    [United States Statutes at Large, Volume 133, 116th Congress, 1st Session]
    [From the U.S. Government Publishing Office, www.gpo.gov]

    Public Law 116-59
    116th Congress

    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, <>
    SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Continuing Appropriations Act, 2020,
    and Health Extenders Act of 2019''.
    SEC. 2. TABLE OF CONTENTS.

    The table of contents of this Act is as follows:

    Sec. 1. Short title.
    Sec. 2. Table of Contents.
    Sec. 3. References.

    DIVISION A--CONTINUING APPROPRIATIONS ACT, 2020

    DIVISION B--HEALTH AND HUMAN SERVICES EXTENDERS AND OTHER MATTERS

    TITLE I--PUBLIC HEALTH EXTENDERS

    TITLE II--OTHER HEALTH EXTENDERS

    TITLE III--MEDICAID EXTENDERS

    TITLE IV--MEDICARE EXTENDERS

    TITLE V--HUMAN SERVICES EXTENDERS

    TITLE VI--MISCELLANEOUS POLICIES

    TITLE VII--BUDGETARY EFFECTS

    SEC. 3. REFERENCES.

    Except as expressly provided otherwise, any reference to ``this
    Act'' contained in any division of this Act shall be treated as
    referring only to the provisions of that division.

    DIVISION A--CONTINUING <>
    APPROPRIATIONS ACT, 2020

    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:
    Sec. 101.  Such amounts as may be necessary, at a rate for
    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

    [[Page 1094]]

    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).

    Sec. 102. (a) No appropriation or funds made available or authority
    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.

    [[Page 1095]]

    (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.

    Sec. 103.  Appropriations made by section 101 shall be available to
    the extent and in the manner that would be provided by the pertinent
    appropriations Act.
    Sec. 104.  Except as otherwise provided in section 102, no
    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.
    Sec. 105.  Appropriations made and authority granted pursuant to
    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.
    Sec. 106.  Unless otherwise provided for in this Act or in the
    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.

    Sec. 107.  Expenditures made pursuant to this Act shall be charged
    to the applicable appropriation, fund, or authorization whenever a bill
    in which such applicable appropriation, fund, or authorization is
    contained is enacted into law.
    Sec. 108.  Appropriations made and funds made available by or
    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.
    Sec. 109.  Notwithstanding any other provision of this Act, except
    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.
    Sec. 110.  This Act shall be implemented so that only the most
    limited funding action of that permitted in the Act shall be taken in
    order to provide for continuation of projects and activities.
    Sec. 111. <>  (a) For entitlements and other
    mandatory payments whose 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).

    [[Page 1096]]

    (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.

    Sec. 112.  Amounts made available under section 101 for civilian
    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.
    Sec. 113.  Funds appropriated by this Act may be obligated and
    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)).
    Sec. 114. (a) Each amount incorporated by reference in this Act 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).

    Sec. 115. (a) Rescissions or cancellations of discretionary budget
    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.

    [[Page 1097]]

    (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.

    Sec. 116.  Title I of the Additional Supplemental Appropriations 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.

    Sec. 117.  The <>  Secretary of Agriculture
    may waive the matching funds requirement under Section 412(g) of the
    Agricultural Research, Extension, and Education Reform Act of 1998 (7
    U.S.C. 7632(g)).

    Sec. 118.  Amounts made available by section 101 for ``Department 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.
    Sec. 119.  Amounts provided by section 111 to the Department of
    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.

    Sec. 120.  In addition to amounts provided by section 101, amounts
    are provided for ``Department of Agriculture--Agricultural Marketing
    Service--Marketing Services'' at a rate for operations

    [[Page 1098]]

    of $16,496,000 to continue the implementation of the Hemp Production
    Program (section 10113 of Public Law 115-334).
    Sec. 121.  Amounts made available by section 101 for ``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).
    Sec. 122.  Amounts made available by section 101 to the Department
    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.
    Sec. 123.  Notwithstanding section 2208(l)(3) of title 10, United
    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.

    Sec. 124. (a) <>  The remaining unobligated
    balances of funds as of 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.

    Sec. 125. (a) No funds shall be transferred directly from
    ``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.

    [[Page 1099]]

    Sec. 126.  During <>  the period covered by
    this Act, title I of Public 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.

    Sec. 127.  Notwithstanding <>  section 101,
    title I of division D of 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.''.

    Sec. 128.  Notwithstanding any other provision of this Act, except
    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.
    Sec. 129.  In addition to amounts provided by section 101, amounts
    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.

    Sec. 130.  Notwithstanding <>  section 101,
    the matter preceding the 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

    [[Page 1100]]

    business loans authorized under section 7(a) of the Small Business Act
    (15 U.S.C. 636(a)).

    Sec. 131.  Notwithstanding section 101, amounts are provided for
    ``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)''.

    Sec. 132.  Amounts made available by section 101 to the Department
    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.
    Sec. 133.  Amounts made available by section 101 to the Department
    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.).
    Sec. 134. (a) <>  Sections 1309(a) and 1319 of
    the National Flood 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.
    Sec. 135.  Amounts made available by section 101 to the Department
    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.
    Sec. 136. (a) In addition to amounts provided by section 101,
    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

    [[Page 1101]]

    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.
    Sec. 137.  Amounts made available by section 101 to the Department
    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.
    Sec. 138.  During <>  the period covered
    by this Act, up to $20,000,000 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.

