[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4378 Enrolled Bill (ENR)]
H.R.4378
One Hundred Sixteenth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Thursday,
the third day of January, two thousand and nineteen
An Act
Making continuing appropriations for fiscal year 2020, 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 ``Continuing Appropriations Act, 2020,
and Health Extenders Act of 2019''.

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The table of contents of this Act is as follows:

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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.
The following sums are hereby appropriated, out of any money in
the Treasury not otherwise appropriated, and out of applicable
corporate or other revenues, receipts, and funds, for the several
departments, agencies, corporations, and other organizational units of
Government for fiscal year 2020, and for other purposes, namely:

9e79104b41a3d16d19fb774f63f5522ed4deb18fa6de7621ca6c30df9829be1b

TITLE VII

-BUDGETARY EFFECTS

operations as provided in the applicable appropriations Acts for fiscal
year 2019 and under the authority and conditions provided in such Acts,
for continuing projects or activities (including the costs of direct
loans and loan guarantees) that are not otherwise specifically provided
for in this Act, that were conducted in fiscal year 2019, and for which
appropriations, funds, or other authority were made available in the
following appropriations Acts:
(1) The Agriculture, Rural Development, Food and Drug
Administration, and Related Agencies Appropriations Act, 2019
(division B of Public Law 116-6), 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 ``the cost of direct loans,'' before ``loan guarantees''
at the beginning of the second sentence in the matter preceding the
first proviso.
(2) The Commerce, Justice, Science, and Related Agencies
Appropriations Act, 2019 (division C of Public Law 116-6), except
section 523(b)(6).
(3) The Department of Defense Appropriations Act, 2019
(division A of Public Law 115-245).
(4) The Energy and Water Development and Related Agencies
Appropriations Act, 2019 (division A of Public Law 115-244), except
section 505.
(5) The Financial Services and General Government
Appropriations Act, 2019 (division D of Public Law 116-6).
(6) The Department of Homeland Security Appropriations Act,
2019 (division A of Public Law 116-6) as amended, and title I of
division H of Public Law 116-6.
(7) The Department of the Interior, Environment, and Related
Agencies Appropriations Act, 2019 (division E of Public Law 116-6).
(8) The Departments of Labor, Health and Human Services, and
Education, and Related Agencies Appropriations Act, 2019 (division
B of Public Law 115-245).
(9) The Legislative Branch Appropriations Act, 2019 (division B
of Public Law 115-244).
(10) The Military Construction, Veterans Affairs, and Related
Agencies Appropriations Act, 2019 (division C of Public Law 115-
244).
(11) The Department of State, Foreign Operations, and Related
Programs Appropriations Act, 2019 (division F of Public Law 116-6),
except section 7058(d).
(12) The Transportation, Housing and Urban Development, and
Related Agencies Appropriations Act, 2019 (division G of Public Law
116-6).

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granted pursuant to section 101 for the Department of Defense shall be
used for:
(1) the new production of items not funded for production in
fiscal year 2019 or prior years;
(2) the increase in production rates above those sustained with
fiscal year 2019 funds; or
(3) the initiation, resumption, or continuation of any project,
activity, operation, or organization (defined as any project,
subproject, activity, budget activity, program element, and
subprogram within a program element, and for any investment items
defined as a P-1 line item in a budget activity within an
appropriation account and an R-1 line item that includes a program
element and subprogram element within an appropriation account) for
which appropriations, funds, or other authority were not available
during fiscal year 2019.
(b) No appropriation or funds made available or authority granted
pursuant to section 101 for the Department of Defense shall be used to
initiate multi-year procurements utilizing advance procurement funding
for economic order quantity procurement unless specifically
appropriated later.

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the extent and in the manner that would be provided by the pertinent
appropriations Act.

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appropriation or funds made available or authority granted pursuant to
section 101 shall be used to initiate or resume any project or activity
for which appropriations, funds, or other authority were not available
during fiscal year 2019.

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this Act shall cover all obligations or expenditures incurred for any
project or activity during the period for which funds or authority for
such project or activity are available under this Act.

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applicable appropriations Act for fiscal year 2020, appropriations and
funds made available and authority granted pursuant to this Act shall
be available until whichever of the following first occurs:
(1) The enactment into law of an appropriation for any project
or activity provided for in this Act.
(2) The enactment into law of the applicable appropriations Act
for fiscal year 2020 without any provision for such project or
activity.
(3) November 21, 2019.

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to the applicable appropriation, fund, or authorization whenever a bill
in which such applicable appropriation, fund, or authorization is
contained is enacted into law.

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authority granted pursuant to this Act may be used without regard to
the time limitations for submission and approval of apportionments set
forth in section 1513 of title 31, United States Code, but nothing in
this Act may be construed to waive any other provision of law governing
the apportionment of funds.

