘‘(ii) the National Heart, Lung, and 
Blood Institute; and 
‘‘(iii) the Office of Rare Diseases. 
‘‘(C) The Centers for Disease Control and 
Prevention. 
‘‘(D) Clinicians with experience in— 
‘‘(i) diagnosing or treating acquired 
bone marrow failure diseases; or 
‘‘(ii) medical data registries. 
‘‘(E) Epidemiologists who have experience 
with data registries. 
‘‘(F) Publicly or privately funded research-
ers who have experience researching acquired 
bone marrow failure diseases. 
‘‘(G) The entity operating the C.W. Bill 
Young Cell Transplantation Program estab-
lished pursuant to section 379 and the entity 
operating the C.W. Bill Young Cell Transplan-
tation Program Outcomes Database. 
‘‘(3) RESPONSIBILITIES.—The Advisory Com-
mittee on Acquired Bone Marrow Failure Diseases 
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shall provide recommendations to the Secretary on 
the establishment and maintenance of the National 
Acquired Bone Marrow Failure Disease Registry, in-
cluding recommendations on the collection, mainte-
nance, and dissemination of data. 
‘‘(4) PUBLIC
AVAILABILITY.—The Secretary 
shall make the recommendations of the Advisory 
Committee on Acquired Bone Marrow Failure Dis-
ease publicly available. 
‘‘(c) GRANTS.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion, may award grants to, and enter into contracts and 
cooperative agreements with, public or private nonprofit 
entities for the management of, as well as the collection, 
analysis, and reporting of data to be included in, the Na-
tional Acquired Bone Marrow Failure Disease Registry. 
‘‘(d) DEFINITION.—In this section, the term ‘ac-
quired bone marrow failure disease’ means— 
‘‘(1) myelodysplastic syndromes; 
‘‘(2) aplastic anemia; 
‘‘(3) paroxysmal nocturnal hemoglobinuria; 
‘‘(4) pure red cell aplasia; 
‘‘(5) acute myeloid leukemia that has pro-
gressed from myelodysplastic syndromes; or 
‘‘(6) large granular lymphocytic leukemia. 
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‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$3,000,000 for each of fiscal years 2023 through 2027.’’. 
(d) PILOT STUDIES THROUGH THE AGENCY FOR 
TOXIC SUBSTANCES AND DISEASE REGISTRY.— 
(1) PILOT STUDIES.—The Secretary of Health 
and Human Services, acting through the Director of 
the Agency for Toxic Substances and Disease Reg-
istry, shall conduct pilot studies to determine which 
environmental factors, including exposure to toxins, 
may cause acquired bone marrow failure diseases. 
(2) COLLABORATION WITH THE RADIATION IN-
JURY TREATMENT NETWORK.—In carrying out the 
directives of this section, the Secretary of Health 
and Human Services may collaborate with the Radi-
ation Injury Treatment Network of the C.W. Bill 
Young Cell Transplantation Program established 
pursuant to section 379 of the Public Health Service 
Act (42 U.S.C. 274k) to— 
(A) augment data for the pilot studies au-
thorized by this section; 
(B) access technical assistance that may be 
provided by the Radiation Injury Treatment 
Network; or 
(C) perform joint research projects. 
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1266 
(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this section $1,000,000 for each of fiscal years 2023 
through 2027. 
(e) MINORITY-FOCUSED PROGRAMS ON ACQUIRED 
BONE MARROW FAILURE DISEASES.—Title XVII of the 
Public Health Service Act (42 U.S.C. 300u et seq.) is 
amended by inserting after section 1707A the following: 
‘‘SEC. 
1707B. 
MINORITY-FOCUSED 
PROGRAMS 
ON 
AC-
QUIRED BONE MARROW FAILURE DISEASE. 
‘‘(a) INFORMATION AND REFERRAL SERVICES.— 
‘‘(1) IN GENERAL.—Not later than 6 months 
after the date of the enactment of this section, the 
Secretary, acting through the Deputy Assistant Sec-
retary for Minority Health, shall establish and co-
ordinate outreach and informational programs tar-
geted to minority populations affected by acquired 
bone marrow failure diseases. 
‘‘(2) PROGRAM
REQUIREMENTS.—Minority-fo-
cused outreach and informational programs author-
ized by this section at the National Minority Health 
Resource Center supported under section 1707(b)(8) 
(including by means of the Center’s website, through 
appropriate locations such as the Center’s knowledge 
center, and through appropriate programs such as 
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the Center’s resource persons network) and through 
minority health consultants located at each Depart-
ment of Health and Human Services regional of-
fice— 
‘‘(A) shall make information about treat-
ment options and clinical trials for acquired 
bone marrow failure diseases publicly available; 
and 
‘‘(B) shall provide referral services for 
treatment options and clinical trials. 
‘‘(b) HISPANIC AND ASIAN-AMERICAN AND PACIFIC 
ISLANDER OUTREACH.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Deputy Assistant Secretary for Minority 
Health, shall undertake a coordinated outreach ef-
fort to connect Hispanic, Asian-American, and Pa-
cific Islander communities with comprehensive serv-
ices focused on treatment of, and information about, 
acquired bone marrow failure diseases. 
‘‘(2) COLLABORATION.—In carrying out this 
subsection, the Secretary may collaborate with public 
health agencies, nonprofit organizations, community 
groups, and online entities to disseminate informa-
tion about treatment options and clinical trials for 
acquired bone marrow failure diseases. 
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‘‘(c) GRANTS AND COOPERATIVE AGREEMENTS.— 
‘‘(1) IN GENERAL.—Not later than 6 months 
after the date of the enactment of this section, the 
Secretary, acting through the Deputy Assistant Sec-
retary for Minority Health, shall award grants to, or 
enter into cooperative agreements with, entities to 
perform research on acquired bone marrow failure 
diseases. 
‘‘(2) REQUIREMENT.—Grants and cooperative 
agreements authorized by this subsection shall be 
awarded or entered into on a competitive, peer-re-
viewed basis. 
‘‘(3) SCOPE OF RESEARCH.—Research funded 
under this section shall examine factors affecting the 
incidence of acquired bone marrow failure diseases 
in minority populations. 
‘‘(d) DEFINITION.—In this section, the term ‘ac-
quired bone marrow failure disease’ has the meaning given 
to such term in section 317V(d). 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$2,000,000 for each of fiscal years 2023 through 2027’’. 
(f) DIAGNOSIS
AND QUALITY
OF CARE
FOR AC-
QUIRED BONE MARROW FAILURE DISEASES.— 
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(1) GRANTS.—The Secretary of Health and 
Human Services, acting through the Director of the 
Agency for Healthcare Research and Quality, shall 
award grants to entities to improve diagnostic prac-
tices and quality of care with respect to patients 
with acquired bone marrow failure diseases. 
(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this section $2,000,000 for each of fiscal years 2023 
through 2027. 
(g) DEFINITION.—In this section, the term ‘‘acquired 
bone marrow failure disease’’ has the meaning given such 
term in section 317V(d) of the Public Health Service Act, 
as added by subsection (c). 
Subtitle 
D—Cardiovascular 
Dis-
ease, Chronic Disease, Obesity, 
and Other Disease Issues 
SEC. 7151. GUIDELINES FOR DISEASE SCREENING FOR MI-
NORITY PATIENTS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), acting through the Director of the Agency for 
Healthcare Research and Quality, shall convene a series 
of meetings to develop guidelines for disease screening for 
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minority patient populations that have a higher than aver-
age risk for many chronic diseases and cancers. 
