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‘‘(8) GENERIC INVESTIGATIONAL NEW ANIMAL 
DRUG MEETING REQUEST.—The term ‘generic inves-
tigational new animal drug meeting request’ means 
a request submitted by a generic new animal drug 
sponsor to meet with the Secretary to discuss an in-
vestigational submission for a generic new animal 
drug.’’; 
(3) in paragraph (11) (as so redesignated), by 
adding at the end the following: 
‘‘(I) The activities necessary for explo-
ration and implementation of the United States 
and European Union Mutual Recognition 
Agreement for Pharmaceutical Good Manufac-
turing Practice Inspections, and the United 
States and United Kingdom Mutual Recogni-
tion Agreement Sectoral Annex for Pharma-
ceutical Good Manufacturing Practices, and 
other mutual recognition agreements, with re-
spect to generic new animal drug products sub-
ject to review, including implementation activi-
ties prior to and following product approval.’’; 
and 
(4) by inserting after paragraph (11) (as so re-
designated) the following: 
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‘‘(12) REQUEST TO ESTABLISH A GENERIC IN-
VESTIGATIONAL
NEW
ANIMAL
DRUG
FILE.—The 
term ‘request to establish a generic investigational 
new animal drug file’ means the submission to the 
Secretary of a request to establish a generic inves-
tigational new animal drug file to contain investiga-
tional submissions for a generic new animal drug.’’. 
SEC. 
2313. 
REAUTHORIZATION; 
REPORTING 
REQUIRE-
MENTS. 
Section 742 of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 379j–22) is amended— 
(1) in subsection (a), by striking ‘‘2018’’ and 
inserting ‘‘2023’’; 
(2) by striking ‘‘2019’’ each place it appears in 
subsections (a) and (b) and inserting ‘‘2024’’; and 
(3) in subsection (d), by striking ‘‘2023’’ each 
place it appears and inserting ‘‘2028’’. 
SEC. 2314. SAVINGS CLAUSE. 
Notwithstanding the amendments made by this chap-
ter, part 5 of subchapter C of chapter VII of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j–21 et 
seq.), as in effect on the day before the date of enactment 
of this chapter, shall continue to be in effect with respect 
to abbreviated applications for a generic new animal drug 
and supplemental abbreviated applications for a generic 
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new animal drug (as defined in such part as of such day) 
that on or after October 1, 2018, but before October 1, 
2023, were accepted by the Food and Drug Administra-
tion for filing with respect to assessing and collecting any 
fee required by such part for a fiscal year prior to fiscal 
year 2024. 
SEC. 2315. EFFECTIVE DATE. 
The amendments made by this chapter shall take ef-
fect on October 1, 2023, or the date of the enactment of 
this Act, whichever is later, except that fees under part 
5 of subchapter C of chapter VII of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 379j–21 et seq.), as 
amended by this chapter, shall be assessed for abbreviated 
applications for a generic new animal drug and supple-
mental abbreviated applications for a generic new animal 
drug received on or after October 1, 2023, regardless of 
the date of enactment of this Act. 
SEC. 2316. SUNSET DATES. 
(a) AUTHORIZATION.—Section 741 of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 379j–21) shall 
cease to be effective October 1, 2028. 
(b) REPORTING REQUIREMENTS.—Section 742 of the 
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j– 
22) shall cease to be effective January 31, 2029. 
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(c) PREVIOUS SUNSET PROVISION.—Effective Octo-
ber 1, 2023, subsections (a) and (b) of section 206 of the 
Animal Generic Drug User Fee Amendments of 2018 
(Public Law 115–234) are repealed. 
Subtitle B—Public Health 
Extenders 
SEC. 2321. EXTENSION FOR COMMUNITY HEALTH CENTERS, 
NATIONAL HEALTH SERVICE CORPS, AND 
TEACHING HEALTH CENTERS THAT OPERATE 
GME PROGRAMS. 
(a) TEACHING HEALTH CENTERS THAT OPERATE 
GRADUATE MEDICAL EDUCATION PROGRAMS.—Section 
340H(g) of the Public Health Service Act (42 U.S.C. 