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section 106, for those programs that would otherwise have high initial
rates of operation or complete distribution of appropriations at the
beginning of fiscal year 2020 because of distributions of funding to
States, foreign countries, grantees, or others, such high initial rates
of operation or complete distribution shall not be made, and no grants
shall be awarded for such programs funded by this Act that would
impinge on final funding prerogatives.

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limited funding action of that permitted in the Act shall be taken in
order to provide for continuation of projects and activities.

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budget authority was provided in appropriations Acts for fiscal year
2019, and for activities under the Food and Nutrition Act of 2008,
activities shall be continued at the rate to maintain program levels
under current law, under the authority and conditions provided in the
applicable appropriations Act for fiscal year 2019, to be continued
through the date specified in section 106(3).
(b) Notwithstanding section 106, obligations for mandatory payments
due on or about the first day of any month that begins after October
2019 but not later than 30 days after the date specified in section
106(3) may continue to be made, and funds shall be available for such
payments.

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personnel compensation and benefits in each department and agency may
be apportioned up to the rate for operations necessary to avoid
furloughs within such department or agency, consistent with the
applicable appropriations Act for fiscal year 2019, except that such
authority provided under this section shall not be used until after the
department or agency has taken all necessary actions to reduce or defer
non-personnel-related administrative expenses.

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expended notwithstanding section 10 of Public Law 91-672 (22 U.S.C.
2412), section 15 of the State Department Basic Authorities Act of 1956
(22 U.S.C. 2680), section 313 of the Foreign Relations Authorization
Act, Fiscal Years 1994 and 1995 (22 U.S.C. 6212), and section 504(a)(1)
of the National Security Act of 1947 (50 U.S.C. 3094(a)(1)).

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that was previously designated by the Congress for Overseas Contingency
Operations/Global War on Terrorism or as an emergency requirement
pursuant to section 251(b)(2)(A) of the Balanced Budget and Emergency
Deficit Control Act of 1985 or as being for disaster relief pursuant to
section 251(b)(2)(D) of such Act is designated by the Congress for
Overseas Contingency Operations/Global War on Terrorism or as an
emergency requirement pursuant to section 251(b)(2)(A) of such Act or
as being for disaster relief pursuant to section 251(b)(2)(D) of such
Act, respectively.
(b) Section 5 of Public Law 116-6 shall apply to amounts designated
in subsection (a) and section 124 of this Act for Overseas Contingency
Operations/Global War on Terrorism.
(c) This section shall become effective immediately upon enactment
of this Act, and shall remain in effect through the date in section
106(3).

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authority that continue pursuant to section 101 in Treasury
Appropriations Fund Symbols (TAFS)--
(1) to which other appropriations are not provided by this Act,
but for which there is a current applicable TAFS that does receive
an appropriation in this Act; or
(2) which are no-year TAFS and receive other appropriations in
this Act,
may be continued instead by reducing the rate for operations otherwise
provided by section 101 for such current applicable TAFS, as long as
doing so does not impinge on the final funding prerogatives of the
Congress.
(b) Rescissions or cancellations described in subsection (a) shall
continue in an amount equal to the lesser of--
(1) the amount specified for rescission or cancellation in the
applicable appropriations Act referenced in section 101 of this
Act; or
(2) the amount of balances available, as of October 1, 2019,
from the funds specified for rescission or cancellation in the
applicable appropriations Act referenced in section 101 of this
Act.
(c) No later than November 11, 2019, the Director of the Office of
Management and Budget shall provide to the Committees on Appropriations
of the House of Representatives and the Senate a comprehensive list of
the rescissions or cancellations that will continue pursuant to section
101: Provided, That the information in such comprehensive list shall be
periodically updated to reflect any subsequent changes in the amount of
balances available, as of October 1, 2019, from the funds specified for
rescission or cancellation in the applicable appropriations Act
referenced in section 101, and such updates shall be transmitted to the
Committees on Appropriations of the House of Representatives and the
Senate upon request.

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for Disaster Relief Act, 2019 (Public Law 116-20) is amended in the
matter under the heading ``Department of Agriculture--Office of the
Secretary'' by inserting ``to cooperative processors for reduced
quantity and quality sugar beets,'' after ``planting in 2019,'':
Provided, That amounts repurposed pursuant to this section that were
previously designated by the Congress as an emergency requirement
pursuant to the Balanced Budget and Emergency Deficit Control Act of
1985 are designated by the 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 shall be available only if
the President subsequently so designates all such amounts and transmits
such designations to the Congress.

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funds requirement under Section 412(g) of the Agricultural Research,
Extension, and Education Reform Act of 1998 (7 U.S.C. 7632(g)).

