[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 266 Enrolled Bill (ENR)]
H.R.266
One Hundred Sixteenth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Friday,
the third day of January, two thousand and twenty
An Act
Making appropriations for the Department of the Interior, environment,
and related agencies for the fiscal year ending September 30, 2019, and
for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

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This Act may be cited as the ``Paycheck Protection Program and
Health Care Enhancement Act''.

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The table of contents for this Act is as follows:

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41d57da51bcf00cec0373e86c96869d0827043923a631820609db9d5442b1d0c

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.

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INJURY DISASTER LOANS, AND EMERGENCY GRANTS.
(a) Increased Authority for Commitments and Appropriations for
Paycheck Protection Program.--Title I of division A of the Coronavirus
Aid, Relief, and Economic Security Act (Public Law 116-136) is
amended--
(1) in section 1102(b)(1), by striking ``$349,000,000,000'' and
inserting ``$659,000,000,000''; and
(2) in section 1107(a)(1), by striking ``$349,000,000,000'' and
inserting ``$670,335,000,000''.
(b) Increased Authorization for Emergency EIDL Grants.--Section
1110(e)(7) of division A of the Coronavirus Aid, Relief, and Economic
Security Act (Public Law 116-136) is amended by striking
``$10,000,000,000'' and inserting ``$20,000,000,000''.
(c) Eligibility of Agricultural Enterprises for Economic Injury
Disaster Loans and Emergency Grants.--Section 1110(a)(2) of division A
of the Coronavirus Aid, Relief, and Economic Security Act (Public Law
116-136) is amended--
(1) in subparagraph (D), by striking ``or'' at the end;
(2) in subparagraph (E), by striking the period at the end and
inserting ``; or''; and
(3) by adding at the end the following:
``(F) an agricultural enterprise (as defined in section
18(b) of the Small Business Act (15 U.S.C. 647(b)) with not
more than 500 employees.''.
(d) Set Aside for Insured Depository Institutions, Credit Unions,
and Community Financial Institutions.--Section 7(a)(36) of the Small
Business Act (15 U.S.C. 636(a)(36)) is amended--
(1) in subparagraph (A)--
(A) in clause (viii), by striking ``and'' at the end;
(B) in clause (ix), by striking the period at the end and
inserting a semicolon; and
(C) by adding at the end the following:
``(x) the term `community development financial
institution' has the meaning given the term in section 103
of the Riegle Community Development and Regulatory
Improvement Act of 1994 (12 U.S.C. 4702));
``(xi) the term `community financial institutions'
means--
``(I) a community development financial
institution;
``(II) a minority depository institution, as
defined in section 308 of the Financial Institutions
Reform, Recovery, and Enforcement Act of 1989 (12
U.S.C. 1463 note);
``(III) a development company that is certified
under title V of the Small Business Investment Act of
1958 (15 U.S.C. 695 et seq.); and
``(IV) an intermediary, as defined in section
7(m)(11); and
``(xii) the term `credit union' means a State credit
union or a Federal credit union, as those terms are
defined, respectively, in section 101 of the Federal Credit
Union Act (12 U.S.C. 1752).''; and
(2) by adding at the end the following:
``(S) Set-aside for insured depository institutions, credit
unions, and community financial institutions.--
``(i) Insured depository institutions and credit
unions.--In making loan guarantees under this paragraph
after the date of enactment of this clause, the
Administrator shall guarantee not less than $30,000,000,000
in loans made by--
``(I) insured depository institutions with
consolidated assets of not less than $10,000,000,000
and less than $50,000,000,000; and
``(II) credit unions with consolidated assets of
not less than $10,000,000,000 and less than
$50,000,000,000.
``(ii) Community financial institutions, small insured
depository institutions, and credit unions.--In making loan
guarantees under this paragraph after the date of enactment
of this clause, the Administrator shall guarantee not less
than $30,000,000,000 in loans made by--
``(I) community financial institutions;
``(II) insured depository institutions with
consolidated assets of less than $10,000,000,000; and
``(III) credit unions with consolidated assets of
less than $10,000,000,000.''.

