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<dc:title>117 S4472 ES: Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<congress display="yes">119th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">S. 4472</legis-num><current-chamber display="no">IN THE SENATE OF THE UNITED STATES</current-chamber><legis-type display="yes">AN ACT</legis-type><official-title display="yes">To amend the Accelerating Access to Critical Therapies for ALS Act to reauthorize the provisions of such Act through fiscal year 2031, and for other purposes.</official-title></form><legis-body style="OLC" display-enacting-clause="yes-display-enacting-clause"><section section-type="section-one" id="id761ff24a-7560-4af8-baad-3e08ae4f9c9c" changed="not-changed" commented="no" display-inline="no-display-inline"><enum>1.</enum><header display-inline="yes-display-inline">Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026</short-title></quote>.</text></section><section id="idaf128bb6-04e8-4f7a-9010-4dde68941bc0" changed="not-changed" commented="no" display-inline="no-display-inline" section-type="subsequent-section"><enum>2.</enum><header display-inline="yes-display-inline">Reauthorization of Accelerating Access to Critical Therapies for ALS Act</header><subsection id="id2020fcca-cbbe-4f26-9475-4ab163696426" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 7 of the Accelerating Access to Critical Therapies for ALS Act (<external-xref legal-doc="public-law" parsable-cite="pl/117/79">Public Law 117–79</external-xref>) is amended by striking <quote>2022 through 2026</quote> and inserting <quote>2027 through 2031</quote>.</text></subsection><subsection id="id5e743fbc-2534-4e04-99f5-61dd3d8c8930" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(b)</enum><header display-inline="yes-display-inline">Grants for ALS research</header><text display-inline="yes-display-inline">Section 2(f) of the Accelerating Access to Critical Therapies for ALS Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360ee">21 U.S.C. 360ee</external-xref> note) is amended by striking <quote>2026</quote> and inserting <quote>2031</quote>. </text></subsection></section><section id="id4c777c4e-8d1c-445c-ae87-7a3287d9e5e9" changed="not-changed" commented="no" display-inline="no-display-inline" section-type="subsequent-section"><enum>3.</enum><header display-inline="yes-display-inline">Improvements to program for grants for research on therapies for ALS</header><text display-inline="no-display-inline">Section 2 of the Accelerating Access to Critical Therapies for ALS Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360ee">21 U.S.C. 360ee</external-xref> note) is amended—</text><paragraph commented="no" display-inline="no-display-inline" id="id0636b85609d24eda832fd3ba134a84e2" changed="not-changed"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a), by inserting <quote>(referred to in this section as <quote>expanded access grants</quote>)</quote> before the period at the end of the first sentence;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id11d5a93c7c974f4f8d4f142f44e2021f" changed="not-changed"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)—</text><subparagraph commented="no" display-inline="no-display-inline" id="id8b560c6c920a49e7ba8bd15b60ce7967" changed="not-changed"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>(b) <header-in-text style="OLC" level="subsection">Application—</header-in-text></quote> and all that follows through <quote>A participating</quote> in paragraph (1) and inserting the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idadcada6d52e7468ea44615adddb53478" changed="not-changed"><subsection id="idda209721f03348ea935cc7bd560aadaa" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(b)</enum><header display-inline="yes-display-inline">Application</header><text display-inline="yes-display-inline">A participating</text></subsection><after-quoted-block display="yes">;</after-quoted-block></quoted-block></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id84658a384cac45c196fc8ddc71276d68" changed="not-changed"><enum>(B)</enum><text display-inline="yes-display-inline">by redesignating paragraphs (2) and (3) as paragraphs (1) and (2) respectively;</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id5d8463f2d5a04acb812b81bdc9be2f3f" changed="not-changed"><enum>(C)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1), as so redesignated, by striking the period at the end and inserting <quote>including—</quote>;</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id527acf31be62495194ce90f6a0ed3218" changed="not-changed"><enum>(D)</enum><text display-inline="yes-display-inline">by amending paragraph (1), as so redesignated, to read as follows:</text><quoted-block style="OLC" display-inline="no-display-inline" id="ida14f41a20d9d40acb7488bff899c11ba" changed="not-changed"><paragraph commented="no" display-inline="no-display-inline" id="ide0d8544e325e421f9a73f5a56a725a39" changed="not-changed"><enum>(1)</enum><text display-inline="yes-display-inline">a description of how data generated through the proposed expanded access grant will be used to support research or development related to the