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of Agriculture--Food and Nutrition Service--Child Nutrition Programs''
to carry out section 749(g) of the Agriculture, Rural Development, Food
and Drug Administration, and Related Agencies Appropriations Act, 2010
(Public Law 111-80) may be apportioned up to the rate for operations
necessary to ensure that the program can be fully operational by May
2020.

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Agriculture for ``Corporations--Commodity Credit Corporation Fund--
Reimbursement for Net Realized Losses'' may be used, prior to the
completion of the report described in section 2 of the Act of August
17, 1961 (15 U.S.C. 713a-11), to reimburse the Commodity Credit
Corporation for net realized losses sustained, but not previously
reimbursed, as of September 17, 2019: Provided, That the Secretary of
Agriculture shall submit a report, no later than October 31, 2019, to
the Committees on Appropriations and Agriculture of both Houses of
Congress, including estimates for all Market Facilitation Program
payments, in calendar year 2018 and 2019 and projected payments in
calendar year 2020 resulting from the calendar year 2019 program that
include State-by-State, commodity-by-commodity, including specialty
crops, analysis of the trade damage caused by retaliatory tariffs and
separately by non-tariff trade barriers, including dumping, on U.S.
agricultural producers, and an accounting of any commodity purchases
made from substantially foreign-owned companies or their subsidiaries.

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are provided for ``Department of Agriculture--Agricultural Marketing
Service--Marketing Services'' at a rate for operations of $16,496,000
to continue the implementation of the Hemp Production Program (section
10113 of Public Law 115-334).

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``International Trade Commission--Salaries and Expenses'' may be
apportioned up to the rate for operations necessary to carry out
responsibilities under the American Manufacturing Competitiveness Act
of 2016 (Public Law 114-159).

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of Commerce for ``Bureau of the Census--Periodic Censuses and
Programs'' may be apportioned up to the rate for operations necessary
to maintain the schedule and deliver the required data according to the
statutory deadlines in the 2020 Decennial Census Program.

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States Code, during the period covered by this Act, any advanced
billing for background investigation services and related services
purchased from activities financed using Defense Working Capital Funds
shall be excluded from the calculation of cumulative advance billings
under section 2208(l)(3) of such title. In the preceding sentence, the
term ``advance billing'' has the meaning given the term in section
2208(l)(4) of such title.

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September 30, 2019, from amounts provided by section 9013 of division A
of Public Law 115-245 are hereby rescinded: Provided, That such amounts
that were previously designated by the Congress as being for Overseas
Contingency Operations/Global War on Terrorism pursuant to section
251(b)(2)(A)(ii) of the Balanced Budget and Emergency Deficit Control
Act of 1985 are designated by the Congress as being for Overseas
Contingency Operations/Global War on Terrorism pursuant to that section
of that Act.
(b) In addition to the amount otherwise provided by section 101 for
the ``Ukraine Security Assistance Initiative'', there is appropriated
on September 30, 2019, for an additional amount for fiscal year 2019,
an amount equal to the unobligated balances rescinded pursuant to
subsection (a) of this section: Provided, That amounts made available
pursuant to this subsection shall remain available until September 30,
2020, and shall be available for the same purposes and under the same
authorities for which they were originally provided in Public Law 115-
245: Provided further, That such amount is designated by the Congress
as being for Overseas Contingency Operations/Global War on Terrorism
pursuant to section 251(b)(2)(A)(ii) of the Balanced Budget and
Emergency Deficit Control Act of 1985.
(c) This section shall become effective immediately upon enactment
of this Act.
(d) If this Act is enacted after September 30, 2019, or if the
designation in subsection 114(b) occurs after September 30, 2019, this
section shall be applied as if it were in effect on September 30, 2019.

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``Department of Energy--Power Marketing Administration--Colorado River
Basins Power Marketing Fund, Western Area Power Administration'' to the
general fund of the Treasury in fiscal year 2019.
(b) This section shall become effective immediately upon enactment
of this Act.

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Law 108-361, as amended (the Calfed Bay-Delta Authorization Act) (118
Stat. 1681), shall be applied by substituting ``2020'' for ``2019''
each place it appears.

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Public Law 116-6 shall be applied by adding the following new heading
and appropriation language under the heading ``Department of the
Treasury--Departmental Offices'':
``COMMITTEE ON FOREIGN INVESTMENT IN THE UNITED STATES FUND
``For necessary expenses of the Committee on Foreign Investment in
the United States, $15,000,000, to remain available until expended:
Provided, That the chairperson of the Committee may transfer such
amounts to any department or agency represented on the Committee
(including the Department of the Treasury) subject to advance
notification to the Committees on Appropriations of the House of
Representatives and the Senate: Provided further, That amounts so
transferred shall remain available until expended for expenses of
implementing section 721 of the Defense Production Act of 1950, as
amended (50 U.S.C. 4565), and shall be available in addition to any
other funds available to any department or agency: Provided further,
That fees authorized by section 721(p) of such Act shall be credited to
this appropriation as offsetting collections: Provided further, That
the total amount appropriated pursuant to this section from the general
fund shall be reduced as such offsetting collections are received
during this fiscal year, so as to result in a total appropriation from
the general fund estimated at not more than $5,000,000.''.

