[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4348 Reported in Senate (RS)]
<DOC>
Calendar No. 444
117th CONGRESS
2d Session
S. 4348
To amend the Federal Food, Drug, and Cosmetic Act to revise and extend
the user-fee programs for prescription drugs, medical devices, generic
drugs, and biosimilar biological products, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 26, 2022
Mrs. Murray (for herself and Mr. Burr) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
July 13, 2022
Reported by Mrs. Murray, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To amend the Federal Food, Drug, and Cosmetic Act to revise and extend
the user-fee programs for prescription drugs, medical devices, generic
drugs, and biosimilar biological products, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.</DELETED>
<DELETED> (a) Short Title.--This Act may be cited as the ``Food and
Drug Administration Safety and Landmark Advancements Act of 2022'' or
the ``FDASLA Act of 2022''.</DELETED>
<DELETED> (b) Table of Contents.--The table of contents for this Act
is as follows:</DELETED>
<DELETED>Sec. 1. Short title; table of contents.
<DELETED>TITLE I--FEES RELATING TO DRUGS
<DELETED>Sec. 101. Short title; finding.
<DELETED>Sec. 102. Definitions.
<DELETED>Sec. 103. Authority to assess and use drug fees.
<DELETED>Sec. 104. Reauthorization; reporting requirement.
<DELETED>Sec. 105. Sunset dates.
<DELETED>Sec. 106. Effective date.
<DELETED>Sec. 107. Savings clause.
<DELETED>TITLE II--FEES RELATING TO DEVICES
<DELETED>Sec. 201. Short title; finding.
<DELETED>Sec. 202. Definitions.
<DELETED>Sec. 203. Authority to assess and use device fees.
<DELETED>Sec. 204. Accreditation programs.
<DELETED>Sec. 205. Sunset dates.
<DELETED>Sec. 206. Effective date.
<DELETED>Sec. 207. Savings clause.
<DELETED>TITLE III--FEES RELATING TO GENERIC DRUGS
<DELETED>Sec. 301. Short title; finding.
<DELETED>Sec. 302. Authority to assess and use human generic drug fees.
<DELETED>Sec. 303. Reauthorization; reporting requirements.
<DELETED>Sec. 304. Sunset dates.
<DELETED>Sec. 305. Effective date.
<DELETED>Sec. 306. Savings clause.
<DELETED>TITLE IV--FEES RELATING TO BIOSIMILAR BIOLOGICAL PRODUCTS
<DELETED>Sec. 401. Short title; finding.
<DELETED>Sec. 402. Definitions.
<DELETED>Sec. 403. Authority to assess and use biosimilar biological
product fees.
<DELETED>Sec. 404. Reauthorization; reporting requirements.
<DELETED>Sec. 405. Sunset dates.
<DELETED>Sec. 406. Effective date.
<DELETED>Sec. 407. Savings clause.
<DELETED>TITLE V--IMPROVING REGULATION OF DRUGS AND BIOLOGICAL PRODUCTS
<DELETED>Sec. 501. Alternatives to animal testing.
<DELETED>Sec. 502. Safer disposal of opioids.
<DELETED>Sec. 503. Clarifications to exclusivity provisions for first
interchangeable biosimilar biological
products.
<DELETED>Sec. 504. Improvements to the Purple Book.
<DELETED>Sec. 505. Therapeutic equivalence evaluations.
<DELETED>Sec. 506. Modernizing accelerated approval.
<DELETED>TITLE VI--OTHER REAUTHORIZATIONS
<DELETED>Sec. 601. Reauthorization of the critical path public-private
partnership.
<DELETED>Sec. 602. Reauthorization of the best pharmaceuticals for
children program.
<DELETED>Sec. 603. Reauthorization of the humanitarian device exemption
incentive.
<DELETED>Sec. 604. Reauthorization of the pediatric device consortia
program.
<DELETED>Sec. 605. Reauthorization of provision pertaining to drugs
containing single enantiomers.
<DELETED>Sec. 606. Reauthorization of orphan drug grants.
<DELETED>Sec. 607. Reauthorization of certain device inspections.
<DELETED>TITLE VII--ENHANCING FDA HIRING AUTHORITIES
<DELETED>Sec. 701. Enhancing FDA hiring authority for scientific,
technical, and professional personnel.
<DELETED>Sec. 702. Strategic workforce plan and report.
<DELETED>TITLE VIII--ADVANCING REGULATION OF COSMETICS, DIETARY
SUPPLEMENTS, AND LABORATORY DEVELOPED TESTS
<DELETED>Subtitle A--Cosmetics
<DELETED>Sec. 801. Short title.
<DELETED>Sec. 802. Amendments to cosmetic requirements.
<DELETED>Sec. 803. Enforcement and conforming amendments.
<DELETED>Sec. 804. Records inspection.
<DELETED>Sec. 805. Talc-containing cosmetics.
<DELETED>Sec. 806. PFAS in cosmetics.
<DELETED>Sec. 807. Funding.
<DELETED>Subtitle B--Dietary Supplements
<DELETED>Sec. 811. Regulation of dietary supplements.
<DELETED>Subtitle C--In Vitro Clinical Tests
<DELETED>Sec. 821. Short title; table of contents.
<DELETED>Sec. 822. Definitions.
<DELETED>Sec. 823. Regulation of in vitro clinical tests.
<DELETED>Sec. 824. Enforcement and other provisions.
<DELETED>Sec. 825. Transition.
<DELETED>Sec. 826. Emergency use authorization.
<DELETED>Sec. 827. Antimicrobial susceptibility tests.
<DELETED>Sec. 828. Combination products.
<DELETED>Sec. 829. Resources.
<DELETED>Sec. 830. Authorization of appropriations.
<DELETED>TITLE IX--OTHER PROVISIONS
<DELETED>Sec. 901. Facilities management.
<DELETED>Sec. 902. Annual report on inspections.
<DELETED>Sec. 903. User fee program transparency and accountability.
<DELETED>Sec. 904. OTC hearing aids final rule.
<DELETED>Sec. 905. Enhance intra-agency coordination and public health
assessment with regard to compliance
activities.
<DELETED>TITLE I--FEES RELATING TO DRUGS</DELETED>
<DELETED>SEC. 101. SHORT TITLE; FINDING.</DELETED>
<DELETED> (a) Short Title.--This title may be cited as the
``Prescription Drug User Fee Amendments of 2022''.</DELETED>
<DELETED> (b) Finding.--Congress finds that the fees authorized by
the amendments made in this title will be dedicated toward expediting
the drug development process and the process for the review of human
drug applications, including postmarket drug safety activities, as set
forth in the goals identified for purposes of part 2 of subchapter C of
chapter VII of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379g
et seq.), in the letters from the Secretary of Health and Human
Services to the Chairman of the Committee on Health, Education, Labor,
and Pensions of the Senate and the Chairman of the Committee on Energy
and Commerce of the House of Representatives, as set forth in the
Congressional Record.</DELETED>
<DELETED>SEC. 102. DEFINITIONS.</DELETED>
<DELETED> Section 735 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379g) is amended--</DELETED>
<DELETED> (1) in paragraph (1), in the matter following
subparagraph (B), by striking ``an allergenic extract product,
or'' and inserting ``does not include an application with
respect to an allergenic extract product licensed before
October 1, 2022, does not include an application with respect
to a standardized allergenic extract product submitted pursuant
to a notification to the applicant from the Secretary regarding
the existence of a potency test that measures the allergenic
activity of an allergenic extract product licensed by the
applicant before October 1, 2022, does not include an
application with respect to'';</DELETED>
<DELETED> (2) in paragraph (3), in the matter following
subparagraph (C)--</DELETED>
<DELETED> (A) by inserting ``licensed before October
1, 2022, a standardized allergenic extract product
submitted pursuant to a notification to the applicant
from the Secretary regarding the existence of a potency
test that measures the allergenic activity of an
allergenic extract product licensed by the applicant
before October 1, 2022,'' after ``an allergenic extract
product'';</DELETED>
<DELETED> (B) by adding at the end the following:
``If a written request to place a product in the
discontinued section of either of the lists described
in subparagraph (C) is submitted to the Secretary on
behalf of an applicant, and the request identifies the
date the product is, or will be, withdrawn from sale,
then, for purposes of assessing the prescription drug
program fee under section 736(a)(2), the Secretary
shall consider such product to have been included in
the discontinued section on the later of (i) the date
such request was received, or (ii) if the product will
be withdrawn from sale on a future date, such future
date when the product is withdrawn from sale. For
purposes of subparagraph (C), a product shall be
considered withdrawn from sale once the applicant has
ceased its own distribution of the product, whether or
not the applicant has ordered recall of all previously
distributed lots of the product, except that a routine,
temporary interruption in supply shall not render a
product withdrawn from sale.''; and</DELETED>
<DELETED> (C) by adding at the end the
following:</DELETED>
<DELETED> ``(12) The term `skin-test diagnostic product'--
</DELETED>
<DELETED> ``(A) means a product--</DELETED>
<DELETED> ``(i) for prick, scratch,
intradermal, or subcutaneous
administration;</DELETED>
<DELETED> ``(ii) expected to produce a
limited, local reaction at the site of
administration (if positive), rather than a
systemic effect;</DELETED>
<DELETED> ``(iii) not intended to be a
preventive or therapeutic intervention;
and</DELETED>
<DELETED> ``(iv) intended to detect an
immediate or delayed-type skin hypersensitivity
reaction to aid in the diagnosis of--</DELETED>
<DELETED> ``(I) an allergy to an
antimicrobial agent;</DELETED>
<DELETED> ``(II) an allergy that is
not to an antimicrobial agent, if the
diagnostic product was authorized for
marketing prior to October 1, 2022;
or</DELETED>
<DELETED> ``(III) infection with
fungal or mycobacterial pathogens;
and</DELETED>
<DELETED> ``(B) includes positive and negative
controls required to interpret the results of a product
described in subparagraph (A).''.</DELETED>
<DELETED>SEC. 103. AUTHORITY TO ASSESS AND USE DRUG FEES.</DELETED>
<DELETED> (a) Types of Fees.--Section 736(a) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379h(a)) is amended--</DELETED>
<DELETED> (1) in the matter preceding paragraph (1), by
striking ``2018'' and inserting ``2023'';</DELETED>
<DELETED> (2) in paragraph (1)--</DELETED>
<DELETED> (A) in subparagraph (A), by striking
``subsection (c)(5)'' each place it appears and
inserting ``subsection (c)(6)'';</DELETED>
<DELETED> (B) in subparagraph (C), by inserting
``prior to approval'' after ``or was withdrawn'';
and</DELETED>
<DELETED> (C) by adding at the end the
following:</DELETED>
<DELETED> ``(H) Exception for skin-test diagnostic
products.--A human drug application for a skin-test
diagnostic product shall not be subject to a fee under
subparagraph (A).''; and</DELETED>
<DELETED> (3) in paragraph (2)--</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) by striking ``subsection
(c)(5)'' and inserting ``subsection
(c)(6)'';</DELETED>
<DELETED> (ii) by striking ``Except as
provided'' and inserting the
following:</DELETED>
<DELETED> ``(i) Payment of fees.--Except as
provided''; and</DELETED>
<DELETED> (iii) by adding at the end the
following:</DELETED>
<DELETED> ``(ii) Previously discontinued
drug products.--If a drug product that is
identified in a human drug application approved
as of October 1 of a fiscal year is not a
prescription drug product as of that date
because the drug product is in the discontinued
section of a list identified in section 735(3),
and on any subsequent day during such fiscal
year the drug product is a prescription drug
product, then except as provided in
subparagraphs (B) and (C), each person who is
named as the applicant in a human drug
application with respect to such product, and
who, after September 1, 1992, had pending
before the Secretary a human drug application
or supplement, shall pay the annual
prescription drug program fee established for a
fiscal year under subsection (c)(6) for such
prescription drug product. Such fee shall be
due on the last business day of such fiscal
year and shall be paid only once for each
product for a fiscal year in which the fee is
payable.''; and</DELETED>
<DELETED> (B) by amending subparagraph (B) to read
as follows:</DELETED>
<DELETED> ``(B) Exception for certain prescription
drug products.--A prescription drug program fee shall
not be assessed for a prescription drug product under
subparagraph (A) if such product is--</DELETED>
<DELETED> ``(i) a large volume parenteral
product (a sterile aqueous drug product
packaged in a single-dose container with a
volume greater than or equal to 100 mL, not
including powders for reconstitution or
pharmacy bulk packages) identified on the list
compiled under section 505(j)(7);</DELETED>
<DELETED> ``(ii) pharmaceutically equivalent
(as defined in section 314.3 of title 21, Code
of Federal Regulations (or any successor
regulations)), to another product on the list
of products compiled under section 505(j)(7)
(not including the discontinued section of such
list); or</DELETED>
<DELETED> ``(iii) a skin-test diagnostic
product.''.</DELETED>
<DELETED> (b) Fee Revenue Amounts.--Section 736(b) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379h(b)) is amended--</DELETED>
<DELETED> (1) in paragraph (1)--</DELETED>
<DELETED> (A) in the matter preceding subparagraph
(A), by striking ``2018 through 2022'' and inserting
``2023 through 2027'';</DELETED>
<DELETED> (B) by redesignating subparagraphs (C)
through (F) as subparagraphs (D) through (G),
respectively;</DELETED>
<DELETED> (C) by inserting after subparagraph (B)
the following:</DELETED>
<DELETED> ``(C) The dollar amount equal to the
strategic hiring and retention adjustment for the
fiscal year (as determined under subsection
(c)(2));'';</DELETED>
<DELETED> (D) in subparagraph (D), as so
redesignated, by striking ``(c)(2)'' and inserting
``(c)(3)'';</DELETED>
<DELETED> (E) in subparagraph (E), as so
redesignated, by striking ``(c)(3)'' and inserting
``(c)(4)'';</DELETED>
<DELETED> (F) in subparagraph (F), as so
redesignated, by striking ``(c)(4)'' and inserting
``(c)(5)''; and</DELETED>
<DELETED> (G) in subparagraph (G), as so
redesignated, by striking clauses (i) through (v) and
inserting the following:</DELETED>
<DELETED> ``(i) $65,773,693 for fiscal year
2023.</DELETED>
<DELETED> ``(ii) $25,097,671 for fiscal year
2024.</DELETED>
<DELETED> ``(iii) $14,154,169 for fiscal
year 2025.</DELETED>
<DELETED> ``(iv) $4,864,860 for fiscal year
2026.</DELETED>
<DELETED> ``(v) $1,314,620 for fiscal year
2027.''; and</DELETED>
<DELETED> (2) in paragraph (3)--</DELETED>
<DELETED> (A) in subparagraph (A), by striking
``2018, $878,590,000'' and inserting ``2023,
$1,151,522,958''; and</DELETED>
<DELETED> (B) in subparagraph (B)--</DELETED>
<DELETED> (i) by striking ``2019 through
2022'' and inserting ``2024 through 2027'';
and</DELETED>
<DELETED> (ii) by striking ``subsection
(c)(3) or (c)(4)'' and inserting ``subsection
(c)(4) or (c)(5)''.</DELETED>
<DELETED> (c) Adjustments; Annual Fee Setting.--Section 736(c) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379h(c)) is
amended--</DELETED>
<DELETED> (1) in paragraph (1)(B)(ii), by striking
``Washington-Baltimore, DC-MD-VA-WV'' and inserting
``Washington-Arlington-Alexandria, DC-VA-MD-WV'';</DELETED>
<DELETED> (2) by redesignating paragraphs (2) through (6) as
paragraphs (3) through (7), respectively;</DELETED>
<DELETED> (3) by inserting after paragraph (1) the
following:</DELETED>
<DELETED> ``(2) Strategic hiring and retention adjustment.--
For each fiscal year, after the annual base revenue established
in subsection (b)(1)(A) is adjusted for inflation in accordance
with paragraph (1), the Secretary shall further increase the
fee revenue and fees--</DELETED>
<DELETED> ``(A) for fiscal year 2023, by $9,000,000;
and</DELETED>
<DELETED> ``(B) for fiscal year 2024 and each
subsequent fiscal year, by $4,000,000.'';</DELETED>
<DELETED> (4) in paragraph (3), as so redesignated--
</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) by striking ``for inflation'';
and</DELETED>
<DELETED> (ii) by striking ``paragraph (1)''
and inserting ``paragraphs (1) and
(2)'';</DELETED>
<DELETED> (B) by amending subparagraph (B) to read
as follows:</DELETED>
<DELETED> ``(B) Methodology.--For purposes of this
paragraph, the Secretary shall employ the capacity
planning methodology utilized by the Secretary in
setting fees for fiscal year 2021, as described in the
notice titled `Prescription Drug User Fee Rates for
Fiscal Year 2021' (85 Fed. Reg. 46651; August 3, 2020).
The workload categories used in forecasting shall
include only the activities described in such notice
and, as feasible, additional activities that are
directly related to the direct review of applications
and supplements, including additional formal meeting
types, the direct review of postmarketing commitments
and requirements, the direct review of risk evaluation
and mitigation strategies, and the direct review of
annual reports for approved prescription drug products.
Subject to the exceptions in the preceding sentence,
the Secretary shall not include as workload categories
in forecasting any non-core review activities,
including any activities that the Secretary referenced
for potential future use in such notice but did not
utilize in the setting fees for fiscal year
2021.'';</DELETED>
<DELETED> (C) by striking subparagraph
(C);</DELETED>
<DELETED> (D) by redesignating subparagraphs (D) and
(E) as subparagraphs (C) and (D),
respectively;</DELETED>
<DELETED> (E) in subparagraph (C), as so
redesignated--</DELETED>
<DELETED> (i) by striking ``year) and'' and
inserting ``year),''; and</DELETED>
<DELETED> (ii) by inserting ``, and
subsection (b)(1)(C) (the dollar amount of the
strategic hiring and retention adjustment).'';
and</DELETED>
<DELETED> (F) in subparagraph (D), as so
redesignated, by striking ``paragraph (5)'' and
inserting ``paragraph (6)'';</DELETED>
<DELETED> (5) in paragraph (4), as so redesignated--
</DELETED>
<DELETED> (A) by amending subparagraph (A) to read
as follows:</DELETED>
<DELETED> ``(A) Increase.--For fiscal year 2023 and
subsequent fiscal years, the Secretary shall, in
addition to adjustments under paragraphs (1), (2), and
(3), further increase the fee revenue and fees if such
an adjustment is necessary to provide for at least the
following amounts of operating reserves of carryover
user fees for the process for the review of human drug
applications for each fiscal year, as
follows:</DELETED>
<DELETED> ``(i) For fiscal year 2023, at
least 8 weeks of operating reserves.</DELETED>
<DELETED> ``(ii) For fiscal year 2024, at
least 9 weeks of operating reserves.</DELETED>
<DELETED> ``(iii) For fiscal year 2025 and
subsequent fiscal years, at least 10 weeks of
operating reserves.''; and</DELETED>
<DELETED> (B) in subparagraph (C), by striking
``paragraph (5)'' and inserting ``paragraph
(6)'';</DELETED>
<DELETED> (6) by amending paragraph (5), as so redesignated,
to read as follows:</DELETED>
<DELETED> ``(5) Additional direct cost adjustment.--The
Secretary shall, in addition to adjustments under paragraphs
(1), (2), (3), and (4), further increase the fee revenue and
fees--</DELETED>
<DELETED> ``(A) for fiscal year 2023, by
$44,386,150; and</DELETED>
<DELETED> ``(B) for fiscal years 2024 through 2027,
by the amount set forth in clauses (i) through (iv), as
applicable, multiplied by the Consumer Price Index for
urban consumers (Washington-Arlington-Alexandria, DC-
VA-MD-WV; Not Seasonally Adjusted; All Items; Annual
Index) for the most recent year of available data,
divided by such Index for 2021--</DELETED>
<DELETED> ``(i) for fiscal year 2024,
$60,967,993;</DELETED>
<DELETED> ``(ii) for fiscal year 2025,
$35,799,314;</DELETED>
<DELETED> ``(iii) for fiscal year 2026,
$35,799,314; and</DELETED>
<DELETED> ``(iv) for fiscal year 2027,
$35,799,314.''; and</DELETED>
<DELETED> (7) in paragraph (6), as so redesignated, by
striking ``2017'' and inserting ``2022''.</DELETED>
<DELETED> (d) Crediting and Availability of Fees.--Section 736(g)(3)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379h(g)(3)) is
amended by striking ``2018 through 2022'' and inserting ``2023 through
2027''.</DELETED>
<DELETED> (e) Written Requests for Waivers, Reductions, and
Refunds.--Section 736(i) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379h(i)) is amended to read as follows:</DELETED>
<DELETED> ``(i) Written Requests for Waivers, Reductions,
Exemptions, and Returns; Disputes Concerning Fees.--To qualify for
consideration for a waiver or reduction under subsection (d), an
exemption under subsection (k), or the return of any fee paid under
this section, including if the fee is claimed to have been paid in
error, a person shall submit to the Secretary a written request
justifying such waiver, reduction, exemption, or return not later than
180 days after such fee is due. A request submitted under this
paragraph shall include any legal authorities under which the request
is made.''.</DELETED>
<DELETED> (f) Orphan Drugs.--Section 736(k) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379h(k)) is amended--</DELETED>
<DELETED> (1) in paragraph (1)(B), by striking ``during the
previous year'' and inserting ``, as determined under paragraph
(2)''; and</DELETED>
<DELETED> (2) in paragraph (2), by striking ``that its gross
annual revenues'' and all that follows through the period at
the end and inserting ``supported by tax returns submitted to
the Internal Revenue Service, or, as necessary, by other
appropriate financial information, that its gross annual
revenues did not exceed $50,000,000 for the last calendar year
ending prior to the fiscal year for which the exemption is
requested.''.</DELETED>
<DELETED>SEC. 104. REAUTHORIZATION; REPORTING REQUIREMENT.</DELETED>
<DELETED> Section 736B of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379h-2) is amended--</DELETED>
<DELETED> (1) by striking ``2018'' each place it appears and
inserting ``2023'';</DELETED>
<DELETED> (2) by striking ``Prescription Drug User Fee
Amendments of 2017'' each place it appears and inserting
``Prescription Drug User Fee Amendments of 2022'';</DELETED>
<DELETED> (3) in subsection (a)(4), by striking ``2020'' and
inserting ``2023''; and</DELETED>
<DELETED> (4) in subsection (f), by striking ``2022'' each
place it appears and inserting ``2027''.</DELETED>
<DELETED>SEC. 105. SUNSET DATES.</DELETED>
<DELETED> (a) Authorization.--Sections 735 and 736 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379g; 379h) shall cease to be
effective October 1, 2027.</DELETED>
<DELETED> (b) Reporting Requirements.--Section 736B of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379h-2) shall cease to be
effective January 31, 2028.</DELETED>
<DELETED> (c) Previous Sunset Provision.--Effective October 1, 2022,
subsections (a) and (b) of section 104 of the FDA Reauthorization Act
of 2017 (Public Law 115-52) are repealed.</DELETED>
<DELETED>SEC. 106. EFFECTIVE DATE.</DELETED>
<DELETED> The amendments made by this title shall take effect on
October 1, 2022, or the date of the enactment of this Act, whichever is
later, except that fees under part 2 of subchapter C of chapter VII of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379g et seq.) shall
be assessed for all human drug applications received on or after
October 1, 2022, regardless of the date of the enactment of this
Act.</DELETED>
<DELETED>SEC. 107. SAVINGS CLAUSE.</DELETED>
<DELETED> Notwithstanding the amendments made by this title, part 2
of subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 379g et seq.), as in effect on the day before the date
of the enactment of this title, shall continue to be in effect with
respect to human drug applications and supplements (as defined in such
part as of such day) that were accepted by the Food and Drug
Administration for filing on or after October 1, 2017, but before
October 1, 2022, with respect to assessing and collecting any fee
required by such part for a fiscal year prior to fiscal year
2023.</DELETED>
<DELETED>TITLE II--FEES RELATING TO DEVICES</DELETED>
<DELETED>SEC. 201. SHORT TITLE; FINDING.</DELETED>
<DELETED> (a) Short Title.--This title may be cited as the ``Medical
Device User Fee Amendments of 2022''.</DELETED>
<DELETED> (b) Finding.--Congress finds that the fees authorized
under the amendments made by this title will be dedicated toward
expediting the process for the review of device applications and for
assuring the safety and effectiveness of devices, as set forth in the
goals identified for purposes of part 3 of subchapter C of chapter VII
of the Federal Food, Drug, and Cosmetic Act in the letters from the
Secretary of Health and Human Services to the Chairman of the Committee
on Health, Education, Labor, and Pensions of the Senate and the
Chairman of the Committee on Energy and Commerce of the House of
Representatives, as set forth in the Congressional Record.</DELETED>
<DELETED>SEC. 202. DEFINITIONS.</DELETED>
<DELETED> Section 737 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379i) is amended--</DELETED>
<DELETED> (1) in paragraph (9)--</DELETED>
<DELETED> (A) in the matter preceding subparagraph
(A), by striking ``and premarket notification
submissions'' and inserting ``premarket notification
submissions, and de novo classification
requests'';</DELETED>
<DELETED> (B) in subparagraph (D), by striking ``and
submissions'' and inserting ``submissions, and de novo
classification requests'';</DELETED>
<DELETED> (C) in subparagraph (F), by striking ``and
premarket notification submissions'' and inserting
``premarket notification submissions, and de novo
classification requests'';</DELETED>
<DELETED> (D) in subparagraphs (G) and (H), by
striking ``or submissions'' each place it appears and
inserting ``submissions, or requests''; and</DELETED>
<DELETED> (E) in subparagraph (K), by striking ``or
premarket notification submissions'' and inserting
``premarket notification submissions, or de novo
classification requests''; and</DELETED>
<DELETED> (2) in paragraph (11), by striking ``2016'' and
inserting ``2021''.</DELETED>
<DELETED>SEC. 203. AUTHORITY TO ASSESS AND USE DEVICE FEES.</DELETED>
<DELETED> (a) Types of Fees.--Section 738(a) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j(a)) is amended--</DELETED>
<DELETED> (1) in paragraph (1), by striking ``2018'' and
inserting ``2023''; and</DELETED>
<DELETED> (2) in paragraph (2)--</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) in the matter preceding clause
(i), by striking ``2017'' and inserting
``2022'';</DELETED>
<DELETED> (ii) in clause (iii), by striking
``75 percent'' and inserting ``80 percent'';
and</DELETED>
<DELETED> (iii) in clause (viii), by
striking ``3.4 percent'' and inserting ``4.5
percent'';</DELETED>
<DELETED> (B) in subparagraph (B)(iii), by striking
``or premarket notification submission'' and inserting
``premarket notification submission, or de novo
classification request''; and</DELETED>
<DELETED> (C) in subparagraph (C), by striking ``or
periodic reporting concerning a class III device'' and
inserting ``periodic reporting concerning a class III
device, or de novo classification request''.</DELETED>
<DELETED> (b) Fee Amounts.--Section 738(b) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j(b)) is amended--</DELETED>
<DELETED> (1) in paragraph (1), by striking ``2018 through
2022'' and inserting ``2023 through 2027'';</DELETED>
<DELETED> (2) by amending the table in paragraph (2) to read
as follows:</DELETED>
----------------------------------------------------------------------------------------------------------------
Fiscal Fiscal Fiscal Fiscal Fiscal
``Fee Type Year 2023 Year 2024 Year 2025 Year 2026 Year 2027
----------------------------------------------------------------------------------------------------------------
Premarket Application................................... $425,000 $435,000 $445,000 $455,000 $470,000
Establishment Registration.............................. $6,250 $6,875 $7,100 $7,575 $8,465'';
----------------------------------------------------------------------------------------------------------------
<DELETED>and</DELETED>
<DELETED> (3) in paragraph (3), by amending subparagraphs
(A) through (E) to read as follows:</DELETED>
<DELETED> ``(A) $312,606,000 for fiscal year
2023.</DELETED>
<DELETED> ``(B) $335,750,000 for fiscal year
2024.</DELETED>
<DELETED> ``(C) $350,746,400 for fiscal year
2025.</DELETED>
<DELETED> ``(D) $366,486,300 for fiscal year
2026.</DELETED>
<DELETED> ``(E) $418,343,000 for fiscal year
2027.''.</DELETED>
<DELETED> (c) Annual Fee Setting; Adjustments.--Section 738(c) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j(c)) is
amended--</DELETED>
<DELETED> (1) in paragraph (1), by striking ``2017'' and
inserting ``2022'';</DELETED>
<DELETED> (2) in paragraph (2)--</DELETED>
<DELETED> (A) by striking ``2018'' each place it
appears and inserting ``2023'';</DELETED>
<DELETED> (B) in subparagraph (B)(ii), by striking
``2016'' and inserting ``2022'';</DELETED>
<DELETED> (C) in subparagraph (C)(i)(II), by
striking ``Washington-Baltimore, DC-MD-VA-WV'' and
inserting ``Washington-Arlington-Alexandria, DC-VA-MD-
WV''; and</DELETED>
<DELETED> (D) in subparagraph (D), by striking
``2022'' and inserting ``2027'';</DELETED>
<DELETED> (3) in paragraph (3), by striking ``2018 through
2022'' and inserting ``2023 through 2027'';</DELETED>
<DELETED> (4) by redesignating paragraphs (4) and (5) as
paragraphs (7) and (8), respectively; and</DELETED>
<DELETED> (5) by inserting after paragraph (3) the
following:</DELETED>
<DELETED> ``(4) Performance improvement adjustment.--
</DELETED>
<DELETED> ``(A) In general.--For each of fiscal
years 2025 through 2027, after the adjustment under
paragraph (3), the base establishment registration fee
amounts for such fiscal year shall be increased to
reflect changes in the resource needs of the Secretary
due to improved review performance goals for the
process for the review of device applications
identified in the letters described in section 201(b)
of the Medical Device User Fee Amendments of 2022, as
the Secretary determines necessary to achieve an
increase in total fee collections for such fiscal year,
equal to the following amounts, as
applicable:</DELETED>
<DELETED> ``(i) For fiscal year 2025, the
product of--</DELETED>
<DELETED> ``(I) the amount
determined under subparagraph
(B)(i)(I); and</DELETED>
<DELETED> ``(II) the applicable
inflation adjustment under paragraph
(2)(B) for such fiscal year.</DELETED>
<DELETED> ``(ii) For fiscal year 2026, the
product of--</DELETED>
<DELETED> ``(I) the sum of the
amounts determined under subparagraphs
(B)(i)(II), (B)(ii)(I), and
(B)(iii)(I); and</DELETED>
<DELETED> ``(II) the applicable
inflation adjustment under paragraph
(2)(B) for such fiscal year.</DELETED>
<DELETED> ``(iii) For fiscal year 2027, the
product of--</DELETED>
<DELETED> ``(I) the sum of the
amounts determined under subparagraphs
(B)(i)(III), (B)(ii)(II), and
(B)(iii)(II); and</DELETED>
<DELETED> ``(II) the applicable
inflation adjustment under paragraph
(2)(B) for such fiscal year.</DELETED>
<DELETED> ``(B) Amounts.--</DELETED>
<DELETED> ``(i) Presubmission amount.--For
purposes of subparagraph (A), with respect to
the presubmission written feedback goal, the
amounts determined under this subparagraph are
as follows:</DELETED>
<DELETED> ``(I) For fiscal year
2025, $15,396,600 if the goal for
fiscal year 2023 is met.</DELETED>
<DELETED> ``(II) For fiscal year
2026--</DELETED>
<DELETED> ``(aa) $15,396,600
if the goal for fiscal year
2023 is met and the goal for
fiscal year 2024 is missed;
or</DELETED>
<DELETED> ``(bb) $36,792,200
if the goal for fiscal year
2024 is met.</DELETED>
<DELETED> ``(III) For fiscal year
2027--</DELETED>
<DELETED> ``(aa) $15,396,600
if the goal for fiscal year
2023 is met and the goal for
each of fiscal years 2024 and
2025 is missed;</DELETED>
<DELETED> ``(bb) $36,792,200
if the goal for fiscal year
2024 is met and the goal for
fiscal year 2025 is missed;
or</DELETED>
<DELETED> ``(cc) $40,572,600
if the goal for fiscal year
2025 is met.</DELETED>
<DELETED> ``(ii) De novo classification
request amount.--For purposes of subparagraph
(A), with respect to the de novo decision goal,
the amounts determined under this subparagraph
are as follows:</DELETED>
<DELETED> ``(I) For fiscal year
2026, $6,323,500 if the goal for fiscal
year 2023 is met.</DELETED>
<DELETED> ``(II) For fiscal year
2027--</DELETED>
<DELETED> ``(aa) $6,323,500
if the goal for fiscal year
2023 is met and the goal for
fiscal year 2024 is missed;
or</DELETED>
<DELETED> ``(bb) $11,765,400
if the goal for fiscal year
2024 is met.</DELETED>
<DELETED> ``(iii) Premarket notification and
premarket approval amount.--For purposes of
subparagraph (A), with respect to the 510(k)
decision goal, 510(k) shared outcome total time
to decision goal, PMA decision goal, and PMA
shared outcome total time to decision goal, the
amounts determined under this subparagraph are
as follows:</DELETED>
<DELETED> ``(I) For fiscal year
2026, $1,020,000 if the 4 goals for
fiscal year 2023 are met.</DELETED>
<DELETED> ``(II) For fiscal year
2027--</DELETED>
<DELETED> ``(aa) $1,020,000
if the 4 goals for fiscal year
2023 are met and one or more of
the 4 goals for fiscal year
2024 is missed; or</DELETED>
<DELETED> ``(bb) $3,906,000
if the 4 goals for fiscal year
2024 are met.</DELETED>
<DELETED> ``(C) Performance calculation.--For
purposes of this paragraph, performance of the
following goals shall be determined as specified in the
letters described in section 201(b) of the Medical
Device User Fee Amendments of 2022 and based on data
available as of the applicable dates as
follows:</DELETED>
<DELETED> ``(i) The performance of the
presubmission written feedback goal--</DELETED>
<DELETED> ``(I) for fiscal year
2023, shall be based on data available
as of March 31, 2024;</DELETED>
<DELETED> ``(II) for fiscal year
2024, shall be based on data available
as of March 31, 2025; and</DELETED>
<DELETED> ``(III) for fiscal year
2025, shall be based on data available
as of March 31, 2026.</DELETED>
<DELETED> ``(ii) The performance of the de
novo decision goal, 510(k) decision goal,
510(k) shared outcome total time to decision
goal, PMA decision goal, and PMA shared outcome
total time to decision goal--</DELETED>
<DELETED> ``(I) for fiscal year
2023, shall be based on data available
as of March 31, 2025; and</DELETED>
<DELETED> ``(II) for fiscal year
2024, shall be based on data available
as of March 31, 2026.</DELETED>
<DELETED> ``(D) Definitions.--For purposes of this
paragraph, the terms `presubmission written feedback
goal', `de novo decision goal', `510(k) decision goal',
`510(k) shared outcome total time to decision goal',
`PMA decision goal', and `PMA shared outcome total time
to decision goal' have the meanings given such terms in
the goals identified in the letters described in
section 201(b) of the Medical Device User Fee
Amendments of 2022.</DELETED>
<DELETED> ``(5) Hiring adjustment.--</DELETED>
<DELETED> ``(A) In general.--For each of fiscal
years 2025 through 2027, after the adjustments under
paragraphs (3) and (4), if applicable, the base
establishment registration fee amounts shall be
decreased as the Secretary determines necessary to
achieve a reduction in total fee collections equal to
the hiring adjustment amount under subparagraph (B), if
the number of hires to support the process for the
review of device applications falls below the following
thresholds for the applicable fiscal years:</DELETED>
<DELETED> ``(i) For fiscal year 2025, 85
percent of the hiring goal specified in
subparagraph (C) for fiscal year
2023.</DELETED>
<DELETED> ``(ii) For fiscal year 2026, 90
percent of the hiring goal specified in
subparagraph (C) for fiscal year
2024.</DELETED>
<DELETED> ``(iii) For fiscal year 2027, 90
percent of the hiring goal specified in
subparagraph (C) for fiscal year
2025.</DELETED>
<DELETED> ``(B) Hiring adjustment amount.--The
hiring adjustment amount for fiscal year 2025 and each
subsequent fiscal year is the product of--</DELETED>
<DELETED> ``(i) the number of hires by which
the hiring goal specified in subparagraph (C)
for the fiscal year before the prior fiscal
year was missed;</DELETED>
<DELETED> ``(ii) $72,877; and</DELETED>
<DELETED> ``(iii) the applicable inflation
adjustment under paragraph (2)(B) for the
fiscal year for which the hiring goal was
missed.</DELETED>
<DELETED> ``(C) Hiring goals.--</DELETED>
<DELETED> ``(i) In general.--For purposes of
subparagraph (B), the hiring goals for each of
fiscal years 2023 through 2025 are as
follows:</DELETED>
<DELETED> ``(I) For fiscal year
2023, 144 hires.</DELETED>
<DELETED> ``(II) For fiscal year
2024, 42 hires.</DELETED>
<DELETED> ``(III) For fiscal year
2025--</DELETED>
<DELETED> ``(aa) 24 hires if
the base establishment
registration fees are not
increased by the amount
determined under paragraph
(4)(A)(i); or</DELETED>
<DELETED> ``(bb) 83 hires if
the base establishment
registration fees are increased
by the amount determined under
paragraph (4)(A)(i).</DELETED>
<DELETED> ``(ii) Number of hires.--For
purposes of this paragraph, the number of hires
for a fiscal year shall be determined by the
Secretary, as set forth in the letters
described in section 201(b) of the Medical
Device User Fee Amendments of 2022.</DELETED>
<DELETED> ``(6) Operating reserve adjustment.--</DELETED>
<DELETED> ``(A) In general.--For each of fiscal
years 2023 through 2027, after the adjustments under
paragraphs (3), (4), and (5), if applicable, if the
Secretary has operating reserves of carryover user fees
for the process for the review of device applications
in excess of the designated amount in subparagraph (B),
the Secretary shall decrease the base establishment
registration fee amounts to provide for not more than
such designated amount of operating reserves.</DELETED>
<DELETED> ``(B) Designated amount.--Subject to
subparagraph (C), for each fiscal year, the designated
amount in this subparagraph is equal to the sum of--
</DELETED>
<DELETED> ``(i) 13 weeks of operating
reserves of carryover user fees; and</DELETED>
<DELETED> ``(ii) the 1 month of operating
reserves described in paragraph (8).</DELETED>
<DELETED> ``(C) Excluded amount.--For the period of
fiscal years 2023 through 2026, a total amount equal to
$118,000,000 shall not be considered part of the
designated amount under subparagraph (B) and shall not
be subject to the decrease under subparagraph
(A).''.</DELETED>
<DELETED> (d) Small Businesses.--Section 738 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j) is amended--</DELETED>
<DELETED> (1) in subsection (d)(2)(B)(iii), by inserting ``,
if extant,'' after ``national taxing authority''; and</DELETED>
<DELETED> (2) in subsection (e)(2)(B)(iii), by inserting ``,
if extant,'' after ``national taxing authority''.</DELETED>
<DELETED> (e) Conditions.--Section 738(g) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379j(g)) is amended--</DELETED>
<DELETED> (1) in paragraph (1)(A), by striking
``$320,825,000'' and inserting ``$398,566,000''; and</DELETED>
<DELETED> (2) in paragraph (2), by inserting ``de novo
classification requests,'' after ``class III
device,''.</DELETED>
<DELETED> (f) Authorization of Appropriations.--Section 738(h)(3) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j(h)(3)) is
amended to read as follows:</DELETED>
<DELETED> ``(3) Authorization of appropriations.--</DELETED>
<DELETED> ``(A) In general.--For each of the fiscal
years 2023 through 2027, there is authorized to be
appropriated for fees under this section an amount
equal to the revenue amount determined in subparagraph
(B), less the amount of reductions determined in
subparagraph (C).</DELETED>
<DELETED> ``(B) Revenue amount.--For purposes of
this paragraph, the revenue amount for each fiscal year
is the sum of--</DELETED>
<DELETED> ``(i) the total revenue amount
under subsection (b)(3) for the fiscal year, as
adjusted under subsection (c)(2); and</DELETED>
<DELETED> ``(ii) the performance improvement
adjustment amount for the fiscal year under
subsection (c)(4)(A), if applicable.</DELETED>
<DELETED> ``(C) Amount of reductions.--For purposes
of this paragraph, the amount of reductions for each
fiscal year is the sum of--</DELETED>
<DELETED> ``(i) the hiring adjustment amount
for the fiscal year under subsection (c)(5), if
applicable; and</DELETED>
<DELETED> ``(ii) the operating reserve
adjustment amount for the fiscal year under
subsection (c)(6), if applicable.''.</DELETED>
<DELETED>SEC. 204. ACCREDITATION PROGRAMS.</DELETED>
<DELETED> (a) Accreditation Scheme for Conformity Assessment.--
Section 514(d) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
360d(d)) is amended--</DELETED>
<DELETED> (1) in the subsection heading, by striking
``Pilot'';</DELETED>
<DELETED> (2) in paragraph (1)--</DELETED>
<DELETED> (A) in the matter preceding subparagraph
(A), by striking ``pilot'';</DELETED>
<DELETED> (B) in subparagraph (A)--</DELETED>
<DELETED> (i) by inserting ``meeting
criteria specified by the Secretary in
guidance'' after ``testing
laboratories'';</DELETED>
<DELETED> (ii) by inserting ``in guidance''
after ``by the Secretary''; and</DELETED>
<DELETED> (iii) by striking ``assess the
conformance of a device with'' and inserting
``conduct testing to support the assessment of
the conformance of a device to''; and</DELETED>
<DELETED> (C) in subparagraph (B)--</DELETED>
<DELETED> (i) by striking ``determinations''
and inserting ``results'';</DELETED>
<DELETED> (ii) by inserting ``to support''
after ``so accredited''; and</DELETED>
<DELETED> (iii) by striking ``a particular
such determination'' and inserting ``particular
such results'';</DELETED>
<DELETED> (3) in paragraph (2)--</DELETED>
<DELETED> (A) in the paragraph heading, by striking
``determinations'' and inserting ``results'';</DELETED>
<DELETED> (B) in subparagraph (A)--</DELETED>
<DELETED> (i) by striking ``determinations
by testing laboratories'' and all that follows
through ``such determinations or'' and
inserting ``results by testing laboratories
accredited pursuant to this subsection,
including by conducting periodic audits of such
results or of the'';</DELETED>
<DELETED> (ii) by inserting a comma after
``or testing laboratories'';</DELETED>
<DELETED> (iii) by inserting ``or
recognition of an accreditation body'' after
``accreditation of such testing laboratory'';
and</DELETED>
<DELETED> (iv) by striking ``such device''
and inserting ``a device''; and</DELETED>
<DELETED> (C) in subparagraph (B)--</DELETED>
<DELETED> (i) by striking ``by a testing
laboratory so accredited'' and inserting
``under this subsection''; and</DELETED>
<DELETED> (ii) by inserting ``or recognition
of an accreditation body'' before ``under
paragraph (1)(A)'';</DELETED>
<DELETED> (4) in paragraph (3)(C)--</DELETED>
<DELETED> (A) in the subparagraph heading, by
inserting ``and transition'' after ``initiation'';
and</DELETED>
<DELETED> (B) by adding at the end the following:
``After September 30, 2023, such pilot program will be
considered to be completed, and the Secretary shall
have the authority to continue operating a program
consistent with this subsection.''; and</DELETED>
<DELETED> (5) by striking paragraph (4).</DELETED>
<DELETED> (b) Accredited Persons.--Section 523(c) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360m(c)) is amended by striking
``2022'' and inserting ``2027''.</DELETED>
<DELETED>SEC. 205. SUNSET DATES.</DELETED>
<DELETED> (a) Authorization.--Sections 737 and 738 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379i; 379fj) shall cease to be
effective October 1, 2027.</DELETED>
<DELETED> (b) Reporting Requirements.--Section 738A of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j-1) shall cease to be
effective January 31, 2028.</DELETED>
<DELETED> (c) Previous Sunset Provision.--Effective October 1, 2022,
subsections (a) and (b) of section 210 of the FDA Reauthorization Act
of 2017 (Public Law 115-52) are repealed.</DELETED>
<DELETED>SEC. 206. EFFECTIVE DATE.</DELETED>
<DELETED> The amendments made by this title shall take effect on
October 1, 2022, or the date of the enactment of this Act, whichever is
later, except that fees under part 3 of subchapter C of chapter VII of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379i et seq.) shall
be assessed for all submissions listed in section 738(a)(2)(A) of such
Act received on or after October 1, 2022, regardless of the date of the
enactment of this Act.</DELETED>
<DELETED>SEC. 207. SAVINGS CLAUSE.</DELETED>
<DELETED> Notwithstanding the amendments made by this title, part 3
of subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 379i et seq.), as in effect on the day before the date
of the enactment of this title, shall continue to be in effect with
respect to the submissions listed in section 738(a)(2)(A) of such Act
(as defined in such part as of such day) that on or after October 1,
2017, but before October 1, 2022, were received by the Food and Drug
Administration with respect to assessing and collecting any fee
required by such part for a fiscal year prior to fiscal year
2023.</DELETED>
<DELETED>TITLE III--FEES RELATING TO GENERIC DRUGS</DELETED>
<DELETED>SEC. 301. SHORT TITLE; FINDING.</DELETED>
<DELETED> (a) Short Title.--This title may be cited as the ``Generic
Drug User Fee Amendments of 2022''.</DELETED>
<DELETED> (b) Finding.--The Congress finds that the fees authorized
by the amendments made in this title will be dedicated to human generic
drug activities, as set forth in the goals identified for purposes of
part 7 of subchapter C of chapter VII of the Federal Food, Drug, and
Cosmetic Act, in the letters from the Secretary of Health and Human
Services to the Chairman of the Committee on Health, Education, Labor,
and Pensions of the Senate and the Chairman of the Committee on Energy
and Commerce of the House of Representatives, as set forth in the
Congressional Record.</DELETED>
<DELETED>SEC. 302. AUTHORITY TO ASSESS AND USE HUMAN GENERIC DRUG
FEES.</DELETED>
<DELETED> (a) Types of Fees.--Section 744B(a) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-42(a)) is amended--</DELETED>
<DELETED> (1) in the matter preceding paragraph (1), by
striking ``2018'' and inserting ``2023'';</DELETED>
<DELETED> (2) in paragraph (2)(C), by striking ``fiscal
years 2018 through 2022'' and inserting ``fiscal years 2023
through 2027'';</DELETED>
<DELETED> (3) in paragraph (3)(B), by striking ``fiscal
years 2018 through 2022'' and inserting ``fiscal years 2023
through 2027'';</DELETED>
<DELETED> (4) in paragraph (4)(D), by striking ``fiscal
years 2018 through 2022'' and inserting ``fiscal years 2023
through 2027''; and</DELETED>
<DELETED> (5) in paragraph (5)(D), by striking ``fiscal
years 2018 through 2022'' and inserting ``fiscal years 2023
through 2027''.</DELETED>
<DELETED> (b) Fee Revenue Amounts.--Section 744B(b) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j-42(b)) is amended--
</DELETED>
<DELETED> (1) in paragraph (1)--</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) in the heading, by striking
``2018'' and inserting ``2023'';</DELETED>
<DELETED> (ii) by striking ``2018'' and
inserting ``2023''; and</DELETED>
<DELETED> (iii) by striking ``$493,600,000''
and inserting ``$582,500,000''; and</DELETED>
<DELETED> (B) in subparagraph (B)--</DELETED>
<DELETED> (i) in the heading, by striking
``2019 through 2022'' and inserting ``2024
through 2027'';</DELETED>
<DELETED> (ii) by striking ``For each'' and
inserting the following:</DELETED>
<DELETED> ``(i) In general.--For
each'';</DELETED>
<DELETED> (iii) by striking ``2019 through
2022'' and inserting ``2024 through
2027'';</DELETED>
<DELETED> (iv) by striking ``$493,600,000''
and inserting ``the base revenue amount under
clause (ii)''; and</DELETED>
<DELETED> (v) by adding at the end the
following:</DELETED>
<DELETED> ``(ii) Base revenue amount.--The
base revenue amount for a fiscal year is the
total revenue amount established under this
paragraph for the previous fiscal year, not
including any adjustments made for such
previous fiscal year under subsection
(c)(3).''; and</DELETED>
<DELETED> (2) in paragraph (2)--</DELETED>
<DELETED> (A) in subparagraph (C), by striking
``one-third the amount'' and inserting ``24
percent'';</DELETED>
<DELETED> (B) in subparagraph (D), by striking
``Seven'' and inserting ``Six''; and</DELETED>
<DELETED> (C) in subparagraph (E)(i), by striking
``Thirty-five'' and inserting ``Thirty-six''.</DELETED>
<DELETED> (c) Adjustments.--Section 744B(c) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-42(c)) is amended--</DELETED>
<DELETED> (1) in paragraph (1)--</DELETED>
<DELETED> (A) in the matter preceding subparagraph
(A)--</DELETED>
<DELETED> (i) by striking ``2019'' and
inserting ``2024''; and</DELETED>
<DELETED> (ii) by striking ``the product of
the total revenues established in such notice
for the prior fiscal year'' and inserting ``the
base revenue amount for the fiscal year
determined under subsection (b)(1)(B)(ii)'';
and</DELETED>
<DELETED> (B) in subparagraph (C), by striking
``Washington-Baltimore, DC-MD-VA-WV'' and inserting
``Washington-Arlington-Alexandria, DC-VA-MD-WV'';
and</DELETED>
<DELETED> (2) by striking paragraph (2) and inserting the
following:</DELETED>
<DELETED> ``(2) Capacity planning adjustment.--</DELETED>
<DELETED> ``(A) In general.--Beginning with fiscal
year 2024, the Secretary shall, in addition to the
adjustment under paragraph (1), further increase the
fee revenue and fees under this section for a fiscal
year, in accordance with this paragraph, to reflect
changes in the resource capacity needs of the Secretary
for human generic drug activities.</DELETED>
<DELETED> ``(B) Capacity planning methodology.--The
Secretary shall establish a capacity planning
methodology for purposes of this paragraph, which
shall--</DELETED>
<DELETED> ``(i) be derived from the
methodology and recommendations made in the
report titled `Independent Evaluation of the
GDUFA Resource Capacity Planning Adjustment
Methodology: Evaluation and Recommendations' as
announced in the Federal Register on August 3,
2020 (85 Fed. Reg. 46658); and</DELETED>
<DELETED> ``(ii) incorporate approaches and
attributes determined appropriate by the
Secretary, including those made in such report
recommendations, except the workload categories
used in forecasting resources shall only be
those specified in section VIII.B.2.e. of the
letters described in section 301(b) of the
Generic Drug User Fee Amendments of
2022.</DELETED>
<DELETED> ``(C) Limitations.--</DELETED>
<DELETED> ``(i) In general.--Under no
circumstances shall an adjustment under this
paragraph result in fee revenue for a fiscal
year that is less than the sum of the amounts
under subsection (b)(1)(B)(ii) (the base
revenue amount for the fiscal year) and
paragraph (1) (the dollar amount of the
inflation adjustment for the fiscal
year).</DELETED>
<DELETED> ``(ii) Additional limitation.--An
adjustment under this paragraph shall not
exceed 3 percent of the sum described in clause
(i) for the fiscal year, except that such
limitation shall be 4 percent if--</DELETED>
<DELETED> ``(I) for purposes of an
adjustment for fiscal year 2024, the
Secretary determines that, during the
period from April 1, 2021, through
March 31, 2023--</DELETED>
<DELETED> ``(aa) the total
number of abbreviated new drug
applications submitted was
greater than or equal to 2,000;
or</DELETED>
<DELETED> ``(bb) thirty-five
percent or more of abbreviated
new drug applications submitted
related to complex products (as
that term is defined in section
XI of the letters described in
section 301(b) of the Generic
Drug User Fee Amendments of
2022);</DELETED>
<DELETED> ``(II) for purposes of an
adjustment for fiscal year 2025, the
Secretary determines that, during the
period from April 1, 2022, through
March 31, 2024--</DELETED>
<DELETED> ``(aa) the total
number of abbreviated new drug
applications submitted was
greater than or equal to 2,300;
or</DELETED>
<DELETED> ``(bb) thirty-five
percent or more of abbreviated
new drug applications submitted
related to complex products (as
so defined);</DELETED>
<DELETED> ``(III) for purposes of an
adjustment for fiscal year 2026, the
Secretary determines that, during the
period from April 1, 2023, through
March 31, 2025--</DELETED>
<DELETED> ``(aa) the total
number of abbreviated new drug
applications submitted was
greater than or equal to 2,300;
or</DELETED>
<DELETED> ``(bb) thirty-five
percent or more of abbreviated
new drug applications submitted
related to complex products (as
so defined); and</DELETED>
<DELETED> ``(IV) for purposes of an
adjustment for fiscal year 2027, the
Secretary determines that, during the
period from April 1, 2024, through
March 31, 2026--</DELETED>
<DELETED> ``(aa) the total
number of abbreviated new drug
applications submitted was
greater than or equal to 2,300;
or</DELETED>
<DELETED> ``(bb) thirty-five
percent or more of abbreviated
new drug applications submitted
related to complex products (as
so defined).</DELETED>
<DELETED> ``(D) Publication in federal register.--
The Secretary shall publish in the Federal Register
notice under subsection (a), the fee revenue and fees
resulting from the adjustment and the methodology under
this paragraph.</DELETED>
<DELETED> ``(3) Operating reserve adjustment.--</DELETED>
<DELETED> ``(A) In general.--For fiscal year 2024
and subsequent fiscal years, the Secretary may, in
addition to adjustments under paragraphs (1) and (2),
further increase the fee revenue and fees under this
section if such an adjustment is necessary to provide
operating reserves of carryover user fees for human
generic drug activities for not more than the number of
weeks specified in subparagraph (B).</DELETED>
<DELETED> ``(B) Number of weeks.--The number of
weeks specified in this subparagraph is--</DELETED>
<DELETED> ``(i) 8 weeks for fiscal year
2024;</DELETED>
<DELETED> ``(ii) 9 weeks for fiscal year
2025; and</DELETED>
<DELETED> ``(iii) 10 weeks for each of
fiscal year 2026 and 2027.</DELETED>
<DELETED> ``(C) Decrease.--If the Secretary has
carryover balances for human generic drug activities in
excess of 12 weeks of the operating reserves referred
to in subparagraph (A), the Secretary shall decrease
the fee revenue and fees referred to in such
subparagraph to provide for not more than 12 weeks of
such operating reserves.</DELETED>
<DELETED> ``(D) Rationale for adjustment.--If an
adjustment under this paragraph is made, the rationale
for the amount of the increase or decrease (as
applicable) in fee revenue and fees shall be contained
in the annual Federal Register notice under subsection
(a) publishing the fee revenue and fees for the fiscal
year involved.''.</DELETED>
<DELETED> (d) Annual Fee Setting.--Section 744B(d)(1) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j-42(d)(1)) is amended--
</DELETED>
<DELETED> (1) in the heading, by striking ``2018 through
2022'' and inserting ``2023 through 2027'';</DELETED>
<DELETED> (2) by striking ``more'' and inserting ``later'';
and</DELETED>
<DELETED> (3) by striking ``2018 through 2022'' and
inserting ``2023 through 2027''.</DELETED>
<DELETED> (e) Effect of Failure To Pay Fees.--The heading of
paragraph (3) of section 744B(g) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j-42(g)) is amended by striking ``and prior
approval supplement fee''.</DELETED>
<DELETED> (f) Crediting and Availability of Fees.--Section
744B(i)(3) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-
42(i)(3)) is amended by striking ``2018 through 2022'' and inserting
``2023 through 2027''.</DELETED>
<DELETED>SEC. 303. REAUTHORIZATION; REPORTING REQUIREMENTS.</DELETED>
<DELETED> Section 744C of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379j-43) is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) by striking ``2018'' each place it
appears and inserting ``2023''; and</DELETED>
<DELETED> (B) by striking ``Generic Drug User Fee
Amendments of 2017'' each place it appears and
inserting ``Generic Drug User Fee Amendments of
2022'';</DELETED>
<DELETED> (2) in subsection (b), by striking ``2018'' and
inserting ``2023'';</DELETED>
<DELETED> (3) in subsection (c)--</DELETED>
<DELETED> (A) by striking ``2018'' and inserting
``2023''; and</DELETED>
<DELETED> (B) by striking ``Generic Drug User Fee
Amendments of 2017'' each place it appears and
inserting ``Generic Drug User Fee Amendments of 2022'';
and</DELETED>
<DELETED> (4) in subsection (f)--</DELETED>
<DELETED> (A) in paragraph (1), by striking ``2022''
and inserting ``2027''; and</DELETED>
<DELETED> (B) in paragraph (5), by striking
``January 15, 2022'' and inserting ``January 15,
2027''.</DELETED>
<DELETED>SEC. 304. SUNSET DATES.</DELETED>
<DELETED> (a) Authorization.--Sections 744A and 744B of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j-41; 379j-42) shall cease
to be effective October 1, 2027.</DELETED>
<DELETED> (b) Reporting Requirements.--Section 744C of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j-43) shall cease to be
effective January 31, 2028.</DELETED>
<DELETED> (c) Previous Sunset Provision.--Effective October 1, 2022,
subsections (a) and (b) of section 305 of the FDA Reauthorization Act
of 2017 (Public Law 115-52) are repealed.</DELETED>
<DELETED>SEC. 305. EFFECTIVE DATE.</DELETED>
<DELETED> The amendments made by this title shall take effect on
October 1, 2022, or the date of the enactment of this Act, whichever is
later, except that fees under part 7 of subchapter C of chapter VII of
the Federal Food, Drug, and Cosmetic Act shall be assessed for all
abbreviated new drug applications received on or after October 1, 2022,
regardless of the date of the enactment of this Act.</DELETED>
<DELETED>SEC. 306. SAVINGS CLAUSE.</DELETED>
<DELETED> Notwithstanding the amendments made by this title, part 7
of subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic
Act, as in effect on the day before the date of the enactment of this
title, shall continue to be in effect with respect to abbreviated new
drug applications (as defined in such part as of such day) that were
received by the Food and Drug Administration within the meaning of
section 505(j)(5)(A) of such Act (21 U.S.C. 355(j)(5)(A)), prior
approval supplements that were submitted, and drug master files for
Type II active pharmaceutical ingredients that were first referenced on
or after October 1, 2017, but before October 1, 2022, with respect to
assessing and collecting any fee required by such part for a fiscal
year prior to fiscal year 2023.</DELETED>
<DELETED>TITLE IV--FEES RELATING TO BIOSIMILAR BIOLOGICAL
PRODUCTS</DELETED>
<DELETED>SEC. 401. SHORT TITLE; FINDING.</DELETED>
<DELETED> (a) Short Title.--This title may be cited as the
``Biosimilar User Fee Amendments of 2022''.</DELETED>
<DELETED> (b) Finding.--Congress finds that the fees authorized by
the amendments made in this title will be dedicated to expediting the
process for the review of biosimilar biological product applications,
including postmarket safety activities, as set forth in the goals
identified for purposes of part 8 of subchapter C of chapter VII of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-51 et seq.), in
the letters from the Secretary of Health and Human Services to the
Chairman of the Committee on Health, Education, Labor, and Pensions of
the Senate and the Chairman of the Committee on Energy and Commerce of
the House of Representatives, as set forth in the Congressional
Record.</DELETED>
<DELETED>SEC. 402. DEFINITIONS.</DELETED>
<DELETED> Section 744G of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379j-51) is amended--</DELETED>
<DELETED> (1) in paragraph (1)--</DELETED>
<DELETED> (A) by striking ``Washington-Baltimore,
DC-MD-VA-WV'' and inserting ``Washington-Arlington-
Alexandria, DC-VA-MD-WV'';</DELETED>
<DELETED> (B) by striking ``October of'' and
inserting ``September of''; and</DELETED>
<DELETED> (C) by striking ``October 2011'' and
inserting ``September 2011''; and</DELETED>
<DELETED> (2) in paragraph (4)(B)(iii)--</DELETED>
<DELETED> (A) by striking subclause (II);
and</DELETED>
<DELETED> (B) by redesignating subclauses (III) and
(IV) as subclauses (II) and (III),
respectively.</DELETED>
<DELETED>SEC. 403. AUTHORITY TO ASSESS AND USE BIOSIMILAR BIOLOGICAL
PRODUCT FEES.</DELETED>
<DELETED> (a) Types of Fees.--Section 744H(a) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-52(a)) is amended--</DELETED>
<DELETED> (1) in the matter preceding paragraph (1), by
striking ``2018'' and inserting ``2023'';</DELETED>
<DELETED> (2) in paragraph (1)--</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) in clause (iv)(I), by striking
``5 days'' and inserting ``7 days'';
and</DELETED>
<DELETED> (ii) in clause (v)(II), by
striking ``5 days'' and inserting ``7
days'';</DELETED>
<DELETED> (B) in subparagraph (B)--</DELETED>
<DELETED> (i) in clause (i), by inserting
``except that, in the case that such product
(including, where applicable, ownership of the
relevant investigational new drug application)
is transferred to a licensee, assignee, or
successor of such person, and written notice of
such transfer is provided to the Secretary,
such licensee, assignee or successor shall pay
the annual biosimilar biological product
development fee'' before the period;</DELETED>
<DELETED> (ii) in clause (iii)--</DELETED>
<DELETED> (I) in subclause (I), by
striking ``; or'' and inserting a
semicolon;</DELETED>
<DELETED> (II) in subclause (II), by
striking the period and inserting ``;
or''; and</DELETED>
<DELETED> (III) by adding at the end
the following:</DELETED>
<DELETED> ``(III) been
administratively removed from the
biosimilar biological product
development program for the product
under subparagraph (E)(v).'';
and</DELETED>
<DELETED> (iii) in clause (iv), by striking
``accepted for filing on or after October 1 of
such fiscal year'' and inserting ``subsequently
accepted for filing'';</DELETED>
<DELETED> (C) in subparagraph (D)--</DELETED>
<DELETED> (i) in clause (i)--</DELETED>
<DELETED> (I) in the matter
preceding subclause (I), by striking
``shall, if the person seeks to resume
participation in such program, pay''
and inserting ``or who has been
administratively removed from such
program for a product under
subparagraph (E)(v) shall, if the
person seeks to resume participation in
such program, pay all annual biosimilar
biological product development fees
previously assessed for such product
and still owed and'';</DELETED>
<DELETED> (II) in subclause (I)--
</DELETED>
<DELETED> (aa) by striking
``5 days'' and inserting ``7
days''; and</DELETED>
<DELETED> (bb) by inserting
``or the date of administrative
removal, as applicable'' after
``discontinued''; and</DELETED>
<DELETED> (III) in subclause (II),
by inserting ``or the date of
administrative removal, as applicable''
after ``discontinued''; and</DELETED>
<DELETED> (ii) in clause (ii), by inserting
``except that, in the case that such product
(including, where applicable, ownership of the
relevant investigational new drug application)
is transferred to a licensee, assignee, or
successor of such person, and written notice of
such transfer is provided to the Secretary,
such licensee, assignee or successor shall pay
the annual biosimilar biological product
development fee'' before the period at the end;
and</DELETED>
<DELETED> (D) in subparagraph (E), by adding at the
end the following:</DELETED>
<DELETED> ``(v) Administrative removal from
the biosimilar biological product development
program.--If a person has failed to pay an
annual biosimilar biological product
development fee for a product as required under
subparagraph (B) for a period of 2 consecutive
fiscal years, the Secretary may
administratively remove such person from the
biosimilar biological product development
program for the product. At least 30 days prior
to administratively removing a person from the
biosimilar biological product development
program for a product under this clause, the
Secretary shall provide written notice to such
person of the intended administrative
removal.'';</DELETED>
<DELETED> (3) in paragraph (2)(D), by inserting ``prior to
approval'' after ``withdrawn'';</DELETED>
<DELETED> (4) in paragraph (3)--</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) in clause (i), by striking ``;
and'' and inserting a semicolon;</DELETED>
<DELETED> (ii) by redesignating clause (ii)
as clause (iii); and</DELETED>
<DELETED> (iii) by inserting the following
after clause (i):</DELETED>
<DELETED> ``(ii) may be dispensed only under
prescription pursuant to section 503(b); and'';
and</DELETED>
<DELETED> (B) by adding at the end the
following:</DELETED>
<DELETED> ``(E) Movement to discontinued list.--
</DELETED>
<DELETED> ``(i) Written request to place on
discontinued list.--</DELETED>
<DELETED> ``(I) In general.--If a
written request to place a product on
the list of discontinued biosimilar
biological products referred to in
subparagraph (A)(iii) is submitted to
the Secretary on behalf of an
applicant, and the request identifies
the date the product is, or will be,
withdrawn from sale, then for purposes
of assessing the biosimilar biological
product program fee, the Secretary
shall consider such product to have
been included on such list on the later
of--</DELETED>
<DELETED> ``(aa) the date
such request was received;
or</DELETED>
<DELETED> ``(bb) if the
product will be withdrawn from
sale on a future date, such
future date when the product is
withdrawn from sale.</DELETED>
<DELETED> ``(II) Withdrawn from sale
defined.--For purposes of this clause,
a product shall be considered withdrawn
from sale once the applicant has ceased
its own distribution of the product,
whether or not the applicant has
ordered recall of all previously
distributed lots of the product, except
that a routine, temporary interruption
in supply shall not render a product
withdrawn from sale.</DELETED>
<DELETED> ``(ii) Products removed from
discontinued list.--If a biosimilar biological
product that is identified in a biosimilar
biological product application approved as of
October 1 of a fiscal year appears, as of
October 1 of such fiscal year, on the list of
discontinued biosimilar biological products
referred to in subparagraph (A)(iii), and on
any subsequent day during such fiscal year the
biosimilar biological product does not appear
on such list, except as provided in
subparagraph (D), each person who is named as
the applicant in the biosimilar biological
product application shall pay the annual
biosimilar biological product program fee
established for a fiscal year under subsection
(c)(5) for such biosimilar biological product.
