II Calendar No. 248 118th CONGRESS 1st Session H. R. 6363 IN THE SENATE OF THE UNITED STATES November 14 (legislative day, November 13), 2023 Received; read the first time November 14, 2023 Read the second time and placed on the calendar AN ACT Making further continuing appropriations for fiscal year 2024, and for other purposes.

1. Short title This Act may be cited as the Further Continuing Appropriations and Other Extensions Act, 2024 . 2. Table of Contents The table of contents of this Act is as follows: Sec. 1. Short title. Sec. 2. Table of Contents. Sec. 3. References. Division A—Further Continuing Appropriations Act, 2024 Division B—Other Matters Title I—Extensions and Other Matters Title II—Health and Human Services Title III—Miscellaneous Extensions Title IV—Budgetary Effects 3. References Except as expressly provided otherwise, any reference to this Act contained in any division of this Act shall be treated as referring only to the provisions of that division. A Further Continuing Appropriations Act, 2024 101. Division A of the Continuing Appropriations Act, 2024 and Other Extensions Act (Public Law 118–15) is amended— (1) by striking the date specified in section 106(3) and inserting February 2, 2024, except as provided in paragraph (4) ; (2) by inserting after paragraph (3) of section 106 the following: (4) In the case of appropriations and funds made available and authority granted pursuant to sections 101(1), 101(4), 101(10), 101(12), 134, and 137, January 19, 2024. ; (3) in section 101(1) by inserting after except section 729, the following: and except that the language under the heading ‘Rural Utilities Service—Rural Water and Waste Disposal Program Account’ in title III shall be applied by inserting ‘direct loans and,’ before ‘loan guarantees’ at the beginning of the first sentence of the second paragraph, ; (4) in section 101(10), by inserting before the period , except section 123 as well as the provisions carrying the same restriction in prior Acts ; (5) in section 123, by striking 17 days and inserting 94 days and by striking 17-day and inserting 94-day ; (6) in section 124, by striking $621,270,000 and inserting $663,070,000 ; (7) in section 125, by striking During the period covered by this Act and inserting Through the date specified in section 106(3) of this Act ; and (8) by adding after section 137 the following new sections: 138. Section 2(f)(2) of the Undetectable Firearms Act of 1988 (18 U.S.C. 922 note) shall be applied through the date specified in section 106(3) of this Act by substituting 36 for 35 . 139. Through the date specified in section 106(3) of this Act, amounts appropriated in section 124 of the Continuing Appropriations Act, 2023 (division A of Public Law 117–180) may be charged for any proper expense pursuant to section 1553(b)(1) of title 31, United States Code, notwithstanding the limitation in section 1553(b)(2) of such title. 140. Notwithstanding sections 102 and 104, amounts made available by section 101 to the Department of Defense for Procurement—Shipbuilding and Conversion, Navy may be apportioned up to the rate for operations necessary for Columbia Class Submarine (AP) in an amount not to exceed $3,338,413,000. 141. (a) Notwithstanding section 101, section 747 of title VII of division E of Public Law 117–328 shall be applied through the date specified in section 106(3) of this Act by— (1) substituting 2025 for 2024 ; (2) substituting 2024 for 2023 each place it appears; (3) substituting 2023 for 2022 each place it appears; and (4) substituting section 747 of division E of Public Law 117–328, as in effect on September 30, 2023 for section 747 of division E of Public Law 117–103 each place it appears. (b) Subsection (a) shall not take effect until the first day of the first applicable pay period beginning on or after January 1, 2024. 142. Section 302 of title III of Public Law 108–494 shall be applied by substituting the date specified in section 106(3) of this Act for ‘December 31, 2023’ each place it appears. 