(b) PARTICIPANTS.—In convening meetings under 
subsection (a), the Secretary shall ensure that meeting 
participants include representatives of— 
(1) professional societies and associations; 
(2) minority health organizations; 
(3) health care researchers and providers, in-
cluding those with expertise in minority health; 
(4) Federal health agencies, including the Of-
fice of Minority Health, the National Institute on 
Minority Health and Health Disparities, and the 
National Institutes of Health; and 
(5) other experts as the Secretary determines 
appropriate. 
(c) DISEASES.—Screening guidelines for minority 
populations shall be developed as appropriate under sub-
section (a) for— 
(1) hypertension; 
(2) hypercholesterolemia; 
(3) diabetes; 
(4) cardiovascular disease; 
(5) cancers, including breast, prostate, colon, 
cervical, and lung cancer; 
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(6) other pulmonary problems including sleep 
apnea; 
(7) asthma; 
(8) kidney diseases; 
(9) eye diseases and disorders, including glau-
coma; 
(10) HIV/AIDS and sexually transmitted infec-
tions; 
(11) uterine fibroids; 
(12) autoimmune diseases, including lupus; 
(13) mental health conditions; 
(14) dental health conditions and oral diseases, 
including oral cancer; 
(15) environmental and related health illnesses 
and conditions; 
(16) sickle cell disease and sickle cell trait; 
(17) violence and injury prevention and control; 
(18) genetic and related conditions; 
(19) heart disease and stroke; 
(20) tuberculosis; 
(21) chronic obstructive pulmonary disease; 
(22) musculoskeletal diseases, arthritis, and 
obesity; and 
(23) other diseases determined appropriate by 
the Secretary. 
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(d) DISSEMINATION.—Not later than 2 years after 
the date of enactment of this Act, the Secretary shall pub-
lish and disseminate to health care provider organizations 
the guidelines developed under subsection (a). 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2023 through 2027. 
SEC. 7152. CDC WISEWOMAN SCREENING PROGRAM. 
Section 1509 of the Public Health Service Act (42 
U.S.C. 300n–4a) is amended— 
(1) in subsection (a)— 
(A) by striking the heading and inserting 
‘‘IN GENERAL.—’’; and 
(B) in the matter preceding paragraph (1), 
by striking ‘‘may make grants’’ and all that fol-
lows through ‘‘purpose’’ and inserting the fol-
lowing: ‘‘may make grants to such States for 
the purpose’’; and 
(2) in subsection (d)(1), by striking ‘‘there are 
authorized’’ and all that follows through the period 
and inserting ‘‘there are authorized to be appro-
priated 
$23,000,000 
for 
fiscal 
year 
2023, 
$25,300,000 for fiscal year 2024, $27,800,000 for 
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fiscal year 2025, $30,800,000 for fiscal year 2026, 
and $34,000,000 for fiscal year 2027.’’. 
SEC. 7153. REPORT ON CARDIOVASCULAR CARE FOR 
WOMEN AND MINORITIES. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 399V–7. REPORT ON CARDIOVASCULAR CARE FOR 
WOMEN AND MINORITIES. 
‘‘Not later than September 30, 2023, and annually 
thereafter, the Secretary shall prepare and submit to Con-
gress a report on the quality of and access to care for 
women and minorities with heart disease, stroke, and 
other cardiovascular diseases. The report shall contain rec-
ommendations for eliminating disparities in, and improv-
ing the treatment of, heart disease, stroke, and other car-
diovascular diseases in women, racial and ethnic minori-
ties, those for whom English is not their primary lan-
guage, and individuals with disabilities.’’. 
SEC. 7154. COVERAGE OF COMPREHENSIVE TOBACCO CES-
SATION SERVICES IN MEDICAID, CHIP, AND 
PRIVATE HEALTH INSURANCE. 
(a) REQUIRING MEDICAID COVERAGE
OF COUN-
SELING AND PHARMACOTHERAPY FOR CESSATION OF TO-
BACCO USE AND TEMPORARY ENHANCED FMAP FOR 
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COVERAGE OF TOBACCO CESSATION SERVICES.—Section 
1905 of the Social Security Act (42 U.S.C. 1396d) is 
amended— 
(1) by amending subsection (a)(4)(D) to read 
as follows: 
‘‘(D) counseling and pharmacotherapy for 
cessation of tobacco use by individuals who are 
eligible under the State plan (as defined in sub-
section (bb)); and’’; 
(2) in subsection (b), by inserting ‘‘(bb)(2),’’ 
after ‘‘(aa),’’; and 
(3) by striking subsection (bb) and inserting 
the following: 
‘‘(bb) COUNSELING
AND PHARMACOTHERAPY
FOR 
CESSATION OF TOBACCO USE.— 
‘‘(1) IN GENERAL.—For purposes of this title, 
the term ‘counseling and pharmacotherapy for ces-
sation of tobacco use by individuals who are eligible 
under the State plan’ means diagnostic, therapy, 
and counseling services and pharmacotherapy (in-
cluding the coverage of prescription and nonprescrip-
tion tobacco cessation agents approved by the Food 
and Drug Administration) for the cessation of to-
bacco use by individuals who use tobacco products or 
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who are being treated for tobacco use that is fur-
nished— 
‘‘(A) by or under the supervision of a phy-
sician; or 
‘‘(B) by any other health care professional 
who— 
‘‘(i) is legally authorized to furnish 
such services under State law (or the State 
regulatory mechanism provided by State 
law) of the State in which the services are 
furnished; and 
‘‘(ii) is authorized to receive payment 
for other services under this title or is des-
ignated by the Secretary for this purpose; 
which is recommended in the guideline entitled, 
‘Treating Tobacco Use and Dependence: 2008 
Update: A Clinical Practice Guideline’ pub-
lished by the Public Health Service in May 
2008 (or any subsequent modification of such 
guideline) or is recommended for the cessation 
of tobacco use by the United States Preventive 
Services Task Force or any additional interven-
tion approved by the Food and Drug Adminis-
tration as safe and effective in helping smokers 
quit. 
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1276 
‘‘(2) TEMPORARY ENHANCED FMAP FOR COV-
ERAGE
OF
TOBACCO
CESSATION
SERVICES.—Not-
withstanding subsection (b), for calendar quarters 
occurring during the period beginning on the date of 
the enactment of this paragraph and ending 2 years 
after the last day of the emergency period described 
in section 1135(g)(1)(B), the Federal medical assist-
ance percentage with respect to amounts expended 
by a State for medical assistance for counseling and 
pharmacotherapy for cessation of tobacco use by in-
dividuals who are eligible under the State plan (as 
defined in paragraph (1)) shall be equal to 100 per-
cent.’’. 
(b) NO COST SHARING.— 
(1) IN
GENERAL.—Subsections (a)(2) and 
(b)(2) of section 1916 of the Social Security Act (42 
U.S.C. 1396o) are each amended— 
(A) in subparagraph (B), by striking ‘‘, 
and counseling’’ and all that follows through 
‘‘section 1905(bb)(2)(A)’’; 
(B) by adjusting the left margins of sub-
paragraphs (H) and (I) so as to align with the 
left margin of subparagraph (G); 
(C) in subparagraph (H), by striking ‘‘or’’ 
at the end; 
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1277 
(D) in subparagraph (I), by striking ‘‘; 
and’’ and inserting ‘‘; or’’; and 
(E) by adding at the end the following new 
subparagraph: 
‘‘(J) counseling and pharmacotherapy for 
cessation of tobacco use by individuals who are 
eligible under the State plan (as defined in sec-
tion 1905(bb)) and covered outpatient drugs (as 
defined in subsection (k)(2) of section 1927 and 
including nonprescription drugs described in 
subsection (d)(2) of such section) that are pre-
scribed for purposes of promoting tobacco ces-
sation in accordance with the guideline specified 
in section 1905(bb); and’’. 