Notwithstanding subparagraph (B), such fee
shall be due on the last business day of such
fiscal year and shall be paid only once for
each product for each fiscal year.'';
and</DELETED>
<DELETED> (5) by striking paragraph (4).</DELETED>
<DELETED> (b) Fee Revenue Amounts.--Section 744H(b) of the Federal
Food, Drug, and Cosmetic Act ((21 U.S.C. 379j-52(b)) is amended--
</DELETED>
<DELETED> (1) by striking paragraph (1);</DELETED>
<DELETED> (2) by redesignating paragraphs (2) through (4) as
paragraphs (1) through (3), respectively;</DELETED>
<DELETED> (3) in paragraph (1), as so redesignated--
</DELETED>
<DELETED> (A) in the paragraph heading, by striking
``Subsequent fiscal years'' and inserting ``In
general'';</DELETED>
<DELETED> (B) in the matter preceding subparagraph
(A), by striking ``2019 through 2022'' and inserting
``2023 through 2027'';</DELETED>
<DELETED> (C) in subparagraph (A), by striking
``paragraph (4)'' and inserting ``paragraph
(3)'';</DELETED>
<DELETED> (D) by redesignating subparagraphs (C) and
(D) as subparagraphs (D) and (E),
respectively;</DELETED>
<DELETED> (E) by inserting after subparagraph (B)
the following:</DELETED>
<DELETED> ``(C) the dollar amount equal to the
strategic hiring and retention adjustment (as
determined under subsection (c)(2));'';</DELETED>
<DELETED> (F) in subparagraph (D), as so
redesignated, by striking ``subsection (c)(2)); and''
and inserting ``subsection (c)(3));'';</DELETED>
<DELETED> (G) in subparagraph (E), as so
redesignated, by striking ``subsection (c)(3)).'' and
inserting ``subsection (c)(4)); and''; and</DELETED>
<DELETED> (H) by adding at the end the
following:</DELETED>
<DELETED> ``(F) for fiscal years 2023 and 2024,
additional dollar amounts equal to--</DELETED>
<DELETED> ``(i) $4,428, 886 for fiscal year
2023; and</DELETED>
<DELETED> ``(ii) $320,569 for fiscal year
2024.'';</DELETED>
<DELETED> (4) in paragraph (2), as so redesignated--
</DELETED>
<DELETED> (A) in the paragraph heading, by striking
``; limitations on fee amounts'';</DELETED>
<DELETED> (B) by striking subparagraph (B);
and</DELETED>
<DELETED> (C) by redesignating subaparagraphs (C)
and (D) as subparagraphs (B) and (C), respectively;
and</DELETED>
<DELETED> (5) by amending paragraph (3), as so redesignated,
to read as follows:</DELETED>
<DELETED> ``(3) Annual base revenue.--For purposes of
paragraph (1), the dollar amount of the annual base revenue for
a fiscal year shall be--</DELETED>
<DELETED> ``(A) for fiscal year 2023, $43,376,922;
and</DELETED>
<DELETED> ``(B) for fiscal years 2024 through 2027,
the dollar amount of the total revenue amount
established under paragraph (1) for the previous fiscal
year, excluding any adjustments to such revenue amount
under subsection (c)(4).''.</DELETED>
<DELETED> (c) Adjustments; Annual Fee Setting.--Section 744H(c) of
the Federal Food, Drug, and Cosmetic Act ((21 U.S.C. 379j-52(c)) is
amended--</DELETED>
<DELETED> (1) in paragraph (1)--</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) in the matter preceding clause
(i), by striking ``subsection (b)(2)(B)'' and
inserting ``subsection (b)(1)(B)'';
and</DELETED>
<DELETED> (ii) in clause (i), by striking
``subsection (b)'' and inserting ``subsection
(b)(1)(A)''; and</DELETED>
<DELETED> (B) in subparagraph (B)(ii), by striking
``Washington-Baltimore, DC-MD-VA-WV'' and inserting
``Washington-Arlington-Alexandria, DC-VA-MD-
WV'';</DELETED>
<DELETED> (2) by striking paragraph (4);</DELETED>
<DELETED> (3) by redesignating paragraphs (2) and (3) as
paragraphs (3) and (4), respectively;</DELETED>
<DELETED> (4) by inserting after paragraph (1) the
following:</DELETED>
<DELETED> ``(2) Strategic hiring and retention adjustment.--
For each fiscal year beginning in fiscal year 2023, after the
annual base revenue under subsection (b)(1)(A) is adjusted for
inflation in accordance with paragraph (1), the Secretary shall
further increase the fee revenue and fees by
$150,000.'';</DELETED>
<DELETED> (5) in paragraph (3), as so redesignated--
</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) by striking ``Beginning with
the fiscal year described in subparagraph
(B)(ii)(II)'' and inserting ``For each fiscal
year''; and</DELETED>
<DELETED> (ii) by striking ``adjustment
under paragraph (1), further increase'' and
inserting ``adjustments under paragraphs (1)
and (2), further adjust''; and</DELETED>
<DELETED> (B) by amending subparagraph (B) to read
as follows:</DELETED>
<DELETED> ``(B) Methodology.--For purposes of this
paragraph, the Secretary shall employ the capacity
planning methodology utilized by the Secretary in
setting fees for fiscal year 2021, as described in the
notice titled `Biosimilar User Fee Rates for Fiscal
Year 2021' (85 Fed. Reg. 47220; August 4, 2020). The
workload categories used in forecasting shall include
only the activities described in such notice and, as
feasible, additional activities that are also directly
related to the direct review of biosimilar biological
product applications and supplements, including
additional formal meeting types and the direct review
of postmarketing commitments and requirements, the
direct review of risk evaluation and mitigation
strategies, and the direct review of annual reports for
approved biosimilar biological products. Subject to the
exceptions in the preceding sentence, the Secretary
shall not include as workload categories in forecasting
any non-core review activities, including any
activities that the Secretary referenced for potential
future use in such notice but did not utilize in
setting fees for fiscal year 2021.''; and</DELETED>
<DELETED> (C) in subparagraph (C)--</DELETED>
<DELETED> (i) by striking ``subsections
(b)(2)(A)'' and inserting ``subsections
(b)(1)(A)'';</DELETED>
<DELETED> (ii) by striking ``and (b)(2)(B)''
and inserting ``, (b)(1)(B)''; and</DELETED>
<DELETED> (iii) by inserting ``, and
(b)(1)(C) (the dollar amount of the strategic
hiring and retention adjustment)'' before the
period at the end;</DELETED>
<DELETED> (6) by amending paragraph (4), as so redesignated,
to read as follows:</DELETED>
<DELETED> ``(4) Operating reserve adjustment.--</DELETED>
<DELETED> ``(A) Increase.--For fiscal year 2023 and
subsequent fiscal years, the Secretary shall, in
addition to adjustments under paragraphs (1), (2), and
(3), further increase the fee revenue and fees if such
an adjustment is necessary to provide for at least 10
weeks of operating reserves of carryover user fees for
the process for the review of biosimilar biological
product applications.</DELETED>
<DELETED> ``(B) Decrease.--</DELETED>
<DELETED> ``(i) Fiscal year 2023.--For
fiscal year 2023, if the Secretary has
carryover balances for the process for the
review of biosimilar biological product
applications in excess of 33 weeks of such
operating reserves, the Secretary shall
decrease such fee revenue and fees to provide
for not more than 33 weeks of such operating
reserves.</DELETED>
<DELETED> ``(ii) Fiscal year 2024.--For
fiscal year 2024, if the Secretary has
carryover balances for the process for the
review of biosimilar biological product
applications in excess of 27 weeks of such
operating reserves, the Secretary shall
decrease such fee revenue and fees to provide
for not more than 27 weeks of such operating
reserves.</DELETED>
<DELETED> ``(iii) Fiscal year 2025 and
subsequent fiscal years.--For fiscal year 2025
and subsequent fiscal years, if the Secretary
has carryover balances for the process for the
review of biosimilar biological product
applications in excess of 21 weeks of such
operating reserves, the Secretary shall
decrease such fee revenue and fees to provide
for not more than 21 weeks of such operating
reserves.</DELETED>
<DELETED> ``(C) Federal register notice.--If an
adjustment under subparagraph (A) or (B) is made, the
rationale for the amount of the increase or decrease
(as applicable) in fee revenue and fees shall be
contained in the annual Federal Register notice under
paragraph (5)(B) establishing fee revenue and fees for
the fiscal year involved.''; and</DELETED>
<DELETED> (7) in paragraph (5), in the matter preceding
subparagraph (A), by striking ``2018'' and inserting
``2023''.</DELETED>
<DELETED> (d) Crediting and Availability of Fees.--Section
744H(f)(3) of the Federal Food, Drug, and Cosmetic Act ((21 U.S.C.
379j-52(f)(3)) is amended by striking ``2018 through 2022'' and
inserting ``2023 through 2027''.</DELETED>
<DELETED> (e) Written Requests for Waivers and Refunds.--Subsection
(h) of section 744H of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 379j-52) is amended to read as follows:</DELETED>
<DELETED> ``(h) Written Requests for Waivers and Returns; Disputes
Concerning Fees.--To qualify for consideration for a waiver under
subsection (d), or the return of any fee paid under this section,
including if the fee is claimed to have been paid in error, a person
shall submit to the Secretary a written request justifying such waiver
or return and, except as otherwise specified in this section, such
written request shall be submitted to the Secretary not later than 180
days after such fee is due. A request submitted under this paragraph
shall include any legal authorities under which the request is
made.''.</DELETED>
<DELETED>SEC. 404. REAUTHORIZATION; REPORTING REQUIREMENTS.</DELETED>
<DELETED> Section 744I of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379j-53) is amended--</DELETED>
<DELETED> (1) by striking ``2018'' each place it appears and
inserting ``2023'';</DELETED>
<DELETED> (2) by striking ``Biosimilar User Fee Amendments
of 2017'' each place it appears and inserting ``Biosimilar User
Fee Amendments of 2022'';</DELETED>
<DELETED> (3) in subsection (a)(4), by striking ``2020'' and
inserting ``2023''; and</DELETED>
<DELETED> (4) in subsection (f), by striking ``2022'' each
place it appears and inserting ``2027''.</DELETED>
<DELETED>SEC. 405. SUNSET DATES.</DELETED>
<DELETED> (a) Authorization.--Sections 744G and 744H of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j-51, 379j-52 ) shall cease
to be effective October 1, 2027.</DELETED>
<DELETED> (b) Reporting Requirements.--Section 744I of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j-53) shall cease to be
effective January 31, 2028.</DELETED>
<DELETED> (c) Previous Sunset Provision.--Effective October 1, 2022,
subsections (a) and (b) of section 405 of the FDA Reauthorization Act
of 2017 (Public Law 115-52) are repealed.</DELETED>
<DELETED>SEC. 406. EFFECTIVE DATE.</DELETED>
<DELETED> The amendments made by this title shall take effect on
October 1, 2022, or the date of the enactment of this Act, whichever is
later, except that fees under part 8 of subchapter C of chapter VII of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-51 et seq.)
shall be assessed for all biosimilar biological product applications
received on or after October 1, 2022, regardless of the date of the
enactment of this Act.</DELETED>
<DELETED>SEC. 407. SAVINGS CLAUSE.</DELETED>
<DELETED> Notwithstanding the amendments made by this title, part 8
of subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 379j-51 et seq.), as in effect on the day before the
date of the enactment of this title, shall continue to be in effect
with respect to biosimilar biological product applications and
supplements (as defined in such part as of such day) that were accepted
by the Food and Drug Administration for filing on or after October 1,
2017, but before October 1, 2022, with respect to assessing and
collecting any fee required by such part for a fiscal year prior to
fiscal year 2023.</DELETED>
<DELETED>TITLE V--IMPROVING REGULATION OF DRUGS AND BIOLOGICAL
PRODUCTS</DELETED>
<DELETED>SEC. 501. ALTERNATIVES TO ANIMAL TESTING.</DELETED>
<DELETED> (a) In General.--Section 505 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 355) is amended--</DELETED>
<DELETED> (1) in subsection (i)--</DELETED>
<DELETED> (A) in paragraph (1)(A), by striking
``preclinical tests (including tests on animals)'' and
inserting ``nonclinical tests''; and</DELETED>
<DELETED> (B) in paragraph (2)(B), by striking
``animal'' and inserting ``nonclinical tests'';
and</DELETED>
<DELETED> (2) after subsection (y), by inserting the
following:</DELETED>
<DELETED> ``(z) Nonclinical Test Defined.--For purposes of this
section, the term `nonclinical test' means a test conducted in vitro,
in silico, or in chemico, or a non-human in vivo test that occurs
before or during the clinical trial phase of the investigation of the
safety and effectiveness of a drug, and may include animal tests, or
non-animal or human biology-based test methods, such as cell-based
assays, microphysiological systems, or computer models.''.</DELETED>
<DELETED> (b) Biosimilar Biological Product Applications.--Item (bb)
of section 351(k)(2)(A)(i)(I) of the Public Health Service Act (42
U.S.C. 262(k)(2)(A)(i)(I)) is amended to read as follows:</DELETED>
<DELETED> ``(bb) an
assessment of toxicity (which
may rely on, or consist of, a
study or studies described in
item (aa) or (cc));
and''.</DELETED>
<DELETED>SEC. 502. SAFER DISPOSAL OF OPIOIDS.</DELETED>
<DELETED> Section 505-1(e)(4)(B) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355-1(e)(4)(B)) is amended by striking ``for
purposes of rendering drugs nonretrievable (as defined in section
1300.05 of title 21, Code of Federal Regulations (or any successor
regulation))''.</DELETED>
<DELETED>SEC. 503. CLARIFICATIONS TO EXCLUSIVITY PROVISIONS FOR FIRST
INTERCHANGEABLE BIOSIMILAR BIOLOGICAL PRODUCTS.</DELETED>
<DELETED> Section 351(k)(6) of the Public Health Service Act (42
U.S.C. 262(k)(6)) is amended--</DELETED>
<DELETED> (1) in the matter preceding subparagraph (A)--
</DELETED>
<DELETED> (A) by striking ``Upon review of'' and
inserting ``The Secretary shall not make licensure as
an interchangeable biological product effective with
respect to'';</DELETED>
<DELETED> (B) by striking ``relying on'' and
inserting ``that relies on''; and</DELETED>
<DELETED> (C) by striking ``the Secretary shall not
make a determination under paragraph (4) that the
second or subsequent biological product is
interchangeable for any condition of use'';
and</DELETED>
<DELETED> (2) in the flush text that follows subparagraph
(C), by striking the period and inserting ``, and the term
`first interchangeable biosimilar biological product' means any
interchangeable biosimilar biological product that is approved
on the first day on which such a product is approved as
interchangeable with the reference product.''.</DELETED>
<DELETED>SEC. 504. IMPROVEMENTS TO THE PURPLE BOOK.</DELETED>
<DELETED> (a) In General.--Section 506I of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 356i) is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) by striking ``The holder of an
application approved under subsection (c) or (j) of
section 505'' and inserting ``The holder of an
application approved under subsection (c) or (j) of
section 505 of this Act or subsection (a) or (k) of
section 351 of the Public Health Service
Act'';</DELETED>
<DELETED> (B) in paragraph (2), by inserting ``(in
the case of a biological product, the proper name)''
after ``established name''; and</DELETED>
<DELETED> (C) in paragraph (3), by striking ``or
abbreviated application number'' and inserting ``,
abbreviated application number, or biologics license
application number''; and</DELETED>
<DELETED> (2) in subsection (b)--</DELETED>
<DELETED> (A) in the matter preceding paragraph (1),
by striking ``The holder of an application approved
under subsection (c) or (j)'' and inserting ``The
holder of an application approved under subsection (c)
or (j) of section 505 of this Act or subsection (a) or
(k) of section 351 of the Public Health Service
Act'';</DELETED>
<DELETED> (B) in paragraph (1), by inserting ``(in
the case of a biological product, the proper name)''
after ``established name''; and</DELETED>
<DELETED> (C) in paragraph (2), by striking ``or
abbreviated application number'' and inserting ``,
abbreviated application number, or biologics license
application number''.</DELETED>
<DELETED> (b) Additional One-Time Report.--Subsection (c) of section
506I of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 356i) is
amended to read as follows:</DELETED>
<DELETED> ``(c) Additional One-Time Report.--Within 180 days of the
date of enactment of the Food and Drug Administration Safety and
Landmark Advancements Act of 2022, all holders of applications approved
under subsection (a) or (k) of section 351 of the Public Health Service
Act shall review the information in the list published under section
351(k)(9)(A) and shall submit a written notice to the Secretary--
</DELETED>
<DELETED> ``(1) stating that all of the application holder's
biological products in the list published under section
351(k)(9)(A) that are not listed as discontinued are available
for sale; or</DELETED>
<DELETED> ``(2) including the information required pursuant
to subsection (a) or (b), as applicable, for each of the
application holder's biological products that are in the list
published under section 351(k)(9)(A) and not listed as
discontinued, but have been discontinued from sale or never
have been available for sale.''.</DELETED>
<DELETED> (c) Purple Book.--Section 506I of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 356i) is amended--</DELETED>
<DELETED> (1) in subsection (d)--</DELETED>
<DELETED> (A) by striking ``or (c), the Secretary''
and inserting ``or (c)--</DELETED>
<DELETED> ``(1) the Secretary'';</DELETED>
<DELETED> (B) by striking the period at the end, and
inserting ``; and''; and</DELETED>
<DELETED> (C) by adding at the end the
following:</DELETED>
<DELETED> ``(2) the Secretary may identify the application
holder's biological products as discontinued in the list
published under section 351(k)(9)(A) of the Public Health
Service Act, except that the Secretary shall remove from the
list in accordance with section 351(k)(9)(B) of such Act any
biological product for which a license has been revoked or
suspended for reasons of safety, purity, or potency.'';
and</DELETED>
<DELETED> (2) in subsection (e)--</DELETED>
<DELETED> (A) by inserting after the first sentence
the following: ``The Secretary shall update the list
published under section 351(k)(9)(A) of the Public
Health Service Act based on information provided under
subsections (a), (b), and (c) by identifying as
discontinued biological products that are not available
for sale, except that any biological product for which
the license has been revoked or suspended for reasons
of safety, purity, or potency shall be removed from the
list in accordance with section 351(k)(9)(B) of the
Public Health Service Act.''; and</DELETED>
<DELETED> (B) in the last sentence--</DELETED>
<DELETED> (i) by striking ``updates to the
list'' and inserting ``updates to the lists
published under section 505(j)(7)(A) of this
Act and section 351(k)(9)(A) of the Public
Health Service Act''; and</DELETED>
<DELETED> (ii) by striking ``update the
list'' and inserting ``update such
lists''.</DELETED>
<DELETED>SEC. 505. THERAPEUTIC EQUIVALENCE EVALUATIONS.</DELETED>
<DELETED> Section 505(j)(7)(A) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355(j)(7)(A)) is amended by adding at the end
the following:</DELETED>
<DELETED> ``(v)(I) With respect to an application submitted pursuant
to subsection (b)(2) for a drug that is subject to section 503(b) for
which the sole difference from a listed drug relied upon in the
application is a difference in inactive ingredients not permitted under
clause (iii) or (iv) of section 314.94(a)(9) of title 21, Code of
Federal Regulations (or successor regulations), the Secretary shall
make an evaluation with respect to whether such drug is a therapeutic
equivalent (as defined in section 314.3 of title 21, Code of Federal
Regulations (or any successor regulations)) to another approved drug
product in the prescription drug product section of the list under this
paragraph as follows:</DELETED>
<DELETED> ``(aa) With respect to such an application
submitted after the date of enactment of the Food and Drug
Administration Safety and Landmark Advancements Act of 2022,
the evaluation shall be made with respect to a listed drug
relied upon in the application under subsection (b)(2) that is
a pharmaceutical equivalent (as defined in section 314.3 of
title 21, Code of Federal Regulations (or any successor
regulations)) to the drug in the application under subsection
(b)(2) at the time of approval of such application or not later
than 180 days after the date of such approval, provided that
the request for such a determination is made in the original
application (or in a resubmission to a complete response
letter), and all necessary data and information are submitted
in the original application (or in a resubmission in response
to a complete response letter) for the therapeutic equivalence
evaluation, including information to demonstrate
bioequivalence, in a form and manner prescribed by the
Secretary.</DELETED>
<DELETED> ``(bb) With respect to such an application
submitted prior to the date of enactment of the Food and Drug
Administration Safety and Landmark Advancements Act of 2022,
with respect to an application approved on or after the date of
enactment of such Act, the evaluation shall be made not later
than 180 days after receipt of a request for a therapeutic
equivalence evaluation submitted as part of a supplement to
such application; or with respect to an application that was
not approved as of the date of enactment of such Act, the
evaluation shall be made not later than 180 days after the date
of approval of such application if a request for such
evaluation is submitted to the application, provided that--
</DELETED>
<DELETED> ``(AA) such request for a therapeutic
equivalent evaluation is being sought with respect to a
listed drug relied upon in the application, and the
relied upon listed drug is in the prescription drug
product section of the list under this paragraph and is
a pharmaceutical equivalent (as defined in section
314.3 of title 21, Code of Federal Regulations (or any
successor regulations)) to the drug for which a
therapeutic equivalence evaluation is sought;
and</DELETED>
<DELETED> ``(BB) the initial submission containing
such request, or the relevant application, includes all
necessary data and information for the therapeutic
equivalence evaluation, including information to
demonstrate bioequivalence, in a form and manner
prescribed by the Secretary.</DELETED>
<DELETED> ``(II) When the Secretary makes an evaluation under
subclause (I), the Secretary shall, in revisions made to the list
pursuant to clause (ii), include such information for such
drug.''.</DELETED>
<DELETED>SEC. 506. MODERNIZING ACCELERATED APPROVAL.</DELETED>
<DELETED> (a) In General.--Section 506(c) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 356(c)) is amended--</DELETED>
<DELETED> (1) in paragraph (2)--</DELETED>
<DELETED> (A) by redesignating subparagraphs (A) and
(B) as clauses (i) and (ii), respectively, and
adjusting the margins accordingly;</DELETED>
<DELETED> (B) by striking ``Approval of a product''
and inserting the following:</DELETED>
<DELETED> ``(A) In general.--Approval of a
product'';</DELETED>
<DELETED> (C) in clause (i) of such subparagraph
(A), as so redesignated, by striking ``appropriate
postapproval studies'' and inserting ``an appropriate
postapproval study or studies (which may be augmented
or supported by real world evidence)''; and</DELETED>
<DELETED> (D) by adding at the end the
following:</DELETED>
<DELETED> ``(B) Studies not required.--If the
Secretary does not require that the sponsor of a
product approved under accelerated approval conduct a
postapproval study under this paragraph, the Secretary
shall publish on the website of the Food and Drug
Administration the rationale for why such study is not
appropriate or necessary.</DELETED>
<DELETED> ``(C) Postapproval study conditions.--Not
later than the time of approval of a product under
accelerated approval, the Secretary shall specify the
conditions for a postapproval study or studies required
to be conducted under this paragraph with respect to
such product, which may include enrollment targets, the
study protocol, and milestones, including the target
date of study completion.</DELETED>
<DELETED> ``(D) Studies begun before approval.--The
Secretary may require such study or studies to be
underway prior to approval.''; and</DELETED>
<DELETED> (2) in paragraph (3)--</DELETED>
<DELETED> (A) by redesignating subparagraphs (A)
through (D) as clauses (i) through (iv), respectively
and adjusting the margins accordingly;</DELETED>
<DELETED> (B) by striking ``The Secretary may'' and
inserting the following:</DELETED>
<DELETED> ``(A) In general.--The Secretary
may'';</DELETED>
<DELETED> (C) in clause (i) of such subparagraph
(A), as so redesignated, by striking ``drug with due
diligence'' and inserting ``product with due diligence,
including with respect to conditions specified by the
Secretary under paragraph (2)(C)'';</DELETED>
<DELETED> (D) in clause (iii) of such subparagraph
(A), as so redesignated, by inserting ``shown to be''
after ``product is not''; and</DELETED>
<DELETED> (E) by adding at the end the
following:</DELETED>
<DELETED> ``(B) Expedited procedures described.--
Expedited procedures described in this subparagraph
shall consist of, prior to the withdrawal of
accelerated approval--</DELETED>
<DELETED> ``(i) providing the sponsor with--
</DELETED>
<DELETED> ``(I) due
notice;</DELETED>
<DELETED> ``(II) an explanation for
the proposed withdrawal;</DELETED>
<DELETED> ``(III) an opportunity for
a meeting with the Commissioner or the
Commissioner's designee; and</DELETED>
<DELETED> ``(IV) an opportunity for
written appeal to--</DELETED>
<DELETED> ``(aa) the
Commissioner; or</DELETED>
<DELETED> ``(bb) a designee
of the Commissioner who has not
participated in the proposal
withdrawal of approval (other
than a meeting pursuant to
subclause (III)) and is not
subordinate of an individual
(other than the Commissioner)
who participated in such
proposed withdrawal;</DELETED>
<DELETED> ``(ii) providing an opportunity
for public comment on the proposing to
withdrawal approval;</DELETED>
<DELETED> ``(iii) the publication of a
summary of the public comments received, and
the Secretary's response to such comments, on
the website of the Food and Drug
Administration; and</DELETED>
<DELETED> ``(iv) convening and consulting an
advisory committee on issues related to the
proposed withdrawal, if requested by the
sponsor and if no such advisory committee has
previously advised the Secretary on such issues
with respect to the withdrawal of the product
prior to the sponsor's request.''.</DELETED>
<DELETED> (b) Reports of Postmarketing Studies.--Section 506B of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 356b(a)) is amended--
</DELETED>
<DELETED> (1) by redesignating paragraph (2) as paragraph
(3); and</DELETED>
<DELETED> (2) by inserting after paragraph (1) the
following:</DELETED>
<DELETED> ``(2) Accelerated approval.--Notwithstanding
paragraph (1), a sponsor of a drug approved under accelerated
approval shall submit to the Secretary a report of the progress
of any study required under section 506(c), including progress
toward enrollment targets, milestones, and other information as
required by the Secretary, not later than 180 days after the
approval of such drug and not less frequently than every 180
days thereafter, until the study is completed or
terminated.''.</DELETED>
<DELETED> (c) Enforcement.--Section 301 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 331), as amended by section 824, is further
amended by adding at the end the following:</DELETED>
<DELETED> ``(ll) The failure of a sponsor of a product approved
under accelerated approval pursuant to section 506(c)--</DELETED>
<DELETED> ``(1) to conduct with due diligence any
postapproval study required under section 506(c) with respect
to such product; or</DELETED>
<DELETED> ``(2) to submit timely reports with respect to
such product in accordance with section
506B(a)(2).''.</DELETED>
<DELETED> (d) Guidance.--</DELETED>
<DELETED> (1) In general.--The Secretary of Health and Human
Services shall issue guidance describing--</DELETED>
<DELETED> (A) how sponsor questions related to the
identification of novel surrogate or intermediate
clinical endpoints may be addressed in early-stage
development meetings with the Food and Drug
Administration;</DELETED>
<DELETED> (B) the use of novel clinical trial
designs that may be used to conduct appropriate post-
approval studies as may be required under section
506(c)(2)(A) of the Federal Food, Drug, and Cosmetic
Act, as amended by subsection (a);</DELETED>
<DELETED> (C) the expedited procedures described in
section 506(c)(3)(B) of the Federal Food, Drug, and
Cosmetic Act; and</DELETED>
<DELETED> (D) considerations related to the use of
surrogate or intermediate clinical endpoints that may
support the accelerated approval of an application
under 506(c)(1)(A), including considerations in
evaluating the evidence related to any such
endpoints.</DELETED>
<DELETED> (2) Final guidance.--The Secretary shall issue--
</DELETED>
<DELETED> (A) a draft guidance under paragraph (1)
not later than 18 months after the date of enactment of
this Act; and</DELETED>
<DELETED> (B) final guidance not later than 1 year
after the close of the public comment period on such
draft guidance.</DELETED>
<DELETED> (e) Rare Disease Endpoint Advancement Pilot.--</DELETED>
<DELETED> (1) In general.--The Secretary of Health and Human
Services shall establish a pilot program under which the
Secretary will establish procedures to provide increased
interaction with sponsors of rare disease drug development
programs for purposes of advancing the development of efficacy
endpoints, including surrogate and intermediate endpoints, for
drugs intended to treat rare diseases, including through--
</DELETED>
<DELETED> (A) determining eligibility of
participants for such program; and</DELETED>
<DELETED> (B) developing and implementing a process
for applying to, and participating in, such a
program.</DELETED>
<DELETED> (2) Public workshops.--The Secretary shall conduct
up to 3 public workshops, which shall be completed not later
than September 30, 2026, to discuss topics relevant to the
development of endpoints for rare diseases, which may include
discussions about--</DELETED>
<DELETED> (A) novel endpoints developed through the
pilot program established under this subsection;
and</DELETED>
<DELETED> (B) as appropriate, the use of real world
evidence and real work data to support the validation
of efficacy endpoints, including surrogate and
intermediate endpoints, for rare diseases.</DELETED>
<DELETED> (3) Report.--Not later than September 30, 2027,
the Secretary shall submit to the Committee on Energy and
Commerce of the House of Representatives and the Committee on
Health, Education, Labor, and Pensions of the Senate a report
describing the outcomes of the pilot program established under
this subsection.</DELETED>
<DELETED> (4) Guidance.--Not later than September 30, 2027,
the Secretary shall issue guidance describing best practices
and strategies for development of efficacy endpoints, including
surrogate and intermediate endpoints, for rare
diseases.</DELETED>
<DELETED> (5) Sunset.--The Secretary may not accept any new
application or request to participate in the program
established by this subsection on or after October 1,
2027.</DELETED>
<DELETED> (f) Accelerated Approval Council.--</DELETED>
<DELETED> (1) General.--Not later than 180 days after the
date of enactment of this Act, the Secretary of Health and
Human Services shall establish an intra-agency coordinating
council within the Food and Drug Administration to ensure the
consistent and appropriate use of accelerated approval across
the Food and Drug Administration, pursuant to section 506(c) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
356(c)).</DELETED>
<DELETED> (2) Membership.--The members of the Council shall
consist of the following senior officials, or a designee of
such official, from the Food and Drug Administration and
relevant Centers:</DELETED>
<DELETED> (A) The Director of the Center for Drug
Evaluation and Research.</DELETED>
<DELETED> (B) The Director of the Center for
Biologics Evaluation and Research.</DELETED>
<DELETED> (C) The Director of the Oncology Center of
Excellence.</DELETED>
<DELETED> (D) The Director of the Office of New
Drugs.</DELETED>
<DELETED> (E) The Director of the Office of Orphan
Products Development.</DELETED>
<DELETED> (F) The Director of the Office of Tissues
and Advanced Therapies.</DELETED>
<DELETED> (G) The Director of the Office of Medical
Policy.</DELETED>
<DELETED> (H) At least 3 directors of review
division overseeing products approved under accelerated
approval, including at least one director of a review
division within the Office of Neuroscience.</DELETED>
<DELETED> (3) Duties of the council.--</DELETED>
<DELETED> (A) Meetings.--The Council shall convene
not fewer than 3 times per calendar year to discuss
issues related to accelerated approval, including any
relevant cross-disciplinary approaches related to
product review with respect to accelerated
approval.</DELETED>
<DELETED> (B) Policy development.--The Council shall
directly engage with product review teams to support
the consistent and appropriate use of accelerated
approval across the Food and Drug Administration. Such
activities may include--</DELETED>
<DELETED> (i) developing guidance for Food
and Drug Administration staff and best
practices for, and across, product review
teams, including with respect to communication
between sponsors and the Food and Drug
Administration and the review of products under
accelerated approval;</DELETED>
<DELETED> (ii) providing training for
product review teams; and</DELETED>
<DELETED> (iii) advising review divisions on
product-specific development, review, and
withdrawal of products under accelerated
approval.</DELETED>
<DELETED> (4) Publication of a report.--Not later than 1
year after the date of enactment of this Act, and annually
thereafter, the council shall publish on the public website of
the Food and Drug Administration a report on the activities of
the council.</DELETED>
<DELETED> (g) Rule of Construction.--Nothing in this section
(including the amendments made by this section) shall be construed to
affect products approved under 506(c) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 356(c)) prior to the date of enactment of this
Act.</DELETED>
<DELETED>TITLE VI--OTHER REAUTHORIZATIONS</DELETED>
<DELETED>SEC. 601. REAUTHORIZATION OF THE CRITICAL PATH PUBLIC-PRIVATE
PARTNERSHIP.</DELETED>
<DELETED> Section 566(f) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 360bbb-5(f)) is amended by striking ``2018 through 2022''
and inserting ``2023 through 2027''.</DELETED>
<DELETED>SEC. 602. REAUTHORIZATION OF THE BEST PHARMACEUTICALS FOR
CHILDREN PROGRAM.</DELETED>
<DELETED> Section 409I(d)(1) of the Public Health Service Act (42
U.S.C. 284m(d)(1)) is amended by striking ``2018 through 2022'' and
inserting ``2023 through 2027''.</DELETED>
<DELETED>SEC. 603. REAUTHORIZATION OF THE HUMANITARIAN DEVICE EXEMPTION
INCENTIVE.</DELETED>
<DELETED> Section 520(m)(6)(A)(iv) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360j(m)(6)(A)(iv)) is amended by striking
``2022'' and inserting ``2027''.</DELETED>
<DELETED>SEC. 604. REAUTHORIZATION OF THE PEDIATRIC DEVICE CONSORTIA
PROGRAM.</DELETED>
<DELETED> Section 305(e) of the Food and Drug Administration
Amendments Act of 2007 (Public Law 110-85; 42 U.S.C. 282 note) is
amended by striking ``$5,250,000 for each of fiscal years 2018 through
2022'' and inserting ``$7,000,000 for each of fiscal years 2023 through
2027''.</DELETED>
<DELETED>SEC. 605. REAUTHORIZATION OF PROVISION PERTAINING TO DRUGS
CONTAINING SINGLE ENANTIOMERS.</DELETED>
<DELETED> Section 505(u) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 355(u)) is amended by--</DELETED>
<DELETED> (1) in paragraph (1)(A)(ii)(II), by adding
``(other than bioavailability studies)'' after ``any clinical
investigations''; and</DELETED>
<DELETED> (2) in paragraph (4), by striking ``October 1,
2022'' and inserting ``October 1, 2027''.</DELETED>
<DELETED>SEC. 606. REAUTHORIZATION OF ORPHAN DRUG GRANTS.</DELETED>
<DELETED> Section 5(c) of the Orphan Drug Act (21 U.S.C. 360ee(c))
is amended by striking ``2018 through 2022'' and inserting ``2023
through 2027''.</DELETED>
<DELETED>SEC. 607. REAUTHORIZATION OF CERTAIN DEVICE
INSPECTIONS.</DELETED>
<DELETED> Section 704(g)(11) of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 374(g)(11)) is amended by striking ``2022'' and
inserting ``2027''.</DELETED>
<DELETED>TITLE VII--ENHANCING FDA HIRING AUTHORITIES</DELETED>
<DELETED>SEC. 701. ENHANCING FDA HIRING AUTHORITY FOR SCIENTIFIC,
TECHNICAL, AND PROFESSIONAL PERSONNEL.</DELETED>
<DELETED> Section 714A of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379d-3a) is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) by inserting ``, including cross-
cutting operational positions,'' after ``professional
positions''; and</DELETED>
<DELETED> (B) by inserting ``and the regulation of
food'' after ``medical products''; and</DELETED>
<DELETED> (2) in subsection (d)(1)--</DELETED>
<DELETED> (A) in the matter preceding subparagraph
(A)--</DELETED>
<DELETED> (i) by striking ``the 21st Century
Cures Act'' and inserting ``the Food and Drug
Administration Safety and Landmark Advancements
Act of 2022''; and</DELETED>
<DELETED> (ii) by striking ``that examines
the extent'' and all that follows through ``,
including'' and inserting ``that
addresses'';</DELETED>
<DELETED> (B) in subparagraph (A)--</DELETED>
<DELETED> (i) by inserting ``updated''
before ``analysis''; and</DELETED>
<DELETED> (ii) by striking ``; and'' and
inserting a semicolon;</DELETED>
<DELETED> (C) by redesignating subparagraph (B) as
subparagraph (C);</DELETED>
<DELETED> (D) by inserting after subparagraph (A)
the following:</DELETED>
<DELETED> ``(B) an analysis of how the Secretary has
used the authorities provided under this section, and a
plan for how the Secretary will use the authority under
this section, and other applicable hiring authorities,
for employees of the Food and Drug Administration;
and''; and</DELETED>
<DELETED> (E) in subparagraph (C), as so
redesignated, by striking ``a recruitment'' and
inserting ``an updated recruitment''.</DELETED>
<DELETED>SEC. 702. STRATEGIC WORKFORCE PLAN AND REPORT.</DELETED>
<DELETED> Chapter VII of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 371 et seq.) is amended by inserting after section 714A the
following:</DELETED>
<DELETED>``SEC. 714B. STRATEGIC WORKFORCE PLAN AND REPORT.</DELETED>
<DELETED> ``(a) In General.--Not later than September 30, 2023, and
at least every 4 years thereafter, the Secretary shall develop and
submit to the appropriate committees of Congress and post on the
website of the Food and Drug Administration, a coordinated strategy and
report to provide direction for the activities and programs of the
Secretary to recruit, hire, train, develop, and retain the workforce
needed to fulfill the public health mission of the Food and Drug
Administration, including to facilitate collaboration across centers,
to keep pace with new biomedical, technological, and scientific
advancements, and support the development, review, and regulation of
medical products. Each such report shall be known as the `Food and Drug
Administration Strategic Workforce Plan'.</DELETED>
<DELETED> ``(b) Use of the Food and Drug Administration Strategic
Workforce Plan.--Each center within the Food and Drug Administration
shall develop and update, as appropriate, a strategic plan that will be
informed by the Food and Drug Administration Strategic Workforce Plan
developed and updated under this subsection.</DELETED>
<DELETED> ``(c) Contents of the Food and Drug Administration
Strategic Workforce Plan.--Each Food and Drug Administration Strategic
Workforce Plan under subsection (a) shall--</DELETED>
<DELETED> ``(1) include agency-wide strategic goals and
priorities for recruiting, hiring, training, developing, and
retaining a qualified workforce for the Food and Drug
Administration;</DELETED>
<DELETED> ``(2) establish specific activities the Secretary
will take to achieve its strategic goals and priorities and
address the workforce needs of the Food and Drug Administration
in the forthcoming fiscal years;</DELETED>
<DELETED> ``(3) identify challenges and risks the Secretary
will face in meeting its strategic goals and priorities, and
the activities the Secretary will undertake to overcome those
challenges and mitigate those risks;</DELETED>
<DELETED> ``(4) establish metrics and milestones that the
Secretary will use to measure progress in achieving its
strategic goals and priorities; and</DELETED>
<DELETED> ``(5) define functions, capabilities, and gaps in
such workforce and identify strategies to recruit, hire, train,
develop, and retain such workforce.</DELETED>
<DELETED> ``(d) Considerations.--In developing each Food and Drug
Administration Strategic Workforce Plan under subsection (a), the
Secretary shall consider--</DELETED>
<DELETED> ``(1) the number of employees, employee expertise,
and employing center of employees, including senior leadership
and non-senior leadership employees, eligible for
retirement;</DELETED>
<DELETED> ``(2) the vacancy and turnover rates for employees
with different types of expertise and from different centers,
including any changes or trends related to such
rates;</DELETED>
<DELETED> ``(3) the results of the Federal Employee
Viewpoint Survey for employees of the Food and Drug
Administration, including any changes or trends related to such
results;</DELETED>
<DELETED> ``(4) rates of pay for different types of
positions, including rates for different types of expertise
within the same field (such as differences in pay between
different medical specialists), and how such rates of pay
impact the ability of the Secretary to achieve strategic goals
and priorities; and</DELETED>
<DELETED> ``(5) the statutory hiring authorities used to
hire Food and Drug Administration employees, and the time to
hire across different hiring authorities.</DELETED>
<DELETED> ``(e) Evaluation of Progress.--Each Food and Drug
Administration Strategic Workforce Plan issued pursuant to subsection
(a), with the exception of the first such Food and Drug Administration
Strategic Workforce Plan, shall include an evaluation of the progress
the Secretary has made, based on the metrics, benchmarks, and other
milestones that measure successful recruitment, hiring, training,
development, and retention activities; and whether such actions
improved the capacity of the Food and Drug Administration to achieve
the strategic goals and priorities set forth in the previous Food and
Drug Administration Strategic Workforce Plan.</DELETED>
<DELETED> ``(f) Additional Considerations.--The Food and Drug
Administration Strategic Workforce Plan issued in fiscal year 2023
shall address the effect of the COVID-19 pandemic on hiring, retention,
and other workforce challenges for the Food and Drug Administration,
including protecting such workforce during public health
emergencies.''.</DELETED>
<DELETED>TITLE VIII--ADVANCING REGULATION OF COSMETICS, DIETARY
SUPPLEMENTS, AND LABORATORY DEVELOPED TESTS</DELETED>
<DELETED>Subtitle A--Cosmetics</DELETED>
<DELETED>SEC. 801. SHORT TITLE.</DELETED>
<DELETED> This subtitle may be cited as the ``Modernization of
Cosmetics Regulation Act of 2022''.</DELETED>
<DELETED>SEC. 802. AMENDMENTS TO COSMETIC REQUIREMENTS.</DELETED>
<DELETED> Chapter VI of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 361 et seq.) is amended by adding at the end the
following:</DELETED>
<DELETED>``SEC. 604. DEFINITIONS.</DELETED>
<DELETED> ``In this chapter:</DELETED>
<DELETED> ``(1) Adverse event.--The term `adverse event'
means any health-related event associated with the use of a
cosmetic product that is adverse.</DELETED>
<DELETED> ``(2) Cosmetic product.--The term `cosmetic
product' means a preparation of cosmetic ingredients with a
qualitatively and quantitatively set composition for use in a
finished product.</DELETED>
<DELETED> ``(3) Facility.--</DELETED>
<DELETED> ``(A) In general.--The term `facility'
includes any establishment (including an establishment
of an importer) that manufactures or processes cosmetic
products distributed in the United States.</DELETED>
<DELETED> ``(B) Such term does not include any of
the following:</DELETED>
<DELETED> ``(i) Beauty shops and salons,
unless such establishment manufactures or
processes cosmetic products at that
location.</DELETED>
<DELETED> ``(ii) Cosmetic product retailers,
including individual sales representatives,
direct sellers, retail distribution facilities,
and pharmacies, unless such establishment
manufactures or processes cosmetic products
that are not sold directly to consumers at that
location.</DELETED>
<DELETED> ``(iii) Hospitals, physicians'
offices, and health care clinics.</DELETED>
<DELETED> ``(iv) Public health agencies and
other nonprofit entities that provide cosmetic
products directly to the consumer.</DELETED>
<DELETED> ``(v) Entities (such as hotels and
airlines) that provide complimentary cosmetic
products to customers incidental to other
services.</DELETED>
<DELETED> ``(vi) Trade shows and other
venues where cosmetic product samples are
provided free of charge.</DELETED>
<DELETED> ``(vii) An establishment that
manufactures or processes cosmetic products
that are solely for use in research or
evaluation, including for production testing
and not offered for retail sale.</DELETED>
<DELETED> ``(viii) An establishment that
solely performs one or more of the following
with respect to cosmetic products:</DELETED>
<DELETED> ``(I) Labeling.</DELETED>
<DELETED> ``(II)
Relabeling.</DELETED>
<DELETED> ``(III)
Packaging.</DELETED>
<DELETED> ``(IV)
Repackaging.</DELETED>
<DELETED> ``(V) Holding.</DELETED>
<DELETED> ``(VI)
Distributing.</DELETED>
<DELETED> ``(C) Clarification.--For the purposes of
subparagraph (B)(viii), the terms `packaging' and
`repackaging' do not include filling a product
container with a cosmetic product.</DELETED>
<DELETED> ``(4) Responsible person.--The term `responsible
person' means the manufacturer, packer, or distributor of a
cosmetic product whose name appears on the label of such
cosmetic product in accordance with section 609(a) of this Act
or section 4(a) of the Fair Packaging and Labeling
Act.</DELETED>
<DELETED> ``(5) Serious adverse event.--The term `serious
adverse event' means an adverse event that--</DELETED>
<DELETED> ``(A) results in--</DELETED>
<DELETED> ``(i) death;</DELETED>
<DELETED> ``(ii) a life-threatening
experience;</DELETED>
<DELETED> ``(iii) inpatient
hospitalization;</DELETED>
<DELETED> ``(iv) a persistent or significant
disability or incapacity;</DELETED>
<DELETED> ``(v) a congenital anomaly or
birth defect; or</DELETED>
<DELETED> ``(vi) significant disfigurement
(including serious and persistent rashes or
infections, second- or third-degree burns,
significant hair loss, or permanent or
significant alteration of appearance), other
than as intended, under conditions of use that
are customary or usual; or</DELETED>
<DELETED> ``(B) requires, based on reasonable
medical judgment, a medical or surgical intervention to
prevent an outcome described in subparagraph
(A).</DELETED>
<DELETED>``SEC. 605. ADVERSE EVENTS.</DELETED>
<DELETED> ``(a) Serious Adverse Event Reporting Requirements.--The
responsible person shall submit to the Secretary any report received of
a serious adverse event associated with the use, in the United States,
of a cosmetic product manufactured, packed, or distributed by such
person.</DELETED>
<DELETED> ``(b) Submission of Reports.--</DELETED>
<DELETED> ``(1) Serious adverse event report.--The
responsible person shall submit to the Secretary a serious
adverse event report accompanied by a copy of the label on or
within the retail packaging of such cosmetic product no later
than 15 business days after the report is received by the
responsible person.</DELETED>
<DELETED> ``(2) New medical information.--The responsible
person shall submit to the Secretary any new and material
medical information, related to a serious adverse event report
submitted to the Secretary in accordance with paragraph (1),
that is received by the responsible person within 1 year of the
initial report to the Secretary, no later than 15 business days
after such information is received by such responsible
person.</DELETED>
<DELETED> ``(3) Consolidation of reports.--The Secretary
shall develop systems to enable responsible persons to submit a
single report that includes duplicate reports of, or new
medical information related to, a serious adverse
event.</DELETED>
<DELETED> ``(c) Exemptions.--The Secretary may establish by
regulation an exemption to any of the requirements of this section if
the Secretary determines that such exemption would have no significant
adverse effect on public health.</DELETED>
<DELETED> ``(d) Contact Information.--The responsible person shall
receive reports of adverse events through the domestic address,
domestic telephone number, or electronic contact information included
on the label in accordance with section 609(a).</DELETED>
<DELETED> ``(e) Maintenance and Inspection of Adverse Event
Records.--</DELETED>
<DELETED> ``(1) Maintenance.--The responsible person shall
maintain records related to each report of an adverse event
associated with the use, in the United States, of a cosmetic
product manufactured or distributed by such person received by
such person, for a period of 6 years.</DELETED>
<DELETED> ``(2) Inspection.--</DELETED>
<DELETED> ``(A) In general.-- The responsible person
shall permit an authorized person to have access to
records required to be maintained under this section
during an inspection pursuant to section 704.</DELETED>
<DELETED> ``(B) Authorized person.--For purposes of
this paragraph, the term `authorized person' means an
officer or employee of the Department of Health and
Human Services who has--</DELETED>
<DELETED> ``(i) appropriate credentials, as
determined by the Secretary; and</DELETED>
<DELETED> ``(ii) been duly designated by the
Secretary to have access to the records
required under this section.</DELETED>
<DELETED> ``(f) Fragrance and Flavor Ingredients.--If the Secretary
has reasonable grounds to believe that an ingredient or combination of
ingredients in a fragrance or flavor has caused or contributed to a
serious adverse event required to be reported under this section, the
Secretary may request in writing a complete list of ingredients in the
specific fragrances or flavors in the cosmetic product, from the
responsible person. The responsible person shall ensure that the
requested information is submitted to the Secretary within 30 days of
such request. Information submitted to the Secretary under this
subsection that is confidential commercial or trade secret information
shall be exempt from disclosure under section 552 of title 5, United
States Code.</DELETED>
<DELETED> ``(g) Protected Information.--A serious adverse event
report submitted to the Secretary under this section, including any new
medical information submitted under subsection (a)(2), or an adverse
event report, or any new information, voluntarily submitted to the
Secretary shall be considered to be--</DELETED>
<DELETED> ``(1) a safety report under section 756 and may be
accompanied by a statement, which shall be a part of any report
that is released for public disclosure, that denies that the
report or the records constitute an admission that the product
involved caused or contributed to the adverse event;
and</DELETED>
<DELETED> ``(2) a record about an individual under section
552a of title 5, United States Code (commonly referred to as
the `Privacy Act of 1974') and a medical or similar file the
disclosure of which would constitute a violation of section 552
of such title 5 (commonly referred to as the `Freedom of
Information Act'), and shall not be publicly disclosed unless
all personally identifiable information is redacted.</DELETED>
<DELETED> ``(h) Effect of Section.--</DELETED>
<DELETED> ``(1) In general.--Nothing in this section shall
affect the authority of the Secretary to provide adverse event
reports and information to any health, food, or drug officer or
employee of any State, territory, or political subdivision of a
State or territory, under a memorandum of understanding between
the Secretary and such State, territory, or political
subdivision.</DELETED>
<DELETED> ``(2) Personally identifiable information.--
Notwithstanding any other provision of law, personally
identifiable information in adverse event reports provided by
the Secretary to any health, food, or drug officer or employee
of any State, territory, or political subdivision of a State or
territory, shall not--</DELETED>
<DELETED> ``(A) be made publicly available pursuant
to any State or other law requiring disclosure of
information or records; or</DELETED>
<DELETED> ``(B) otherwise be disclosed or
distributed to any party without the written consent of
the Secretary and the person submitting such
information to the Secretary.</DELETED>
<DELETED> ``(3) Use of reports.--Nothing in this section
shall permit a State, territory, or political subdivision of a
State or territory, to use any safety report received from the
Secretary in a manner inconsistent with this section.</DELETED>
<DELETED> ``(4) Rule of construction.--The submission of any
report in compliance with this section shall not be construed
as an admission that the cosmetic product involved caused or
contributed to the relevant adverse event.</DELETED>
<DELETED>``SEC. 606. GOOD MANUFACTURING PRACTICE.</DELETED>
<DELETED> ``(a) In General.--The Secretary shall by regulation
establish good manufacturing practices for facilities that are
consistent, to the extent practicable, and appropriate, with national
and international standards, in accordance with section 601. Any such
regulations shall be intended to protect the public health and ensure
that cosmetic products are not adulterated. Such regulations may allow
for the Secretary to inspect records necessary to demonstrate
compliance with good manufacturing practices prescribed by the
Secretary under this paragraph during an inspection conducted under
section 704.</DELETED>
<DELETED> ``(b) Considerations.--In establishing regulations for
good manufacturing practices under this section, the Secretary shall
take into account the size and scope of the businesses engaged in the
manufacture of cosmetics, and the risks to public health posed by such
cosmetics, and provide sufficient flexibility to be practicable for all
sizes and types of facilities to which such regulations will apply.
Such regulations shall include simplified good manufacturing practice
requirements for smaller businesses, as appropriate, to ensure that
such regulations do not impose undue economic hardship for smaller
businesses, and may include longer compliance times for smaller
businesses. Before issuing regulations to implement subsection (a), the
Secretary shall consult with cosmetics manufacturers, including smaller
businesses, consumer organizations, and other experts selected by the
Secretary.</DELETED>
<DELETED> ``(c) Timeframe.--The Secretary shall publish a notice of
proposed rulemaking not later than 2 years after the date of enactment
of the Modernization of Cosmetics Regulation Act of 2022 and shall
publish a final such rule not later than 3 years after such date of
enactment.</DELETED>
<DELETED>``SEC. 607. REGISTRATION AND PRODUCT LISTING.</DELETED>
<DELETED> ``(a) Submission of Registration.--</DELETED>
<DELETED> ``(1) Initial registration.--</DELETED>
<DELETED> ``(A) Existing facilities.--Every person
that, on the date of enactment of the Modernization of
Cosmetics Regulation Act of 2022, owns or operates a
facility that engages in the manufacturing or
processing of a cosmetic product for distribution in
the United States shall register each facility with the
Secretary not later than 1 year after date of enactment
of such Act.</DELETED>
<DELETED> ``(B) New facilities.--Every person that
owns or operates a facility that first engages, after
the date of enactment of the Modernization of Cosmetics
Regulation Act of 2022, in manufacturing or processing
of a cosmetic product for distribution in the United
States, shall register with the Secretary such facility
within 60 days of first engaging in such activity or 60
days after the deadline for registration under
subparagraph (A), whichever is later.</DELETED>
<DELETED> ``(2) Biennial renewal of registration.--A person
required to register a facility under paragraph (1) shall renew
such registrations with the Secretary biennially.</DELETED>
<DELETED> ``(3) Contract manufacturers.--If a facility
manufactures or processes cosmetic products on behalf of a
responsible person, the Secretary shall require only a single
registration for such facility even if such facility is
manufacturing or processing its own cosmetic products or
cosmetic products on behalf of more than one responsible
person. Such single registration may be submitted to the
Secretary by such facility or any responsible person whose
products are manufactured or processed at such
facility.</DELETED>
<DELETED> ``(4) Updates to content.--A person that is
required to register under subsection (a)(1) shall notify the
Secretary within 60 days of any changes to information required
under subsection (b)(2).</DELETED>
<DELETED> ``(5) Abbreviated renewal registrations.--The
Secretary shall provide for an abbreviated registration renewal
process for any person that owns or operates a facility that
has not been required to submit updates under paragraph (4) for
a registered facility since submission of the most recent
registration of such facility under paragraph (1) or
(2).</DELETED>
<DELETED> ``(b) Format; Contents of Registration.--</DELETED>
<DELETED> ``(1) In general.--Registration information under
this section may be submitted at such time and in such manner
as the Secretary may prescribe.</DELETED>
<DELETED> ``(2) Contents.--The registration under subsection
(a) shall contain--</DELETED>
<DELETED> ``(A) the facility's name, physical
address, email address, and telephone number;</DELETED>
<DELETED> ``(B) with respect to any foreign
facility, the contact for the United States agent of
the facility, and, if available, the electronic contact
information;</DELETED>
<DELETED> ``(C) the facility registration number, if
any, previously assigned by the Secretary under
subsection (d);</DELETED>
<DELETED> ``(D) all brand names under which cosmetic
products manufactured or processed in the facility are
sold; and</DELETED>
<DELETED> ``(E) the product category or categories
and responsible person for each cosmetic product
manufactured or processed at the facility.</DELETED>
<DELETED> ``(c) Cosmetic Product Listing.--</DELETED>
<DELETED> ``(1) In general.--For each cosmetic product, the
responsible person shall submit, or ensure is submitted, to the
Secretary a cosmetic product listing, at such time and in such
manner as the Secretary may prescribe.</DELETED>
<DELETED> ``(2) Cosmetic product listing.--The responsible
person of a cosmetic product that is marketed on the date of
enactment of the Modernization of Cosmetics Regulation Act of
2022 shall submit to the Secretary a cosmetic product listing
not later than 1 year after the date of enactment of the
Modernization of Cosmetics Regulation Act of 2022, or for a
cosmetic product that is first marketed after the date of
enactment of such Act, within 120 days of marketing such
product in interstate commerce. Thereafter, any updates to such
listing shall be made annually, consistent with paragraphs (4)
and (5).</DELETED>
<DELETED> ``(3) Abbreviated renewal.--The Secretary shall
provide for an abbreviated process for the renewal of any
cosmetic product listing under this subsection with respect to
which there has been no change since the responsible person
submitted the previous listing.</DELETED>
<DELETED> ``(4) Contents of listing.--</DELETED>
<DELETED> ``(A) In general.--Each such cosmetic
product listing shall include--</DELETED>
<DELETED> ``(i) the facility registration
number of each facility where the cosmetic
product is manufactured or processed;</DELETED>
<DELETED> ``(ii) the name and contact number
of the responsible person and the name for the
cosmetic product, as such name appears on the
label;</DELETED>
<DELETED> ``(iii) the applicable cosmetic
category or categories for the cosmetic
product;</DELETED>
<DELETED> ``(iv) a list of ingredients in
the cosmetic product, including any fragrances,
flavors, or colors, with each ingredient
identified by the name adopted in regulations
promulgated by the Secretary, if any, or by the
common or usual name of the ingredient;
and</DELETED>
<DELETED> ``(v) the product listing number,
if any previously assigned by the Secretary
under subsection (d).</DELETED>
<DELETED> ``(B) Flexible listings.--A single listing
submission for a cosmetic product may include multiple
cosmetic products with identical formulations, or
formulations that differ only with respect to colors,
fragrances or flavors, or quantity of
contents.</DELETED>
<DELETED> ``(5) Updates to content.--A responsible person
that is required to submit a cosmetic product listing shall
submit any updates to such cosmetic product listing
annually.</DELETED>
<DELETED> ``(6) Submission.--A responsible person may submit
product listing information as part of a facility registration
or separately.</DELETED>
<DELETED> ``(d) Facility Registration and Product Listing Numbers.--
At the time of the initial registration of any facility under
subsection (a)(1) or initial listing of any cosmetic product under
(c)(1), the Secretary shall assign a facility registration number to
the facility and a product listing number to each cosmetic product. The
Secretary shall not make such product listing number publicly
available.</DELETED>
<DELETED> ``(e) Confidentiality.--Information submitted to the
Secretary under this section that is confidential commercial or trade
secret information shall be exempt from disclosure under section 552 of
title 5, United States Code, including all information submitted under
subsection (b)(2)(D) or (c)(4)(A)(i).</DELETED>
<DELETED> ``(f) Suspensions.--</DELETED>
<DELETED> ``(1) Suspension of registration of a facility.--
The Secretary may suspend the registration of a facility if the
Secretary determines that a cosmetic product manufactured or
processed by a registered facility and distributed in the
United States has a reasonable probability of causing serious
adverse health consequences or death to humans and the
Secretary has a reasonable belief that other products
manufactured or processed by the facility may be similarly
affected because of a failure that cannot be isolated to a
product or products, or is sufficiently pervasive to raise
concerns about other products manufactured in the
facility.</DELETED>
<DELETED> ``(2) Notice of suspension.--Before suspending a
facility registration under this section, the Secretary shall
provide--</DELETED>
<DELETED> ``(A) notice to the facility registrant of
the cosmetic product or other responsible person, as
appropriate, of the intent to suspend the facility
registration, which shall specify the basis of the
determination by the Secretary that the facility should
be suspended; and</DELETED>
<DELETED> ``(B) an opportunity, within 5 business
days of the notice provided under subparagraph (A), for
the responsible person to provide a plan for addressing
the reasons for possible suspension of the facility
registration.</DELETED>
<DELETED> ``(3) Hearing on suspension.--The Secretary shall
provide the registrant subject to an order under paragraph (1)
or (2) with an opportunity for an informal hearing, to be held
as soon as possible but not later than 5 business days after
the issuance of the order, or such other time period agreed
upon by the Secretary and the registrant, on the actions
required for reinstatement of registration and why the
registration that is subject to the suspension should be
reinstated. The Secretary shall reinstate a registration if the
Secretary determines, based on evidence presented, that
adequate grounds do not exist to continue the suspension of the
registration.</DELETED>
<DELETED> ``(4) Post-hearing corrective action plan.--If,
after providing opportunity for an informal hearing under
paragraph (3), the Secretary determines that the suspension of
registration remains necessary, the Secretary shall require the
registrant to submit a corrective action plan to demonstrate
how the registrant plans to correct the conditions found by the
Secretary. The Secretary shall review such plan not later than
14 business days after the submission of the corrective action
plan or such other time period as determined by the Secretary,
in consultation with the registrant.</DELETED>
<DELETED> ``(5) Vacating of order; reinstatement.--Upon a
determination by the Secretary that adequate grounds do not
exist to continue the suspension actions, the Secretary shall
promptly vacate the suspension and reinstate the registration
of the facility.</DELETED>
<DELETED> ``(6) Effect of suspension.--If the registration
of the facility is suspended under this section, no person
shall introduce or deliver for introduction into commerce in
the United States cosmetic products from such
facility.</DELETED>
<DELETED> ``(7) No delegation.--The authority conferred by
this section to issue an order to suspend a registration or
vacate an order of suspension shall not be delegated to any
officer or employee other than the Commissioner.</DELETED>
<DELETED>``SEC. 608. SAFETY SUBSTANTIATION.</DELETED>
<DELETED> ``(a) Substantiation of Safety.--A responsible person for
a cosmetic product shall ensure, and maintain records supporting, that
there is adequate substantiation of safety of such cosmetic
product.</DELETED>
<DELETED> ``(b) Coal-Tar Hair Dye.--Subsection (a) shall not apply
to coal-tar hair dye that otherwise complies with the requirements of
section 601(a). A responsible person for a coal-tar hair dye shall
maintain records related to the safety of such product.</DELETED>
<DELETED> ``(c) Definitions.--For purposes of this
section:</DELETED>
<DELETED> ``(1) Adequate substantiation of safety.--The term
`adequate substantiation of safety' means tests or studies,
research, analyses, or other evidence or information that is
considered, among experts qualified by scientific training and
experience to evaluate the safety of cosmetic products and
their ingredients, sufficient to support a reasonable certainty
that a cosmetic product is safe.</DELETED>
<DELETED> ``(2) Safe.--The term `safe' means that the
cosmetic product, including any ingredient thereof, is not
injurious to users under the conditions of use prescribed in
the labeling thereof, or under such conditions of use as are
customary or usual. The Secretary shall not consider a cosmetic
ingredient or cosmetic product injurious to users solely
because it can cause minor and transient reactions or minor and
transient skin irritations in some users. In determining for
purposes of this section whether a cosmetic product is safe,
the Secretary may consider, as appropriate and available, the
cumulative or other relevant exposure to the cosmetic product,
including any ingredient thereof.</DELETED>
<DELETED>``SEC. 609. LABELING.</DELETED>
<DELETED> ``(a) General Requirement.--Each cosmetic product shall
bear a label that includes a domestic address, domestic phone number,
or electronic contact information, which may include a website, through
which the responsible person can receive adverse event reports with
respect to such cosmetic product.</DELETED>
<DELETED> ``(b) Fragrance Allergens.--The responsible person shall
identify on the label of a cosmetic product each fragrance allergen
included in such cosmetic product. Substances that are fragrance
allergens for purposes of this subsection shall be determined by the
Secretary by regulation. The Secretary shall issue a notice of proposed
rulemaking promulgating the regulation implementing this requirement
not later than 18 months after the date of enactment of the
Modernization of Cosmetics Regulation Act of 2022, and not later than
180 days after the date on which the public comment period on the
proposed rulemaking closes, shall issue a final rulemaking. In
promulgating regulations implementing this subsection, the Secretary
shall consider international, State, and local requirements for
allergen disclosure, including the substance and format of requirements
in the European Union, and may establish threshold levels of amounts of
substances subject to disclosure pursuant to such
regulations.</DELETED>
<DELETED> ``(c) Cosmetic Products for Professional Use.--</DELETED>
<DELETED> ``(1) Definition of professional.--For purposes of
this subsection, the term `professional' means an individual
who is licensed by an official State authority to practice in
the field of cosmetology, nail care, barbering, or
esthetics.</DELETED>
<DELETED> ``(2) Professional use labeling.--A cosmetic
product introduced into interstate commerce and intended to be
used only by a professional shall bear a label that--</DELETED>
<DELETED> ``(A) contains a clear and prominent
statement that the product shall be administered or
used only by licensed professionals; and</DELETED>
<DELETED> ``(B) is in conformity with the
requirements of the Secretary for cosmetics labeling
under this Act and section 4(a) of the Fair Packaging
and Labeling Act.</DELETED>
<DELETED>``SEC. 610. RECORDS.</DELETED>
<DELETED> ``(a) In General.--If the Secretary has a reasonable
belief that a cosmetic product, including an ingredient in such
cosmetic product, and any other cosmetic product that the Secretary
reasonably believes is likely to be affected in a similar manner, is
likely to be adulterated such that the use or exposure to such product
presents a threat of serious adverse health consequences or death to
humans, each responsible person and facility shall, at the request of
an officer or employee duly designated by the Secretary, permit such
officer or employee, upon presentation of appropriate credentials and a
written notice to such person, at reasonable times and within
reasonable limits and in a reasonable manner, to have access to and
copy all records relating to such cosmetic product, and to any other
cosmetic product that the Secretary reasonably believes is likely to be
affected in a similar manner, that are needed to assist the Secretary
in determining whether the cosmetic product is adulterated and presents
a threat of serious adverse health consequences or death to humans.