143. Amounts made available by section 101 to the Department of Homeland Security under the heading United States Secret Service—Operations and Support may be apportioned up to the rate for operations necessary to carry out activities related to National Special Security Events and the 2024 Presidential Campaign. 144. Section 1901(e) of the Homeland Security Act of 2002 (6 U.S.C. 591(e)) shall be applied by substituting the date that is 1 day after the date specified in section 106(3) of this Act for the date that is 5 years after the date of the enactment of the Countering Weapons of Mass Destruction Act of 2018 . 145. (a) Amounts made available by section 101 for Department of Education—Student Aid Administration may be apportioned up to the rate for operations necessary to ensure the continuation of student loan servicing activities, including supporting borrowers reentering repayment. (b) The limitation in section 302 of division H of Public Law 117–328 regarding transfers increasing any appropriation shall be applied to transfers to appropriations under the heading Department of Education—Student Aid Administration through the date specified in section 106(3) of this Act by substituting 10 percent for 3 percent for the purposes of the continuation of basic operations, including student loan servicing, business process operations, digital customer care, common origination and disbursement, cybersecurity activities, and information technology systems. 146. Notwithstanding any other provision of this Act, there is hereby appropriated for fiscal year 2024, out of any money in the Treasury not otherwise appropriated, for payment to Katherine Anne Feinstein, beneficiary of Dianne Feinstein, late a Senator from the State of California, $174,000. This division may be cited as the Continuing Appropriations Act, 2024 . . This division may be cited as the Further Continuing Appropriations Act, 2024 . B Other Matters I Extensions and Other Matters 101. Extension of certain provisions of the Compacts of Free Association with the Federated States of Micronesia and the Republic of the Marshall Islands Section 2101 of the Continuing Appropriations Act, 2024 and Other Extensions Act (Public Law 118–15; 137 Stat. 81) is amended— (1) in the section heading, by striking compact of free association with the federated states of micronesia and inserting compacts of free association with the federated states of micronesia and the republic of the marshall islands ; and (2) in subsection (a)(1)— (A) by striking November 17, 2023 and inserting February 2, 2024 ; (B) by inserting , section 103(f)(2) of the Compact of Free Association Amendments Act of 2003 (48 U.S.C. 1921b(f)(2)), and sections 211, 213, and 216 of the Compact of Free Association between the Government of the United States of America and the Government of the Republic of the Marshall Islands set forth in section 201(b) of that Act (48 U.S.C. 1921 note; Public Law 108–188) before shall, ; (C) by inserting or the Republic of the Marshall Islands, as applicable before , continue ; and (D) by striking of that Compact and inserting of the applicable Compact . 102. Extension of agricultural programs (a) Extension Except as otherwise provided in this section and the amendments made by this section, notwithstanding any other provision of law, the authorities (including any limitations on the authorities) provided by each provision of the Agriculture Improvement Act of 2018 (Public Law 115–334; 132 Stat. 4490) and each provision of law amended by that Act (and for mandatory programs at such funding levels), as in effect on September 30, 2023, shall continue, and the authorities shall be carried out, until the later of— (1) September 30, 2024; or (2) the date specified in the provision of that Act or the provision of law amended by that Act. (b) Discretionary programs Programs carried out using the authorities described in subsection (a) that are funded by discretionary appropriations (as defined in section 250(c) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 900(c))) shall be subject to the availability of appropriations. (c) Commodity programs (1) In general The provisions of law applicable to a covered commodity (as defined in section 1111 of the Agricultural Act of 2014 (7 U.S.C. 9011)), a loan commodity (as defined in section 1201 of that Act (7 U.S.C. 9031)), sugarcane, or sugar beets for the 2023 crop year pursuant to title I of that Act (7 U.S.C. 9011 et seq.) and each amendment made by subtitle C of title I of the Agriculture Improvement Act of 2018 (Public Law 115–334; 132 Stat. 4511) shall be applicable to the 2024 crop year for that covered commodity, loan commodity, sugarcane, or sugar beets. (2) Dairy (A) Base production history adjustment for participating dairy operations with production of less than 5,000,000 pounds Section 1405(a) of the Agricultural Act of 2014 (7 U.S.C. 9055(a)) is amended— (i) in paragraph (1), by inserting paragraph (4) and before subsection (b) ; and (ii) by adding at the end the following: (4) Base production history adjustment for participating dairy operations with production of less than 5,000,000 pounds (A) In general If the amount determined under paragraph (1) is less than 5,000,000 pounds, the production history of the dairy operation for dairy margin coverage shall be equal to— (i) the amount determined under paragraph (1); plus (ii) 75 percent of the amount described in subparagraph (B). (B) Amount The amount referred to in subparagraph (A)(ii) is, with respect to a dairy operation, the amount equal to— (i) the production volume of such dairy operation for the 2019 milk marketing year; minus (ii) the amount determined under paragraph (1). . (B) Dairy margin coverage (i) Duration Section 1409 of the Agricultural Act of 2014 (7 U.S.C. 9059) is amended by striking 2023 and inserting 2024 . (ii) Availability of premium discount With respect to coverage for calendar year 2024, section 1407(g) of the Agricultural Act of 2014 (7 U.S.C. 9057(g)) shall only apply to a participating dairy operation with respect to which the premium was reduced in accordance with that section for calendar year 2023. (C) Dairy forward pricing program Section 1502(e)(2) of the Food, Conservation, and Energy Act of 2008 (7 U.S.C. 8772(e)(2)) is amended by striking 2026 and inserting 2027 . (3) Extension of payment amount Section 1116(d) of the Agricultural Act of 2014 (7 U.S.C. 9016(d)) is amended, in the matter preceding paragraph (1), by striking 2018 and inserting 2024 . (4) Suspension of permanent price support authorities The provisions of law specified in— (A) subsections (a) and (b) of section 1602 of the Agricultural Act of 2014 (7 U.S.C. 9092)— (i) shall not be applicable to the 2024 crops of covered commodities (as defined in section 1111 of that Act (7 U.S.C. 9011)), cotton, and sugar; and (ii) shall not be applicable to milk through December 31, 2024; and (B) section 1602(c) of that Act (7 U.S.C. 9092(c)) shall not be applicable to the crops of wheat planted for harvest in calendar year 2024. (d) Other programs (1) Conservation (A) Grassroots source water protection program Section 1240O(b)(3) of the Food Security Act of 1985 (16 U.S.C. 3839bb–2(b)(3)) is amended— (i) by striking the period at the end and inserting ; and ; (ii) by striking use $5,000,000 and inserting the following: use— (A) $5,000,000 ; and (iii) by adding at the end the following: (B) $1,000,000 beginning in fiscal year 2024, to remain available until expended. . (B) Voluntary public access and habitat incentive program Section 1240R(f)(1) of the Food Security Act of 1985 (16 U.S.C. 3839bb–5(f)(1)) is amended— (i) by striking and after 2018, ; and (ii) by inserting , and $10,000,000 for fiscal year 2024 before the period at the end. (C) Feral swine eradication and control pilot program Section 2408(g)(1) of the Agriculture Improvement Act of 2018 (7 U.S.C. 8351 note; Public Law 115–334) is amended by inserting and $15,000,000 for fiscal year 2024 before the period at the end. (2) Trade Section 302(h)(2) of the Bill Emerson Humanitarian Trust Act (7 U.S.C. 1736f–1(h)(2)) is amended by striking 2023 and inserting 2024 . (3) Nutrition Section 203D(d)(5) of the Emergency Food Assistance Act of 1983 (7 U.S.C. 7507(d)(5)) is amended by striking 2023 and inserting 2024 . (4) Rural economic development program Section 313B(e)(2) of the Rural Electrification Act of 1936 (7 U.S.C. 940c–2(e)(2)) is amended by striking