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(a) In General.--The amounts provided under this division are
designated as an emergency requirement pursuant to section 4(g) of the
Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 933(g)).
(b) Designation in Senate.--In the Senate, this division is
designated as an emergency requirement pursuant to section 4112(a) of
H. Con. Res. 71 (115th Congress), the concurrent resolution on the
budget for fiscal year 2018.
RESPONSE
The following sums are hereby appropriated, out of any money in
the Treasury not otherwise appropriated, for the fiscal year ending
September 30, 2020, and for other purposes, namely:
TITLE I
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
public health and social services emergency fund
(including transfer of funds)
For an additional amount for ``Public Health and Social Services
Emergency Fund'', $75,000,000,000, to remain available until expended,
to prevent, prepare for, and respond to coronavirus, domestically or
internationally, for necessary expenses to reimburse, through grants or
other mechanisms, eligible health care providers for health care
related expenses or lost revenues that are attributable to coronavirus:
Provided, That these funds may not be used to reimburse expenses or
losses that have been reimbursed from other sources or that other
sources are obligated to reimburse:  Provided further, That recipients
of payments under this paragraph in this Act shall submit reports and
maintain documentation as the Secretary of Health and Human Services
(referred to in this paragraph as the ``Secretary'') determines are
needed to ensure compliance with conditions that are imposed by this
paragraph in this Act for such payments, and such reports and
documentation shall be in such form, with such content, and in such
time as the Secretary may prescribe for such purpose:  Provided
further, That ``eligible health care providers'' means public entities,
Medicare or Medicaid enrolled suppliers and providers, and such for-
profit entities and not-for-profit entities not otherwise described in
this proviso as the Secretary may specify, within the United States
(including territories), that provide diagnoses, testing, or care for
individuals with possible or actual cases of COVID-19:  Provided
further, That the Secretary shall, on a rolling basis, review
applications and make payments under this paragraph in this Act:
Provided further, That funds appropriated under this paragraph in this
Act shall be available for building or construction of temporary
structures, leasing of properties, medical supplies and equipment
including personal protective equipment and testing supplies, increased
workforce and trainings, emergency operation centers, retrofitting
facilities, and surge capacity:  Provided further, That, in this
paragraph, the term ``payment'' means a pre-payment, prospective
payment, or retrospective payment, as determined appropriate by the
Secretary:  Provided further, That payments under this paragraph in
this Act shall be made in consideration of the most efficient payment
systems practicable to provide emergency payment:  Provided further,
That to be eligible for a payment under this paragraph in this Act, an
eligible health care provider shall submit to the Secretary an
application that includes a statement justifying the need of the
provider for the payment and the eligible health care provider shall
have a valid tax identification number:  Provided further, That, not
later than 3 years after final payments are made under this paragraph
in this Act, the Office of Inspector General of the Department of
Health and Human Services shall transmit a final report on audit
findings with respect to this program to the Committees on
Appropriations of the House of Representatives and the Senate:
Provided further, That nothing in this paragraph limits the authority
of the Inspector General or the Comptroller General to conduct audits
of interim payments at an earlier date:  Provided further, That not
later than 60 days after the date of enactment of this Act, the
Secretary shall provide a report to the Committees on Appropriations of
the House of Representatives and the Senate on obligation of funds,
including obligations to such eligible health care providers summarized
by State of the payment receipt:  Provided further, That such reports
shall be updated and submitted to such Committees every 60 days until
funds are expended:  Provided further, That such amount is designated
by the Congress as being for an emergency requirement pursuant to
section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit
Control Act of 1985.
For an additional amount for ``Public Health and Social Services
Emergency Fund'', $25,000,000,000, to remain available until expended,
to prevent, prepare for, and respond to coronavirus, domestically or
internationally, for necessary expenses to research, develop, validate,
manufacture, purchase, administer, and expand capacity for COVID-19
tests to effectively monitor and suppress COVID-19, including tests for
both active infection and prior exposure, including molecular, antigen,
and serological tests, the manufacturing, procurement and distribution
of tests, testing equipment and testing supplies, including personal
protective equipment needed for administering tests, the development
and validation of rapid, molecular point-of-care tests, and other
tests, support for workforce, epidemiology, to scale up academic,
commercial, public health, and hospital laboratories, to conduct
surveillance and contact tracing, support development of COVID-19
testing plans, and other related activities related to COVID-19
testing:  Provided, That of the amount appropriated under this
paragraph in this Act, not less than $11,000,000,000 shall be for
States, localities, territories, tribes, tribal organizations, urban
Indian health organizations, or health service providers to tribes for
necessary expenses to develop, purchase, administer, process, and