prevention, diagnosis, mitigation, treatment, or cure of amyotrophic lateral sclerosis;</text></paragraph><after-quoted-block display="yes">;</after-quoted-block></quoted-block></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idf52c356bf22547c39ca80c92fef6e281" changed="not-changed"><enum>(E)</enum><text display-inline="yes-display-inline">in paragraph (2), as so redesignated—</text><clause commented="no" display-inline="no-display-inline" id="id7bf85e6dff8249c19962408713445206" changed="not-changed"><enum>(i)</enum><text display-inline="yes-display-inline">by striking <quote><header-in-text style="OLC" level="paragraph">Noninterference with clinical trials—</header-in-text></quote> and all that follows through <quote>shall include</quote>;</text></clause><clause commented="no" display-inline="no-display-inline" id="id424f52a3d0e24772be371a14695a8202" changed="not-changed"><enum>(ii)</enum><text display-inline="yes-display-inline">by striking <quote>program</quote> and inserting <quote>grant</quote>; and</text></clause><clause commented="no" display-inline="no-display-inline" id="id6657bc8bff6c45ec80a6c729b2592f28" changed="not-changed"><enum>(iii)</enum><text display-inline="yes-display-inline">by striking the period at the end and inserting <quote>; and</quote>; and</text></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id395eb5f43f904e71b8b43555f6984abc" changed="not-changed"><enum>(F)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id8cb011773bb540af9eb9e57047c4b342" changed="not-changed"><paragraph commented="no" display-inline="no-display-inline" id="id8c4276aa483a44dbb8a5d5ec6053414b" changed="not-changed"><enum>(3)</enum><text display-inline="yes-display-inline">an assurance that such entity will promptly report to the Secretary available safety data from any ongoing clinical trial of the investigational drug as set forth in the terms and conditions of the grant.</text></paragraph><after-quoted-block display="yes">;</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idd9c0c2f8ce6a4defa09a8193c9d65a05" changed="not-changed"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (c)—</text><subparagraph commented="no" display-inline="no-display-inline" id="ida37f0e2c1d8e4217a041b7d3f8fb6467" changed="not-changed"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating subparagraphs (A) and (B) of paragraph (2) as clauses (i) and (ii), respectively, and adjusting the margins accordingly;</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id000bff5522c74045a5a2e30284021e29" changed="not-changed"><enum>(B)</enum><text display-inline="yes-display-inline">by redesignating paragraphs (1) through (3) as subparagraphs (A) through (C), respectively, and adjusting the margins accordingly; </text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id9b469b1fb9634f1a99903d66b749970a" changed="not-changed"><enum>(C)</enum><text display-inline="yes-display-inline">in subparagraph (C), as so redesignated, by striking the period at the end and inserting <quote>; and</quote>;</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ide2a39ee684cc4b709c9f308fb9b088b7" changed="not-changed"><enum>(D)</enum><text display-inline="yes-display-inline">in the matter preceding subparagraph (A), as so redesignated, by striking <quote>this section, confirm that—</quote> and inserting the following: “this section—</text><quoted-block style="OLC" display-inline="no-display-inline" id="ide533238d25d64c6cb7d5e983a2f25974" changed="not-changed"><paragraph id="idaffcd9ffc45d4aa28dda8e4ebdc674b6" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(1)</enum><text display-inline="yes-display-inline">confirm that—</text></paragraph><after-quoted-block display="yes">; and</after-quoted-block></quoted-block></subparagraph><subparagraph id="id312208d621aa4bf3adee453ba69827ca" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(E)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="ida30a792e4e084fd3a507d1aaa4cdeff8" changed="not-changed"><paragraph id="idbc7e69dd037f4b16a0479525f23b2a2e" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(2)</enum><text display-inline="yes-display-inline">in the case of a renewal of such a grant, request from the sponsor of the investigational new drug application involved, and assess, the enrollment, safety, and any available efficacy data of the drug related to the prevention, diagnosis, mitigation, treatment, or cure of amyotrophic lateral sclerosis.</text></paragraph><after-quoted-block display="yes">;</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id5b090121c53945dc83a8396906f73d9c" changed="not-changed"><enum>(4)</enum><text display-inline="yes-display-inline">in subsection (d)(1), by striking <quote>request described in subsection (a)</quote> and inserting <quote>grant</quote>; and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idc8970d6e2fc243cabf7097a2816e78b1" changed="not-changed"><enum>(5)</enum><text display-inline="yes-display-inline">in subsection (e)—</text><subparagraph commented="no" display-inline="no-display-inline" id="id7ad8b2ac6a2940e5967cba45291731e4" changed="not-changed"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (2), by inserting <quote>, and that begins enrollment within a timeframe as determined by the Secretary through the terms and conditions of the grant</quote> before the period at the end; and</text></subparagraph><subparagraph id="id1a563869b24443b48229c37d9d05251d" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(B)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id39cc2795-d780-422c-8aa3-ee9def5d9997" changed="not-changed"><paragraph id="ide48ac3d0-cf6f-4228-a3a6-e1c7cd6c2d49" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(4)</enum><text display-inline="yes-display-inline">The term <term>phase 3 clinical trial</term> includes a phase 2/3 combined trial and a planned phase 3 clinical trial that is not yet enrolling participants.