US Codex
Pub. L.
Notes

Division B — Health and Human Services Extenders and Other Matters

116th Congress · Approved Sep 27, 2019 · 133 Stat. 1093

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).
(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
(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:

“(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
(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.”

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)).

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
(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.