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section 106, the District of Columbia may expend local funds made
available under the heading ``District of Columbia--District of
Columbia Funds'' for such programs and activities under the District of
Columbia Appropriations Act, 2019 (title IV of division D of Public Law
116-6) at the rate set forth in the Fiscal Year 2020 Local Budget Act
of 2019 (D.C. Act 23-78), as modified as of the date of enactment of
this Act.

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are provided to the Office of Personnel Management for ``Salaries and
Expenses'' at a rate for operations of $48,000,000, for an additional
amount for administrative expenses: Provided, That of such amounts,
$29,760,000 shall be transferred from the appropriate trust funds of
the Office without regard to any other provision of law: Provided
further, That such amounts may be apportioned up to the rate for
operations necessary to maintain agency operations.

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first proviso under the heading ``Small Business Administration--
Business Loans Program Account'' in title V of division D of Public Law
116-6 shall be applied as if the following were inserted before the
colon: ``, and for the cost of guaranteed loans as authorized by
section 7(a) of the Small Business Act (Public Law 83-163),
$99,000,000, to remain available until expended'': Provided, That
amounts made available under such heading by this Act may be
apportioned up to the rate for operations necessary to accommodate
increased demand for commitments for general business loans authorized
under section 7(a) of the Small Business Act (15 U.S.C. 636(a)).

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``Small Business Administration--Disaster Loans Program Account'' at a
rate for operations of $177,136,000: Provided, That amounts made
available under such heading by this Act may be apportioned up to the
rate for operations necessary to accommodate increased demand for
commitments for disaster administrative expenses authorized under
section 20(a) of the Small Business Act (15 U.S.C. 631): Provided
further, That the language under such heading in title V of division D
of Public Law 116-6 shall be applied by--
(1) substituting ``$1,600,000'' for ``$1,000,000'';
(2) substituting ``$8,400,000'' for ``$9,000,000''; and
(3) inserting the following before the period: ``; and of which
$167,136,000 is for direct administrative expenses of loan making
and servicing to carry out the direct loan program, which may be
transferred to and merged with the appropriations for Salaries and
Expenses: Provided, That, of the funds provided under this heading,
$150,888,000 shall be for major disasters declared pursuant to the
Robert T. Stafford Disaster Relief and Emergency Assistance Act (42
U.S.C. 5122(2)): Provided further, That the amount for major
disasters under this heading is designated by Congress as being for
disaster relief pursuant to section 251(b)(2)(D) of the Balanced
Budget and Emergency Deficit Control Act of 1985 (Public Law 99-
177)''.

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of Homeland Security for ``United States Secret Service--Operations and
Support'' may be apportioned up to the rate for operations necessary to
support hiring and operations required for protective activities
associated with the 2020 presidential election campaign.

02f8e0eec0359b7e7aa383ee294d7627c5ca88b6a60c0e5881420018844daa9a

of Homeland Security for ``Federal Emergency Management Agency--
Disaster Relief Fund'' may be apportioned up to the rate for operations
necessary to carry out response and recovery activities under the
Robert T. Stafford Disaster Relief and Emergency Assistance Act (42
U.S.C. 5121 et seq.).

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Insurance Act of 1968 (42 U.S.C. 4016(a) and 4026) shall be applied by
substituting the date specified in section 106(3) of this Act for
``September 30, 2019''.
(b) If this Act is enacted after September 30, 2019, this section
shall be applied as if it were in effect on September 30, 2019.

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of Homeland Security for ``Office of the Secretary and Executive
Management--Operations and Support'', ``Management Directorate--
Operations and Support'', and ``Intelligence, Analysis, and Operations
Coordination--Operations and Support'' may be apportioned up to the
rate for operations necessary to carry out activities previously funded
by the Working Capital Fund of the Department of Homeland Security,
consistent with the fiscal year 2020 President's Budget.

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amounts are provided to the ``Department of Health and Human Services--
Indian Health Service--Indian Health Services'' at a rate for
operations of $18,397,500, for an additional amount for costs of
staffing and operating facilities that were opened, renovated, or
expanded in fiscal years 2019 and 2020, and such amounts may be
apportioned up to the rate for operations necessary to staff and
operate such facilities.
(b) In addition to amounts provided by section 101, amounts are
provided for ``Department of Health and Human Services--Indian Health
Service--Indian Health Facilities'' at a rate for operations of
$631,000, for an additional amount for costs of staffing and operating
facilities that were opened, renovated, or expanded in fiscal years
2019 and 2020, and such amounts may be apportioned up to the rate for
operations necessary to staff and operate such facilities.