</text></paragraph><after-quoted-block display="yes">.</after-quoted-block></quoted-block></subparagraph></paragraph></section><section id="id8bb01401-414b-4e06-aa25-2c92c3e75fb2" changed="not-changed" commented="no" display-inline="no-display-inline" section-type="subsequent-section"><enum>4.</enum><header display-inline="yes-display-inline">Report on ALS and other rare neurodegenerative disease action plans</header><text display-inline="no-display-inline">Section 4 of the Accelerating Access to Critical Therapies for ALS Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360aa">21 U.S.C. 360aa</external-xref> note) is amended—</text><paragraph commented="no" display-inline="no-display-inline" id="id0363c5e5ee994c34980c5f612a85a6d2" changed="not-changed"><enum>(1)</enum><text display-inline="yes-display-inline">in the section heading, by striking <quote><header-in-text style="OLC" level="section">ALS and other</header-in-text></quote> and inserting <quote><header-in-text style="OLC" level="section">FDA</header-in-text></quote>;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idd307d9ccd6624fb680e5c0849572484e" changed="not-changed"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (a), in the matter preceding paragraph (1)—</text><subparagraph commented="no" display-inline="no-display-inline" id="id1bd5e73be2a740bd8bd1948629775e59" changed="not-changed"><enum>(A)</enum><text display-inline="yes-display-inline">by inserting <quote>and not later than 1 year after the date of enactment of the <short-title>Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026</short-title> and every 5 years thereafter,</quote> after <quote>this Act,</quote>; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idec16ca8deed741988728a70a69ebc039" changed="not-changed"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting <quote>develop, or update, as applicable, and</quote> before <quote>publish on</quote>;</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idcc7af6bf9286464c898e3414921efd78" changed="not-changed"><enum>(3)</enum><text display-inline="yes-display-inline">in subsection (b)—</text><subparagraph commented="no" display-inline="no-display-inline" id="idd3588df0cfbe4d2fab909bfe7e1ae2b8" changed="not-changed"><enum>(A)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1), by striking <quote>initial</quote>;</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idf95678e42b3e4a95b0b2fda3dc6e7cf3" changed="not-changed"><enum>(B)</enum><text display-inline="yes-display-inline">in paragraph (2)—</text><clause commented="no" display-inline="no-display-inline" id="iddbf3fa925d0948a3973ac3d1ad72e42b" changed="not-changed"><enum>(i)</enum><text display-inline="yes-display-inline">in subparagraph (A), by inserting <quote>of relevant investigational new drug applications</quote> after <quote>sponsors</quote>; </text></clause><clause commented="no" display-inline="no-display-inline" id="id060b206fdcd846f681175fde86acd95e" changed="not-changed"><enum>(ii)</enum><text display-inline="yes-display-inline">in subparagraph (C) by inserting <quote>for the prevention, diagnosis, mitigation, treatment, or cure of rare neurodegenerative diseases</quote> before the semicolon; and</text></clause><clause commented="no" display-inline="no-display-inline" id="id1b5e77a7915e4e96a408187d240d1045" changed="not-changed"><enum>(iii)</enum><text display-inline="yes-display-inline">in subparagraph (D), by striking <quote>; and</quote> and inserting a semicolon;</text></clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id917a7f53ec5f495b95fbaac7538de967" changed="not-changed"><enum>(C)</enum><text display-inline="yes-display-inline">in paragraph (3), by striking the period at the end and inserting <quote>; and</quote>; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id68fa6bdc016849f69d43c9d83e4233ba" changed="not-changed"><enum>(D)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id83b2e434bf8d49daaf2000058ac9094e" changed="not-changed"><paragraph id="id3feea0ad6eea4a56b3bd10d89098a3ab" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(4)</enum><text display-inline="yes-display-inline">for each action plan published after the date of enactment of the <short-title>Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026</short-title>, include a description of—</text><subparagraph commented="no" display-inline="no-display-inline" id="id09fc725bde774072bb5efc40820f7dd6" changed="not-changed"><enum>(A)</enum><text display-inline="yes-display-inline">previous actions taken by the Food and Drug Administration to implement the previous action plan published under subsection (a); </text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idf2b4d16e98ba4d7cabd21badfec30480" changed="not-changed"><enum>(B)</enum><text display-inline="yes-display-inline">any other planned actions to implement such action plan; and </text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="ida36dc8fb5a7c4d6fb5a7fe993758af0b" changed="not-changed"><enum>(C)</enum><text display-inline="yes-display-inline">any barriers to implementing such action plan and related recommendations, which may include an estimate of resources necessary to address such barriers.