[116th Congress Public Law 59]
[From the U.S. Government Publishing Office]
[[Page 133 STAT. 1093]]
Public Law 116-59
116th Congress
An Act
Making continuing appropriations for fiscal year 2020, and for other
purposes. <<NOTE: Sept. 27, 2019 - [H.R. 4378]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: Continuing
Appropriations Act, 2020, and Health Extenders Act of 2019.>>
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 <<NOTE: Continuing Appropriations Act, 2020.>>
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 133 STAT. 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) <<NOTE: Applicability.>> 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 <<NOTE: Ante, p. 64.>> 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 133 STAT. 1095]]
(b) <<NOTE: Contracts.>> 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) <<NOTE: Expiration date.>> 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. <<NOTE: Continuation.>> (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 133 STAT. 1096]]
(b) <<NOTE: Time period.>> 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) <<NOTE: Applicability.>> 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) <<NOTE: Effective date.>> 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) <<NOTE: Continuation.>> 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 133 STAT. 1097]]
(c) <<NOTE: Deadline. Lists.>> 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, <<NOTE: Effective
date.>> 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) <<NOTE: Ante, p. 871.>>
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 <<NOTE: Waiver authority.>> 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 <<NOTE: Reports. Deadline. Estimates. Analysis.>> 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 133 STAT. 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. <<NOTE: Definition.>> 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) <<NOTE: Rescissions.>> 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: <<NOTE: Expiration date.>> 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) <<NOTE: Effective date.>> This section shall become effective
immediately upon enactment of this Act.
(d) <<NOTE: Applicability.>> 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) <<NOTE: Effective date.>> This section shall become effective
immediately upon enactment of this Act.
[[Page 133 STAT. 1099]]
Sec. 126. During <<NOTE: Applicability.>> 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 <<NOTE: Applicability.>> section 101,
title I of division D of Public Law 116-6 shall <<NOTE: Ante, p. 139.>>
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 <<NOTE: Transfer authority. Notification.>> 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 <<NOTE: Transfer authority.>> 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 <<NOTE: Applicability.>> 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 <<NOTE: Ante, p. 179.>> 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 133 STAT. 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 <<NOTE: Applicability.>> the language under such heading
in title V of division D of Public Law 116-6 <<NOTE: Ante, p. 179.>>
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) <<NOTE: Applicability.>> 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 133 STAT. 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 <<NOTE: Transfer authority.>> 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 <<NOTE: Applicability.>> 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 <<NOTE: Applicability.>> 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 <<NOTE: Applicability.>> 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 133 STAT. 1102]]
of Transportation--Federal Transit Administration--Capital Investment
Grants'' <<NOTE: 132 Stat. 997;3Ante, p. 422.>> 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. <<NOTE: Contracts. Time period.>> 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) <<NOTE: Time period.>> 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 133 STAT. 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 133 STAT. 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 133 STAT. 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) <<NOTE: Time period.>> 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 133 STAT. 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 133 STAT. 1107]]
SEC. 1403. EXTENSION OF TERMINATION DATE OF PATIENT-CENTERED
OUTCOMES RESEARCH TRUST FUND.
Section 9511(f) of the Internal Revenue Code of 1986 <<NOTE: 26 USC
9511.>> 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 <<NOTE: Applicability.>> 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), <<NOTE: 128 Stat. 343.>> 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) <<NOTE: 42 USC 300mm-21 note.>> 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 133 STAT. 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) <<NOTE: 42 USC 1396r-8 note.>> 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 133 STAT. 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:
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CONGRESSIONAL RECORD, Vol. 165 (2019):
Sept. 19, considered and passed House.
Sept. 26, considered and passed Senate.
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