H. R. 6157—112 
SEC. 216. Not to exceed $45,000,000 of funds appropriated 
by this Act to the institutes and centers of the National Institutes 
of Health may be used for alteration, repair, or improvement of 
facilities, as necessary for the proper and efficient conduct of the 
activities authorized herein, at not to exceed $3,500,000 per project. 
(TRANSFER OF FUNDS) 
SEC. 217. Of the amounts made available for NIH, 1 percent 
of the amount made available for National Research Service Awards 
(‘‘NRSA’’) shall be made available to the Administrator of the Health 
Resources and Services Administration to make NRSA awards for 
research in primary medical care to individuals affiliated with 
entities who have received grants or contracts under sections 736, 
739, or 747 of the PHS Act, and 1 percent of the amount made 
available for NRSA shall be made available to the Director of 
the Agency for Healthcare Research and Quality to make NRSA 
awards for health service research. 
SEC. 218. (a) The Biomedical Advanced Research and Develop-
ment Authority (‘‘BARDA’’) may enter into a contract, for more 
than one but no more than 10 program years, for purchase of 
research services or of security countermeasures, as that term is 
defined in section 319F–2(c)(1)(B) of the PHS Act (42 U.S.C. 247d– 
6b(c)(1)(B)), if— 
(1) funds are available and obligated— 
(A) for the full period of the contract or for the first 
fiscal year in which the contract is in effect; and 
(B) for the estimated costs associated with a necessary 
termination of the contract; and 
(2) the Secretary determines that a multi-year contract 
will serve the best interests of the Federal Government by 
encouraging full and open competition or promoting economy 
in administration, performance, and operation of BARDA’s pro-
grams. 
(b) A contract entered into under this section— 
(1) shall include a termination clause as described by sub-
section (c) of section 3903 of title 41, United States Code; 
and 
(2) shall be subject to the congressional notice requirement 
stated in subsection (d) of such section. 
SEC. 219. (a) The Secretary shall publish in the fiscal year 
2020 budget justification and on Departmental Web sites informa-
tion concerning the employment of full-time equivalent Federal 
employees or contractors for the purposes of implementing, admin-
istering, enforcing, or otherwise carrying out the provisions of the 
ACA, and the amendments made by that Act, in the proposed 
fiscal year and each fiscal year since the enactment of the ACA. 
(b) With respect to employees or contractors supported by all 
funds appropriated for purposes of carrying out the ACA (and 
the amendments made by that Act), the Secretary shall include, 
at a minimum, the following information: 
(1) For each such fiscal year, the section of such Act under 
which such funds were appropriated, a statement indicating 
the program, project, or activity receiving such funds, the Fed-
eral operating division or office that administers such program, 
and the amount of funding received in discretionary or manda-
tory appropriations.
H. R. 6157—113 
(2) For each such fiscal year, the number of full-time 
equivalent employees or contracted employees assigned to each 
authorized and funded provision detailed in accordance with 
paragraph (1). 
(c) In carrying out this section, the Secretary may exclude 
from the report employees or contractors who— 
(1) are supported through appropriations enacted in laws 
other than the ACA and work on programs that existed prior 
to the passage of the ACA; 
(2) spend less than 50 percent of their time on activities 
funded by or newly authorized in the ACA; or 
(3) work on contracts for which FTE reporting is not a 
requirement of their contract, such as fixed-price contracts. 
SEC. 220. The Secretary shall publish, as part of the fiscal 
year 2020 budget of the President submitted under section 1105(a) 
of title 31, United States Code, information that details the uses 
of all funds used by the Centers for Medicare & Medicaid Services 
specifically for Health Insurance Exchanges for each fiscal year 
since the enactment of the ACA and the proposed uses for such 
funds for fiscal year 2020. Such information shall include, for each 
such fiscal year, the amount of funds used for each activity specified 
under the heading ‘‘Health Insurance Exchange Transparency’’ in 
the joint explanatory statement accompanying this Act. 
SEC. 221. None of the funds made available by this Act from 
the Federal Hospital Insurance Trust Fund or the Federal Supple-
mental Medical Insurance Trust Fund, or transferred from other 
accounts funded by this Act to the ‘‘Centers for Medicare & Medicaid 
Services—Program Management’’ account, may be used for pay-
ments under section 1342(b)(1) of Public Law 111–148 (relating 
to risk corridors). 
(TRANSFER OF FUNDS) 
SEC. 222. (a) Within 45 days of enactment of this Act, the 
Secretary shall transfer funds appropriated under section 4002 
of the ACA to the accounts specified, in the amounts specified, 
and for the activities specified under the heading ‘‘Prevention and 
Public Health Fund’’ in the joint explanatory statement accom-
panying this Act. 
(b) Notwithstanding section 4002(c) of the ACA, the Secretary 
may not further transfer these amounts. 
(c) Funds transferred for activities authorized under section 
2821 of the PHS Act shall be made available without reference 
to section 2821(b) of such Act. 
SEC. 223. Effective during the period beginning on November 
1, 2015 and ending January 1, 2021, any provision of law that 
refers (including through cross-reference to another provision of 
law) to the current recommendations of the United States Preven-
tive Services Task Force with respect to breast cancer screening, 
mammography, and prevention shall be administered by the Sec-
retary involved as if— 
(1) such reference to such current recommendations were 
a reference to the recommendations of such Task Force with 
respect to breast cancer screening, mammography, and preven-
tion last issued before 2009; and
H. R. 6157—114 
(2) such recommendations last issued before 2009 applied 
to any screening mammography modality under section 1861(jj) 
of the Social Security Act (42 U.S.C. 1395x(jj)). 