(2) APPLICATION TO ALTERNATIVE COST SHAR-
ING.—Section 1916A(b)(3)(B) of the Social Security 
Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended— 
(A) in clause (iii), by striking ‘‘, and coun-
seling and pharmacotherapy for cessation of to-
bacco use by pregnant women (as defined in 
section 1905(bb))’’; 
(B) by adjusting the left margins of 
clauses (xii) and (xiii) so as to align with the 
left margin of clause (xi); and 
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1278 
(C) by adding at the end the following new 
clause: 
‘‘(xiv) 
Counseling 
and 
pharmacotherapy for cessation of tobacco 
use by individuals who are eligible under 
the State plan (as defined in section 
1905(bb)) and covered outpatient drugs 
(as defined in subsection (k)(2) of section 
1927 and including nonprescription drugs 
described in subsection (d)(2) of such sec-
tion) that are prescribed for purposes of 
promoting tobacco cessation in accordance 
with the guideline specified in section 
1905(bb).’’. 
(c) EXCEPTION
FROM
OPTIONAL
RESTRICTION 
UNDER MEDICAID PRESCRIPTION DRUG COVERAGE.— 
Section 1927(d)(2)(F) of the Social Security Act (42 
U.S.C. 1396r–8(d)(2)(F)) is amended to read as follows: 
‘‘(F) Nonprescription drugs, except, when 
recommended in accordance with the guideline 
referred to in section 1905(bb), agents ap-
proved by the Food and Drug Administration 
under the over-the-counter monograph process 
for purposes of promoting tobacco cessation.’’. 
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1279 
(d) STATE MONITORING AND PROMOTING OF COM-
PREHENSIVE TOBACCO CESSATION SERVICES UNDER 
MEDICAID.—Section 1902(a) of the Social Security Act 
(42 U.S.C. 1396a(a)) is amended— 
(1) in paragraph (86), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (87), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by inserting after paragraph (87) the fol-
lowing new paragraph: 
‘‘(88) provide for the State to monitor and pro-
mote the use of comprehensive tobacco cessation 
services under the State plan (including conducting 
an outreach campaign to increase awareness of the 
benefits of using such services) among— 
‘‘(A) individuals entitled to medical assist-
ance under the State plan who use tobacco 
products; and 
‘‘(B) clinicians and others who provide 
services to individuals entitled to medical assist-
ance under the State plan.’’. 
(e) FEDERAL
REIMBURSEMENT
FOR
OUTREACH 
CAMPAIGN.—Section 1903(a) of the Social Security Act 
(42 U.S.C. 1396b(a)) is amended— 
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1280 
(1) in paragraph (6)(B), by striking ‘‘plus’’ at 
the end; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘; plus’’; and 
(3) by inserting after paragraph (7) the fol-
lowing new paragraph: 
‘‘(8) with respect to the development, imple-
mentation, and evaluation of an outreach campaign 
to— 
‘‘(A) increase awareness of comprehensive 
tobacco cessation services covered in the State 
plan among— 
‘‘(i) individuals who are likely to be el-
igible for medical assistance under the 
State plan; and 
‘‘(ii) clinicians and others who provide 
services to individuals who are likely to be 
eligible for medical assistance under the 
State plan; and 
‘‘(B) increase awareness of the benefits of 
using comprehensive tobacco cessation services 
covered in the State plan among— 
‘‘(i) individuals who are likely to be el-
igible for medical assistance under the 
State plan; and 
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1281 
‘‘(ii) clinicians and others who provide 
services to individuals who are likely to be 
eligible for medical assistance under the 
State plan about the benefits of using com-
prehensive tobacco cessation services; 
for calendar quarters occurring during the pe-
riod beginning on the date of the enactment of 
this paragraph and ending on 2 years after the 
last day of the emergency period described in 
section 1135(g)(1)(B), an amount equal to 100 
percent of the sums expended during each quar-
ter which are attributable to such development, 
implementation, and evaluation, and for cal-
endar quarters succeeding such period, an 
amount equal to Federal medical assistance 
percentage determined under section 1905(b) of 
the sums expended during each quarter which 
are so attributable.’’. 
(f) NO PRIOR AUTHORIZATION FOR TOBACCO CES-
SATION DRUGS UNDER MEDICAID.—Section 1927(d) of 
the Social Security Act (42 U.S.C. 1396r–8(d)) is amend-
ed— 
(1) in paragraph (1)(A), by striking ‘‘A State’’ 
and inserting ‘‘Subject to paragraph (8), a State’’; 
and 
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1282 
(2) by adding at the end the following new 
paragraph: 
‘‘(8) NO PRIOR AUTHORIZATION PROGRAMS FOR 
TOBACCO CESSATION DRUGS.—A State plan may not 
require, as a condition of coverage or payment for 
a covered outpatient drug, the approval of an agent 
to promote smoking cessation (including agents ap-
proved by the Food and Drug Administration) or to-
bacco cessation.’’. 
(g) EXCLUSION
OF ENHANCED PAYMENTS FROM 
TERRITORIAL CAPS.—Notwithstanding any other provi-
sion of law, for purposes of section 1108 of the Social Se-
curity Act (42 U.S.C. 1308), with respect to any addi-
tional amount paid to a territory as a result of the applica-
tion of section 1905(bb)(2) of the Social Security Act (42 
U.S.C. 1396d(bb)(2))— 
(1) the limitation on payments to territories 
under subsections (f) and (g) of such section 1108 
shall not apply to such additional amounts; and 
(2) such additional amounts shall be dis-
regarded in applying such subsections. 
(h) REQUIRING CHIP COVERAGE OF COUNSELING 
AND PHARMACOTHERAPY FOR CESSATION OF TOBACCO 
USE.— 
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1283 
(1) IN
GENERAL.—Section 2103(c)(2) of the 
Social Security Act (42 U.S.C. 1397cc(c)(2)) is 
amended by adding at the end the following new 
subparagraph: 
‘‘(D) Counseling and pharmacotherapy for 
cessation of tobacco use by individuals who are 
eligible under the State child health plan.’’. 
(2) COUNSELING AND PHARMACOTHERAPY FOR 
CESSATION
OF
TOBACCO
USE
DEFINED.—Section 
2110(c) of the Social Security Act (42 U.S.C. 
1397jj(c)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(10) COUNSELING
AND
PHARMACOTHERAPY 
FOR CESSATION OF TOBACCO USE.—The term ‘coun-
seling and pharmacotherapy for cessation of tobacco 
use’ means diagnostic, therapy, and counseling serv-
ices and pharmacotherapy (including the coverage of 
prescription and nonprescription tobacco cessation 
agents approved by the Food and Drug Administra-
tion) for the cessation of tobacco use by individuals 
who use tobacco products or who are being treated 
for tobacco use that are furnished— 
‘‘(A) by or under the supervision of a phy-
sician; or 
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1284 
‘‘(B) by any other health care professional 
who— 
‘‘(i) is legally authorized to furnish 
such services under State law (or the State 
regulatory mechanism provided by State 
law) of the State in which the services are 
furnished; and 
‘‘(ii) is authorized to receive payment 
for other services under this title or is des-
ignated by the Secretary for this purpose; 
which is recommended in the guideline entitled, 
‘Treating Tobacco Use and Dependence: 2008 
Update: A Clinical Practice Guideline’ pub-
lished by the Public Health Service in May 
2008 (or any subsequent modification of such 
guideline) or is recommended for the cessation 
of tobacco use by the United States Preventive 
Services Task Force or any additional interven-
tion approved by the Food and Drug Adminis-
tration as safe and effective in helping smokers 
quit.’’. 