This subsection shall not be construed to extend to recipes or formulas
for cosmetics, financial data, pricing data, personnel data (other than
data as to qualification of technical and professional personnel
performing functions subject to this Act), research data (other than
safety substantiation data for cosmetic products and their
ingredients), or sales data (other than shipment data regarding
sales).</DELETED>
<DELETED> ``(b) Protection of Sensitive Information.--The Secretary
shall take appropriate measures to ensure that there are in effect
effective procedures to prevent the unauthorized disclosure of any
trade secret or confidential information that is obtained by the
Secretary pursuant to this section.</DELETED>
<DELETED> ``(c) Rule of Construction.--Nothing in this section shall
be construed to limit the authority of the Secretary to inspect records
or require establishment and maintenance of records under any other
provision of this Act, including section 605 or 606.</DELETED>
<DELETED>``SEC. 611. MANDATORY RECALL AUTHORITY.</DELETED>
<DELETED> ``(a) In General.--If the Secretary determines that there
is a reasonable probability that a cosmetic is adulterated under
section 601 or misbranded under section 602 and the use of or exposure
to such cosmetic will cause serious adverse health consequences or
death, the Secretary shall provide the responsible person with an
opportunity to voluntarily cease distribution and recall such article.
If the responsible person refuses to or does not voluntarily cease
distribution or recall such cosmetic within the time and manner
prescribed by the Secretary (if so prescribed), the Secretary may, by
order, require, as the Secretary deems necessary, such person to
immediately cease distribution of such article.</DELETED>
<DELETED> ``(b) Hearing.--The Secretary shall provide the
responsible person who is subject to an order under subsection (a) with
an opportunity for an informal hearing, to be held not later than 10
days after the date of issuance of the order, on whether adequate
evidence exists to justify the order.</DELETED>
<DELETED> ``(c) Order Resolution.--After an order is issued
according to the process under subsections (a) and (b), the Secretary
shall, except as provided in subsection (d)--</DELETED>
<DELETED> ``(1) vacate the order, if the Secretary
determines that inadequate grounds exist to support the actions
required by the order;</DELETED>
<DELETED> ``(2) continue the order ceasing distribution of
the cosmetic until a date specified in such order; or</DELETED>
<DELETED> ``(3) amend the order to require a recall of the
cosmetic, including any requirements to notify appropriate
persons, a timetable for the recall to occur, and a schedule
for updates to be provided to the Secretary regarding such
recall.</DELETED>
<DELETED> ``(d) Action Following Order.--Any person who is subject
to an order pursuant to paragraph (2) or (3) of subsection (c) shall
immediately cease distribution of or recall, as applicable, the
cosmetic and provide notification as required by such order.</DELETED>
<DELETED> ``(e) Notice to Persons Affected.--If the Secretary
determines necessary, the Secretary may require the person subject to
an order pursuant to subsection (a) or an amended order pursuant to
paragraph (2) or (3) of subsection (c) to provide either a notice of a
recall order for, or an order to cease distribution of, such cosmetic,
as applicable, under this section to appropriate persons, including
persons who manufacture, distribute, import, or offer for sale such
product that is the subject of an order and to the public.</DELETED>
<DELETED> ``(f) Public Notification.--In conducting a recall under
this section, the Secretary shall--</DELETED>
<DELETED> ``(1) ensure that a press release is published
regarding the recall, and that alerts and public notices are
issued, as appropriate, in order to provide notification--
</DELETED>
<DELETED> ``(A) of the recall to consumers and
retailers to whom such cosmetic was, or may have been,
distributed; and</DELETED>
<DELETED> ``(B) that includes, at a minimum--
</DELETED>
<DELETED> ``(i) the name of the cosmetic
subject to the recall;</DELETED>
<DELETED> ``(ii) a description of the risk
associated with such article; and</DELETED>
<DELETED> ``(iii) to the extent practicable,
information for consumers about similar
cosmetics that are not affected by the recall;
and</DELETED>
<DELETED> ``(2) ensure publication, as appropriate, on the
website of the Food and Drug Administration of an image of the
cosmetic that is the subject of the press release described in
paragraph (1), if available.</DELETED>
<DELETED> ``(g) No Delegation.--The authority conferred by this
section to order a recall or vacate a recall order shall not be
delegated to any officer or employee other than the
Commissioner.</DELETED>
<DELETED> ``(h) Effect.--Nothing in this section shall affect the
authority of the Secretary to request or participate in a voluntary
recall, or to issue an order to cease distribution or to recall under
any other provision of this chapter.</DELETED>
<DELETED>``SEC. 612. SMALL BUSINESSES.</DELETED>
<DELETED> ``(a) In General.--Responsible persons, and owners and
operators of facilities, whose average gross annual sales in the United
States of cosmetic products for the previous 3-year period is less than
$1,000,000, adjusted for inflation, and who do not engage in the
manufacturing or processing of the cosmetic products described in
subsection (b), shall be considered small businesses and not subject to
the requirements of section 606 or 607.</DELETED>
<DELETED> ``(b) Requirements Applicable to All Manufacturers and
Processors of Cosmetics.--The exemptions under subsection (a) shall not
apply to any responsible person or facility engaged in the
manufacturing or processing of any of the following products:</DELETED>
<DELETED> ``(1) Cosmetic products that regularly come into
contact with mucus membrane of the eye under conditions of use
that are customary or usual.</DELETED>
<DELETED> ``(2) Cosmetic products that are
injected.</DELETED>
<DELETED> ``(3) Cosmetic products that are intended for
internal use.</DELETED>
<DELETED> ``(4) Cosmetic products that are intended to alter
appearance for more than 24 hours under conditions of use that
are customary or usual and removal by the consumer is not part
of such conditions of use that are customary or
usual.</DELETED>
<DELETED>``SEC. 613. EXEMPTION FOR CERTAIN PRODUCTS AND
FACILITIES.</DELETED>
<DELETED> ``(a) In General.--Notwithstanding any other provision of
law, except as provided in subsection (b), a cosmetic product or
facility that is also subject to the requirements of chapter V shall be
exempt from the requirements of sections 605, 606, 607, 608, 609(a),
610, and 611.</DELETED>
<DELETED> ``(b) Exception.--A facility described in subsection (a)
that also manufactures or processes cosmetic products that are not
subject to the requirements of chapter V shall not be exempt from the
requirements of sections 605, 606, 607, 608, 609(a), 610, and 611, with
respect to such cosmetic products.</DELETED>
<DELETED>``SEC. 614. PREEMPTION.</DELETED>
<DELETED> ``(a) In General.--No State or political subdivision of a
State may establish or continue in effect any law, regulation, order,
or other requirement for cosmetics that is different from or in
addition to, or otherwise not identical with, any requirement
applicable under this chapter with respect to registration and product
listing, good manufacturing practice, recordkeeping, recalls, adverse
event reporting, or safety substantiation.</DELETED>
<DELETED> ``(b) Limitation.--Nothing in the amendments to this Act
made by the Modernization of Cosmetics Regulation Act of 2022 shall be
construed to preempt any State statute, public initiative, referendum,
regulation, or other State action, except as expressly provided in
subsection (a). Notwithstanding subsection (a), nothing in this section
shall be construed to prevent any State from prohibiting the use or
limiting the amount of an ingredient in a cosmetic product, or from
continuing in effect a requirement of any State that is in effect at
the time of enactment of the Modernization of Cosmetics Regulation Act
of 2022 for the reporting to the State of an ingredient in an cosmetic
product.</DELETED>
<DELETED> ``(c) Savings.--Nothing in the amendments to this Act made
by the Modernization of Cosmetics Regulation Act of 2022, nor any
standard, rule, requirement, regulation, or adverse event report shall
be construed to modify, preempt, or displace any action for damages or
the liability of any person under the law of any State, whether
statutory or based in common law.</DELETED>
<DELETED> ``(d) Rule of Construction.--Nothing in this section shall
be construed to amend, expand, or limit the provisions under section
752.''.</DELETED>
<DELETED>SEC. 803. ENFORCEMENT AND CONFORMING AMENDMENTS.</DELETED>
<DELETED> (a) In General.--</DELETED>
<DELETED> (1) Prohibited acts.--Section 301 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 331) is amended--
</DELETED>
<DELETED> (A) by adding at the end the
following:</DELETED>
<DELETED> ``(fff) The failure to register or submit listing
information in accordance with section 607.</DELETED>
<DELETED> ``(ggg) The refusal or failure to follow an order under
section 611.''; and</DELETED>
<DELETED> (B) in paragraph (d), by striking ``or
564'' and inserting ``, 564, or 607''.</DELETED>
<DELETED> (2) Adulterated products.--Section 601 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 361) is amended
by adding at the end the following:</DELETED>
<DELETED> ``(f) If it has been manufactured or processed under
conditions that do not meet good manufacturing practice regulations, as
prescribed by the Food and Drug Administration in accordance with
section 606.</DELETED>
<DELETED> ``(g) If it is a cosmetic product, and the cosmetic
product, including each ingredient in the cosmetic product, does not
have adequate substantiation for safety, as defined in section
608(c).''.</DELETED>
<DELETED> (3) Misbranded cosmetics.--Section 602(b) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 362(b)) is
amended--</DELETED>
<DELETED> (A) by striking ``and (2)'' and inserting
``(2)''; and</DELETED>
<DELETED> (B) by inserting after ``numerical count''
the following: ``; and (3) the information required
under section 609''.</DELETED>
<DELETED> (4) Adverse event reporting.--The Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 301 et seq.) is amended--
</DELETED>
<DELETED> (A) in section 301(e) (21 U.S.C. 331(e))--
</DELETED>
<DELETED> (i) by striking ``564, 703'' and
inserting ``564, 605, 703''; and</DELETED>
<DELETED> (ii) by striking ``564, 760'' and
inserting ``564, 605, 611, 760'';</DELETED>
<DELETED> (B) in section 301(ii) (21 U.S.C.
331(ii))--</DELETED>
<DELETED> (i) by striking ``760 or 761) or''
and inserting ``604, 760, or 761) or'';
and</DELETED>
<DELETED> (ii) by inserting ``or required
under section 605(a)'' after ``report (as
defined under section 760 or 761'';</DELETED>
<DELETED> (C) in section 801(a) (21 U.S.C. 381(a))--
</DELETED>
<DELETED> (i) by striking ``under section
760 or 761'' and inserting ``under section 605,
760, or 761'';</DELETED>
<DELETED> (ii) by striking ``defined in such
section 760 or 761'' and inserting ``defined in
section 604, 760, or 761'';</DELETED>
<DELETED> (iii) by striking ``of such
section 760 or 761'' and inserting ``of such
section 605, 760, or 761''; and</DELETED>
<DELETED> (iv) by striking ``described in
such section 760 or 761'' and inserting
``described in such section 605, 760, or 761'';
and</DELETED>
<DELETED> (D) in section 801(b) (21 U.S.C. 381(b))--
</DELETED>
<DELETED> (i) by striking ``requirements of
sections 760 or 761,'' and inserting
``requirements of section 605, 760, or
761'';</DELETED>
<DELETED> (ii) by striking ``as defined in
section 760 or 761'' and inserting ``as defined
in section 604, 760, or 761''; and</DELETED>
<DELETED> (iii) by striking ``with section
760 or 761'' and inserting ``with section 605,
760, or 761''.</DELETED>
<DELETED> (b) Effective Date.--The amendments made by subsection (a)
shall take effect on the date that is 1 year after the date of
enactment of this Act.</DELETED>
<DELETED>SEC. 804. RECORDS INSPECTION.</DELETED>
<DELETED> Section 704(a)(1) of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 374(a)(1)) is amended by inserting after the second
sentence the following: ``In the case of a facility (as defined in
section 604) that manufactures or processes cosmetic products, the
inspection shall extend to all records and other information described
in sections 605, 606, and 610, when the standard for records inspection
under such section applies.''.</DELETED>
<DELETED>SEC. 805. TALC-CONTAINING COSMETICS.</DELETED>
<DELETED> The Secretary of Health and Human Services--</DELETED>
<DELETED> (1) not later than one year after the date of
enactment of this Act, shall promulgate proposed regulations to
establish and require standardized testing methods for
detecting and identifying asbestos in talc-containing cosmetic
products; and</DELETED>
<DELETED> (2) not later than 180 days after the date on
which the public comment period on the proposed regulations
closes, shall issue such final regulations.</DELETED>
<DELETED>SEC. 806. PFAS IN COSMETICS.</DELETED>
<DELETED> (a) In General.--The Secretary of Health and Human
Services (referred to in this section as the ``Secretary'') shall
assess the use of perfluoroalkyl and polyfluoroalkyl substances in
cosmetic products and the scientific evidence regarding the safety of
such use in cosmetic products, including any risks associated with such
use. In conducting such assessment, the Secretary may, as appropriate,
consult with the National Center for Toxicological Research.</DELETED>
<DELETED> (b) Report.--Not later than 2 years after enactment of
this Act, the Secretary shall publish on the website of the Food and
Drug Administration a report summarizing the results of the assessment
conducted under subsection (a).</DELETED>
<DELETED>SEC. 807. FUNDING.</DELETED>
<DELETED> There is authorized to be appropriated $14,200,000 for
fiscal year 2023, $25,960,000 for fiscal year 2024, and $41,890,000 for
each of the fiscal years 2025 through 2027, for purposes of conducting
the activities under this subtitle (including the amendments made by
this subtitle) and hiring personnel required to carry out this subtitle
(including the amendments made by this subtitle).</DELETED>
<DELETED>Subtitle B--Dietary Supplements</DELETED>
<DELETED>SEC. 811. REGULATION OF DIETARY SUPPLEMENTS.</DELETED>
<DELETED> (a) In General.--Chapter IV of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 341 et seq.) is amended by adding after section
403C of such Act (21 U.S.C. 343-3) the following:</DELETED>
<DELETED>``SEC. 403D. DIETARY SUPPLEMENT LISTING REQUIREMENT.</DELETED>
<DELETED> ``(a) In General.--Beginning on the date specified in
subsection (b)(4), each dietary supplement shall be listed with the
Secretary in accordance with this section. Each such listing shall
include, with respect to the dietary supplement, the information
specified in subsection (b)(1).</DELETED>
<DELETED> ``(b) Requirements.--</DELETED>
<DELETED> ``(1) In general.--The manufacturer, packer, or
distributor of a dietary supplement whose name (pursuant to
section 403(e)(1)) appears on the label of a dietary supplement
marketed in the United States (referred to in this section as
the `responsible person'), or if the responsible person is a
foreign entity, the United States agent of such person, shall
submit to the Secretary in accordance with this section the
following information for a dietary supplement that is
marketed:</DELETED>
<DELETED> ``(A) Any name of the dietary supplement
and the statement of identity, including brand name and
specified flavors, if applicable.</DELETED>
<DELETED> ``(B) The name and address of the
responsible person and the name and email address of
the owner, operator, or agent in charge of the
responsible person.</DELETED>
<DELETED> ``(C) The name, domestic address, and
email address for the United States agent, if the
responsible person is a foreign entity.</DELETED>
<DELETED> ``(D) The business name and mailing
address of all locations at which the responsible
person manufactures, packages, labels, or holds the
dietary supplement.</DELETED>
<DELETED> ``(E) A list of all ingredients in each
such dietary supplement required under sections 101.4
and 101.36, title 21, Code of Federal Regulations (or
any successor regulations) to appear on the label of a
dietary supplement, including--</DELETED>
<DELETED> ``(i) where applicable,
ingredients in a proprietary blend as described
in section 101.36(c) of title 21, Code of
Federal Regulations (or any successor
regulations);</DELETED>
<DELETED> ``(ii) the amount per serving of
each listed dietary ingredient;</DELETED>
<DELETED> ``(iii) if required by section
101.36 of title 21, Code of Federal Regulations
(or any successor regulations), the percent of
the daily value of each listed dietary
ingredient; and</DELETED>
<DELETED> ``(iv) the amount per serving of
dietary ingredients within a proprietary
blend.</DELETED>
<DELETED> ``(F) The number of servings per container
for each container size of the identical
formulation.</DELETED>
<DELETED> ``(G) The directions for use.</DELETED>
<DELETED> ``(H) Warnings, notice, and safe handling
statements, as required by section 101.17 of title 21,
Code of Federal Regulations (or any successor
regulations).</DELETED>
<DELETED> ``(I) Allergen statements for major food
allergens (pursuant to sections 403(w) and
403(x)).</DELETED>
<DELETED> ``(J) The form of the dietary supplement
(such as tablets, capsules).</DELETED>
<DELETED> ``(K) Any health claims or structure or
function claims.</DELETED>
<DELETED> ``(L) The dietary supplement product
listing number for the product provided by the
Secretary in accordance with subsection (c) for that
product.</DELETED>
<DELETED> ``(2) Format.--The Secretary may require that a
listing submitted under paragraph (1) be submitted in an
electronic format. Upon receipt of a complete listing under
paragraph (1), the Secretary shall promptly notify the
responsible person of the receipt of such listing.</DELETED>
<DELETED> ``(3) Listing content.--A single listing
submission for a dietary supplement under paragraph (1) may
include multiple dietary supplements with identical
formulations, or formulations that differ only with respect to
color, additives, or flavorings, whether offered in a single
package size or in multiple package sizes.</DELETED>
<DELETED> ``(4) Timing.--</DELETED>
<DELETED> ``(A) In general.--</DELETED>
<DELETED> ``(i) Dietary supplements on the
market.--In the case of a dietary supplement
that is being offered in interstate commerce on
or before January 1, 2024, a listing for each
such dietary supplement introduced or delivered
for introduction into interstate commerce shall
be submitted by the responsible person to the
Secretary under this subsection not later than
18 months after the date of enactment of the
Food and Drug Administration Safety and
Landmark Advancements Act of 2022.</DELETED>
<DELETED> ``(ii) New dietary supplements.--
In the case of a dietary supplement that is not
being offered in interstate commerce on or
before January 1, 2024, a listing for each such
dietary supplement introduced or delivered for
introduction into interstate commerce that has
not been included in any listing previously
submitted by the responsible person to the
Secretary under this subsection shall be
submitted to the Secretary at the time of
introduction into interstate
commerce.</DELETED>
<DELETED> ``(B) Discontinued dietary supplements.--
The responsible person shall notify the Secretary
within one year of the date of discontinuance of a
dietary supplement required to be listed with the
Secretary under paragraph (1) for which the responsible
person has discontinued commercial marketing.</DELETED>
<DELETED> ``(C) Changes to existing listings.--The
responsible person shall submit to the Secretary a
change or modification to listing information submitted
under paragraph (1) included on the label for a dietary
supplement at the time the dietary supplement with the
change or modification is introduced into interstate
commerce.</DELETED>
<DELETED> ``(5) Additional information.--The responsible
person shall provide upon request from the Secretary, within 10
calendar days of such request, the full business name and
physical and mailing address from which the responsible person
receives a dietary ingredient or combination of dietary
ingredients that the responsible person uses in the manufacture
of the dietary supplement or, if applicable, from which the
responsible person receives the dietary supplement.</DELETED>
<DELETED> ``(c) Product Listing Number and Dietary Supplement
Electronic Database.--</DELETED>
<DELETED> ``(1) Dietary supplement product listing number.--
The Secretary shall provide each dietary supplement listed in
accordance with subsection (b)(1) a dietary supplement product
listing number, which may apply to multiple dietary supplements
with identical formulations, or formulations that differ only
with respect to color, additives, or flavorings, including
dietary supplements offered in a single package size or in
multiple package sizes. The Secretary shall provide a process
for a responsible person to reserve dietary supplement listing
numbers in advance of listing under subsection
(b)(1).</DELETED>
<DELETED> ``(2) Electronic database.--Not later than 2 years
after the date of enactment of the Food and Drug Administration
Safety and Landmark Advancements Act of 2022, the Secretary
shall establish and maintain an electronic database that is
publicly available and contains information submitted under
subsection (b)(1) (except for the information submitted under
subparagraphs (D) and (E)(iv) of such subsection). The
Secretary shall make such information maintained in the
electronic database publicly searchable, including by dietary
supplement product listing number, and by any field of
information or combination of fields of information provided
under subsection (b)(1).</DELETED>
<DELETED> ``(d) Rule of Construction.--Nothing in this section shall
be construed--</DELETED>
<DELETED> ``(1) to limit the authority of the Secretary to
inspect or copy records or to require the establishment and
maintenance of records under any other provision of this Act;
or</DELETED>
<DELETED> ``(2) to authorize the disclosure of trade secret
or confidential commercial information subject to section
552(b)(4) of title 5, United States Code, as prohibited under
section 301(j) of this Act or section 1905 of title 18, United
States Code, including information provided to the Secretary
under subsection (b)(1)(D) or (b)(1)(E)(iv).</DELETED>
<DELETED> ``(e) Authorization of Appropriations.--There is
authorized to be appropriated $7,498,080 for fiscal year 2023, and
$6,300,000 for each of fiscal years 2024 through 2027, for purposes of
conducting the activities under this section and hiring personnel
required to carry out this section.''.</DELETED>
<DELETED> (b) Guidance.--Not later than 18 months after the date of
enactment of this Act, the Secretary of Health and Human Services shall
publish final guidance related to the draft guidance titled, ``Dietary
Supplements: New Dietary Ingredient Notifications and Related Issues;
Revised Draft Guidance for Industry; Availability'' (81 Fed. Reg.
53486; August 12, 2016), consistent with section 403D of the Federal
Food, Drug, and Cosmetic Act, as added by subsection (a).</DELETED>
<DELETED> (c) Inspections for Certain Dietary Supplements.--The
Secretary of Health and Human Services shall direct resources to
inspections of facilities, suppliers, and dietary supplement types that
present a high risk to public health (as identified by the
Secretary).</DELETED>
<DELETED> (d) Misbranding.--Section 403 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 343) is amended by adding at the end the
following:</DELETED>
<DELETED> ``(z) If it is a dietary supplement for which a
responsible person is required under section 403D to file a listing,
file a change to an existing listing, or provide additional information
to the Secretary, and such person has failed to comply with any such
requirements under section 403D with respect to such dietary
supplement.''.</DELETED>
<DELETED> (e) New Prohibited Act.--Section 301 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 331), as amended by section 803(a),
is further amended by adding at the end the following:</DELETED>
<DELETED> ``(hhh) The introduction or delivery for introduction into
interstate commerce of any product marketed as a dietary supplement
that does not meet the definition of a dietary supplement under section
201(ff).</DELETED>
<DELETED> ``(iii) The introduction or delivery for introduction into
interstate commerce of a dietary supplement that has been prepared,
packed, or held using the assistance of, or at the direction of, a
person debarred under section 306.''.</DELETED>
<DELETED>Subtitle C--In Vitro Clinical Tests</DELETED>
<DELETED>SEC. 821. SHORT TITLE; TABLE OF CONTENTS.</DELETED>
<DELETED> (a) Short Title.--This subtitle may be cited as the ``Food
and Drug Administration Safety and Landmark Advancements Act of 2022''
or the ``VALID Act of 2022''.</DELETED>
<DELETED> (b) Table of Contents.--The table of contents of this
subtitle is as follows:</DELETED>
<DELETED>subchapter c--in vitro clinical tests
<DELETED>Sec. 821. Short title; table of contents.
<DELETED>Sec. 822. Definitions.
<DELETED>Sec. 823. Regulation of in vitro clinical tests.
<DELETED>``subchapter j--in vitro clinical tests
<DELETED>``SUBCHAPTER J. In Vitro Clinical Tests
<DELETED>``Sec. 587. Definitions.
<DELETED>``Sec. 587A. Regulation of in vitro clinical tests.
<DELETED>``Sec. 587B. Premarket review.
<DELETED>``Sec. 587C. Exemptions.
<DELETED>``Sec. 587D. Technology certification.
<DELETED>``Sec. 587E. Mitigating measures.
<DELETED>``Sec. 587F. Regulatory pathway designation.
<DELETED>``Sec. 587G. Grandfathered in vitro clinical tests.
<DELETED>``Sec. 587H. Advisory committees.
<DELETED>``Sec. 587I. Breakthrough in vitro clinical tests.
<DELETED>``Sec. 587J. Registration and listing.
<DELETED>``Sec. 587K. Test design and quality requirements.
<DELETED>``Sec. 587L. Labeling requirements.
<DELETED>``Sec. 587M. Adverse event reporting.
<DELETED>``Sec. 587N. Corrections and removals.
<DELETED>``Sec. 587O. Restricted in vitro clinical tests.
<DELETED>``Sec. 587P. Appeals.
<DELETED>``Sec. 587Q. Accredited persons.
<DELETED>``Sec. 587R. Recognized standards.
<DELETED>``Sec. 587S. Investigational use.
<DELETED>``Sec. 587T. Collaborative communities for in vitro
clinical tests.
<DELETED>``Sec. 587U. Comprehensive test information system.
<DELETED>``Sec. 587V. Preemption.
<DELETED>``Sec. 587W. Adulteration.
<DELETED>``Sec. 587X. Misbranding.
<DELETED>``Sec. 587Y. Postmarket surveillance.
<DELETED>``Sec. 587Z. Electronic format for submissions.
<DELETED>``Sec. 587AA. Postmarket remedies.
<DELETED>``Sec. 587BB. Applicability.
<DELETED>``Sec. 587CC. Judicial review.
<DELETED>Sec. 824. Enforcement and other provisions.
<DELETED>Sec. 825. Transition.
<DELETED>Sec. 826. Emergency use authorization.
<DELETED>Sec. 827. Antimicrobial susceptibility tests.
<DELETED>Sec. 828. Combination products.
<DELETED>Sec. 829. Resources.
<DELETED>SEC. 822. DEFINITIONS.</DELETED>
<DELETED> (a) In General.--Section 201 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 321) is amended--</DELETED>
<DELETED> (1) by adding at the end the following:</DELETED>
<DELETED> ``(ss)(1) The term `in vitro clinical test' means an
article specified in subparagraph (2) that is intended by its developer
(as defined in section 587) to be used in the collection, preparation,
analysis, or in vitro clinical examination of specimens taken or
derived from the human body for the purpose of--</DELETED>
<DELETED> ``(A) identifying or diagnosing a disease or
condition;</DELETED>
<DELETED> ``(B) providing information for diagnosing,
screening, measuring, detecting, predicting, prognosing,
analyzing, or monitoring a disease or condition, including by
making a determination of an individual's state of health;
or</DELETED>
<DELETED> ``(C) selecting, monitoring, or informing therapy
or treatment for a disease or condition.</DELETED>
<DELETED> ``(2) An article specified in this subparagraph is--
</DELETED>
<DELETED> ``(A) a test kit;</DELETED>
<DELETED> ``(B) a test system;</DELETED>
<DELETED> ``(C) a test protocol or laboratory test
protocol;</DELETED>
<DELETED> ``(D) an instrument (as defined in section
587(11));</DELETED>
<DELETED> ``(E) a specimen receptacle (as defined in section
587(17));</DELETED>
<DELETED> ``(F) software, excluding software that is
excluded by section 520(o) from the definition of a device
under section 201(h), that--</DELETED>
<DELETED> ``(i) is a component or part of another in
vitro clinical test or analyzes, processes, or
interprets a signal or pattern from another in vitro
clinical test; and</DELETED>
<DELETED> ``(ii) does not analyze, process, or
interpret a signal, pattern, or medical image from a
device; and</DELETED>
<DELETED> ``(G) subject to subparagraph (3), a component or
part of a test, a test protocol, an instrument, an article, or
software described in any of clauses (A) through (D) of such
subparagraph, whether alone or in combination, including
reagents, calibrators, and controls.</DELETED>
<DELETED> ``(3) Notwithstanding subparagraph (2)(G), an article
intended to be used as a component or part of an in vitro clinical test
described in subparagraph (1) is excluded from the definition in
subparagraph (1) if the article consists of any of the
following:</DELETED>
<DELETED> ``(A) Blood, blood components, or human cells or
tissues, from the time of acquisition, donation, or recovery of
such article, including determination of donor eligibility, as
applicable, until such time as the article is released as a
component or part of an in vitro clinical test by the
establishment that collected such article.</DELETED>
<DELETED> ``(B) An article used for invasive sampling, a
needle, or a lancet, except to the extent such article, needle,
or lancet is an integral component of an article for holding,
storing, or transporting a specimen.</DELETED>
<DELETED> ``(C) General purpose laboratory equipment,
including certain pre-analytical equipment, as determined by
the Secretary.</DELETED>
<DELETED> ``(D) An article used solely for personal
protection during the administering, conducting, or otherwise
performing of test activities.'';</DELETED>
<DELETED> (2) by adding at the end of section 201(g) the
following:</DELETED>
<DELETED> ``(3) The term `drug' does not include an in vitro
clinical test.''; and</DELETED>
<DELETED> (3) in section 201(h)(1), in the matter following
clause (C), by striking ``section 520(o)'' and inserting
``section 520(o) or an in vitro clinical test''.</DELETED>
<DELETED> (b) Exclusion From Definition of Biological Product.--
Section 351(i)(1) of the Public Health Service Act (42 U.S.C.
262(i)(1)) is amended--</DELETED>
<DELETED> (1) by striking ``(1) The term `biological
product' means'' and inserting ``(1)(A) The term `biological
product' means''; and</DELETED>
<DELETED> (2) by adding at the end the following:</DELETED>
<DELETED> ``(B) The term `biological product' does not
include an in vitro clinical test as defined in section 201(ss)
of the Federal Food, Drug, and Cosmetic Act.''.</DELETED>
<DELETED> (c) In Vitro Clinical Test Definition.--In this Act, the
term ``in vitro clinical test'' has the meaning given such term in
section 201(ss) of the Federal Food, Drug, and Cosmetic Act, as added
by subsection (a).</DELETED>
<DELETED>SEC. 823. REGULATION OF IN VITRO CLINICAL TESTS.</DELETED>
<DELETED> The Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 et
seq.) is amended--</DELETED>
<DELETED> (1) by amending the heading of chapter V to read
as follows: ``DRUGS, DEVICES, AND IN VITRO CLINICAL TESTS'';
and</DELETED>
<DELETED> (2) by adding at the end of chapter V the
following:</DELETED>
<DELETED>``Subchapter J--In Vitro Clinical Tests</DELETED>
<DELETED>``SEC. 587. DEFINITIONS.</DELETED>
<DELETED> ``In this subchapter:</DELETED>
<DELETED> ``(1) Analytical validity.--The term `analytical
validity' means, with respect to an in vitro clinical test, the
ability of the in vitro clinical test, to identify, measure,
detect, calculate, or analyze (or assist in such
identification, measurement, detection, calculation, or
analysis of) one or more analytes, biomarkers, substances, or
other targets intended to be identified, measured, detected,
calculated, or analyzed by the test.</DELETED>
<DELETED> ``(2) Applicable standard.--The term `applicable
standard', with respect to an in vitro clinical test, means a
reasonable assurance of analytical and clinical validity for
its indications for use, and a reasonable assurance of safety
for individuals who come into contact with such in vitro
clinical test, except that such term, with respect to specimen
receptacles and test instruments, means a reasonable assurance
of analytical validity for its indications for use and safety
for individuals who come into contact with such specimen
receptacle or test instrument.</DELETED>
<DELETED> ``(3) Clinical use.--The term `clinical use' means
the operation, application, or functioning of an in vitro
clinical test for the purpose for which it is intended as
described in section 201(ss)(1).</DELETED>
<DELETED> ``(4) Clinical validity.--The term `clinical
validity' means the ability of an in vitro clinical test to
achieve the purpose for which it is intended as described in
section 201(ss)(1).</DELETED>
<DELETED> ``(5) Component or part.--The term `component or
part' means a substance, piece, part, raw material, software,
firmware, labeling, or assembly, including reagents, that is
intended by the developer to be included as an aspect of an in
vitro clinical test described in section 201(ss)(1).</DELETED>
<DELETED> ``(6) Develop.--The term `develop', with respect
to an in vitro clinical test, means--</DELETED>
<DELETED> ``(A) designing, validating, producing,
manufacturing, remanufacturing, labeling, advertising,
propagating, or assembling an in vitro clinical
test;</DELETED>
<DELETED> ``(B) modifying an in vitro clinical test,
including modifying the indications for use of the in
vitro clinical test, or modifying an article to be in
an in vitro clinical test; or</DELETED>
<DELETED> ``(C) establishing a test system as
described or included in a test protocol developed by
another entity unless such test protocol is listed as
an in vitro clinical test in the comprehensive test
information system established under section 587T by
that other entity.</DELETED>
<DELETED> ``(7) Developer.--The term `developer' means a
person who engages in development as described in paragraph
(6), except the term does not include a laboratory that--
</DELETED>
<DELETED> ``(A) is certified by the Secretary under
section 353 of the Public Health Service Act;
and</DELETED>
<DELETED> ``(B) assembles for use solely within that
laboratory, without otherwise developing, an in vitro
clinical test appropriately listed in the comprehensive
test information system established under section 587T
by a different person.</DELETED>
<DELETED> ``(8) First-of-a-kind.--The term `first-of-a-
kind', with respect to an in vitro clinical test, means that
such test has any novel combination of the elements specified
in paragraph (10) that differs from in vitro clinical tests
that already are legally available in the United States, except
for such tests offered under section 587C(a)(3), 587C(a)(4), or
587G.</DELETED>
<DELETED> ``(9) High-risk.--The term `high-risk', with
respect to an in vitro clinical test or category of in vitro
clinical tests, means that an undetected inaccurate result from
such test, or such category of tests, when used as intended--
</DELETED>
<DELETED> ``(A)(i) has the substantial likelihood to
result in serious or irreversible harm or death to a
patient or patients, or would otherwise cause serious
harm to the public health; or</DELETED>
<DELETED> ``(ii) is reasonably likely to result in
the absence, significant delay, or discontinuation of
life-supporting or life-sustaining medical treatment;
and</DELETED>
<DELETED> ``(B) sufficient mitigating measures are
not able to be established and applied to prevent,
mitigate, or detect the inaccurate result, or otherwise
mitigate the risk resulting from an undetected
inaccurate result described in subparagraph (A), such
that the test would be moderate-risk or low-
risk.</DELETED>
<DELETED> ``(10) Indications for use.--The term `indications
for use', with respect to an in vitro clinical test, means the
following elements:</DELETED>
<DELETED> ``(A) Substance or substances measured by
the in vitro clinical test, such as an analyte,
protein, or pathogen.</DELETED>
<DELETED> ``(B) Test method.</DELETED>
<DELETED> ``(C) Test purpose or purposes, as
described in section 201(ss)(1).</DELETED>
<DELETED> ``(D) Diseases or conditions for which the
in vitro clinical test is intended for use, including
intended patient populations.</DELETED>
<DELETED> ``(E) Context of use, such as in a
clinical laboratory, in a health care facility,
prescription home use, over-the-counter use, or direct-
to-consumer testing.</DELETED>
<DELETED> ``(11) Instrument.--</DELETED>
<DELETED> ``(A) In general.--The term `instrument'
means an analytical or pre-analytical
instrument.</DELETED>
<DELETED> ``(B) Analytic instrument.--The term
`analytic instrument' means an in vitro clinical test
that is hardware intended by the hardware developer to
be used with one or more other in vitro clinical tests
to generate a clinical test result, including software
used to effectuate the functionality of the
hardware.</DELETED>
<DELETED> ``(C) Pre-analytical instrument.--The term
`pre-analytical instrument' means an in vitro clinical
test that is hardware intended by the hardware's
developer solely to generate an output for use
exclusively with one or more analytical instruments as
defined in subparagraph (B) and which does not itself
generate a clinical test result. Such term may include
software used to effectuate the hardware's
functionality.</DELETED>
<DELETED> ``(12) Instrument family.--The term `instrument
family' means more than one instrument developed by the same
developer for which the developer demonstrates and documents,
with respect to all such instruments, that all--</DELETED>
<DELETED> ``(A) have the same basic architecture,
design, and performance characteristics;</DELETED>
<DELETED> ``(B) have the same indications for use
and capabilities;</DELETED>
<DELETED> ``(C) share the same measurement
principles, detection methods, and reaction conditions,
as applicable; and</DELETED>
<DELETED> ``(D) produce the same or similar
analytical results from samples of the same specimen
type or types.</DELETED>
<DELETED> ``(13) Low-risk.--The term `low-risk', with
respect to an in vitro clinical test or category of in vitro
clinical tests, means that an undetected inaccurate result from
such in vitro clinical test, or such category of in vitro
clinical tests, when used as intended--</DELETED>
<DELETED> ``(A) would cause only minimal or
immediately reversible harm, and would lead to only a
remote risk of adverse patient impact or adverse public
health impact; or</DELETED>
<DELETED> ``(B) sufficient mitigating measures are
able to be established and applied such that the in
vitro clinical test meets the standard described in
subparagraph (A).</DELETED>
<DELETED> ``(14) Mitigating measures.--The term `mitigating
measures'--</DELETED>
<DELETED> ``(A) means controls, standards, and other
requirements that the Secretary determines, based on
evidence, are necessary--</DELETED>
<DELETED> ``(i) for an in vitro clinical
test, or a category of in vitro clinical tests,
to meet the applicable standard; or</DELETED>
<DELETED> ``(ii) to mitigate the risk of
harm ensuing from an undetected inaccurate
result or misinterpretation of a result;
and</DELETED>
<DELETED> ``(B) may include, as required by the
Secretary, as appropriate, applicable requirements
regarding labeling, conformance to performance
standards and consensus standards, performance testing,
submission of clinical data, advertising, website
posting of information, clinical studies, postmarket
surveillance, user comprehension studies, training, and
confirmatory laboratory, clinical findings, or
testing.</DELETED>
<DELETED> ``(15) Moderate-risk.--The term `moderate-risk',
with respect to an in vitro clinical test or category of in
vitro clinical tests, means that, when used as intended, such
test or category of tests--</DELETED>
<DELETED> ``(A) meets the criteria specified in
paragraph (9) for classification as high-risk, but one
or more mitigating measures are able to be established
and applied to prevent or detect an inaccurate result
or otherwise sufficiently mitigate such risk, but are
not sufficient such that the test is low-risk;
or</DELETED>
<DELETED> ``(B)(i) an undetected inaccurate result
for the intended use of the test would cause only non-
life-threatening harm, harm that is medically
reversible, or the absence, significant delay, or
discontinuation of necessary treatment that is not
life-supporting or life-sustaining; and</DELETED>
<DELETED> ``(ii) mitigating measures are not able to
be established and applied to prevent or detect such
inaccurate result or otherwise sufficiently mitigate
the risk of such inaccurate result such that the test
would be low-risk.</DELETED>
<DELETED> ``(16) Specimen receptacle.--The term `specimen
receptacle' means an in vitro clinical test intended for
taking, collecting, holding, storing, or transporting of
specimens derived from the human body or for in vitro
examination for purposes described in subparagraph (A) or (B)
of section 201(ss)(1).</DELETED>
<DELETED> ``(17) Technology.--The term `technology'--
</DELETED>
<DELETED> ``(A) means a set of control mechanisms,
energy sources, or operating principles--</DELETED>
<DELETED> ``(i) that do not differ
significantly among multiple in vitro clinical
tests; and</DELETED>
<DELETED> ``(ii) for which design and
development (including analytical and clinical
validation, as applicable) of the tests would
be addressed in a similar manner or through
similar procedures; and</DELETED>
<DELETED> ``(B) may include clot detection,
colorimetric (non-immunoassay), electrochemical (non-
immunoassay), enzymatic (non-immunoassay), flow
cytometry, fluorometry (non-immunoassay), immunoassay,
mass spectrometry or chromatography, microbial culture,
next generation sequencing, nephlometric or
turbidimetric (non-immunoassay), singleplex or
multiplex non-NGS nucleic acid analysis, slide-based
technology, spectroscopy, and any other technology, as
the Secretary determines appropriate.</DELETED>
<DELETED> ``(18) Test.--The term `test', unless otherwise
provided, means an in vitro clinical test.</DELETED>
<DELETED> ``(19) Valid scientific evidence.--The term `valid
scientific evidence'--</DELETED>
<DELETED> ``(A) means, with respect to an in vitro
clinical test, evidence that--</DELETED>
<DELETED> ``(i) has been generated and
evaluated by persons qualified by training or
experience to do so, using procedures generally
accepted by other persons so qualified;
and</DELETED>
<DELETED> ``(ii) forms an appropriate basis
for concluding by qualified experts whether the
applicable standard has been met by the in
vitro clinical test; and</DELETED>
<DELETED> ``(B) may include evidence described in
subparagraph (A) consisting of--</DELETED>
<DELETED> ``(i) peer-reviewed
literature;</DELETED>
<DELETED> ``(ii) clinical
guidelines;</DELETED>
<DELETED> ``(iii) reports of significant
human experience with an in vitro clinical
test;</DELETED>
<DELETED> ``(iv) bench studies;</DELETED>
<DELETED> ``(v) case studies or
histories;</DELETED>
<DELETED> ``(vi) clinical data;</DELETED>
<DELETED> ``(vii) consensus
standards;</DELETED>
<DELETED> ``(viii) reference
standards;</DELETED>
<DELETED> ``(ix) data registries;</DELETED>
<DELETED> ``(x) postmarket data;</DELETED>
<DELETED> ``(xi) real world data;</DELETED>
<DELETED> ``(xii) clinical trials;
and</DELETED>
<DELETED> ``(xiii) data collected in
countries other than the United States if such
data are demonstrated to be appropriate for the
purpose of making a regulatory determination
under this subchapter.</DELETED>
<DELETED>``SEC. 587A. REGULATION OF IN VITRO CLINICAL TESTS.</DELETED>
<DELETED> ``(a) In General.--No person shall introduce or deliver
for introduction into interstate commerce any in vitro clinical test,
unless--</DELETED>
<DELETED> ``(1) an approval of an application filed pursuant
to subsection (a) or (b) of section 587B is effective with
respect to such in vitro clinical test;</DELETED>
<DELETED> ``(2) a technology certification order is in
effect under section 587D; or</DELETED>
<DELETED> ``(3) the test is exempt under sections 587C or
587G from the requirements of section 587B.</DELETED>
<DELETED> ``(b) Transfer or Sale of In Vitro Clinical Tests.--
</DELETED>
<DELETED> ``(1) Transfer and assumption of regulatory
obligations.--If ownership of an in vitro clinical test is sold
or transferred in such manner that the developer transfers the
regulatory submissions and obligations applicable under this
subchapter with respect to the test, the transferee or
purchaser becomes the developer of the test and shall have all
regulatory obligations applicable to such a test under this
subchapter. The transferee or purchaser shall update the
registration and listing information under section 587J for the
in vitro clinical test.</DELETED>
<DELETED> ``(2) Transfer or sale of premarket approval.--
</DELETED>
<DELETED> ``(A) Notice required.--If a developer of
an in vitro clinical test transfers or sells the
approval of the in vitro clinical test, the transferor
or seller shall--</DELETED>
<DELETED> ``(i) submit a notice of the
transfer or sale to the Secretary and update
the registration and listing information under
section 587J for the in vitro clinical test;
and</DELETED>
<DELETED> ``(ii) submit a supplement to an
application if required under section
587B(h).</DELETED>
<DELETED> ``(B) Effective date of approval
transfer.--A transfer or sale described in subparagraph
(A) shall become effective upon completion of a
transfer or sale described in paragraph (1) or the
approval of a supplement to an application under
section 587B(h) if required, whichever is later. The
transferee or purchaser shall update the registration
and listing information under section 587J for the in
vitro clinical test within 15 calendar days of the
effective date of the transfer or sale.</DELETED>
<DELETED> ``(3) Transfer or sale of technology
certification.--</DELETED>
<DELETED> ``(A) Requirements for transfer or sale of
technology certification.--An unexpired technology
certification can be transferred or sold if the
transferee or purchaser--</DELETED>
<DELETED> ``(i) is an eligible person under
section 587D(a)(2); and</DELETED>
<DELETED> ``(ii) maintains, upon such
transfer or sale, test design and quality
requirements, processes and procedures under
the scope of technology certification, and
scope of the technology certification
identified in the applicable technology
certification order.</DELETED>
<DELETED> ``(B) Notice required.--If a developer of
an in vitro clinical test transfers or sells a
technology certification order that has not expired,
the transferor or seller shall submit a notice of the
transfer or sale to the Secretary and shall update the
registration and listing information under section 587J
for all in vitro clinical tests covered by the
technology certification.</DELETED>
<DELETED> ``(C) Effective date of technology
certification transfer.--The transfer of a technology
certification shall become effective upon completion of
a transfer or sale described in subparagraph (A). The
transferee or purchaser shall update the registration
and listing information under section 587J for the in
vitro clinical test within 30 calendar days of the
effective date of the technology certification
transfer.</DELETED>
<DELETED> ``(D) New technology certification
required.--If the requirements of subparagraph (A)(ii)
are not met, the technology certification order may not
be transferred and the transferee or purchaser of an in
vitro clinical test is required to submit an
application for technology certification and obtain a
technology certification order prior to offering the
test for clinical use.</DELETED>
<DELETED> ``(c) Regulations.--The Secretary may issue regulations to
implement this subchapter.</DELETED>
<DELETED>``SEC. 587B. PREMARKET REVIEW.</DELETED>
<DELETED> ``(a) Application.--</DELETED>
<DELETED> ``(1) Filing.--Any developer may file with the
Secretary an application for premarket approval of an in vitro
clinical test under this subsection.</DELETED>
<DELETED> ``(2) Transparency and predictability.--If a
developer files a premarket application under this section and
provides any additional documentation required under section
587D, the in vitro clinical test that is the subject of the
premarket application may be utilized as the representative in
vitro clinical test reviewed by the Secretary to support a
technology certification order under section 587D.</DELETED>
<DELETED> ``(3) Application content.--An application
submitted under paragraph (1) shall include the following, in
such format as the Secretary specifies:</DELETED>
<DELETED> ``(A) General information regarding the in
vitro clinical test, including--</DELETED>
<DELETED> ``(i) the name and address of the
applicant;</DELETED>
<DELETED> ``(ii) the table of contents for
the application and the identification of the
information the applicant claims as trade
secret or confidential commercial or financial
information;</DELETED>
<DELETED> ``(iii) a description of the
test's design and intended use, including the
indications for use; and</DELETED>
<DELETED> ``(iv) a description regarding
test function and performance
characteristics.</DELETED>
<DELETED> ``(B) A summary of the data and
information in the application for the in vitro
clinical test, including--</DELETED>
<DELETED> ``(i) a brief description of the
foreign and domestic marketing history of the
test, if any, including a list of all countries
in which the test has been marketed and a list
of all countries in which the test has been
withdrawn from marketing for any reason related
to the ability of the in vitro clinical test to
meet the applicable standard, if known by the
applicant;</DELETED>
<DELETED> ``(ii) a description of benefit
and risk considerations related to the in vitro
clinical test, including a description of any
applicable adverse effects of the test on
health and how such adverse effects have been,
or will be, mitigated;</DELETED>
<DELETED> ``(iii) a risk assessment of the
test; and</DELETED>
<DELETED> ``(iv) a description of how the
data and information in the application
constitute valid scientific evidence and
support a showing that the test meets the
applicable standard under section
587(2).</DELETED>
<DELETED> ``(C) The signature of the developer
filing the premarket application or an authorized
representative.</DELETED>
<DELETED> ``(D) A bibliography of applicable
published reports relied upon by the applicant and a
description of any studies conducted, including any
unpublished studies related to such test, that are
known or that should reasonably be known to the
applicant, and a description of data and information
relevant to the evaluation of whether the test meets
the applicable standard.</DELETED>
<DELETED> ``(E) Applicable information regarding the
methods used in, and the facilities or controls used
for, the development of the test to demonstrate
compliance with the applicable quality requirements
under section 587K.</DELETED>
<DELETED> ``(F) Information demonstrating compliance
with any relevant and applicable--</DELETED>
<DELETED> ``(i) mitigating measures under
section 587E; and</DELETED>
<DELETED> ``(ii) standards established or
recognized under section 514 prior to the date
of enactment of the VALID Act of 2022, or,
after applicable standards are established or
recognized under section 587Q, with such
standards.</DELETED>
<DELETED> ``(G) Valid scientific evidence to support
that the test meets the applicable standard, which
shall include--</DELETED>
<DELETED> ``(i) summary information for all
supporting validation studies performed,
including a description of the objective of the
study, a description of the experimental design
of the study, a description of any limitations
of the study, a brief description of how the
data were collected and analyzed, a brief
description of the results of each study, and
conclusions drawn from each study;</DELETED>
<DELETED> ``(ii) new raw data for each
study, which may include, as applicable,
tabulations of data and results as required
under section 814.20(b)(6)(ii) of title 21,
Code of Federal Regulations (or any successor
regulations); and</DELETED>
<DELETED> ``(iii) for nonclinical laboratory
studies involving the test, if applicable, a
statement that studies were conducted in
compliance with applicable good laboratory
practices.</DELETED>
<DELETED> ``(H) To the extent the application seeks
authorization to make modifications to the test within
the scope of the approval that are not otherwise
permitted without premarket review under this
subchapter, a proposed change protocol that includes
validation procedures and acceptance criteria for
anticipated modifications that could be made to the
test within the scope of the approval.</DELETED>
<DELETED> ``(I) Proposed labeling, in accordance
with the requirements of section 587L.</DELETED>
<DELETED> ``(J) Such other data or information as
the Secretary may require in accordance with the least
burdensome requirements under section
587AA(c).</DELETED>
<DELETED> ``(4) Guidance for premarket and abbreviated
premarket applications.--In accordance with section 825 of the
VALID Act of 2022, the Secretary shall issue draft guidance
detailing the information to be provided in a premarket
application and abbreviated premarket application under this
section. The Secretary shall issue final guidance detailing the
information to be provided in a premarket application and
abbreviated premarket application under this section not later
than 1 year prior to the effective date of such Act.</DELETED>
<DELETED> ``(5) Refuse to file a premarket or abbreviated
premarket application.--The Secretary may refuse to file an
application under this section only for lack of completeness or
legibility of the application. If, after receipt of an
application under this section, the Secretary refuses to file
such an application, the Secretary shall provide to the
developer, within 60 calendar days of receipt of such
application, a description of the reason for such refusal, and
identify the information required, if any, to allow for the
filing of the application.</DELETED>
<DELETED> ``(6) Substantive review for deficient
application.--If, after receipt of an application under this
section, the Secretary determines that any portion of such
application is materially deficient, the Secretary shall
provide to the applicant a description of such material
deficiencies and the information required to resolve such
deficiencies.</DELETED>
<DELETED> ``(7) Inspections.--With respect to an application
under paragraph (1), preapproval inspections authorized by an
employee of the Food and Drug Administration or a person
accredited under section 587Q need not occur unless requested
by the Secretary.</DELETED>
<DELETED> ``(b) Abbreviated Premarket Review.--</DELETED>
<DELETED> ``(1) In general.--Any developer may file with the
Secretary an application for abbreviated premarket approval
for--</DELETED>
<DELETED> ``(A) an instrument;</DELETED>
<DELETED> ``(B) a specimen receptacle;</DELETED>
<DELETED> ``(C) an in vitro clinical test that is
moderate-risk; or</DELETED>
<DELETED> ``(D) an in vitro clinical test that is
determined by the Secretary to be eligible for
abbreviated premarket review under section
587F(a)(1)(B).</DELETED>
<DELETED> ``(2) Application content.--An application under
paragraph (1) shall include--</DELETED>
<DELETED> ``(A) the information required for
applications submitted under subsection (a)(2), except
that applications under paragraph (1) need not
include--</DELETED>
<DELETED> ``(i) quality requirement
information; or</DELETED>
<DELETED> ``(ii) raw data, unless explicitly
requested by the Secretary; and</DELETED>
<DELETED> ``(B) data, as applicable, to support
software validation, electromagnetic compatibility, and
electrical safety, and information demonstrating
compliance with maintaining quality systems
documentation.</DELETED>
<DELETED> ``(3) Safety information.--The developer of an in
vitro clinical test specimen receptacle reviewed under this
subsection shall maintain safety information for such specimen
receptacle.</DELETED>
<DELETED> ``(4) Inspections.--With respect to an application
under paragraph (1), preapproval inspections authorized by an
employee of the Food and Drug Administration or a person
accredited under section 587Q need not occur unless requested
by the Secretary.</DELETED>
<DELETED> ``(c) Instruments and Instrument Families.--</DELETED>
<DELETED> ``(1) In general.--A developer of an instrument
family shall file with the Secretary an application for
premarket approval of one version of an instrument under this
subsection. Any modified versions of the instrument that
generate a new instrument within the same instrument family
shall be exempt from premarket review requirements of this
section, provided that the developer of such instrument or
instrument family--</DELETED>
<DELETED> ``(A) maintains documentation that the new
instrument is part of the instrument family, as defined
in section 587;</DELETED>
<DELETED> ``(B) performs, documents, and maintains a
risk assessment (as described in subsection
(a)(2)(B)(iv)) of the new instrument compared to the
instrument approved under subsection (b) and no new
risks are identified;</DELETED>
<DELETED> ``(C) performs, documents, and maintains
validation and verification activities for the new
instrument;</DELETED>
<DELETED> ``(D) makes such documentation available
to the Secretary upon request; and</DELETED>
<DELETED> ``(E) registers and lists the new
instrument in accordance with section 587J.</DELETED>
<DELETED> ``(2) Test kits and test protocols.--A test kit or
test protocol that is approved under this section for use on an
approved instrument or an instrument exempt from premarket
review, including an instrument within an instrument family
under this section, a submission under this section shall not
be required for such test kit or test protocol in order for it
to be used on a new instrument within its instrument family,
provided that--</DELETED>
<DELETED> ``(A) use of the test kit or test protocol
with the new instrument does not--</DELETED>
<DELETED> ``(i) change the claims for the
test kit or test protocol, except as
applicable, claims regarding an instrument or
instruments that can be used with such test kit
or test protocol;</DELETED>
<DELETED> ``(ii) adversely affect
performance of the test kit or test protocol;
or</DELETED>
<DELETED> ``(iii) cause the test kit or test
protocol to no longer conform with performance
standards required under section 587R or comply
with any applicable mitigating measures under
section 587E, conditions of approval under
subsection (e)(2)(B), or restrictions under
section 587O;</DELETED>
<DELETED> ``(B) the test developer does not identify
any new risks for the test kit or test protocol when
using the new instrument;</DELETED>
<DELETED> ``(C) the test developer validates the use
of the new instrument with the test kit or test
protocol and maintains validation
documentation;</DELETED>
<DELETED> ``(D) the test kit or test protocol is not
intended for use--</DELETED>
<DELETED> ``(i) at the point of care setting
or in settings for which a certificate of
waiver is in effect under section 353 of the
Public Health Service Act;</DELETED>
<DELETED> ``(ii) without a
prescription;</DELETED>
<DELETED> ``(iii) at home; or</DELETED>
<DELETED> ``(iv) in testing donors,
donations, and recipients of blood, blood
components, human cells, tissues, cellular-
based products, or tissue-based
products;</DELETED>
<DELETED> ``(E) the test developer makes the
documentation described under subparagraph (C)
available to the Secretary upon request; and</DELETED>
<DELETED> ``(F) the test developer updates the
listing information for the test kit or test protocol,
as applicable.</DELETED>
<DELETED> ``(d) Amendments to an Application.--An applicant shall
amend an application submitted under subsection (a), (b), or (f) if the
applicant becomes aware of information that could reasonably affect an
evaluation under subsection (e) of whether the approval standard has
been met.</DELETED>
<DELETED> ``(e) Action on an Application for Premarket Approval.--
</DELETED>
<DELETED> ``(1) Review.--</DELETED>
<DELETED> ``(A) Disposition.--As promptly as
possible, but not later than 90 calendar days after an
application under subsection (a) is accepted for
submission (unless the Secretary determines that an
extension is necessary to review one or more major
amendments to the application), or not later than 60
calendar days after an application under subsection (b)
is accepted for submission or a supplemental
application under subsection (f) is accepted for
submission, the Secretary, after considering any
applicable report and recommendations pursuant to
advisory committees under section 587H, shall issue an
order approving the application, unless the Secretary
finds that the grounds for approval in paragraph (2)
are not met.</DELETED>
<DELETED> ``(B) Reliance on proposed labeling.--In
determining whether to approve or deny an application
under paragraph (1), the Secretary shall rely on the
indications for use included in the proposed labeling,
provided that such labeling is not false or misleading
based on a fair evaluation of all material
facts.</DELETED>
<DELETED> ``(2) Approval of an application.--</DELETED>
<DELETED> ``(A) In general.--The Secretary shall
approve an application submitted under subsection (a)
or (b) with respect to an in vitro clinical test if the
Secretary finds that the applicable standard is met,
and--</DELETED>
<DELETED> ``(i) the applicant is in
compliance with applicable quality requirements
in section 587K;</DELETED>
<DELETED> ``(ii) the application does not
contain a false statement or misrepresentation
of material fact;</DELETED>
<DELETED> ``(iii) based on a fair evaluation
of all material facts, the proposed labeling is
truthful and non-misleading and complies with
the requirements of section 587L;</DELETED>
<DELETED> ``(iv) the applicant permits, if
requested, authorized employees of the Food and
Drug Administration and persons accredited
under section 587Q an opportunity to inspect
pursuant to section 704;</DELETED>
<DELETED> ``(v) the test conforms with any
applicable performance standards required under
section 587R and any applicable mitigating
measures under section 587E;</DELETED>
<DELETED> ``(vi) all nonclinical laboratory
studies and clinical investigations involving
human subjects that are described in the
application were conducted in a manner that
meets the applicable requirements of this
subchapter; and</DELETED>
<DELETED> ``(vii) other data and information
the Secretary may require under subsection
(a)(2)(K) support approval.</DELETED>
<DELETED> ``(B) Conditions of approval.--An order
approving an application pursuant to this section may
require reasonable conditions of approval for the in
vitro clinical test, which may include conformance with
applicable mitigating measures under section 587E,
restrictions under section 587O, and performance
standards under section 587R.</DELETED>
<DELETED> ``(C) Publication.--The Secretary shall
publish an order for each application approved pursuant
to this paragraph on the public website of the Food and
Drug Administration and make publicly available a
summary of the data used to approve such application,
except to the extent the Secretary determines that such
order--</DELETED>
<DELETED> ``(i) contains commercially
confidential or trade secret information;
or</DELETED>
<DELETED> ``(ii) if published, would present
a risk to national security.</DELETED>
<DELETED> ``(3) Review of denials.--An applicant whose
application submitted under this section has been denied
approval under this subsection may, by petition filed not more
than 60 calendar days after the date on which the applicant
receives notice of such denial, obtain review of the denial in
accordance with section 587P.</DELETED>
<DELETED> ``(f) Supplements to an Approved Application.--</DELETED>
<DELETED> ``(1) Risk analysis.--Prior to implementing any
modification to an in vitro clinical test, the holder of the
application approved under subsection (a) or (b) for such test
shall perform risk analyses in accordance with this subsection,
unless such modification is included in the change protocol
submitted by the applicant and approved under this section or
exempt under section 587C.</DELETED>
<DELETED> ``(2) Supplement requirement.--</DELETED>
<DELETED> ``(A) In general.--If the holder of an
application of an approved in vitro clinical test makes
a modification to such in vitro clinical test, except
as provided in subparagraph (C), or otherwise specified
by the Secretary, the holder of the application
approved under subsection (e) for an in vitro clinical
test shall submit a supplemental application to the
Secretary. The holder of the application may not
implement such modification to the in vitro clinical
test until such supplemental application is approved.
The information required in a supplemental application
is limited to what is needed to support the
change.</DELETED>
<DELETED> ``(B) Adjustments to change protocol.--The
holder of an approved application may submit under this
paragraph a supplemental application to modify the
change protocol of the test at any time after the
application is submitted under subsection (a) or
(b).</DELETED>
<DELETED> ``(C) Exceptions.--Notwithstanding
subparagraphs (A) and (B), and so long as the holder of
an approved application submitted under subsection (a)
or (b) for an in vitro clinical test does not add a
manufacturing site, or change activities at an existing
manufacturing site, with respect to the test, the
holder of an approved application may, without
submission of a supplemental application, implement the
following modifications to the test:</DELETED>
<DELETED> ``(i) Modifications in accordance
with an approved change protocol under
subsection (a)(3)(H).</DELETED>
<DELETED> ``(ii) Modifications that are
exempt under section 587C(b).</DELETED>
<DELETED> ``(iii) Labeling changes that are
appropriate to address a safety concern, except
such labeling changes that include any of the
following, remain subject to subparagraph
(A):</DELETED>
<DELETED> ``(I) A change to the
indications for use of the
test.</DELETED>
<DELETED> ``(II) A change to the
performance claims made with respect to
the test.</DELETED>
<DELETED> ``(III) A change that
adversely affects performance of the
test.</DELETED>
<DELETED> ``(D) Reporting for certain modifications
made pursuant to a change protocol.--The holder of an
application approved under subsection (e), with an
approved change protocol under subsection (a)(2)(H) for
such in vitro clinical test shall--</DELETED>
<DELETED> ``(i) report any modification to
such test made pursuant to such change protocol
approved under subsection (a)(2)(H) in a
submission under section 587J(c)(2)(B);
and</DELETED>
<DELETED> ``(ii) include in such report--
</DELETED>
<DELETED> ``(I) a description of the
modification;</DELETED>
<DELETED> ``(II) the rationale for
implementing such modification;
and</DELETED>
<DELETED> ``(III) as applicable, a
summary of the evidence supporting that
the test, as modified, meets the
applicable standard, complies with
performance standards required under
section 587Q, and complies with any
mitigating measures established under
section 587E and any restrictions under
section 587O.</DELETED>
<DELETED> ``(E) Reporting for certain safety related
labeling changes.--The holder of the application for an
in vitro clinical test approved under subsection (a) or
(b) pursuant to subsection (e) shall--</DELETED>
<DELETED> ``(i) report to the Secretary any
modification to the test described in
subparagraph (C)(iii) not more than 30 days
after the date on which the test, with the
modifications, is introduced into interstate
commerce; and</DELETED>
<DELETED> ``(ii) include in the report--
</DELETED>
<DELETED> ``(I) a description of the
change or changes;</DELETED>
<DELETED> ``(II) the rationale for
implementing such change or changes;
and</DELETED>
<DELETED> ``(III) a description of
how the change or changes were
evaluated.</DELETED>
<DELETED> ``(3) Contents of supplement.--Unless otherwise
specified by the Secretary, a supplement under this subsection
shall include--</DELETED>
<DELETED> ``(A) for modifications other than
manufacturing site changes requiring a supplement--
</DELETED>
<DELETED> ``(i) a description of the
modification;</DELETED>
<DELETED> ``(ii) data relevant to the
modification to demonstrate that the applicable
standard is met, not to exceed data
requirements for the original
submission;</DELETED>
<DELETED> ``(iii) acceptance criteria;
and</DELETED>
<DELETED> ``(iv) any revised labeling;
and</DELETED>
<DELETED> ``(B) for manufacturing site changes--
</DELETED>
<DELETED> ``(i) the information listed in
subparagraph (A); and</DELETED>
<DELETED> ``(ii) information regarding the
methods used in, or the facilities or controls
used for, the development of the test to
demonstrate compliance with the applicable
quality requirements under section
587K.</DELETED>
<DELETED> ``(4) Additional data.--The Secretary may require,
when necessary, data to evaluate a modification to an in vitro
clinical test that is in addition to the data otherwise
required under the preceding paragraphs if the data request is
in accordance with the least burdensome requirements under
section 587AA(c).</DELETED>
<DELETED> ``(5) Conditions of approval.--In an order
approving a supplement under this subsection, the Secretary may
require conditions of approval for the in vitro clinical test,
including compliance with restrictions under section 587O and
conformance to performance standards under section
587R.</DELETED>
<DELETED> ``(6) Approval.--The Secretary shall approve a
supplement under this subsection if--</DELETED>
<DELETED> ``(A) the data demonstrate that the
modified in vitro clinical test meets the applicable
standard; and</DELETED>
<DELETED> ``(B) the holder of the application
approved under subsection (e) for the test has
demonstrated compliance with applicable quality and
inspection requirements, as applicable and
appropriate.</DELETED>
<DELETED> ``(7) Publication.--The Secretary shall publish on
the public website of the Food and Drug Administration notice
of any order approving a supplement under this subsection,
except that such publication shall exclude--</DELETED>
<DELETED> ``(A) commercial confidential or trade
secret information; and</DELETED>
<DELETED> ``(B) any other information that the
Secretary determines to relate to national security or
countermeasures or to be restricted from disclosure
pursuant to another provision of law.</DELETED>
<DELETED> ``(8) Review of denial.--An applicant whose
supplement under this subsection has been denied approval may,
by petition filed on or before the 60th calendar day after the
date upon which the applicant receives notice of such denial,
obtain review of the denial in accordance with section
587P.</DELETED>
<DELETED> ``(g) Withdrawal and Temporary Suspension of Approval.--
</DELETED>
<DELETED> ``(1) Order withdrawing approval.--</DELETED>
<DELETED> ``(A) In general.--The Secretary may,
after providing due notice and an opportunity for an
informal hearing to the holder of an approved
application for an in vitro clinical test under this
section, issue an order withdrawing approval of the
application if the Secretary finds that--</DELETED>
<DELETED> ``(i) the grounds for approval
under subsection (e) are no longer
met;</DELETED>
<DELETED> ``(ii) there is a reasonable
likelihood that the test would cause death or
serious adverse health consequences, including
by causing the absence, significant delay, or
discontinuation of life-saving or life
sustaining medical treatment;</DELETED>
<DELETED> ``(iii) the holder of the approved
application--</DELETED>
<DELETED> ``(I) has failed to, or
repeatedly or deliberately failed to,
maintain records to make reports, as
required under section 587M;</DELETED>
<DELETED> ``(II) has refused to
permit access to, or copying or
verification of such records, as
required under section 704;</DELETED>
<DELETED> ``(III) has not complied
with the requirements of section 587K;
or</DELETED>
<DELETED> ``(IV) has not complied
with any mitigating measure required
under section 587E or restriction under
section 587O; or</DELETED>
<DELETED> ``(iv) the labeling of such in
vitro clinical test, based on a fair evaluation
of all material facts, is false or misleading
in any particular and was not corrected within
a reasonable time after receipt of written
notice from the Secretary of such
fact.</DELETED>
<DELETED> ``(B) Content.--An order under
subparagraph (A) withdrawing approval of an application
shall state each ground for withdrawal and shall notify
the holder of such application 60 calendar days prior
to issuing such order.</DELETED>
<DELETED> ``(C) Publication.--The Secretary shall
publish any order under subparagraph (A) on the public
website of the Food and Drug Administration, except
that such publication shall exclude--</DELETED>
<DELETED> ``(i) commercial confidential or
trade secret information; and</DELETED>
<DELETED> ``(ii) any other information that
the Secretary determines, if published, would
present a risk to national security.</DELETED>
<DELETED> ``(2) Order of temporary suspension.--If, after
providing due notice and an opportunity for an informal hearing
to the holder of an approved application for an in vitro
clinical test under this section, the Secretary determines,
based on scientific evidence, that there is a reasonable
likelihood that the in vitro clinical test would cause death or
serious adverse health consequences, such as by causing the
absence, significant delay, or discontinuation of life-saving
or life-sustaining medical treatment, the Secretary shall, by
order, temporarily suspend the approval of the application. If
the Secretary issues such an order, the Secretary shall proceed
expeditiously under paragraph (1) to withdraw approval of such
application.</DELETED>
<DELETED> ``(3) Appeal withdrawing approval and orders of
temporary suspensions.--An order of withdrawal or an order of
temporary suspension may be appealed under 587P.</DELETED>
``SEC. 587C. EXEMPTIONS.