and 2023 and inserting through 2024 . (5) Research (A) Scholarships for students Section 1446 of the National Agricultural Research, Extension, and Teaching Policy Act of 1977 (7 U.S.C. 3222a) is amended— (i) in subsection (a)(3), by striking three and inserting 4 ; and (ii) in subsection (b)(1)— (I) by striking Of and inserting the following: (A) Funding Of ; and (II) by adding at the end the following: (B) Additional funding Not later than 30 days after the date of enactment of this subparagraph, of the funds of the Commodity Credit Corporation, the Secretary shall make available to carry out this section $10,000,000, to remain available until expended. . (B) Urban, indoor, and other emerging agricultural production research, education, and extension initiative Section 1672E(d)(1) of the Food, Agriculture, Conservation, and Trade Act of 1990 (7 U.S.C. 5925g(d)(1)) is amended— (i) by striking the period at the end and inserting ; and ; (ii) by striking section $10,000,000 and inserting the following: section— (A) $10,000,000 ; and (iii) by adding at the end the following: (B) $2,000,000 for fiscal year 2024, to remain available until expended. . (C) Foundation for food and agriculture research Section 7601(g)(1)(A) of the Agricultural Act of 2014 (7 U.S.C. 5939(g)(1)(A)) is amended by adding at the end the following: (iii) Additional funding Not later than 30 days after the date of enactment of this clause, of the funds of the Commodity Credit Corporation, the Secretary shall transfer to the Foundation to carry out this section $37,000,000, to remain available until expended. . (D) Grazinglands research laboratory Section 7502 of the Food, Conservation, and Energy Act of 2008 (Public Law 110–246; 122 Stat. 2019; 132 Stat. 4817) shall be applied by substituting the period beginning on the date of enactment of this Act and ending on September 30, 2024 for the 15-year period beginning on the date of enactment of this Act . (6) Energy (A) Biobased markets program Section 9002(k)(1) of the Farm Security and Rural Investment Act of 2002 (7 U.S.C. 8102(k)(1)) is amended by striking 2023 and inserting 2024 . (B) Bioenergy program for advanced biofuels Section 9005(g)(1)(F) of the Farm Security and Rural Investment Act of 2002 (7 U.S.C. 8105(g)(1)(F)) is amended by striking 2023 and inserting 2024 . (C) Feedstock flexibility program Section 9010(b) of the Farm Security and Rural Investment Act of 2002 (7 U.S.C. 8110(b)) is amended in paragraphs (1)(A) and (2)(A) by striking 2023 each place it appears and inserting 2024 . (7) Horticulture (A) Organic production and market data initiatives Section 7407(d)(1) of the Farm Security and Rural Investment Act of 2002 (7 U.S.C. 5925c(d)(1)) is amended— (i) in subparagraph (A), by striking and at the end; (ii) in subparagraph (B), by striking the period at the end and inserting ; and ; and (iii) by adding at the end the following: (C) $1,000,000 for fiscal year 2024. . (B) Modernization and improvement of international trade technology systems and data collection Section 2123(c)(4) of the Organic Foods Production Act of 1990 (7 U.S.C. 6522(c)(4)) is amended, in the matter preceding subparagraph (A), by inserting and $1,000,000 for fiscal year 2024 after 2019 . (C) National organic certification cost-share program Section 10606(d)(1)(C) of the Farm Security and Rural Investment Act of 2002 (7 U.S.C. 6523(d)(1)(C)) is amended by striking and 2023 and inserting through 2024 . (D) Multiple crop and pesticide use survey Section 10109(c)(1) of the Agriculture Improvement Act of 2018 (Public Law 115–334; 132 Stat. 4906) is amended by inserting and $100,000 for fiscal year 2024 after 2019 . (8) Miscellaneous (A) Pima agriculture cotton trust fund Section 12314 of the Agricultural Act of 2014 (7 U.S.C. 2101 note; Public Law 113–79) is amended— (i) in subsection (b), in the matter preceding paragraph (1), by striking 2023 and inserting 2024 ; and (ii) in subsection (h), by striking 2023 and inserting 2024 . (B) Agriculture wool apparel manufacturers trust fund Section 12315 of the Agricultural Act of 2014 (7 U.S.C. 7101 note; Public Law 113–79) is amended by striking 2023 each