(i) NO COST SHARING.—Section 2103(e) of the So-
cial Security Act (42 U.S.C. 1397cc(e)) is amended by 
adding at the end the following new paragraph: 
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1285 
‘‘(5) NO
COST
SHARING
ON
BENEFITS
FOR 
COUNSELING
AND
PHARMACOTHERAPY
FOR
CES-
SATION OF TOBACCO USE.—The State child health 
plan may not impose deductibles, coinsurance, or 
other cost sharing with respect to benefits for coun-
seling and pharmacotherapy for cessation of tobacco 
use (as defined in section 2110(c)(10)) and prescrip-
tion drugs that are covered under a State child 
health plan that are prescribed for purposes of pro-
moting tobacco cessation in accordance with the 
guideline specified in section 2110(c)(10)(B).’’. 
(j) EXCEPTION
FROM
OPTIONAL
RESTRICTION 
UNDER CHIP PRESCRIPTION DRUG COVERAGE.—Section 
2103 of the Social Security Act (42 U.S.C. 1397cc) is 
amended by adding at the end the following new sub-
section: 
‘‘(g) EXCEPTION FROM OPTIONAL RESTRICTION 
UNDER CHIP PRESCRIPTION DRUG COVERAGE.—The 
State child health plan may exclude or otherwise restrict 
nonprescription drugs, except, in the case of— 
‘‘(1) pregnant women when recommended in ac-
cordance with the guideline specified in section 
2110(c)(10)(B), agents approved by the Food and 
Drug Administration under the over-the-counter 
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1286 
monograph process for purposes of promoting to-
bacco cessation; and 
‘‘(2) individuals who are eligible under the 
State child health plan when recommended in ac-
cordance with the Guideline referred to in section 
2110(c)(10)(B), agents approved by the Food and 
Drug Administration under the over-the-counter 
monograph process for purposes of promoting to-
bacco cessation.’’. 
(k) STATE MONITORING AND PROMOTING OF COM-
PREHENSIVE TOBACCO CESSATION SERVICES UNDER 
CHIP.—Section 2102 of the Social Security Act (42 
U.S.C. 1397bb) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(d) STATE MONITORING AND PROMOTING OF COM-
PREHENSIVE TOBACCO CESSATION SERVICES UNDER 
CHIP.—A State child health plan shall include a descrip-
tion of the procedures to be used by the State to monitor 
and promote the use of comprehensive tobacco cessation 
services under the State plan (including conducting an 
outreach campaign to increase awareness of the benefits 
of using such services) among— 
‘‘(1) individuals entitled to medical assistance 
under the State child health plan who use tobacco 
products; and 
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1287 
‘‘(2) clinicians and others who provide services 
to individuals entitled to medical assistance under 
the State child health plan.’’. 
(l) FEDERAL REIMBURSEMENT
FOR CHIP COV-
ERAGE AND OUTREACH CAMPAIGN.— 
(1) IN GENERAL.—Section 2105(a) of the So-
cial Security Act (42 U.S.C. 1397ee(a)) is amended 
by adding at the end the following new paragraph: 
‘‘(5) FEDERAL
REIMBURSEMENT
FOR
CHIP 
COVERAGE
OF
COMPREHENSIVE
TOBACCO
CES-
SATION
SERVICES
AND
OUTREACH
CAMPAIGN.—In 
addition to the payments made under paragraph (1) 
for calendar quarters occurring during the period be-
ginning on the date of the enactment of this para-
graph and ending on 2 years after the last day of 
the 
emergency 
period 
described 
in 
section 
1135(g)(1)(B), the Secretary shall pay— 
‘‘(A) an amount equal to 100 percent of 
the sums expended during each quarter which 
are attributable to the cost of furnishing coun-
seling and pharmacotherapy for cessation of to-
bacco use by individuals who are eligible under 
the State child health plan (net of any pay-
ments made to the State under paragraph (1) 
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1288 
with 
respect 
to 
such 
counseling 
and 
pharmacotherapy); plus 
‘‘(B) an amount equal to 100 percent of 
the sums expended during each quarter which 
are attributable to the development, implemen-
tation, and evaluation of an outreach campaign 
to— 
‘‘(i) increase awareness of comprehen-
sive tobacco cessation services covered in 
the State child health plan among— 
‘‘(I) individuals who are likely to 
be eligible for medical assistance 
under the State child health plan; and 
‘‘(II) clinicians and others who 
provide services to individuals who are 
likely to be eligible for medical assist-
ance under the State child health 
plan; and 
‘‘(ii) increase awareness of the bene-
fits of using comprehensive tobacco ces-
sation services covered in the State child 
health plan among— 
‘‘(I) individuals who are likely to 
be eligible for medical assistance 
under the State child health plan; and 
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1289 
‘‘(II) clinicians and others who 
provide services to individuals who are 
likely to be eligible for medical assist-
ance under the State child health plan 
about the benefits of using com-
prehensive tobacco cessation serv-
ices.’’. 
(2) ADJUSTMENT OF CHIP ALLOTMENTS.—Sec-
tion 2104(m) of the Social Security Act (42 U.S.C. 
1397dd(m)) is amended— 
(A) in paragraph (2)(B), by striking ‘‘and 
(12)’’ and inserting ‘‘(12), and (13)’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(13) ADJUSTING
ALLOTMENTS
TO
ACCOUNT 
FOR FEDERAL PAYMENTS FOR CHIP COVERAGE OF 
COMPREHENSIVE
TOBACCO
CESSATION
SERVICES 
AND OUTREACH CAMPAIGN.—If a State (including 
the District of Columbia and each commonwealth 
and territory) receives a payment for a fiscal year 
under section 2105(a)(5), the allotment determined 
for the State for such fiscal year shall be increased 
by the amount of such payment.’’. 
(m) NO PRIOR AUTHORIZATION FOR TOBACCO CES-
SATION DRUGS UNDER CHIP.—Section 2103 of the So-
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1290 
cial Security Act (42 U.S.C. 1397cc), as amended by sub-
section (h), is further amended— 
(1) in subsection (c)(2)(A), by inserting ‘‘(in ac-
cordance with subsection (h))’’ after ‘‘Coverage of 
prescription drugs’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(h) NO PRIOR AUTHORIZATION PROGRAMS FOR TO-
BACCO CESSATION DRUGS.—A State child health plan 
may not require, as a condition of coverage or payment 
for a prescription drugs, the approval of an agent to pro-
mote smoking cessation (including agents approved by the 
Food and Drug Administration) or tobacco cessation.’’. 
(n) COMPREHENSIVE COVERAGE OF TOBACCO CES-
SATION COVERAGE IN PRIVATE HEALTH INSURANCE.— 
Section 2713 of the Public Health Service Act (42 U.S.C. 
300gg–13) is amended by adding at the end the following: 
‘‘(d) NO PRIOR AUTHORIZATION.—A group health 
plan and a health insurance issuer offering group or indi-
vidual health insurance coverage shall not impose any 
prior authorization requirement for tobacco cessation 
counseling and pharmacotherapy that has in effect a rat-
ing of ‘A’ or ‘B’ in the current recommendations of the 
United States Preventive Services Task Force.’’. 
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1291 
(o) RULE OF CONSTRUCTION.—None of the amend-
ments made by this section shall be construed to limit cov-
erage of any counseling or pharmacotherapy for individ-
uals under 18 years of age. 
(p) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the first day of the first 
fiscal year that begins on or after the date of enactment 
of this Act. 
SEC. 7155. CLINICAL RESEARCH FUNDING FOR ORAL 
HEALTH. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall expand and intensify the conduct 
and support of the research activities of the National In-
stitutes of Health and the National Institute of Dental 
and Craniofacial Research to improve the oral health of 
the population through the prevention and management 
of oral diseases and conditions. 
(b) INCLUDED RESEARCH ACTIVITIES.—Research 
activities under subsection (a) shall include— 
(1) comparative effectiveness research and clin-
ical disease management research addressing early 
childhood caries and oral cancer; and 
(2) awarding of grants and contracts to support 
the training and development of health services re-
searchers, comparative effectiveness researchers, and 
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1292 
clinical researchers whose research improves the oral 
health of the population. 