<DELETED> ``(a) In General.--The following in vitro clinical tests
are exempt from premarket review under section 587B, and may be
lawfully marketed subject to other applicable requirements of this
Act:</DELETED>
<DELETED> ``(1) Tests exempt from section 510(k).--
</DELETED>
<DELETED> ``(A) Exemption.--An in vitro clinical
test is exempt from premarket review under section 587B
and may be lawfully marketed subject to the other
applicable requirements of this Act, if the developer
of the in vitro clinical test--</DELETED>
<DELETED> ``(i) maintains documentation
demonstrating that the test meets and continues
to meet the criteria set forth in subparagraph
(B); and</DELETED>
<DELETED> ``(ii) makes such documentation
available to the Secretary upon
request.</DELETED>
<DELETED> ``(B) Criteria for exemption.--An in vitro
clinical test is exempt as specified in subparagraph
(A) if such test--</DELETED>
<DELETED> ``(i)(I) was offered for clinical
use prior to the date of enactment of the VALID
Act of 2022;</DELETED>
<DELETED> ``(II) immediately prior to such
date of enactment was exempt pursuant to
subsection (l) or (m)(2) of section 510 from
the requirements for submission of a report
under section 510(k); or</DELETED>
<DELETED> ``(III)(aa) was not offered for
clinical use prior to such date of
enactment;</DELETED>
<DELETED> ``(bb) is not an instrument;
and</DELETED>
<DELETED> ``(cc) falls within a category of
tests that was exempt from the requirements for
submission of a report under section 510(k) as
of such date of enactment (including class II
devices and excluding class I devices described
in section 510(l));</DELETED>
<DELETED> ``(ii) meets the applicable
standard as described in section
587(2);</DELETED>
<DELETED> ``(iii) is not offered with
labeling and advertising that is false or
misleading; and</DELETED>
<DELETED> ``(iv) is not likely to cause or
contribute to serious adverse health
consequences.</DELETED>
<DELETED> ``(C) Effect on special controls.--For any
in vitro clinical test, or category of in vitro
clinical tests, that is exempt from premarket review
based on the criteria in subparagraph (B), any special
control that applied to a device within a predecessor
category immediately prior to the date of enactment of
the VALID Act of 2022 shall be deemed a mitigating
measure applicable under section 587E to an in vitro
clinical test within the successor category, except to
the extent such mitigating measure is withdrawn or
changed in accordance with section 587E.</DELETED>
<DELETED> ``(D) Near-patient testing.--Not later
than 1 year after the date of enactment of the VALID
Act of 2022, the Secretary shall issue draft guidance
indicating categories of tests that shall be exempt
from premarket review under section 587B when offered
for near-patient testing (point of care), which were
not exempt from submission of a report under section
510(k) pursuant to subsection (l) or (m)(2) of section
510 and regulations imposing limitations on exemption
for in vitro devices intended for near-patient testing
(point of care).</DELETED>
<DELETED> ``(2) Low-risk tests.--</DELETED>
<DELETED> ``(A) Exemption.--An in vitro clinical
test is exempt from premarket review under section 587B
and may be lawfully marketed subject to the other
applicable requirements of this Act, including section
587J(b)(6), if such test meets the definition of low-
risk under section 587 and if the developer of the
test--</DELETED>
<DELETED> ``(i) maintains documentation
demonstrating that the in vitro clinical test
meets and continues to meet the criteria set
forth in paragraph (2); and</DELETED>
<DELETED> ``(ii) makes such documentation
available to the Secretary upon
request.</DELETED>
<DELETED> ``(B) Criteria for exemption.--An in vitro
clinical test is exempt as specified in subparagraph
(A) if--</DELETED>
<DELETED> ``(i) the in vitro clinical test
meets the applicable standard as described in
587(2);</DELETED>
<DELETED> ``(ii) the labeling and
advertising are not false or
misleading;</DELETED>
<DELETED> ``(iii) the in vitro clinical test
is not likely to cause or contribute to serious
adverse health consequences; and</DELETED>
<DELETED> ``(iv) the in vitro clinical test
is listed pursuant to section 587J or falls
within a category of tests listed as described
in subparagraph (C).</DELETED>
<DELETED> ``(C) List of low-risk tests.--</DELETED>
<DELETED> ``(i) In general.--The Secretary
shall maintain, and make publicly available on
the website of the Food and Drug
Administration, a list of in vitro clinical
tests, and categories of in vitro clinical
tests, that are low-risk in vitro clinical
tests for purposes of the exemption under this
paragraph.</DELETED>
<DELETED> ``(ii) Inclusion.--The list under
clause (i) shall consist of--</DELETED>
<DELETED> ``(I) all in vitro
clinical tests and categories of in
vitro clinical tests that are exempt
from premarket review pursuant to
subsection (d)(1) or (d)(3);
and</DELETED>
<DELETED> ``(II) all in vitro
clinical tests and categories of in
vitro clinical tests that are
designated by the Secretary pursuant to
subparagraph (C) as low-risk for
purposes of this paragraph.</DELETED>
<DELETED> ``(D) Designation of tests and
categories.--Without regard to subchapter II of chapter
5 of title 5, United States Code, the Secretary may
designate, in addition to the tests and categories
described in subparagraph (C)(i), additional in vitro
clinical tests, and categories of in vitro clinical
tests, as low-risk in vitro clinical tests for purposes
of the exemption under this paragraph. The Secretary
may make such a designation on the Secretary's own
initiative or in response to a request by a developer
pursuant to subsection (a) or (b) of section 587F. In
making such a designation for a test or category of
tests, the Secretary shall consider--</DELETED>
<DELETED> ``(i) whether the test, or
category of tests, is low-risk;</DELETED>
<DELETED> ``(ii) the existence of and
ability to develop mitigating measures
sufficient for such test category to meet the
low-risk standard; and</DELETED>
<DELETED> ``(iii) such other factors as the
Secretary determines to be appropriate for the
protection of the public health.</DELETED>
<DELETED> ``(3) Humanitarian test exemption.--</DELETED>
<DELETED> ``(A) In general.--An in vitro clinical
test that meets the criteria under subparagraph (B) is
exempt from premarket review under section 587B and may
be lawfully offered subject to the other applicable
requirements of this subchapter, if the developer of
the test--</DELETED>
<DELETED> ``(i) maintains documentation
(which may include literature citations in
specialized medical journals, textbooks,
specialized medical society proceedings, and
governmental statistics publications, or, if no
such studies or literature citations exist,
credible conclusions from appropriate research
or surveys) demonstrating that such test meets
and continues to meet the criteria described in
this subsection; and</DELETED>
<DELETED> ``(ii) makes such documentation
available to the Secretary upon
request.</DELETED>
<DELETED> ``(B) Criteria for exemption.--An in vitro
clinical test is exempt as described in subparagraph
(A) if--</DELETED>
<DELETED> ``(i) the in vitro clinical test
is intended by the developer for use for a
diagnostic purpose for a disease or condition
that affects not more than 10,000 (or such
other higher number determined by the
Secretary) individuals in the United States per
year; and</DELETED>
<DELETED> ``(ii) the in vitro clinical test
meets the applicable standard described in
section 587(2);</DELETED>
<DELETED> ``(iii) the labeling and
advertising for the in vitro clinical test are
not false or misleading;</DELETED>
<DELETED> ``(iv) the in vitro clinical test
is not likely to cause or contribute to serious
health consequences; and</DELETED>
<DELETED> ``(v) the in vitro clinical test
is not intended for screening.</DELETED>
<DELETED> ``(C) Exception for certain tests.--An in
vitro clinical test intended to inform the use of a
specific individual or specific type of biological
product, drug, or device shall be eligible for an
exemption from premarket review under this subsection
only if, the developer submits a request under
subsection (m) for informal feedback and the Secretary
determines that such in vitro clinical test is eligible
for an exemption from premarket review under this
subsection.</DELETED>
<DELETED> ``(4) Custom tests and low-volume tests.--An in
vitro clinical test is exempt from premarket review under
section 587B, quality requirements under section 587K, and
listing requirements under section 587J, and may be lawfully
marketed subject to the other applicable requirements of this
Act, if--</DELETED>
<DELETED> ``(A) such in vitro clinical test--
</DELETED>
<DELETED> ``(i) is a test protocol performed
for not more than 5 patients per year (or such
other higher number determined by the
Secretary), in a laboratory certified by the
Secretary under section 353 of the Public
Health Service Act that--</DELETED>
<DELETED> ``(I) meets the
requirements to perform tests of high-
complexity in which the test protocol
was developed; or</DELETED>
<DELETED> ``(II) meets the
requirements to perform tests of high-
complexity within the same corporate
organization and having common
ownership by the same parent
corporation as the laboratory in which
such test protocol was developed;
or</DELETED>
<DELETED> ``(ii) is an in vitro clinical
test developed or modified to diagnose a unique
pathology or physical condition of a specific
patient or patients, upon order of a health
professional or other specially qualified
person designated under regulations, for which
no other in vitro clinical test is commercially
available in the United States, and is--
</DELETED>
<DELETED> ``(I) not intended for use
with respect to more than 5 (or such
other higher number determined by the
Secretary) other patients;
and</DELETED>
<DELETED> ``(II) after the
development of such test, not included
in any test menu or template test
report or other promotional materials,
and is not otherwise advertised;
and</DELETED>
<DELETED> ``(B) the developer of the in vitro
clinical test--</DELETED>
<DELETED> ``(i) maintains documentation
demonstrating that such test meets the
applicable criteria described in subparagraph
(A);</DELETED>
<DELETED> ``(ii) makes such documentation,
such as a prescription order requesting the
custom test for an individual patient,
available to the Secretary upon request;
and</DELETED>
<DELETED> ``(iii) informs the Secretary, on
an annual basis, in a manner prescribed by the
Secretary by guidance, that such test was
offered.</DELETED>
<DELETED> ``(5) In vitro clinical tests under a technology
certification order.--An in vitro clinical test that is within
the scope of a technology certification order, as described in
section 587D(a), is exempt from premarket review under section
587B.''.</DELETED>
<DELETED> ``(6) Modified tests.--</DELETED>
<DELETED> ``(A) In general.--An in vitro clinical
test that is modified is exempt from premarket review
under section 587B if--</DELETED>
<DELETED> ``(i)(I) the modification is made
by--</DELETED>
<DELETED> ``(aa) the developer that
obtained premarket approval for the
unmodified version of the test under
section 587B; or</DELETED>
<DELETED> ``(bb) a clinical
laboratory certified by the Secretary
under section 353 of the Public Health
Service Act that meets the requirements
for performing high complexity testing,
to a lawfully offered in vitro clinical
test, including another developer's
lawfully offered in vitro clinical
test, excluding investigational in
vitro clinical tests offered under
section 587S, and the modified test is
performed--</DELETED>
<DELETED> ``(AA) in the same
clinical laboratory in which it
was developed for which a
certification is still in
effect under section 353 that
meets the requirements to
perform tests of high
complexity;</DELETED>
<DELETED> ``(BB) by another
clinical laboratory for which a
certificate is in effect under
section 353 that meets the
requirements to perform tests
of high complexity, is within
the same corporate
organization, and has common
ownership by the same parent
corporation as the laboratory
in which the test was
developed; or</DELETED>
<DELETED> ``(CC) by a
clinical laboratory for which a
certificate is in effect under
section 353 that meets the
requirements to perform tests
of high complexity and is
within a public health
laboratory network coordinated
[or managed] by the Centers for
Disease Control and Prevention,
if the test was developed by
the Centers for Disease Control
and Prevention or another
laboratory within such public
health laboratory network;
or</DELETED>
<DELETED> ``(II) the modification does not--
</DELETED>
<DELETED> ``(aa) constitute a
significant change to the indications
for use;</DELETED>
<DELETED> ``(bb) cause the test to
no longer comply with applicable
mitigating measures under section 587E
or restrictions under section
587O;</DELETED>
<DELETED> ``(cc) significantly
change performance claims or
significantly and adversely change
performance, unless provided for under
an approved change protocol under
section 587(a)(2)(H); or</DELETED>
<DELETED> ``(dd) constitute an
adverse change in the safety of the in
vitro clinical test for individuals who
come in contact with the in vitro
clinical test;</DELETED>
<DELETED> ``(ii) the test meets the
applicable standard as described in section
587(2);</DELETED>
<DELETED> ``(iii) the labeling and
advertising are not false or misleading;
and</DELETED>
<DELETED> ``(iv) the test is not likely to
cause or contribute to serious adverse health
consequences.</DELETED>
<DELETED> ``(B) Certain modifications.--A
modification to extend specimen stability is exempt
from premarket review under section 587B if the
modified test meets the requirements in clauses (iii)
through (v) of subparagraph (A).</DELETED>
<DELETED> ``(C) Modifications under a change
protocol.--Notwithstanding subparagraph (A), a
modification made under a change protocol pursuant to
subsection (a)(2)(H) of section 587B is exempt from
review under such section.</DELETED>
<DELETED> ``(D) Documentation.--A person who
modifies an in vitro clinical test in a manner that is
a modification described in subparagraph (A) shall--
</DELETED>
<DELETED> ``(i) document the modification
that was made and the basis for determining
that the modification, considering the changes
individually and collectively, is a type of
modification described in subparagraph (A),
(B), or (C); and</DELETED>
<DELETED> ``(ii) provide such documentation
to the Secretary upon request or
inspection.</DELETED>
<DELETED> ``(E) Guidance.--Not later than 30 months
after the date of enactment of the VALID Act of 2022,
the Secretary shall issue guidance regarding the in
vitro clinical tests that are modified and exempt from
premarket review under section 587B pursuant to this
paragraph.</DELETED>
<DELETED> ``(b) Manual Tests.--</DELETED>
<DELETED> ``(1) Exemption.--An in vitro clinical test is
exempt from all requirements of this subchapter if the output
of such in vitro clinical test is the result of direct, manual
observation, without the use of automated instrumentation or
software for intermediate or final interpretation, by a
qualified laboratory professional, and such in vitro clinical
test--</DELETED>
<DELETED> ``(A) is designed, developed, and used
within a single clinical laboratory for which a
certificate is in effect under section 353 of the
Public Health Service Act that meets the requirements
under section 353 for performing high-complexity
testing;</DELETED>
<DELETED> ``(B) is not a specimen receptacle,
instrument, or an in vitro clinical test that includes
an instrument or specimen receptacle that is not
approved under or exempt from section 587B;</DELETED>
<DELETED> ``(C) is not a high-risk test, or is a
high-risk test that the Secretary has determined meets
at least one condition in paragraph (2) and is
otherwise appropriate for this exemption; and</DELETED>
<DELETED> ``(D) is not intended for testing donors,
donations, or recipients of blood, blood components,
human cells, tissues, cellular-based products, or
tissue-based products.</DELETED>
<DELETED> ``(2) High-risk test limitation or condition.--A
high-risk test may be exempt under paragraph (1) from the
requirements of this subchapter only if--</DELETED>
<DELETED> ``(A) no component or part of such test,
including any reagent, is introduced into interstate
commerce under the exemption under paragraph (5), and
any article for taking or deriving specimens from the
human body used in conjunction with the test remains
subject to the requirements of this subchapter;
or</DELETED>
<DELETED> ``(B) the test has been developed in
accordance with the applicable test design and quality
requirements under section 587J.</DELETED>
<DELETED> ``(c) Public Health Surveillance Activities.--</DELETED>
<DELETED> ``(1) In general.--The provisions of this
subchapter shall not apply to a test intended by the developer
to be used solely for public health surveillance
activities.</DELETED>
<DELETED> ``(2) Exclusion.--An in vitro clinical test used
for public health surveillance activities is not excluded from
the provisions of this subchapter pursuant to this subsection
if such test is intended for use in making clinical decisions
for individual patients. </DELETED>
<DELETED> ``(d) General Laboratory Equipment.--Any instrument that
does not produce an analytical result, and that functions as a
component of pre-analytical procedures related to in vitro clinical
tests, is not subject to the requirements of this subchapter, provided
that the instrument is operating in a clinical laboratory that is
certified under section 353 of the Public Health Service Act.</DELETED>
<DELETED> ``(e) Components and Parts.--</DELETED>
<DELETED> ``(1) In general.--Subject to paragraph (2), a
component or part described in section 201(ss)(2)(E) is--
</DELETED>
<DELETED> ``(A) exempt from the requirements of this
subchapter if it is intended for further development as
described in paragraph (3); or</DELETED>
<DELETED> ``(B) subject to the requirements of this
subchapter and regulated based on its risk when used as
intended by the developer, notwithstanding its
subsequent use by a developer as a component, part, or
raw material of another in vitro clinical
test.</DELETED>
<DELETED> ``(2) Inapplicability to other tests.--
Notwithstanding paragraph (1), an in vitro clinical test that
is described in section 201(ss)(1)(B) and that uses a component
or part described in such subparagraph shall be subject to the
requirements of this subchapter, unless the test is otherwise
exempt under this section.</DELETED>
<DELETED> ``(3) Further development.--A component, part, or
raw material (as described in paragraph (1)) is intended for
further development (for purposes of such paragraph) if--
</DELETED>
<DELETED> ``(A) it is intended solely for use in the
development of another in vitro clinical test;
and</DELETED>
<DELETED> ``(B) in the case of such a test that is
introduced or delivered for introduction into
interstate commerce after the date of enactment of the
VALID Act of 2022, the labeling of such test bears the
following statement: `This product is intended solely
for further development of an in vitro clinical test
and is exempt from FDA regulation. This product must be
evaluated by the in vitro clinical test developer if it
is used with or in the development of an in vitro
clinical test.'.</DELETED>
<DELETED> ``(f) General Exemption Authority.--The Secretary may, by
order published in the Federal Register following notice and an
opportunity for comment, exempt a class of persons from any section
under this subchapter upon a finding that such exemption is appropriate
for the protection of the public health and other relevant
considerations.</DELETED>
<DELETED> ``(g) Exemption.--An in vitro clinical test that is
intended solely for use in forensic analysis or law enforcement
activity is exempt from the requirements of this subchapter. An in
vitro clinical test that is intended for use in making clinical
decisions for individual patients, or whose individually identifiable
results may be reported back to an individual patient or the patient's
health care provider, even if also intended for forensic analysis or
law enforcement purposes, is not intended solely for forensic analysis
or law enforcement for purposes of this subsection.</DELETED>
<DELETED> ``(h) Revocation.--</DELETED>
<DELETED> ``(1) In general.--The Secretary may revoke any
exemption with respect to in vitro clinical tests with the same
indications for use if new clinical information indicates that
the exemption of an in vitro clinical test or tests from
premarket review under section 587B has a reasonable
probability of severe adverse health consequences, including
the absence, delay, or discontinuation of appropriate medical
treatment.</DELETED>
<DELETED> ``(2) Process.--Any action under paragraph (1)
shall be made by publication of a notice of such proposed
action on the website of the Food and Drug Administration, the
consideration of comments to a public docket on such proposal,
and publication of a final action on such website within 60
calendar days of the close of the comment period posted to such
public docket, notwithstanding subchapter II of chapter 5 of
title 5, United States Code.</DELETED>
<DELETED> ``(i) Pre-Analytical Instrument.--A pre-analytical
instrument is exempt from premarket review under section 587B and may
be lawfully offered subject to the other applicable requirements of
this Act, if either of the following applies:</DELETED>
<DELETED> ``(1) Such instrument provides additional
information regarding the sample or performs an action on the
sample but is not preparing or processing the sample and does
not perform any function of an analytical instrument. Such
types of pre-analytical instruments include barcode readers,
sample movers, and sample identifiers.</DELETED>
<DELETED> ``(2) Such instrument processes or prepares the
sample prior to use on an analytical instrument, does not
perform any function of an analytical instrument, and does not
select, isolate, or prepare a part of a sample based on
specific properties. Such types of pre-analytical instruments
may include sample mixers, DNA extractors and those used to
dilute samples.</DELETED>
<DELETED>``SEC. 587D. TECHNOLOGY CERTIFICATION.</DELETED>
<DELETED> ``(a) Definitions.--In this section:</DELETED>
<DELETED> ``(1) Eligible in vitro clinical test.--The term
`eligible in vitro clinical test' means an in vitro clinical
test that is not--</DELETED>
<DELETED> ``(A) a component or part of an in vitro
clinical test as described in section
201(ss)(2)(E);</DELETED>
<DELETED> ``(B) an instrument under section
201(ss)(2)(B) or an in vitro clinical test that
includes an instrument that is not approved under, or
exempt from, section 587B;</DELETED>
<DELETED> ``(C) a specimen receptacle under section
201(ss)(2)(C) or an in vitro clinical test that
includes a specimen receptacle that is not approved
under, or exempt from, section 587B;</DELETED>
<DELETED> ``(D) an in vitro clinical test, including
reagents used in such tests, intended for use for
testing donors, donations, and recipients of blood,
blood components, human cells, tissues, cellular-based
products, or tissue-based products;</DELETED>
<DELETED> ``(E) high-risk;</DELETED>
<DELETED> ``(F) a combination product unless such
test has been determined to be eligible to be
introduced into interstate commerce under a technology
certification order pursuant to the regulatory pathway
designation process described in section 587F, or as
described in subsection (k); or</DELETED>
<DELETED> ``(G) a first-of-a-kind in vitro clinical
test, unless such test has been determined to be
eligible to be introduced into interstate commerce
under a technology certification order pursuant to the
regulatory pathway designation process described in
section 587F, or as described in subsection
(k).</DELETED>
<DELETED> ``(2) Eligible person.--The term `eligible person'
means an in vitro clinical test developer unless such
developer--</DELETED>
<DELETED> ``(A) is a laboratory subject to section
353 of the Public Health Service Act and does not have
in effect a certificate applicable to the category of
laboratory examination or other procedure;</DELETED>
<DELETED> ``(B) was a laboratory, or an owner or
operator or any employee of a laboratory, found to have
committed a significant violation of section 353 of the
Public Health Service Act that resulted in a suspended,
revoked, or limited certificate within the 2-year
period preceding the date of the submission of the
application for a technology certificate under
subsection (c) and such violation has not been
resolved; or</DELETED>
<DELETED> ``(C) has been found to have submitted
information to the Secretary, or otherwise disseminated
information, that--</DELETED>
<DELETED> ``(i) made false or misleading
statements relevant to the requirements of this
subchapter; or</DELETED>
<DELETED> ``(ii) violated any requirement of
this Act, where such violation exposed
individuals to serious risk of illness, injury,
or death, unless--</DELETED>
<DELETED> ``(I) such violation has
been resolved; or</DELETED>
<DELETED> ``(II) such violation is
not pertinent to any in vitro clinical
test within the scope of the technology
certification that such developer
seeks.</DELETED>
<DELETED> ``(b) Applicability.--</DELETED>
<DELETED> ``(1) In general.--An in vitro clinical test is
not subject to section 587B and may be introduced into
interstate commerce if the in vitro clinical test--</DELETED>
<DELETED> ``(A) is an eligible in vitro clinical
test;</DELETED>
<DELETED> ``(B) is developed by an eligible
person;</DELETED>
<DELETED> ``(C) falls within the scope of a
technology certification order issued under this
section and that is in effect;</DELETED>
<DELETED> ``(D) complies with the conditions of the
technology certification order, including with
applicable mitigating measures under section 587E,
restrictions under section 587O, and performance
standards under section 587R; and</DELETED>
<DELETED> ``(E) meets the applicable standard
described in section 587(2).</DELETED>
<DELETED> ``(2) Scope.--</DELETED>
<DELETED> ``(A) In general.--Subject to subparagraph
(B), the scope of a technology certification order
issued under this section shall apply to multiple in
vitro clinical tests utilizing the technology do not
significantly differ in control mechanisms, energy
sources, or operating principles and for which
development, including design, and analytical and
clinical validation, of the in vitro clinical tests
would be addressed through similar procedures, and be
no broader than--</DELETED>
<DELETED> ``(i) a single technology type;
or</DELETED>
<DELETED> ``(ii) a fixed combination of
technologies.</DELETED>
<DELETED> ``(B) Technology type.--A technology type
described in this paragraph may include clot detection,
colorimetric (non-immunoassay), electrochemical (non-
immunoassay), enzymatic (non-immunoassay), flow
cytometry, fluorometry (non-immunoassay), immunoassay,
mass spectrometry or chromatography, microbial culture,
next generation sequencing, nephlometric or
turbidimetric (non-immunoassay), singleplex or
multiplex non-NGS nucleic acid analysis, slide-based
technology, spectroscopy, and any other technology, as
the Secretary determines appropriate.</DELETED>
<DELETED> ``(c) Application for Technology Certification.--
</DELETED>
<DELETED> ``(1) In general.--A developer seeking a
technology certification order shall submit an application
under this subsection, which shall contain the information
specified under paragraph (2).</DELETED>
<DELETED> ``(2) Content of application.--A developer that
submits an application for a technology certification shall
include all necessary information to make a showing that all
eligible in vitro clinical tests developed within the scope of
the technology certification order will meet the applicable
standard, including--</DELETED>
<DELETED> ``(A) the name and address of the
developer;</DELETED>
<DELETED> ``(B) a table of contents for the
application and the identification of the information
the developer claims as trade secret or confidential
commercial or financial information;</DELETED>
<DELETED> ``(C) the signature of the individual
filing the application or an authorized
representative;</DELETED>
<DELETED> ``(D) a statement identifying the scope of
the proposed technology certification intended to be
introduced into interstate commerce under the
application;</DELETED>
<DELETED> ``(E) information establishing that the
developer submitting the application is an eligible
person;</DELETED>
<DELETED> ``(F) quality procedures showing that
eligible in vitro clinical tests covered under the
technology certification will conform to the applicable
quality requirements of section 587K with respect to--
</DELETED>
<DELETED> ``(i) design controls, including
related purchasing controls and acceptance
activities;</DELETED>
<DELETED> ``(ii) complaint investigation,
adverse event reporting, and corrections and
removals; and</DELETED>
<DELETED> ``(iii) process validation, as
applicable;</DELETED>
<DELETED> ``(G) procedures for analytical and
clinical validation, including all procedures for
validation, verification, and acceptance criteria, and
an explanation as to how such procedures, when used,
provide a showing of analytical validity of eligible in
vitro clinical tests within the proposed scope of the
technology certification order that is analytically and
clinically valid;</DELETED>
<DELETED> ``(H) procedures that provide a showing
that in vitro clinical tests covered by the proposed
scope of the technology certification order will be
safe for individuals who come into contact with in
vitro clinical tests covered by such order;</DELETED>
<DELETED> ``(I) a proposed listing submission under
section 587J(b) for in vitro clinical tests that the
developer intends to introduce into interstate commerce
upon receiving a technology certification order, which
shall not be construed to limit the developer from
introducing additional tests not included in such
submission under the same technology certification
order;</DELETED>
<DELETED> ``(J) information concerning one or more
representative in vitro clinical tests, including--
</DELETED>
<DELETED> ``(i) a test within the scope of
the technology certification application with
the appropriate analytical complexity at the
time of the submission of the application under
this section to serve as the representative
test and validate and run within the
developer's stated scope;</DELETED>
<DELETED> ``(ii) the information specified
in subsection (a) or (b) of section 587B, as
applicable, for the representative in vitro
clinical test or tests, including information
and data required pursuant to subsection
(a)(2)(G) of section 587B, unless the Secretary
determines that such information is not
necessary;</DELETED>
<DELETED> ``(iii) a summary of a risk
assessment of the in vitro clinical
test;</DELETED>
<DELETED> ``(iv) an explanation of the
choice of the representative in vitro clinical
test or tests for the technology certification
application and how such test adequately
demonstrates the range of procedures that the
developer includes in the application under
subparagraphs (F), (G), (H), and (I);
and</DELETED>
<DELETED> ``(v) a brief explanation of the
ways in which the procedures included in the
application under subparagraphs (F), (G), (H),
and (I) have been applied to the representative
in vitro clinical test or tests; and</DELETED>
<DELETED> ``(K) such other information necessary to
make a determination on a technology certification
application as the Secretary may determine
necessary.</DELETED>
<DELETED> ``(3) Reference to existing applications.--With
respect to the content requirements in the technology
certification application described in paragraph (2), a
developer may incorporate by reference any content of an
application previously submitted by the developer.</DELETED>
<DELETED> ``(d) Action on an Application for Technology
Certification.--</DELETED>
<DELETED> ``(1) Secretary response.--</DELETED>
<DELETED> ``(A) In general.--As promptly as
practicable, and not later than 90 days after receipt
of an application under subsection (c), the Secretary
shall--</DELETED>
<DELETED> ``(i) issue a technology
certification order granting the application,
which shall specify the scope of the technology
certification, if the Secretary finds that all
of the grounds in paragraph (3) are met;
or</DELETED>
<DELETED> ``(ii) deny the application if the
Secretary finds (and sets forth the basis of
such finding as part of or accompanying such
denial) that one or more grounds for granting
the application specified in paragraph (3) are
not met.</DELETED>
<DELETED> ``(B) Extension.--The timeline described
in subparagraph (A) may be extended by mutual agreement
between the Secretary and the applicant.</DELETED>
<DELETED> ``(2) Deficient applications.--</DELETED>
<DELETED> ``(A) In general.--If, after receipt of an
application under this section, the Secretary
determines that any portion of such application is
deficient, the Secretary, not later than 60 days after
receipt of such application, shall provide to the
applicant a description of such deficiencies and
identify the information required to resolve such
deficiencies.</DELETED>
<DELETED> ``(B) Converting to premarket
applications.--When responding to the deficiency
letter, the developer may convert the application for
technology certification under subsection (c) into a
premarket application under section 587B.</DELETED>
<DELETED> ``(3) Technology certification order.--The
Secretary shall issue an order granting a technology
certification under this section if, on the basis of the
information submitted to the Secretary as part of the
application and any other information with respect to such
applicant, the Secretary finds that--</DELETED>
<DELETED> ``(A) there is a showing that in vitro
clinical tests within the scope of the technology
certification order will meet the applicable
standard;</DELETED>
<DELETED> ``(B) the methods used in, and the
facilities or controls used for, the development of
eligible in vitro clinical tests covered by the
proposed scope of the technology certification conform
to the applicable requirements of section 587K with
respect to--</DELETED>
<DELETED> ``(i) design controls, including
related purchasing controls and acceptance
activities;</DELETED>
<DELETED> ``(ii) complaint investigation,
adverse event reporting, and corrections and
removals; and</DELETED>
<DELETED> ``(iii) process validation, as
applicable;</DELETED>
<DELETED> ``(C) based on a fair evaluation of all
material facts, the applicant's proposed labeling and
advertising are not false or misleading in any
particular;</DELETED>
<DELETED> ``(D) the application does not contain a
false statement of material fact;</DELETED>
<DELETED> ``(E) there is a showing that the
representative in vitro clinical test or tests--
</DELETED>
<DELETED> ``(i) meet the applicable
standard; and</DELETED>
<DELETED> ``(ii) reasonably represent the
range of procedures required to be submitted in
the application;</DELETED>
<DELETED> ``(F) the applicant has agreed to permit,
upon request, authorized employees of the Food and Drug
Administration or persons accredited, or recognized
under this Act, an opportunity to inspect at a
reasonable time and in a reasonable manner the
facilities and all pertinent equipment, finished and
unfinished materials, containers, and labeling therein,
including all things (including records, files, papers,
and controls) bearing on whether an in vitro clinical
test is adulterated, misbranded, or otherwise in
violation of this Act, and permits such authorized
employees or persons accredited under this Act to view
and to copy and verify all records pertinent to the
application and the in vitro clinical test;
and</DELETED>
<DELETED> ``(G) based on other data and information
the Secretary may require under subsection (c)(2)(K),
the Secretary finds that such data and information
support granting a technology certification
order.</DELETED>
<DELETED> ``(4) Review of denials.--An applicant whose
application has been denied under this subsection may obtain
review of such denial under section 587P.</DELETED>
<DELETED> ``(e) Supplements.--</DELETED>
<DELETED> ``(1) Supplemental applications.--</DELETED>
<DELETED> ``(A) In general.--With respect to any of
the following changes related to an in vitro clinical
test under a technology certification order, a
supplemental application to a technology certification
order shall be submitted by the holder of the
technology certification order describing such proposed
changes, prior to introducing the in vitro clinical
test that is the subject of the technology
certification order into interstate commerce--
</DELETED>
<DELETED> ``(i) any significant change to
the procedures provided in support of the
application for technology certification
submitted under subparagraph (G) or (H) of
subsection (c)(2); or</DELETED>
<DELETED> ``(ii) any significant change to
the procedures provided in support of the
application for technology certification
submitted under subparagraph (F) of subsection
(c)(2).</DELETED>
<DELETED> ``(B) Secretary action on supplemental
applications.--Any action by the Secretary on a
supplemental application shall be in accordance with
subsection (d), and any order resulting from such
supplement shall be treated as an amendment to a
technology certification order.</DELETED>
<DELETED> ``(2) Content of application.--</DELETED>
<DELETED> ``(A) In general.--A supplemental
application for a change to an in vitro clinical test
under a technology certification order shall--
</DELETED>
<DELETED> ``(i) contain all necessary
information to make a showing that any in vitro
clinical test affected by such change that is
within the scope of the technology
certification order will meet the applicable
standard; and</DELETED>
<DELETED> ``(ii) be limited to such
information that is needed to support the
change.</DELETED>
<DELETED> ``(B) Content.--Unless otherwise specified
by the Secretary, a supplemental application under this
subsection shall include--</DELETED>
<DELETED> ``(i) a description of the change,
including a rationale for implementing such
change;</DELETED>
<DELETED> ``(ii) a description of how the
change was evaluated;</DELETED>
<DELETED> ``(iii) data from a representative
in vitro clinical test or tests that supports a
showing that, in using the modified procedure
or procedures, all eligible in vitro clinical
tests within the scope of the technology
certification will meet the applicable
standard;</DELETED>
<DELETED> ``(iv) as applicable, information
to demonstrate that the modified procedure or
procedures submitted under subsection (c)(2)(F)
continue to conform to applicable requirements
under section 587K; and</DELETED>
<DELETED> ``(v) any other information
requested by the Secretary.</DELETED>
<DELETED> ``(3) Changes in response to a public health
risk.--</DELETED>
<DELETED> ``(A) In general.--If the holder of a
technology certification makes a change to an in vitro
clinical test or tests to address a potential risk to
public health by adding a new specification or test
method, such holder may immediately implement such
change and shall submit a notification for such change
to the Secretary within 30 days.</DELETED>
<DELETED> ``(B) Content.--Any notification to the
Secretary under this paragraph shall include--
</DELETED>
<DELETED> ``(i) a summary of the relevant
change;</DELETED>
<DELETED> ``(ii) the rationale for
implementing such change;</DELETED>
<DELETED> ``(iii)(I) if such a change
necessitates a change to the procedures
reviewed as part of the granted technology
certification order, the modified procedures;
or</DELETED>
<DELETED> ``(II) if the procedures were not
changed, an explanation as to why they were not
changed; and</DELETED>
<DELETED> ``(iv) if such a change
necessitates a change to the procedures
reviewed as part of the granted technology
certification order, data from a representative
in vitro clinical test or tests that support a
showing that, in using the modified procedures,
all eligible in vitro clinical tests within the
scope of the technology certification will meet
the applicable standard.</DELETED>
<DELETED> ``(f) Temporary Hold.--</DELETED>
<DELETED> ``(1) In general.--Subject to the process
specified in paragraph (2), and based on one or more findings
under paragraph (4), the Secretary may issue a temporary hold
prohibiting any holder of a technology certification order
issued under this section from introducing into interstate
commerce an in vitro clinical test that was not previously the
subject of a listing under section 587J. The temporary hold
shall identify the grounds for the temporary hold under
paragraph (4) and the rationale for such finding.</DELETED>
<DELETED> ``(2) Process for issuing a temporary hold.--If
the Secretary makes a finding that a temporary hold may be
warranted based on one or more grounds specified in paragraph
(4), the Secretary shall promptly notify the holder of the
technology certification order of such finding and provide 30
calendar days for the developer to come into compliance with or
otherwise resolve the finding.</DELETED>
<DELETED> ``(3) Written requests.--Any written request to
the Secretary from the holder of a technology certification
order that a temporary hold under paragraph (1) be removed
shall receive a decision, in writing and specifying the reasons
therefore, within 90 days after receipt of such request. Any
such request shall include information to support the removal
of the temporary hold.</DELETED>
<DELETED> ``(4) Grounds for temporary hold.--The Secretary
may initiate a temporary hold under this subsection upon a
finding that the holder of a technology certification order--
</DELETED>
<DELETED> ``(A) is not in compliance with the
conditions of the technology certification order
pursuant to subsection (b)(1)(D);</DELETED>
<DELETED> ``(B) offers one or more in vitro clinical
tests with advertising or labeling that is false or
misleading;</DELETED>
<DELETED> ``(C) has reported a correction or removal
of an in vitro clinical test that is offered under a
technology certification order under this section and
has failed to demonstrate that the issue or issues
causing the correction or removal does not adversely
impact the ability of other in vitro clinical tests
offered under the same technology certification order
to meet the applicable standard; or</DELETED>
<DELETED> ``(D) has introduced into interstate
commerce an in vitro clinical test under a technology
certification order and such test is adulterated or
misbranded, based on a determination by the Secretary,
and has failed to demonstrate that the issue or issues
causing the adulteration or misbranding does not
adversely impact the ability of other in vitro clinical
tests offered under the same technology certification
granted under this section to meet the applicable
standard.</DELETED>
<DELETED> ``(g) Withdrawal.--The Secretary may, after due notice and
opportunity for an informal hearing, issue an order withdrawing a
technology certification order including all tests introduced into
interstate commerce under the technology certification order if the
Secretary finds that--</DELETED>
<DELETED> ``(1) the application, supplement, or report under
subsection (h) contains false or misleading information or
fails to reveal a material fact;</DELETED>
<DELETED> ``(2) such holder fails to correct false or
misleading labeling or advertising upon the request of the
Secretary;</DELETED>
<DELETED> ``(3) in connection with a technology
certification, the holder provides false or misleading
information to the Secretary; or</DELETED>
<DELETED> ``(4) the holder of such technology certification
order fails to correct the grounds for a temporary hold within
a timeframe specified in the temporary hold order.</DELETED>
<DELETED> ``(h) Reports to Congress.--</DELETED>
<DELETED> ``(1) In general.--Not later than 1 year after the
effective date of the VALID Act of 2022, and annually
thereafter for the next 4 years, the Secretary shall submit to
the Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives, and make publicly available, including through
posting on the website of the Food and Drug Administration, a
report containing the information described in paragraph
(2).</DELETED>
<DELETED> ``(2) Content.--</DELETED>
<DELETED> ``(A) In general.--Each report under
paragraph (1) shall address, at a minimum--</DELETED>
<DELETED> ``(i) the total number of
applications for technology certifications
filed, granted, withdrawn and denied;</DELETED>
<DELETED> ``(ii) the total number of
technology certification orders the Secretary
put on temporary hold under subsection (h) and
the number of technology certification orders
withdrawn under subsection (i);</DELETED>
<DELETED> ``(iii) the types of technologies
for which the Secretary granted technology
certification orders;</DELETED>
<DELETED> ``(iv) the total number of holders
of technology certification orders that are in
effect; and</DELETED>
<DELETED> ``(v) the total number of in vitro
clinical test categories that required
premarket review under section 587B that were
redesignated as eligible in vitro clinical
tests under this section.</DELETED>
<DELETED> ``(B) Final report.--The fifth report
submitted under paragraph (1) shall include a summary
of, and responses to, comments raised in the
docket.</DELETED>
<DELETED> ``(C) Performance reports.--The reports
required under this section may be issued with
performance reports as required under section 829 of
the VALID Act of 2022.</DELETED>
<DELETED> ``(i) Public Meeting and Input.--</DELETED>
<DELETED> ``(1) Public docket.--Not later than 30 days after
the date of enactment of the VALID Act of 2022, the Secretary
shall establish a public docket to receive comments concerning
recommendations for implementation of this section, including
criteria and procedures for subsections (c) through (h). The
public docket shall remain open for at least 1 year after the
establishment of the public docket.</DELETED>
<DELETED> ``(2) Public meeting.--Not later than 180 days
after the date of enactment of the VALID Act of 2022, the
Secretary shall convene a public meeting to which stakeholders
from organizations representing patients and consumers,
academia, and the in vitro clinical test industry are invited
to discuss the technology certification process including
application requirements, inspections, alignment with third-
party accreditors, and the definition of the term `technology'
under section 587.</DELETED>
<DELETED> ``(j) Regulations.--The Secretary shall issue regulations
regarding the technology certification process, including describing
criteria or procedures relating to technology certification under this
section, which shall be subject to public comment for a minimum of 60
days from issuance prior to finalizing such regulations after
considering the comments received. The regulation shall include an
outline of the application process, opportunities to meet with
officials of the Food and Drug Administration, and plans to streamline
inspections.</DELETED>
<DELETED> ``(k) Notification.--</DELETED>
<DELETED> ``(1) In general.--Notwithstanding subsection
(a)(1), a first-of-a-kind in vitro clinical test or a
combination product that meets the definition of a moderate-
risk test under section 587A may be introduced into interstate
commerce under a technology certification order that has been
issued by the Secretary, subject to other applicable
requirements if--</DELETED>
<DELETED> ``(A) the developer provides notification
to the Secretary 60 days prior to introducing such
tests into interstate commerce that includes
information demonstrating that the test is moderate-
risk and within the scope of the applicable technology
certification order; and</DELETED>
<DELETED> ``(B) the Secretary has not issued a
notification to the developer under paragraph (2)
before such time has elapsed.</DELETED>
<DELETED> ``(2) Notification from secretary.--The Secretary
shall issue a notification to the developer that such test may
not be introduced into interstate commerce under such order if
the Secretary determines that--</DELETED>
<DELETED> ``(A) such test--</DELETED>
<DELETED> ``(i) does not meet the definition
of a moderate-risk test under section
587A;</DELETED>
<DELETED> ``(ii) is not eligible to be
introduced into interstate commerce under the
referenced technology certification order
issued by the Secretary; or</DELETED>
<DELETED> ``(iii) is not eligible for
technology certification under subsection
(b)(2); or</DELETED>
<DELETED> ``(B) based on the information included in
the notification submitted by the developer pursuant to
this subsection, there is insufficient information for
the Secretary to make the determinations described in
clauses (i), (ii), and (iii) of subparagraph
(A).</DELETED>
<DELETED>``SEC. 587E. MITIGATING MEASURES.</DELETED>
<DELETED> ``(a) Establishment of Mitigating Measures.--</DELETED>
<DELETED> ``(1) Establishing, changing, or withdrawing.--
</DELETED>
<DELETED> ``(A) Establishment.--The Secretary may
establish and require, on the basis of evidence,
mitigating measures for any in vitro clinical test or
category of in vitro clinical tests with the same
indications for use that is introduced or delivered for
introduction into interstate commerce after the
establishment of such mitigating measures.</DELETED>
<DELETED> ``(B) Methods of establishment.--The
Secretary may establish mitigating measures--</DELETED>
<DELETED> ``(i) under the process set forth
in subparagraph (D);</DELETED>
<DELETED> ``(ii) as provided under section
587F; or</DELETED>
<DELETED> ``(iii) through a premarket
approval or technology certification order,
which may establish mitigating measures for an
individual in vitro clinical test or a category
of in vitro clinical tests.</DELETED>
<DELETED> ``(C) Methods of change or withdrawal.--
The Secretary may change or withdraw mitigating
measures--</DELETED>
<DELETED> ``(i) under the process set forth
in subparagraph (D); or</DELETED>
<DELETED> ``(ii) as provided under section
587F.</DELETED>
<DELETED> ``(D) Process for establishment, change,
or withdrawal.--Notwithstanding subchapter II of
chapter 5 of title 5, United States Code, the Secretary
may, upon the initiative of the Secretary or upon
petition of an interested person--</DELETED>
<DELETED> ``(i) establish, change, or
withdraw mitigating measures for an in vitro
clinical test or category of in vitro clinical
tests by--</DELETED>
<DELETED> ``(I) publishing a
proposed order in the Federal
Register;</DELETED>
<DELETED> ``(II) providing an
opportunity for public comment for a
period of not less than 30 60 calendar
days; and</DELETED>
<DELETED> ``(III) after
consideration of any comments
submitted, publishing a final order in
the Federal Register that responds to
the comments submitted, and which shall
include a reasonable transition
period.</DELETED>
<DELETED> ``(E) Effect of mitigating measures on
grandfathered tests.--A mitigating measure shall not be
required by the Secretary for an in vitro clinical test
subject to section 587G(a), unless otherwise provided
under section 587F.</DELETED>
<DELETED> ``(2) In vitro clinical tests previously cleared
or exempt as devices with special controls.--</DELETED>
<DELETED> ``(A) In general.--Any special controls
applicable to an in vitro clinical test previously
cleared or exempt under section 510(k), or classified
under section 513(f)(2) prior to date of enactment of
the VALID Act of 2022, including any such special
controls established during the period beginning on the
date of enactment of the VALID Act of 2022 and ending
on the effective date of such Act (as described in
section 5(b) of such Act)--</DELETED>
<DELETED> ``(i) shall continue to apply to
such in vitro clinical test after such
effective date; and</DELETED>
<DELETED> ``(ii) are deemed to be mitigating
measures as of the effective date specified in
section 825(a)(1)(A) of the VALID Act of
2022.</DELETED>
<DELETED> ``(B) Changes.--Notwithstanding
subparagraph (A), the Secretary may establish, change,
or withdraw mitigating measures for such tests or
category of tests using the procedures under paragraph
(1).</DELETED>
<DELETED> ``(b) Documentation.--</DELETED>
<DELETED> ``(1) In vitro clinical tests subject to premarket
review.--The developer of an in vitro clinical test subject to
premarket review under section 587B and to which mitigating
measures apply shall--</DELETED>
<DELETED> ``(A) in accordance with section
587B(c)(2)(G)(i), submit documentation to the Secretary
as part of the application for the test under
subsection (c) or (d) of section 587B demonstrating
that such mitigating measures have been met;</DELETED>
<DELETED> ``(B) if such application is approved,
maintain documentation demonstrating that such
mitigating measures continue to be met following a test
modification by the developer; and</DELETED>
<DELETED> ``(C) make such documentation available to
the Secretary upon request or inspection.</DELETED>
<DELETED> ``(2) Other tests.--The developer of an in vitro
clinical test that is offered under a technology certification
order or other exemption from premarket review under section
587B and to which mitigating measures apply shall--</DELETED>
<DELETED> ``(A) maintain documentation in accordance
with the applicable quality requirements under section
587J demonstrating that such mitigating measures
continue to be met following a test modification by the
developer;</DELETED>
<DELETED> ``(B) make such documentation available to
the Secretary upon request or inspection; and</DELETED>
<DELETED> ``(C) include in the performance summary
for such test a brief description of how such
mitigating measures are met, if applicable.</DELETED>
<DELETED>``SEC. 587F. REGULATORY PATHWAY DESIGNATION.</DELETED>
<DELETED> ``(a) Pathway Determinations.--</DELETED>
<DELETED> ``(1) In general.--After considering available
evidence with respect to an in vitro clinical test or category
of in vitro clinical tests with the same intended use,
including the identification, establishment, and implementation
of mitigating measures under section 587E, as appropriate, the
Secretary may, upon the initiative of the Secretary or upon
request of a developer, determine that--</DELETED>
<DELETED> ``(A) such in vitro clinical test is high-
risk and subject to premarket review under section
587B;</DELETED>
<DELETED> ``(B) such in vitro clinical tests,
including a first of a kind test, is moderate-risk and
subject to abbreviated premarket review under section
587B(d) or technology certification under section
587D(b)(2); or</DELETED>
<DELETED> ``(C) such in vitro clinical test,
including a first of a kind test is low-risk or
otherwise exempt from premarket review under section
587B.</DELETED>
<DELETED> ``(2) Requests.--</DELETED>
<DELETED> ``(A) Submissions by developers.--
</DELETED>
<DELETED> ``(i) Special premarket review;
technology certification.--A developer
submitting a request that the Secretary make a
determination as described in paragraph (1)(B)
shall submit information to support that the in
vitro clinical test is moderate-risk or propose
mitigating measures, if applicable, that would
support such a determination.</DELETED>
<DELETED> ``(ii) Low-risk; exempt from
premarket review.--A developer submitting a
request that the Secretary make a determination
as described in paragraph (1)(C) shall submit
information that the in vitro clinical test is
low-risk, or otherwise appropriate for
exemption from premarket review under section
587B and propose mitigating measures, if
applicable, that would support such a
determination.</DELETED>
<DELETED> ``(B) Response by the secretary.--After
receiving a request under clause (i) or (ii) of
subparagraph (A), the Secretary shall provide a timely
response describing whether or not the Secretary will
initiate the process for making a determination under
paragraph (1)(B) or (1)(C) as described in paragraph
(4).</DELETED>
<DELETED> ``(3) Sufficiency of mitigating measures.--When
determining whether mitigating measures for an in vitro
clinical test, or category of in vitro clinical tests, are
sufficient to make such test moderate-risk or low-risk, the
Secretary shall take into account the following:</DELETED>
<DELETED> ``(A) The degree to which the technology
for the intended use of the in vitro clinical test is
well-characterized, taking into consideration factors
that include one or more of the following:</DELETED>
<DELETED> ``(i) Peer-reviewed
literature.</DELETED>
<DELETED> ``(ii) Practice
guidelines.</DELETED>
<DELETED> ``(iii) Consensus
standards.</DELETED>
<DELETED> ``(iv) Recognized standards of
care.</DELETED>
<DELETED> ``(v) Use of such technology,
including historical use.</DELETED>
<DELETED> ``(vi) Multiple scientific
publications by different authors.</DELETED>
<DELETED> ``(vii) Adoption by the scientific
or clinical community.</DELETED>
<DELETED> ``(viii) Real world
evidence.</DELETED>
<DELETED> ``(B) Whether the criteria for performance
of the test are well-established to be sufficient for
the intended use.</DELETED>
<DELETED> ``(C) The clinical circumstances under
which the in vitro clinical test is used, including
whether the in vitro clinical test is the sole
determinate for the diagnosis or treatment of the
targeted disease, and the availability of other tests
(such as confirmatory or adjunctive tests) or relevant
material standards.</DELETED>
<DELETED> ``(D) Whether such mitigating measures
sufficiently mitigate the risk of harm such that the
test or category of tests is moderate-risk or low-
risk.</DELETED>
<DELETED> ``(4) Process.--</DELETED>
<DELETED> ``(A) In general.--For a test that is not
first-of-a-kind, any action under paragraph (1) shall
be made by publication of a notice of such proposed
action on the website of the Food and Drug
Administration, the consideration of comments to a
public docket on such proposal, and publication of a
final action on such website within 60 calendar days of
the close of the comment period posted to such public
docket, notwithstanding subchapter II of chapter 5 of
title 5, United States Code.</DELETED>
<DELETED> ``(B) Process for first-of-a-kind test.--
In the case of an in vitro clinical test that is first-
of-a-kind, the process is as follows:</DELETED>
<DELETED> ``(i) Any determination that the
test is subject to premarket approval or
abbreviated premarket review under subparagraph
(A) or (B) of paragraph (1) shall be published
on the website of the Food and Drug
Administration, notwithstanding subclause II of
chapter 5 of title 5, United States Code, only
after the in vitro clinical test is approved
under section 587B. Until that time, the
determination shall not be binding on other in
vitro clinical tests.</DELETED>
<DELETED> ``(ii) Any determination other
than those made under clause (i) shall be made
by publication of a notice of final action on
the website of the Food and Drug
Administration, notwithstanding subchapter II
of chapter 5 of title 5, United States
Code.</DELETED>
<DELETED> ``(b) Transition Period.--Upon a decision by the Secretary
to change a regulatory pathway designation, or reclassifies an in vitro
clinical test, or category of in vitro clinical tests, the Secretary
shall provide an appropriate transition period with respect to any new
requirements.</DELETED>
<DELETED> ``(c) Appeals.--A decision by the Secretary under this
section shall be deemed a significant decision subject to appeal under
section 587P.</DELETED>
<DELETED> ``(d) Advisory Committee.--The Secretary may request
recommendations from an advisory committee under section 587H pursuant
to carrying out this section.</DELETED>
<DELETED> ``(e) Request for Informal Feedback.--Before submitting a
premarket application or technology certification application for an in
vitro clinical test--</DELETED>
<DELETED> ``(1) the developer of the test may submit to the
Secretary a written request for a meeting, conference, or
written feedback to discuss and provide information relating to
the regulation of such in vitro clinical test which may
include--</DELETED>
<DELETED> ``(A) the submission process and the type
and amount of evidence expected to demonstrate the
applicable standard;</DELETED>
<DELETED> ``(B) which regulatory pathway is
appropriate for an in vitro clinical test;
and</DELETED>
<DELETED> ``(C) an investigation plan for an in
vitro clinical test, including a clinical protocol;
and</DELETED>
<DELETED> ``(2) upon receipt of such a request, the
Secretary shall--</DELETED>
<DELETED> ``(A) if a meeting is requested--
</DELETED>
<DELETED> ``(i) within 60 calendar days
after such receipt, or within such time period
as may be agreed to by the developer, meet or
confer with the developer submitting the
request; and</DELETED>
<DELETED> ``(ii) within 15 calendar days
after such meeting or conference, provide to
the developer a written record or response
describing the issues discussed and conclusions
reached in the meeting or conference;
and</DELETED>
<DELETED> ``(B) if written feedback is requested,
provide feedback to the requestor within 75 days after
such receipt.</DELETED>
<DELETED>``SEC. 587G. GRANDFATHERED IN VITRO CLINICAL TESTS.</DELETED>
<DELETED> ``(a) In General.--Subject to subsection (d), an in vitro
clinical test is exempt from the requirements of this subchapter
specified in subsection (b) if--</DELETED>
<DELETED> ``(1) the test was first offered for clinical use
before the date of enactment of the VALID Act of
2022;</DELETED>
<DELETED> ``(2) the was developed by a clinical laboratory
for which a certificate was in effect under section 353 of the
Public Health Service Act that meets the requirements for
performing tests of high complexity;</DELETED>
<DELETED> ``(3) the test is performed--</DELETED>
<DELETED> ``(A) in the same clinical laboratory in
which the test was developed for which a certification
is still in effect under section 353 of the Public
Health Service Act that meets the requirements to
perform tests of high complexity;</DELETED>
<DELETED> ``(B) by another clinical laboratory for
which a certificate is in effect under section 353 of
such Act that meets the requirements to perform tests
of high complexity, and that is within the same
corporate organization and having common ownership by
the same parent corporation as the laboratory in which
the test was developed; or</DELETED>
<DELETED> ``(C) in the case of a test that was
developed by the Centers for Disease Control and
Prevention or another laboratory a public health
laboratory network coordinated or managed by the
Centers for Disease Control and Prevention, by a
clinical laboratory for which a certificate is in
effect under section 353 of such Act that meets the
requirements to perform tests of high complexity, and
that is within a public health laboratory network
coordinated or managed by the Centers for Disease
Control and Prevention;</DELETED>
<DELETED> ``(4) the test does not have in effect an approval
under section 515, a clearance under section 510(k), an
authorization under section 513(f)(2), or an exemption under
section 520(m), or licensure under section 351 of the Public
Health Service Act;</DELETED>
<DELETED> ``(5) any modification to the test on or after the
date of enactment of the VALID Act of 2022 made by the initial
developer and conform with section 587C(a)(6)(A)(ii) and does
not meet the criterial in subsection (d)(1);</DELETED>
<DELETED> ``(6) the test is not for investigational
use;</DELETED>
<DELETED> ``(7) the test is offered with an order from an
authorized person as required under section 353 of the Public
Health Service Act, and was offered with a prescription
required under section 809.30(f) of title 21, Code of Federal
Regulations prior to the effective date of this
subchapter;</DELETED>
<DELETED> ``(8) the test is not for use with home specimen
collection, unless the specimen is collected with a collection
container, receptacle, or kit that--</DELETED>
<DELETED> ``(A) has been approved, cleared, or
authorized by the Secretary for home specimen
collection and the collection is performed pursuant to
the approved, cleared, or authorized labeling,
including any indication for use as prescription use or
over-the-counter use, or</DELETED>
<DELETED> ``(B) is exempt from premarket review and
its use is consistent with applicable limitations on
the exemption;</DELETED>
<DELETED> ``(9) is not a specimen receptacle or
instrument</DELETED>
<DELETED> ``(10) each test report template for the test
bears a statement that reads as follows: `This in vitro
clinical test has not been reviewed by the Food and Drug
Administration.'; and</DELETED>
<DELETED> ``(11) the developer of the test--</DELETED>
<DELETED> ``(A) maintains documentation
demonstrating that the test meets and continues to meet
the criteria set forth in this subsection;
and</DELETED>
<DELETED> ``(B) makes such documentation available
to the Secretary upon request.</DELETED>
<DELETED> ``(b) Exemptions Applicable to Grandfathered Tests.--An in
vitro clinical test that meets the criteria specified in subsection (a)
is exempt from premarket review under 587B, labeling requirements under
587L, and test design requirements and quality requirements under 587K,
and may be lawfully offered subject to the other applicable
requirements of this Act.</DELETED>
<DELETED> ``(c) Modifications.--In the case of an in vitro clinical
test that meets the criteria specified in subsection (a), such test
continues to qualify for the exemptions described in subsection (b) if
the test is modified and the modification is not of a type described in
subsection (a)(5), and the person modifying such in vitro clinical
test--</DELETED>
<DELETED> ``(1) documents each such modification and
maintains documentation of the basis for such
determination;</DELETED>
<DELETED> ``(2) provides such documentation relating to the
change to the Secretary upon request or inspection;
and</DELETED>
<DELETED> ``(3) does not modify the in vitro clinical test
such that it no longer meets the criteria under subsection
(a).</DELETED>
<DELETED> ``(d) Request for Information.--</DELETED>
<DELETED> ``(1) Criteria.--The criteria described in this
paragraph are any of the following:</DELETED>
<DELETED> ``(A) There is insufficient valid
scientific evidence to support that the test is
analytically valid or clinically valid.</DELETED>
<DELETED> ``(B) Such in vitro clinical test is being
offered by its developer with any false or misleading
analytical or clinical claims.</DELETED>
<DELETED> ``(C) It is probable that such in vitro
clinical test will cause serious adverse health
consequences.</DELETED>
<DELETED> ``(2) Process.--</DELETED>
<DELETED> ``(A) Written request for information.--
The Secretary may issue a written request to a
developer identifying specific scientific concerns,
based on credible information, with an in vitro
clinical test, which indicate that one or more of the
criteria described in paragraph (1) apply to such in
vitro clinical tests. Such written request shall
include specific information requests pertaining to
such criteria.</DELETED>
<DELETED> ``(B) Deadline for submitting
information.--Not later than 45 days after receiving a
request for information under subparagraph (A)--
</DELETED>
<DELETED> ``(i) the developer of an in vitro
clinical test--</DELETED>
<DELETED> ``(I) may seek a
teleconference prior to the submission
of information under clause (ii) to
discuss the Secretary's request;
and</DELETED>
<DELETED> ``(II) shall submit the
information requested pursuant to
subparagraph (A) within 30 days of
receipt of such request; and</DELETED>
<DELETED> ``(ii) the Secretary shall--
</DELETED>
<DELETED> ``(I) schedule a
teleconference requested under clause
(i)(I); and</DELETED>
<DELETED> ``(II) hold a
teleconference so requested within 10
days of the Secretary's receipt of the
information requested under clause
(i)(II).</DELETED>
<DELETED> ``(C) Review deadline.--Upon receiving a
submission under subparagraph (B), the Secretary
shall--</DELETED>
<DELETED> ``(i) review the submitted
information within 45 calendar days of such
receipt, which may include communication with
the developer; and</DELETED>
<DELETED> ``(ii) determine whether the
criteria listed in paragraph (1) apply to the
in vitro clinical test and communicate such
determination to the developer as described in
subparagraph (D).</DELETED>
<DELETED> ``(D) Communication and results of
determination.--The Secretary shall notify the
developer, in writing, of the Secretary's determination
under subparagraph (C), as follows:</DELETED>
<DELETED> ``(i) If the Secretary determines
that none of the criteria listed in paragraph
(1) apply to the in vitro clinical test, such
test shall be exempt from relevant requirements
of this subchapter, as set forth in subsection
(b), subject to applicable
limitation.</DELETED>
<DELETED> ``(ii) If the Secretary determines
that one or more of the criteria listed in
subparagraph (1) apply to the test but such a
determination may be resolved within a
reasonable time, and the test has not been
previously subject to this subsection on the
basis of the same or substantially similar
scientific concerns identified in the written
request issued under paragraph (d)(2)(A)--
</DELETED>
<DELETED> ``(I) the Secretary shall
notify the developer of such a
determination and allow the developer
to seek a teleconference to discuss the
finding;</DELETED>
<DELETED> ``(II) the developer shall
submit information demonstrating
resolution of the determination within
15 days of receiving the notification;
and</DELETED>
<DELETED> ``(III) the Secretary
shall make a determination within 30
days of the submission of information
as to whether the criteria under
paragraph (1) apply to the
test.</DELETED>
<DELETED> ``(iii) If the Secretary
determines that none of the criteria listed in
paragraph (1) apply to the test, such test
shall be exempt from relevant requirements of
the subchapter as set forth in subsection (b),
subject to applicable limitations.</DELETED>
<DELETED> ``(iv) If the Secretary determines
that one or more of the criteria listed in
paragraph (1) apply to the in vitro clinical
test, such test is not exempt as set forth in
this section and shall not be offered unless
approved under section 587B, offered under a
technology certification order under section
587D, or offered as a low-risk test. upon a
determination by the Secretary pursuant to
section 587F.</DELETED>
<DELETED> ``(v) If the Secretary determines
that one or more of the criteria listed in
paragraph (1) apply to the in vitro clinical
test and clause (ii) does not apply, the in
vitro clinical test is not exempt as set forth
in section and shall not be offered unless
approved under section 587B, offered under a
technology certification order under section
587D, or offered as a low-risk test upon a
determination by the Secretary pursuant to
section 587F.</DELETED>
<DELETED>``SEC. 587H. ADVISORY COMMITTEES.</DELETED>
<DELETED> ``(a) In General.--The Secretary may establish advisory
committees or use advisory committee panels of experts established
before the date of enactment of the VALID Act of 2022 (including a
device classification panel under section 513) for the purposes of
providing expert scientific advice and making recommendations related
to--</DELETED>
<DELETED> ``(1) the approval of an application for an in
vitro clinical test submitted under this subchapter, including
for evaluating, as applicable, the analytical validity,
clinical validity, and safety of in vitro clinical
tests;</DELETED>
<DELETED> ``(2) the potential effectiveness of mitigating
measures for a determination of the applicable regulatory
pathway under section 587F(b) or risk evaluation for an in
vitro clinical test or tests;</DELETED>
<DELETED> ``(3) quality requirements under section 587K or
applying such requirements to in vitro clinical tests developed
or imported by developers;</DELETED>
<DELETED> ``(4) appeals under section 587P; or</DELETED>
<DELETED> ``(5) such other purposes as the Secretary
determines appropriate.</DELETED>
<DELETED> ``(b) Appointments.--</DELETED>
<DELETED> ``(1) Voting members.--The Secretary shall appoint
to each committee established under subsection (a), as voting
members, individuals who are qualified by training and
experience to evaluate in vitro clinical tests referred to the
committee for the purposes specified in subsection (a),
including individuals with, to the extent feasible, scientific
expertise in the development of such in vitro clinical tests,
laboratory operations, and the use of in vitro clinical tests.