place it appears and inserting 2024 . (C) Wool research and promotion Section 12316(a) of the Agricultural Act of 2014 (7 U.S.C. 7101 note; Public Law 113–79) is amended by striking 2023 and inserting 2024 . (D) Emergency citrus disease research and development trust fund Section 12605(d) of the Agriculture Improvement Act of 2018 (7 U.S.C. 7632 note; Public Law 115–334) is amended by striking 2023 and inserting 2024 . (E) Sheep production and marketing grant program Section 209(c) of the Agricultural Marketing Act of 1946 (7 U.S.C. 1627a(c)) is amended by inserting and $400,000 for fiscal year 2024, after 2019, . (9) Exceptions Subsection (a) shall not apply with respect to mandatory funding under the following provisions of law: (A) Section 1614(c)(4) of the Agricultural Act of 2014 (7 U.S.C. 9097(c)(4)). (B) Subparagraphs (A) and (B) of section 1241(a)(1) of the Food Security Act of 1985 (16 U.S.C. 3841(a)(1)). (e) Reports (1) In general Subject to paragraph (2), any requirement under a provision of law described in subsection (a) to submit a report on a recurring basis, and the final report under which was required to be submitted during fiscal year 2023, shall continue, and the requirement shall be carried out, on the same recurring basis, until the later of the dates specified in paragraphs (1) and (2) of that subsection. (2) Appropriations required If discretionary appropriations (as defined in section 250(c) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 900(c))) are required to carry out a reporting requirement described in paragraph (1), the application of that paragraph to that reporting requirement shall be subject to the availability of appropriations. (f) Rescission Of the unobligated balances of amounts made available under section 9003(g)(1)(A) of the Farm Security and Rural Investment Act of 2002 (7 U.S.C. 8103(g)(1)(A)), $177,350,000 is rescinded. (g) Effective date This section and the amendments made by this section (except subsection (f) and the amendments made by subparagraphs (A) and (C) of subsection (d)(5)) shall be applied and administered as if this section and those amendments had been enacted on September 30, 2023. II Health and Human Services A Public Health Extenders 201. 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)(1) of the Public Health Service Act (42 U.S.C. 256h(g)) is amended by striking and $16,635,616 for the period beginning on October 1, 2023, and ending on November 17, 2023 and inserting $16,635,616 for the period beginning on October 1, 2023, and ending on November 17, 2023, and $21,834,247 for the period beginning on November 18, 2023, and ending on January 19, 2024 . (b) Extension for community health centers Section 10503(b)(1)(F) of the Patient Protection and Affordable Care Act (42 U.S.C. 254b–2(b)(1)(F)), as amended by the Continuing Appropriations Act, 2024 and Other Extensions Act, is further amended by striking and $526,027,397 for the period beginning on October 1, 2023, and ending on November 17, 2023 and inserting $526,027,397 for the period beginning on October 1, 2023, and ending on November 17, 2023, and $690,410,959 for the period beginning on November 18, 2023, and ending on January 19, 2024 . (c) Extension for the National Health Service Corps Section 10503(b)(2)(I) of the Patient Protection and Affordable Care Act (42 U.S.C. 254b–2(b)(2)(I)), as amended by the Continuing Appropriations Act, 2024 and Other Extensions Act, is further amended by striking $40,767,123 for the period beginning on October 1, 2023, and ending on November 17, 2023 and inserting $40,767,123 for the period beginning on October 1, 2023, and ending on November 17, 2023, and $53,506,849 for the period beginning on November 18, 2023, and ending on January 19, 2024 . (d) Application of provisions Amounts appropriated 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) Conforming amendment Section 3014(h)(4) of title 18, United States Code, is amended by striking and section 2321(d) of the Continuing Appropriations Act, 2024 and Other Extensions Act and inserting section 2321(d) of the Continuing Appropriations Act, 2024 and Other Extensions Act, and section 201(d) of the Further Continuing Appropriations and Other Extensions Act, 2024 . 