SEC. 7156. GUIDE ON EVIDENCE-BASED STRATEGIES FOR 
PUBLIC HEALTH DEPARTMENT OBESITY PRE-
VENTION PROGRAMS. 
(a) DEVELOPMENT AND DISSEMINATION OF AN EVI-
DENCE-BASED STRATEGIES GUIDE.—The Secretary of 
Health and Human Services (referred to in this section 
as the ‘‘Secretary’’), acting through the Director of the 
Centers for Disease Control and Prevention, not later than 
2 years after the date of enactment of this Act, shall— 
(1) develop a guide on evidence-based strategies 
for State, territorial, and local health departments to 
use to build and maintain effective obesity preven-
tion and reduction programs, and, in consultation 
with stakeholders that have expertise in Tribal 
health, a guide on such evidence-based strategies 
with respect to Indian Tribes and Tribal organiza-
tions for such Indian Tribes and Tribal organiza-
tions to use for such purpose, both of which guides 
shall— 
(A) describe an integrated program struc-
ture for implementing interventions proven to 
be effective in preventing and reducing the inci-
dence of obesity; and 
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1293 
(B) recommend— 
(i) optimal resources, including staff-
ing and infrastructure, for promoting nu-
trition and obesity prevention and reduc-
tion; and 
(ii) strategies for effective obesity pre-
vention programs for State and local 
health departments, Indian Tribes, and 
Tribal organizations, including strategies 
related to— 
(I) the application of evidence- 
based and evidence-informed practices 
to prevent and reduce obesity rates; 
(II) the development, implemen-
tation, and evaluation of obesity pre-
vention and reduction strategies for 
specific communities and populations; 
(III) demonstrated knowledge of 
obesity prevention practices that re-
duce associated preventable diseases, 
health conditions, death, and health 
care costs; 
(IV) best practices for the coordi-
nation of efforts to prevent and re-
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1294 
duce obesity and related chronic dis-
eases; 
(V) addressing the underlying 
risk factors and social determinants of 
health that impact obesity rates; and 
(VI) interdisciplinary coordina-
tion between relevant public health of-
ficials specializing in fields such as 
nutrition, physical activity, epidemi-
ology, communications, and policy im-
plementation, and collaboration be-
tween public health officials and com-
munity-based organizations; and 
(2) disseminate the guides and current re-
search, evidence-based practices, tools, and edu-
cational materials related to obesity prevention, con-
sistent with the guides, to State and local health de-
partments, Indian Tribes, and Tribal organizations. 
(b) TECHNICAL ASSISTANCE.—The Secretary, acting 
through the Director of the Centers for Disease Control 
and Prevention, shall provide technical assistance to State 
and local health departments, Indian Tribes, and Tribal 
organizations to support such health departments in im-
plementing the guides developed under subsection (a)(1). 
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1295 
(c) INDIAN TRIBES; TRIBAL ORGANIZATIONS.—In 
this section, the terms ‘‘Indian Tribe’’ and ‘‘Tribal organi-
zation’’ have the meanings given the terms ‘‘Indian tribe’’ 
and ‘‘tribal organization’’, respectively, in section 4 of the 
Indian Self-Determination and Education Assistance Act 
(25 U.S.C. 5304). 
SEC. 7157. STEPHANIE TUBBS JONES UTERINE FIBROID RE-
SEARCH AND EDUCATION ACT. 
(a) RESEARCH
WITH
RESPECT
TO
UTERINE 
FIBROIDS.— 
(1) RESEARCH.—The Secretary of Health and 
Human Services (referred to in this section as the 
‘‘Secretary’’) shall expand, intensify, and coordinate 
programs for the conduct and support of research 
with respect to uterine fibroids. 
(2) ADMINISTRATION
AND
COORDINATION.— 
The Secretary shall carry out the conduct and sup-
port of research pursuant to paragraph (1), in co-
ordination with the appropriate institutes, offices, 
and centers of the National Institutes of Health and 
any other relevant Federal agency, as determined by 
the Director. 
(3) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out this subsection, there 
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are authorized to be appropriated $30,000,000 for 
each of fiscal years 2022 through 2026. 
(b) RESEARCH WITH RESPECT TO MEDICAID COV-
ERAGE OF UTERINE FIBROIDS TREATMENT.— 
(1) RESEARCH.—The Secretary (or the Sec-
retary’s designee) shall establish a research data-
base, or expand an existing research database, to 
collect data on services furnished to individuals diag-
nosed with uterine fibroids under a State plan (or a 
waiver of such a plan) under the Medicaid program 
under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) or under a State child health 
plan (or a waiver of such a plan) under the Chil-
dren’s Health Insurance Program under title XXI of 
such Act (42 U.S.C. 1397aa et seq.) for the treat-
ment of such fibroids for purposes of assessing the 
frequency at which such individuals are furnished 
such services. 
(2) REPORT.— 
(A) IN GENERAL.—Not later than the date 
that is two years after the date of the enact-
ment of this Act, the Secretary shall submit to 
Congress a report on the amount of Federal 
and State expenditures with respect to services 
furnished for the treatment of uterine fibroids 
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under State plans (or waivers of such plans) 
under the Medicaid program under such title 
XIX and State child health plans (or waivers of 
such plans) under the Children’s Health Insur-
ance Program under such title XXI. 
(B) COORDINATION.—The Secretary shall 
coordinate the development and submission of 
the report required under subparagraph (A) 
with any other relevant Federal agency, as de-
termined by the Secretary. 
(c) EDUCATION AND DISSEMINATION OF INFORMA-
TION WITH RESPECT TO UTERINE FIBROIDS.— 
(1) UTERINE
FIBROIDS
PUBLIC
EDUCATION 
PROGRAM.—The Secretary shall develop and dis-
seminate to the public information regarding uterine 
fibroids, including information on— 
(A) the awareness, incidence, and preva-
lence of uterine fibroids among individuals, in-
cluding all minority individuals; 
(B) the elevated risk for minority individ-
uals to develop uterine fibroids; and 
(C) the availability, as medically appro-
priate, of the range of treatment options for 
symptomatic uterine fibroids, including non- 
hysterectomy treatments and procedures. 
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(2) DISSEMINATION
OF
INFORMATION.—The 
Secretary may disseminate information under para-
graph (1) directly or through arrangements with 
intra-agency initiatives, nonprofit organizations, con-
sumer groups, institutions of higher education (as 
defined in section 101 of the Higher Education Act 
of 1965 (20 U.S.C. 1001)), or Federal, State, or 
local public private partnerships. 
(3) AUTHORIZATION OF APPROPRIATIONS.—For 
the purpose of carrying out this subsection, there 
are authorized to be appropriated such sums as may 
be necessary for each of fiscal years 2022 through 
2026. 
Subtitle E—HIV/AIDS 
SEC. 7201. STATEMENT OF POLICY. 
It is the policy of the United States to achieve an 
AIDS-free generation, and to— 
(1) expand access to lifesaving antiretroviral 
therapy for people living with HIV and immediately 
link people to continuous and coordinated high-qual-
ity care when they learn they are living with HIV; 
(2) expand targeted efforts to prevent HIV in-
fection using a combination of effective, evidence- 
based approaches, including routine HIV screening, 
and universal access to HIV prevention tools, includ-
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ing preexposure prophylaxis, in communities dis-
proportionately impacted by HIV, particularly com-
munities of color; 
(3) ensure laws, policies, and regulations do not 
impede access to prevention, treatment, and care for 
people living with HIV or disproportionately im-
pacted by HIV; 
(4) accelerate research for more efficacious HIV 
prevention and treatments tools, a cure, and a vac-
cine; and 
(5) respect the human rights and dignity of 
persons living with HIV. 