The Secretary shall designate one member of each committee to
serve as chair.</DELETED>
<DELETED> ``(2) Nonvoting members.--In addition to the
individuals appointed pursuant to paragraph (1), the Secretary
shall appoint to each committee established under subsection
(a), as nonvoting members--</DELETED>
<DELETED> ``(A) a representative of consumer
interests; and</DELETED>
<DELETED> ``(B) a representative of interests of in
vitro clinical test developers not directly affected by
the matter to be brought before the
committee.</DELETED>
<DELETED> ``(3) Limitation.--No individual who is a regular
full-time employee of the United States and engaged in the
administration of this Act may be a member of any advisory
committee established under subsection (a).</DELETED>
<DELETED> ``(4) Education and training.--The Secretary
shall, as appropriate, provide education and training to each
new committee member before such member participates in a
committee's activities, including education regarding
requirements under this Act and related regulations of the
Secretary, and the administrative processes and procedures
related to committee meetings.</DELETED>
<DELETED> ``(5) Meetings.--The Secretary shall ensure that
scientific advisory committees meet regularly and at
appropriate intervals so that any matter to be reviewed by such
a committee can be presented to the committee not more than 60
calendar days after the matter is ready for such review.
Meetings of the committee may be held using electronic or
telephonic communication to convene the meetings.</DELETED>
<DELETED> ``(6) Compensation.--Members of an advisory
committee established under subsection (a), while attending
meetings or conferences or otherwise engaged in the business of
the advisory committee--</DELETED>
<DELETED> ``(A) shall be entitled to receive
compensation at rates to be fixed by the Secretary, but
not to exceed the daily equivalent of the rate in
effect for positions classified above level GS-15 of
the General Schedule; and</DELETED>
<DELETED> ``(B) may be allowed travel expenses as
authorized by section 5703 of title 5, United States
Code, for employees serving intermittently in the
Government service.</DELETED>
<DELETED> ``(c) Guidance.--The Secretary may issue guidance on the
policies and procedures governing advisory committees established under
subsection (a).</DELETED>
<DELETED>``SEC. 587I. BREAKTHROUGH IN VITRO CLINICAL TESTS.</DELETED>
<DELETED> ``(a) In General.--The purpose of this section is to
encourage the Secretary, and provide the Secretary with sufficient
authority, to apply efficient and flexible approaches to expedite the
development of, and prioritize the review of, in vitro clinical tests
that represent breakthrough technologies.</DELETED>
<DELETED> ``(b) Establishment of Program.--The Secretary shall
establish a program to expedite the development of, and provide for the
priority review of, in vitro clinical tests.</DELETED>
<DELETED> ``(c) Eligibility.--The program developed under subsection
(b) shall be available for any in vitro clinical test that--</DELETED>
<DELETED> ``(1) provides or enables more effective treatment
or diagnosis of life-threatening or irreversibly debilitating
human disease or conditions compared to existing approved or
cleared alternatives, including an in vitro clinical test
offered under a technology certification order; and</DELETED>
<DELETED> ``(2) is a test--</DELETED>
<DELETED> ``(A) that represents a breakthrough
technology;</DELETED>
<DELETED> ``(B) for which no approved or cleared
alternative in vitro clinical test exists, including no
in vitro clinical test offered under a technology
certification order;</DELETED>
<DELETED> ``(C) that offers a clinically meaningful
advantage over any existing alternative in vitro
clinical test that is approved or cleared (including
any in vitro clinical test offered under a technology
certification order), including the potential to reduce
or eliminate the need for hospitalization, improve
patient quality of life, facilitate patients' ability
to manage their own care (such as through self-directed
personal assistance), or establish long-term clinical
efficiencies; or</DELETED>
<DELETED> ``(D) the availability of which is in the
best interest of patients or public health.</DELETED>
<DELETED> ``(d) Designation.--</DELETED>
<DELETED> ``(1) Request.--To receive breakthrough
designation under this section, an applicant may request that
the Secretary designate the in vitro clinical test for
expedited development and priority review. Any such request for
designation may be made at any time prior to, or at the time
of, the submission of an application under section 587B or
587D, and shall include information demonstrating that the test
meets the criteria described in subsection (c).</DELETED>
<DELETED> ``(2) Determination.--Not later than 60 calendar
days after the receipt of a request under paragraph (1), the
Secretary shall determine whether the in vitro clinical test
that is the subject of the request meets the criteria described
in subsection (c). If the Secretary determines that the test
meets the criteria, the Secretary shall designate the test for
expedited development and priority review.</DELETED>
<DELETED> ``(3) Review.--Review of a request under paragraph
(1) shall be undertaken by a team that is composed of
experienced staff and senior managers of the Food and Drug
Administration.</DELETED>
<DELETED> ``(4) Withdrawal.--</DELETED>
<DELETED> ``(A) In general.--The designation of an
in vitro clinical test under this subsection is deemed
to be withdrawn, and such in vitro clinical test shall
no longer be eligible for designation under this
section, if an application for approval for such test
under section 587B or 587D is denied. Such test shall
be eligible for breakthrough designation upon a new
request for such designation.</DELETED>
<DELETED> ``(B) Exception.--The Secretary may not
withdraw a designation granted under this subsection
based on the subsequent approval or technology
certification of another in vitro clinical test that--
</DELETED>
<DELETED> ``(i) is designated under this
section; or</DELETED>
<DELETED> ``(ii) was given priority review
under section 515B.</DELETED>
<DELETED> ``(e) Actions.--For purposes of expediting the development
and review of in vitro clinical tests under this section, the Secretary
may take the actions and additional actions set forth in paragraphs (1)
and (2), respectively, of section 515B(e) when reviewing such tests.
Any reference or authorization in section 515B(e) with respect to a
device shall be deemed a reference or authorization with respect to an
in vitro clinical test for purposes of this section.</DELETED>
<DELETED> ``(f) Guidance.--Not later than the date specified for
final guidance under section 825 of the VALID Act of 2022, the
Secretary shall issue final guidance on the implementation of this
section. Such guidance shall--</DELETED>
<DELETED> ``(1) set forth the process by which a person may
seek a designation under subsection (d);</DELETED>
<DELETED> ``(2) provide a template for request under
subsection (d);</DELETED>
<DELETED> ``(3) identify the criteria the Secretary will use
in evaluating a request for designation; and</DELETED>
<DELETED> ``(4) identify the criteria and processes the
Secretary will use to assign a team of staff, including team
leaders, to review in vitro clinical tests designated for
expedited development and priority review, including any
training required for such personnel to ensure effective and
efficient review.</DELETED>
<DELETED> ``(g) Rules of Construction.--Nothing in this section
shall be construed to affect--</DELETED>
<DELETED> ``(1) the criteria and standards for evaluating an
application pursuant to section 587B or 587D, including the
recognition of valid scientific evidence as described in
section 587(17) and consideration and application of the least
burdensome means described under section 587AA(c);</DELETED>
<DELETED> ``(2) the authority of the Secretary with respect
to clinical holds under section 587R;</DELETED>
<DELETED> ``(3) the authority of the Secretary to act on an
application pursuant to section 587B before completion of an
establishment inspection, as the Secretary determines
appropriate; or</DELETED>
<DELETED> ``(4) the authority of the Secretary with respect
to postmarket surveillance under sections 587L(d) and
587Y.</DELETED>
<DELETED>``SEC. 587J. REGISTRATION AND LISTING.</DELETED>
<DELETED> ``(a) Registration Requirement.--</DELETED>
<DELETED> ``(1) In general.--Each person described in
subsection (b)(1) shall--</DELETED>
<DELETED> ``(A) during the period beginning on
October 1 and ending on December 31 of each year,
register with the Secretary the name of such person,
places of business of such person, all establishments
engaged in the activities specified under this
paragraph, the establishment registration number of
each such establishment, and a point of contact for
each such establishment, including an electronic point
of contact; and</DELETED>
<DELETED> ``(B) submit an initial registration
containing the information required under subparagraph
(A) not later than--</DELETED>
<DELETED> ``(i) the effective date of this
section if such establishment is engaged in any
activity described in subsection (b)(1) on such
effective date, unless the Secretary
establishes by guidance a date later than such
implementation date for all or a category of
such establishments; or</DELETED>
<DELETED> ``(ii) 30 days prior to engaging
in any activity described in subsection (b)(1),
if such establishment is not engaged in any
activity described in this paragraph on such
effective date.</DELETED>
<DELETED> ``(2) Registration numbers.--The Secretary may
assign a registration number to any person or an establishment
registration number to any establishment registered in
accordance with this section. Registration information shall be
made publicly available by publication on the website
maintained by the Food and Drug Administration, in accordance
with subsection (d).</DELETED>
<DELETED> ``(3) Inspection.--Each person or establishment
that is required to be registered with the Secretary under this
section shall be subject to inspection pursuant to section
704.</DELETED>
<DELETED> ``(b) Listing Information for In Vitro Clinical Tests.--
</DELETED>
<DELETED> ``(1) In general.--Each person who--</DELETED>
<DELETED> ``(A) is a developer; and</DELETED>
<DELETED> ``(B) introduces or proposes to begin the
introduction or delivery for introduction into
interstate commerce through an exemption under
subsection (a)(1), (a)(2), (a)(3), or (g) of section
587C or section 587G or through the filing of an
application under section 587B or section
587D,</DELETED>
<DELETED>shall submit a listing to the Secretary containing the
information described in paragraph (2), (4), or (5), as
applicable, in accordance with the applicable schedule
described under subsection (c). Such listing shall be prepared
in such form and manner as the Secretary may specify in
guidance. Listing information shall be submitted through the
comprehensive test information system in accordance with
section 587T, as appropriate.</DELETED>
<DELETED> ``(2) Submissions.--Each developer submitting a
listing under paragraph (1) shall electronically submit to the
comprehensive test information system described in section 587T
the following information, as applicable, for each in vitro
clinical test for which such person is a developer in the form
and manner prescribed by the Secretary, taking into account
least burdensome principles:</DELETED>
<DELETED> ``(A) Name of the establishment and its
establishment registration number.</DELETED>
<DELETED> ``(B) Contact information for the official
correspondent for the listing.</DELETED>
<DELETED> ``(C) Name (common name and trade name, if
applicable) of the in vitro clinical test and its test
listing number (when available).</DELETED>
<DELETED> ``(D) The certificate number for any
laboratory certified by the Secretary under section 353
of the Public Health Service Act that meets the
requirements to perform high-complexity testing and
that is the developer of the in vitro clinical test,
and the certificate number under such section for any
laboratory that is performing the test, is within the
same corporate organization, and has common ownership
by the same parent corporation.</DELETED>
<DELETED> ``(E) Whether the in vitro clinical test
is, as applicable, offered as a test approved under
section 587B, cleared to be offered under a granted
technology certification order, or offered as an exempt
in vitro clinical test under section 587A.</DELETED>
<DELETED> ``(F) Indications for use information
under section 587(10).</DELETED>
<DELETED> ``(G) A brief summary of the analytical
and clinical performance of the in vitro clinical test,
and as applicable, the lot release criteria.</DELETED>
<DELETED> ``(H) A brief description of conformance
with any applicable mitigating measures, restrictions,
and standards.</DELETED>
<DELETED> ``(I) Representative labeling for the in
vitro clinical test, as appropriate.</DELETED>
<DELETED> ``(3) Test listing number.--The Secretary may
assign a test listing number to each in vitro clinical test
that is the subject of a listing under this section. The
process for assigning test listing numbers may be established
through guidance, and may include the recognition of standards,
formats, or conventions developed by a third-party
organization.</DELETED>
<DELETED> ``(4) Abbreviated listing.--A person who is not a
developer but is otherwise required to register pursuant to
subsection (a) shall submit an abbreviated listing to the
Secretary containing the information described in subparagraphs
(A) through (C) of paragraph (2), and the name of the
developer. The information shall be submitted in accordance
with the applicable schedule described under subsection (c).
Such abbreviated listing shall be prepared in such form and
manner as the Secretary may specify through guidance. Listing
information shall be submitted to the comprehensive test
information system in accordance with section 587T, as
appropriate.</DELETED>
<DELETED> ``(5) Grandfathered tests.--A developer offering a
test that is a grandfathered in vitro clinical test under
section 587G(a) shall submit listing information required under
subparagraphs (A) through (F) of paragraph (2), and may submit
a statement of the performance specifications for such in vitro
clinical tests.</DELETED>
<DELETED> ``(6) Exempt tests.--A developer of an in vitro
clinical test who introduces or proposes to begin the
introduction or delivery for introduction into interstate
commerce that is otherwise exempt from the requirement to
submit listing information pursuant to an exemption under
section 587C may submit listing information under this
subsection.</DELETED>
<DELETED> ``(c) Timelines for Submission of Listing Information.--
</DELETED>
<DELETED> ``(1) In general.--The timelines for submission of
registration and listing under subsections (a) and (b) are as
follows:</DELETED>
<DELETED> ``(A) For an in vitro clinical test that
was listed as a device under section 510(j) prior to
the effective date of this section, a person shall
maintain a device listing under section 510 until such
time as the system for submitting the listing
information required under subsection (b) becomes
available and thereafter shall submit the listing
information not later than the later of 1 year after
the system for submitting the listing under this
section becomes available or the effective date of this
section.</DELETED>
<DELETED> ``(B) For an in vitro clinical test that
is subject to grandfathering under section 587G(a) a
person shall submit the listing information required
under subsection (b)(5) not later that the later of 1
year after the system for submitting the listing under
this section becomes available or the effective date of
this section.</DELETED>
<DELETED> ``(C) For an in vitro clinical test that
is not described in subparagraph (A) or (B), a person
shall submit the required listing information as
follows:</DELETED>
<DELETED> ``(i) For an in vitro clinical
test that is not exempt from premarket approval
under section 587B, a person shall submit the
required listing information, prior to offering
the in vitro clinical test and not later than
30 business days after the date of approval of
the premarket approval application.</DELETED>
<DELETED> ``(ii) For an in vitro clinical
test that is exempt from premarket review under
section 587C, the required listing information
shall be submitted prior to offering the in
vitro clinical test.</DELETED>
<DELETED> ``(2) Updates.--</DELETED>
<DELETED> ``(A) Updates after changes.--Each
developer required to submit listing information under
this section shall update such information within 10
business days of any change that causes any previously
listed information to be inaccurate or
incomplete.</DELETED>
<DELETED> ``(B) Annual updates.--Each developer
required to submit listing information under this
section shall update its information annually during
the period beginning on October 1 and ending on
December 31 of each year.</DELETED>
<DELETED> ``(d) Public Availability of Listing Information.--
</DELETED>
<DELETED> ``(1) In general.--Listing information submitted
pursuant to this section shall be made publicly available on
the website of the Food and Drug Administration in accordance
with paragraph (3).</DELETED>
<DELETED> ``(2) Confidentiality.--Listing information for an
in vitro clinical test that is subject to premarket approval or
technology certification shall remain confidential until such
date as the in vitro clinical test receives the applicable
premarket approval or the developer receives a technology
certification order and for subsequent tests introduced under a
technology certification order until their
introduction.</DELETED>
<DELETED> ``(3) Exceptions from public availability
requirements.--The public listing requirements of this
subsection shall not apply to any registration and listing
information submitted under subsection (a) or (b), if the
Secretary determines that such information--</DELETED>
<DELETED> ``(A) is a trade secret or confidential
commercial information; or</DELETED>
<DELETED> ``(B) if posted, would present a risk to
national security.</DELETED>
<DELETED> ``(e) Submission of Information by Accredited Persons.--If
agreed upon by the developer, the information required under this
section may be submitted by a person accredited under section
587Q.</DELETED>
<DELETED>``SEC. 587K. TEST DESIGN AND QUALITY REQUIREMENTS.</DELETED>
<DELETED> ``(a) Applicability.--</DELETED>
<DELETED> ``(1) In general.--Each developer and each other
person required to register under section 587I(b)(1) shall
establish and maintain quality requirements in accordance with
the applicable requirements set forth in subsection
(b).</DELETED>
<DELETED> ``(2) Certified laboratory requirements.--A
developer shall establish and maintain quality requirement
under subsection (b)(2) or (b)(3), as applicable, if such
developer is a clinical laboratory certified by the Secretary
under section 353 of the Public Health Service Act that--
</DELETED>
<DELETED> ``(A) is certified to perform high-
complexity testing;</DELETED>
<DELETED> ``(B) develops an in vitro clinical test
that is for use only--</DELETED>
<DELETED> ``(i) within the laboratory
certified by the Secretary under such section
353 in which such test was developed;
or</DELETED>
<DELETED> ``(ii) within another laboratory
certified by the Secretary under such section
353 if such laboratory is--</DELETED>
<DELETED> ``(I) within the same
corporate organization and has common
ownership by the same parent
corporation as the laboratory in which
the test was developed; or</DELETED>
<DELETED> ``(II) within a public
health laboratory network coordinated
or managed by the Centers for Disease
Control and Prevention, if the test is
developed by a public health laboratory
or the Centers for Disease Control and
Prevention; and</DELETED>
<DELETED> ``(C) does not manufacture, produce, or
distribute in vitro clinical tests other than
laboratory test protocols.</DELETED>
<DELETED> ``(3) Regulations.--The Secretary shall promulgate
quality system regulations implementing this section. In
promulgating such regulations under this section, the Secretary
shall consider whether, and to what extent, international
harmonization is appropriate.</DELETED>
<DELETED> ``(4) Quality systems for hybrid developers of
both laboratory test protocols and other in vitro clinical
tests.--An entity that develops both finished products and
laboratory test protocols and other in vitro clinical tests
shall comply with subsection (b)(1) for activities related to
the development of any in vitro clinical test that is not a
laboratory test protocol product and with subsection (b)(2) or
(b)(3), as applicable, for activities related to the
development of any laboratory test protocol.</DELETED>
<DELETED> ``(b) Quality Requirements.--</DELETED>
<DELETED> ``(1) In general.--The quality requirements
applicable under this section shall--</DELETED>
<DELETED> ``(A) avoid duplication of regulations
under section 353 of the Public Health Service Act;
and</DELETED>
<DELETED> ``(B) shall include the following, as
applicable, subject to subparagraph (A) and paragraphs
(2) and (3)--</DELETED>
<DELETED> ``(i) management
responsibilities;</DELETED>
<DELETED> ``(ii) quality audits;</DELETED>
<DELETED> ``(iii) personnel;</DELETED>
<DELETED> ``(iv) design controls;</DELETED>
<DELETED> ``(v) document controls;</DELETED>
<DELETED> ``(vi) purchasing
controls;</DELETED>
<DELETED> ``(vii) identification and
traceability;</DELETED>
<DELETED> ``(viii) production and process
controls;</DELETED>
<DELETED> ``(ix) acceptance
activities;</DELETED>
<DELETED> ``(x) nonconforming in vitro
clinical tests;</DELETED>
<DELETED> ``(xi) corrective and preventive
action;</DELETED>
<DELETED> ``(xii) labeling and packaging
controls;</DELETED>
<DELETED> ``(xiii) handling, storage,
distribution, and installation;</DELETED>
<DELETED> ``(xiv) complaints and
records;</DELETED>
<DELETED> ``(xv) servicing; and</DELETED>
<DELETED> ``(xvi) statistical
techniques.</DELETED>
<DELETED> ``(2) Exception for laboratory test protocols.--
Developers that are developing test protocols for use as
described in subsection (a)(2)(B)(i) are exempt from the
requirements under paragraph (1)(B) except for the requirements
described in clauses (iv), (vi), (ix), (xi), and (xiv) of such
paragraph.</DELETED>
<DELETED> ``(3) Quality requirements for certain
laboratories distributing laboratory test protocols within
organizations or public health networks.--Quality requirements
applicable to the developer who is distributing a laboratory
test protocol as described in subsection (a)(2)(B)(ii) shall
consist of the following:</DELETED>
<DELETED> ``(A) Clauses (iv), (vi), (ix), (xi),
(xiv), (xii) of paragraph (1)(B).</DELETED>
<DELETED> ``(B) The requirement to maintain records
of the laboratories to which the laboratory test
protocol is distributed.</DELETED>
<DELETED> ``(c) Regulations.--In implementing quality requirements
for test developers that participate in international audit programs
under this section, the Secretary shall--</DELETED>
<DELETED> ``(1) for purposes of facilitating international
harmonization, consider whether the developer participates in
an international audit program in which the United States
participates and recognizes compliance with, or conformance to,
such standards recognized by the Secretary; and</DELETED>
<DELETED> ``(2) ensure a least burdensome approach described
in section 587AA(c) by leveraging, to the extent applicable,
the quality assurance requirements applicable to developers
certified by the Secretary under section 353 of the Public
Health Service Act.</DELETED>
<DELETED>``SEC. 587L. LABELING REQUIREMENTS.</DELETED>
<DELETED> ``(a) In General.--An in vitro clinical test shall bear or
be accompanied by labeling, as applicable, that meets the requirements
set forth in subsections (b) and (c), unless such test is exempt under
subsection (d) or (e).</DELETED>
<DELETED> ``(b) Labels.--</DELETED>
<DELETED> ``(1) In general.--The label of an in vitro
clinical test, shall meet the requirements set forth in
paragraph (2) if there is an immediate container to which the
label is applied.</DELETED>
<DELETED> ``(2) Regulations.--The label of an in vitro
clinical test shall state the name and place of business of its
developer and meet the requirements set forth in regulations
promulgated in accordance with this section.</DELETED>
<DELETED> ``(c) Labeling.--</DELETED>
<DELETED> ``(1) In general.--Labeling of an in vitro
clinical test, including labeling in the form of a package
insert, website, standalone laboratory reference document, or
other similar document shall include--</DELETED>
<DELETED> ``(A) adequate directions for use and
shall meet the requirements set forth in regulations
promulgated under this section, except as provided in
subsection (d) or (e); and</DELETED>
<DELETED> ``(B) the information described in
paragraph (2), as applicable.</DELETED>
<DELETED> ``(2) Content.--Labeling of an in vitro clinical
test shall include--</DELETED>
<DELETED> ``(A) the test listing number that was
provided to the developer at the time of
listing;</DELETED>
<DELETED> ``(B) information to facilitate reporting
an adverse event;</DELETED>
<DELETED> ``(C) information regarding accessing the
performance summary data displayed in the listing
database for the test;</DELETED>
<DELETED> ``(D) the indications of use of the in
vitro clinical test; and</DELETED>
<DELETED> ``(E) any warnings, contraindications, or
limitations.</DELETED>
<DELETED> ``(3) Public availability of information.--The
Secretary shall make all of the information described in
paragraph (2) with respect to each in vitro clinical test
available to the public, as applicable, in accordance with
section 587T, except to the extent that the Secretary
determines that such information--</DELETED>
<DELETED> ``(A) is trade secret or confidential
commercial information; or</DELETED>
<DELETED> ``(B) if posted, would present a risk to
national security.</DELETED>
<DELETED> ``(4) Additional requirements.--Labeling for an in
vitro clinical test used for immunohematology testing shall
meet the applicable requirements set forth in part 660 of title
21, Code of Federal Regulations (or any successor regulations),
related to the labeling of blood grouping reagents, reagent red
blood cells, and anti-human globulin.</DELETED>
<DELETED> ``(d) Exemptions and Alternative Requirements.--</DELETED>
<DELETED> ``(1) In general.--</DELETED>
<DELETED> ``(A) In general.--With respect to an in
vitro clinical test that meets the criteria of
subparagraph (B), the `state in one place' regulations
under section 809.10(b) of title 21, Code of Federal
Regulations (or any successor regulations) may be
satisfied by the laboratory posting such information on
its website or in multiple documents, if such documents
are maintained and accessible in one place.</DELETED>
<DELETED> ``(B) Applicable tests.--An in vitro
clinical test meets the criteria of this subparagraph
if such test is--</DELETED>
<DELETED> ``(i) developed by a laboratory
certified by the Secretary under section 353 of
the Public Health Service Act that meets the
requirements to perform tests of high-
complexity; and</DELETED>
<DELETED> ``(ii) performed in--</DELETED>
<DELETED> ``(I) the same laboratory
in which such test was developed;
or</DELETED>
<DELETED> ``(II) by another
laboratory certified by the Secretary
under section 353 of the Public Health
Service Act that--</DELETED>
<DELETED> ``(aa) meets the
requirements to perform tests
of high complexity;
and</DELETED>
<DELETED> ``(bb) is under
common ownership and control as
the laboratory that developed
the test.</DELETED>
<DELETED> ``(2) Test instrument labeling.--Unless the
instrument is the entire test system, the labeling for an
instrument is not required to bear the information indicated in
paragraphs (3), (4), (5), (7), (8), (9), (10), (11), (12), and
(13) of section 809.10(b) of title 21, Code of Federal
Regulations (or any successor regulations).</DELETED>
<DELETED> ``(3) Reagent labeling.--For purposes of
compliance with subsection (c)(1), the labeling for a reagent
intended for use as a replacement in an in vitro clinical test
may be limited to that information necessary to identify the
reagent adequately and to describe its proper use in the
test.</DELETED>
<DELETED> ``(4) Investigational use.--A shipment or other
delivery of an in vitro clinical test for investigational use
pursuant to section 587S shall be exempt from the labeling
requirements of subsections (b) and (c)(1) and from any
standard promulgated through regulations, except as required
under section 353 of the Public Health Service Act or section
587R of this Act.</DELETED>
<DELETED> ``(5) General purpose laboratory reagents.--The
labeling of general purpose laboratory reagents (such as
hydrochloric acid) whose uses are generally known by persons
trained in their use need not bear the directions for use
required by subsection (c)(1)(A).</DELETED>
<DELETED> ``(6) Over-the-counter test specimen receptacle
labeling.--The labeling for over-the-counter test specimen
receptacles for drugs of abuse testing shall bear the name and
place of business of the developer included in the registration
under section 587J and any information specified in applicable
regulations promulgated under this section, in language
appropriate for the intended users.</DELETED>
<DELETED> ``(e) Tests in the Strategic National Stockpile.--
</DELETED>
<DELETED> ``(1) In general.--The Secretary may grant an
exception or alternative to any provision listed in this
section, unless explicitly required by a statutory provision
outside this subchapter, for specified lots, batches, or other
units of an in vitro clinical test, if the Secretary determines
that compliance with such labeling requirement could adversely
affect the availability of such products that are, or will be,
included in the Strategic National Stockpile under section
319F-2 of the Public Health Service Act.</DELETED>
<DELETED> ``(2) Regulations.--The Secretary may issue
regulations amending section 809.11 of title 21, Code of
Federal Regulations (or any successor regulation) to apply in
full or in part to in vitro clinical tests and in vitro
clinical test developers.</DELETED>
<DELETED> ``(f) Regulations.--The Secretary shall issue or revise
regulations related to standardized, general content and format for in
vitro clinical test labeling pursuant to this subsection.</DELETED>
<DELETED>``SEC. 587M. ADVERSE EVENT REPORTING.</DELETED>
<DELETED> ``(a) In General.--Each in vitro clinical test developer
shall establish and maintain a system for establishing and maintaining
records of adverse events and reporting adverse events in accordance
with this section.</DELETED>
<DELETED> ``(b) Submission of Individual Reports.--A developer shall
submit an individual adverse event not later than 5 calendar days after
the developer receives or becomes aware of an adverse event that
reasonably suggests that an in vitro clinical test may--</DELETED>
<DELETED> ``(1) have caused or contributed to a patient or
user death; or</DELETED>
<DELETED> ``(2) present an imminent threat to public
health.</DELETED>
<DELETED> ``(c) Submission of Quarterly Reports.--As applicable, a
developer shall submit quarterly reports that include any in vitro
clinical test errors and serious injuries that occurred during the
applicable quarter. Such quarterly reports shall be submitted not later
than the end of the quarter following the quarter in which the
developer receives or becomes aware of such adverse events.</DELETED>
<DELETED> ``(d) Definitions.--For the purposes of this section--
</DELETED>
<DELETED> ``(1) the term `in vitro clinical test error'
means a failure of an in vitro clinical test to meet its
performance specifications, or to otherwise perform as intended
by the developer, including an inaccurate result resulting from
such failure; and</DELETED>
<DELETED> ``(2) the term `serious injury' means--</DELETED>
<DELETED> ``(A) a significant delay in a diagnosis
that results in the absence, delay, or discontinuation
of critical medical treatment or that irreversibly or
seriously and negatively alters the course of a disease
or condition; or</DELETED>
<DELETED> ``(B) an injury that--</DELETED>
<DELETED> ``(i) is life
threatening;</DELETED>
<DELETED> ``(ii) results in permanent
impairment of a body function or permanent
damage to a body structure; or</DELETED>
<DELETED> ``(iii) necessitates medical or
surgical intervention to preclude permanent
impairment of a body function or permanent
damage to a body structure.</DELETED>
<DELETED> ``(e) Regulations.--The Secretary shall promulgate
regulations to implement this section.</DELETED>
<DELETED>``SEC. 587N. CORRECTIONS AND REMOVALS.</DELETED>
<DELETED> ``(a) Regulations.--The Secretary shall promulgate
regulations, or amend existing regulations, as appropriate, to
implement this section.</DELETED>
<DELETED> ``(b) Reports of Corrections and Removals.--</DELETED>
<DELETED> ``(1) In general.--Each in vitro clinical test
developer shall report to the Secretary any correction or
removal of an in vitro clinical test undertaken by such
developer if the correction or removal was undertaken--
</DELETED>
<DELETED> ``(A) to reduce the risk to health posed
by the in vitro clinical test; or</DELETED>
<DELETED> ``(B) to remedy a violation of this Act
caused by the in vitro clinical test which may present
a risk to health.</DELETED>
<DELETED> ``(2) Exception for in vitro clinical tests
offered under a technology certification order.--For any
eligible test offered under a technology certification order
under section 587D, a correction and removal report for any
correction or removal of an in vitro clinical test should
demonstrate that the issue or issues causing the correction or
removal do not adversely impact the ability of other in vitro
clinical tests offered under the same technology certification
order to meet the applicable standard.</DELETED>
<DELETED> ``(c) Timing.--A developer shall submit any report
required under this subsection to the Secretary within 15 business days
of initiating such correction or removal.</DELETED>
<DELETED> ``(d) Recordkeeping.--A developer of an in vitro clinical
test that undertakes a correction or removal of an in vitro clinical
test which is not required to be reported under this subsection shall
keep a record of such correction or removal.</DELETED>
<DELETED> ``(e) Recall Communications.--Upon the voluntary reporting
of a correction or removal by the developer--</DELETED>
<DELETED> ``(1) the Secretary shall classify such correction
or removal under this section within 15 calendar days;
and</DELETED>
<DELETED> ``(2) not later than 45 calendar days after the
developer or other responsible party notifies the Secretary
that it has completed a recall action, the Secretary shall
provide the developer or other responsible party with a written
statement closing the recall action or stating the reasons the
Secretary cannot close the recall at that time.</DELETED>
<DELETED>``SEC. 587O. RESTRICTED IN VITRO CLINICAL TESTS.</DELETED>
<DELETED> ``(a) Applicability.--</DELETED>
<DELETED> ``(1) In general.--For the types of in vitro
clinical tests described in paragraph (3) the Secretary may
require, in issuing an approval of an in vitro clinical test
under section 587B, granting a technology certification order
under section 587D, or in issuing a determination under section
587F(a), or by issuing a regulation, that such test, or
category of tests, be restricted to sale, distribution, or use
upon such conditions as the Secretary may prescribe under
paragraph (2).</DELETED>
<DELETED> ``(2) Conditions.-- The Secretary may prescribe
conditions under this section, based on available evidence,
with respect to an in vitro clinical test described in
paragraph (3), that are determined to be needed due to the
potential for harmful effect of such test (including any
resulting absence, significant delay, or discontinuation of
appropriate medical treatment), and are necessary to ensure
that the test meets the applicable standard.</DELETED>
<DELETED> ``(3) In vitro clinical tests subject to
restrictions.--The restrictions or conditions authorized under
this section may be applied by the Secretary to any high-risk
or moderate-risk in vitro clinical test, prescription home-use
in vitro clinical test, direct-to-consumer in vitro clinical
test, or over-the-counter in vitro clinical test.</DELETED>
<DELETED> ``(b) Labeling and Advertising of a Restricted in Vitro
Clinical Test.--The labeling and advertising of an in vitro clinical
test to which restrictions apply under subsection (a) shall bear such
appropriate statements of the restrictions as the Secretary may
prescribe in an approval under section 587B, an order under section
587D, a determination under section 587F(a), or in regulation, as
applicable.</DELETED>
<DELETED> ``(c) Device Restrictions.--An in vitro clinical test that
was offered as a restricted device prior to the date of enactment of
this subchapter--</DELETED>
<DELETED> ``(1) shall continue to comply with the applicable
restrictions under section 515 or section 520(e) until the this
subchapter takes effect; and</DELETED>
<DELETED> ``(2) except for in vitro clinical tests required
to meet section 809.30 of title 21, Code of Federal Regulations
prior to the effective date of this subchapter specified in
section 825(a)(1)(A) of the VALID Act of 2022, such
restrictions shall be deemed to be restrictions under this Act
as of such effective date.</DELETED>
<DELETED>``SEC. 587P. APPEALS.</DELETED>
<DELETED> ``(a) Significant Decision.--</DELETED>
<DELETED> ``(1) In general.--The Secretary shall maintain a
substantive summary of the scientific and regulatory rationale
for any significant decision of the Food and Drug
Administration pursuant to section 587F, regarding--</DELETED>
<DELETED> ``(A) the submission of an application
for, or a review of, an in vitro clinical test under
section 587B or section 587D;</DELETED>
<DELETED> ``(B) an exemption under section 587C;
or</DELETED>
<DELETED> ``(C) any requirements for mitigation
measures to an in vitro clinical test or category of in
vitro clinical tests.</DELETED>
<DELETED>Such summaries shall include documentation of
significant controversies or differences of opinion and the
resolution of such controversies or differences of
opinion.</DELETED>
<DELETED> ``(2) Provision of documentation.--Upon request,
the Secretary shall furnish a substantive summary described in
paragraph (1) to the person who has made, or is seeking to
make, a submission described in such paragraph.</DELETED>
<DELETED> ``(3) Application of least burdensome
requirements.--The substantive summary required under this
subsection shall include a brief statement regarding how the
least burdensome requirements were considered and applied
consistent with section 587AA(c), as applicable.</DELETED>
<DELETED> ``(b) Review of Significant Decisions.--</DELETED>
<DELETED> ``(1) Request for supervisory review of
significant decision.--A developer may request a supervisory
review of the significant decision described in subsection
(a)(1). Such review may be conducted at the next supervisory
level or higher above the agency official who made the
significant decision.</DELETED>
<DELETED> ``(2) Submission of request.--A developer
requesting a supervisory review under paragraph (1) shall
submit such request to the Secretary not later than 30 days
after the decision for which the review is requested and shall
indicate in the request whether such developer seeks an in-
person meeting or a teleconference review.</DELETED>
<DELETED> ``(3) Timeframe.--The Secretary shall schedule an
in-person or teleconference review, if so requested, not later
than 30 days after such request is made. The Secretary shall
issue a decision to the developer requesting a review under
this subsection not later than 45 days after the request is
made under paragraph (1), or, in the case of a developer who
requests an in-person meeting or teleconference, 30 days after
such meeting or teleconference.</DELETED>
<DELETED> ``(c) Advisory Panels.--The process established under
subsection (a) shall permit the appellant to request review by an
advisory committee established under section 587G when there is a
dispute involving substantial scientific fact. If an advisory panel
meeting is held, the Secretary shall make a determination under this
subsection not later than 45 days after the requested advisory
committee meeting has concluded.</DELETED>
<DELETED> ``(d) Least Burdensome Review.--Any developer who has
submitted an application under section 587B or 587D may request a
supervisory review of a request for additional information during an
evaluation of such submission within 60 calendar days of receipt of the
additional information request from the Secretary.</DELETED>
<DELETED> ``(e) Availability of All Remedies.--The procedures set
forth in this section shall be in addition to, and not in lieu of,
other remedies available to the developer.</DELETED>
<DELETED>``SEC. 587Q. ACCREDITED PERSONS.</DELETED>
<DELETED> ``(a) In General.--</DELETED>
<DELETED> ``(1) Authorization.--Beginning on the date of
enactment of the VALID Act of 2022, the Secretary shall
accredit persons for any of the following purposes:</DELETED>
<DELETED> ``(A) Reviewing applications for premarket
approval under section 587B and making findings with
respect to such applications.</DELETED>
<DELETED> ``(B) Reviewing applications for
technology certification under section 587D and making
recommendations to the Secretary with respect to such
applications.</DELETED>
<DELETED> ``(C) Conducting inspections as specified
in subsection (c) of in vitro clinical test developers
and other persons required to register pursuant to
section 587I.</DELETED>
<DELETED> ``(2) Persons submitting applications.--A person
submitting an application for premarket approval under section
587B or an application for technology certification under
section 587D may submit such application to the Secretary or to
a person accredited pursuant to subparagraph (A) or (B) of
paragraph (1).</DELETED>
<DELETED> ``(b) Accredited Persons Application Reviews, Findings and
Recommendations.--</DELETED>
<DELETED> ``(1) Requirements for premarket application.--
</DELETED>
<DELETED> ``(A) Review and finding requirements.--An
accredited person receiving an application for
premarket approval under section 587B shall either--
</DELETED>
<DELETED> ``(i) provide to the Secretary,
together with the application for premarket
approval submitted by the applicant, a finding
that the criteria for approval of the
application under section 587B(g)(2)(A) are met
and issue a copy of such finding to the
applicant, which finding shall plainly state--
</DELETED>
<DELETED> ``(I) the basis for the
accredited person's finding that the
criteria under section 587B(g)(2)(A)
are met; and</DELETED>
<DELETED> ``(II) any proposed
restrictions, mitigating measures, or
conditions of approval under section
587B(g)(2)(B), as applicable;
or</DELETED>
<DELETED> ``(ii) provide a notification to
the applicant that the accredited person cannot
find that the criteria for approval of the
application under section 587B(g)(2)(A) are met
and the reasons for such decision.</DELETED>
<DELETED> ``(B) Requesting missing or clarifying
information.--After receipt of an application under
this section, the Secretary may request missing or
clarifying information from the applicant concerning
the application, which the applicant shall promptly
provide.</DELETED>
<DELETED> ``(C) Secretary action on finding that
approval criteria are met.--If the accredited person
transmits a finding to the Secretary under clause (i)
of subparagraph (A), then prior to the date that is 45
calendar days after the transmittal date the Secretary
shall--</DELETED>
<DELETED> ``(i) approve the application for
premarket approval under section 587B(g)(2)
with appropriate restrictions, mitigating
measures, or conditions of approval, as
applicable; or</DELETED>
<DELETED> ``(ii) deny approval of the
application by issuing a written notice that
reflects appropriate management input and
concurrence to the accredited person and the
applicant detailing the scientific basis for
the Secretary's determination that the criteria
for issuance of an approval under section
587B(g)(2)(A) have not been met.</DELETED>
<DELETED> ``(D) Effect of inaction on finding.--If
the Secretary fails to take an action under
subparagraph (C) the Secretary shall--</DELETED>
<DELETED> ``(i) within 45 calendar days
after the transmittal date, provide written
feedback to the applicant that--</DELETED>
<DELETED> ``(I) includes all
outstanding issues with the application
preventing the Secretary from taking an
action under subparagraph
(B);</DELETED>
<DELETED> ``(II) reflects
appropriate management input and
concurrence; and</DELETED>
<DELETED> ``(III) includes action
items for the Secretary, the applicant,
or both, as appropriate, with an
estimated date of completion for the
Secretary and the applicant to complete
their respective tasks, as applicable;
and</DELETED>
<DELETED> ``(ii) promptly schedule a meeting
or teleconference to discuss the feedback
provided under clause (i), unless the Secretary
and applicant agree that the outstanding issues
are adequately presented through written
correspondence and a meeting or teleconference
is not necessary.</DELETED>
<DELETED> ``(2) Requirements for technology certification.--
</DELETED>
<DELETED> ``(A) Review and recommendation
requirements.--An accredited person receiving an
application for technology certification under section
587D shall either--</DELETED>
<DELETED> ``(i) provide to the Secretary,
together with the application for technology
certification submitted by the applicant, a
recommendation that the criteria for issuance
of a technology certification order under
section 587D(f)(3) are met and issue a copy of
such recommendation to the applicant, which
recommendation shall plainly state the basis
for the accredited person's recommendation that
the criteria under section 587D(f)(3) are met;
or</DELETED>
<DELETED> ``(ii) provide a notification to
the applicant that the accredited person cannot
recommend that the criteria for issuance of a
technology certification order under section
587D(f)(3) are met and the reasons for such
decision.</DELETED>
<DELETED> ``(B) Requesting missing or clarifying
information.--After receipt of an application under
this section, the Secretary may request missing or
clarifying information from the applicant concerning
the application, which the applicant shall promptly
provide.</DELETED>
<DELETED> ``(C) Secretary action on recommendation
for issuance of a technology certification order.--If
the accredited person transmits a recommendation to the
Secretary under clause (i) of subparagraph (A), then
prior to the date that is 60 calendar days after the
transmittal date the Secretary shall--</DELETED>
<DELETED> ``(i) issue the technology
certification order under section 587D(f)(3),
consistent with such recommendation from the
accredited person; or</DELETED>
<DELETED> ``(ii) deny approval of the
application by issuing a written notice to the
accredited person and the applicant detailing
the scientific basis for a determination by the
Secretary that the criteria for issuance of a
technology certification order under section
587D(f)(3) have not been met.</DELETED>
<DELETED> ``(c) Requirements for Inspections.--</DELETED>
<DELETED> ``(1) In general.--When conducting inspection,
persons accredited under subparagraph (a)(1)(B) shall record in
writing their specific observations and shall present their
observations to the designated representative of the inspected
establishment.</DELETED>
<DELETED> ``(2) Inspection report requirements.--Each person
accredited under this subparagraph (a)(1)(C) shall prepare and
submit to the Secretary an inspection report in a form and
manner designated by the Secretary for conducting inspections.
Any statement or representation made by an employee or agent of
an establishment to a person accredited to conduct inspections
under subparagraph (a)(1)(C) shall be subject to section 1001
of title 18, United States Code.</DELETED>
<DELETED> ``(3) Savings clause.--Nothing in this section
affects the authority of the Secretary to inspect any in vitro
clinical test developer or other person registered under
section 587I or recognize inspections conducted by auditing
organizations as described under section 704(g)(15).</DELETED>
<DELETED> ``(4) Inspection limitations.--The Secretary shall
ensure that inspections carried out under this section are not
duplicative of inspections carried out under section 353 of the
Public Health Service Act. Inspections under this section shall
be limited to the data and information necessary--</DELETED>
<DELETED> ``(A) for routine surveillance activities
of facilities associated with an approved application
under section 587B or issuance of a technology
certification order under section 587D; or</DELETED>
<DELETED> ``(B) to meet the requirements for
premarket approval under section 587B or issuance of a
technology certification order under section 587D, as
applicable.</DELETED>
<DELETED> ``(d) Accreditation.--</DELETED>
<DELETED> ``(1) Accreditation program.--The Secretary may
provide for accreditation under this section through programs
administered by the Food and Drug Administration, by other non-
Federal government agencies, or by qualified nongovernmental
organizations. A person may be accredited for the review of
applications submitted under sections 587B as described in
subsection (a)(1)(A), for the review of applications submitted
under section 587D as described in subsection (a)(1)(B) and to
conduct inspection activities under subsection (a)(1)(C), or
for a subset of such reviews or activities.</DELETED>
<DELETED> ``(2) Eligible persons.--</DELETED>
<DELETED> ``(A) Minimum qualifications.--An
accredited person, at a minimum, shall--</DELETED>
<DELETED> ``(i) not be an employee of the
Federal Government;</DELETED>
<DELETED> ``(ii) not engage in the
activities of a developer, as defined in
section 587(7);</DELETED>
<DELETED> ``(iii) not be a person required
to register under section 587I, unless such
person has established sufficient processes and
protocols to separate activities to develop in
vitro clinical tests and the activities for
which such person would be accredited under
subsection (a) and discloses applicable
information under this section;</DELETED>
<DELETED> ``(iv) not be owned or controlled
by, and shall have no organizational, material,
or financial affiliation with, an in vitro
clinical test developer or other person
required to register under section
587I;</DELETED>
<DELETED> ``(v) be a legally constituted
entity permitted to conduct the activities for
which it seeks accreditation;</DELETED>
<DELETED> ``(vi) ensure that the operations
of such person are in accordance with generally
accepted professional and ethical business
practices; and</DELETED>
<DELETED> ``(vii) include in its request for
accreditation a commitment to, at the time of
accreditation and at any time it is performing
activities pursuant to this section--</DELETED>
<DELETED> ``(I) certify that the
information reported to the Secretary
accurately reflects the data or
protocol reviewed, and the documented
inspection findings, as
applicable;</DELETED>
<DELETED> ``(II) limit work to that
for which competence and capacity are
available;</DELETED>
<DELETED> ``(III) treat information
received or learned, records, reports,
and recommendations as proprietary
information of the person submitting
such information; and</DELETED>
<DELETED> ``(IV) in conducting the
activities for which the person is
accredited in respect to a particular
in vitro clinical test, protect against
the use of any employee or consultant
who has a financial conflict of
interest regarding that in vitro
clinical test.</DELETED>
<DELETED> ``(B) Waiver.--The Secretary may waive any
requirements in clauses (i), (ii), (iii), or (iv) of
subparagraph (A) upon making a determination that such
person has implemented other appropriate controls
sufficient to ensure a competent and impartial
review.</DELETED>
<DELETED> ``(3) Accreditation process.--</DELETED>
<DELETED> ``(A) Accreditation process guidance and
regulations.--Not later than 180 days after the date of
enactment of the VALID Act of 2022, the Secretary shall
issue draft guidance specifying the process for
submitting a request for accreditation and
reaccreditation under this section, including the form
and content of information to be submitted, including
the criteria that the Secretary will consider to
accredit or deny accreditation and, not later than 1
year after the close of the comment period for the
draft guidance, issue final guidance.</DELETED>
<DELETED> ``(B) Response to request.--The Secretary
shall respond to a request for accreditation or
reaccreditation within 60 calendar days of the receipt
of the request. The Secretary's response may be to
accredit or reaccredit the person, to deny
accreditation, or to request additional information in
support of the request. If the Secretary requests
additional information, the Secretary shall respond
within 60 calendar days of receipt of such additional
information to accredit or deny the
accreditation.</DELETED>
<DELETED> ``(C) Type of accreditation.--The
accreditation or reaccreditation of a person shall
specify the particular activity or activities under
subsection (a) for which such person is accredited, and
shall include any limitation to certain eligible in
vitro clinical tests.</DELETED>
<DELETED> ``(D) Public list.--The Secretary shall
publish on the website of the Food and Drug
Administration a list of persons who are accredited
under this section. Such list shall be updated on at
least a monthly basis. The list shall specify the
particular activity or activities under this section
for which the person is accredited.</DELETED>
<DELETED> ``(E) Audit.--The Secretary may audit the
performance of persons accredited under this section
for purposes of ensuring that such persons continue to
meet the published criteria for accreditation, and may
modify the scope or particular activities for which a
person is accredited if the Secretary determines that
such person fails to meet one or more criteria for
accreditation.</DELETED>
<DELETED> ``(F) Suspension or withdrawal.--The
Secretary may suspend or withdraw accreditation of any
person accredited under this section, after providing
notice and an opportunity for an informal hearing, when
such person is substantially not in compliance with the
requirements of this section or the published criteria
for accreditation, or poses a threat to public health,
or fails to act in a manner that is consistent with the
purposes of this section.</DELETED>
<DELETED> ``(G) Reaccreditation.--Accredited persons
may be initially accredited for up to 3 years. After
expiration of such initial period, persons may be
reaccredited for unlimited additional 35-year periods,
as determined by the Secretary.</DELETED>
<DELETED> ``(e) Compensation of Accredited Persons.--Compensation of
an accredited person shall be determined by agreement between the
accredited person and the person who engages the services of the
accredited person, and shall be paid by the person who engages such
services.</DELETED>
<DELETED> ``(f) International Harmonization.--Notwithstanding any
other provision of this section, to facilitate international
harmonization the Secretary may recognize persons accredited or
recognized by governments, who have also entered into information
sharing agreements, including confidentiality commitments, with the
Commissioner of Food and Drugs.</DELETED>
<DELETED> ``(g) Information Sharing Agreements.--An accredited
person may enter into an agreement with a test developer to provide
information to the comprehensive test information system under section
587T, including any requirements under section 587I.</DELETED>
<DELETED> ``(h) Reports.--Not later than 2 years after the effective
date of the VALID Act of 2022, and annually thereafter for the next 4
years, the Secretary shall post on the website of the Food and Drug
Administration, a report describing the Secretary's performance in
implementing this section, including the Secretary's progress in
minimizing duplicative reviews of applications for which an accredited
person finds the criteria for approval are met. Such reports shall
include, for each period--</DELETED>
<DELETED> ``(1) with regard to premarket approval
applications--</DELETED>
<DELETED> ``(A) the total number of findings
transmitted to the Secretary under subsection
(b)(1)(A)(i);</DELETED>
<DELETED> ``(B) the total number of determinations
made by the Secretary under subsection (b)(1)(B)(i)
within 30 calendar days of the transmittal date to
approve an application;</DELETED>
<DELETED> ``(C) the total number of determinations
made by the Secretary under subsection (b)(1)(B)(ii)
within 30 calendar days of the transmittal date to deny
approval of an application; and</DELETED>
<DELETED> ``(D) the total number of applications
that were approved and the total number of applications
that were denied approval, after the Secretary failed
to make a determination within 30 calendar days of the
transmittal date under subsection (b)(1)(B);
and</DELETED>
<DELETED> ``(2) with regard to applications for technology
certification--</DELETED>
<DELETED> ``(A) the total number of recommendations
transmitted to the Secretary under subsection
(b)(2)(A)(i);</DELETED>
<DELETED> ``(B) the total number of determinations
made by the Secretary under subsection (b)(2)(B)(i) to
issue a technology certification order, including
determinations made within 30 days of the transmittal
date;</DELETED>
<DELETED> ``(C) the total number of determinations
made by the Secretary under subsection (b)(2)(B)(ii) to
deny the application for technology certification,
including determinations made within 30 calendar days
of the transmittal date; and</DELETED>
<DELETED> ``(D) the total number of technology
certification orders issued, and the total number of
applications for technology certification that were
denied, including applications denied after the
Secretary failed to make a determination within 30
calendar days of the transmittal date under subsection
(b)(2)(B).</DELETED>
<DELETED>``SEC. 587R. RECOGNIZED STANDARDS.</DELETED>
<DELETED> ``(a) In General.--The Secretary may recognize all or part
of appropriate standards established by nationally or internationally
recognized standards development organizations for which a person may
submit a declaration of conformity in order to meet a requirement under
this subchapter to which that standard is applicable. Standards for in
vitro diagnostic devices previously recognized under section 514(c)
shall be considered recognized standards under this section. Recognized
and proposed standards shall be accessible to the public at no charge.