analyze COVID-19 tests, including support for workforce, epidemiology,
use by employers or in other settings, scale up of testing by public
health, academic, commercial, and hospital laboratories, and community-
based testing sites, health care facilities, and other entities engaged
in COVID-19 testing, conduct surveillance, trace contacts, and other
related activities related to COVID-19 testing:  Provided further, That
of the amount identified in the preceding proviso, not less than
$2,000,000,000 shall be allocated to States, localities, and
territories according to the formula that applied to the Public Health
Emergency Preparedness cooperative agreement in fiscal year 2019, not
less than $4,250,000,000 shall be allocated to States, localities, and
territories according to a formula methodology that is based on
relative number of cases of COVID-19, and not less than $750,000,000
shall be allocated in coordination with the Director of the Indian
Health Service, to tribes, tribal organizations, urban Indian health
organizations, or health service providers to tribes:  Provided
further, That the Secretary of Health and Human Services (referred to
in this paragraph as the ``Secretary'') may satisfy the funding
thresholds outlined in the first and second provisos under this
paragraph in this Act by making awards through other grant or
cooperative agreement mechanisms:  Provided further, That not later
than 30 days after the date of enactment of this Act, the Governor or
designee of each State, locality, territory, tribe, or tribal
organization receiving funds pursuant to this Act shall submit to the
Secretary its plan for COVID-19 testing, including goals for the
remainder of calendar year 2020, to include: (1) the number of tests
needed, month-by-month, to include diagnostic, serological, and other
tests, as appropriate; (2) month-by-month estimates of laboratory and
testing capacity, including related to workforce, equipment and
supplies, and available tests; and (3) a description of how the State,
locality, territory, tribe, or tribal organization will use its
resources for testing, including as it relates to easing any COVID-19
community mitigation policies:  Provided further, That the Secretary
shall submit such formula methodology identified in the first proviso
under this paragraph in this Act to the Committees on Appropriations of
the House of Representatives and the Senate one day prior to awarding
such funds:  Provided further, That such funds identified in the first
and second provisos under this paragraph in this Act shall be allocated
within 30 days of the date of enactment of this Act:  Provided further,
That of the amount appropriated under this paragraph in this Act, not
less than $1,000,000,000 shall be transferred to the ``Centers for
Disease Control and Prevention--CDC-Wide Activities and Program
Support'' for surveillance, epidemiology, laboratory capacity
expansion, contact tracing, public health data surveillance and
analytics infrastructure modernization, disseminating information about
testing, and workforce support necessary to expand and improve COVID-19
testing:  Provided further, That of the amount appropriated under this
paragraph in this Act, not less than $306,000,000 shall be transferred
to the ``National Institutes of Health--National Cancer Institute'' to
develop, validate, improve, and implement serological testing and
associated technologies for the purposes specified under this paragraph
in this Act:  Provided further, That of the amount appropriated under
this paragraph in this Act, not less than $500,000,000 shall be
transferred to the ``National Institutes of Health--National Institute
of Biomedical Imaging and Bioengineering'' to accelerate research,
development, and implementation of point of care and other rapid
testing related to coronavirus:  Provided further, That of the amount
appropriated under this paragraph in this Act, not less than
$1,000,000,000 shall be transferred to the ``National Institutes of
Health--Office of the Director'' to develop, validate, improve, and
implement testing and associated technologies; to accelerate research,
development, and implementation of point of care and other rapid
testing; and for partnerships with governmental and non-governmental
entities to research, develop, and implement the activities outlined in
this proviso:  Provided further, That funds in the preceding proviso
may be transferred to the accounts of the Institutes and Centers of the
National Institutes of Health (referred to in this paragraph as the
``NIH'') for the purposes specified in the preceding proviso:  Provided
further, That the transfer authority provided in the preceding proviso
is in addition to all other transfer authority available to the NIH:
Provided further, That of the amount appropriated under this paragraph
in this Act, not less than $1,000,000,000 shall be available to the
Biomedical Advanced Research and Development Authority for necessary
expenses of advanced research, development, manufacturing, production,
and purchase of diagnostic, serologic, or other COVID-19 tests or
related supplies, and other activities related to COVID-19 testing at
the discretion of the Secretary:  Provided further, That of the amount
appropriated under this paragraph in this Act, $22,000,000, shall be
transferred to the ``Department of Health and Human Services--Food and
Drug Administration--Salaries and Expenses'' to support activities
associated with diagnostic, serological, antigen, and other tests, and
related administrative activities:  Provided further, That the amount
appropriated under this paragraph in this Act may be used for grants
for the rent, lease, purchase, acquisition, construction, alteration,
renovation, or equipping of non-federally owned facilities to improve
preparedness and response capability at the State and local level for
diagnostic, serologic, or other COVID-19 tests, or related supplies:
Provided further, That the amount appropriated under this paragraph in