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of Health and Human Services for ``Centers for Disease Control and
Prevention--Public Health Preparedness and Response'' and ``Office of
the Secretary--Public Health and Social Services Emergency Fund'' may
be obligated in the account and budget structure, and under the
authorities and conditions, set forth in H.R. 2740, as passed by the
U.S. House of Representatives on June 19, 2019.

9fd0a52ad3650662b3faf514f45aa434820a068f3a1b1027758688824cb03dce

of the unobligated amounts in the Infectious Diseases Rapid Response
Reserve Fund established by section 231 of division B of Public Law
115-245 may be transferred to ``Department of Health and Human
Services--Centers for Disease Control and Prevention--CDC-Wide
Activities and Program Support'' and shall be available until expended
for Ebola preparedness and response activities without regard to the
limitations in the third proviso in such section 231: Provided, That
the Director of the Centers for Disease Control and Prevention may
transfer such amounts to any of the appropriations accounts under the
heading ``Centers for Disease Control and Prevention'' for Ebola
response activities: Provided further, That such transfer authority
shall be in addition to any other transfer authority provided to the
Department of Health and Human Services.

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U.S.C. 1011c(f)) shall be applied by substituting the date specified in
section 106(3) of this Act for ``September 30, 2019''.

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of Veterans Affairs--Veterans Benefits Administration--General
Operating Expenses, Veterans Benefits Administration'' and ``Department
of Veterans Affairs--Departmental Administration--Information
Technology Systems'' may be apportioned up to the rate for operations
necessary to support projects and activities created by the Blue Water
Navy Vietnam Veterans Act of 2019 (Public Law 116-23).

e39c28f1031c3ef7a150b99a8690333e9e08c0bdc3efabc25772d383980282c4

U.S.C. 635f) shall be applied by substituting the date specified in
section 106(3) of this Act for ``September 30, 2019''.

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of 1998 (22 U.S.C. 6436) shall be applied by substituting the date
specified in section 106(3) of this Act for ``September 30, 2019''.

3507ec75af0b0de46c96c935b8c4e449baa07b481cf0542654e246c6589a9658

of division G of Public Law 116-6 shall be amended in the first
provisos in each Act under the headings ``Department of
Transportation--Federal Transit Administration--Capital Investment
Grants'' by striking ``obligated'' and inserting ``allocated''.

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shall not apply during the period covered by this Act.

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of Housing and Urban Development for ``Housing Programs--Housing for
the Elderly'' may be apportioned up to the rate for operations
necessary to maintain project rental assistance for the elderly under
section 202(c)(2) of the Housing Act of 1959 (12 U.S.C. 1701q(c)(2)),
including making amendments to contracts for such assistance and
renewing expiring contracts for such assistance for up to a 1-year
term.
This division may be cited as the ``Continuing Appropriations Act,
2020''.

d5e456bf84884d92cabd5e3054db137486f9e5454cb81b882fbe18791a92ffcf

SERVICE CORPS, AND TEACHING HEALTH CENTERS THAT OPERATE GME PROGRAMS.
(a) 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))
is amended by striking ``2018 and $4,000,000,000 for fiscal year
2019.'' and inserting ``2018, $4,000,000,000 for fiscal year 2019, and
$569,863,014 for the period beginning on October 1, 2019, and ending on
November 21, 2019; and''.
(b) National Health Service Corps.--Section 10503(b)(2) of the
Patient Protection and Affordable Care Act (42 U.S.C. 254b-2(b)(2)) is
amended--
(1) in subparagraph (E), by striking ``; and'' and inserting a
semicolon;
(2) in subparagraph (F), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following:
``(G) $44,164,384 for the period beginning on October 1,
2019, and ending on November 21, 2019.''.
(c) 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)(1)) is amended--
(1) by striking ``and $126,500,000'' and inserting
``$126,500,000''; and
(2) by inserting ``and $18,021,918 for the period beginning on
October 1, 2019, and ending on November 21, 2019,'' before ``to
remain available''.
(d) Application of Provisions.--Amounts appropriated pursuant to
this section for the period beginning on October 1, 2019, and ending on
November 21, 2019, shall be subject to the requirements contained in
Public Law 115-245 for funds for programs authorized under sections 330
through 340 of the Public Health Service Act (42 U.S.C. 254 through
256).
(e) Conforming Amendment.--Paragraph (4) of section 3014(h) of
title 18, United States Code, as amended by section 50901 of Public Law
115-123, is amended by striking ``and section 50901(e) of the Advancing
Chronic Care, Extenders, and Social Services Act'' and inserting ``,
section 50901(e) of the Advancing Chronic Care, Extenders, and Social
Services Act, and section 1101(d) of division B of the Continuing
Appropriations Act, 2020, and Health Extenders Act of 2019''.