The application of any such consensus standard shall only apply
prospectively. The Secretary shall issue regulations establishing the
criteria and process, for such recognition and adoption.</DELETED>
<DELETED> ``(b) Amendment Process.--The procedures established in
this section or in regulation or guidance issued under this section
shall apply to amendment of an existing standard.</DELETED>
<DELETED>``SEC. 587S. INVESTIGATIONAL USE.</DELETED>
<DELETED> ``(a) In General.--Subject to the conditions prescribed in
subsections (c), (d), (e), (f), and (g) of this section, an in vitro
clinical test for investigational use shall be exempt from the
requirements of this subchapter other than sections 587A, 587P, 587T,
and 587V. The Secretary may amend parts 50, 54, and 56 of title 21 of
the Code of Federal Regulations, or any successor regulations, to apply
to in vitro clinical tests to permit the investigational use of such
tests by experts qualified by scientific training and
experience.</DELETED>
<DELETED> ``(b) Regulations.--</DELETED>
<DELETED> ``(1) In general.--Not later than 2 years after
the date of enactment of the VALID Act of 2022, the Secretary
shall promulgate regulations, or amend existing regulations, to
implement this section.</DELETED>
<DELETED> ``(2) Variation.--The requirements in the
regulations promulgated under this section shall take into
account variations based on--</DELETED>
<DELETED> ``(A) the scope and duration of clinical
testing to be conducted under investigation that is the
subject of such application;</DELETED>
<DELETED> ``(B) the number of human subjects that
are to be involved in such testing;</DELETED>
<DELETED> ``(C) the need to permit changes to be
made to the in vitro clinical test involved during
testing conducted in accordance with a plan required
under subsection (c)(5); or</DELETED>
<DELETED> ``(D) whether the clinical testing of such
in vitro clinical test is for the purpose of developing
data to obtain approval to offer such test.</DELETED>
<DELETED> ``(c) Application for Investigational Use.--The following
shall apply with respect to in vitro clinical tests for investigational
use:</DELETED>
<DELETED> ``(1) Significant risk and other studies.--In the
case of an in vitro clinical test the investigational use of
which poses a significant risk to the human subject, a sponsor
of an investigation of such a test seeking an investigational
use exemption shall submit to the Secretary an investigational
use application with respect to the in vitro clinical test in
accordance with paragraphs (3) and (4). For purposes of this
subparagraph, the term `significant risk' means, with respect
to an in vitro clinical test and that the use of such in vitro
clinical test--</DELETED>
<DELETED> ``(A) is of substantial importance in
performing an activity or activities described in
section 201(ss)(1) for, a serious or life-threatening
disease or condition without confirmation of the
diagnosis by a medically established diagnostic product
or procedure;</DELETED>
<DELETED> ``(B) requires an invasive sampling
procedure that presents a significant risk to the human
subject, provided that routine venipuncture shall not
be considered an invasive sampling procedure;
or</DELETED>
<DELETED> ``(C) otherwise presents a potential for
serious risk to the health of a human
subject.</DELETED>
<DELETED> ``(2) Non-significant risk studies.--In the case
of an in vitro clinical test, the investigational use of which
is not described in paragraph (1)--</DELETED>
<DELETED> ``(A) the sponsor of such investigation
shall--</DELETED>
<DELETED> ``(i) ensure such investigation is
conducted in compliance with an investigational
plan approved by an institutional review
committee and the labeling of the in vitro
clinical test involved clearly and
conspicuously states, `For investigational use
only', as specified in paragraph
(4)(A)(ii);</DELETED>
<DELETED> ``(ii) ensure each investigator
obtains informed consent as required under part
50, 54, and 56 of title 21, Code of Federal
Regulations (or any successor regulations),
subject to the exceptions set forth in
paragraph (6)(C);</DELETED>
<DELETED> ``(iii) establish and maintain
records with respect to all requirements in
this subparagraph;</DELETED>
<DELETED> ``(iv) maintain records and make
reports as established by the Secretary in
regulations issued under subsection (b);
and</DELETED>
<DELETED> ``(v) ensure that investigators
monitor investigations, maintain records and
make reports as established by the Secretary in
regulations issued under subsection (b);
and</DELETED>
<DELETED> ``(B) the sponsor may rely on any
exception or exemption described in paragraph (5)(B) or
as established by the Secretary in regulations issued
under subsection (b).</DELETED>
<DELETED> ``(3) Application.--An investigational use
application shall be submitted in such time and manner and
contain such information as the Secretary may require in
regulation, and shall include an investigational plan for
proposed clinical testing and assurances that the sponsor
submitting the application will--</DELETED>
<DELETED> ``(A) establish and maintain records
relevant to the investigation of such in vitro clinical
test; and</DELETED>
<DELETED> ``(B) submit to the Secretary annual
reports of data obtained as a result of the
investigational use of the in vitro clinical test
during the period covered by the exemption that the
Secretary reasonably determines will enable the
Secretary--</DELETED>
<DELETED> ``(i) to ensure compliance with
the conditions for the exemption specified in
paragraph (4);</DELETED>
<DELETED> ``(ii) to review the progress of
the investigation involved; and</DELETED>
<DELETED> ``(iii) to evaluate the ability to
meet the applicable standard.</DELETED>
<DELETED> ``(4) Conditions for exemption.--</DELETED>
<DELETED> ``(A) In general.--An application for an
investigational use exemption with respect to a
significant risk study shall be granted if each of the
following conditions is met:</DELETED>
<DELETED> ``(i) The risks to the subjects of
the in vitro clinical test are outweighed by
the anticipated benefits of the test to the
subjects and the importance of the knowledge to
be gained, and adequate assurance of informed
consent is provided in accordance with
paragraphs (6)(A)(iii) and (6)(B).</DELETED>
<DELETED> ``(ii) The proposed labeling for
the in vitro clinical test involved clearly and
conspicuously states `For investigational use
only'.</DELETED>
<DELETED> ``(iii) Such other requirements
the Secretary determines--</DELETED>
<DELETED> ``(I) are necessary for
the protection of the public health and
safety; and</DELETED>
<DELETED> ``(II) do not unduly delay
investigation.</DELETED>
<DELETED> ``(B) Certain significant risk studies of
in vitro clinical tests for an unmet need.--The
Secretary shall not impose a limit on the sample size
for a significant risk study of an in vitro clinical
test that has received breakthrough designation under
section 587I.</DELETED>
<DELETED> ``(5) Coordination with investigational new drug
applications.--Any requirement for the submission of a report
to the Secretary pursuant to an application for an
investigational new drug exemption involving an in vitro
clinical test shall supersede the reporting requirement in
paragraph (3)(B), but only to the extent the requirement with
respect to the application for exemption with respect to the
drug is duplicative of the reporting requirement under such
paragraph.</DELETED>
<DELETED> ``(6) Investigational plan, procedures, and
conditions.--With respect to an investigational plan submitted
under paragraph (3), the sponsor submitting such plan shall--
</DELETED>
<DELETED> ``(A) promptly notify the Secretary of the
approval or the suspension or termination of the
approval of such plan by an institutional review
committee;</DELETED>
<DELETED> ``(B) in the case of an in vitro clinical
test made available to investigators for clinical
testing, obtain agreements from each investigator that
any testing of the in vitro clinical test involving
human subjects will be under such investigator's
supervision and in accordance with paragraph (C) and
submit such agreements to the Secretary that ensure--
</DELETED>
<DELETED> ``(i) all investigators will
comply with this section, regulations
promulgated or revised under this section, and
applicable human subjects regulations;
and</DELETED>
<DELETED> ``(ii) the investigator will
ensure that--</DELETED>
<DELETED> ``(I) informed consent is
obtained as required under part 50 of
title 21, Code of Federal Regulations
(or any successor regulations), amended
to apply to in vitro clinical tests;
and</DELETED>
<DELETED> ``(II) the requirements
for institutional review board under
part 56 of title 21 of the Code of
Federal Regulations (or successor
regulations), amended to apply to in
vitro clinical tests, are met;
and</DELETED>
<DELETED> ``(C) assure that informed consent will be
obtained from each human subject (or the representative
of such subject) of proposed clinical testing involving
such in vitro clinical test, except where, subject to
such other conditions as the Secretary may prescribe--
</DELETED>
<DELETED> ``(i) the proposed clinical
testing poses no more than minimal risk to the
human subject and includes appropriate
safeguards to protect the rights, safety, and
welfare of the human subject; or</DELETED>
<DELETED> ``(ii) the investigator conducting
or supervising the clinical testing determines
in writing that there exists a life-threatening
situation involving the human subject of such
testing which necessitates the use of such in
vitro clinical test and it is not feasible to
obtain informed consent from the subject and
there is not sufficient time to obtain such
consent from a representative of such
subject.</DELETED>
<DELETED> ``(7) Concurred by licensed physician.--The
determination required by paragraph (6)(C)(ii) shall be
concurred in writing by a licensed physician who is not
involved in the testing of the human subject with respect to
which such determination is made unless immediate use of the
device is required to save the life of the human subject of
such testing and there is not sufficient time to obtain such
concurrence.</DELETED>
<DELETED> ``(d) Review of Applications.--</DELETED>
<DELETED> ``(1) In general.--The Secretary may issue an
order approving an investigation as proposed, approving it with
conditions or modifications, or disapproving it.</DELETED>
<DELETED> ``(2) Failure to act.--Unless the Secretary, not
later than the date that is 30 calendar days after the date of
the submission of an application for an investigational use
exemption that meets the requirements of subsection (c), issues
an order under paragraph (1) and notifies the sponsor
submitting the application, the application shall be treated as
approved as of such date without further action by the
Secretary.</DELETED>
<DELETED> ``(3) Denial.--The Secretary may deny an
investigational use application submitted under this subsection
if the Secretary determines that the investigation with respect
to which the application is submitted does not conform to the
requirements of subsection (c). A notification of such denial
submitted to the sponsor with respect to such a request shall
contain the order of disapproval and a complete statement of
the reasons for the Secretary's denial of the
application.</DELETED>
<DELETED> ``(e) Withdrawal of Exemption.--</DELETED>
<DELETED> ``(1) In general.--The Secretary may, by
administrative order, withdraw an exemption approved under this
section with respect to an in vitro clinical test, including an
exemption treated as approved based on the Secretary's failure
to act pursuant to subsection (d)(2), if the Secretary
determines that an investigation conducted under such an
exemption does not meet the applicable conditions under
subsection (c)(3) for such exemption.</DELETED>
<DELETED> ``(2) Opportunity to be heard.--</DELETED>
<DELETED> ``(A) In general.--Subject to subparagraph
(B), an order withdrawing an investigational use
exemption granted under this section may be issued only
after the Secretary provides the sponsor of the in
vitro clinical test with an opportunity for an informal
hearing.</DELETED>
<DELETED> ``(B) Exception.--An order referred to in
subparagraph (A) with respect to an investigational use
exemption granted under this section may be issued on a
preliminary basis before the provision of an
opportunity for an informal hearing if the Secretary
determines that the continuation of testing under the
exemption will result in an unreasonable risk to the
public health. The Secretary will provide an
opportunity for an informal hearing promptly following
any preliminary action under this
subparagraph.</DELETED>
<DELETED> ``(f) Changes.--</DELETED>
<DELETED> ``(1) In general.--The regulations promulgated
under subsection (b) shall provide, with respect to an in vitro
clinical test for which an exemption under this subsection is
in effect, procedures and conditions under which changes are
allowed without the additional approval of an application for
an exemption or submission of a supplement to such an
application. Such regulations shall provide that such a change
may be made if--</DELETED>
<DELETED> ``(A) the sponsor determines, on the basis
of credible information (as defined in regulations)
that the change meets the conditions specified in
paragraph (2); and</DELETED>
<DELETED> ``(B) the sponsor submits to the
Secretary, not later than 5 calendar days after making
the change, a notice of the change.</DELETED>
<DELETED> ``(2) Conditions.--The conditions specified in
this paragraph are that--</DELETED>
<DELETED> ``(A) in the case of developmental changes
to an in vitro clinical test, including manufacturing
changes, the changes--</DELETED>
<DELETED> ``(i) do not constitute a
significant change in design or in basic
principles of operation;</DELETED>
<DELETED> ``(ii) do not affect the rights,
safety, or welfare of the human subjects
involved in the investigation; and</DELETED>
<DELETED> ``(iii) are made in response to
information gathered during the course of an
investigation; and</DELETED>
<DELETED> ``(B) in the case of changes to clinical
protocols applicable to the test, the changes do not
affect--</DELETED>
<DELETED> ``(i) the validity of data or
information resulting from the completion of an
approved clinical protocol, or the relationship
of likely patient risk to benefit relied upon
to approve a product;</DELETED>
<DELETED> ``(ii) the scientific soundness of
a plan submitted under subsection (c)(3);
or</DELETED>
<DELETED> ``(iii) the rights, safety, or
welfare of the human subjects involved in the
investigation.</DELETED>
<DELETED> ``(g) Clinical Hold.--</DELETED>
<DELETED> ``(1) In general.--At any time, the Secretary may
impose a clinical hold with respect to an investigation of an
in vitro clinical test if the Secretary makes a written
determination described in paragraph (2). The Secretary shall,
in imposing such clinical hold, specify the basis for the
clinical hold, including the specific information available to
the Secretary which served as the basis for such clinical hold,
and confirm such determination in writing. The applicant may
immediately appeal any such determination pursuant to section
587P.</DELETED>
<DELETED> ``(2) Determination.--</DELETED>
<DELETED> ``(A) In general.--For purposes of
paragraph (1), a determination described in this
subparagraph with respect to a clinical hold is a
determination that, based on credible evidence, the in
vitro clinical test involved represents an unreasonable
risk to the safety of the persons who are the subjects
of the clinical investigation, taking into account the
qualifications of the clinical investigators,
information about the in vitro clinical test, the
design of the clinical investigation, the condition for
which the in vitro clinical test is to be investigated,
and the health status of the subjects
involved.</DELETED>
<DELETED> ``(B) Removal of clinical hold.--Any
written request to the Secretary from the sponsor of an
investigation that a clinical hold be removed shall
receive a decision, in writing and specifying the
reasons therefor, within 30 days after receipt of such
request. Any such request shall include sufficient
information to support the removal of such clinical
hold.</DELETED>
<DELETED>``SEC. 587T. COMPREHENSIVE TEST INFORMATION SYSTEM.</DELETED>
<DELETED> ``(a) Establishment.--Not later than 2 years after the
date of enactment of the VALID Act of 2022, the Secretary shall make
available a comprehensive test information system for in vitro clinical
tests that is designed to--</DELETED>
<DELETED> ``(1) provide a transparent interface on the
website of the Food and Drug Administration for stakeholders,
to the extent permitted by applicable law, which may include
access to the--</DELETED>
<DELETED> ``(A) regulatory pathway designation
information for each in vitro clinical test or tests
with the same indications for use;</DELETED>
<DELETED> ``(B) registration and listing information
provided by developers under section 587J, including
the use of a link for labels;</DELETED>
<DELETED> ``(C) adverse event reports submitted
under section 587M, as appropriate;</DELETED>
<DELETED> ``(D) reports of corrections and removals
submitted under section 587N; and</DELETED>
<DELETED> ``(E) other information pertaining to an
in vitro clinical test or tests with the same
indications for use, as the Secretary determines
appropriate; and</DELETED>
<DELETED> ``(2) provide a secure portal for electronic
submission, including applications and other in vitro clinical
test submissions, registration and listing information, and
adverse event reports, which provides protections from
unauthorized disclosure of information, including of--
</DELETED>
<DELETED> ``(A) trade secret or commercial
confidential information; and</DELETED>
<DELETED> ``(B) national security, countermeasure,
or other information restricted from disclosure
pursuant to any provision of law.</DELETED>
<DELETED> ``(b) Submission Function.--The comprehensive test
information system shall serve as the electronic submission service for
test developers submitting information for applications under sections
587B and 587D.</DELETED>
<DELETED>``SEC. 587U. PREEMPTION.</DELETED>
<DELETED> ``(a) In General.--Except as provided in subsection (b),
no State, Tribal, or local government (or political subdivision
thereof) may establish or continue in effect any requirement that--
</DELETED>
<DELETED> ``(1) is different from, or in addition to, any
requirement applicable to an in vitro clinical test under this
Act; or</DELETED>
<DELETED> ``(2) with respect to the analytical validity,
clinical validity, or safety for individuals who come into
contact with such an in vitro clinical test under this
Act.</DELETED>
<DELETED> ``(b) Exceptions.--Subsection (a) shall not be construed
to affect the authority of a State, Tribal, or local government to do
any of the following:</DELETED>
<DELETED> ``(1) To license laboratory personnel, health care
practitioners, or health care facilities or to regulate any
aspect of a health care practitioner-patient
relationship.</DELETED>
<DELETED> ``(2) To enforce laws of general applicability,
such as zoning laws, environmental laws, labor laws, and
general business laws.</DELETED>
<DELETED> ``(3) To authorize laboratories to develop and
perform an in vitro clinical test, pursuant to a law enacted by
a State prior to January 1, 2022, as long as such law does not
impose requirements that are different from any requirement
applicable to an in vitro clinical test under this Act. If a
State has enacted such a law, the Secretary may exempt such
laboratories in that State from compliance with this
subchapter.</DELETED>
<DELETED> ``(c) Clarification.--Nothing in this section shall be
construed to--</DELETED>
<DELETED> ``(1) modify any action for damages or the
liability of any person under the law of any State;
or</DELETED>
<DELETED> ``(2) shift liability to health care practitioners
or other users.</DELETED>
<DELETED>``SEC. 587V. ADULTERATION.</DELETED>
<DELETED> ``An in vitro clinical test shall be deemed to be
adulterated:</DELETED>
<DELETED> ``(1) If it consists in whole or in part of any
filthy, putrid, or decomposed substance.</DELETED>
<DELETED> ``(2) If it has been developed, prepared, packed,
or held under insanitary conditions whereby it may have been
contaminated with filth, or whereby it may have been rendered
injurious to health.</DELETED>
<DELETED> ``(3) If its container or package is composed, in
whole or in part, of any poisonous or deleterious substance
which may render the contents injurious to health.</DELETED>
<DELETED> ``(4) If it bears or contains, for purposes of
coloring only, a color additive which is unsafe within the
meaning of section 721(a).</DELETED>
<DELETED> ``(5) If its analytical or clinical validity, as
applicable, or with respect to a specimen receptacle, its
safety, falls below that which it purports or is represented to
possess.</DELETED>
<DELETED> ``(6) If it is required to be, declared to be,
purports to be, or is represented as being, in conformity with
any performance standard established or recognized under
section 587R and is not in conformity with such
standard.</DELETED>
<DELETED> ``(7) If it is required to be in compliance with
mitigating measures established under section 587E and is not
in conformity with such mitigating measures.</DELETED>
<DELETED> ``(8) If it fails to have in effect an approved
premarket application under section 587B unless such in vitro
clinical test is in compliance with the requirements for--
</DELETED>
<DELETED> ``(A) offering without an approved
premarket application under section 587D;</DELETED>
<DELETED> ``(B) an exemption from premarket approval
under section 587C or 587G; or</DELETED>
<DELETED> ``(C) investigational use pursuant to
section 587S.</DELETED>
<DELETED> ``(9) If it is not in conformity with any
condition established under section 587B or 587D.</DELETED>
<DELETED> ``(10) If it purports to be an in vitro clinical
test subject to an exemption under section 587C and it fails to
meet or maintain any criteria, condition, or requirement of
such exemption.</DELETED>
<DELETED> ``(11) If it has been granted an exemption under
section 587S for investigational use, and the person granted
such exemption or any investigator who uses such in vitro
clinical test under such exemption fails to comply with a
requirement prescribed by or under such section.</DELETED>
<DELETED> ``(12) If it fails to meet the quality
requirements prescribed in or established under section 587K
(as applicable), or the methods used in, or facilities or
controls used for, its development, packaging, storage, or
installation are not in conformity with applicable requirements
established under such section.</DELETED>
<DELETED> ``(13) If it has been developed, processed,
packaged, or held in any establishment, factory, or warehouse
and the owner, operator or agent of such establishment,
factory, or warehouse delays, denies, or limits an inspection,
or refuses to permit entry or inspection.</DELETED>
<DELETED> ``(14) If it is not in compliance with any
restriction required under section 587O.</DELETED>
<DELETED>``SEC. 587W. MISBRANDING.</DELETED>
<DELETED> ``An in vitro clinical test shall be deemed to be
misbranded:</DELETED>
<DELETED> ``(1) If its labeling is false or misleading in
any particular.</DELETED>
<DELETED> ``(2) If in a package form unless it bears a label
containing--</DELETED>
<DELETED> ``(A) the name and place of business of
the test developer, packager, or distributor;
and</DELETED>
<DELETED> ``(B) an accurate statement of the
quantity of contents in terms of weight, measure, or
numerical count with respect to small packages, unless
an exemption is granted by the Secretary by the
issuance of guidance.</DELETED>
<DELETED> ``(3) If any word, statement, or other information
required by or under authority of this Act to appear on the
label or labeling, including a test report, is not prominently
placed thereon with such conspicuousness (as compared with
other words, statements, designs, or devices, in the labeling)
and in such terms as to render it likely to be read and
understood by the ordinary individual under customary
conditions of purchase and use.</DELETED>
<DELETED> ``(4) Unless its labeling bears adequate
directions for use and such adequate warnings as are necessary
for the protection of users of the in vitro clinical test and
recipients of the results of such in vitro clinical test,
including patients, consumers, donors, and related health care
professionals. Required labeling for in vitro clinical tests
intended for use in health care facilities, blood
establishments, or by a health care professional may be made
available solely by electronic means, provided that the
labeling complies with all applicable requirements of law, and
that the test developer, or distributor affords such users the
opportunity to request the labeling in paper form, and after
such request, promptly provides the requested information
without additional cost.</DELETED>
<DELETED> ``(5) If there is a reasonable probability that it
could cause serious or adverse health consequences or death,
including through absence, delay, or discontinuation in
diagnosis or treatment, when used in the manner prescribed,
recommended, or suggested in the labeling thereof.</DELETED>
<DELETED> ``(6) If it was developed, sterilized, packaged,
repackaged, relabeled, installed, or imported in an
establishment not duly registered under section 587J or it was
not included in a listing under section 587J, in accordance
with timely reporting requirements under this
subchapter.</DELETED>
<DELETED> ``(7) In the case of any in vitro clinical test
subject to restrictions under section 587O, (1) if its
advertising is false or misleading in any particular, (2) if it
is offered for clinical use, sold, distributed, or used in
violation of such restrictions, or (3) unless the test
developer or distributor includes in all advertisements and
other descriptive printed matter that such person issues or
causes to be issued, a brief statement of the indications for
use of the in vitro clinical test and relevant warnings,
precautions, side effects, and contraindications. This
subsection shall not be applicable to any printed matter that
the Secretary determines to be labeling as defined in section
201(m).</DELETED>
<DELETED> ``(8) If it is subject to a mitigating measure
established under section 587E and does not bear such labeling
as may be prescribed in such mitigating measure.</DELETED>
<DELETED> ``(9) If it is subject to a standard established
under section 587R and it does not bear such labeling as may be
prescribed in such standard.</DELETED>
<DELETED> ``(10) Unless it bears such labeling as may be
required by or established under an applicable labeling
requirement under this Act.</DELETED>
<DELETED> ``(11) If there was a failure to comply with any
requirement prescribed in or under section 587D, 587J, 587K,
587L, 587M, 587N, 587X, 587Y, 587Z, or to provide any report,
material, or other information required with respect to in
vitro clinical tests under this subchapter.</DELETED>
<DELETED>``SEC. 587X. POSTMARKET SURVEILLANCE.</DELETED>
<DELETED> ``(a) In General.--</DELETED>
<DELETED> ``(1) In general.--In addition to other applicable
requirements under this Act, the Secretary may issue an order
requiring a developer of a high-risk or moderate-risk in vitro
clinical test to conduct postmarket surveillance of such in
vitro clinical test, if the failure of the in vitro clinical
test is reasonably likely to result in serious adverse health
consequences or death from use of such in vitro clinical
test.</DELETED>
<DELETED> ``(2) Consideration.--In determining whether to
require a developer to conduct postmarket surveillance of an in
vitro clinical test, the Secretary shall take into
consideration the benefits and risks for the patient and the
least burdensome principles under section 587B(j).</DELETED>
<DELETED> ``(b) Surveillance Approval.--</DELETED>
<DELETED> ``(1) In general.--Each developer required to
conduct surveillance of an in vitro clinical test shall submit,
within 30 days of receiving an order from the Secretary, a plan
for the required surveillance. The Secretary, within 60 days of
the receipt of such plan, shall determine if the person
designated to conduct the surveillance has the appropriate
qualifications and experience to undertake such surveillance
and if the plan will result in useful data that can reveal
unforeseen adverse events or other information necessary to
protect the health of patients or the public.</DELETED>
<DELETED> ``(2) Timeline.--The developer shall commence
surveillance under this section not later than 15 months after
the day on which the Secretary orders such postmarket
surveillance, unless the Secretary determines more time is
needed to commence surveillance.</DELETED>
<DELETED> ``(3) Prospective surveillance.--The Secretary may
order a prospective surveillance period of up to 3 years. Any
determination by the Secretary that a longer period is
necessary shall be made by mutual agreement between the
Secretary and the developer or, if no agreement can be reached,
upon the completion of a dispute resolution process pursuant to
section 562.</DELETED>
<DELETED>``SEC. 587Y. ELECTRONIC FORMAT FOR SUBMISSIONS.</DELETED>
<DELETED> ``(a) In General.--All submissions to the Food and Drug
Administration with respect to an in vitro clinical test, unless
otherwise agreed to by the Secretary, shall--</DELETED>
<DELETED> ``(1) be made electronically; and</DELETED>
<DELETED> ``(2) with respect to the information required
under sections 587B and 587D, utilize the system described in
section 587U.</DELETED>
<DELETED> ``(b) Electronic Format.--Beginning on such date as the
Secretary specifies in final guidance issued under subsection (c),
submissions for in vitro clinical tests, including recommendations
submitted by accredited and recognized persons under section 587Q, and
any appeals of action taken by the Secretary with respect to such
submissions, shall be submitted in such electronic format as specified
by the Secretary in such guidance.</DELETED>
<DELETED> ``(c) Guidance.--The Secretary shall issue guidance
implementing this section. Such guidance may--</DELETED>
<DELETED> ``(1) provide standards for the electronic
submission required under subsection (a) or the submission in
electronic format required under subsection (b);</DELETED>
<DELETED> ``(2) set forth criteria for waivers of, or
exemptions from, the requirements of subsection (a) or (b);
and</DELETED>
<DELETED> ``(3) provide any other information for the
efficient implementation and enforcement of this
section.</DELETED>
<DELETED>``SEC. 587Z. POSTMARKET REMEDIES.</DELETED>
<DELETED> ``(a) Safety Notice.--</DELETED>
<DELETED> ``(1) In general.--If the Secretary determines
that an in vitro clinical test presents an unreasonable risk of
substantial harm to the public health, and notification under
this subsection is necessary to eliminate the unreasonable risk
of such harm and no more practicable means is available under
the provisions of this Act (other than this section) to
eliminate the risk, the Secretary may issue such order as may
be necessary to ensure that adequate safety notice is provided
in an appropriate form, by the persons and means best suited
under the circumstances, to all health care professionals who
prescribe, order, or use the in vitro clinical test and to any
other person (including developers, importers, distributors,
retailers, and users) who should properly receive such
notice.</DELETED>
<DELETED> ``(2) Notice to individuals.--An order under this
subsection shall require that the individuals subject to the
risk with respect to which the order is to be issued be
included in the persons to be notified of the risk unless the
Secretary determines that notice to such individuals would
present a greater danger to the health of such individuals than
no such notice. If the Secretary makes such a determination
with respect to such individuals, the order shall require the
health care professionals who prescribed, ordered, or used the
in vitro clinical test provide notification to the individuals
for whom the health professionals prescribed, ordered, or used
such test, of the risk presented by such in vitro clinical test
and of any action which may be taken by or on behalf of such
individuals to eliminate or reduce such risk. Before issuing an
order under this subsection, the Secretary shall consult with
the persons required to give notice under the order.</DELETED>
<DELETED> ``(b) Repair, Replacement, or Refund.--</DELETED>
<DELETED> ``(1) Determination after an informal hearing.--
</DELETED>
<DELETED> ``(A) In general.--If, after affording
opportunity for an informal hearing, the Secretary
determines that--</DELETED>
<DELETED> ``(i) an in vitro clinical test
presents an unreasonable risk of substantial
harm to the public health;</DELETED>
<DELETED> ``(ii) there are reasonable
grounds to believe that the in vitro clinical
test was not properly developed or manufactured
considering the state of the art as it existed
at the time of its development;</DELETED>
<DELETED> ``(iii) there are reasonable
grounds to believe that the unreasonable risk
was not caused by failure of a person other
than a developer, importer, distributor, or
retailer of the in vitro clinical test to
exercise due care in the installation,
maintenance, repair, or use of the in vitro
clinical test; and</DELETED>
<DELETED> ``(iv) the notice authorized by
subsection (a) would not by itself be
sufficient to eliminate the unreasonable risk
and action described in paragraph (2) of this
subsection is necessary to eliminate such
risk,</DELETED>
<DELETED>the Secretary may order the developer,
importer, or any distributor of such in vitro clinical
test, or any combination of such persons, to submit to
him within a reasonable time a plan for taking one or
more of the actions described in paragraph (2). An
order issued under the preceding sentence which is
directed to more than one person shall specify which
person may decide which action shall be taken under
such plan and the person specified shall be the person
who the Secretary determines bears the principal,
ultimate financial responsibility for action taken
under the plan unless the Secretary cannot determine
who bears such responsibility or the Secretary
determines that the protection of the public health
requires that such decision be made by a person
(including a health professional or user of the in
vitro clinical test) other than the person the
Secretary determines bears such
responsibility.</DELETED>
<DELETED> ``(B) Secretary approval of plan.--The
Secretary shall approve a plan submitted pursuant to an
order issued under subparagraph (A) unless the
Secretary determines (after affording opportunity for
an informal hearing) that the action or actions to be
taken under the plan or the manner in which such action
or actions are to be taken under the plan will not
assure that the unreasonable risk with respect to which
such order was issued will be eliminated. If the
Secretary disapproves a plan, the Secretary shall order
a revised plan to be submitted within a reasonable
time. If the Secretary determines (after affording
opportunity for an informal hearing) that the revised
plan is unsatisfactory or if no revised plan or no
initial plan has been submitted to the Secretary within
the prescribed time, the Secretary shall (i) prescribe
a plan to be carried out by the person or persons to
whom the order issued under subparagraph (A) was
directed, or (ii) after affording an opportunity for an
informal hearing, by order prescribe a plan to be
carried out by a person who is a developer, importer,
distributor, or retailer of the in vitro clinical test
with respect to which the order was issued but to whom
the order under subparagraph (A) was not
directed.</DELETED>
<DELETED> ``(2) Actions on a plan.--The actions which may be
taken under a plan submitted under an order issued under
paragraph (1)(A) are as follows:</DELETED>
<DELETED> ``(A) To repair the in vitro clinical test
so that it does not present the unreasonable risk of
substantial harm with respect to which the order under
paragraph (1)(A) was issued.</DELETED>
<DELETED> ``(B) To replace the in vitro clinical
test with a like or equivalent test which is in
conformity with all applicable requirements of this
Act.</DELETED>
<DELETED> ``(C) To refund the purchase price of the
in vitro clinical test (less a reasonable allowance for
use if such in vitro clinical test has been in the
possession of the user for one year or more at the time
of notice ordered under subsection (a), or at the time
the user receives actual notice of the unreasonable
risk with respect to which the order was issued under
paragraph (1)(A), whichever occurs first).</DELETED>
<DELETED> ``(3) No charge.--No charge shall be made to any
person (other than a developer, importer, distributor or
retailer) for using a remedy described in paragraph (2) and
provided under an order issued under paragraph (1), and the
person subject to the order shall reimburse each person (other
than a developer, manufacturer, importer, distributor, or
retailer) who is entitled to such a remedy for any reasonable
and foreseeable expenses actually incurred by such person in
using such remedy.</DELETED>
<DELETED> ``(c) Reimbursement.--An order issued under subsection
(b)(1)(A) with respect to an in vitro clinical test may require any
person who is a developer, importer, distributor, or retailer of the in
vitro clinical test to reimburse any other person who is a developer,
importer, distributor, or retailer of such in vitro clinical test for
such other person's expenses actually incurred in connection with
carrying out the order if the Secretary determines such reimbursement
is required for the protection of the public health. Any such
requirement shall not affect any rights or obligations under any
contract to which the person receiving reimbursement or the person
making such reimbursement is a party.</DELETED>
<DELETED> ``(d) Recall Authority.--</DELETED>
<DELETED> ``(1) In general.--If the Secretary finds that
there is a reasonable probability that an in vitro clinical
test approved under section 587B or offered under a technology
certification order under section 587D would cause serious,
adverse health consequences or death, including by the absence,
significant delay, or discontinuation of appropriate medical
treatment, the Secretary shall issue an order requiring the
appropriate person (including the developers, importers,
distributors, or retailers of the in vitro clinical test)--
</DELETED>
<DELETED> ``(A) to immediately cease distribution of
such in vitro clinical test; and</DELETED>
<DELETED> ``(B) to immediately notify health
professionals and applicable in vitro clinical test
user facilities of the order and to instruct such
professionals and facilities to cease use of such in
vitro clinical test.</DELETED>
<DELETED> ``(2) Informal hearing.--The order issued under
paragraph (1)(A), shall provide the person subject to the order
with an opportunity for an informal hearing, to be held not
later than 10 calendar days after the date of the issuance of
the order, on the actions required by the order and on whether
the order should be amended to require a recall of such in
vitro clinical test. If, after providing an opportunity for
such a hearing, the Secretary determines that inadequate
grounds exist to support the actions required by the order, the
Secretary shall vacate the order.</DELETED>
<DELETED> ``(3) Amended order.--</DELETED>
<DELETED> ``(A) In general.--If, after providing an
opportunity for an informal hearing under paragraph
(2), the Secretary determines that the order should be
amended to include a recall of the in vitro clinical
test with respect to which the order was issued, the
Secretary shall, except as provided in subparagraph
(B), amend the order to require a recall. The Secretary
shall specify a timetable in which the recall will
occur and shall require periodic reports describing the
progress of the recall.</DELETED>
<DELETED> ``(B) Requirements.--An amended order
under subparagraph (A)--</DELETED>
<DELETED> ``(i) shall not include recall of
the in vitro clinical test from
individuals;</DELETED>
<DELETED> ``(ii) shall not include recall of
an in vitro clinical test from test user
facilities if the Secretary determines that the
risk of recalling such in vitro clinical test
from the facilities presents a greater health
risk than the health risk of not recalling the
in vitro clinical test from use; and</DELETED>
<DELETED> ``(iii) shall provide for notice
to individuals subject to the risks associated
with the use of such in vitro clinical test. In
providing the notice required by this clause,
the Secretary may use the assistance of health
professionals who prescribed, ordered, or used
such an in vitro clinical test for
individuals.</DELETED>
<DELETED> ``(4) Clarification.--The remedy provided by this
subsection shall be in addition to remedies provided by
subsections (a), (b), and (c).</DELETED>
<DELETED>``SEC. 587AA. APPLICABILITY.</DELETED>
<DELETED> ``(a) In General.--An in vitro clinical test shall be
subject to the requirements of this subchapter, except as otherwise
provided in this subchapter.</DELETED>
<DELETED> ``(b) Interstate Commerce.--Any in vitro clinical test
that is offered, including by making available for clinical use in the
United States is deemed to be an act that constitutes introduction into
interstate commerce for purposes of enforcing the requirements of this
Act.</DELETED>
<DELETED> ``(c) Least Burdensome Requirements.--</DELETED>
<DELETED> ``(1) In general.--In carrying out this
subchapter, the Secretary shall consider the least burdensome
means necessary to meet the applicable standard, and other
regulatory requirements, as determined by the
Secretary.</DELETED>
<DELETED> ``(2) Necessary defined.--For purposes of
paragraph (1) and paragraph (3), the term `necessary' means the
minimum required information that would support a determination
by the Secretary that the application meet the applicable
standard or regulatory requirement, as determined by the
Secretary.</DELETED>
<DELETED> ``(d) Service of Orders.--Orders of the Secretary under
this section with respect to applications under subsection (a) or (b)
of section 587B or supplements under subsection (f) of such section
shall be served--</DELETED>
<DELETED> ``(1) in person by any officer or employee of the
Department of Health and Human Services designated by the
Secretary; or</DELETED>
<DELETED> ``(2) by mailing the order by registered mail or
certified mail or electronic equivalent addressed to the
applicant at the last known address in the records of the
Secretary.</DELETED>
<DELETED> ``(e) Laboratories and Blood and Tissue Establishments.--
</DELETED>
<DELETED> ``(1) Relation to laboratory certification
pursuant to section 353 of the public health service act.--
Nothing in this subchapter shall be construed to modify the
authority of the Secretary with respect to laboratories or
clinical laboratories under section 353 of the Public Health
Service Act.</DELETED>
<DELETED> ``(2) Avoiding duplication.--In implementing this
subchapter, the Secretary shall avoid issuing or enforcing
regulations or guidance that are duplicative of regulations or
guidance under section 353 of the Public Health Service
Act.</DELETED>
<DELETED> ``(3) Blood and tissue.--Nothing in this
subchapter shall be construed to modify the authority of the
Secretary with respect to laboratories, establishments, or
other facilities to the extent they are engaged in the
propagation, manufacture, or preparation, including filling,
labeling, packaging, and storage, of blood, blood components,
human cells, tissues, or tissue products pursuant to any
requirements under this Act or section 351 or 361 of the Public
Health Service Act.</DELETED>
<DELETED> ``(f) Not Combination Product.--A product constituted of a
device and an in vitro clinical test is not a combination product and
shall be regulated as a device.</DELETED>
<DELETED> ``(g) Practice of Medicine.--Nothing in this subchapter
shall be construed to limit or interfere with the authority of a health
care practitioner to prescribe or administer any lawfully offered in
vitro clinical test for any condition or disease within a legitimate
health care practitioner-patient relationship pursuant to applicable
Federal or State law.</DELETED>
<DELETED> ``(h) Rules of Construction.--</DELETED>
<DELETED> ``(1) Sale, distribution, labeling.--Nothing in
this paragraph shall be construed to limit the authority of the
Secretary to establish or enforce restrictions on the sale,
distribution, or labeling of an in vitro clinical test under
this Act.</DELETED>
<DELETED> ``(2) Promotion of unapproved uses.--Nothing in
this paragraph shall be construed to alter any prohibition on
the promotion of unapproved uses of legally marketed in vitro
clinical tests.</DELETED>
<DELETED>``SEC. 587BB. JUDICIAL REVIEW.</DELETED>
<DELETED> ``(a) In General.--Not later than 30 days after an order
issued pursuant to sections 587B or 587D, any person adversely affected
by such order may file a petition with the United States Court of
Appeals for the District of Columbia or for the circuit wherein such
person resides or has a principal place of business for judicial review
of such order, in accordance with the procedure set forth in section
517(a).</DELETED>
<DELETED> ``(b) Application of Provisions.--Subsections (a) through
(e) of section 517 shall apply with respect to a petition under
subsection (a) of this section in the same manner such subsections
apply to a petition under section 517. Subsection (f) of section 517
shall apply to an order issued under section 587B or 587D.''.</DELETED>
<DELETED>SEC. 824. ENFORCEMENT AND OTHER PROVISIONS.</DELETED>
<DELETED> (a) Prohibited Acts.--Section 301 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 331), as amended by section 811, is
further amended--</DELETED>
<DELETED> (1) in paragraphs (a), (b), (c), (g), (h), (k),
(q), (r), and (y), by inserting ``in vitro clinical test,''
after ``device,'' each place it appears;</DELETED>
<DELETED> (2) in paragraph (g), by inserting after
``misbranded'', ``, and the development within any Territory of
any in vitro clinical test that is adulterated or
misbranded'';</DELETED>
<DELETED> (3) in paragraph (y), by inserting ``or 587Q''
after ``section 523'' each place it appears;</DELETED>
<DELETED> (4) in paragraph (ff), by striking ``or device''
and inserting ``, device, or in vitro clinical test'';
and</DELETED>
<DELETED> (5) by adding at the end, the following:</DELETED>
<DELETED> ``(jjj)(1) Forging, counterfeiting, simulating, or falsely
representing, or without proper authority using any mark, stamp, tag,
label, or other identification upon any in vitro clinical test or
container, packaging, or labeling thereof so as to render such in vitro
clinical test a counterfeit in vitro clinical test.</DELETED>
<DELETED> ``(2) Making, selling, disposing of, or keeping in
possession, control, or custody, or concealing any punch, die, plate,
stone, or other thing designed to print, imprint, or reproduce the
trademark, trade name, or other identifying mark or imprint of another
or any likeness of any of the foregoing upon any in vitro clinical test
or container, packaging, or labeling thereof so as to render such in
vitro clinical test a counterfeit in vitro clinical test.</DELETED>
<DELETED> ``(3) The doing of any act which causes an in vitro
clinical test to be a counterfeit in vitro clinical test, or the sale
or dispensing, or the holding for sale or dispensing, of a counterfeit
in vitro clinical test.</DELETED>
<DELETED> ``(kkk)(1) The introduction or delivery for introduction
into interstate commerce of an in vitro clinical test in violation of
section 587B(a).</DELETED>
<DELETED> ``(2) The making of a false, fraudulent, or deceptive
statement about an in vitro clinical test that is exempt from premarket
review under section 587C.</DELETED>
<DELETED> ``(3) The failure to maintain complete and accurate
documentation for an exemption as required under section 587C or the
failure to provide labeling required under section 587L.</DELETED>
<DELETED> ``(4) With respect to an in vitro clinical test, the
submission of any report or listing under this Act that is false or
misleading in any material respect.</DELETED>
<DELETED> ``(5) The failure to comply with a condition of approval,
or restriction required under an approved application under section
587B; the failure to perform a risk analysis required by section 587B;
the failure to submit an annual update required under section
587J(c)(2)(B); or the failure to complete postmarket surveillance as
required under section 587X.</DELETED>
<DELETED> ``(6) The failure to comply with applicable requirements
to submit an application or report under section 587D(e).</DELETED>
<DELETED> ``(7) The failure to comply with applicable mitigating
measures established under section 587E or to submit, maintain, or make
available the documentation required under section 587E(b); or the
failure to comply with applicable performance standards established
under section 587R.</DELETED>
<DELETED> ``(8) The failure to register in accordance with section
587J, the failure to provide information required under section
587J(b), or the failure to maintain or submit information required
under section 587J(c).</DELETED>
<DELETED> ``(9) The failure to comply with requirements under
section 587M or 587N, the failure to comply with a restriction required
under section 587O, or the failure to comply with labeling and
advertising requirements under section 587O(b).</DELETED>
<DELETED> ``(10) The failure to comply with the requirements of
section 587Q.</DELETED>
<DELETED> ``(11) The failure to comply with any requirement of
section 587S; the failure to furnish any notification, information,
material, or report required under section 587S; or the failure to
comply with an order issued under section 587S.</DELETED>
<DELETED> ``(12) The failure to furnish information requested by the
Secretary under 587G(d)(2).''.</DELETED>
<DELETED> (b) Penalties.--Section 303 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 333) is amended--</DELETED>
<DELETED> (1) in subsection (b)(8), by inserting ``or
counterfeit in vitro clinical test'' after ``counterfeit
drug'';</DELETED>
<DELETED> (2) in subsection (c)--</DELETED>
<DELETED> (A) by striking ``; or (5)'' and inserting
``; (5)''; and</DELETED>
<DELETED> (B) by inserting before the period at the
end the following: ``; or (6) for having violated
section 301(fff)(2) if such person acted in good faith
and had no reason to believe that use of the punch,
die, plate, stone, or other thing involved would result
in an in vitro clinical test being a counterfeit in
vitro clinical test, or for having violated section
301(fff)(3) if the person doing the act or causing it
to be done acted in good faith and had no reason to
believe that the in vitro clinical test was a
counterfeit in vitro clinical test''; and</DELETED>
<DELETED> (3) in subsection (f)(1)--</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) by inserting ``or in vitro
clinical tests'' after ``which relates to
devices'';</DELETED>
<DELETED> (ii) by inserting ``or section
587Q(a)(2)'' after ``section 704(g)'';
and</DELETED>
<DELETED> (iii) by inserting ``or in vitro
clinical tests, as applicable'' before the
period at the end of the second sentence;
and</DELETED>
<DELETED> (B) in subparagraph (B)(i), by striking
``or 520(f)'' and inserting ``, 520(f), 587K, or
587M,''.</DELETED>
<DELETED> (c) Seizure.--Section 304 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 334) is amended--</DELETED>
<DELETED> (1) in subsection (a)(2)--</DELETED>
<DELETED> (A) by striking ``, and (E)'' and
inserting ``, (E)''; and</DELETED>
<DELETED> (B) by inserting before the period at the
end the following: ``, and (F) Any in vitro clinical
test that is a counterfeit in vitro clinical test, (G)
Any container, packaging, or labeling of a counterfeit
in vitro clinical test, and (H) Any punch, die, plate,
stone, labeling, container, or other thing used or
designed for use in making a counterfeit in vitro
clinical test'';</DELETED>
<DELETED> (2) in subsection (d)(1), by inserting ``in vitro
clinical test,'' after ``device,''; and</DELETED>
<DELETED> (3) in subsection (g)--</DELETED>
<DELETED> (A) in paragraph (1), by inserting ``, in
vitro clinical test,'' after ``device'' each place it
appears; and</DELETED>
<DELETED> (B) in paragraph (2)--</DELETED>
<DELETED> (i) in subparagraph (A), by
inserting ``, in vitro clinical test,'' after
``device''; and</DELETED>
<DELETED> (ii) in subparagraph (B), by
inserting ``or in vitro clinical test'' after
``device'' each place it appears.</DELETED>
<DELETED> (d) Debarment, Temporary Denial of Approval, and
Suspension.--Section 306 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 335a) is amended by adding at the end the
following:</DELETED>
<DELETED> ``(n) In Vitro Clinical Tests; Mandatory Debarment
Regarding Third-Party Inspections and Reviews.--</DELETED>
<DELETED> ``(1) In general.--If the Secretary finds that a
person has been convicted of a felony for a violation of
section 301(gg) or 301(jjj)(1), the Secretary shall debar such
person from being accredited under section 587Q and from
carrying out activities under an agreement described in section
803(b).</DELETED>
<DELETED> ``(2) Debarment period.--The Secretary shall debar
a person under paragraph (1) for the following
periods:</DELETED>
<DELETED> ``(A) The period of debarment of a person
(other than an individual) shall not be less than 1
year or more than 10 years, but if an act leading to a
subsequent debarment under such paragraph occurs within
10 years after such person has been debarred under such
paragraph, the period of debarment shall be
permanent.</DELETED>
<DELETED> ``(B) The debarment of an individual shall
be permanent.</DELETED>
<DELETED> ``(3) Termination of debarment; judicial review;
other matters.--Subsections (c)(3), (d), (e), (i), (j), and
(l)(1) apply with respect to a person (other than an
individual) or an individual who is debarred under paragraph
(1) to the same extent and in the same manner as such
subsections apply with respect to a person who is debarred
under subsection (a)(1), or an individual who is debarred under
subsection (a)(2), respectively.''.</DELETED>
<DELETED> (e) Expanded Access to Unapproved Therapies and
Diagnostics.--Section 561 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 360bbb) is amended--</DELETED>
<DELETED> (1) in subsections (a) through (d)--</DELETED>
<DELETED> (A) by striking ``or investigational
devices'' each place it appears and inserting ``,
investigational devices, or investigational in vitro
clinical tests''; and</DELETED>
<DELETED> (B) by striking ``or investigational
device'' each place it appears (other than the second
such place in paragraph (3)(A)) of subsection (c)) and
inserting ``, investigational device, or
investigational in vitro clinical test'';</DELETED>
<DELETED> (2) in subsection (b)(4) by striking ``or 520(g)''
and inserting ``, 520(g), or 587S'' each place it
appears;</DELETED>
<DELETED> (3) in subsection (c)--</DELETED>
<DELETED> (A) by amending the subsection heading to
read: ``Treatment Investigational New Drug
Applications, Treatment Investigational Device
Exemptions, and Treatment Investigational in Vitro
Clinical Test Exemptions.--'';</DELETED>
<DELETED> (B) in paragraph (3)(A), by striking ``or
investigational device exemption in effect under
section 520(g)'' and inserting ``, investigational
device exemption in effect under section 520(g), or
investigational in vitro clinical test exemption under
section 587S'';</DELETED>
<DELETED> (C) by striking ``or treatment
investigational device exemption'' each place it
appears and inserting ``, treatment investigational
device exemption, or treatment investigational in vitro
clinical test exemption'';</DELETED>
<DELETED> (D) in paragraph (5), by striking ``or
520(g)'' and inserting ``, 520(g), or 587S'';
and</DELETED>
<DELETED> (E) in the matter following paragraph (7)
by striking ``or 520(g)'' each place it appears and
inserting ``, 520(g) or 587S''; and</DELETED>
<DELETED> (4) by amending subsection (e) to read as
follows:</DELETED>
<DELETED> ``(e) Definitions.--In this section, the terms
`investigational drug', `investigational device', `investigational in
vitro clinical test', `treatment investigational new drug application',
`treatment investigational device exemption', and `treatment
investigational in vitro clinical test exemption' shall have the
meanings given the terms in regulations prescribed by the
Secretary.''.</DELETED>
<DELETED> (f) Optimizing Global Clinical Trials.--Section 569A(b) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-8a(b)) is
amended by inserting ``an in vitro clinical test, as defined in
subsection (ss) of such section,'' before ``or a biological
product''.</DELETED>
<DELETED> (g) Patient Participation in Medical Product Discussion.--
The heading of subsection (a) of section 569C of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 360bbb-8c) is amended by striking
``Drugs and Devices'' and inserting ``Drugs, Devices, and In Vitro
Clinical Tests''.</DELETED>
<DELETED> (h) Regulations and Hearings.--Section 701(h)(1)(C)(ii) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 371(h)(1)(C)(ii))
is amended by inserting ``and in vitro clinical tests'' after
``devices''.</DELETED>
<DELETED> (i) Records.--Section 703 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 373) is amended--</DELETED>
<DELETED> (1) by inserting ``in vitro clinical tests'' after
``devices'' each place such term appears; and</DELETED>
<DELETED> (2) by inserting ``in vitro clinical test'' after
``device'' each place such term appears.</DELETED>
<DELETED> (j) Factory Inspection.--Section 704 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 374) (other than subsection (g)) is
amended--</DELETED>
<DELETED> (1) by striking ``drugs or devices'' each place it
appears and inserting ``drugs, devices, or in vitro clinical
tests'';</DELETED>
<DELETED> (2) in subsection (a)(1), in the fourth sentence,
by striking ``or chapter IX'' and inserting ``section 587S,
section 587M, section 587N, or chapter IX'';</DELETED>
<DELETED> (3) after making the amendments in paragraphs (1)
and (2), by inserting ``in vitro clinical tests,'' after
``devices,'' each place it appears;</DELETED>
<DELETED> (4) in subsection (a)(2)(B)--</DELETED>
<DELETED> (A) by inserting ``or in vitro clinical
tests'' after ``prescribe or use devices'';
and</DELETED>
<DELETED> (B) by inserting ``or in vitro clinical
tests'' after ``process devices'';</DELETED>
<DELETED> (5) by inserting ``in vitro clinical test,'' after
``device,'' each place it appears;</DELETED>
<DELETED> (6) in subsection (e), by inserting ``, or section
587M, 587N, or 587S,'' after ``section 519 or
520(g)'';</DELETED>
<DELETED> (7) in subsection (f)(3)--</DELETED>
<DELETED> (A) in subparagraph (A), by striking
``or'' at the end;</DELETED>
<DELETED> (B) in subparagraph (B), by striking the
period at the end and inserting ``; or''; and</DELETED>
<DELETED> (C) after subparagraph (B), by inserting
the following:</DELETED>
<DELETED> ``(C) is accredited under section 587Q.'';
and</DELETED>
<DELETED> (8) by adding at the end the following:</DELETED>
<DELETED> ``(i) For purposes of this section, the term
`establishment' includes a laboratory performing an in vitro clinical
test.''.</DELETED>
<DELETED> (k) Publicity.--Section 705(b) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 375(b)) is amended by inserting ``in vitro
clinical tests,'' after ``devices,''.</DELETED>
<DELETED> (l) Presumption.--Section 709 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379a) is amended by inserting ``in vitro
clinical test,'' after ``device,''.</DELETED>
<DELETED> (m) Listing and Certification of Color Additives for
Foods, Drugs, and Cosmetics.--Section 721(a) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379e(a)) is amended--</DELETED>
<DELETED> (1) in the matter preceding paragraph (1), by
inserting ``or in vitro clinical tests'' after ``or devices'';
and</DELETED>
<DELETED> (2) in the flush text following paragraph (2)--
</DELETED>
<DELETED> (A) by inserting ``or an in vitro clinical
test'' after ``a device''; and</DELETED>
<DELETED> (B) by inserting ``or in vitro clinical
tests'' after ``devices''.</DELETED>
<DELETED> (n) Imports and Exports.--Section 801 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 381) is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) by inserting ``in vitro clinical
tests,'' after ``devices,'' each place it appears;
and</DELETED>
<DELETED> (B) by inserting ``in the case of an in
vitro clinical test, the test does not conform to the
applicable requirements of section 587K, or'' after
``requirements of section 520(f), or'';</DELETED>
<DELETED> (2) in subsection (d)(3)--</DELETED>
<DELETED> (A) in subparagraph (A)--</DELETED>
<DELETED> (i) in the matter preceding clause
(i), by inserting ``and no component of an in
vitro clinical test or other article of in
vitro clinical test that requires further
processing,'' after ``health-related
purposes'';</DELETED>
<DELETED> (ii) in clause (i), by striking
``drug or device'' and inserting ``drug,
device, or in vitro clinical test'';
and</DELETED>
<DELETED> (iii) in clause (i)(I), by
inserting ``in vitro clinical test,'' after
``device,''; and</DELETED>
<DELETED> (B) in subparagraph (B), by inserting ``in
vitro clinical test,'' after ``device,'';</DELETED>
<DELETED> (3) in subsection (e)(1), by inserting ``in vitro
clinical test,'' after ``device,''; and</DELETED>
<DELETED> (4) in subsection (o)--</DELETED>
<DELETED> (A) by inserting ``or in vitro clinical
test'' after ``device''; and</DELETED>
<DELETED> (B) by inserting ``section 587J of each
foreign establishment'' after ``section 510(i) of each
establishment''.</DELETED>
<DELETED> (o) Office of International Relations.--Section 803 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 383) is amended--
</DELETED>
<DELETED> (1) in subsection (b)--</DELETED>
<DELETED> (A) in the matter preceding paragraph (1),
by inserting ``and in vitro clinical tests'' after
``devices''; and</DELETED>
<DELETED> (B) in paragraph (1), by inserting
``quality requirements established under section 587K;
and'' at the end; and</DELETED>
<DELETED> (2) in subsection (c)--</DELETED>
<DELETED> (A) in paragraph (2), by inserting ``in
vitro clinical tests,'' after ``devices,'';
and</DELETED>
<DELETED> (B) in paragraph (4), by inserting ``or in
vitro clinical tests'' after ``devices''.</DELETED>
<DELETED> (p) Recognition of Foreign Government Inspections.--
Section 809(a)(1) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 384e(a)(1)) is amended by inserting ``, or of foreign
establishments registered under section 587J'' after
``510(h)''.</DELETED>
<DELETED> (q) Food and Drug Administration.--Section 1003(b)(2) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 393(b)(2)) is
amended--</DELETED>
<DELETED> (1) in subparagraph (D), by striking ``and'' at
the end;</DELETED>
<DELETED> (2) in subparagraph (E), by striking the semicolon
at the end and inserting ``; and''; and</DELETED>
<DELETED> (3) by adding at the end the following:</DELETED>
<DELETED> ``(F) in vitro clinical tests are
analytically and clinically valid;''.</DELETED>
<DELETED> (r) Office of Women's Health.--Section 1011(b) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 399b(b)) is amended--
</DELETED>
<DELETED> (1) in paragraph (1), by inserting ``in vitro
clinical tests,'' after ``devices,''; and</DELETED>
<DELETED> (2) in paragraph (4), by striking ``and device
manufacturers'' and inserting ``device manufacturers, and in
vitro clinical test developers,''.</DELETED>
<DELETED> (s) Countermeasure Provisions of the Public Health Service
Act.--Title III of the Public Health Service Act is amended--</DELETED>
<DELETED> (1) in section 319F-1(a)(2)(A) (42 U.S.C. 247d-
6a(a)(2)(A))--</DELETED>
<DELETED> (A) in the matter preceding clause (i)--
</DELETED>
<DELETED> (i) by striking ``or device'' and
inserting ``device''; and</DELETED>
<DELETED> (ii) by inserting ``or an in vitro
clinical tests (as that term is defined in
section 201(ss) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 321(ss))),'' after
``Act (21 U.S.C. 321(h))),''; and</DELETED>
<DELETED> (B) in each of clauses (ii) and (iii), by
striking ``or device'' and inserting ``device, or in
vitro clinical test'';</DELETED>
<DELETED> (2) in section 319F-2(c)(1)(B) (42 U.S.C. 247d-
6b(c)(1)(B))--</DELETED>
<DELETED> (A) by striking ``or device'' and
inserting ``device''; and</DELETED>
<DELETED> (B) by inserting ``, or an in vitro
clinical test (as that term is defined in section
201(ss) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 321(ss)))'' after ``Act (21 U.S.C. 321(h))),'';
and</DELETED>
<DELETED> (3) in section 319F-3(i)(7) (42 U.S.C. 247d-
6d(i)(7))--</DELETED>
<DELETED> (A) in the matter preceding subparagraph
(A)--</DELETED>
<DELETED> (i) by striking ``or device'' and
inserting ``device''; and</DELETED>
<DELETED> (ii) by inserting ``or an in vitro
clinical tests (as that term is defined in
section 201(ss) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 321(ss))),'' after
``Act (21 U.S.C. 321(h))'';</DELETED>
<DELETED> (B) in subparagraph (A)--</DELETED>
<DELETED> (i) by moving the margin of clause
(iii) 2 ems to the left; and</DELETED>
<DELETED> (ii) in clause (iii), by striking
``or device'' and inserting ``device, or in
vitro clinical test''; and</DELETED>
<DELETED> (C) in subparagraph (B)--</DELETED>
<DELETED> (i) in clause (i), by inserting
``or the subject of a technology certification
order'' after ``approved or cleared'';
and</DELETED>
<DELETED> (ii) in clause (ii), by striking
``or 520(g)'' and inserting ``, 520(g), or
587S''.</DELETED>
<DELETED>SEC. 825. TRANSITION.</DELETED>
<DELETED> (a) Implementation.--</DELETED>
<DELETED> (1) Effective date.--</DELETED>
<DELETED> (A) In general.--Except as otherwise
provided in this section, the amendments made by this
Act shall take effect on October 1, 2027 (in this
section and in subchapter J of chapter V of the Federal
Food, Drug, and Cosmetic Act, as added by this Act,
referred to in this section as the ``effective date of
this Act'').</DELETED>
<DELETED> (B) Exceptions.--</DELETED>
<DELETED> (i) In general.--The Secretary of
Health and Human Services (in this section
referred to as the ``Secretary'') may take the
actions described in paragraph (3), and may
expend such funds as the Secretary determines
necessary to ensure an orderly transition,
including prior to the effect date of this
Act.</DELETED>
<DELETED> (ii) Implementation of certain
provisions.--The Secretary may implement
sections 587J and 587U of the Federal Food,
Drug, and Cosmetic Act (as added by section 3)
beginning on October 1, 2024, and such sections
may take effect not earlier than October 1,
2027, to the extent and for the purposes
indicated in such sections. In the case of a
developer who, between October 1, 2024, and the
effective date of this Act specified in
subparagraph (A), registers under such section
587K with respect to an article that is an in
vitro clinical test, such developer shall not
be required to register with respect to such
article under section 510 of such Act (21
U.S.C. 360).</DELETED>
<DELETED> (2) Actions.--The Secretary--</DELETED>
<DELETED> (A) shall--</DELETED>
<DELETED> (i) within 1 year of the date of
enactment of this Act, hold the public meetings
described in section 587D(c) of the Federal
Food, Drug, and Cosmetic Act (as added by
section 3);</DELETED>
<DELETED> (ii) within 3 years of the date of
enactment of this Act, promulgate final
regulations required under the amendments made
by this Act; and</DELETED>
<DELETED> (iii) within 30 months of the date
of enactment of this Act, issue final guidance
on applicability requirements under amendments
made by this Act; and</DELETED>
<DELETED> (B) may take additional actions after the
date of enactment that the Secretary determines
necessary to ensure an orderly transition, which may
not take effect until after the effective date,
including--</DELETED>
<DELETED> (i) establishment of mitigating
measures for an in vitro clinical test or
category of in vitro clinical tests;
and</DELETED>
<DELETED> (ii) establishment of the
comprehensive test information system under
section 587T.</DELETED>
<DELETED> (3) Applicability of guidance and regulations.--
Notwithstanding the date on which guidance or regulations are
issued under paragraph (3) and section 587K, no guidance or
regulations issued pursuant to the amendments made by this Act
shall be implemented or take effect until the effective date of
this Act, as described in paragraph (1), except as otherwise
specified in this Act (including the amendments made by this
Act).</DELETED>
<DELETED> (b) Application of Authorities to in Vitro Clinical Tests
Under Review on the Effective Date of This Act.--For any in vitro
clinical test, as defined in section 201(ss) of the Federal Food, Drug,
and Cosmetic Act, as added by section 822, for which a submission for
approval under section 515 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 360e), clearance under section 510(k) of such Act (21 U.S.C.
360(k)), authorization under section 513(f)(2) of such Act (21 U.S.C.
360c(f)(2)), or licensure under section 351 of the Public Health
Service Act (42 U.S.C. 262) is pending on the effective date of this
Act, including transitional in vitro clinical tests as described in
subsection (c), the Secretary may review and take action on such
submission after the effective date of this Act according to the
statutory provision under which such submission was
submitted.</DELETED>
<DELETED> (c) Application of Authorities to Transitional In Vitro
Clinical Tests.--</DELETED>
<DELETED> (1) Definition.--For purposes of this section, the
term ``transitional in vitro clinical test'' means an in vitro
clinical test, as defined in section 201(ss) of the Federal
Food, Drug, and Cosmetic Act, as added by this Act, that--
</DELETED>
<DELETED> (A) is first offered for clinical use
during the period beginning on the date of enactment of
this Act and ending on the effective date of this
Act;</DELETED>
<DELETED> (B) is developed by a clinical laboratory
certified by the Secretary under section 353 of the
Public Health Service Act (42 U.S.C. 263a) that meets
the requirements for performing high-complexity testing
and performed--</DELETED>
<DELETED> (i) in the same clinical
laboratory in which the test was developed and
for which a certification is still in effect
under such section 353 that meets the
requirements to perform tests of high
complexity;</DELETED>
<DELETED> (ii) by another laboratory for
which a certificate is in effect under such
section 353 that meets the requirements to
perform tests of high complexity, is within the
same corporate organization, and has common
ownership by the same parent corporation as the
laboratory in which the test was developed;
or</DELETED>
<DELETED> (iii) in the case of a test that
was developed by the Centers for Disease
Control and Prevention or another laboratory a
public health laboratory network coordinated or
managed by the Centers for Disease Control and
Prevention, by a clinical laboratory for which
a certificate is in effect under section 353 of
such Act that meets the requirements to perform
tests of high complexity, and that is within a
public health laboratory network coordinated or
managed by the Centers for Disease Control and
Prevention; and</DELETED>
<DELETED> (C) when first offered, is not approved
under section 515 of the Federal Food, Drug, and
Cosmetic Act, cleared under section 510(k) of such Act,
authorized under section 513(f)(2) of such Act, subject
to a humanitarian device exemption under section 520(m)
of such Act (21 U.S.C. 360j(m)), subject to an
exemption for investigation use under section 520(g) of
such Act (21 U.S.C. 360j(g)), authorized under section
564 of such Act (21 U.S.C. 360bbb-3), or licensed under
section 351 of the Public Health Service Act (42 U.S.C.
262).</DELETED>
<DELETED> (2) Premarket review or technology
certification.--A transitional in vitro clinical test that is
the subject of an application for premarket review under
section 587B of the Federal Food, Drug, and Cosmetic Act or
technology certification application under section 587D of such
Act, as added by this Act, may continue to be offered, sold, or
distributed until completion of the Secretary's review of the
premarket application or technology certification application,
if such application is submitted no later than 90 days after
the effective date of this Act.</DELETED>
<DELETED> (3) Tests approved by new york state.--
Notwithstanding paragraph (2), a transitional in vitro clinical
test that has been approved by the New York State Department of
Health may continue to be offered, sold, or distributed after
the effective date if--</DELETED>
<DELETED> (A) starting on the effective date of this
Act, the in vitro clinical test complies with the
requirements of subchapter J of the Federal Food, Drug,
and Cosmetic Act, as added by this Act, except for
sections 587B and design control provisions of section
587K;</DELETED>
<DELETED> (B) each test report template for the test
bears a statement of adequate prominence that reads as
follows: ``This in vitro clinical test was developed
and first introduced prior to the effective date of the
VALID Act of 2022. This test was approved by the New
York State Department of Health, but the test has not
been reviewed by the Food and Drug
Administration.'';</DELETED>
<DELETED> (C) a premarket application under section
587B or technology certification application under
section 587D is submitted no later than--</DELETED>
<DELETED> (i) 5 years after the effective
date of this Act, if the in vitro clinical test
is approved by the New York State Department of
Health as a genetic testing molecular test, a
microbiology molecular test, an oncology
molecular test, or any other type of molecular
test; or</DELETED>
<DELETED> (ii) 2 years after the effective
date of this Act, if the in vitro clinical test
is approved by the New York State Department of
Health as a type of test not described in
clause (i); and</DELETED>
<DELETED> (D) a test in compliance with this
paragraph (3) may continue to be offered, sold, or
distributed until the completion of the Secretary's
review of the premarket application or technology
certification application referenced in subparagraph
(C).</DELETED>
<DELETED> (d) Conversion.--</DELETED>
<DELETED> (1) Deemed premarket approval.--Beginning on the
effective date of this Act--</DELETED>
<DELETED> (A) any in vitro clinical test (as defined
in section 201(ss) of the Federal Food, Drug, and
Cosmetic Act, as added by section 822) with a premarket
approval under section 515 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 360e) or a licensure under
section 351 of the Public Health Service Act (42 U.S.C.
262) is deemed to be approved pursuant to an
application under section 587B(c) of the Federal Food,
Drug, and Cosmetic Act, as added by this Act;
and</DELETED>
<DELETED> (B) any in vitro clinical test (as so
defined) that was cleared under section 510(k) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360(k))
or authorized under section 513(f)(2) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360c(f)(2)) is
deemed to be approved pursuant to an application under
section 587B(d) of the Federal Food, Drug, and Cosmetic
Act, as added by this Act.</DELETED>
<DELETED> (2) Deemed investigational use exemption.--Any in
vitro clinical test (as defined in section 201(ss) of the
Federal Food, Drug, and Cosmetic Act, as added by section 822)
that has an investigational device exemption in effect under
section 520(g) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 360j(g)) is deemed to have an investigational use
exemption in effect under section 587S of such Act, as added by
this Act, beginning on the effective date of this
Act.</DELETED>
<DELETED> (3) Deemed humanitarian device exemption.--Any in
vitro clinical test (as defined in section 201(ss) of the
Federal Food, Drug, and Cosmetic Act, as added by section 822)
that has an approved humanitarian device exemption under
section 520(m) of such Act is deemed to have a humanitarian
test exemption under section 587A(g) of such Act, as added by
this Act, beginning on the effective date of this
Act.</DELETED>
<DELETED> (4) Deemed designated breakthrough.--Any in vitro
clinical test (as defined in section 201(gg) of the Federal
Food, Drug, and Cosmetic Act, as added by section 822) that has
received a breakthrough device designation under section
515B(e)(1)(D) of such Act (21 U.S.C. 360e-3(e)(1)(D)) is deemed
to have a breakthrough in vitro clinical test designation under
section 587C of such Act, as added by this Act, beginning on
the effective date of this Act.</DELETED>
<DELETED> (5) Deemed request for informal feedback.--With
regard to any in vitro clinical test that is the subject of a
pre-submission request described in the guidance, ``Requests
for Feedback and Meetings for Medical Device Submissions: The
Q-Submission Program'', issued by the Food and Drug
Administration on January 6, 2021, such request is deemed to
constitute a request for informal feedback under section 587F
of the Federal Food, Drug, and Cosmetic Act, as added by
section 823, beginning on the effective date of this
Act.</DELETED>
<DELETED> (e) Previously Classified Devices.--Notwithstanding
section 587 of the Federal Food, Drug, and Cosmetic Act, as added by
section 823, for purposes of subchapter J of chapter V of such Act, as
added by section 823, the following apply:</DELETED>
<DELETED> (1) In the case of an in vitro clinical test type
that has been classified by the Secretary as a class I device
pursuant to section 513 of such Act (21 U.S.C. 360c), such in
vitro clinical test shall be low-risk, unless the in vitro
clinical test is a test described in section 510(l) or the test
is redesignated by the Secretary pursuant to section 587F of
such Act.</DELETED>
<DELETED> (2) In the case of an in vitro clinical test type
that has been classified by the Secretary as a class II device
pursuant to section 513 of such Act (21 U.S.C. 360c), such in
vitro clinical test shall be moderate-risk, unless inaccurate
results from the test would be immediately life threatening or
the test is redesignated by the Secretary pursuant to section
587F of such Act.</DELETED>
<DELETED> (3) In the case of an in vitro clinical test type
that is a class III device pursuant to section 513 of such Act
(21 U.S.C. 360c), such in vitro clinical test shall be high-
risk, unless redesignated by the Secretary pursuant to section
587F of such Act.</DELETED>
<DELETED>SEC. 826. EMERGENCY USE AUTHORIZATION.</DELETED>
<DELETED> (a) In General.--Section 564 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 360bbb-3) is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) in paragraphs (1) and (4)(C), by
inserting ``in vitro clinical test,'' before ``or
biological product'' each place such term appears;
and</DELETED>
<DELETED> (B) in paragraph (2)(A), by striking ``or
515'' and inserting ``515, or 587B'';</DELETED>
<DELETED> (2) in subsection (e)--</DELETED>
<DELETED> (A) in paragraph (3)--</DELETED>
<DELETED> (i) in subparagraph (B), by
striking ``and'' at the end;</DELETED>
<DELETED> (ii) in subparagraph (C), by
striking the period and inserting ``; and'';
and</DELETED>
<DELETED> (iii) by adding at the end the
following:</DELETED>
<DELETED> ``(D) quality requirements (with respect
to in vitro clinical tests) under section 587K.'';
and</DELETED>
<DELETED> (B) in paragraph (4)--</DELETED>
<DELETED> (i) in subparagraph (A), by
striking ``; or'' and inserting a
semicolon;</DELETED>
<DELETED> (ii) in subparagraph (B), by
striking the period and inserting ``; or'';
and</DELETED>
<DELETED> (iii) by adding at the end the
following:</DELETED>
<DELETED> ``(C) with respect to in vitro clinical
tests, requirements applicable to restricted in vitro
clinical tests pursuant to section 587O.'';</DELETED>
<DELETED> (3) in subsection (m)--</DELETED>
<DELETED> (A) in the subsection heading, by striking
``Laboratory Tests Associated With Devices'' inserting
``in Vitro Clinical Tests'' after ``Devices'';
and</DELETED>
<DELETED> (B) in paragraph (1)--</DELETED>
<DELETED> (i) by striking ``to a device''
and inserting ``to an in vitro clinical test'';
and</DELETED>
<DELETED> (ii) by striking ``such device''
and inserting ``such in vitro clinical
test''.</DELETED>
<DELETED> (b) Emergency Use of Medical Products.--Section 564A(a)(2)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-3a(a)(2))
is amended by inserting ``in vitro clinical test,'' after
``device,''.</DELETED>
<DELETED> (c) Products Held for Emergency Use.--Section 564B(2) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-3b(2)) is
amended--</DELETED>
<DELETED> (1) in subparagraph (A), by striking ``or 515''
and inserting ``515, or 587B''; and</DELETED>
<DELETED> (2) in subparagraph (B), by striking ``or 520''
and inserting 520, or 587S.</DELETED>
<DELETED>SEC. 827. ANTIMICROBIAL SUSCEPTIBILITY TESTS.</DELETED>
<DELETED> Section 511A of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 360a-2) is amended--</DELETED>
<DELETED> (1) in subsection (a)(1)(C)--</DELETED>
<DELETED> (A) by striking ``clear under section
510(k), classify under section 513(f)(2), or approve
under section 515'' and inserting ``approve under
section 587B, exempt from premarket review under
section 587C, or grant a technology certification order
under section 587D''; and</DELETED>
<DELETED> (B) by striking ``testing devices'' and
inserting ``in vitro clinical tests'';</DELETED>
<DELETED> (2) in subsection (c)(5), by striking ``drug or
device'' each place it appears and inserting ``drug, device, or
in vitro clinical test'';</DELETED>
<DELETED> (3) in subsection (e)--</DELETED>
<DELETED> (A) in the heading, by striking ``Testing
Devices'' and inserting ``In Vitro Clinical
Tests'';</DELETED>
<DELETED> (B) in paragraph (1)--</DELETED>
<DELETED> (i) by striking ``510, 513, and
515,'' and inserting ``587B, and
587D'';</DELETED>
<DELETED> (ii) by striking ``antimicrobial
susceptibility testing device'' and inserting
``antimicrobial susceptibility in vitro
clinical test''; and</DELETED>
<DELETED> (iii) by striking ``such device''
and inserting ``such in vitro clinical test'';
and</DELETED>
<DELETED> (C) in paragraph (2)--</DELETED>
<DELETED> (i) in the heading, by striking
``testing devices'' and inserting ``in vitro
clinical tests'';</DELETED>
<DELETED> (ii) in subparagraphs (A) and (B)
(other than clause (iii) of such subparagraph
(B)), by striking ``device'' each place it
appears and inserting ``in vitro clinical
test'';</DELETED>
<DELETED> (iii) in subparagraph (B)(iii), by
striking ``a device'' and inserting ``an in
vitro clinical test''; and</DELETED>
<DELETED> (iv) by amending subparagraph (C)
to read as follows:</DELETED>
<DELETED> ``(C) The antimicrobial susceptibility in
vitro clinical test meets all other requirements to be
approved under section 587B, exempted from premarket
review under section 587C, or offered under a
technology certification order under section
587D.'';</DELETED>
<DELETED> (4) in subsection (f), by amending paragraph (1)
to read as follows:</DELETED>
<DELETED> ``(1) The term `antimicrobial susceptibility in
vitro clinical test' means an in vitro clinical test that
utilizes susceptibility test interpretive criteria to determine
and report the in vitro susceptibility of certain
microorganisms to a drug (or drugs).''; and</DELETED>
<DELETED> (5) in subsection (g)(2)--</DELETED>
<DELETED> (A) by amending the matter preceding
subparagraph (A) to read as follows:</DELETED>
<DELETED> ``(2) with respect to approving an application
under section 587B or granting a technology certification order
under section 587D--''; and</DELETED>
<DELETED> (B) in subparagraph (A)--</DELETED>
<DELETED> (i) by striking ``device'' and
inserting ``in vitro clinical test'';
and</DELETED>
<DELETED> (ii) by striking ``antimicrobial
susceptibility testing device'' and inserting
``antimicrobial susceptibility in vitro
clinical test''.</DELETED>
<DELETED>SEC. 828. COMBINATION PRODUCTS.</DELETED>
<DELETED> (a) In General.--Section 503(g) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 353(g)) is amended--</DELETED>
<DELETED> (1) in paragraph (1)--</DELETED>
<DELETED> (A) in subparagraph (A), by striking ``or
biological product'' and inserting ``in vitro clinical
test, or biological product (except for a product
constituted of a device and an in vitro clinical
test)'';</DELETED>
<DELETED> (B) in subparagraph (B), by adding at the
end the following: ``For purposes of this Act, a
product that constitutes a combination of a drug and an
in vitro clinical test is not a combination product
within the meaning of this subsection.''; and</DELETED>
<DELETED> (C) in subparagraph (D)(ii)--</DELETED>
<DELETED> (i) by inserting ``or in vitro
clinical test'' after ``device''; and</DELETED>
<DELETED> (ii) by inserting ``and in vitro
clinical tests'' before ``shall'';</DELETED>
<DELETED> (2) in paragraph (3), by striking ``safety and
effectiveness or substantial equivalence'' and inserting
``safety and effectiveness, substantial equivalence, or
analytical validity and clinical validity'' before ``for the
approved constituent part'';</DELETED>
<DELETED> (3) in paragraph (4)--</DELETED>
<DELETED> (A) in subparagraph (A), by striking ``or
513(f)(2) (submitted in accordance with paragraph
(5))'' and inserting ``513(f)(2) (submitted in
accordance with paragraph (5)), 587B, or 587D, or an
exempt test under section 587C, as applicable'';
and</DELETED>
<DELETED> (B) in subparagraph (B), by inserting ``,
587B, or 587D'' after ``section 515'';</DELETED>
<DELETED> (4) in paragraph (5)(A), by striking ``or 510(k)''
and inserting ``, 510(k), 587B, or 587D'';</DELETED>
<DELETED> (5) in paragraph (7), by striking ``or substantial
equivalence'' and inserting ``, substantial equivalence, or
analytical validity and clinical validity'';</DELETED>
<DELETED> (6) in paragraph (8), by adding at the end the
following:</DELETED>
<DELETED> ``(I) This paragraph shall not apply to a
product constituted of a device and an in vitro
clinical test.''; and</DELETED>
<DELETED> (7) in paragraph (9)--</DELETED>
<DELETED> (A) in subparagraph (C)(i), by striking
``or 520(g)'' and inserting ``520(g), 587B, or 587D'';
and</DELETED>
<DELETED> (B) in subparagraph (D), by striking ``or
520'' and inserting ``520, 587B, or 587D''.</DELETED>
<DELETED> (b) Classification of Products.--Section 563 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-2) is amended by
adding at the end the following:</DELETED>
<DELETED> ``(d) Exemption.--This section shall not apply to a
product constituted of a device and an in vitro clinical
test.''.</DELETED>
<DELETED>SEC. 829. RESOURCES.</DELETED>
<DELETED> (a) Findings.--Congress finds that the fees authorized by
this section will be dedicated to meeting the goals identified in the
letters from the Secretary of Health and Human Services to the
Committee on Health, Education, Labor, and Pensions of the Senate and
the Committee on Energy and Commerce of the House of Representatives,
as set forth in the Congressional Record.</DELETED>
<DELETED> (b) Authorization of Appropriations.--For purposes of
funding implementation of subchapter J of title V of the Federal Food,
Drug, and Cosmetic Act, as added by this Act, including undertaking
activities for the development of regulations and guidances, hiring of
necessary staff, and the development of technology systems to implement
this subchapter in a timely, effective, and efficient manner there is
authorized to be appropriated $480,000,000.</DELETED>
<DELETED> (c) Establishment of User Fee Program.--</DELETED>
<DELETED> (1) Development of user fees for in vitro clinical
tests.--</DELETED>
<DELETED> (A) In general.--Beginning not later than
October 1, 2021, the Secretary of Health and Human
Services (in this section referred to as the
``Secretary'') shall develop recommendations to present
to Congress with respect to the goals, and plans for
meeting the goals, for the process for the review of in
vitro clinical test submissions and applications under
subchapter J of chapter V of the Federal Food, Drug,
and Cosmetic Act, as added by this Act, for the first 5
fiscal years after fiscal year 2022. In developing such
recommendations, the Secretary shall consult with--
</DELETED>
<DELETED> (i) the Committee on Health,
Education, Labor, and Pensions of the
Senate;</DELETED>
<DELETED> (ii) the Committee on Energy and
Commerce of the House of
Representatives;</DELETED>
<DELETED> (iii) scientific and academic
experts;</DELETED>
<DELETED> (iv) health care
professionals;</DELETED>
<DELETED> (v) representatives of patient and
consumer advocacy groups; and</DELETED>
<DELETED> (vi) the regulated
industry.</DELETED>
<DELETED> (B) Prior public input.--Prior to
beginning negotiations with the regulated industry on
the authorization of such subchapter J, the Secretary
shall--</DELETED>
<DELETED> (i) publish a notice in the
Federal Register requesting public input on the
authorization of user fees;</DELETED>
<DELETED> (ii) hold a public meeting at
which the public may present its views on the
authorization, including specific suggestions
for the recommendations submitted under
subparagraph (E);</DELETED>
<DELETED> (iii) provide a period of 30 days
after the public meeting to obtain written
comments from the public suggesting changes to
such subchapter J; and</DELETED>
<DELETED> (iv) publish any comments received
under clause (iii) on the website of the Food
and Drug Administration.</DELETED>
<DELETED> (C) Periodic consultation.--Not less
frequently than once every month during negotiations
with the regulated industry, the Secretary shall hold
discussions with representatives of patient and
consumer advocacy groups to continue discussions of the
authorization under such subchapter J and to solicit
suggestions to be included in the recommendations
transmitted to Congress under subparagraph
(E).</DELETED>
<DELETED> (D) Public review of recommendations.--
After negotiations with the regulated industry, the
Secretary shall--</DELETED>
<DELETED> (i) present the recommendations
developed under subparagraph (A) to the
Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on
Energy and Commerce of the House of
Representatives;</DELETED>
<DELETED> (ii) publish such recommendations
in the Federal Register;</DELETED>
<DELETED> (iii) provide for a period of 30
days for the public to provide written comments
on such recommendations;</DELETED>
<DELETED> (iv) hold a meeting at which the
public may present its views on such
recommendations; and</DELETED>
<DELETED> (v) after consideration of such
public views and comments, revise such
recommendations as necessary.</DELETED>
<DELETED> (E) Transmittal of recommendations.--
</DELETED>
<DELETED> (i) In general.--Not later than
January 15, 2027, the Secretary shall transmit
to Congress the revised recommendations under
subparagraph (A), a summary of the views and
comments received under such subparagraph, and
any changes made to the recommendations in
response to such views and comments.</DELETED>
<DELETED> (ii) Recommendation
requirements.--The recommendations transmitted
under this subparagraph shall--</DELETED>
<DELETED> (I) include the number of
full-time equivalent employees per
fiscal year that are agreed to be hired
to carry out the goals included in such
recommendations for each year of the 5-
year period;</DELETED>
<DELETED> (II) provide that the
amount of operating reserve balance in
the user fee program established under
this section is not more than the
equivalent of 10 weeks of operating
reserve;</DELETED>
<DELETED> (III) require the
development of a strategic plan for any
surplus within the operating reserve
account above the 10-week operating
reserve within 2 years of the
establishment of the program;</DELETED>
<DELETED> (IV) include an operating
reserve adjustment such that, if the
Secretary has an operating reserve
balance in excess of 10 weeks of such
operating reserves, the Secretary shall
decrease such fee revenue and fees to
provide for not more than 10 weeks of
such operating reserves;</DELETED>
<DELETED> (V) if an adjustment is
made as described in subclause (IV),
provide the rationale for the amount of
the decrease in fee revenue and fees
shall be contained in the Federal
Register; and</DELETED>
<DELETED> (VI) provide that the fees
assessed and collected for the full-
time equivalent employees at the Center
for Devices and Radiological Health,
with respect to which the majority of
time reporting data indicates are
dedicated to the process for the review
of in vitro clinical test submissions
and applications under paragraph (5),
are not supported by the funds
authorized to be collected and assessed
under section 738 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C.