this Act may be used for construction, alteration, renovation, or
equipping of non-federally owned facilities for the production of
diagnostic, serologic, or other COVID-19 tests, or related supplies,
where the Secretary determines that such a contract is necessary to
secure, or for the production of, sufficient amounts of such tests or
related supplies:  Provided further, That funds appropriated under this
paragraph in this Act may be used for purchase of medical supplies and
equipment, including personal protective equipment and testing supplies
to be used for administering tests, increased workforce and trainings,
emergency operation centers, and surge capacity for diagnostic,
serologic, or other COVID-19 tests, or related supplies:  Provided
further, That products purchased with funds appropriated under this
paragraph in this Act may, at the discretion of the Secretary, be
deposited in the Strategic National Stockpile under section 319F-2 of
the Public Health Service Act:  Provided further, That of the amount
appropriated under this paragraph in this Act, $600,000,000 shall be
transferred to ``Health Resources and Services Administration--Primary
Health Care'' for grants under the Health Centers program, as defined
by section 330 of the Public Health Service Act, and for grants to
federally qualified health centers, as defined in section
1861(aa)(4)(B) of the Social Security Act:  Provided further, That
sections 330(e)(6)(A)(iii), 330(e)(6)(B)(iii), and 330(r)(2)(B) of the
Public Health Service Act shall not apply to funds provided under the
previous proviso:  Provided further, That of the amount appropriated
under this paragraph in this Act, $225,000,000 shall be used to provide
additional funding for COVID-19 testing and related expenses, through
grants or other mechanisms, to rural health clinics as defined in
section 1861(aa)(2) of the Social Security Act, with such funds also
available to such entities for building or construction of temporary
structures, leasing of properties, and retrofitting facilities as
necessary to support COVID-19 testing:  Provided further, That such
funds shall be distributed using the procedures developed for the
Provider Relief Fund authorized under the third paragraph under this
heading in division B of the Coronavirus Aid, Relief, and Economic
Security Act (Public Law 116-136); may be distributed using contracts
or agreements established for such program; and shall be subject to the
process requirements applicable to such program:  Provided further,
That the Secretary may specify a minimum amount for each eligible
entity accepting assistance under the two previous provisos:  Provided
further, That up to $1,000,000,000 of funds provided under this
paragraph in this Act may be used to cover the cost of testing for the
uninsured, using the definitions applicable to funds provided under
this heading in Public Law 116-127:  Provided further, That not later
than 21 days after the date of enactment of this Act, the Secretary, in
coordination with other appropriate departments and agencies, shall
issue a report on COVID-19 testing:  Provided further, That such report
shall include data on demographic characteristics, including, in a de-
identified and disaggregated manner, race, ethnicity, age, sex,
geographic region and other relevant factors of individuals tested for
or diagnosed with COVID-19, to the extent such information is
available:  Provided further, That such report shall include
information on the number and rates of cases, hospitalizations, and
deaths as a result of COVID-19:  Provided further, That such report
shall be submitted to the Committees on Appropriations of the House and
Senate, and the Committee on Energy and Commerce of the House of
Representatives and the Committee on Health, Education, Labor, and
Pensions of the Senate, and updated and resubmitted to such Committees,
as necessary, every 30 days until the end of the COVID-19 public health
emergency first declared by the Secretary on January 31, 2020:
Provided further, That not later than 180 days after the date of
enactment of this Act, the Secretary shall issue a report on the number
of positive diagnoses, hospitalizations, and deaths as a result of
COVID-19, disaggregated nationally by race, ethnicity, age, sex,
geographic region, and other relevant factors:  Provided further, That
such report shall include epidemiological analysis of such data:
Provided further, That not later than 30 days after the date of the
enactment of this Act, the Secretary, in coordination with other
departments and agencies, as appropriate, shall report to the
Committees on Appropriations of the House and Senate, the Committee on
Energy and Commerce of the House of Representatives, and the Committee
on Health, Education, Labor, and Pensions of the Senate on a COVID-19
strategic testing plan:  Provided further, That such plan shall assist
States, localities, territories, tribes, tribal organizations, and
urban Indian health organizations, in understanding COVID-19 testing
for both active infection and prior exposure, including hospital-based
testing, high-complexity laboratory testing, point-of-care testing,
mobile-testing units, testing for employers and other settings, and
other tests as necessary:  Provided further, That such plan shall
include estimates of testing production that account for new and
emerging technologies, as well as guidelines for testing:  Provided
further, That such plan shall address how the Secretary will increase
domestic testing capacity, including testing supplies; and address
disparities in all communities:  Provided further, That such plan shall
outline Federal resources that are available to support the testing
plans of each State, locality, territory, tribe, tribal organization,
and urban Indian health organization:  Provided further, That such plan
shall be updated every 90 days until funds are expended:  Provided
further, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.
GENERAL PROVISIONS--THIS TITLE
(including transfer of funds)