202. Extension of special diabetes programs (a) Extension of special diabetes programs for Type I diabetes Section 330B(b)(2)(E) of the Public Health Service Act (42 U.S.C. 254c–2(b)(2)(E)), as amended by the Continuing Appropriations Act, 2024 and Other Extensions Act, is further amended by striking $19,726,027 for the period beginning on October 1, 2023, and ending on November 17, 2023 and inserting $19,726,027 for the period beginning on October 1, 2023, and ending on November 17, 2023, and $25,890,411 for the period beginning on November 18, 2023, and ending on January 19, 2024 . (b) Extending funding for special diabetes programs for Indians Section 330C(c)(2)(E) of the Public Health Service Act (42 U.S.C. 254c–3(c)(2)(E)), as amended by the Continuing Appropriations Act, 2024 and Other Extensions Act, is further amended by striking $19,726,027 for the period beginning on October 1, 2023, and ending on November 17, 2023 and inserting $19,726,027 for the period beginning on October 1, 2023, and ending on November 17, 2023, and $25,890,411 for the period beginning on November 18, 2023, and ending on January 19, 2024 . 203. National Health Security Extensions (a) Section 319(e)(8) of the Public Health Service Act (42 U.S.C. 247d(e)(8)) is amended by striking November 17, 2023 and inserting January 19, 2024 . (b) Section 319L(e)(1)(D) of the Public Health Service Act (42 U.S.C. 247d–7e(e)(1)(D)) is amended by striking on the date that is 17 years after the date of enactment of the Pandemic and All-Hazards Preparedness Act and inserting after January 19, 2024 . (c) Section 319L–1(b) of the Public Health Service Act (42 U.S.C. 247d–7f(b)) is amended by striking at the end of the 17-year period that begins on the date of enactment of this Act and inserting after January 19, 2024 . (d) (1) Section 2811A(g) of the Public Health Service Act (42 U.S.C. 300hh–10b(g)) is amended by striking November 17, 2023 and inserting January 19, 2024 . (2) Section 2811B(g)(1) of the Public Health Service Act (42 U.S.C. 300hh–10c(g)(1)) is amended by striking November 17, 2023 and inserting January 19, 2024 . (3) Section 2811C(g)(1) of the Public Health Service Act (42 U.S.C. 300hh–10d(g)(1)) is amended by striking November 17, 2023 and inserting January 19, 2024 . (e) Section 2812(c)(4)(B) of the Public Health Service Act (42 U.S.C. 300hh–11(c)(4)(B)) is amended by striking November 17, 2023 and inserting January 19, 2024 . B Medicaid 301. Delaying certain disproportionate share payment cuts 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), by striking November 18, 2023 and inserting January 20, 2024 ; and (2) in clause (ii), by striking November 18, 2023 and inserting January 20, 2024 . 302. Medicaid Improvement Fund reduction Section 1941(b)(3)(A) of the Social Security Act (42 U.S.C. 1396w–1(b)(3)(A)), as amended by the Continuing Appropriations Act, 2024 and Other Extensions Act, is further amended by striking $6,357,117,810 and inserting 5,796,117,810 . C Human Services 401. Extension of child and family services programs Activities authorized by part B of title IV of the Social Security Act shall continue through January 19, 2024, 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. 402. Sexual risk avoidance education extension Section 510 of the Social Security Act (42 U.S.C. 710), as amended by the Continuing Appropriations Act, 2024 and Other Extensions Act, is further amended— (1) in subsection (a)— (A) in paragraph (1)— (i) by striking and for the period beginning on October 1, 2023, and ending on November 17, 2023 and inserting , for the period beginning on October 1, 2023, and ending on November 17, 2023, and for the period beginning on November 18, 2023, and ending on January 19, 2024 ; and (ii) by striking with respect to such period and inserting with respect to the applicable period ; (B) in paragraphs (2)(A), by striking for the period and inserting for the applicable period ; and (C) in paragraphs (2)(B), by striking for the period and inserting for the applicable period ; and (2) in subsection (f)— (A) in paragraph (1), by striking 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 corresponding period for fiscal year 2023 and inserting 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 corresponding period for fiscal year 2023, and for the period beginning on November 18, 2023, and ending on January 19, 2024, an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year 2023 ; and (B) in paragraph (2), by striking for the period and inserting for the applicable period . 