379j).</DELETED>
<DELETED> (F) Publication of recommendations.--The
Secretary shall publish on the website of the Food and
Drug Administration the revised recommendations under
subparagraph (A), a summary of the views and comments
received under subparagraphs (B) through (D), and any
changes made to the recommendations originally proposed
by the Secretary in response to such views and
comments.</DELETED>
<DELETED> (G) Minutes of negotiation meetings.--
</DELETED>
<DELETED> (i) Public availability.--The
Secretary shall make publicly available, on the
website of the Food and Drug Administration,
minutes of all negotiation meetings conducted
under this subsection between the Food and Drug
Administration and the regulated industry not
later than 30 days after such
meeting.</DELETED>
<DELETED> (ii) Content.--The minutes
described under clause (i) shall summarize any
substantive proposal made by any party to the
negotiations, any significant controversies or
differences of opinion during the negotiations,
and the resolution of any such controversy or
difference of opinion.</DELETED>
<DELETED> (2) Establishment of user fee program.--Effective
on October 1, 2027, provided that the Secretary transmits the
recommendations under paragraph (1)(E), the Secretary is
authorized to collect user fees relating to the review of in
vitro clinical test submissions and applications under
subchapter J of chapter V of the Federal Food, Drug, and
Cosmetic Act, as added by this Act. Fees under such program
shall be assessed and collected only if the requirements under
paragraph (4) are met.</DELETED>
<DELETED> (3) Audit.--</DELETED>
<DELETED> (A) In general.--On the date that is 2
years after first receiving a user fee applicable to
submission of an in vitro clinical test application
submitted under subchapter J of chapter V of the
Federal Food, Drug, and Cosmetic Act, as added by this
Act, and on a biennial basis thereafter, the Secretary
shall perform an audit of the costs of reviewing such
applications under such subchapter J. Such an audit
shall compare the costs of reviewing such applications
under such subchapter J to the amount of the user fee
applicable to such applications.</DELETED>
<DELETED> (B) Alteration of user fee.--If the audit
performed under subparagraph (A) indicates that the
user fees applicable to applications submitted under
such subchapter J exceed 49 percent of the costs of
reviewing such applications, the Secretary shall alter
the user fees applicable to applications submitted
under such subchapter J such that the user fees do not
exceed such percentage.</DELETED>
<DELETED> (C) Accounting standards.--The Secretary
shall perform an audit under subparagraph (A) in
conformance with the accounting principles, standards,
and requirements prescribed by the Comptroller General
of the United States under section 3511 of title 31,
United States Code, to ensure the validity of any
potential variability.</DELETED>
<DELETED> (4) Conditions.--The user fee program described in
this subsection shall take effect only if the Food and Drug
Administration issues draft guidance related to the review
requirements for in vitro diagnostic tests that would be
subject to premarket review under section 587B of the Federal
Food, Drug, and Cosmetic Act, as added by section 823, the
review requirements for test categories eligible for technology
certification under section 587D of such Act, as added by
section 823, and the parameters for the test categories that
would be exempt from any review under subchapter J of chapter V
of such Act.</DELETED>
<DELETED> (5) User fee program definitions and resource
requirements.--</DELETED>
<DELETED> (A) In general.--The term ``process for
the review of in vitro clinical test submissions and
applications'' means the following activities of the
Secretary with respect to the review of in vitro
clinical test premarket and technology certification
applications including supplements for such
applications:</DELETED>
<DELETED> (i) The activities necessary for
the review of premarket applications, premarket
reports, technology certification applications,
and supplements to such applications.</DELETED>
<DELETED> (ii) Actions related to
submissions in connection with in vitro
clinical test development, the issuance of
action letters that allow the marketing of in
vitro clinical tests or which set forth in
detail the specific deficiencies in such
applications, reports, supplements, or
submissions and, where appropriate, the actions
necessary to support the development of in
vitro clinical tests.</DELETED>
<DELETED> (iii) The inspection of
manufacturing establishments and other
facilities undertaken as part of the
Secretary's review of pending premarket
applications, technology certifications, and
supplements.</DELETED>
<DELETED> (iv) Monitoring of research
conducted in connection with the review of such
applications, supplements, and
submissions.</DELETED>
<DELETED> (v) Review of in vitro clinical
test applications subject to section 351 of the
Public Health Service Act (42 U.S.C. 262) and
activities conducted in anticipation of the
submission of such applications for
investigational use under section 587S of the
Federal Food, Drug, and Cosmetic Act (as added
by section 823).</DELETED>
<DELETED> (vi) The development of guidance,
policy documents, or regulations to improve the
process for the review of premarket
applications, technology certification
applications, and supplements.</DELETED>
<DELETED> (vii) The development of voluntary
test methods, consensus standards, or mandatory
performance standards in connection with the
review of such applications, supplements, or
submissions and related activities.</DELETED>
<DELETED> (viii) The provision of technical
assistance to in vitro clinical test developers
in connection with the submission of such
applications, reports, supplements, or
submissions.</DELETED>
<DELETED> (ix) Any activity undertaken in
connection with the initial classification or
reclassification of an in vitro clinical test
in connection with any requirement for approval
or eligibility for an exemption from premarket
review of an in vitro clinical test.</DELETED>
<DELETED> (x) Any activity undertaken in
connection with making a pathway determination
of an in vitro clinical test, including the
identification, establishment, and
implementation of mitigation
measures.</DELETED>
<DELETED> (xi) Evaluation of postmarket
studies required as a condition of an approval
of a premarket application of an in vitro
clinical test and ensuring such studies are
conducted as required.</DELETED>
<DELETED> (xii) Any activity undertaken in
connection with ensuring in vitro clinical
tests marketed under an exemption from
premarket review pursuant to section 587C or
587G meet the criteria for such exemption and
the applicable standard.</DELETED>
<DELETED> (xiii) Compiling, developing, and
reviewing information on in vitro clinical
tests necessary to identify issues with the
ability of in vitro clinical tests to meet the
applicable standard, as applicable.</DELETED>
<DELETED> (B) Resource requirements.--Fees collected
and assessed under this section shall be used for the
process for the review of in vitro clinical test
applications, as described in subparagraph (A), and
shall--</DELETED>
<DELETED> (i) be subject to the limitation
under section 738(g)(3) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j(g)(3)),
in the same manner that fees collected and
assessed under section 737(9)(C) of such Act
(21 U.S.C. 379i(9)(C)) are subject to such
limitation;</DELETED>
<DELETED> (ii) include travel expenses for
officers and employees of the Food and Drug
Administration only if the Secretary determines
that such travel is directly related to an
activity described in subparagraph (A);
and</DELETED>
<DELETED> (iii) not be allocated to purposes
described under section 722(a) of the
Consolidated Appropriations Act, 2018 (Public
Law 115-141).</DELETED>
<DELETED> (d) Reports.--</DELETED>
<DELETED> (1) Performance report.--</DELETED>
<DELETED> (A) In general.--</DELETED>
<DELETED> (i) General requirements.--
Beginning with fiscal year 2027, for each
fiscal year for which fees are collected under
this section, the Secretary shall prepare and
submit to the Committee on Health, Education,
Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House
of Representatives annual reports concerning
the progress of the Food and Drug
Administration in achieving the goals
identified in the recommendations transmitted
to Congress by the Secretary pursuant to
subsection (b)(1)(E) during such fiscal year
and the future plans of the Food and Drug
Administration for meeting the goals.</DELETED>
<DELETED> (ii) Additional information.--
Beginning with fiscal year 2021, the annual
report under this subparagraph shall include
the progress of the Food and Drug
Administration in achieving the goals, and
future plans for meeting the goals, including--
</DELETED>
<DELETED> (I) the number of
premarket applications filed under
section 587B of the Federal Food, Drug,
and Cosmetic Act during the applicable
fiscal year;</DELETED>
<DELETED> (II) the number of
technology certification applications
submitted under section 587D of the
Federal Food, Drug, and Cosmetic Act
during the applicable fiscal year for
each review division;</DELETED>
<DELETED> (III) the number of
breakthrough designations under section
587I of the Federal Food, Drug, and
Cosmetic Act during the applicable
fiscal year; and</DELETED>
<DELETED> (IV) the number of
information requests requested by the
Secretary pursuant to section 587G(d)
of such Act.</DELETED>
<DELETED> (iii) Real-time reporting.--
</DELETED>
<DELETED> (I) In general.--Not later
than 30 calendar days after the end of
the second quarter of fiscal year 2027,
and not later than 30 calendar days
after the end of each quarter of each
fiscal year thereafter, the Secretary
shall post the data described in
subclause (II) on the website of the
Food and Drug Administration for such
quarter and on a cumulative basis for
such fiscal year, and may remove
duplicative data from the annual report
under this subparagraph.</DELETED>
<DELETED> (II) Data.--The Secretary
shall post the following data in
accordance with subclause
(I):</DELETED>
<DELETED> (aa) The number
and titles of draft and final
regulations on topics related
to the process for the review
of in vitro clinical test
submissions and applications,
and whether such guidances were
required by statute or pursuant
to the recommendations
transmitted to Congress by the
Secretary pursuant to
subsection (b)(1)(E).</DELETED>
<DELETED> (bb) The number
and titles of draft and final
guidance on topics related to
the process for the review of
in vitro clinical test
submissions and applications,
and whether such guidances were
issued as required by statute
or pursuant to the
recommendations transmitted to
Congress by the Secretary
pursuant to subsection
(c)(1)(E).</DELETED>
<DELETED> (cc) The number
and titles of public meetings
held on topics related to the
process for the review of in
vitro clinical tests, and if
such meetings were required by
statute or pursuant to the
recommendations transmitted to
Congress by the Secretary
pursuant to subsection
(c)(1)(E).</DELETED>
<DELETED> (iv) Rationale for ivct user fee
program changes.--Beginning with fiscal year
2027, the Secretary shall include in the annual
performance report under paragraph (1)--
</DELETED>
<DELETED> (I) data, analysis, and
discussion of the changes in the number
of full-time equivalents hired as
agreed upon in the recommendations
transmitted to Congress by the
Secretary pursuant to subsection
(b)(1)(E) and the number of full-time
equivalents funded by budget authority
at the Food and Drug Administration by
each division within the Center for
Devices and Radiological Health, the
Center for Biologics Evaluation and
Research, the Office of Regulatory
Affairs, and the Office of the
Commissioner;</DELETED>
<DELETED> (II) data, analysis, and
discussion of the changes in the fee
revenue amounts and costs for the
process for the review of in vitro
clinical test submissions and
applications, including identifying
drivers of such changes; and</DELETED>
<DELETED> (III) for each of the
Center for Devices and Radiological
Health, the Center for Biologics
Evaluation and Research, the Office of
Regulatory Affairs, and the Office of
the Commissioner, the number of
employees for whom time reporting is
required and the number of employees
for whom time reporting is not
required.</DELETED>
<DELETED> (v) Analysis.--For each fiscal
year, the Secretary shall include in the report
under clause (i) an analysis of the
following:</DELETED>
<DELETED> (I) The difference between
the aggregate number of premarket
applications filed under section 587B
or section 587D of the Federal Food,
Drug, and Cosmetic Act and the
aggregate number of major deficiency
letters, not approvable letters, and
denials for such applications issued by
the agency, accounting for--</DELETED>
<DELETED> (aa) the number of
applications filed under each
of sections 587B and 587D of
the Federal Food, Drug, and
Cosmetic Act during one fiscal
year for which a decision is
not scheduled to be made until
the following fiscal year;
and</DELETED>
<DELETED> (bb) the aggregate
number of applications under
each of sections 587B and 587D
of the Federal Food, Drug, and
Cosmetic Act for each fiscal
year that did not meet the
goals as identified by the
recommendations transmitted to
Congress by the Secretary
pursuant to subsection
(b)(1)(E).</DELETED>
<DELETED> (II) Relevant data to
determine whether the Center for
Devices and Radiological Health has met
performance enhancement goals
identified by the recommendations
transmitted to Congress by the
Secretary pursuant to subsection
(b)(1)(E).</DELETED>
<DELETED> (III) The most common
causes and trends for external or other
circumstances affecting the ability of
the Food and Drug Administration to
meet review time and performance
enhancement goals identified by the
recommendations transmitted to Congress
by the Secretary pursuant to subsection
(b)(1)(E).</DELETED>
<DELETED> (B) Publication.--With regard to
information to be reported by the Food and Drug
Administration to industry on a quarterly and annual
basis pursuant to recommendations transmitted to
Congress by the Secretary pursuant to subsection
(b)(1)(E), the Secretary shall make such information
publicly available on the website of the Food and Drug
Administration not later than 60 days after the end of
each quarter or 120 days after the end of each fiscal
year, respectively, to which such information
applies.</DELETED>
<DELETED> (C) Updates.--The Secretary shall include
in each report under subparagraph (A) information on
all previous cohorts for which the Secretary has not
given a complete response on all in vitro clinical test
premarket applications and technology certification
orders and supplements, premarket, and technology
certification notifications in the cohort.</DELETED>
<DELETED> (2) Corrective action report.--Beginning with
fiscal year 2022, for each fiscal year for which fees are
collected under this section, the Secretary shall prepare and
submit a corrective action report to the Committee on Health,
Education, Labor, and Pensions and the Committee on
Appropriations of the Senate and the Committee on Energy and
Commerce and the Committee on Appropriations of the House of
Representatives. The report shall include the following
information, as applicable:</DELETED>
<DELETED> (A) Goals met.--For each fiscal year, if
the Secretary determines, based on the analysis under
paragraph (1)(A)(v), that each of the goals identified
by the recommendations transmitted to Congress by the
Secretary pursuant to subsection (b)(1)(E) for the
applicable fiscal year have been met, the corrective
action report shall include recommendations on ways in
which the Secretary can improve and streamline the in
vitro clinical test premarket application and
technology certification review process.</DELETED>
<DELETED> (B) Goals missed.--For each of the goals
identified by the letters described in recommendations
transmitted to Congress by the Secretary pursuant to
subsection (b)(1)(E) for the applicable fiscal year
that the Secretary determines to not have been met, the
corrective action report shall include--</DELETED>
<DELETED> (i) a justification for such
determination;</DELETED>
<DELETED> (ii) a description of the types of
circumstances, in the aggregate, under which
applications or reports submitted under
sections 587B and 587D of the Federal Food,
Drug, and Cosmetic Act missed the review goal
times but were approved during the first cycle
review, as applicable;</DELETED>
<DELETED> (iii) a summary and any trends
with regard to the circumstances for which a
review goal was missed; and</DELETED>
<DELETED> (iv) the performance enhancement
goals that were not achieved during the
previous fiscal year and a description of
efforts the Food and Drug Administration has
put in place for the fiscal year in which the
report is submitted to improve the ability of
such agency to meet each such goal for the such
fiscal year.</DELETED>
<DELETED> (3) Fiscal report.--For fiscal years 2027 and
annually thereafter, not later than 120 days after the end of
each fiscal year during which fees are collected under this
subpart, the Secretary shall prepare and submit to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives, a report on the implementation of the
authority for such fees during such fiscal year and the use, by
the Food and Drug Administration, of the fees collected during
such fiscal year for which the report is made.</DELETED>
<DELETED> (A) Contents.--Such report shall include
expenditures delineated by budget authority and user
fee dollars related to administrative expenses and
information technology infrastructure contracts and
expenditures.</DELETED>
<DELETED> (B) Operating reserve.--Such report shall
provide the amount of operating reserve balance
available each year, and any planned allocations or
obligations of such balance that is above 10 weeks of
operating reserve for the program.</DELETED>
<DELETED> (4) Public availability.--The Secretary shall make
the reports required under paragraphs (1) through (3) available
to the public on the website of the Food and Drug
Administration.</DELETED>
<DELETED> (5) Enhanced communication.--</DELETED>
<DELETED> (A) Communications with congress.--Each
fiscal year, as applicable and requested,
representatives from the Centers with expertise in the
review of in vitro clinical tests shall meet with
representatives from the Committee on Health,
Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of
Representatives to report on the contents described in
the reports under this section.</DELETED>
<DELETED> (B) Participation in congressional
hearing.--Each fiscal year, as applicable and
requested, representatives from the Food and Drug
Administration shall participate in a public hearing
before the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and
Commerce of the House of Representatives, to report on
the contents described in the reports under this
section. Such hearing shall occur not later than 120
days after the end of each fiscal year for which fees
are collected under this section.</DELETED>
<DELETED>SEC. 830. AUTHORIZATION OF APPROPRIATIONS.</DELETED>
<DELETED> For purposes of funding implementation of this subtitle
(including the amendments made by this subtitle), including undertaking
activities for the development of regulations and guidances, hiring of
necessary staff, and the development of technology systems to implement
this subtitle (including the amendments made by this subtitle) in a
timely, effective, and efficient manner, there is authorized to be
appropriated not more than $480,000,000, to remain available through
the end of fiscal year 2027.</DELETED>
<DELETED>TITLE IX--OTHER PROVISIONS</DELETED>
<DELETED>SEC. 901. FACILITIES MANAGEMENT.</DELETED>
<DELETED> (a) PDUFA Authority.--Section 736(g)(2) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379h(g)(2))--</DELETED>
<DELETED> (1) in subparagraph (A)(ii)--</DELETED>
<DELETED> (A) by striking ``shall be available to
defray'' and inserting the following: ``shall be
available--</DELETED>
<DELETED> ``(I) for fiscal year
2023, to defray'';</DELETED>
<DELETED> (B) by striking the period and inserting
``; and''; and</DELETED>
<DELETED> (C) by adding at the end the
following:</DELETED>
<DELETED> ``(II) for fiscal year
2024 and each subsequent fiscal year,
to defray the costs of the resources
allocated for the process for the
review of human drug applications
(including such costs for an additional
number of full-time equivalent
positions in the Department of Health
and Human Services to be engaged in
such process), only if the sum of the
amounts allocated by the Secretary for
such costs, excluding costs paid from
fees collected under this section, plus
other costs for the maintenance,
renovation, and repair of facilities
and acquisition, maintenance, and
repair of fixtures, furniture, and
other necessary materials and supplies
in connection with the process for the
review of human drug applications, is
no less than the amount allocated for
such costs, excluding any such costs
paid from fees collected under this
section, for fiscal year 1997,
multiplied by the adjustment factor.'';
and</DELETED>
<DELETED> (2) in subparagraph (B), by striking ``for the
process for the review of human drug applications'' and
inserting ``as described in subclause (I) or (II) of such
subparagraph, as applicable''.</DELETED>
<DELETED> (b) BsUFA Authority.--Section 744H(f)(2) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j-52(f)(2)) is amended--
</DELETED>
<DELETED> (1) in subparagraph (B)(i)--</DELETED>
<DELETED> (A) by striking ``available for a fiscal
year beginning after fiscal year 2012'' and inserting
the following: ``available--</DELETED>
<DELETED> ``(I) for fiscal year
2023'';</DELETED>
<DELETED> (B) by striking ``the fiscal year
involved.'' and inserting ``such fiscal year; and'';
and</DELETED>
<DELETED> (C) by adding at the end the
following:</DELETED>
<DELETED> ``(II) for fiscal year
2024 and each subsequent fiscal year,
to defray the costs of the process for
the review of biosimilar biological
product applications (including such
costs for an additional number of full-
time equivalent positions in the
Department of Health and Human Services
to be engaged in such process), only if
the sum of the amounts allocated by the
Secretary for such costs, excluding
costs paid from fees collected under
this section, plus other costs for the
maintenance, renovation, and repair of
facilities and acquisition,
maintenance, and repair of fixtures,
furniture, and other necessary
materials and supplies in connection
with the process for the review of
biosimilar biological product
applications, is no less than
$20,000,000, multiplied by the
adjustment factor applicable to the
fiscal year involved.''; and</DELETED>
<DELETED> (2) in subparagraph (C), by striking
``subparagraph (B) in any fiscal year if the costs described in
such subparagraph'' and inserting ``subparagraph (B)(i) in any
fiscal year if the costs allocated as described in subclause
(I) or (II) of such subparagraph, as applicable,''.</DELETED>
<DELETED> (c) GDUFA Authority.--Section 744B of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-42) is amended--</DELETED>
<DELETED> (1) in subsection (e)(2), by striking
``744A(11)(C)'' and inserting ``744A(12)(C)''; and</DELETED>
<DELETED> (2) in subsection (i)(2)--</DELETED>
<DELETED> (A) in subparagraph (A)(ii)--</DELETED>
<DELETED> (i) by striking ``available for a
fiscal year beginning after fiscal year 2012''
and inserting the following: ``available--
</DELETED>
<DELETED> ``(I) for fiscal year
2023; and'';</DELETED>
<DELETED> (ii) by striking ``the fiscal year
involved.'' and inserting ``such fiscal year;
and''; and</DELETED>
<DELETED> (iii) by adding at the end the
following:</DELETED>
<DELETED> ``(II) for fiscal year
2024 and each subsequent fiscal year,
to defray the costs of human generic
drug activities (including such costs
for an additional number of full-time
equivalent positions in the Department
of Health and Human Services to be
engaged in such activities), only if
the sum of the amounts allocated by the
Secretary for such costs, excluding
costs paid from fees collected under
this section, plus other costs for the
maintenance, renovation, and repair of
facilities and acquisition,
maintenance, and repair of fixtures,
furniture, and other necessary
materials and supplies in connection
with human generic drug activities, is
no less than $97,000,000 multiplied by
the adjustment factor defined in
section 744A(3) applicable to the
fiscal year involved.''; and</DELETED>
<DELETED> (B) in subparagraph (B), by striking ``for
human generic activities'' and inserting ``as described
in subclause (I) or (II) of such subparagraph, as
applicable''.</DELETED>
<DELETED> (d) MDUFA Authority.--Section 738 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j) is amended--</DELETED>
<DELETED> (1) in subsection (h)(2)--</DELETED>
<DELETED> (A) in subparagraph (A)(ii)--</DELETED>
<DELETED> (i) by striking ``shall be
available to defray'' and inserting the
following: ``shall be available--</DELETED>
<DELETED> ``(I) for fiscal year
2023, to defray'';</DELETED>
<DELETED> (ii) by striking the period and
inserting ``; and''; and</DELETED>
<DELETED> (iii) by adding at the end the
following:</DELETED>
<DELETED> ``(II) for fiscal year
2024 and each subsequent fiscal year,
to defray the costs of the resources
allocated for the process for the
review of device applications
(including such costs for an additional
number of full-time equivalent
positions in the Department of Health
and Human Services to be engaged in
such process), only if the sum of the
amounts allocated by the Secretary for
such costs, excluding costs paid from
fees collected under this section, plus
other costs for the maintenance,
renovation, and repair of facilities
and acquisition, maintenance, and
repair of fixtures, furniture and other
necessary materials and supplies in
connection with the process for the
review of device applications, is no
less than the amount allocated for such
costs, excluding any such costs paid
from fees collected under this section,
for fiscal year 2009 multiplied by the
adjustment factor.''; and</DELETED>
<DELETED> (B) in subparagraph (B)(i), in the matter
preceding subclause (I), by striking ``for the process
for the review of device applications'' and inserting
``as described in subclause (I) or (II) of such
subparagraph, as applicable''; and</DELETED>
<DELETED> (2) in subsection (g)(3), by striking
``737(9)(C)'' and inserting ``737(10)(C)''.</DELETED>
<DELETED> (e) Technical Correction.--</DELETED>
<DELETED> (1) In general.--Section 905(b)(2) of the FDA
Reauthorization Act of 2017 (Public Law 115-52) is amended by
striking ``Section 738(h) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j(h)) is amended'' and inserting
``Subsection (g) of section 738 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j), as so redesignated by section
203(f)(2)(B)(i), is amended''.</DELETED>
<DELETED> (2) Effective date.--The amendment made by
paragraph (1) shall take effect as though included in the
enactment of section 905 of the FDA Reauthorization Act of 2017
(Public Law 115-52).</DELETED>
<DELETED>SEC. 902. ANNUAL REPORT ON INSPECTIONS.</DELETED>
<DELETED> Section 902 of the FDA Reauthorization Act of 2017 (Public
Law 115-52) is amended, in the matter preceding paragraph (1)--
</DELETED>
<DELETED> (1) by striking ``March 1 of each year'' and
inserting ``120 days after the end of each fiscal year'';
and</DELETED>
<DELETED> (2) by striking ``previous calendar year'' and
inserting ``previous fiscal year''.</DELETED>
<DELETED>SEC. 903. USER FEE PROGRAM TRANSPARENCY AND
ACCOUNTABILITY.</DELETED>
<DELETED> (a) PDUFA.--</DELETED>
<DELETED> (1) Reauthorization; reporting requirements.--
</DELETED>
<DELETED> (A) Performance report.--Section 736B(a)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379h-2(a)) is amended--</DELETED>
<DELETED> (i) in paragraph (1)--</DELETED>
<DELETED> (I) in subparagraph (B)--
</DELETED>
<DELETED> (aa) in clause
(vii), by striking ``; and''
and inserting a
semicolon;</DELETED>
<DELETED> (bb) in clause
(viii), by striking the period
and inserting ``; and'';
and</DELETED>
<DELETED> (cc) by adding at
the end the
following:</DELETED>
<DELETED> ``(ix) the number of
investigational new drug applications submitted
per fiscal year, including for each review
division.''; and</DELETED>
<DELETED> (II) by adding at the end
the following flush text:</DELETED>
<DELETED>``Nothing in subparagraph (B) shall be construed to
authorize the disclosure of confidential commercial information
or other information considered proprietary or trade secret, as
prohibited under section 301(j) of this Act of section 1905 of
title 18, United States Code.''; and</DELETED>
<DELETED> (ii) in paragraph (4)--</DELETED>
<DELETED> (I) by amending
subparagraph (A) to read as
follows:</DELETED>
<DELETED> ``(A) data, analysis, and discussion of
the changes in the number of individuals hired as
agreed upon in the letters described in section 101(b)
of the Prescription Drug User Fee Amendments of 2022
and the number of remaining vacancies, the number of
full-time equivalents funded by fees collected pursuant
to section 736, and the number of full-time equivalents
funded by budget authority at the Food and Drug
Administration by each division within the Center for
Drug Evaluation and Research, the Center for Biologics
Evaluation and Research, the Office of Regulatory
Affairs, and the Office of the
Commissioner;'';</DELETED>
<DELETED> (II) by amending
subparagraph (B) to read as
follows:</DELETED>
<DELETED> ``(B) data, analysis, and discussion of
the changes in the fee revenue amounts and costs for
the process for the review of human drug applications,
including identifying--</DELETED>
<DELETED> ``(i) drivers of such changes;
and</DELETED>
<DELETED> ``(ii) changes in the average
total cost per full-time equivalent in the
prescription drug review program;'';</DELETED>
<DELETED> (III) in subparagraph (C),
by striking the period and inserting
``; and''; and</DELETED>
<DELETED> (IV) by adding at the end
the following:</DELETED>
<DELETED> ``(D) data, analysis, and discussion of
the changes in the average full-time equivalent hours
required to complete review of each type of human drug
application.''.</DELETED>
<DELETED> (2) Reauthorization.--Section 736B(f) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379h-2(f)) is
amended--</DELETED>
<DELETED> (A) by redesignating paragraphs (4)
through (6) as paragraphs (5) through (7),
respectively;</DELETED>
<DELETED> (B) by inserting after paragraph (3) the
following:</DELETED>
<DELETED> ``(4) Updates to congress.--The Secretary, in
consultation with regulated industry, shall provide regular
updates on negotiations on the reauthorization of this part to
the Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.''; and</DELETED>
<DELETED> (C) in paragraph (7), as so redesignated--
</DELETED>
<DELETED> (i) in subparagraph (A)--
</DELETED>
<DELETED> (I) by striking ``Before
presenting the recommendations
developed under paragraphs (1) through
(5) to the Congress, the'' and
inserting ``The''; and</DELETED>
<DELETED> (II) by inserting ``, not
later than 30 days after each such
negotiation meeting'' before the period
at the end; and</DELETED>
<DELETED> (ii) in subparagraph (B), by
inserting ``, in sufficient detail,'' after
``shall summarize''.</DELETED>
<DELETED> (b) MDUFA.--</DELETED>
<DELETED> (1) Reauthorization; reporting requirements.--
</DELETED>
<DELETED> (A) Reports.--Section 738A(a)(1)(A) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-
1(a)(1)(A)) is amended--</DELETED>
<DELETED> (i) in clause (ii)--</DELETED>
<DELETED> (I) in subclause (II), by
striking ``; and'' and inserting a
semicolon;</DELETED>
<DELETED> (II) in subclause (III),
by striking the period and inserting a
semicolon;</DELETED>
<DELETED> (III) by adding at the end
the following:</DELETED>
<DELETED> ``(IV) the number of
investigational device exemption
applications submitted under section
520(g) per fiscal year, including for
each review division; and</DELETED>
<DELETED> ``(V) the number of
expedited development and priority
review requests and designations under
section 515B per fiscal year, including
for each review division.'';
and</DELETED>
<DELETED> (IV) by adding at the end
the following flush text:</DELETED>
<DELETED>``Nothing in this clause shall be
construed to authorize the disclosure of
confidential commercial information or other
information considered proprietary or trade
secret, as prohibited under section 301(j) of
this Act or section 1905 of title 18, United
States Code.'';</DELETED>
<DELETED> (ii) in the first clause (iv)
(relating to rationale for MDUFA program
changes)--</DELETED>
<DELETED> (I) by amending subclause
(I) to read as follows:</DELETED>
<DELETED> ``(I) data, analysis, and
discussion of the changes in the number
of individuals hired as agreed upon in
the letters described in section 201(b)
of the Medical Device User Fee
Amendments of 2022 and the number of
remaining vacancies, the number of
full-time equivalents funded by fees
collected pursuant to section 738, and
the number of full time equivalents
funded by budget authority at the Food
and Drug Administration by each
division within the Center for Devices
and Radiological Health, the Center for
Biologics Evaluation and Research, the
Office of Regulatory Affairs, and the
Office of the
Commissioner;'';</DELETED>
<DELETED> (II) by amending subclause
(II) to read as follows:</DELETED>
<DELETED> ``(II) data, analysis, and
discussion of the changes in the fee
revenue amounts and costs for the
process for the review of device
applications, including identifying--
</DELETED>
<DELETED> ``(aa) drivers of
such changes; and</DELETED>
<DELETED> ``(bb) changes in
the average total cost per
full-time equivalent in the
medical device review
program;'';</DELETED>
<DELETED> (III) in subclause (III),
by striking the period and inserting
``; and''; and</DELETED>
<DELETED> (IV) by adding at the end
the following:</DELETED>
<DELETED> ``(IV) data, analysis, and
discussion of the changes in the
average full-time equivalent hours
required to complete review of medical
device application types.'';
and</DELETED>
<DELETED> (iii) by redesignating the second
clause (iv) (relating to analysis) as clause
(v).</DELETED>
<DELETED> (2) Reauthorization.--Section 738A(b) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-1(b)) is
amended--</DELETED>
<DELETED> (A) by redesignating paragraphs (4)
through (6) as paragraphs (5) through (7),
respectively;</DELETED>
<DELETED> (B) by inserting after paragraph (3) the
following:</DELETED>
<DELETED> ``(4) Updates to congress.--The Secretary, in
consultation with regulated industry, shall provide regular
updates on negotiations on the reauthorization of this part to
the Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.''; and</DELETED>
<DELETED> (C) in paragraph (7), as so redesignated--
</DELETED>
<DELETED> (i) in subparagraph (A)--
</DELETED>
<DELETED> (I) by striking ``Before
presenting the recommendations
developed under paragraphs (1) through
(5) to the Congress, the'' and
inserting ``The''; and</DELETED>
<DELETED> (II) by inserting ``, not
later than 30 days after each such
negotiation meeting'' before the period
at the end; and</DELETED>
<DELETED> (ii) in subparagraph (B), by
inserting ``, in sufficient detail,'' after
``shall summarize''.</DELETED>
<DELETED> (c) GDUFA.--</DELETED>
<DELETED> (1) Reauthorization; reporting requirements.--
</DELETED>
<DELETED> (A) Performance report.--Section
744C(a)(3) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379j-43(a)(3)) is amended--</DELETED>
<DELETED> (i) by amending subparagraph (A)
to read as follows:</DELETED>
<DELETED> ``(A) data, analysis, and discussion of
the changes in the number of individuals hired as
agreed upon in the letters described in section 301(b)
of the Generic Drug User Fee Amendments of 2022 and the
number of remaining vacancies, the number of full-time
equivalents funded by fees collected pursuant to
section 744B, and the number of full time equivalents
funded by budget authority at the Food and Drug
Administration by each division within the Center for
Drug Evaluation and Research, the Center for Biologics
Evaluation and Research, the Office of Regulatory
Affairs, and the Office of the
Commissioner;'';</DELETED>
<DELETED> (ii) by amending subparagraph (B)
to read as follows:</DELETED>
<DELETED> ``(B) data, analysis, and discussion of
the changes in the fee revenue amounts and costs for
human generic drug activities, including--</DELETED>
<DELETED> ``(i) identifying drivers of such
changes; and</DELETED>
<DELETED> ``(ii) changes in the total
average cost per full-time equivalent in the
generic drug review program;'';</DELETED>
<DELETED> (iii) in subparagraph (C), by
striking the period at the end and inserting
``; and''; and</DELETED>
<DELETED> (iv) by adding at the end the
following:</DELETED>
<DELETED> ``(D) data, analysis, and discussion of
the changes in the average full-time equivalent hours
required to complete review of each type of abbreviated
new drug application.''.</DELETED>
<DELETED> (2) Reauthorization.--Section 744C(f) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-43(f)) is
amended--</DELETED>
<DELETED> (A) by redesignating paragraphs (4)
through (6) as paragraphs (5) through (7),
respectively;</DELETED>
<DELETED> (B) by inserting after paragraph (3) the
following:</DELETED>
<DELETED> ``(4) Updates to congress.--The Secretary, in
consultation with regulated industry, shall provide regular
updates on negotiations on the reauthorization of this part to
the Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.''; and</DELETED>
<DELETED> (C) in paragraph (7), as so redesignated--
</DELETED>
<DELETED> (i) in subparagraph (A)--
</DELETED>
<DELETED> (I) by striking ``Before
presenting the recommendations
developed under paragraphs (1) through
(5) to the Congress, the'' and
inserting ``The''; and</DELETED>
<DELETED> (II) by inserting ``, not
later than 30 days after each such
negotiation meeting'' before the period
at the end; and</DELETED>
<DELETED> (ii) in subparagraph (B), by
inserting ``, in sufficient detail,'' after
``shall summarize''.</DELETED>
<DELETED> (d) BSUFA.--</DELETED>
<DELETED> (1) Reauthorization; reporting requirements.--
Section 744I(a)(4) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379j-53(a)(4)) is amended--</DELETED>
<DELETED> (A) by amending subparagraph (A) to read
as follows:</DELETED>
<DELETED> ``(A) data, analysis, and discussion of
the changes in the number of individuals hired as
agreed upon in the letters described in section 401(b)
of the Biosimilar User Fee Amendments of 2022 and the
number of remaining vacancies, the number of full-time
equivalents funded by fees collected pursuant to
section 744H, and the number of full time equivalents
funded by budget authority at the Food and Drug
Administration by each division within the Center for
Drug Evaluation and Research, the Center for Biologics
Evaluation and Research, the Office of Regulatory
Affairs, and the Office of the
Commissioner;'';</DELETED>
<DELETED> (B) by amending subparagraph (B) to read
as follows:</DELETED>
<DELETED> ``(B) data, analysis, and discussion of
the changes in the fee revenue amounts and costs for
the process for the review of biosimilar biological
product applications, including identifying--</DELETED>
<DELETED> ``(i) drivers of such changes;
and</DELETED>
<DELETED> ``(ii) changes in the average
total cost per full-time equivalent in the
biosimilar biological product review
program;'';</DELETED>
<DELETED> (C) in subparagraph (C), by striking the
period at the end and inserting ``; and'';
and</DELETED>
<DELETED> (D) by adding at the end the
following:</DELETED>
<DELETED> ``(D) data, analysis, and discussion of
the changes in the average full-time equivalent hours
required to complete review of each type of biosimilar
biological product application.''.</DELETED>
<DELETED> (2) Reauthorization.--Section 744I(f) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-53(f)) is
amended--</DELETED>
<DELETED> (A) by redesignating paragraphs (2) and
(3) as paragraphs (5) and (6), respectively;</DELETED>
<DELETED> (B) by inserting after paragraph (1) the
following:</DELETED>
<DELETED> ``(2) Prior public input.--Prior to beginning
negotiations with the regulated industry on the reauthorization
of this part, the Secretary shall--</DELETED>
<DELETED> ``(A) publish a notice in the Federal
Register requesting public input on the
reauthorization;</DELETED>
<DELETED> ``(B) hold a public meeting at which the
public may present its views on the
reauthorization;</DELETED>
<DELETED> ``(C) provide a period of 30 days after
the public meeting to obtain written comments from the
public suggesting changes to this part; and</DELETED>
<DELETED> ``(D) publish the comments on the Food and
Drug Administration's website.</DELETED>
<DELETED> ``(3) Periodic consultation.--Not less frequently
than once every month during negotiations with the regulated
industry, the Secretary shall hold discussions with
representatives of patient and consumer advocacy groups to
continue discussions of their views on the reauthorization and
their suggestions for changes to this part as expressed under
paragraph (2).</DELETED>
<DELETED> ``(4) Updates to congress.--The Secretary, in
consultation with regulated industry, shall provide regular
updates on negotiations on the reauthorization of this part to
the Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.''; and</DELETED>
<DELETED> (C) by adding at the end the
following:</DELETED>
<DELETED> ``(7) Minutes of negotiation meetings.--</DELETED>
<DELETED> ``(A) Public availability.--The Secretary
shall make publicly available, on the public website of
the Food and Drug Administration, minutes of all
negotiation meetings conducted under this subsection
between the Food and Drug Administration and the
regulated industry, not later than 30 days after each
such negotiation meeting.</DELETED>
<DELETED> ``(B) Content.--The minutes described
under subparagraph (A) shall summarize, in sufficient
detail, any substantive proposal made by any party to
the negotiations as well as significant controversies
or differences of opinion during the negotiations and
their resolution.''.</DELETED>
<DELETED>SEC. 904. OTC HEARING AIDS FINAL RULE.</DELETED>
<DELETED> Not later than 30 days after the date of enactment of this
Act, the Secretary of Health and Human Services shall issue a final
rule to establish a category of over-the-counter hearing aids, as
defined in subsection (q) of section 520 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360j), as described in section 709(b) of the
FDA Reauthorization Act of 2017 (Public Law 115-52).</DELETED>
SEC. 905. ENHANCE INTRA-AGENCY COORDINATION AND PUBLIC HEALTH
ASSESSMENT WITH REGARD TO COMPLIANCE ACTIVITIES.
<DELETED> (a) Coordination.--Section 506D of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 356d) is amended--</DELETED>
<DELETED> (1) by adding at the end the following:</DELETED>
<DELETED> ``(g) Coordination.--The Secretary shall ensure timely and
effective internal coordination and alignment among the field
investigators of the Food and Drug Administration and the staff of the
Center for Drug Evaluation and Research's Office of Compliance and Drug
Shortage Program regarding the reviews of reports shared pursuant to
section 704(b)(2), and any feedback or corrective or preventive actions
in response to such reports.''; and</DELETED>
<DELETED> (2) by amending subsection (f) to read as
follows:</DELETED>
<DELETED> ``(f) Temporary Sunset.--Subsection (a) shall cease to be
effective on the date that is 5 years after the date of enactment of
the Food and Drug Administration Safety and Innovation Act. Subsections
(b), (c), and (e) shall not be in effect during the period beginning 5
years after the date of enactment of the Food and Drug Administration
Safety and Innovation Act and ending on the date of enactment of the
Food and Drug Administration Safety and Landmark Advancements Act of
2022. Subsections (b), (c), and (e) shall be in effect beginning on the
date of enactment of the Food and Drug Administration Safety and
Landmark Advancements Act of 2022.''.</DELETED>
<DELETED> (b) Reporting.--Section 506C-1(a) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 356c-1(a)) is amended--</DELETED>
<DELETED> (1) by redesignating paragraphs (3) through (7) as
paragraphs (4) through (8), respectively;</DELETED>
<DELETED> (2) by inserting after paragraph (2) the
following:</DELETED>
<DELETED> ``(3) provides the number of reports that were
required under section 704(b)(2) to be sent to the appropriate
offices of the Food and Drug Administration with expertise
regarding drug shortages, and the number of such reports that
were sent;''; and</DELETED>
<DELETED> (3) in paragraph (3)(A), by striking ``paragraph
(7)'' and inserting ``paragraph (8)''.</DELETED>
<DELETED> (c) Applicability.--</DELETED>
<DELETED> (1) Subsection (a).--The amendments made by
subsection (a) shall apply beginning on the date of enactment
of this Act.</DELETED>
<DELETED> (2) Subsection (b).--The amendments made by
subsection (b) shall apply beginning on the date that is 1 year
after the date of enactment of this Act.</DELETED>
<DELETED> (d) Reporting of Mutual Recognition Agreements for
Inspections and Review Activities.--Section 510(h) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 360(h)) is amended--</DELETED>
<DELETED> (1) in paragraph (6)--</DELETED>
<DELETED> (A) in subparagraph (A), by striking
clause (ii) and inserting the following:</DELETED>
<DELETED> ``(ii) the number of such registered
establishments in each region of interest;</DELETED>
<DELETED> ``(iii) the number of such domestic
establishments and the number of such foreign
establishments, including the number of establishments
in each region of interest, that the Secretary
inspected in the previous calendar year;</DELETED>
<DELETED> ``(iv) the number of inspections to
support actions by the Secretary on applications under
section 505 of this Act or section 351 of the Public
Health Service Act, including the number of inspections
to support actions by the Secretary on supplemental
applications, including changes to manufacturing
processes, the Secretary conducted in the previous
fiscal year;</DELETED>
<DELETED> ``(v) the number of routine surveillance
inspections the Secretary conducted in the previous
fiscal year;</DELETED>
<DELETED> ``(vi) the number of for-cause inspections
the Secretary conducted in the previous fiscal year,
not including inspections described in clause (iv);
and</DELETED>
<DELETED> ``(vii) the number of inspections the
Secretary has recognized pursuant to an agreement
entered into pursuant to section 809, or otherwise
recognized, for each of the types of inspections
described in clauses (v) and (vi);'';</DELETED>
<DELETED> (B) in subparagraph (B), by striking ``;
and'' and inserting a semicolon;</DELETED>
<DELETED> (C) in subparagraph (C), by striking the
period and inserting ``; and''; and</DELETED>
<DELETED> (D) by adding at the end the
following:</DELETED>
<DELETED> ``(D) the status of the efforts of the
Food and Drug Administration to expand its recognition
of inspections conducted or recognized by foreign
regulatory authorities under section 809, including any
obstacles to expanding the use of such recognition.'';
and</DELETED>
<DELETED> (2) by adding at the end the following:</DELETED>
<DELETED> ``(7) Region of interest.--For purposes of
paragraph (6)(A), the term `region of interest' means a foreign
geographic region or country, including the People's Republic
of China, India, the European Union, the United Kingdom, and
any other country or geographic region, as the Secretary
determines appropriate.''.</DELETED>
<DELETED> (e) Enhancing Transparency of Drug Facility Inspection
Timelines.--Section 902 of the FDA Reauthorization Act of 2017 (21
U.S.C. 355 note) is amended to read as follows:</DELETED>
<DELETED>``SEC. 902. ANNUAL REPORT ON INSPECTIONS.</DELETED>
<DELETED> ``Not later than March 1 of each year, the Secretary of
Health and Human Services shall post on the website of the Food and
Drug Administration information related to inspections of facilities
necessary for approval of a drug under subsection (c) or (j) of section
505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355),
approval of a device under section 515 of such Act (21 U.S.C. 360e), or
clearance of a device under section 510(k) of such Act (21 U.S.C.
360(k)) that were conducted during the previous calendar year. Such
information shall include the following:</DELETED>
<DELETED> ``(1) The median time following a request from
staff of the Food and Drug Administration reviewing an
application or report to the beginning of the inspection,
including--</DELETED>
<DELETED> ``(A) the median time for drugs described
in 505(j)(11)(A)(i) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355(j)(11)(A)(i));</DELETED>
<DELETED> ``(B) the median time for drugs described
in section 506C(a) of such Act (21 U.S.C. 356c(a))
only; and</DELETED>
<DELETED> ``(C) the median time for drugs on the
drug shortage list in effect under section 506E of such
Act (21 U.S.C. 356f).</DELETED>
<DELETED> ``(2) The median time from the issuance of a
report pursuant to section 704(b) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 374(b)) to the sending of a warning
letter, issuance of an import alert, or holding of a regulatory
meeting for inspections for which the Secretary concluded that
regulatory or enforcement action was indicated, including the
median time for each category of drugs listed in subparagraphs
(A) through (C) of paragraph (1).</DELETED>
<DELETED> ``(3) The median time from the sending of a
warning letter, issuance of an import alert, or holding of a
regulatory meeting related to conditions observed by the
Secretary during an inspection, to the time at which the
Secretary concludes that corrective actions to resolve such
conditions have been taken.</DELETED>
<DELETED> ``(4) The median time spent by staff of the Food
and Drug Administration at a facility during an inspection,
including--</DELETED>
<DELETED> ``(A) the median time when records were
provided remotely in accordance with a request under
section 704(a)(4) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 374(a)(4)) in advance of the
inspection; and</DELETED>
<DELETED> ``(B) the median time when a request for
records pursuant to such section 704(a)(4) was not
issued, or complied with, in advance of the
inspection.</DELETED>
<DELETED> ``(5) The number and type of violations identified
during inspections when a request for records pursuant to such
section 704(a)(4) was issued and complied with in advance of
the inspection, versus when a request for records pursuant to
such section 704(a)(4) was not issued or complied
with.</DELETED>
<DELETED> ``(6) The number of facilities that did not
implement requested corrective or preventive actions following
a report issued pursuant to such section 704(b), resulting in a
withhold recommendation, including the number of such times for
each category of drugs listed in subparagraphs (A) through (C)
of paragraph (1).''.</DELETED>
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Food and Drug
Administration Safety and Landmark Advancements Act of 2022'' or the
``FDASLA Act of 2022''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--FEES RELATING TO DRUGS
Sec. 101. Short title; finding.
Sec. 102. Definitions.
Sec. 103. Authority to assess and use drug fees.
Sec. 104. Reauthorization; reporting requirement.
Sec. 105. Sunset dates.
Sec. 106. Effective date.
Sec. 107. Savings clause.
TITLE II--FEES RELATING TO DEVICES
Sec. 201. Short title; finding.
Sec. 202. Definitions.
Sec. 203. Authority to assess and use device fees.
Sec. 204. Reauthorization; reporting requirement.
Sec. 205. Accreditation programs.
Sec. 206. Sunset dates.
Sec. 207. Effective date.
Sec. 208. Savings clause.
TITLE III--FEES RELATING TO GENERIC DRUGS
Sec. 301. Short title; finding.
Sec. 302. Authority to assess and use human generic drug fees.
Sec. 303. Reauthorization; reporting requirements.
Sec. 304. Sunset dates.
Sec. 305. Effective date.
Sec. 306. Savings clause.
TITLE IV--FEES RELATING TO BIOSIMILAR BIOLOGICAL PRODUCTS
Sec. 401. Short title; finding.
Sec. 402. Definitions.
Sec. 403. Authority to assess and use biosimilar biological product
fees.
Sec. 404. Reauthorization; reporting requirements.
Sec. 405. Sunset dates.
Sec. 406. Effective date.
Sec. 407. Savings clause.
TITLE V--IMPROVING REGULATION OF DRUGS AND BIOLOGICAL PRODUCTS
Sec. 501. Alternatives to animal testing.
Sec. 502. Safer disposal of opioids.
Sec. 503. Clarifications to exclusivity provisions for first
interchangeable biosimilar biological
products.
Sec. 504. Improvements to the Purple Book.
Sec. 505. Therapeutic equivalence evaluations.
Sec. 506. Modernizing accelerated approval.
Sec. 507. Rare disease pilot program.
Sec. 508. Supporting review and development of drugs to treat rare
diseases.
Sec. 509. Generic drug labeling changes.
Sec. 510. Limitations on exclusive approval or licensure of orphan
drugs.
Sec. 511. Ensuring timely access to generics.
Sec. 512. Increasing transparency in generic drug applications.
Sec. 513. GAO report on nonprofit pharmaceutical organizations.
Sec. 514. FDA public meeting on nonprofit prescription drug
manufacturers.
Sec. 515. 180-day exclusivity period.
TITLE VI--OTHER REAUTHORIZATIONS
Sec. 601. Reauthorization of the critical path public-private
partnership.
Sec. 602. Reauthorization of the best pharmaceuticals for children
program.
Sec. 603. Reauthorization of the humanitarian device exemption
incentive.
Sec. 604. Reauthorization of the pediatric device consortia program.
Sec. 605. Reauthorization of provision pertaining to drugs containing
single enantiomers.
Sec. 606. Reauthorization of orphan drug grants.
Sec. 607. Reauthorization of certain device inspections.
TITLE VII--ENHANCING FDA HIRING AUTHORITIES
Sec. 701. Enhancing FDA hiring authority for scientific, technical, and
professional personnel.
Sec. 702. Strategic workforce plan and report.
TITLE VIII--ADVANCING REGULATION OF COSMETICS, DIETARY SUPPLEMENTS, AND
IN VITRO CLINICAL TESTS
Subtitle A--Cosmetics
Sec. 801. Short title.
Sec. 802. Amendments to cosmetic requirements.
Sec. 803. Enforcement and conforming amendments.
Sec. 804. Records inspection.
Sec. 805. Talc-containing cosmetics.
Sec. 806. PFAS in cosmetics.
Sec. 807. Sense of the Senate on animal testing.
Sec. 808. Funding.
Subtitle B--Dietary Supplements
Sec. 811. Regulation of dietary supplements.
Subtitle C--In Vitro Clinical Tests
Sec. 821. Short title.
Sec. 822. Definitions.
Sec. 823. Regulation of in vitro clinical tests.
Sec. 824. Enforcement and other provisions.
Sec. 825. Transition.
Sec. 826. Emergency use authorization.
Sec. 827. Antimicrobial susceptibility tests.
Sec. 828. Combination products.
Sec. 829. Resources.
Sec. 830. Authorization of appropriations.
Sec. 831. Guidance on Diagnostic Innovation.
Sec. 832. GAO report on unique considerations.
TITLE IX--OTHER PROVISIONS
Sec. 901. Facilities management.
Sec. 902. User fee program transparency and accountability.
Sec. 903. OTC hearing aids final rule.
Sec. 904. Enhancing coordination and transparency on inspections.
Sec. 905. Certificates to foreign governments.
Sec. 906. Importation of drugs.
Sec. 907. Improving information technology systems of the Food and Drug
Administration.
Sec. 908. Regulation of certain products as drugs.
Sec. 909. Reporting on mailroom and Office of the Executive Secretariat
of the Food and Drug Administration.
Sec. 910. Protecting infants and improving formula supply.
Sec. 911. Predetermined change control plans for devices.
Sec. 912. Prohibition against food packaging containing intentionally
added PFAS.
Sec. 913. Requirements regarding conflicts of interest.
Sec. 914. Third party data transparency.
Sec. 915. Banned devices.
Sec. 916. Medical device cybersecurity.
Sec. 917. Women's Health Research Roadmap.
Sec. 918. GAO report on deaths due to the cost of drugs in the United
States.
TITLE I--FEES RELATING TO DRUGS
SEC. 101. SHORT TITLE; FINDING.
(a) Short Title.--This title may be cited as the ``Prescription
Drug User Fee Amendments of 2022''.
(b) Finding.--Congress finds that the fees authorized by the
amendments made in this title will be dedicated toward expediting the
drug development process and the process for the review of human drug
applications, including postmarket drug safety activities, as set forth
in the goals identified for purposes of part 2 of subchapter C of
chapter VII of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379g
et seq.), in the letters from the Secretary of Health and Human
Services to the Chairman of the Committee on Health, Education, Labor,
and Pensions of the Senate and the Chairman of the Committee on Energy
and Commerce of the House of Representatives, as set forth in the
Congressional Record.
SEC. 102. DEFINITIONS.
Section 735 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379g) is amended--
(1) in paragraph (1), in the matter following subparagraph
(B), by striking ``an allergenic extract product, or'' and
inserting ``does not include an application with respect to an
allergenic extract product licensed before October 1, 2022,
does not include an application with respect to a standardized
allergenic extract product submitted pursuant to a notification
to the applicant from the Secretary regarding the existence of
a potency test that measures the allergenic activity of an
allergenic extract product licensed by the applicant before
October 1, 2022, does not include an application with respect
to'';
(2) in paragraph (3), in the matter following subparagraph
(C)--
(A) by inserting ``licensed before October 1, 2022,
a standardized allergenic extract product submitted
pursuant to a notification to the applicant from the
Secretary regarding the existence of a potency test
that measures the allergenic activity of an allergenic
extract product licensed by the applicant before
October 1, 2022,'' after ``an allergenic extract
product''; and
(B) by adding at the end the following: ``If a
written request to place a product in the discontinued
section of either of the lists described in
subparagraph (C) is submitted to the Secretary on
behalf of an applicant, and the request identifies the
date the product is, or will be, withdrawn from sale,
then, for purposes of assessing the prescription drug
program fee under section 736(a)(2), the Secretary
shall consider such product to have been included in
the discontinued section on the later of (i) the date
such request was received, or (ii) if the product will
be withdrawn from sale on a future date, such future
date when the product is withdrawn from sale. For
purposes of subparagraph (C), a product shall be
considered withdrawn from sale once the applicant has
ceased its own distribution of the product, whether or
not the applicant has ordered recall of all previously
distributed lots of the product, except that a routine,
temporary interruption in supply shall not render a
product withdrawn from sale.''; and
(3) by adding at the end the following:
``(12) The term `skin-test diagnostic product'--
``(A) means a product--
``(i) for prick, scratch, intradermal, or
subcutaneous administration;
``(ii) expected to produce a limited, local
reaction at the site of administration (if
positive), rather than a systemic effect;
``(iii) not intended to be a preventive or
therapeutic intervention; and
``(iv) intended to detect an immediate or
delayed-type skin hypersensitivity reaction to
aid in the diagnosis of--
``(I) an allergy to an
antimicrobial agent;
``(II) an allergy that is not to an
antimicrobial agent, if the diagnostic
product was authorized for marketing
prior to October 1, 2022; or
``(III) infection with fungal or
mycobacterial pathogens; and
``(B) includes positive and negative controls
required to interpret the results of a product
described in subparagraph (A).''.
SEC. 103. AUTHORITY TO ASSESS AND USE DRUG FEES.
(a) Types of Fees.--Section 736(a) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379h(a)) is amended--
(1) in the matter preceding paragraph (1), by striking
``2018'' and inserting ``2023'';
(2) in paragraph (1)--
(A) in subparagraph (A), by striking ``subsection
(c)(5)'' each place it appears and inserting
``subsection (c)(6)'';
(B) in subparagraph (C), by inserting ``prior to
approval'' after ``or was withdrawn''; and
(C) by adding at the end the following:
``(H) Exception for skin-test diagnostic
products.--A human drug application for a skin-test
diagnostic product shall not be subject to a fee under
subparagraph (A).''; and
(3) in paragraph (2)--
(A) in subparagraph (A)--
(i) by striking ``subsection (c)(5)'' and
inserting ``subsection (c)(6)'';
(ii) by striking ``Except as provided'' and
inserting the following:
``(i) Payment of fees.--Except as
provided''; and
(iii) by adding at the end the following:
``(ii) Previously discontinued drug
products.--If a drug product that is identified
in a human drug application approved as of
October 1 of a fiscal year is not a
prescription drug product as of that date
because the drug product is in the discontinued
section of a list identified in section 735(3),
and on any subsequent day during such fiscal
year the drug product is a prescription drug
product, then except as provided in
subparagraphs (B) and (C), each person who is
named as the applicant in a human drug
application with respect to such product, and
who, after September 1, 1992, had pending
before the Secretary a human drug application
or supplement, shall pay the annual
prescription drug program fee established for a
fiscal year under subsection (c)(6) for such
prescription drug product. Such fee shall be
due on the last business day of such fiscal
year and shall be paid only once for each
product for a fiscal year in which the fee is
payable.''; and
(B) by amending subparagraph (B) to read as
follows:
``(B) Exception for certain prescription drug
products.--A prescription drug program fee shall not be
assessed for a prescription drug product under
subparagraph (A) if such product is--
``(i) a large volume parenteral product (a
sterile aqueous drug product packaged in a
single-dose container with a volume greater
than or equal to 100 mL, not including powders
for reconstitution or pharmacy bulk packages)
identified on the list compiled under section
505(j)(7);
``(ii) pharmaceutically equivalent (as
defined in section 314.3 of title 21, Code of
Federal Regulations (or any successor
regulations)), to another product on the list
of products compiled under section 505(j)(7)
(not including the discontinued section of such
list); or
``(iii) a skin-test diagnostic product.''.
(b) Fee Revenue Amounts.--Section 736(b) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379h(b)) is amended--
(1) in paragraph (1)--
(A) in the matter preceding subparagraph (A), by
striking ``2018 through 2022'' and inserting ``2023
through 2027'';
(B) by redesignating subparagraphs (C) through (F)
as subparagraphs (D) through (G), respectively;
(C) by inserting after subparagraph (B) the
following:
``(C) The dollar amount equal to the strategic
hiring and retention adjustment for the fiscal year (as
determined under subsection (c)(2));'';
(D) in subparagraph (D), as so redesignated, by
striking ``(c)(2)'' and inserting ``(c)(3)'';
(E) in subparagraph (E), as so redesignated, by
striking ``(c)(3)'' and inserting ``(c)(4)'';
(F) in subparagraph (F), as so redesignated, by
striking ``(c)(4)'' and inserting ``(c)(5)''; and
(G) in subparagraph (G), as so redesignated, by
striking clauses (i) through (v) and inserting the
following:
``(i) $65,773,693 for fiscal year 2023.
