chronic and environmental disease, and other health ac-
tivities abroad during fiscal year 2004, the Secretary of 
Health and Human Services may exercise authority equiv-
alent to that available to the Secretary of State in section 
2(c) of the State Department Basic Authorities Act of 
1956 (22 U.S.C. 2669(c)). 
(b) 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 sec-
tion 207 of the Foreign Service Act of 1980 (22 U.S.C. 
3927) and other applicable statutes administered by the 
Department of State. 
SEC. 216. The Division of Federal Occupational 
Health may utilize personal services contracting to employ 
professional management/administrative and occupational 
health professionals. 
SEC. 217. (a) CMS PROGRAM MANAGEMENT AC-
COUNT.—The amount otherwise provided by this Act for 
‘‘Centers for Medicare and Medicaid Services—Program 
Management’’ is hereby reduced by $98,000,000. 
(b) MEDICARE CLAIMS PROCESSING FEE.—
(1) IN
GENERAL.—Notwithstanding section 
1842(c)(4) of the Social Security Act, each claim 
submitted by an individual or entity furnishing items
or services for which payment may be made under 
part A or part B of title XVIII of such Act is sub-
ject to a processing fee of $2.50 if the claim—
(A) duplicates, in whole or in part, another 
claim submitted by the same individual or enti-
ty; or 
(B) is a claim that cannot be processed 
and must be returned by the medicare claims 
processing contractor involved to the individual 
or entity for completion or correction. 
(2) DEDUCTION
AND
TRANSFER.—The Sec-
retary of Health and Human Services shall deduct 
any fees assessed pursuant to paragraph (1) against 
an individual or entity from amounts otherwise pay-
able from a trust fund under such title to such indi-
vidual or entity, and shall transfer the amount so 
deducted from such trust fund to the Program Man-
agement account of the Centers for Medicare & 
Medicaid Services. 
(3) AVAILABILITY.—Fees collected under this 
subsection shall remain available until expended. 
Such fees shall be available for obligation in a fiscal 
year only in the amount specified in the appropria-
tion Act for such fiscal year.
(4) WAIVER
AUTHORITY.—The Secretary of 
Health and Human Services may provide for waiver 
of fees for claims described in paragraph (2) in 
cases of such compelling circumstances as the Sec-
retary may determine. 
(5) EXCLUSION
OF
FEES
IN
ALLOWABLE 
COSTS.—An entity may not include a fee assessed 
pursuant to this subsection as an allowable item on 
a cost report under the Social Security Act. 
(6) EFFECTIVE
DATE.—This subsection shall 
apply to claims referred to in paragraph (1) sub-
mitted on or after a date, specified by the Secretary 
of Health and Human Services, that is not later 
than 3 months after the date of the enactment of 
this Act. 
SEC. 218. The amount appropriated in this Act for 
‘‘Centers for Disease Control and Prevention—Disease 
Control, Research, and Training’’ is hereby reduced by 
$49,982,000, to be derived from the amounts made avail-
able for administrative and related information technology 
expenses: Provided, That the Director of the Centers for 
Disease Control and Prevention shall determine the alloca-
tion of the reduction among Agency activities, and shall 
submit to the Committees on Appropriations a report 
specifying the proposed allocation.
This title may be cited as the ‘‘Department of Health 
and Human Services Appropriations Act, 2004’’. 
TITLE III—DEPARTMENT OF EDUCATION 
EDUCATION FOR THE DISADVANTAGED 
For carrying out title I of the Elementary and Sec-
ondary Education Act of 1965 (‘‘ESEA’’) and section 
418A 
of 
the 
Higher 
Education 
Act 
of 
1965, 
$14,841,311,000, of which $7,277,510,000 shall become 
available on July 1, 2004, and shall remain available 
through 
September 
30, 
2005, 
and 
of 
which 
$7,383,301,000 shall become available on October 1, 
2004, and shall remain available through September 30, 
2005, for academic year 2004–2005: Provided, That 
$7,607,282,000 shall be available for basic grants under 
section 1124: Provided further, That up to $3,500,000 of 
these funds shall be available to the Secretary of Edu-
cation on October 1, 2003, to obtain updated educational-
agency-level census poverty data from the Bureau of the 
Census: Provided further, That $1,365,031,000 shall be 
available for concentration grants under section 1124A: 
Provided further, That $1,920,239,000 shall be available 
for targeted grants under section 1125: Provided further, 
That $1,791,759,000 shall be available for education fi-
nance incentive grants under section 1125A: Provided fur-
ther, That $235,000,000 shall be available for comprehen-
sive school reform grants under part F of the ESEA: Pro-
vided further, That from the $9,500,000 available to carry 
out part E of title I, up to $1,000,000 shall be available 
to the Secretary of Education to provide technical assist-
ance to State and local educational agencies concerning 
part A of title I. 
IMPACT AID 
For carrying out programs of financial assistance to 
federally affected schools authorized by title VIII of the 
Elementary and Secondary Education Act of 1965, 
$1,403,324,000, of which $1,192,000,000 shall be for 
basic 
support 
payments 
under 
section 
8003(b), 
$66,668,000 shall be for payments for children with dis-
abilities under section 8003(d), $54,708,000 shall be for 
construction under section 8007 and shall remain avail-
able through September 30, 2005, $72,000,000 shall be 
for Federal property payments under section 8002, and 
$17,948,000, to remain available until expended, shall be 
for facilities maintenance under section 8008. 
SCHOOL IMPROVEMENT PROGRAMS 
For carrying out school improvement activities au-
thorized by title II, part B of title IV, part A and subpart 
6 of part D of title V, parts A and B of title VI, and 
parts B and C of title VII of the Elementary and Sec-
ondary Education Act of 1965 (‘‘ESEA’’); part B of title
II of the Higher Education Act; the McKinney-Vento 
Homeless Assistance Act; and the Civil Rights Act of 
1964, $6,141,812,000, of which $4,490,947,000 shall be-
come available on July 1, 2004, and remain available 
through 
September 
30, 
2005, 
and 
of 
which 
$1,435,000,000 shall become available on October 1, 
2004, and shall remain available through September 30, 
2005, for academic year 2004–2005: Provided, That funds 
made available to carry out part C of title VII of the 
ESEA may be used for construction: Provided further, 
That funds made available to carry out part B of title 
VII of the ESEA may be used for construction, renovation 
and modernization of any elementary school, secondary 
school, or structure related to an elementary school or sec-
ondary school, run by the Department of Education of the 
State of Hawaii, that serves a predominantly Native Ha-
waiian student body: Provided further, That $390,000,000 
shall be for subpart l of part A of title VI of the ESEA: 
Provided further, That no funds appropriated under this 
heading may be used to carry out section 5494 of the 
ESEA. 
INDIAN EDUCATION 
For expenses necessary to carry out, to the extent 
not otherwise provided, title VII, part A of the Elementary 
and Secondary Education Act of 1965, $121,573,000.