    Sec. 139.  Section <>  114(f) of the Higher
    Education Act of 1965 (20 U.S.C. 1011c(f)) shall be applied by
    substituting the date specified in section 106(3) of this Act for
    ``September 30, 2019''.

    Sec. 140.  Amounts made available by section 101 for ``Department 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).
    Sec. 141.  Section <>  7 of the Export-Import
    Bank Act of 1945 (12 U.S.C. 635f) shall be applied by substituting the
    date specified in section 106(3) of this Act for ``September 30, 2019''.

    Sec. 142.  Section <>  209 of the
    International Religious Freedom Act 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''.

    Sec. 143.  Title I of division L of Public Law 115-141 and title I
    of division G of Public Law 116-6 shall be amended in the first provisos
    in each Act under the headings ``Department

    [[Page 1102]]

    of Transportation--Federal Transit Administration--Capital Investment
    Grants'' <> by striking
    ``obligated'' and inserting ``allocated''.

    Sec. 144.  Section 9503(e)(4) of the Internal Revenue Code of 1986
    shall not apply during the period covered by this Act.
    Sec. 145.  <> Amounts made available
    by section 101 to the Department 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''.

    DIVISION B--HEALTH AND HUMAN SERVICES EXTENDERS AND OTHER MATTERS

    TITLE I--PUBLIC HEALTH EXTENDERS

    SEC. 1101. EXTENSION FOR COMMUNITY HEALTH CENTERS, THE NATIONAL
    HEALTH 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).

    [[Page 1103]]

    (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''.
    SEC. 1102. DIABETES PROGRAMS.

    (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''.

    TITLE II--OTHER HEALTH EXTENDERS

    SEC. 1201. EXTENSION OF SEXUAL RISK AVOIDANCE EDUCATION PROGRAM.

    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

    [[Page 1104]]

    (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)''.
    SEC. 1202. EXTENSION OF PERSONAL RESPONSIBILITY EDUCATION PROGRAM.

    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:

    [[Page 1105]]

    ``(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''.

    TITLE III--MEDICAID EXTENDERS

    SEC. 1301. EXTENSION OF COMMUNITY MENTAL HEALTH SERVICES
    DEMONSTRATION 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''.
    SEC. 1302. TEMPORARY INCREASE IN FEDERAL MEDICAL ASSISTANCE
    PERCENTAGE 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.''.
    SEC. 1303. DELAY OF REDUCTIONS IN MEDICAID DSH ALLOTMENTS.

    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''.

    TITLE IV--MEDICARE EXTENDERS

    SEC. 1401. EXTENSION OF FUNDING FOR QUALITY MEASURE ENDORSEMENT,
    INPUT, 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

    [[Page 1106]]

    (2) in the third sentence, by inserting ``and for the period
    beginning on October 1, 2019, and ending on November 21, 2019,''
    after ``2019''.
    SEC. 1402. EXTENSION OF FUNDING OUTREACH AND ASSISTANCE FOR LOW-
    INCOME 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.''.

    [[Page 1107]]

    SEC. 1403. EXTENSION OF TERMINATION DATE OF PATIENT-CENTERED
    OUTCOMES RESEARCH TRUST FUND.

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

    TITLE V--HUMAN SERVICES EXTENDERS

    SEC. 1501. EXTENSION OF DEMONSTRATION PROJECTS TO ADDRESS HEALTH
    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.
    SEC. 1502. EXTENSION OF THE TEMPORARY ASSISTANCE FOR NEEDY
    FAMILIES 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.

    TITLE VI--MISCELLANEOUS POLICIES

    SEC. 1601. ALASKA NATIVE REGIONAL HEALTH ENTITIES.

    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''.
    SEC. 1602. INCREASING NUMERICAL LIMITATIONS OF THE WORLD TRADE
    CENTER 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)).

    [[Page 1108]]

    SEC. 1603. EXCLUDING AUTHORIZED GENERIC DRUGS FROM CALCULATION OF
    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.
    SEC. 1604. MEDICAID IMPROVEMENT FUND.

    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''.

    TITLE VII--BUDGETARY EFFECTS

    SEC. 1701. BUDGETARY EFFECTS.

    (a) Statutory PAYGO Scorecards.--The budgetary effects of this
    division shall not be entered on either PAYGO scorecard maintained
    pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010.
    (b) Senate PAYGO Scorecards.--The budgetary effects of this division
    shall not be entered on any PAYGO scorecard maintained for purposes of
    section 4106 of H. Con. Res. 71 (115th Congress).
    (c) Classification of Budgetary Effects.--Notwithstanding Rule 3 of
    the Budget Scorekeeping Guidelines set forth in the joint explanatory
    statement of the committee of conference accompanying Conference Report
    105-217 and section 250(c)(8) of the Balanced Budget and Emergency
    Deficit Control Act of 1985, the budgetary effects of this division
    shall not be estimated--
    (1) for purposes of section 251 of such Act; and

    [[Page 1109]]

    (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.

    Approved September 27, 2019.

    LEGISLATIVE HISTORY--H.R. 4378:
    ---------------------------------------------------------------------------

    CONGRESSIONAL RECORD, Vol. 165 (2019):
    Sept. 19, considered and passed House.
    Sept. 26, considered and passed Senate.