956bf55ae30f649cd59b0cfae411a69557429c260c39d52a39c58d5305ab3e40

TITLE I

-PUBLIC HEALTH EXTENDERS

(a) Type I.--Section 330B(b)(2)(D) of the Public Health Service Act
(42 U.S.C. 254c-2(b)(2)(D)) is amended by inserting ``and $21,369,863
for the period beginning on October 1, 2019, and ending on November 21,
2019,'' before ``to remain available''.
(b) Indians.--Section 330C(c)(2)(D) of the Public Health Service
Act (42 U.S.C. 254c-3(c)(2)(D)) is amended by inserting ``and
$21,369,863 for the period beginning on October 1, 2019, and ending on
November 21, 2019,'' before ``to remain available''.

ccd86cf31ce5c39928f202b14a36aa24fd40203ced4edf866fdb493ac880b3ab

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 subparagraph (A)--
(I) by inserting after ``for each of fiscal years
2018 and 2019'' the following: ``and for the period
beginning October 1, 2019, and ending November 21,
2019''; and
(II) by inserting after ``for the fiscal year'' the
following: ``(or, with respect to such period, for
fiscal year 2020)''; and
(ii) in subparagraph (A), by striking ``for the fiscal
year'' each place it appears and inserting ``for the fiscal
year or period'' in each such place; and
(B) in paragraph (2)--
(i) in subparagraph (A)--
(I) by inserting after ``for each of fiscal years
2018 and 2019'' the following: ``and for the period
beginning October 1, 2019, and ending November 21,
2019''; and
(II) by inserting after ``for the fiscal year'' the
following: ``(or, with respect to such period, for
fiscal year 2020)''; and
(ii) in subparagraph (B)(i), by inserting after ``for
the fiscal year'' the following: ``(or, with respect to
such period, for fiscal year 2020)''; and
(2) in subsection (f)--
(A) in paragraph (1), by inserting after ``for each of
fiscal years 2018 and 2019'' the following: ``and $10,684,931
for the period beginning October 1, 2019, and ending November
21, 2019''; and
(B) in paragraph (2), by inserting after ``for each of
fiscal years 2018 and 2019'' the following: ``and for the
period described in paragraph (1)''.

5e851c99cccd8704b7fa9c857a5395314b16b624525ffcd840545e389b5dfa8d

TITLE II

-OTHER HEALTH EXTENDERS

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 after ``for each of fiscal years 2010 through
2019'' the following: ``and for the period beginning
October 1, 2019, and ending November 21, 2019''; and
(II) in clause (i), by inserting after ``for the
fiscal year'' the following: ``or period'';
(ii) in subparagraph (B)(i), by adding at the end the
following new sentence: ``The previous sentence shall not
apply with respect to State allotments under this paragraph
for the period beginning October 1, 2019, and ending
November 21, 2019.''; and
(iii) in subparagraph (C)(i)--
(I) by inserting after ``for a fiscal year'' the
following: ``or the period described in subparagraph
(A)''; and
(II) by inserting after ``for the fiscal year'' the
following: ``or period'';
(B) in paragraph (3)--
(i) by inserting after ``for a fiscal year'' the
following: ``or the period described in paragraph (1)(A)'';
and
(ii) by striking ``the end of the second succeeding
fiscal year'' and inserting ``the end of the second fiscal
year following such fiscal year or period''; and
(C) in paragraph (4)--
(i) in subparagraph (A)--
(I) by inserting after ``for each of fiscal years
2010 through 2019'' the following: ``and for the period
described in paragraph (1)(A)'';
(II) by inserting after ``for each of fiscal years
2012 through 2019'' the following: ``and for the period
so described''; and
(III) by inserting after ``for a fiscal year'' the
following: ``or the period so described''; and
(ii) in subparagraph (B)(i), by striking ``continue
through fiscal year 2019'' and inserting ``continue through
the period described in paragraph (1)(A)'';
(2) in subsection (c)--
(A) in paragraph (1), by striking ``From the amount'' and
inserting ``Subject to paragraph (3), from the amount'';
(B) in paragraph (2), by striking ``From the amount'' and
inserting ``Subject to paragraph (3), from the amount''; and
(C) by adding at the end the following new paragraph:
``(3) Exception.--Paragraphs (1) and (2) shall not apply with
respect to any amount appropriated under subsection (f) for the
period described in subsection (a)(1)(A).''; and
(3) in subsection (f), by inserting after ``for each of fiscal
years 2010 through 2019'' the following: ``and $10,684,931 for the
period beginning October 1, 2019, and ending November 21, 2019''.

de3404ef8978b3ff9333354fd82acfbbb9e26ca73e75ef0701edbbdf34bf56b3

PROGRAM.
Section 223(d)(3) of the Protecting Access to Medicare Act of 2014
(42 U.S.C. 1396a note) is amended by striking ``September 13, 2019''
and inserting ``November 21, 2019''.