256h(g)) is amended— 
(1) by striking ‘‘and $126,500,000’’ and insert-
ing ‘‘$126,500,000’’; and 
(2) by inserting ‘‘and $16,635,616 for the pe-
riod beginning on October 1, 2023, and ending on 
November 17, 2023,’’ before ‘‘to remain available’’. 
(b) EXTENSION
FOR COMMUNITY HEALTH CEN-
TERS.—Section 10503(b)(1)(F) of the Patient Protection 
and Affordable Care Act (42 U.S.C. 254b–2(b)(1)(F)) is 
amended— 
(1) by striking ‘‘and $4,000,000,000’’ and in-
serting ‘‘, $4,000,000,000’’; and 
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(2) by inserting ‘‘, and $526,027,397 for the 
period beginning on October 1, 2023, and ending on 
November 17, 2023’’ before the semicolon. 
(c) EXTENSION FOR THE NATIONAL HEALTH SERV-
ICE CORPS.—Section 10503(b)(2) of the Patient Protec-
tion and Affordable Care Act (42 U.S.C. 254b–2(b)(2)) 
is amended— 
(1) in subparagraph (G), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (H), by striking the period 
at the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(I) $40,767,123 for the period beginning 
on October 1, 2023, and ending on November 
17, 2023.’’. 
(d) APPLICATION OF PROVISIONS.—Amounts appro-
priated pursuant to the amendments made by this section 
shall be subject to the requirements contained in Public 
Law 117–328 for funds for programs authorized under 
sections 330 through 340 of the Public Health Service Act 
(42 U.S.C. 254b et seq.). 
(e) TECHNICAL AND CONFORMING AMENDMENT.— 
Section 3014(h)(4) of title 18, United States Code, is 
amended— 
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(1) by striking ‘‘Other Extensions Act,,’’ and 
inserting ‘‘Other Extensions Act,’’; and 
(2) by striking ‘‘and section 301(d) of division 
BB of the Consolidated Appropriations Act, 2021.’’ 
and inserting ‘‘section 301(d) of division BB of the 
Consolidated Appropriations Act, 2021, and section 
2321(d) of the Continuing Appropriations Act, 2024 
and Other Extensions Act’’. 
SEC. 2322. EXTENSION OF SPECIAL DIABETES PROGRAMS. 
(a) EXTENSION OF SPECIAL DIABETES PROGRAMS 
FOR TYPE I DIABETES.—Section 330B(b)(2) of the Pub-
lic Health Service Act (42 U.S.C. 254c–2(b)(2)) is amend-
ed— 
(1) in subparagraph (C), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (D), by striking the period 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(E) $19,726,027 for the period beginning 
on October 1, 2023, and ending on November 
17, 2023, to remain available until expended.’’. 
(b) EXTENDING FUNDING FOR SPECIAL DIABETES 
PROGRAMS
FOR INDIANS.—Section 330C(c)(2) of the 
Public Health Service Act (42 U.S.C. 254c–3(c)(2)) is 
amended— 
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(1) in subparagraph (C), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (D), by striking the period 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(E) $19,726,027 for the period beginning 
on October 1, 2023, and ending on November 
17, 2023, to remain available until expended.’’. 
Subtitle C—Necessary Authorities 
To Respond to Threats 
SEC. 2331. EXTENSION OF AUTHORITY TO MAKE CERTAIN 
APPOINTMENTS 
OF 
NATIONAL 
DISASTER 
MEDICAL SYSTEM PERSONNEL. 
Section 2812(c)(4)(B) of the Public Health Service 
Act (42 U.S.C. 300hh–11(c)(4)(B)) is amended by strik-
ing ‘‘September 30, 2023’’ and inserting ‘‘November 17, 
2023’’. 
SEC. 2332. TEMPORARY REASSIGNMENT OF STATE AND 
LOCAL 
PERSONNEL 
DURING 
A 
PUBLIC 
HEALTH EMERGENCY. 
Section 319(e)(8) of the Public Health Service Act 
(42 U.S.C. 247d(e)(8)) is amended by striking ‘‘Sep-
tember 30, 2023’’ and inserting ‘‘November 17, 2023’’. 