SEC. 7202. FINDINGS. 
The Congress finds the following: 
(1) Over 1,100,000 people are estimated to be 
living with HIV in the United States according to 
the Centers for Disease Control and Prevention, 14 
percent of whom are unaware they are living with 
HIV. 
(2) The Centers for Disease Control and Pre-
vention estimates that, in 2019, there were approxi-
mately 34,800 people newly diagnosed with HIV. 
New HIV infections declined 8 percent from 37,800 
in 2015, after a period of general stability. From 
2015 to 2019, new infections among young gay and 
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bisexual men (ages 13 to 24) dropped 33 percent 
overall, with declines in young men of all races, but 
African Americans, Hispanics, and Latinos continue 
to be severely and disproportionately affected. 
(3) HIV disproportionately affects certain popu-
lations in the United States. Though Blacks/African 
Americans represent approximately 13 percent of 
the population, they account for almost half (44 per-
cent) of all people living with HIV in the United 
States. Black/African-American men who have sex 
with men account for 26 percent of all new HIV in-
fections and have remained stable from 2010 to 
2019. 
(4) Disparities continue to exist among Latinos 
and Hispanics; in 2019, Latinos and Hispanics 
made up 18 percent of the United States population 
and 30 percent of new infections. 
(5) Though the rate of new infections among 
American Indians and Alaska Natives (referred to in 
this section as ‘‘AI/AN’’) is proportional to their 
population size, from 2015 to 2019, the annual 
number of HIV diagnoses increased among Amer-
ican Indians and Alaska Natives. 
(6) Asian Americans account for about 2 per-
cent of new HIV infections, but in 2013, 22 percent 
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were undiagnosed, the highest rate of undiagnosed 
HIV among any race or ethnicity. Between 2010 
and 2016, the number of Asian Americans receiving 
an HIV diagnosis increased by 42 percent. 
(7) The latest data from the Centers for Dis-
ease Control and Prevention indicates that new in-
fections among women remained stable for women in 
2019. 
(8) The history of HIV shows that culturally 
relevant and gender-responsive supportive services, 
including psychosocial support, treatment literacy, 
case management, and transportation are necessary 
strategies to reach and engage women and girls in 
medical care. 
(9) From 2015 through 2019 in the United 
States and 6 dependent areas, the number of diag-
noses of HIV infection for transgender adults and 
adolescents increased. In 2019, among transgender 
adults and adolescents, the largest percentage (93 
percent) of diagnoses of HIV infections was for 
transgender male-to-female (MTF) people. By age, 
in 2019, the largest percentage (24 percent) of diag-
noses of HIV infection among transgender persons 
was for transgender MTF adults and adolescents 
aged 20 to 24 years, followed by transgender MTF 
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adults and adolescents aged 25 to 29 years (23 per-
cent). 
(10) Stigma and discrimination contribute to 
such disparities. 
(11) The Centers for Disease Control and Pre-
vention has determined that increasing the propor-
tion of people who know their HIV status is an es-
sential component of comprehensive HIV treatment 
and prevention efforts and that early diagnosis is 
critical in order for people with HIV to receive life- 
extending therapy. Additionally, the Centers for Dis-
ease Control and Prevention recommend routine 
HIV screening in health care settings for all patients 
aged 13 to 64, regardless of risk. 
(12) In 1998, Congress created the National 
Minority AIDS Initiative to provide technical assist-
ance, build capacity, and strengthen outreach efforts 
among local institutions and community-based orga-
nizations that serve racial and ethnic minorities liv-
ing with or vulnerable to HIV. 
(13) To combat the HIV epidemic in the United 
States, the National HIV/AIDS Strategy (referred 
to in this section as ‘‘NHAS’’) provides a framework 
of increasing access to care, reducing new infections, 
and eliminating HIV-related health disparities. The 
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vision of NHAS is ‘‘The United States will be a 
place where new HIV infections are prevented, every 
person knows their status, and every person with 
HIV has high-quality care and treatment, lives free 
from stigma and discrimination, and can achieve 
their full potential for health and well-being across 
the lifespan. This vision includes all people, regard-
less of age, sex, gender identity, sexual orientation, 
race, ethnicity, religion, disability, geographic loca-
tion, or socioeconomic circumstance.’’. 
(14) In January 2019, the Department of 
Health and Human Services began implementing the 
initiative ‘‘Ending the HIV Epidemic: A Plan for 
America’’. The initiative seeks to reduce the number 
of new HIV infections in the United States by 75 
percent by 2025, and then by at least 90 percent by 
2030, for an estimated 250,000 total HIV infection 
averted. 
(15) At present, many States and United 
States territories have criminal statutes based on 
‘‘exposure’’ to HIV. Most of these laws were adopted 
before the availability of effective antiretroviral 
treatment for HIV/AIDS. 
(16) Research shows that stable housing leads 
to better health outcomes for those living with HIV. 
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Inadequate or unstable housing is not only a barrier 
to effective treatment, but also increases the likeli-
hood of engaging in risky behaviors leading to HIV 
infection. Insecure housing puts people with HIV/ 
AIDS at risk of premature death from exposure to 
other diseases, poor nutrition, and lack of medical 
care. 
(17) Due to advances in treatment, many peo-
ple living with HIV today are living healthy lives and 
have the ability and desire to fully participate in all 
aspects of community life, including employment. 
Research associates being employed with tremendous 
economic, social, and health benefits for many people 
living with HIV. 
(18) Despite the tremendous progress made in 
the treatment and prevention of HIV/AIDS, dis-
criminatory policies stemming from continued stig-
matization of HIV/AIDS and the LGBTQ+ commu-
nity continue to plague the scientific community. 
This includes blood donation guidance updated by 
Food and Drug Administration in 2020 that rec-
ommends a 3-month deferral policy for gay and bi-
sexual men before they are eligible to donate blood. 
Health agencies in the United States must imple-
ment blood donation policies that are grounded in 
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science and that do not unfairly single out any 
group of individuals. 
(19) The common benefits associated with em-
ployment include income, autonomy, productivity, 
and status within society, daily structure, making a 
contribution to one’s community, and increased skills 
and self-esteem. Research also indicates that many 
people with disabilities, including people living with 
HIV, report perceiving themselves as being less dis-
abled or not disabled at all, when working. Further-
more, some studies link working with better physical 
and mental health outcomes for people living with 
HIV when compared to those who are not working. 
Preliminary data also suggest that transitioning to 
employment is associated with reduced HIV-related 
health risk behavior for many people. 
(20) In July 2012, the Food and Drug Admin-
istration approved the first drug to be used as pre- 
exposure prophylaxis (PrEP). PrEP reduces the risk 
of HIV infection in HIV-negative individuals. Stud-
ies have shown that PrEP reduces HIV transmission 
from sex by about 99 percent when taken consist-
ently. Despite increases in PrEP uptake, PrEP use 
remains low among gay and bisexual men of color. 
The Centers for Disease Control and Prevention 
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found that uptake was lower among African-Amer-
ican (26 percent) and Latino (30 percent) men com-
pared with White men (42 percent). Similarly, PrEP 
awareness was lower among African-American (86 
percent) and Latino (87 percent) men compared 
with White men (95 percent). While clinical research 
on transgender populations and PrEP is currently 
limited, the Centers for Disease Control and Preven-
tion recommends PrEP use in transgender popu-
lations. In September 2019, the Food and Drug Ad-
ministration approved the second drug to be used as 
PrEP. 
(21) Syringe service programs have been associ-
ated with lowered HIV infections, lower hepatitis C 
infections, and increased linkage to substance use 
treatment. 