b67abfee8bc6f435bb54539d3cbc9e3f33617ee3b945c6a9d32ce8327a45d1d4

TITLE III

-MEDICAID EXTENDERS

FOR TERRITORIES UNDER MEDICAID PROGRAM.
Section 1905 of the Social Security Act (42 U.S.C. 1396d) is
amended--
(1) in subsection (b), by striking ``and (aa)'' and inserting
``(aa), and (ff)''; and
(2) by adding at the end the following new subsection:
``(ff) Temporary Increase in FMAP for Territories.--Notwithstanding
subsection (b) or (z)(2), the Federal medical assistance percentage for
Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands,
and American Samoa shall be equal to 100 percent for the period
beginning October 1, 2019, and ending November 21, 2019.''.

f51bd2d327bdabcdecf4c8ab5efaf2df149eebc4ed2613cb3f8a01269956bd73

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), in the matter preceding subclause (I), by
striking ``For each of fiscal years 2020 through 2025'' and
inserting ``For the period beginning November 22, 2019, and ending
September 30, 2020, and for each of fiscal years 2021 through
2025''; and
(2) in clause (ii)(I), by striking ``for fiscal year 2020'' and
inserting ``for the period beginning November 22, 2019, and ending
September 30, 2020''.

0d897c5f69b72ce15855a7a8d9726ad34c29a8a2432778e3827d986891406a08

AND SELECTION.
Section 1890(d)(2) of the Social Security Act (42 U.S.C.
1395aaa(d)(2)) is amended--
(1) in the first sentence--
(A) by striking ``and $7,500,000'' and inserting
``$7,500,000''; and
(B) by inserting before the period at the end the
following: ``, and $1,069,000 for the period beginning on
October 1, 2019, and ending on November 21, 2019''; and
(2) in the third sentence, by inserting ``and for the period
beginning on October 1, 2019, and ending on November 21, 2019,''
after ``2019''.

3864591834d998c7147ffb1b3b8e9b24784fcf5b21f9572b0705c4a927ada59a

TITLE IV

-MEDICARE EXTENDERS

PROGRAMS.
(a) Additional Funding for State Health Insurance Programs.--
Subsection (a)(1)(B) of section 119 of the Medicare Improvements for
Patients and Providers Act of 2008 (42 U.S.C. 1395b-3 note), as amended
by section 3306 of the Patient Protection and Affordable Care Act
(Public Law 111-148), section 610 of the American Taxpayer Relief Act
of 2012 (Public Law 112-240), section 1110 of the Pathway for SGR
Reform Act of 2013 (Public Law 113-67), section 110 of the Protecting
Access to Medicare Act of 2014 (Public Law 113-93), section 208 of the
Medicare Access and CHIP Reauthorization Act of 2015 (Public Law 114-
10), and section 50207 of division E of the Bipartisan Budget Act of
2018 (Public Law 115-123), is amended--
(1) in clause (vii), by striking ``and'' at the end;
(2) in clause (viii), by striking ``and'' at the end;
(3) in clause (ix), by striking the period at the end and
inserting ``; and''; and
(4) by inserting after clause (ix) the following new clause:
``(x) for the period beginning on October 1, 2019, and
ending on November 21, 2019, of $1,852,000.''.
(b) Additional Funding for Area Agencies on Aging.--Subsection
(b)(1)(B) of such section 119, as so amended, is amended--
(1) in clause (vii), by striking ``and'' at the end;
(2) in clause (viii), by striking ``and'' at the end;
(3) in clause (ix), by striking the period at the end and
inserting ``; and''; and
(4) by inserting after clause (ix) the following new clause:
``(x) for the period beginning on October 1, 2019, and
ending on November 21, 2019, of $1,069,000.''.
(c) Additional Funding for Aging and Disability Resource Centers.--
Subsection (c)(1)(B) of such section 119, as so amended, is amended--
(1) in clause (vii), by striking ``and'' at the end;
(2) in clause (viii), by striking ``and'' at the end;
(3) in clause (ix), by striking the period at the end and
inserting ``; and''; and
(4) by inserting after clause (ix) the following new clause:
``(x) for the period beginning on October 1, 2019, and
ending on November 21, 2019, of $712,000.''.
(d) Additional Funding for Contract With the National Center for
Benefits and Outreach Enrollment.--Subsection (d)(2) of such section
119, as so amended, is amended--
(1) in clause (vii), by striking ``and'' at the end;
(2) in clause (viii), by striking ``and'' at the end;
(3) in clause (ix), by striking the period at the end and
inserting ``; and''; and
(4) by inserting after clause (ix) the following new clause:
``(x) for the period beginning on October 1, 2019, and
ending on November 21, 2019, of $1,710,000.''.