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SEC. 2333. EXTENSION OF NATIONAL ADVISORY COMMIT-
TEES. 
(a) NATIONAL ADVISORY COMMITTEE ON CHILDREN 
AND DISASTERS.—Section 2811A(g) of the Public Health 
Service Act (42 U.S.C. 300hh–10b(g)) is amended by 
striking ‘‘September 30, 2023’’ and inserting ‘‘November 
17, 2023’’. 
(b) NATIONAL ADVISORY COMMITTEE ON SENIORS 
AND DISASTERS.—Section 2811B(g)(1) of the Public 
Health Service Act (42 U.S.C. 300hh–10c(g)(1)) is 
amended by striking ‘‘September 30, 2023’’ and inserting 
‘‘November 17, 2023’’. 
(c) NATIONAL ADVISORY COMMITTEE ON INDIVID-
UALS
WITH
DISABILITIES
AND
DISASTERS.—Section 
2811C(g)(1) of the Public Health Service Act (42 U.S.C. 
300hh–10d(g)(1)) is amended by striking ‘‘September 30, 
2023’’ and inserting ‘‘November 17, 2023’’. 
Subtitle D—Medicaid 
SEC. 2341. DSH DELAY. 
Section 1923(f)(7)(A) of the Social Security Act (42 
U.S.C. 1396r–4(f)(7)(A)) is amended— 
(1) in clause (i)— 
(A) in the matter preceding subclause (I), 
by striking ‘‘For each of fiscal years 2024 
through 2027’’ and inserting ‘‘For the period 
beginning November 18, 2023, and ending Sep-
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tember 30, 2024, and for each of fiscal years 
2025 through 2027’’; and 
(B) in subclauses (I) and (II), by inserting 
‘‘or period’’ after ‘‘the fiscal year’’ each place it 
appears; and 
(2) in clause (ii), by striking ‘‘for each of fiscal 
years 2024 through 2027’’ and inserting ‘‘for the 
period beginning November 18, 2023, and ending 
September 30, 2024, and for each of fiscal years 
2025 through 2027.’’. 
SEC. 2342. MIF REDUCTION. 
Section 1941(b)(3)(A) of the Social Security Act (42 
U.S.C. 1396w–1(b)(3)(A)) is amended by striking 
‘‘$7,000,000,000’’ and inserting ‘‘$6,357,117,810’’. 
Subtitle E—Human Services 
SEC. 2351. EXTENSION OF CHILD AND FAMILY SERVICES 
PROGRAMS. 
Activities authorized by part B of title IV of the So-
cial Security Act shall continue through November 17, 
2023, in the manner authorized for fiscal year 2023, and 
out of any money in the Treasury of the United States 
not otherwise appropriated, there are hereby appropriated 
such sums as may be necessary for such purpose. 
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SEC. 2352. SEXUAL RISK AVOIDANCE EDUCATION EXTEN-
SION. 
Section 510 of the Social Security Act (42 U.S.C. 
710) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1)— 
(i) in the matter preceding subpara-
graph (A)— 
(I) by inserting ‘‘and for the pe-
riod beginning on October 1, 2023, 
and ending on November 17, 2023’’ 
after ‘‘2023’’; and 
(II) by inserting ‘‘(or, with re-
spect to such period, for fiscal year 
2024)’’ after ‘‘for the fiscal year’’; 
and 
(ii) in subparagraph (A), by inserting 
‘‘or period’’ after ‘‘fiscal year’’ each place 
it appears; and 
(B) in paragraph (2)— 
(i) in subparagraph (A), by inserting 
‘‘and with respect to fiscal year 2024, for 
the period described in paragraph (1)’’ 
after ‘‘2023’’; and 
(ii) in subparagraph (B)(i), by insert-
ing ‘‘(or, with respect to fiscal year 2024, 
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for the period described in paragraph (1))’’ 
after ‘‘for the fiscal year’’; and 
(2) in subsection (f)— 
(A) in paragraph (1), by inserting ‘‘, and 
for the period beginning on October 1, 2023, 
and ending on November 17, 2023, an amount 
equal to the pro rata portion of the amount ap-
propriated for the corresponding period for fis-
cal year 2023’’ after ‘‘2023’’; and 
(B) in paragraph (2), by inserting ‘‘and 
for the period described in paragraph (1),’’ 
after ‘‘2023,’’. 
