In the Senate of the United States, 
April 15, 2010. 
Resolved, That the bill from the House of Representa-
tives (H.R. 4851) entitled ‘‘An Act to provide a temporary 
extension of certain programs, and for other purposes.’’, do 
pass with the following 
AMENDMENT: 
Strike all after the enacting clause and insert the 
following: 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Continuing Extension 
Act of 2010’’. 
SEC. 2. EXTENSION OF UNEMPLOYMENT INSURANCE PRO-
VISIONS. 
(a) IN GENERAL.—(1) Section 4007 of the Supple-
mental Appropriations Act, 2008 (Public Law 110–252; 26 
U.S.C. 3304 note) is amended— 
(A) by striking ‘‘April 5, 2010’’ each place it ap-
pears and inserting ‘‘June 2, 2010’’;
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(B) in the heading for subsection (b)(2), by strik-
ing ‘‘APRIL 5, 2010’’ and inserting ‘‘JUNE 2, 2010’’; and 
(C) in subsection (b)(3), by striking ‘‘September 
4, 2010’’ and inserting ‘‘November 6, 2010’’. 
(2) Section 2002(e) of the Assistance for Unemployed 
Workers and Struggling Families Act, as contained in Pub-
lic Law 111–5 (26 U.S.C. 3304 note; 123 Stat. 438), is 
amended— 
(A) in paragraph (1)(B), by striking ‘‘April 5, 
2010’’ and inserting ‘‘June 2, 2010’’; 
(B) in the heading for paragraph (2), by strik-
ing ‘‘APRIL 5, 2010’’ and inserting ‘‘JUNE 2, 2010’’; and 
(C) in paragraph (3), by striking ‘‘October 5, 
2010’’ and inserting ‘‘December 7, 2010’’. 
(3) Section 2005 of the Assistance for Unemployed 
Workers and Struggling Families Act, as contained in Pub-
lic Law 111–5 (26 U.S.C. 3304 note; 123 Stat. 444), is 
amended— 
(A) by striking ‘‘April 5, 2010’’ each place it ap-
pears and inserting ‘‘June 2, 2010’’; and 
(B) in subsection (c), by striking ‘‘September 4, 
2010’’ and inserting ‘‘November 6, 2010’’. 
(4) Section 5 of the Unemployment Compensation Ex-
tension Act of 2008 (Public Law 110–449; 26 U.S.C. 3304
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note) is amended by striking ‘‘September 4, 2010’’ and in-
serting ‘‘November 6, 2010’’. 
(b) FUNDING.—Section 4004(e)(1) of the Supplemental 
Appropriations Act, 2008 (Public Law 110–252; 26 U.S.C. 
3304 note) is amended— 
(1) in subparagraph (C), by striking ‘‘and’’ at 
the end; 
(2) by inserting after subparagraph (D) the fol-
lowing new subparagraph: 
‘‘(E) the amendments made by section 
2(a)(1) of the Continuing Extension Act of 2010; 
and’’. 
(c) EFFECTIVE DATE.—The amendments made by this 
section shall take effect as if included in the enactment of 
the Temporary Extension Act of 2010 (Public Law 111– 
144). 
SEC. 3. EXTENSION AND IMPROVEMENT OF PREMIUM AS-
SISTANCE FOR COBRA BENEFITS. 
(a) EXTENSION OF ELIGIBILITY PERIOD.—Subsection 
(a)(3)(A) of section 3001 of division B of the American Re-
covery and Reinvestment Act of 2009 (Public Law 111–5), 
as amended by section 3(a) of the Temporary Extension Act 
of 2010 (Public Law 111–144), is amended by striking 
‘‘March 31, 2010’’ and inserting ‘‘May 31, 2010’’.