84050fd844722fa5efa01f193981db08acc873718b05c8969eb7e978e44746ff

RESEARCH TRUST FUND.
Section 9511(f) of the Internal Revenue Code of 1986 is amended by
striking ``September 30'' and inserting ``November 21''.

049dc0b2da8b9c3f656cb7822e6b3a622cfefee8d4945f071a350b4da5a56d30

PROFESSIONS WORKFORCE NEEDS.
Activities authorized by section 2008 of the Social Security Act
shall continue through November 21, 2019, in the manner authorized for
fiscal year 2019, 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. Grants and payments may be
made pursuant to this authority through the date so specified at the
pro rata portion of the total amount authorized for such activities in
fiscal year 2019.

5b3741e9fc7a6490ad87d9d30fbfca589236cabb944af93cfc6d15eb1b9821cb

TITLE V

-HUMAN SERVICES EXTENDERS

PROGRAM AND RELATED PROGRAMS.
Activities authorized by part A of title IV and section 1108(b) of
the Social Security Act shall continue through November 21, 2019, in
the manner authorized for fiscal year 2019, 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.

1625e9199d78daf9401b122dd89b5f8404413e2d59c5d8d1bb50064c3968bbbc

Section 424(a) of the Consolidated Appropriations Act, 2014 (Public
Law 113-76), as amended by section 428 of the Consolidated
Appropriations Act, 2018 (Public Law 115-141), shall be applied by
substituting ``November 21, 2019'' for ``October 1, 2019''.

f582d0e6f7fc12cafc4110f8a65740fd8fecb20585445f438eda32f2afa4dd7b

TITLE VI

-MISCELLANEOUS POLICIES

HEALTH PROGRAM.
(a) World Trade Center Responders.--Section 3311(a)(4)(A) of the
Public Health Service Act (42 U.S.C. 300mm-21(a)(4)(A)) is amended by
striking ``25,000'' and inserting ``75,000''.
(b) World Trade Center Survivors.--Section 3321(a)(3)(A) of the
Public Health Service Act (42 U.S.C. 300mm-31(a)(3)(A)) is amended by
striking ``25,000'' and inserting ``75,000''.
(c) Rule of Construction Regarding Annual Funding Limitations.--
Nothing in this section, or the amendments made by this section, shall
alter the annual limitations on amounts appropriated to the World Trade
Center Health Program Fund under section 3351(a)(2) of the Public
Health Service Act (42 U.S.C. 300mm-61(a)(2)).

f00ee4d6ba448c6c18aa94e76db31fbab10802998d3e2f2d4fd00b0057b2d28e

AVERAGE MANUFACTURER PRICE FOR PURPOSES OF THE MEDICAID DRUG REBATE
PROGRAM; EXCLUDING MANUFACTURERS FROM DEFINITION OF WHOLESALER.
(a) In General.--Subparagraph (C) of section 1927(k)(1) of the
Social Security Act (42 U.S.C. 1396r-8(k)(1)) is amended--
(1) in the subparagraph heading, by striking ``INCLUSION'' and
inserting ``EXCLUSION'';
(2) by striking ``a new drug application'' and inserting ``the
manufacturer's new drug application''; and
(3) by striking ``inclusive'' and inserting ``exclusive''.
(b) Excluding Manufacturers From Definition of Wholesaler.--Section
1927(k)(11) of the Social Security Act (42 U.S.C. 1396r-8(k)(11)) is
amended--
(1) by striking ``manufacturers,''; and
(2) by striking ``manufacturer's and''.
(c) Effective Date.--The amendments made by this section shall take
effect on the first day of the first fiscal quarter that begins after
the date of enactment of this Act.

4e63b36852e327a55eefbbb5cf741b62334ae3e5fd7b5de02c6315a96e4eed32

Section 1941(b) of the Social Security Act (42 U.S.C. 1396w-1(b)),
as amended by section 2 of Public Law 116-29, is amended--
(1) in paragraph (1), by striking ``$1,000,000'' and inserting
``$0''; and
(2) in paragraph (3)--
(A) by striking ``2023'' each place it appears and
inserting ``2025''; and
(B) in subparagraph (A), by striking ``$0'' and inserting
``$2,387,000,000''.

47360e2f890a6ad19995c72d002affec2f68eb50a29193c4f8d356dc1a581fab

(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; and
(2) 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.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.

ecc99f6a169a84abe0dbb3c2c2fa33c0d929e8fac185bf10556660faeccc1d18

Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 — HR. 4378

Other Sections

DIVISION B / TITLE VII

DIVISION A

DIVISION B / TITLE I

DIVISION B / TITLE II

DIVISION B / TITLE III

DIVISION B / TITLE IV

DIVISION B / TITLE V

DIVISION B / TITLE VI

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