H. R. 1105—258 
Human Services denies participation in such program to an other-
wise eligible entity (including a Provider Sponsored Organization) 
because the entity informs the Secretary that it will not provide, 
pay for, provide coverage of, or provide referrals for abortions: 
Provided, That the Secretary shall make appropriate prospective 
adjustments to the capitation payment to such an entity (based 
on an actuarially sound estimate of the expected costs of providing 
the service to such entity’s enrollees): Provided further, That nothing 
in this section shall be construed to change the Medicare program’s 
coverage for such services and a Medicare Advantage organization 
described in this section shall be responsible for informing enrollees 
where to obtain information about all Medicare covered services. 
SEC. 212. (a) Except as provided by subsection (e) none of 
the funds appropriated by this Act may be used to withhold sub-
stance abuse funding from a State pursuant to section 1926 of 
the Public Health Service Act if such State certifies to the Secretary 
of Health and Human Services by May 1, 2009, that the State 
will commit additional State funds, in accordance with subsection 
(b), to ensure compliance with State laws prohibiting the sale of 
tobacco products to individuals under 18 years of age. 
(b) The amount of funds to be committed by a State under 
subsection (a) shall be equal to 1 percent of such State’s substance 
abuse block grant allocation for each percentage point by which 
the State misses the retailer compliance rate goal established by 
the Secretary under section 1926 of such Act. 
(c) The State is to maintain State expenditures in fiscal year 
2009 for tobacco prevention programs and for compliance activities 
at a level that is not less than the level of such expenditures 
maintained by the State for fiscal year 2008, and adding to that 
level the additional funds for tobacco compliance activities required 
under subsection (a). The State is to submit a report to the Secretary 
on all fiscal year 2008 State expenditures and all fiscal year 2009 
obligations for tobacco prevention and compliance activities by pro-
gram activity by July 31, 2009. 
(d) The Secretary shall exercise discretion in enforcing the 
timing of the State obligation of the additional funds required 
by the certification described in subsection (a) as late as July 
31, 2009. 
(e) None of the funds appropriated by this Act may be used 
to withhold substance abuse funding pursuant to section 1926 of 
the Public Health Service Act from a territory that receives less 
than $1,000,000. 
SEC. 213. In order for the Department of Health and Human 
Services to carry out international health activities, including HIV/ 
AIDS and other infectious disease, chronic and environmental dis-
ease, and other health activities abroad during fiscal year 2009: 
(1) The Secretary of Health and Human Services may 
exercise authority equivalent to that available to the Secretary 
of State in section 2(c) of the State Department Basic Authori-
ties Act of 1956. The Secretary of Health and Human Services 
shall consult with the Secretary of State and relevant Chief 
of Mission to ensure that the authority provided in this section 
is exercised in a manner consistent with section 207 of the 
Foreign Service Act of 1980 and other applicable statutes 
administered by the Department of State. 
(2) The Secretary of Health and Human Services is author-
ized to provide such funds by advance or reimbursement to
H. R. 1105—259 
the Secretary of State as may be necessary to pay the costs 
of acquisition, lease, alteration, renovation, and management 
of facilities outside of the United States for the use of the 
Department of Health and Human Services. The Department 
of State shall cooperate fully with the Secretary of Health 
and Human Services to ensure that the Department of Health 
and Human Services has secure, safe, functional facilities that 
comply with applicable regulation governing location, setback, 
and other facilities requirements and serve the purposes estab-
lished by this Act. The Secretary of Health and Human Services 
is authorized, in consultation with the Secretary of State, 
through grant or cooperative agreement, to make available 
to public or nonprofit private institutions or agencies in partici-
pating foreign countries, funds to acquire, lease, alter, or ren-
ovate facilities in those countries as necessary to conduct pro-
grams of assistance for international health activities, including 
activities relating to HIV/AIDS and other infectious diseases, 
chronic and environmental diseases, and other health activities 
abroad. 
SEC. 214. (a) AUTHORITY.—Notwithstanding any other provision 
of law, the Director of the National Institutes of Health (‘‘Director’’) 
may use funds available under section 402(b)(7) or 402(b)(12) of 
the Public Health Service Act (‘‘PHS Act’’) to enter into transactions 
(other than contracts, cooperative agreements, or grants) to carry 
out research identified pursuant to such section 402(b)(7) (per-
taining to the Common Fund) or research and activities described 
in such section 402(b)(12). 
(b) PEER REVIEW.—In entering into transactions under sub-
section (a), the Director may utilize such peer review procedures 
(including consultation with appropriate scientific experts) as the 
Director determines to be appropriate to obtain assessments of 
scientific and technical merit. Such procedures shall apply to such 
transactions in lieu of the peer review and advisory council review 
procedures that would otherwise be required under sections 
301(a)(3), 405(b)(1)(B), 405(b)(2), 406(a)(3)(A), 492, and 494 of the 
PHS Act. 
SEC. 215. Funds which are available for Individual Learning 
Accounts for employees of the Centers for Disease Control and 
Prevention (‘‘CDC’’) and the Agency for Toxic Substances and Dis-
ease Registry (‘‘ATSDR’’) may be transferred to ‘‘Disease Control, 
Research, and Training’’, to be available only for Individual 
Learning Accounts: Provided, That such funds may be used for 
any individual full-time equivalent employee while such employee 
is employed either by CDC or ATSDR. 
SEC. 216. Notwithstanding any other provisions of law, funds 
made available in this Act may be used to continue operating 
the Council on Graduate Medical Education established by section 
301 of Public Law 102–408. 
SEC. 217. The Director of the National Institutes of Health 
(‘‘NIH’’) shall require in the current fiscal year and thereafter 
that all investigators funded by the NIH submit or have submitted 
for them to the National Library of Medicine’s PubMed Central 
an electronic version of their final, peer-reviewed manuscripts upon 
acceptance for publication, to be made publicly available no later 
than 12 months after the official date of publication: Provided, 
That the NIH shall implement the public access policy in a manner 
consistent with copyright law.