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(b) RULES RELATING
TO 2010 EXTENSION.—Sub-
section (a) of section 3001 of division B of the American 
Recovery and Reinvestment Act of 2009 (Public Law 111– 
5), as amended by section 3(b) of the Temporary Extension 
Act of 2010 (Public Law 111–144), is amended by adding 
at the end the following: 
‘‘(18) RULES RELATED TO APRIL AND MAY 2010 
EXTENSION.—In the case of an individual who, with 
regard to coverage described in paragraph (10)(B), 
experiences a qualifying event related to a termi-
nation of employment on or after April 1, 2010 and 
prior to the date of the enactment of this paragraph, 
rules similar to those in paragraphs (4)(A) and 
(7)(C) shall apply with respect to all continuation 
coverage, including State continuation coverage pro-
grams.’’. 
(c) EFFECTIVE DATE.—The amendments made by this 
section shall take effect as if included in the provisions of 
section 3001 of division B of the American Recovery and 
Reinvestment Act of 2009. 
SEC. 4. INCREASE IN THE MEDICARE PHYSICIAN PAYMENT 
UPDATE. 
Paragraph (10) of section 1848(d) of the Social Secu-
rity Act, as added by section 1011(a) of the Department 
of Defense Appropriations Act, 2010 (Public Law 111–118)
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and as amended by section 5 of the Temporary Extension 
Act of 2010 (Public Law 111–144), is amended— 
(1) in subparagraph (A), by striking ‘‘March 31, 
2010’’ and inserting ‘‘May 31, 2010’’; and 
(2) in subparagraph (B), by striking ‘‘April 1, 
2010’’ and inserting ‘‘June 1, 2010’’. 
SEC. 5. EHR CLARIFICATION. 
(a) QUALIFICATION FOR CLINIC-BASED PHYSICIANS.— 
(1) MEDICARE.—Section 1848(o)(1)(C)(ii) of the 
Social Security Act (42 U.S.C. 1395w–4(o)(1)(C)(ii)) 
is amended by striking ‘‘setting (whether inpatient or 
outpatient)’’ and inserting ‘‘inpatient or emergency 
room setting’’. 
(2) MEDICAID.—Section 1903(t)(3)(D) of the So-
cial Security Act (42 U.S.C. 1396b(t)(3)(D)) is 
amended by striking ‘‘setting (whether inpatient or 
outpatient)’’ and inserting ‘‘inpatient or emergency 
room setting’’. 
(b) EFFECTIVE DATE.—The amendments made by sub-
section (a) shall be effective as if included in the enactment 
of the HITECH Act (included in the American Recovery 
and Reinvestment Act of 2009 (Public Law 111–5)). 
(c) IMPLEMENTATION.—Notwithstanding any other 
provision of law, the Secretary of Health and Human Serv-
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ices may implement the amendments made by this section 
by program instruction or otherwise. 
SEC. 6. EXTENSION OF USE OF 2009 POVERTY GUIDELINES. 
Section 1012 of the Department of Defense Appropria-
tions Act, 2010 (Public Law 111–118), as amended by sec-
tion 7 of the Temporary Extension Act of 2010 (Public Law 
111–144), is amended by striking ‘‘March 31, 2010’’ and 
inserting ‘‘May 31, 2010’’. 
SEC. 7. EXTENSION OF NATIONAL FLOOD INSURANCE PRO-
GRAM. 
(a) EXTENSION.—Section 129 of the Continuing Ap-
propriations Resolution, 2010 (Public Law 111–68), as 
amended by section 8 of Public Law 111–144, is amended 
by striking ‘‘by substituting’’ and all that follows through 
the period at the end and inserting ‘‘by substituting May 
31, 2010, for the date specified in each such section.’’. 
(b) EFFECTIVE DATE.—The amendments made by sub-
section (a) shall be considered to have taken effect on Feb-
ruary 28, 2010. 
SEC. 8. COMPENSATION AND RATIFICATION OF AUTHORITY 
RELATED TO LAPSE IN HIGHWAY PROGRAMS. 
(a) COMPENSATION FOR FEDERAL EMPLOYEES.—Any 
Federal employees furloughed as a result of the lapse in ex-
penditure authority from the Highway Trust Fund after 
11:59 p.m. on February 28, 2010, through March 2, 2010,