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in sections 18108, 18109, and 18112 of division B of the Coronavirus
Aid, Relief, and Economic Security Act (Public Law 116-136) shall apply
to funds appropriated in this Act to the Department of Health and Human
Services.

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``Department of Health and Human Services'', except for the amounts
specified in the first paragraph and the first and second provisos in
the second paragraph under the heading ``Public Health and Social
Services Emergency Fund'', may be transferred to, and merged with,
other appropriation accounts under the headings ``Centers for Disease
Control and Prevention'', ``Public Health and Social Services Emergency
Fund'', ``Food and Drug Administration'', and ``National Institutes of
Health'' to prevent, prepare for, and respond to coronavirus following
consultation with the Office of Management and Budget:  Provided, That
the Committees on Appropriations of the House of Representatives and
the Senate shall be notified 10 days in advance of any such transfer:
Provided further, That, upon a determination that all or part of the
funds transferred from an appropriation by this Act are not necessary,
such amounts may be transferred back to that appropriation:  Provided
further, That none of the funds made available by this Act may be
transferred pursuant to the authority in section 205 of division A of
Public Law 116-94 or section 241(a) of the Public Health Service Act.

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``Public Health and Social Services Emergency Fund'', up to $6,000,000
shall be transferred to, and merged with, funds made available under
the heading ``Office of the Secretary, Office of Inspector General'',
and shall remain available until expended, for oversight of activities
supported with funds appropriated to the Department of Health and Human
Services to prevent, prepare for, and respond to coronavirus,
domestically or internationally:  Provided, That the Inspector General
of the Department of Health and Human Services shall consult with the
Committees on Appropriations of the House of Representatives and the
Senate prior to obligating such funds:  Provided further, That the
transfer authority provided by this section is in addition to any other
transfer authority provided by law.
TITLE II
INDEPENDENT AGENCIES
Small Business Administration
salaries and expenses
For an additional amount for ``Salaries and Expenses'',
$2,100,000,000, to remain available until September 30, 2021, to
prevent, prepare for, and respond to coronavirus, domestically or
internationally:  Provided, That such amount is designated by the
Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control
Act of 1985.
disaster loans program account
For an additional amount for ``Disaster Loans Program Account'' for
the cost of direct loans authorized by section 7(b) of the Small
Business Act, $50,000,000,000, to remain available until expended, to
prevent, prepare for, and respond to coronavirus, domestically or
internationally:  Provided, That such amount is designated by the
Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control
Act of 1985.
emergency eidl grants
For an additional amount for ``Emergency EIDL Grants'' for the cost
of emergency EIDL grants authorized by section 1110 of division A of
the CARES Act (Public Law 116-136), $10,000,000,000, to remain
available until expended, to prevent, prepare for, and respond to
coronavirus, domestically or internationally:  Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.
TITLE III
GENERAL PROVISIONS--THIS ACT

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is in addition to amounts otherwise appropriated for the fiscal year
involved.

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remain available for obligation beyond the current fiscal year unless
expressly so provided herein.

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additional amounts appropriated by this Act to appropriations accounts
shall be available under the authorities and conditions applicable to
such appropriations accounts for fiscal year 2020.

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available in this Act, or transferred pursuant to authorization granted
in this Act, may only be used to prevent, prepare for, and respond to
coronavirus.

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or another coronavirus with pandemic potential.

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being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985 shall
be available (or rescinded or transferred, if applicable) only if the
President subsequently so designates all such amounts and transmits
such designations to the Congress.

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Congress as an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control
Act of 1985 and subsequently so designated by the President, and
transferred pursuant to transfer authorities provided by this Act shall
retain such designation.
budgetary effects

e94aebaed153bc1172e6a7fa0346a916750dbabb425becea98489d18f38cfa99

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)(7) and (c)(8) of the Balanced Budget and
Emergency Deficit Control Act of 1985, the budgetary effects of this
division shall be estimated for purposes of section 251 of such Act.
This division may be cited as the ``Additional Emergency
Appropriations for Coronavirus Response''.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.

9ef29f9177eb9279f8605f36a9e742f84f2c8f8aff11aeb39436343ba70011f8

Paycheck Protection Program and Health Care Enhancement Act — HR. 266

Other Sections

DIVISION A

DIVISION B

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