(22) There is now conclusive scientific evidence 
that a person living with HIV who is on 
antiretroviral therapy and is durably virally sup-
pressed (defined as having a consistent viral load of 
less than 200 copies/ml) does not sexually transmit 
HIV. The conclusive evidence about the highly effec-
tive preventative benefits of antiretroviral therapy 
provides an unprecedented opportunity to improve 
the lives of people living with HIV, improve treat-
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1307 
ment uptake and adherence, and advocate for ex-
panded access to treatment and care. 
SEC. 7203. ADDITIONAL FUNDING FOR AIDS DRUG ASSIST-
ANCE PROGRAM TREATMENTS. 
Section 2623 of the Public Health Service Act (42 
U.S.C. 300ff–31b) is amended by adding at the end the 
following: 
‘‘(c) ADDITIONAL FUNDING FOR AIDS DRUG AS-
SISTANCE
PROGRAM
TREATMENTS.—In addition to 
amounts otherwise authorized to be appropriated for car-
rying out this subpart, there are authorized to be appro-
priated such sums as may be necessary to carry out sec-
tions 2612(b)(3)(B) and 2616 for each of fiscal years 
2023 through 2026.’’. 
SEC. 7204. ENHANCING THE NATIONAL HIV SURVEILLANCE 
SYSTEM. 
(a) GRANTS.—The Secretary of Health and Human 
Services, acting through the Director of the Centers for 
Disease Control and Prevention, shall make grants to 
States to support integration of public health surveillance 
systems into all electronic health records in order to allow 
rapid communications between the clinical setting and 
health departments, by means that include— 
(1) providing technical assistance and policy 
guidance to State and local health departments, clin-
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ical providers, and other agencies serving individuals 
with HIV to improve the interoperability of data sys-
tems relevant to monitoring HIV care and sup-
portive services; 
(2) capturing longitudinal data pertaining to 
the initiation and ongoing prescription or dispensing 
of antiretroviral therapy for individuals diagnosed 
with HIV (such as through pharmacy-based report-
ing); 
(3) obtaining information— 
(A) on a voluntary basis, on sexual orienta-
tion and gender identity; and 
(B) on sources of coverage (or the lack of 
coverage) for medical treatment (including cov-
erage through the Medicaid program under title 
XIX of the Social Security Act (42 U.S.C. 1396 
et seq.), the Medicare program under title 
XVIII of such Act (42 U.S.C. 1395 et seq.), the 
program under title XXVI of the Public Health 
Service Act (42 U.S.C. 300ff–11 et seq.); com-
monly referred to as the ‘‘Ryan White HIV/ 
AIDS Program’’), other public funding, private 
insurance, and health maintenance organiza-
tions); and 
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(4) obtaining and using current geographic 
markers of residence (such as current address, zip 
code, partial zip code, and census block). 
(b) PRIVACY AND SECURITY SAFEGUARDS.—In car-
rying out this section, the Secretary of Health and Human 
Services shall ensure that appropriate privacy and security 
safeguards are met to prevent unauthorized disclosure of 
protected health information and compliance with the 
HIPAA privacy and security law (as defined in section 
3009 of the Public Health Service Act (42 U.S.C. 300jj– 
19)) and other relevant laws and regulations. 
(c) PROHIBITION
AGAINST
IMPROPER
USE
OF 
DATA.—No grant under this section may be used to allow 
or facilitate the collection or use of surveillance or clinical 
data or records— 
(1) for punitive measures of any kind, civil or 
criminal, against the subject of such data or records; 
or 
(2) for imposing any requirement or restriction 
with respect to an individual without the individual’s 
written consent. 
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for each of fiscal years 
2023 through 2026. 
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SEC. 7205. EVIDENCE-BASED STRATEGIES FOR IMPROVING 
LINKAGE TO, AND RETENTION IN, APPRO-
PRIATE CARE. 
(a) STRATEGIES.—The Secretary of Health and 
Human Services, in collaboration with the Director of the 
Centers for Disease Control and Prevention, the Assistant 
Secretary for Mental Health and Substance Use, the Di-
rector of the Office of AIDS Research, the Administrator 
of the Health Resources and Services Administration, and 
the Administrator of the Centers for Medicare & Medicaid 
Services, shall— 
(1) identify evidence-based strategies most ef-
fective at addressing the multifaceted issues that im-
pede disease status awareness with respect to HIV/ 
AIDS and linkage to, and retention in, appropriate 
care, taking into consideration health care systems 
issues, clinic and provider issues, and individual psy-
chosocial, environmental, and other contextual fac-
tors; 
(2) support the wide-scale implementation of 
the evidence-based strategies identified pursuant to 
paragraph (1), including through incorporating such 
strategies into health care coverage supported by the 
Medicaid program under title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.), the program 
under title XXVI of the Public Health Service Act 
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1311 
(42 U.S.C. 300ff–11 et seq.; commonly referred to 
as the ‘‘Ryan White HIV/AIDS Program’’), and 
health plans purchased through an Exchange estab-
lished under title I of the Patient Protection and Af-
fordable Care Act (Public Law 111–148); and 
(3) not later than 1 year after the date of the 
enactment of this Act, submit a report to the Con-
gress on the status of activities under paragraphs 
(1) and (2). 
(b) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for fiscal years 2023 
through 2026. 
SEC. 7206. IMPROVING ENTRY INTO, AND RETENTION IN, 
CARE AND ANTIRETROVIRAL ADHERENCE 
FOR PERSONS WITH HIV. 
(a) SENSE OF CONGRESS.—It is the sense of Con-
gress that AIDS research has led to scientific advance-
ments that have— 
(1) saved the lives of millions of people living 
with HIV; 
(2) prevented millions of individuals from re-
ceiving new diagnoses of HIV; and 
(3) had broad benefits that extend far beyond 
helping people at risk for, or living with, HIV. 
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(b) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of the Na-
tional Institutes of Health, shall expand, intensify, and co-
ordinate operational and translational research and other 
activities of the National Institutes of Health regarding 
methods— 
(1) to increase adoption of evidence-based ad-
herence strategies within HIV care and treatment 
programs; 
(2) to increase HIV testing and case detection 
rates; 
(3) to reduce HIV-related health disparities; 
(4) to ensure that research to improve adher-
ence to HIV care and treatment programs address 
the unique concerns of women; 
(5) to integrate HIV prevention and care serv-
ices with mental health and substance use preven-
tion and treatment delivery systems; 
(6) to increase knowledge on the implementa-
tion of preexposure prophylaxis (referred to in this 
section as ‘‘PrEP’’), including with respect to— 
(A) who can benefit most from PrEP; 
(B) how to provide PrEP safely and effi-
ciently; 
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(C) how to integrate PrEP with other es-
sential prevention methods such as condoms; 
and 
(D) how to ensure high levels of adherence; 
and 
(7) to increase knowledge of ‘‘undetectable and 
untransmittable’’, when a person living with HIV 
who is on antiretroviral therapy and is durably 
virally suppressed (defined as having a consistent 
viral load of less than 200 copies/ml) cannot sexually 
transmit HIV. 
(c) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for fiscal years 2023 
through 2026. 
SEC. 7207. SERVICES TO REDUCE HIV/AIDS IN RACIAL AND 
ETHNIC MINORITY COMMUNITIES. 
(a) IN GENERAL.—For the purpose of reducing new 
HIV diagnoses in racial and ethnic minority communities, 
the Secretary of Health and Human Services, acting 
through the Deputy Assistant Secretary for Minority 
Health, may make grants to public health agencies and 
faith-based organizations to conduct— 
(1) outreach activities related to HIV preven-
tion and testing activities; 
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(2) HIV prevention activities; 
(3) HIV testing activities; and 
(4) public health education campaigns on ac-
cessing HIV prevention medication. 
(b) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for fiscal years 2023 
through 2026. 