SEC. 224. In making Federal financial assistance, the provisions 
relating to indirect costs in part 75 of title 45, Code of Federal 
Regulations, including with respect to the approval of deviations 
from negotiated rates, shall continue to apply to the National 
Institutes of Health to the same extent and in the same manner 
as such provisions were applied in the third quarter of fiscal year 
2017. None of the funds appropriated in this or prior Acts or 
otherwise made available to the Department of Health and Human 
Services or to any department or agency may be used to develop 
or implement a modified approach to such provisions, or to inten-
tionally or substantially expand the fiscal effect of the approval 
of such deviations from negotiated rates beyond the proportional 
effect of such approvals in such quarter. 
(TRANSFER OF FUNDS) 
SEC. 225. The NIH Director may transfer funds specifically 
appropriated for opioid addiction, opioid alternatives, pain manage-
ment, and addiction treatment to other Institutes and Centers 
of the NIH to be used for the same purpose 15 days after notifying 
the Committees on Appropriations: Provided, That the transfer 
authority provided in the previous proviso is in addition to any 
other transfer authority provided by law. 
SEC. 226. (a) The Secretary shall provide to the Committees 
on Appropriations of the House of Representatives and the Senate: 
(1) 
Detailed 
monthly 
enrollment 
figures 
from 
the 
Exchanges established under the Patient Protection and Afford-
able Care Act of 2010 pertaining to enrollments during the 
open enrollment period; and 
(2) Notification of any new or competitive grant awards, 
including supplements, authorized under section 330 of the 
Public Health Service Act. 
(b) The Committees on Appropriations of the House and Senate 
must be notified at least 2 business days in advance of any public 
release of enrollment information or the award of such grants. 
SEC. 227. In addition to the amounts otherwise available for 
‘‘Centers for Medicare & Medicaid Services, Program Management’’, 
the Secretary of Health and Human Services may transfer up 
to $305,000,000 to such account from the Federal Hospital Insur-
ance Trust Fund and the Federal Supplementary Medical Insurance 
Trust Fund to support program management activity related to 
the Medicare Program: Provided, That except for the foregoing 
purpose, such funds may not be used to support any provision 
of Public Law 111–148 or Public Law 111–152 (or any amendment 
made by either such Public Law) or to supplant any other amounts 
within such account. 
(RESCISSION) 
SEC. 228. Of the unobligated balances available in the ‘‘Non-
recurring Expenses Fund’’ established in section 223 of division 
G of Public Law 110–161, $400,000,000 are hereby rescinded. 
SEC. 229. Not later than the 15th day of each month, the 
Department of Health and Human Services shall provide the 
Committees on Appropriations of the House of Representatives and
H. R. 6157—115 
Senate a report on staffing described in the joint explanatory state-
ment accompanying this Act. 
SEC. 230. Funds appropriated in this Act that are available 
for salaries and expenses of employees of the Department of Health 
and Human Services shall also be available to pay travel and 
related expenses of such an employee or of a member of his or 
her family, when such employee is assigned to duty, in the United 
States or in a U.S. territory, during a period and in a location 
that are the subject of a determination of a public health emergency 
under section 319 of the Public Health Service Act and such travel 
is necessary to obtain medical care for an illness, injury, or medical 
condition that cannot be adequately addressed in that location 
at that time. For purposes of this section, the term ‘‘U.S. territory’’ 
means Guam, the Commonwealth of Puerto Rico, the Northern 
Mariana Islands, the Virgin Islands, American Samoa, or the Trust 
Territory of the Pacific Islands. 
(INCLUDING TRANSFER OF FUNDS) 
SEC. 231. There is established in the Treasury a reserve fund 
to be known as the ‘‘Infectious Diseases Rapid Response Reserve 
Fund’’ (the ‘‘Reserve Fund’’): Provided, That of the funds provided 
under the heading ‘‘CDC-Wide Activities and Program Support’’, 
$50,000,000, to remain available until expended, shall be available 
to the Director of the CDC for deposit in the Reserve Fund: Provided 
further, That amounts in the Reserve Fund shall be for carrying 
out titles II, III, and XVII of the PHS Act to prevent, prepare 
for, or respond to an infectious disease emergency, including, in 
connection with such activities, to purchase or lease and provide 
for the insurance of passenger motor vehicles for official use in 
foreign countries: Provided further, That amounts in the Reserve 
Fund may only be provided for an infectious disease emergency 
if the infectious disease emergency (1) is declared by the Secretary 
of Health and Human Services under section 319 of the PHS 
Act to be a public health emergency; or (2) as determined by 
the Secretary, has significant potential to imminently occur and 
potential, on occurrence, to affect national security or the health 
and security of United States citizens, domestically or internation-
ally: Provided further, That amounts in the Reserve Fund may 
be transferred by the Director of the CDC to other accounts of 
the CDC, to accounts of the NIH, or to the Public Health and 
Social Services Emergency Fund, to be merged with such accounts 
or Fund for the purposes provided in this section: Provided further, 
That the Committees on Appropriations of the House of Representa-
tives and the Senate shall be notified in advance of any transfer 
or obligation made under the authority provided in this section, 
including notification on the anticipated uses of such funds by 
program, project, or activity: Provided further, That not later than 
15 days after notification of the planned use of the Reserve Fund, 
the Director shall provide a detailed spend plan of anticipated 
uses of funds, including estimated personnel and administrative 
costs, to the Committees on Appropriations of the House of Rep-
resentatives and the Senate: Provided further, That such plans 
shall be updated and submitted every 90 days thereafter until 
funds have been fully expended which should include the unobli-
gated balances in the Reserve Fund and all the actual obligations 
incurred to date: Provided further, That amounts in the Reserve