</text></subparagraph></paragraph><after-quoted-block display="yes">.</after-quoted-block></quoted-block></subparagraph></paragraph></section><section commented="no" id="id2d1975c3-6ab1-42e4-a59e-cf3c325f19f5" changed="not-changed" display-inline="no-display-inline" section-type="subsequent-section"><enum>5.</enum><header display-inline="yes-display-inline">Reports</header><text display-inline="no-display-inline">Section 6 of the Accelerating Access to Critical Therapies for ALS Act (<external-xref legal-doc="public-law" parsable-cite="pl/117/79">Public Law 117–79</external-xref>) is amended—</text><paragraph commented="no" display-inline="no-display-inline" id="id2b35e49d067d451cb0391d3b9468ef74" changed="not-changed"><enum>(1)</enum><text display-inline="yes-display-inline">in the heading, by striking <quote><header-in-text style="OLC" level="section">GAO Report</header-in-text></quote> and inserting <quote><header-in-text style="OLC" level="section">Reports</header-in-text></quote>;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="ida82cd3ecb3c14d16a9efae933814def1" changed="not-changed"><enum>(2)</enum><text display-inline="yes-display-inline">by striking <quote>Not later than</quote> and inserting the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id92aa39996b114be8acfe30c82a099f43" changed="not-changed"><subsection id="idbc4be5230e7c47bf8c51de1c2dea0137" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(a)</enum><header display-inline="yes-display-inline">GAO report</header><text display-inline="yes-display-inline">Not later than</text></subsection><after-quoted-block display="yes">;</after-quoted-block></quoted-block></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id0ae06c7ad2a443dc9a2a818e32471415" changed="not-changed"><enum>(3)</enum><text display-inline="yes-display-inline">in the matter preceding paragraph (1) of subsection (a), as so designated, by striking <quote>this Act</quote> and inserting <quote>the <short-title>Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026</short-title></quote>; and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id5e1625c0e6aa4db4b46f347dfca60509" changed="not-changed"><enum>(4)</enum><text display-inline="yes-display-inline">by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id953f3582e5c34738ab37259f17b0d6a0" changed="not-changed"><subsection id="iddc0472f5887745a2997696aeb91a0cd4" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(b)</enum><header display-inline="yes-display-inline">HHS report</header><text display-inline="yes-display-inline">Not later than 4 years after the date of enactment of the <short-title>Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026</short-title>, the Secretary of Health and Human Services shall, in a manner that does not duplicate the information described in the action plan published pursuant to section 4, submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report assessing the effectiveness of the activities carried out under sections 2, 3, and 5 and making recommendations to improve such activities.</text></subsection><after-quoted-block display="yes">.</after-quoted-block></quoted-block></paragraph></section><section commented="no" display-inline="no-display-inline" id="ide0297b6f9706493c81cdba5804d635f5" changed="not-changed" section-type="subsequent-section"><enum>6.</enum><header display-inline="yes-display-inline">Technical amendments</header><text display-inline="no-display-inline">Section 3 of the Accelerating Access to Critical Therapies for ALS Act (<external-xref legal-doc="usc" parsable-cite="usc/42/280g-7b">42 U.S.C. 280g–7b</external-xref>) is amended—</text><paragraph id="id8fbed06fd3844233bb46099658138483" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a), in the matter preceding paragraph (1), by striking <quote>amytrophic</quote> and inserting <quote>amyotrophic</quote>; and</text></paragraph><paragraph id="ide59cb6ffd97d4eb6b9b10de9be267b39" commented="no" display-inline="no-display-inline" changed="not-changed"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)(3)(A)(iii), by striking <quote>rational</quote>.</text></paragraph></section></legis-body><attestation><attestation-group><attestation-date date="20260804" chamber="Senate">Passed the Senate August 4, 2026.</attestation-date><attestor display="no"></attestor><role>Secretary</role></attestation-group></attestation><endorsement display="yes"></endorsement></bill> 