SEC. 7208. MINORITY AIDS INITIATIVE. 
(a) EXPANDED FUNDING.—The Secretary of Health 
and Human Services, in collaboration with the Deputy As-
sistant Secretary for Minority Health, the Director of the 
Centers for Disease Control and Prevention, the Adminis-
trator of the Health Resources and Services Administra-
tion, and the Assistant Secretary for Mental Health and 
Substance Use, shall provide funds and carry out activities 
to expand the Minority AIDS Initiative. 
(b) USE OF FUNDS.—The additional funds made 
available under this section may be used, through the Mi-
nority AIDS Initiative, to support the following activities: 
(1) Providing technical assistance and infra-
structure support to reduce HIV/AIDS in minority 
populations. 
(2) Increasing minority populations’ access to 
HIV prevention and care services. 
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(3) Building strong community programs and 
partnerships to address HIV prevention and the 
health care needs of specific racial and ethnic minor-
ity populations. 
(c) PRIORITY INTERVENTIONS.—Within the racial 
and ethnic minority populations referred to in subsection 
(b), priority in conducting intervention services shall be 
given to— 
(1) men who have sex with men; 
(2) youth; 
(3) persons who engage in intravenous drug 
abuse; 
(4) women; 
(5) homeless individuals; 
(6) individuals incarcerated or in the penal sys-
tem; 
(7) transgender individuals; and 
(8) nonbinary individuals. 
(d) AUTHORIZATION OF APPROPRIATIONS.—For car-
rying out this section, there are authorized to be appro-
priated $610,000,000 for fiscal year 2023 and such sums 
as may be necessary for each of fiscal years 2024 through 
2027. 
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1316 
SEC. 7209. HEALTH CARE PROFESSIONALS TREATING INDI-
VIDUALS WITH HIV. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Administrator of the 
Health Resources and Services Administration, shall ex-
pand, intensify, and coordinate workforce initiatives of the 
Health Resources and Services Administration to increase 
the capacity of the health workforce focusing primarily on 
HIV to meet the demand for culturally competent care, 
and may award grants for any of the following: 
(1) Development of curricula for training pri-
mary care providers in HIV/AIDS prevention and 
care, including routine HIV testing. 
(2) Support to expand access to culturally and 
linguistically accessible benefits counselors, trained 
peer navigators, and mental and behavioral health 
professionals with expertise in HIV. 
(3) Training health care professionals to pro-
vide care to individuals living with HIV. 
(4) Development by grant recipients under title 
XXVI of the Public Health Service Act (42 U.S.C. 
300ff–11 et seq.; commonly referred to as the ‘‘Ryan 
White HIV/AIDS Program’’) and other persons, of 
policies for providing culturally relevant and sen-
sitive treatment to individuals living with HIV, with 
particular emphasis on treatment to racial and eth-
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nic minorities, men who have sex with men, and 
women, young people, and children living with HIV. 
(5) Development and implementation of pro-
grams to increase the use of telehealth to respond to 
HIV-specific health care needs in rural and minority 
communities, with particular emphasis given to 
medically underserved communities and insular 
areas. 
(6) Evaluating interdisciplinary medical pro-
vider care team models that promote high-quality 
care, with particular emphasis on care to racial and 
ethnic minorities. 
(7) Training health care professionals to make 
them aware of the high rates of chronic hepatitis B 
and chronic hepatitis C in adult racial and ethnic 
minority populations, and the importance of preven-
tion, detection, and medical management of hepatitis 
B and hepatitis C and of liver cancer screening. 
(8) Development of curricula for training pri-
mary care providers that HIV and tuberculosis are 
significant mutual comorbidities, and that a patient 
who tests positive for one disease should be offered 
and encouraged to receive testing for the other. 
(b) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
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added by subsection (a)), the Federal matching pay-
ments (including payments based on the Federal 
medical assistance percentage) made to such State 
under section 1903 of the Social Security Act (42 
U.S.C. 1396b) for the State expenditures described 
in paragraph (2) shall be increased by 5 percentage 
points. 
(2) EXPENDITURES.—The expenditures de-
scribed in this paragraph are the following: 
(A) Expenditures for which payment is 
available under section 1903 of the Social Secu-
rity Act (42 U.S.C. 1396b) and which are at-
tributable to strengthening the State’s enroll-
ment and administrative resources for the pur-
pose of improving processes for enrolling (or re-
instating the enrollment of) eligible individuals 
(as such term is defined in subparagraph (E) of 
paragraph (16) of section 1902(e) of the Social 
Security Act (42 U.S.C. 1396a(e)) (as amended 
by subsection (a))). 
(B) Expenditures for medical assistance 
(as such term is defined in section 1905(a) of 
the Social Security Act (42 U.S.C. 1396d(a))) 
provided to such eligible individuals. 
(3) REQUIREMENTS; LIMITATION.— 
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1369 
diately following admission to a facility. Health 
care personnel need not provide routine HIV 
testing to an inmate who is transferred to a fa-
cility from another facility if the inmate’s med-
ical records are transferred with the inmate and 
indicate that the inmate has been tested pre-
viously. 
(B) To all inmates admitted to a facility 
prior to the effective date of this policy, health 
care personnel shall provide routine HIV testing 
within no more than 6 months. HIV testing for 
these inmates may be performed in conjunction 
with other health services provided to these in-
mates by health care personnel. 
(C) All HIV tests under this paragraph 
shall comply with the opt-out provision. 
(2) PRE-TEST AND POST-TEST COUNSELING.— 
Health care personnel shall provide confidential pre- 
test and post-test counseling to all inmates who are 
tested for HIV. Counseling may be included with 
other general health counseling provided to inmates 
by health care personnel. 
(3) HIV PREVENTION EDUCATION.— 
(A) Health care personnel shall improve 
HIV awareness through frequent educational 
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1569 
‘‘(e) PARTICIPANT ELIGIBILITY CRITERIA.—The Di-
rector of the Institute shall take such actions as are nec-
essary to ensure that clinical research on Alzheimer’s dis-
ease conducted or supported under this subpart is de-
signed with eligibility criteria that ensure the clinical trial 
population reflects the diversity of the prospective patient 
population. Such actions may include the following: 
‘‘(1) EXAMINATION OF CRITERIA.— 
‘‘(A) IN
GENERAL.—An examination of 
each exclusion criterion to determine if the cri-
terion is necessary to ensure the safety of trial 
participants or to achieve the study objectives. 
‘‘(B) MODIFICATION OF CRITERIA.—In the 
case of an exclusion criterion that is not nec-
essary to ensure the safety of trial participants 
or to achieve the study objectives— 
‘‘(i) encouraging the modification or 
elimination of the criterion; or 
‘‘(ii) encouraging tailoring the cri-
terion as narrowly as possible to avoid un-
necessary limits to the population of the 
clinical study. 
‘‘(2) REQUIREMENT
FOR
STRONG
JUSTIFICA-
TION FOR EXCLUSION.—A review of each exclusion 
criterion to ensure that populations are included in 
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1586 
(2) submit a report to Congress describing the 
results of such study, including any recommenda-
tions for legislative or administrative action. 
(b) STUDY.—The study described in subsection 
(a)(1) shall— 
(1) identify barriers to successful implementa-
tion of health information technology in medically 
underserved areas; 
(2) survey a cross-section of individuals in 
medically underserved areas and report their opin-
ions about the various topics of study; 
(3) examine the degree of interoperability 
among health information technology and users of 
health information technology in medically under-
served areas, including patients, providers, and com-
munity services; 
(4) examine the impact of health information 
technology on providing quality care and reducing 
the cost of care to individuals in such areas, includ-
ing the impact of such technology on improved 
health outcomes for individuals, including which 
technology worked for which population and how it 
improved health outcomes for that population; 
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