403. Personal responsibility education extension Section 513 of the Social Security Act (42 U.S.C. 713), as amended by the Continuing Appropriations Act, 2024 and Other Extensions Act, is further amended— (1) in subsection (a)— (A) in paragraph (1)— (i) in subparagraph (A), by striking and for the period beginning on October 1, 2023, and ending on November 17, 2023, and inserting , for the period beginning on October 1, 2023, and ending on November 17, 2023, and for the period beginning on November 18, 2023, and ending on January 19, 2024, ; and (ii) in subparagraph (B)(i), by inserting after November 17, 2023 the following: , and for the period beginning on November 18, 2023, and ending on January 19, 2024 ; (iii) in subparagraph (C)(i), by striking for a fiscal year or the period and inserting for a fiscal year or period ; and (B) in paragraph (3), by striking for a fiscal year or the period and inserting for a fiscal year or period ; and (C) in paragraph (4)(A)— (i) by striking for the period each place it appears and inserting for each period ; and (ii) by striking for a fiscal year or the period and inserting for a fiscal year or period ; (D) in paragraph (4)(B)(i), by striking the period described in paragraph (1)(A) and inserting each period described in paragraph (1)(A) ; (2) in subsection (c), by striking for the period described in subsection (a)(1)(A) and inserting for a period described in subsection (a)(1)(A) for fiscal year 2024 ; and (3) in subsection (f)(1), by striking 2023, 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 corresponding period for fiscal year 2023 and inserting 2023, 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 corresponding period for fiscal year 2023, and for the period beginning on November 18, 2023, and ending on January 19, 2024, an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year 2023 . D Medicare 501. Extending floor for work geographic index Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w–4(e)(1)(E)) is amended by striking January 1, 2024 and inserting January 20, 2024 . 502. Revising phase-in of Medicare clinical laboratory test payment changes (a) Revised phase-in of reductions from private payor rate implementation Section 1834A(b)(3) of the Social Security Act (42 U.S.C. 1395m–1(b)(3)) is amended— (1) in subparagraph (A), by striking 2026 and inserting 2027 ; and (2) in subparagraph (B)— (A) in clause (ii), by striking 2023 and inserting 2024 ; and (B) in clause (iii), by striking 2024 through 2026 and inserting 2025 through 2027 . (b) Revised reporting period for reporting of private sector payment rates for establishment of Medicare payment rates Section 1834A(a)(1)(B) of the Social Security Act (42 U.S.C. 1395m–1(a)(1)(B)) is amended— (1) in clause (i), by striking 2023 and inserting 2024 ; and (2) in clause (ii), by striking 2024 each place it appears and inserting 2025 . 503. Medicare improvement fund Section 1898(b)(1) of the Social Security Act (42 U.S.C. 1395iii(b)(1)) is amended by striking $180,000,000 and inserting $466,795,056 . III Miscellaneous Extensions 601. Counter-UAS Authorities Section 210G(i) of the Homeland Security Act of 2002 (6 U.S.C. 124n(i)) is amended by striking November 18, 2023 and inserting February 3, 2024 . IV Budgetary Effects 701. Budgetary Effects (a) Statutory PAYGO Scorecards The budgetary effects of this division shall not be entered on either 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 Report 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 Committee 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 November 14, 2023. Kevin F. McCumber, Clerk.

November 14, 2023 Read the second time and placed on the calendar