SEC. 2353. PERSONAL RESPONSIBILITY EDUCATION EXTEN-
SION. 
Section 513 of the Social Security Act (42 U.S.C. 
713) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1)— 
(i) in subparagraph (A)— 
(I) in the matter preceding clause 
(i), by inserting ‘‘and for the period 
beginning on October 1, 2023, and 
ending on November 17, 2023’’ after 
‘‘2023’’; and 
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(II) in clause (i), by inserting ‘‘or 
period’’ after ‘‘for the fiscal year’’; 
(ii) in subparagraph (B)(i), by insert-
ing the following after the period: ‘‘The 
previous sentence shall not apply with re-
spect to State allotments under this para-
graph for the period beginning on October 
1, 2023, and ending on November 17, 
2023.’’; and 
(iii) in subparagraph (C)(i)— 
(I) by inserting ‘‘or the period 
described in subparagraph (A)’’ after 
‘‘for a fiscal year’’; and 
(II) by inserting ‘‘or period’’ 
after ‘‘the fiscal year’’; 
(B) in paragraph (3)— 
(i) by inserting ‘‘or the period de-
scribed in paragraph (1)(A)’’ after ‘‘for a 
fiscal year’’; and 
(ii) by inserting ‘‘or period’’ after 
‘‘such fiscal year’’; and 
(C) in paragraph (4)— 
(i) by inserting ‘‘and for the period 
described in paragraph (1)(A)’’ after ‘‘fis-
cal years 2010 through 2023’’; 
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(ii) by inserting ‘‘and for the period so 
described’’ 
after 
‘‘fiscal 
years 
2012 
through 2023’’; and 
(iii) by inserting ‘‘or the period so de-
scribed’’ after ‘‘for a fiscal year’’; 
(2) in subsection (c)— 
(A) in each of paragraphs (1) and (2), by 
striking ‘‘From’’ and inserting ‘‘Subject to 
paragraph (3), from’’; and 
(B) by adding at the end the following: 
‘‘(3) EXCEPTION.—Paragraphs (1) and (2) 
shall not apply with respect to any amount appro-
priated under subsection (f) for the period described 
in subsection (a)(1)(A).’’; and 
(3) in subsection (f), by inserting ‘‘, and for the 
period beginning on October 1, 2023, and ending on 
November 17, 2023, an amount equal to the pro 
rata portion of the amount appropriated for the cor-
responding period for fiscal year 2023’’ after 
‘‘2023’’. 
TITLE IV—BUDGETARY EFFECTS 
SEC. 2401. BUDGETARY EFFECTS. 
(a) STATUTORY PAYGO SCORECARDS.—The budg-
etary effects of this division shall not be entered on either 
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PAYGO scorecard maintained pursuant to section 4(d) of 
the Statutory Pay-As-You-Go Act of 2010. 
(b) SENATE PAYGO SCORECARDS.—The budgetary 
effects of this division shall not be entered on any PAYGO 
scorecard maintained for purposes of section 4106 of H. 
Con. Res. 71 (115th Congress). 
(c) CLASSIFICATION
OF BUDGETARY EFFECTS.— 
Notwithstanding Rule 3 of the Budget Scorekeeping 
Guidelines set forth in the joint explanatory statement of 
the committee of conference accompanying Conference Re-
port 105–217 and section 250(c)(8) of the Balanced 
Budget and Emergency Deficit Control Act of 1985, the 
budgetary effects of this division shall not be estimated— 
(1) for purposes of section 251 of such Act; 
(2) for purposes of an allocation to the Com-
mittee on Appropriations pursuant to section 302(a) 
of the Congressional Budget Act of 1974; and 
(3) for purposes of paragraph (4)(C) of section 
3 of the Statutory Pay-As-You-Go Act of 2010 as 
being included in an appropriation Act. 
Passed the House of Representatives September 30, 
2023. 
Attest: 
KEVIN F. MCCUMBER, 
Clerk. 
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