``(ii) $25,097,671 for fiscal year 2024.
``(iii) $14,154,169 for fiscal year 2025.
``(iv) $4,864,860 for fiscal year 2026.
``(v) $1,314,620 for fiscal year 2027.'';
and
(2) in paragraph (3)--
(A) in subparagraph (A), by striking ``2018,
$878,590,000'' and inserting ``2023, $1,151,522,958'';
and
(B) in subparagraph (B)--
(i) by striking ``2019 through 2022'' and
inserting ``2024 through 2027''; and
(ii) by striking ``subsection (c)(3) or
(c)(4)'' and inserting ``subsection (c)(4) or
(c)(5)''.
(c) Adjustments; Annual Fee Setting.--Section 736(c) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379h(c)) is amended--
(1) in paragraph (1)(B)(ii), by striking ``Washington-
Baltimore, DC-MD-VA-WV'' and inserting ``Washington-Arlington-
Alexandria, DC-VA-MD-WV'';
(2) by redesignating paragraphs (2) through (6) as
paragraphs (3) through (7), respectively;
(3) by inserting after paragraph (1) the following:
``(2) Strategic hiring and retention adjustment.--For each
fiscal year, after the annual base revenue established in
subsection (b)(1)(A) is adjusted for inflation in accordance
with paragraph (1), the Secretary shall further increase the
fee revenue and fees--
``(A) for fiscal year 2023, by $9,000,000; and
``(B) for fiscal year 2024 and each subsequent
fiscal year, by $4,000,000.'';
(4) in paragraph (3), as so redesignated--
(A) in subparagraph (A)--
(i) by striking ``for inflation''; and
(ii) by striking ``paragraph (1)'' and
inserting ``paragraphs (1) and (2)'';
(B) by amending subparagraph (B) to read as
follows:
``(B) Methodology.--For purposes of this paragraph,
the Secretary shall employ the capacity planning
methodology utilized by the Secretary in setting fees
for fiscal year 2021, as described in the notice titled
`Prescription Drug User Fee Rates for Fiscal Year 2021'
(85 Fed. Reg. 46651; August 3, 2020). The workload
categories used in forecasting shall include only the
activities described in such notice and, as feasible,
additional activities that are directly related to the
direct review of applications and supplements,
including additional formal meeting types, the direct
review of postmarketing commitments and requirements,
the direct review of risk evaluation and mitigation
strategies, and the direct review of annual reports for
approved prescription drug products. Subject to the
exceptions in the preceding sentence, the Secretary
shall not include as workload categories in forecasting
any non-core review activities, including any
activities that the Secretary referenced for potential
future use in such notice but did not utilize in the
setting fees for fiscal year 2021.'';
(C) by striking subparagraph (C);
(D) by redesignating subparagraphs (D) and (E) as
subparagraphs (C) and (D), respectively;
(E) in subparagraph (C), as so redesignated--
(i) by striking ``year) and'' and inserting
``year),''; and
(ii) by striking the period and inserting
``, and subsection (b)(1)(C) (the dollar amount
of the strategic hiring and retention
adjustment).''; and
(F) in subparagraph (D), as so redesignated, by
striking ``paragraph (5)'' and inserting ``paragraph
(6)'';
(5) in paragraph (4), as so redesignated--
(A) by amending subparagraph (A) to read as
follows:
``(A) Increase.--For fiscal year 2023 and
subsequent fiscal years, the Secretary shall, in
addition to adjustments under paragraphs (1), (2), and
(3), further increase the fee revenue and fees if such
an adjustment is necessary to provide for at least the
following amounts of operating reserves of carryover
user fees for the process for the review of human drug
applications for each fiscal year, as follows:
``(i) For fiscal year 2023, at least 8
weeks of operating reserves.
``(ii) For fiscal year 2024, at least 9
weeks of operating reserves.
``(iii) For fiscal year 2025 and subsequent
fiscal years, at least 10 weeks of operating
reserves.''; and
(B) in subparagraph (C), by striking ``paragraph
(5)'' and inserting ``paragraph (6)'';
(6) by amending paragraph (5), as so redesignated, to read
as follows:
``(5) Additional direct cost adjustment.--The Secretary
shall, in addition to adjustments under paragraphs (1), (2),
(3), and (4), further increase the fee revenue and fees--
``(A) for fiscal year 2023, by $44,386,150; and
``(B) for fiscal years 2024 through 2027, by the
amount set forth in clauses (i) through (iv), as
applicable, multiplied by the Consumer Price Index for
urban consumers (Washington-Arlington-Alexandria, DC-
VA-MD-WV; Not Seasonally Adjusted; All Items; Annual
Index) for the most recent year of available data,
divided by such Index for 2021--
``(i) for fiscal year 2024, $60,967,993;
``(ii) for fiscal year 2025, $35,799,314;
``(iii) for fiscal year 2026, $35,799,314;
and
``(iv) for fiscal year 2027,
$35,799,314.''; and
(7) in paragraph (6), as so redesignated, by striking
``2017'' and inserting ``2022''.
(d) Crediting and Availability of Fees.--Section 736(g)(3) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379h(g)(3)) is amended
by striking ``2018 through 2022'' and inserting ``2023 through 2027''.
(e) Written Requests for Waivers, Reductions, and Refunds.--Section
736(i) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379h(i))
is amended to read as follows:
``(i) Written Requests for Waivers, Reductions, Exemptions, and
Returns; Disputes Concerning Fees.--To qualify for consideration for a
waiver or reduction under subsection (d), an exemption under subsection
(k), or the return of any fee paid under this section, including if the
fee is claimed to have been paid in error, a person shall submit to the
Secretary a written request justifying such waiver, reduction,
exemption, or return not later than 180 days after such fee is due. A
request submitted under this paragraph shall include any legal
authorities under which the request is made.''.
(f) Orphan Drugs.--Section 736(k) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379h(k)) is amended--
(1) in paragraph (1)(B), by striking ``during the previous
year'' and inserting ``, as determined under paragraph (2)'';
and
(2) in paragraph (2), by striking ``that its gross annual
revenues'' and all that follows through the period at the end
and inserting ``supported by tax returns submitted to the
Internal Revenue Service, or, as necessary, by other
appropriate financial information, that its gross annual
revenues did not exceed $50,000,000 for the last calendar year
ending prior to the fiscal year for which the exemption is
requested.''.
SEC. 104. REAUTHORIZATION; REPORTING REQUIREMENT.
Section 736B of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379h-2) is amended--
(1) by striking ``2018'' each place it appears and
inserting ``2023'';
(2) by striking ``Prescription Drug User Fee Amendments of
2017'' each place it appears and inserting ``Prescription Drug
User Fee Amendments of 2022'';
(3) in subsection (a)(4), by striking ``2020'' and
inserting ``2023''; and
(4) in subsection (f), by striking ``2022'' each place it
appears and inserting ``2027''.
SEC. 105. SUNSET DATES.
(a) Authorization.--Sections 735 and 736 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379g; 379h) shall cease to be effective
October 1, 2027.
(b) Reporting Requirements.--Section 736B of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379h-2) shall cease to be effective
January 31, 2028.
(c) Previous Sunset Provision.--Effective October 1, 2022,
subsections (a) and (b) of section 104 of the FDA Reauthorization Act
of 2017 (Public Law 115-52) are repealed.
SEC. 106. EFFECTIVE DATE.
The amendments made by this title shall take effect on October 1,
2022, or the date of the enactment of this Act, whichever is later,
except that fees under part 2 of subchapter C of chapter VII of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379g et seq.) shall be
assessed for all human drug applications received on or after October
1, 2022, regardless of the date of the enactment of this Act.
SEC. 107. SAVINGS CLAUSE.
Notwithstanding the amendments made by this title, part 2 of
subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379g et seq.), as in effect on the day before the date of
the enactment of this title, shall continue to be in effect with
respect to human drug applications and supplements (as defined in such
part as of such day) that were accepted by the Food and Drug
Administration for filing on or after October 1, 2017, but before
October 1, 2022, with respect to assessing and collecting any fee
required by such part for a fiscal year prior to fiscal year 2023.
TITLE II--FEES RELATING TO DEVICES
SEC. 201. SHORT TITLE; FINDING.
(a) Short Title.--This title may be cited as the ``Medical Device
User Fee Amendments of 2022''.
(b) Finding.--Congress finds that the fees authorized under the
amendments made by this title will be dedicated toward expediting the
process for the review of device applications and for assuring the
safety and effectiveness of devices, as set forth in the goals
identified for purposes of part 3 of subchapter C of chapter VII of the
Federal Food, Drug, and Cosmetic Act in the letters from the Secretary
of Health and Human Services to the Chairman of the Committee on
Health, Education, Labor, and Pensions of the Senate and the Chairman
of the Committee on Energy and Commerce of the House of
Representatives, as set forth in the Congressional Record.
SEC. 202. DEFINITIONS.
Section 737 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379i) is amended--
(1) in paragraph (9)--
(A) in the matter preceding subparagraph (A), by
striking ``and premarket notification submissions'' and
inserting ``premarket notification submissions, and de
novo classification requests'';
(B) in subparagraph (D), by striking ``and
submissions'' and inserting ``submissions, and de novo
classification requests'';
(C) in subparagraph (F), by striking ``and
premarket notification submissions'' and inserting
``premarket notification submissions, and de novo
classification requests'';
(D) in subparagraphs (G) and (H), by striking ``or
submissions'' each place it appears and inserting
``submissions, or requests''; and
(E) in subparagraph (K), by striking ``or premarket
notification submissions'' and inserting ``premarket
notification submissions, or de novo classification
requests''; and
(2) in paragraph (11), by striking ``2016'' and inserting
``2021''.
SEC. 203. AUTHORITY TO ASSESS AND USE DEVICE FEES.
(a) Types of Fees.--Section 738(a) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j(a)) is amended--
(1) in paragraph (1), by striking ``2018'' and inserting
``2023''; and
(2) in paragraph (2)--
(A) in subparagraph (A)--
(i) in the matter preceding clause (i), by
striking ``2017'' and inserting ``2022'';
(ii) in clause (iii), by striking ``75
percent'' and inserting ``80 percent''; and
(iii) in clause (viii), by striking ``3.4
percent'' and inserting ``4.5 percent'';
(B) in subparagraph (B)(iii), by striking ``or
premarket notification submission'' and inserting
``premarket notification submission, or de novo
classification request''; and
(C) in subparagraph (C), by striking ``or periodic
reporting concerning a class III device'' and inserting
``periodic reporting concerning a class III device, or
de novo classification request''.
(b) Fee Amounts.--Section 738(b) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j(b)) is amended--
(1) in paragraph (1), by striking ``2018 through 2022'' and
inserting ``2023 through 2027'';
(2) by amending the table in paragraph (2) to read as
follows:
----------------------------------------------------------------------------------------------------------------
Fiscal Fiscal Fiscal Fiscal Fiscal
``Fee Type Year 2023 Year 2024 Year 2025 Year 2026 Year 2027
----------------------------------------------------------------------------------------------------------------
Premarket Application................................... $425,000 $435,000 $445,000 $455,000 $470,000
Establishment Registration.............................. $6,250 $6,875 $7,100 $7,575 $8,465'';
----------------------------------------------------------------------------------------------------------------
and
(3) in paragraph (3), by amending subparagraphs (A) through
(E) to read as follows:
``(A) $312,606,000 for fiscal year 2023.
``(B) $335,750,000 for fiscal year 2024.
``(C) $350,746,400 for fiscal year 2025.
``(D) $366,486,300 for fiscal year 2026.
``(E) $418,343,000 for fiscal year 2027.''.
(c) Annual Fee Setting; Adjustments.--Section 738(c) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 379j(c)) is amended--
(1) in paragraph (1), by striking ``2017'' and inserting
``2022'';
(2) in paragraph (2)--
(A) by striking ``2018'' each place it appears and
inserting ``2023'';
(B) in subparagraph (B)(ii), by striking ``2016''
and inserting ``2022'';
(C) in subparagraph (C)(i)(II), by striking
``Washington-Baltimore, DC-MD-VA-WV'' and inserting
``Washington-Arlington-Alexandria, DC-VA-MD-WV''; and
(D) in subparagraph (D), by striking ``2022'' and
inserting ``2027'';
(3) in paragraph (3), by striking ``2018 through 2022'' and
inserting ``2023 through 2027'';
(4) by redesignating paragraphs (4) and (5) as paragraphs
(7) and (8), respectively; and
(5) by inserting after paragraph (3) the following:
``(4) Performance improvement adjustment.--
``(A) In general.--For each of fiscal years 2025
through 2027, after the adjustment under paragraph (3),
the base establishment registration fee amounts for
such fiscal year shall be increased to reflect changes
in the resource needs of the Secretary due to improved
review performance goals for the process for the review
of device applications identified in the letters
described in section 201(b) of the Medical Device User
Fee Amendments of 2022, as the Secretary determines
necessary to achieve an increase in total fee
collections for such fiscal year, equal to the
following amounts, as applicable:
``(i) For fiscal year 2025, the product
of--
``(I) the amount determined under
subparagraph (B)(i)(I); and
``(II) the applicable inflation
adjustment under paragraph (2)(B) for
such fiscal year.
``(ii) For fiscal year 2026, the product
of--
``(I) the sum of the amounts
determined under subparagraphs
(B)(i)(II), (B)(ii)(I), and
(B)(iii)(I); and
``(II) the applicable inflation
adjustment under paragraph (2)(B) for
such fiscal year.
``(iii) For fiscal year 2027, the product
of--
``(I) the sum of the amounts
determined under subparagraphs
(B)(i)(III), (B)(ii)(II), and
(B)(iii)(II); and
``(II) the applicable inflation
adjustment under paragraph (2)(B) for
such fiscal year.
``(B) Amounts.--
``(i) Presubmission amount.--For purposes
of subparagraph (A), with respect to the
presubmission written feedback goal, the
amounts determined under this subparagraph are
as follows:
``(I) For fiscal year 2025,
$15,396,600 if the goal for fiscal year
2023 is met.
``(II) For fiscal year 2026--
``(aa) $15,396,600 if the
goal for fiscal year 2023 is
met and the goal for fiscal
year 2024 is missed; or
``(bb) $36,792,200 if the
goal for fiscal year 2024 is
met.
``(III) For fiscal year 2027--
``(aa) $15,396,600 if the
goal for fiscal year 2023 is
met and the goal for each of
fiscal years 2024 and 2025 is
missed;
``(bb) $36,792,200 if the
goal for fiscal year 2024 is
met and the goal for fiscal
year 2025 is missed; or
``(cc) $40,572,600 if the
goal for fiscal year 2025 is
met.
``(ii) De novo classification request
amount.--For purposes of subparagraph (A), with
respect to the de novo decision goal, the
amounts determined under this subparagraph are
as follows:
``(I) For fiscal year 2026,
$6,323,500 if the goal for fiscal year
2023 is met.
``(II) For fiscal year 2027--
``(aa) $6,323,500 if the
goal for fiscal year 2023 is
met and the goal for fiscal
year 2024 is missed; or
``(bb) $11,765,400 if the
goal for fiscal year 2024 is
met.
``(iii) Premarket notification and
premarket approval amount.--For purposes of
subparagraph (A), with respect to the 510(k)
decision goal, 510(k) shared outcome total time
to decision goal, PMA decision goal, and PMA
shared outcome total time to decision goal, the
amounts determined under this subparagraph are
as follows:
``(I) For fiscal year 2026,
$1,020,000 if the 4 goals for fiscal
year 2023 are met.
``(II) For fiscal year 2027--
``(aa) $1,020,000 if the 4
goals for fiscal year 2023 are
met and one or more of the 4
goals for fiscal year 2024 is
missed; or
``(bb) $3,906,000 if the 4
goals for fiscal year 2024 are
met.
``(C) Performance calculation.--For purposes of
this paragraph, performance of the following goals
shall be determined as specified in the letters
described in section 201(b) of the Medical Device User
Fee Amendments of 2022 and based on data available as
of the applicable dates as follows:
``(i) The performance of the presubmission
written feedback goal--
``(I) for fiscal year 2023, shall
be based on data available as of March
31, 2024;
``(II) for fiscal year 2024, shall
be based on data available as of March
31, 2025; and
``(III) for fiscal year 2025, shall
be based on data available as of March
31, 2026.
``(ii) The performance of the de novo
decision goal, 510(k) decision goal, 510(k)
shared outcome total time to decision goal, PMA
decision goal, and PMA shared outcome total
time to decision goal--
``(I) for fiscal year 2023, shall
be based on data available as of March
31, 2025; and
``(II) for fiscal year 2024, shall
be based on data available as of March
31, 2026.
``(D) Definitions.--For purposes of this paragraph,
the terms `presubmission written feedback goal', `de
novo decision goal', `510(k) decision goal', `510(k)
shared outcome total time to decision goal', `PMA
decision goal', and `PMA shared outcome total time to
decision goal' have the meanings given such terms in
the goals identified in the letters described in
section 201(b) of the Medical Device User Fee
Amendments of 2022.
``(5) Hiring adjustment.--
``(A) In general.--For each of fiscal years 2025
through 2027, after the adjustments under paragraphs
(3) and (4), if applicable, the base establishment
registration fee amounts shall be decreased as the
Secretary determines necessary to achieve a reduction
in total fee collections equal to the hiring adjustment
amount under subparagraph (B), if the number of hires
to support the process for the review of device
applications falls below the following thresholds for
the applicable fiscal years:
``(i) For fiscal year 2025, 85 percent of
the hiring goal specified in subparagraph (C)
for fiscal year 2023.
``(ii) For fiscal year 2026, 90 percent of
the hiring goal specified in subparagraph (C)
for fiscal year 2024.
``(iii) For fiscal year 2027, 90 percent of
the hiring goal specified in subparagraph (C)
for fiscal year 2025.
``(B) Hiring adjustment amount.--The hiring
adjustment amount for fiscal year 2025 and each
subsequent fiscal year is the product of--
``(i) the number of hires by which the
hiring goal specified in subparagraph (C) for
the fiscal year before the prior fiscal year
was missed;
``(ii) $72,877; and
``(iii) the applicable inflation adjustment
under paragraph (2)(B) for the fiscal year for
which the hiring goal was missed.
``(C) Hiring goals.--
``(i) In general.--For purposes of
subparagraph (B), the hiring goals for each of
fiscal years 2023 through 2025 are as follows:
``(I) For fiscal year 2023, 144
hires.
``(II) For fiscal year 2024, 42
hires.
``(III) For fiscal year 2025--
``(aa) 24 hires if the base
establishment registration fees
are not increased by the amount
determined under paragraph
(4)(A)(i); or
``(bb) 83 hires if the base
establishment registration fees
are increased by the amount
determined under paragraph
(4)(A)(i).
``(ii) Number of hires.--For purposes of
this paragraph, the number of hires for a
fiscal year shall be determined by the
Secretary, as set forth in the letters
described in section 201(b) of the Medical
Device User Fee Amendments of 2022.
``(6) Operating reserve adjustment.--
``(A) In general.--For each of fiscal years 2023
through 2027, after the adjustments under paragraphs
(3), (4), and (5), if applicable, if the Secretary has
operating reserves of carryover user fees for the
process for the review of device applications in excess
of the designated amount in subparagraph (B), the
Secretary shall decrease the base establishment
registration fee amounts to provide for not more than
such designated amount of operating reserves.
``(B) Designated amount.--Subject to subparagraph
(C), for each fiscal year, the designated amount in
this subparagraph is equal to the sum of--
``(i) 13 weeks of operating reserves of
carryover user fees; and
``(ii) the 1 month of operating reserves
described in paragraph (8).
``(C) Excluded amount.--For the period of fiscal
years 2023 through 2026, a total amount equal to
$118,000,000 shall not be considered part of the
designated amount under subparagraph (B) and shall not
be subject to the decrease under subparagraph (A).''.
(d) Small Businesses.--Section 738 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j) is amended--
(1) in subsection (a)(3)(B)--
(A) by striking ``No fee'' and inserting the
following:
``(i) In general.--No fee''; and
(B) by adding at the end the following:
``(ii) Small businesses fee waiver.--
``(I) Definition of small
business.--For the purposes of this
clause, the term `small business' means
an entity that reported $1,000,000 or
less of gross receipts or sales in its
most recent Federal income tax return
for a taxable year, including such
returns of all of its affiliates.
``(II) Waiver.--The Secretary may
grant a waiver of the fee required
under subparagraph (A) for the annual
registration (excluding the initial
registration) of an establishment for a
year, if the Secretary finds that the
establishment is a small business and
paying the fee for such year represents
a financial hardship to the
establishment as determined on the
basis of criteria established by the
Secretary.
``(III) Firms submitting tax
returns to the united states internal
revenue service.--The establishment
shall support its claim that it meets
the definition under subclause (I) by
submission of a copy of its most recent
Federal income tax return for a taxable
year, and a copy of such returns of its
affiliates, which show an amount of
gross sales or receipts that is less
than the maximum established in
subclause (I). The establishment, and
each of such affiliates, shall certify
that the information provided is a true
and accurate copy of the actual tax
forms they submitted to the Internal
Revenue Service. If no tax forms are
submitted for any affiliate, the
establishment shall certify that the
establishment has no affiliates.
``(IV) Firms not submitting tax
returns to the united states internal
revenue service.--In the case of an
establishment that has not previously
submitted a Federal income tax return,
the establishment and each of its
affiliates shall demonstrate that it
meets the definition under subclause
(I) by submission of a signed
certification, in such form as the
Secretary may direct through a notice
published in the Federal Register, that
the establishment or affiliate meets
the criteria for a small business and a
certification, in English, from the
national taxing authority, if extant,
of the country in which the
establishment or, if applicable,
affiliate is headquartered. The
certification from such taxing
authority shall bear the official seal
of such taxing authority and shall
provide the establishment's or
affiliate's gross receipts or sales for
the most recent year in both the local
currency of such country and in United
States dollars, the exchange rate used
in converting such local currency to
dollars, and the dates during which
these receipts or sales were collected.
The establishment shall also submit a
statement signed by the head of the
establishment's firm or by its chief
financial officer that the
establishment has submitted
certifications for all of its
affiliates, or that the establishment
has no affiliates.
``(V) Request for waiver.--An
establishment seeking a fee waiver for
a year under this clause shall submit
supporting information to the Secretary
at least 60 days before the fee is
required pursuant to subparagraph (C).
The decision of the Secretary regarding
whether an entity may receive the
waiver for such year is not
reviewable.'';
(2) in subsection (d)(2)(B)(iii), by inserting ``, if
extant,'' after ``national taxing authority''; and
(3) in subsection (e)(2)(B)(iii), by inserting ``, if
extant,'' after ``national taxing authority''.
(e) Conditions.--Section 738(g) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j(g)) is amended--
(1) in paragraph (1)(A), by striking ``$320,825,000'' and
inserting ``$398,566,000''; and
(2) in paragraph (2), by inserting ``de novo classification
requests,'' after ``class III device,''.
(f) Authorization of Appropriations.--Section 738(h)(3) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j(h)(3)) is amended
to read as follows:
``(3) Authorization of appropriations.--
``(A) In general.--For each of the fiscal years
2023 through 2027, there is authorized to be
appropriated for fees under this section an amount
equal to the revenue amount determined in subparagraph
(B), less the amount of reductions determined in
subparagraph (C).
``(B) Revenue amount.--For purposes of this
paragraph, the revenue amount for each fiscal year is
the sum of--
``(i) the total revenue amount under
subsection (b)(3) for the fiscal year, as
adjusted under subsection (c)(2); and
``(ii) the performance improvement
adjustment amount for the fiscal year under
subsection (c)(4)(A), if applicable.
``(C) Amount of reductions.--For purposes of this
paragraph, the amount of reductions for each fiscal
year is the sum of--
``(i) the hiring adjustment amount for the
fiscal year under subsection (c)(5), if
applicable; and
``(ii) the operating reserve adjustment
amount for the fiscal year under subsection
(c)(6), if applicable.''.
SEC. 204. REAUTHORIZATION; REPORTING REQUIREMENT.
(a) Performance Reports.--Section 738A(a) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-1(a)) is amended--
(1) by striking ``fiscal year 2018'' each place it appears
and inserting ``fiscal year 2023''; and
(2) by striking ``Medical Device User Fee Amendments of
2017'' each place it appears and inserting ``Medical Device
User Fee Amendments of 2022'';
(3) in paragraph (1)--
(A) in subparagraph (A), by redesignating the
second clause (iv) (relating to analysis) as clause
(v); and
(B) in subparagraph (A)(iv) (relating to rationale
for MDUFA program changes), by striking ``fiscal year
2020'' and inserting ``fiscal year 2023''; and
(4) in paragraph (4), by striking ``2018 through 2022'' and
inserting ``2023 through 2027.''
(b) Reauthorization.--Section 738A(b) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379j-1(b)) is amended--
(1) in paragraph (1), by striking ``2022'' and inserting
``2027''; and
(2) in paragraph (5), by striking ``2022'' and inserting
``2027''.
SEC. 205. ACCREDITATION PROGRAMS.
(a) Accreditation Scheme for Conformity Assessment.--Section 514(d)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360d(d)) is
amended--
(1) in the subsection heading, by striking ``Pilot'';
(2) in paragraph (1)--
(A) in the matter preceding subparagraph (A), by
striking ``pilot'';
(B) in subparagraph (A)--
(i) by inserting ``meeting criteria
specified by the Secretary in guidance'' after
``testing laboratories'';
(ii) by inserting ``in guidance'' after
``by the Secretary''; and
(iii) by striking ``assess the conformance
of a device with'' and inserting ``conduct
testing to support the assessment of the
conformance of a device to''; and
(C) in subparagraph (B)--
(i) by striking ``determinations'' and
inserting ``results'';
(ii) by inserting ``to support'' after ``so
accredited''; and
(iii) by striking ``a particular such
determination'' and inserting ``particular such
results'';
(3) in paragraph (2)--
(A) in the paragraph heading, by striking
``determinations'' and inserting ``results'';
(B) in subparagraph (A)--
(i) by striking ``determinations by testing
laboratories'' and all that follows through
``such determinations or'' and inserting
``results by testing laboratories accredited
pursuant to this subsection, including by
conducting periodic audits of such results or
of the'';
(ii) by inserting a comma after ``or
testing laboratories'';
(iii) by inserting ``or recognition of an
accreditation body'' after ``accreditation of
such testing laboratory''; and
(iv) by striking ``such device'' and
inserting ``a device''; and
(C) in subparagraph (B)--
(i) by striking ``by a testing laboratory
so accredited'' and inserting ``under this
subsection''; and
(ii) by inserting ``or recognition of an
accreditation body'' before ``under paragraph
(1)(A)'';
(4) in paragraph (3)(C)--
(A) in the subparagraph heading, by inserting ``and
transition'' after ``initiation''; and
(B) by adding at the end the following: ``After
September 30, 2023, such pilot program will be
considered to be completed, and the Secretary shall
have the authority to continue operating a program
consistent with this subsection.''; and
(5) by striking paragraph (4).
(b) Accredited Persons.--Section 523(c) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 360m(c)) is amended by striking ``2022''
and inserting ``2027''.
SEC. 206. SUNSET DATES.
(a) Authorization.--Sections 737 and 738 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379i; 379fj) shall cease to be effective
October 1, 2027.
(b) Reporting Requirements.--Section 738A of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-1) shall cease to be effective
January 31, 2028.
(c) Previous Sunset Provision.--Effective October 1, 2022,
subsections (a) and (b) of section 210 of the FDA Reauthorization Act
of 2017 (Public Law 115-52) are repealed.
SEC. 207. EFFECTIVE DATE.
The amendments made by this title shall take effect on October 1,
2022, or the date of the enactment of this Act, whichever is later,
except that fees under part 3 of subchapter C of chapter VII of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379i et seq.) shall be
assessed for all submissions listed in section 738(a)(2)(A) of such Act
received on or after October 1, 2022, regardless of the date of the
enactment of this Act.
SEC. 208. SAVINGS CLAUSE.
Notwithstanding the amendments made by this title, part 3 of
subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379i et seq.), as in effect on the day before the date of
the enactment of this title, shall continue to be in effect with
respect to the submissions listed in section 738(a)(2)(A) of such Act
(as defined in such part as of such day) that on or after October 1,
2017, but before October 1, 2022, were received by the Food and Drug
Administration with respect to assessing and collecting any fee
required by such part for a fiscal year prior to fiscal year 2023.
TITLE III--FEES RELATING TO GENERIC DRUGS
SEC. 301. SHORT TITLE; FINDING.
(a) Short Title.--This title may be cited as the ``Generic Drug
User Fee Amendments of 2022''.
(b) Finding.--The Congress finds that the fees authorized by the
amendments made in this title will be dedicated to human generic drug
activities, as set forth in the goals identified for purposes of part 7
of subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic
Act, in the letters from the Secretary of Health and Human Services to
the Chairman of the Committee on Health, Education, Labor, and Pensions
of the Senate and the Chairman of the Committee on Energy and Commerce
of the House of Representatives, as set forth in the Congressional
Record.
SEC. 302. AUTHORITY TO ASSESS AND USE HUMAN GENERIC DRUG FEES.
(a) Types of Fees.--Section 744B(a) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j-42(a)) is amended--
(1) in the matter preceding paragraph (1), by striking
``2018'' and inserting ``2023'';
(2) in paragraph (2)(C), by striking ``fiscal years 2018
through 2022'' and inserting ``fiscal years 2023 through
2027'';
(3) in paragraph (3)(B), by striking ``fiscal years 2018
through 2022'' and inserting ``fiscal years 2023 through
2027'';
(4) in paragraph (4)(D), by striking ``fiscal years 2018
through 2022'' and inserting ``fiscal years 2023 through
2027''; and
(5) in paragraph (5)(D), by striking ``fiscal years 2018
through 2022'' and inserting ``fiscal years 2023 through
2027''.
(b) Fee Revenue Amounts.--Section 744B(b) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-42(b)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A)--
(i) in the heading, by striking ``2018''
and inserting ``2023'';
(ii) by striking ``2018'' and inserting
``2023''; and
(iii) by striking ``$493,600,000'' and
inserting ``$582,500,000''; and
(B) in subparagraph (B)--
(i) in the heading, by striking ``2019
through 2022'' and inserting ``2024 through
2027'';
(ii) by striking ``For each'' and inserting
the following:
``(i) In general.--For each'';
(iii) by striking ``2019 through 2022'' and
inserting ``2024 through 2027'';
(iv) by striking ``$493,600,000'' and
inserting ``the base revenue amount under
clause (ii)''; and
(v) by adding at the end the following:
``(ii) Base revenue amount.--The base
revenue amount for a fiscal year is the total
revenue amount established under this paragraph
for the previous fiscal year, not including any
adjustments made for such previous fiscal year
under subsection (c)(3).''; and
(2) in paragraph (2)--
(A) in subparagraph (C), by striking ``one-third
the amount'' and inserting ``24 percent'';
(B) in subparagraph (D), by striking ``Seven'' and
inserting ``Six''; and
(C) in subparagraph (E)(i), by striking ``Thirty-
five'' and inserting ``Thirty-six''.
(c) Adjustments.--Section 744B(c) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j-42(c)) is amended--
(1) in paragraph (1)--
(A) in the matter preceding subparagraph (A)--
(i) by striking ``2019'' and inserting
``2024''; and
(ii) by striking ``the product of the total
revenues established in such notice for the
prior fiscal year'' and inserting ``the base
revenue amount for the fiscal year determined
under subsection (b)(1)(B)(ii)''; and
(B) in subparagraph (C), by striking ``Washington-
Baltimore, DC-MD-VA-WV'' and inserting ``Washington-
Arlington-Alexandria, DC-VA-MD-WV''; and
(2) by striking paragraph (2) and inserting the following:
``(2) Capacity planning adjustment.--
``(A) In general.--Beginning with fiscal year 2024,
the Secretary shall, in addition to the adjustment
under paragraph (1), further increase the fee revenue
and fees under this section for a fiscal year, in
accordance with this paragraph, to reflect changes in
the resource capacity needs of the Secretary for human
generic drug activities.
``(B) Capacity planning methodology.--The Secretary
shall establish a capacity planning methodology for
purposes of this paragraph, which shall--
``(i) be derived from the methodology and
recommendations made in the report titled
`Independent Evaluation of the GDUFA Resource
Capacity Planning Adjustment Methodology:
Evaluation and Recommendations' as announced in
the Federal Register on August 3, 2020 (85 Fed.
Reg. 46658); and
``(ii) incorporate approaches and
attributes determined appropriate by the
Secretary, including those made in such report
recommendations, except the workload categories
used in forecasting resources shall only be
those specified in section VIII.B.2.e. of the
letters described in section 301(b) of the
Generic Drug User Fee Amendments of 2022.
``(C) Limitations.--
``(i) In general.--Under no circumstances
shall an adjustment under this paragraph result
in fee revenue for a fiscal year that is less
than the sum of the amounts under subsection
(b)(1)(B)(ii) (the base revenue amount for the
fiscal year) and paragraph (1) (the dollar
amount of the inflation adjustment for the
fiscal year).
``(ii) Additional limitation.--An
adjustment under this paragraph shall not
exceed 3 percent of the sum described in clause
(i) for the fiscal year, except that such
limitation shall be 4 percent if--
``(I) for purposes of an adjustment
for fiscal year 2024, the Secretary
determines that, during the period from
April 1, 2021, through March 31, 2023--
``(aa) the total number of
abbreviated new drug
applications submitted was
greater than or equal to 2,000;
or
``(bb) thirty-five percent
or more of abbreviated new drug
applications submitted related
to complex products (as that
term is defined in section XI
of the letters described in
section 301(b) of the Generic
Drug User Fee Amendments of
2022);
``(II) for purposes of an
adjustment for fiscal year 2025, the
Secretary determines that, during the
period from April 1, 2022, through
March 31, 2024--
``(aa) the total number of
abbreviated new drug
applications submitted was
greater than or equal to 2,300;
or
``(bb) thirty-five percent
or more of abbreviated new drug
applications submitted related
to complex products (as so
defined);
``(III) for purposes of an
adjustment for fiscal year 2026, the
Secretary determines that, during the
period from April 1, 2023, through
March 31, 2025--
``(aa) the total number of
abbreviated new drug
applications submitted was
greater than or equal to 2,300;
or
``(bb) thirty-five percent
or more of abbreviated new drug
applications submitted related
to complex products (as so
defined); and
``(IV) for purposes of an
adjustment for fiscal year 2027, the
Secretary determines that, during the
period from April 1, 2024, through
March 31, 2026--
``(aa) the total number of
abbreviated new drug
applications submitted was
greater than or equal to 2,300;
or
``(bb) thirty-five percent
or more of abbreviated new drug
applications submitted related
to complex products (as so
defined).
``(D) Publication in federal register.--The
Secretary shall publish in the Federal Register notice
under subsection (a), the fee revenue and fees
resulting from the adjustment and the methodology under
this paragraph.
``(3) Operating reserve adjustment.--
``(A) In general.--For fiscal year 2024 and
subsequent fiscal years, the Secretary may, in addition
to adjustments under paragraphs (1) and (2), further
increase the fee revenue and fees under this section if
such an adjustment is necessary to provide operating
reserves of carryover user fees for human generic drug
activities for not more than the number of weeks
specified in subparagraph (B).
``(B) Number of weeks.--The number of weeks
specified in this subparagraph is--
``(i) 8 weeks for fiscal year 2024;
``(ii) 9 weeks for fiscal year 2025; and
``(iii) 10 weeks for each of fiscal year
2026 and 2027.
``(C) Decrease.--If the Secretary has carryover
balances for human generic drug activities in excess of
12 weeks of the operating reserves referred to in
subparagraph (A), the Secretary shall decrease the fee
revenue and fees referred to in such subparagraph to
provide for not more than 12 weeks of such operating
reserves.
``(D) Rationale for adjustment.--If an adjustment
under this paragraph is made, the rationale for the
amount of the increase or decrease (as applicable) in
fee revenue and fees shall be contained in the annual
Federal Register notice under subsection (a) publishing
the fee revenue and fees for the fiscal year
involved.''.
(d) Annual Fee Setting.--Section 744B(d)(1) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-42(d)(1)) is amended--
(1) in the heading, by striking ``2018 through 2022'' and
inserting ``2023 through 2027'';
(2) by striking ``more'' and inserting ``later''; and
(3) by striking ``2018 through 2022'' and inserting ``2023
through 2027''.
(e) Effect of Failure To Pay Fees.--The heading of paragraph (3) of
section 744B(g) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379j-42(g)) is amended by striking ``and prior approval supplement
fee''.
(f) Crediting and Availability of Fees.--Section 744B(i)(3) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-42(i)(3)) is
amended by striking ``2018 through 2022'' and inserting ``2023 through
2027''.
SEC. 303. REAUTHORIZATION; REPORTING REQUIREMENTS.
Section 744C of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379j-43) is amended--
(1) in subsection (a)--
(A) by striking ``2018'' each place it appears and
inserting ``2023''; and
(B) by striking ``Generic Drug User Fee Amendments
of 2017'' each place it appears and inserting ``Generic
Drug User Fee Amendments of 2022'';
(2) in subsection (b), by striking ``2018'' and inserting
``2023'';
(3) in subsection (c)--
(A) by striking ``2018'' and inserting ``2023'';
and
(B) by striking ``Generic Drug User Fee Amendments
of 2017'' each place it appears and inserting ``Generic
Drug User Fee Amendments of 2022''; and
(4) in subsection (f)--
(A) in paragraph (1), by striking ``2022'' and
inserting ``2027''; and
(B) in paragraph (5), by striking ``January 15,
2022'' and inserting ``January 15, 2027''.
SEC. 304. SUNSET DATES.
(a) Authorization.--Sections 744A and 744B of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-41; 379j-42) shall cease to be
effective October 1, 2027.
(b) Reporting Requirements.--Section 744C of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-43) shall cease to be effective
January 31, 2028.
(c) Previous Sunset Provision.--Effective October 1, 2022,
subsections (a) and (b) of section 305 of the FDA Reauthorization Act
of 2017 (Public Law 115-52) are repealed.
SEC. 305. EFFECTIVE DATE.
The amendments made by this title shall take effect on October 1,
2022, or the date of the enactment of this Act, whichever is later,
except that fees under part 7 of subchapter C of chapter VII of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-41 et seq.) shall
be assessed for all abbreviated new drug applications received on or
after October 1, 2022, regardless of the date of the enactment of this
Act.
SEC. 306. SAVINGS CLAUSE.
Notwithstanding the amendments made by this title, part 7 of
subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic
Act, as in effect on the day before the date of the enactment of this
title, shall continue to be in effect with respect to abbreviated new
drug applications (as defined in such part as of such day) that were
received by the Food and Drug Administration within the meaning of
section 505(j)(5)(A) of such Act (21 U.S.C. 355(j)(5)(A)), prior
approval supplements that were submitted, and drug master files for
Type II active pharmaceutical ingredients that were first referenced on
or after October 1, 2017, but before October 1, 2022, with respect to
assessing and collecting any fee required by such part for a fiscal
year prior to fiscal year 2023.
TITLE IV--FEES RELATING TO BIOSIMILAR BIOLOGICAL PRODUCTS
SEC. 401. SHORT TITLE; FINDING.
(a) Short Title.--This title may be cited as the ``Biosimilar User
Fee Amendments of 2022''.
(b) Finding.--Congress finds that the fees authorized by the
amendments made in this title will be dedicated to expediting the
process for the review of biosimilar biological product applications,
including postmarket safety activities, as set forth in the goals
identified for purposes of part 8 of subchapter C of chapter VII of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-51 et seq.), in
the letters from the Secretary of Health and Human Services to the
Chairman of the Committee on Health, Education, Labor, and Pensions of
the Senate and the Chairman of the Committee on Energy and Commerce of
the House of Representatives, as set forth in the Congressional Record.
SEC. 402. DEFINITIONS.
Section 744G of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379j-51) is amended--
(1) in paragraph (1)--
(A) by striking ``Washington-Baltimore, DC-MD-VA-
WV'' and inserting ``Washington-Arlington-Alexandria,
DC-VA-MD-WV'';
(B) by striking ``October of'' and inserting
``September of''; and
(C) by striking ``October 2011'' and inserting
``September 2011''; and
(2) in paragraph (4)(B)(iii)--
(A) by striking subclause (II); and
(B) by redesignating subclauses (III) and (IV) as
subclauses (II) and (III), respectively.
SEC. 403. AUTHORITY TO ASSESS AND USE BIOSIMILAR BIOLOGICAL PRODUCT
FEES.
(a) Types of Fees.--Section 744H(a) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j-52(a)) is amended--
(1) in the matter preceding paragraph (1), by striking
``2018'' and inserting ``2023'';
(2) in paragraph (1)--
(A) in subparagraph (A)--
(i) in clause (iv)(I), by striking ``5
days'' and inserting ``7 days''; and
(ii) in clause (v)(II), by striking ``5
days'' and inserting ``7 days'';
(B) in subparagraph (B)--
(i) in clause (i), by inserting ``, except
that, in the case that such product (including,
where applicable, ownership of the relevant
investigational new drug application) is
transferred to a licensee, assignee, or
successor of such person, and written notice of
such transfer is provided to the Secretary,
such licensee, assignee or successor shall pay
the annual biosimilar biological product
development fee'' before the period;
(ii) in clause (iii)--
(I) in subclause (I), by striking
``; or'' and inserting a semicolon;
(II) in subclause (II), by striking
the period and inserting ``; or''; and
(III) by adding at the end the
following:
``(III) been administratively
removed from the biosimilar biological
product development program for the
product under subparagraph (E)(v).'';
and
(iii) in clause (iv), by striking
``accepted for filing on or after October 1 of
such fiscal year'' and inserting ``subsequently
accepted for filing'';
(C) in subparagraph (D)--
(i) in clause (i)--
(I) in the matter preceding
subclause (I), by striking ``shall, if
the person seeks to resume
participation in such program, pay''
and inserting ``or who has been
administratively removed from such
program for a product under
subparagraph (E)(v) shall, if the
person seeks to resume participation in
such program, pay all annual biosimilar
biological product development fees
previously assessed for such product
and still owed and'';
(II) in subclause (I)--
(aa) by striking ``5 days''
and inserting ``7 days''; and
(bb) by inserting ``or the
date of administrative removal,
as applicable'' after
``discontinued''; and
(III) in subclause (II), by
inserting ``or the date of
administrative removal, as applicable''
after ``discontinued''; and
(ii) in clause (ii), by inserting ``,
except that, in the case that such product
(including, where applicable, ownership of the
relevant investigational new drug application)
is transferred to a licensee, assignee, or
successor of such person, and written notice of
such transfer is provided to the Secretary,
such licensee, assignee or successor shall pay
the annual biosimilar biological product
development fee'' before the period at the end;
and
(D) in subparagraph (E), by adding at the end the
following:
``(v) Administrative removal from the
biosimilar biological product development
program.--If a person has failed to pay an
annual biosimilar biological product
development fee for a product as required under
subparagraph (B) for a period of 2 consecutive
fiscal years, the Secretary may
administratively remove such person from the
biosimilar biological product development
program for the product. At least 30 days prior
to administratively removing a person from the
biosimilar biological product development
program for a product under this clause, the
Secretary shall provide written notice to such
person of the intended administrative
removal.'';
(3) in paragraph (2)(D), by inserting ``prior to approval''
after ``withdrawn'';
(4) in paragraph (3)--
(A) in subparagraph (A)--
(i) in clause (i), by striking ``; and''
and inserting a semicolon;
(ii) by redesignating clause (ii) as clause
(iii); and
(iii) by inserting the following after
clause (i):
``(ii) may be dispensed only under
prescription pursuant to section 503(b); and'';
and
(B) by adding at the end the following:
``(E) Movement to discontinued list.--
``(i) Written request to place on
discontinued list.--
``(I) In general.--If a written
request to place a product on the list
of discontinued biosimilar biological
products referred to in subparagraph
(A)(iii) is submitted to the Secretary
on behalf of an applicant, and the
request identifies the date the product
is, or will be, withdrawn from sale,
then for purposes of assessing the
biosimilar biological product program
fee, the Secretary shall consider such
product to have been included on such
list on the later of--
``(aa) the date such
request was received; or
``(bb) if the product will
be withdrawn from sale on a
future date, such future date
when the product is withdrawn
from sale.
``(II) Withdrawn from sale
defined.--For purposes of this clause,
a product shall be considered withdrawn
from sale once the applicant has ceased
its own distribution of the product,
whether or not the applicant has
ordered recall of all previously
distributed lots of the product, except
that a routine, temporary interruption
in supply shall not render a product
withdrawn from sale.
``(ii) Products removed from discontinued
list.--If a biosimilar biological product that
is identified in a biosimilar biological
product application approved as of October 1 of
a fiscal year appears, as of October 1 of such
fiscal year, on the list of discontinued
biosimilar biological products referred to in
subparagraph (A)(iii), and on any subsequent
day during such fiscal year the biosimilar
biological product does not appear on such
list, except as provided in subparagraph (D),
each person who is named as the applicant in
the biosimilar biological product application
shall pay the annual biosimilar biological
product program fee established for a fiscal
year under subsection (c)(5) for such
biosimilar biological product. Notwithstanding
subparagraph (B), such fee shall be due on the
last business day of such fiscal year and shall
be paid only once for each product for each
fiscal year.''; and
(5) by striking paragraph (4).
(b) Fee Revenue Amounts.--Section 744H(b) of the Federal Food,
Drug, and Cosmetic Act ((21 U.S.C. 379j-52(b)) is amended--
(1) by striking paragraph (1);
(2) by redesignating paragraphs (2) through (4) as
paragraphs (1) through (3), respectively;
(3) in paragraph (1), as so redesignated--
(A) in the paragraph heading, by striking
``Subsequent fiscal years'' and inserting ``In
general'';
(B) in the matter preceding subparagraph (A), by
striking ``2019 through 2022'' and inserting ``2023
through 2027'';
(C) in subparagraph (A), by striking ``paragraph
(4)'' and inserting ``paragraph (3)'';
(D) by redesignating subparagraphs (C) and (D) as
subparagraphs (D) and (E), respectively;
(E) by inserting after subparagraph (B) the
following:
``(C) the dollar amount equal to the strategic
hiring and retention adjustment (as determined under
subsection (c)(2));'';
(F) in subparagraph (D), as so redesignated, by
striking ``subsection (c)(2)); and'' and inserting
``subsection (c)(3));'';
(G) in subparagraph (E), as so redesignated, by
striking ``subsection (c)(3)).'' and inserting
``subsection (c)(4)); and''; and
(H) by adding at the end the following:
``(F) for fiscal years 2023 and 2024, additional
dollar amounts equal to--
``(i) $4,428, 886 for fiscal year 2023; and
``(ii) $320,569 for fiscal year 2024.'';
(4) in paragraph (2), as so redesignated--
(A) in the paragraph heading, by striking ``;
limitations on fee amounts'';
(B) by striking subparagraph (B); and
(C) by redesignating subaparagraphs (C) and (D) as
subparagraphs (B) and (C), respectively; and
(5) by amending paragraph (3), as so redesignated, to read
as follows:
``(3) Annual base revenue.--For purposes of paragraph (1),
the dollar amount of the annual base revenue for a fiscal year
shall be--
``(A) for fiscal year 2023, $43,376,922; and
``(B) for fiscal years 2024 through 2027, the
dollar amount of the total revenue amount established
under paragraph (1) for the previous fiscal year,
excluding any adjustments to such revenue amount under
subsection (c)(4).''.
(c) Adjustments; Annual Fee Setting.--Section 744H(c) of the
Federal Food, Drug, and Cosmetic Act ((21 U.S.C. 379j-52(c)) is
amended--
(1) in paragraph (1)--
(A) in subparagraph (A)--
(i) in the matter preceding clause (i), by
striking ``subsection (b)(2)(B)'' and inserting
``subsection (b)(1)(B)''; and
(ii) in clause (i), by striking
``subsection (b)'' and inserting ``subsection
(b)(1)(A)''; and
(B) in subparagraph (B)(ii), by striking
``Washington-Baltimore, DC-MD-VA-WV'' and inserting
``Washington-Arlington-Alexandria, DC-VA-MD-WV'';
(2) by striking paragraph (4);
(3) by redesignating paragraphs (2) and (3) as paragraphs
(3) and (4), respectively;
(4) by inserting after paragraph (1) the following:
``(2) Strategic hiring and retention adjustment.--For each
fiscal year beginning in fiscal year 2023, after the annual
base revenue under subsection (b)(1)(A) is adjusted for
inflation in accordance with paragraph (1), the Secretary shall
further increase the fee revenue and fees by $150,000.'';
(5) in paragraph (3), as so redesignated--
(A) in subparagraph (A)--
(i) by striking ``Beginning with the fiscal
year described in subparagraph (B)(ii)(II)''
and inserting ``For each fiscal year''; and
(ii) by striking ``adjustment under
paragraph (1), further increase'' and inserting
``adjustments under paragraphs (1) and (2),
further adjust''; and
(B) by amending subparagraph (B) to read as
follows:
``(B) Methodology.--For purposes of this paragraph,
the Secretary shall employ the capacity planning
methodology utilized by the Secretary in setting fees
for fiscal year 2021, as described in the notice titled
`Biosimilar User Fee Rates for Fiscal Year 2021' (85
Fed. Reg. 47220; August 4, 2020). The workload
categories used in forecasting shall include only the
activities described in such notice and, as feasible,
additional activities that are also directly related to
the direct review of biosimilar biological product
applications and supplements, including additional
formal meeting types and the direct review of
postmarketing commitments and requirements, the direct
review of risk evaluation and mitigation strategies,
and the direct review of annual reports for approved
biosimilar biological products. Subject to the
exceptions in the preceding sentence, the Secretary
shall not include as workload categories in forecasting
any non-core review activities, including any
activities that the Secretary referenced for potential
future use in such notice but did not utilize in
setting fees for fiscal year 2021.''; and
(C) in subparagraph (C)--
(i) by striking ``subsections (b)(2)(A)''
and inserting ``subsections (b)(1)(A)'';
(ii) by striking ``and (b)(2)(B)'' and
inserting ``, (b)(1)(B)''; and
(iii) by inserting ``, and (b)(1)(C) (the
dollar amount of the strategic hiring and
retention adjustment)'' before the period at
the end;
(6) by amending paragraph (4), as so redesignated, to read
as follows:
``(4) Operating reserve adjustment.--
``(A) Increase.--For fiscal year 2023 and
subsequent fiscal years, the Secretary shall, in
addition to adjustments under paragraphs (1), (2), and
(3), further increase the fee revenue and fees if such
an adjustment is necessary to provide for at least 10
weeks of operating reserves of carryover user fees for
the process for the review of biosimilar biological
product applications.
``(B) Decrease.--
``(i) Fiscal year 2023.--For fiscal year
2023, if the Secretary has carryover balances
for the process for the review of biosimilar
biological product applications in excess of 33
weeks of such operating reserves, the Secretary
shall decrease such fee revenue and fees to
provide for not more than 33 weeks of such
operating reserves.
``(ii) Fiscal year 2024.--For fiscal year
2024, if the Secretary has carryover balances
for the process for the review of biosimilar
biological product applications in excess of 27
weeks of such operating reserves, the Secretary
shall decrease such fee revenue and fees to
provide for not more than 27 weeks of such
operating reserves.
``(iii) Fiscal year 2025 and subsequent
fiscal years.--For fiscal year 2025 and
subsequent fiscal years, if the Secretary has
carryover balances for the process for the
review of biosimilar biological product
applications in excess of 21 weeks of such
operating reserves, the Secretary shall
decrease such fee revenue and fees to provide
for not more than 21 weeks of such operating
reserves.
``(C) Federal register notice.--If an adjustment
under subparagraph (A) or (B) is made, the rationale
for the amount of the increase or decrease (as
applicable) in fee revenue and fees shall be contained
in the annual Federal Register notice under paragraph
(5)(B) establishing fee revenue and fees for the fiscal
year involved.''; and
(7) in paragraph (5), in the matter preceding subparagraph
(A), by striking ``2018'' and inserting ``2023''.
(d) Crediting and Availability of Fees.--Section 744H(f)(3) of the
Federal Food, Drug, and Cosmetic Act ((21 U.S.C. 379j-52(f)(3)) is
amended by striking ``2018 through 2022'' and inserting ``2023 through
2027''.
(e) Written Requests for Waivers and Refunds.--Subsection (h) of
section 744H of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379j-52) is amended to read as follows:
``(h) Written Requests for Waivers and Returns; Disputes Concerning
Fees.--To qualify for consideration for a waiver under subsection (d),
or the return of any fee paid under this section, including if the fee
is claimed to have been paid in error, a person shall submit to the
Secretary a written request justifying such waiver or return and,
except as otherwise specified in this section, such written request
shall be submitted to the Secretary not later than 180 days after such
fee is due. A request submitted under this paragraph shall include any
legal authorities under which the request is made.''.
SEC. 404. REAUTHORIZATION; REPORTING REQUIREMENTS.
Section 744I of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379j-53) is amended--
(1) by striking ``2018'' each place it appears and
inserting ``2023'';
(2) by striking ``Biosimilar User Fee Amendments of 2017''
each place it appears and inserting ``Biosimilar User Fee
Amendments of 2022'';
(3) in subsection (a)(4), by striking ``2020'' and
inserting ``2023''; and
(4) in subsection (f), by striking ``2022'' each place it
appears and inserting ``2027''.
SEC. 405. SUNSET DATES.
(a) Authorization.--Sections 744G and 744H of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-51, 379j-52 ) shall cease to be
effective October 1, 2027.
(b) Reporting Requirements.--Section 744I of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-53) shall cease to be effective
January 31, 2028.
(c) Previous Sunset Provision.--Effective October 1, 2022,
subsections (a) and (b) of section 405 of the FDA Reauthorization Act
of 2017 (Public Law 115-52) are repealed.
SEC. 406. EFFECTIVE DATE.
The amendments made by this title shall take effect on October 1,
2022, or the date of the enactment of this Act, whichever is later,
except that fees under part 8 of subchapter C of chapter VII of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-51 et seq.) shall
be assessed for all biosimilar biological product applications received
on or after October 1, 2022, regardless of the date of the enactment of
this Act.
SEC. 407. SAVINGS CLAUSE.
Notwithstanding the amendments made by this title, part 8 of
subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379j-51 et seq.), as in effect on the day before the date of
the enactment of this title, shall continue to be in effect with
respect to biosimilar biological product applications and supplements
(as defined in such part as of such day) that were accepted by the Food
and Drug Administration for filing on or after October 1, 2017, but
before October 1, 2022, with respect to assessing and collecting any
fee required by such part for a fiscal year prior to fiscal year 2023.
TITLE V--IMPROVING REGULATION OF DRUGS AND BIOLOGICAL PRODUCTS
SEC. 501. ALTERNATIVES TO ANIMAL TESTING.
(a) In General.--Section 505 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355) is amended--
(1) in subsection (i)--
(A) in paragraph (1)(A), by striking ``preclinical
tests (including tests on animals)'' and inserting
``nonclinical tests''; and
(B) in paragraph (2)(B), by striking ``animal'' and
inserting ``nonclinical tests''; and
(2) after subsection (y), by inserting the following:
``(z) Nonclinical Test Defined.--For purposes of this section, the
term `nonclinical test' means a test conducted in vitro, in silico, or
in chemico, or a non-human in vivo test that occurs before or during
the clinical trial phase of the investigation of the safety and
effectiveness of a drug, and may include animal tests, or non-animal or
human biology-based test methods, such as cell-based assays,
microphysiological systems, or bioprinted or computer models.''.
(b) Biosimilar Biological Product Applications.--Item (bb) of
section 351(k)(2)(A)(i)(I) of the Public Health Service Act (42 U.S.C.
262(k)(2)(A)(i)(I)) is amended to read as follows:
``(bb) an assessment of
toxicity (which may rely on, or
consist of, a study or studies
described in item (aa) or
(cc)); and''.
SEC. 502. SAFER DISPOSAL OF OPIOIDS.
Section 505-1(e)(4)(B) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 355-1(e)(4)(B)) is amended by striking ``for purposes of
rendering drugs nonretrievable (as defined in section 1300.05 of title
21, Code of Federal Regulations (or any successor regulation))''.
SEC. 503. CLARIFICATIONS TO EXCLUSIVITY PROVISIONS FOR FIRST
INTERCHANGEABLE BIOSIMILAR BIOLOGICAL PRODUCTS.
Section 351(k)(6) of the Public Health Service Act (42 U.S.C.
262(k)(6)) is amended--
(1) in the matter preceding subparagraph (A)--
(A) by striking ``Upon review of'' and inserting
``The Secretary shall not make approval as an
interchangeable biological product effective with
respect to'';
(B) by striking ``relying on'' and inserting ``that
relies on''; and
(C) by striking ``the Secretary shall not make a
determination under paragraph (4) that the second or
subsequent biological product is interchangeable for
any condition of use''; and
(2) in the flush text that follows subparagraph (C), by
striking the period and inserting ``, and the term `first
interchangeable biosimilar biological product' means any
interchangeable biosimilar biological product that is approved
on the first day on which such a product is approved as
interchangeable with the reference product.''.
SEC. 504. IMPROVEMENTS TO THE PURPLE BOOK.
(a) In General.--Section 506I of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 356i) is amended--
(1) in subsection (a)--
(A) by striking ``The holder of an application
approved under subsection (c) or (j) of section 505''
and inserting ``The holder of an application approved
under subsection (c) or (j) of section 505 of this Act
or subsection (a) or (k) of section 351 of the Public
Health Service Act'';
(B) in paragraph (2), by inserting ``(in the case
of a biological product, the proper name)'' after
``established name''; and
(C) in paragraph (3), by striking ``or abbreviated
application number'' and inserting ``, abbreviated
application number, or biologics license application
number''; and
(2) in subsection (b)--
(A) in the matter preceding paragraph (1), by
striking ``The holder of an application approved under
subsection (c) or (j)'' and inserting ``The holder of
an application approved under subsection (c) or (j) of
section 505 of this Act or subsection (a) or (k) of
section 351 of the Public Health Service Act'';
(B) in paragraph (1), by inserting ``(in the case
of a biological product, the proper name)'' after
``established name''; and
(C) in paragraph (2), by striking ``or abbreviated
application number'' and inserting ``, abbreviated
application number, or biologics license application
number''.
(b) Additional One-Time Report.--Subsection (c) of section 506I of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 356i) is amended to
read as follows:
``(c) Additional One-Time Report.--Within 180 days of the date of
enactment of the Food and Drug Administration Safety and Landmark
Advancements Act of 2022, all holders of applications approved under
subsection (a) or (k) of section 351 of the Public Health Service Act
shall review the information in the list published under section
351(k)(9)(A) and shall submit a written notice to the Secretary--
``(1) stating that all of the application holder's
biological products in the list published under section
351(k)(9)(A) that are not listed as discontinued are available
for sale; or
``(2) including the information required pursuant to
subsection (a) or (b), as applicable, for each of the
application holder's biological products that are in the list
published under section 351(k)(9)(A) and not listed as
discontinued, but have been discontinued from sale or never
have been available for sale.''.
(c) Purple Book.--Section 506I of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 356i) is amended--
(1) in subsection (d)--
(A) by striking ``or (c), the Secretary'' and
inserting ``or (c)--
``(1) the Secretary'';
(B) by striking the period at the end, and
inserting ``; and''; and
(C) by adding at the end the following:
``(2) the Secretary may identify the application holder's
biological products as discontinued in the list published under
section 351(k)(9)(A) of the Public Health Service Act, except
that the Secretary shall remove from the list in accordance
with section 351(k)(9)(B) of such Act any biological product
for which a license has been revoked or suspended for reasons
of safety, purity, or potency.''; and
(2) in subsection (e)--
(A) by inserting after the first sentence the
following: ``The Secretary shall update the list
published under section 351(k)(9)(A) of the Public
Health Service Act based on information provided under
subsections (a), (b), and (c) by identifying as
discontinued biological products that are not available
for sale, except that any biological product for which
the license has been revoked or suspended for reasons
of safety, purity, or potency shall be removed from the
list in accordance with section 351(k)(9)(B) of the
Public Health Service Act.''; and
(B) in the last sentence--
(i) by striking ``updates to the list'' and
inserting ``updates to the lists published
under section 505(j)(7)(A) of this Act and
section 351(k)(9)(A) of the Public Health
Service Act''; and
(ii) by striking ``update the list'' and
inserting ``update such lists''.
SEC. 505. THERAPEUTIC EQUIVALENCE EVALUATIONS.
Section 505(j)(7)(A) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 355(j)(7)(A)) is amended by adding at the end the following:
``(v)(I) With respect to an application submitted pursuant to
subsection (b)(2) for a drug that is subject to section 503(b) for
which the sole difference from a listed drug relied upon in the
application is a difference in inactive ingredients not permitted under
clause (iii) or (iv) of section 314.94(a)(9) of title 21, Code of
Federal Regulations (or any successor regulations), the Secretary shall
make an evaluation with respect to whether such drug is a therapeutic
equivalent (as defined in section 314.3 of title 21, Code of Federal
Regulations (or any successor regulations)) to another approved drug
product in the prescription drug product section of the list under this
paragraph as follows:
``(aa) With respect to such an application submitted after
the date of enactment of the Food and Drug Administration
Safety and Landmark Advancements Act of 2022, the evaluation
shall be made with respect to a listed drug relied upon in the
application pursuant to subsection (b)(2) that is a
pharmaceutical equivalent (as defined in section 314.3 of title
21, Code of Federal Regulations (or any successor regulations))
to the drug in the application pursuant to subsection (b)(2) at
the time of approval of such application or not later than 180
days after the date of such approval, provided that the request
for such an evaluation is made in the original application (or
in a resubmission to a complete response letter), and all
necessary data and information are submitted in the original
application (or in a resubmission in response to a complete
response letter) for the therapeutic equivalence evaluation,
including information to demonstrate bioequivalence, in a form
and manner prescribed by the Secretary.
``(bb) With respect to such an application approved prior
to or on the date of enactment of the Food and Drug
Administration Safety and Landmark Advancements Act of 2022,
the evaluation shall be made not later than 180 days after
receipt of a request for a therapeutic equivalence evaluation
submitted as part of a supplement to such application; or with
respect to an application that was submitted prior to the date
of enactment of the Food and Drug Administration Safety and
Landmark Advancements Act of 2022 but not approved as of the
date of enactment of such Act, the evaluation shall be made not
later than 180 days after the date of approval of such
application if a request for such evaluation is submitted as an
amendment to the application, provided that--
``(AA) such request for a therapeutic equivalence
evaluation is being sought with respect to a listed
drug relied upon in the application, and the relied
upon listed drug is in the prescription drug product
section of the list under this paragraph and is a
pharmaceutical equivalent (as defined in section 314.3
of title 21, Code of Federal Regulations (or any
successor regulations)) to the drug for which a
therapeutic equivalence evaluation is sought; and
``(BB) the amendment or supplement, as applicable,
containing such request, or the relevant application,
includes all necessary data and information for the
therapeutic equivalence evaluation, including
information to demonstrate bioequivalence, in a form
and manner prescribed by the Secretary.
``(II) When the Secretary makes an evaluation under subclause (I),
the Secretary shall, in revisions made to the list pursuant to clause
(ii), include such information for such drug.''.
SEC. 506. MODERNIZING ACCELERATED APPROVAL.
(a) In General.--Section 506(c) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 356(c)) is amended--
(1) in paragraph (2)--
(A) by redesignating subparagraphs (A) and (B) as
clauses (i) and (ii), respectively, and adjusting the
margins accordingly;
(B) by striking ``Approval of a product'' and
inserting the following:
``(A) In general.--Approval of a product'';
(C) in clause (i) of such subparagraph (A), as so
redesignated, by striking ``appropriate postapproval
studies'' and inserting ``an appropriate postapproval
study or studies (which may be augmented or supported
by real world evidence)''; and
(D) by adding at the end the following:
``(B) Studies not required.--If the Secretary does
not require that the sponsor of a product approved
under accelerated approval conduct a postapproval study
under this paragraph, the Secretary shall publish on
the website of the Food and Drug Administration the
rationale for why such study is not appropriate or
necessary.
``(C) Postapproval study conditions.--Not later
than the date of approval of a product under
accelerated approval, the Secretary shall specify the
conditions for a postapproval study or studies required
to be conducted under this paragraph with respect to
such product, which may include enrollment targets, the
study protocol, and milestones, including the target
date of study completion.
``(D) Studies begun before approval.--The Secretary
may require such study or studies to be underway prior
to approval of the applicable product.''; and
(2) in paragraph (3)--
(A) by redesignating subparagraphs (A) through (D)
as clauses (i) through (iv), respectively and adjusting
the margins accordingly;
(B) by striking ``The Secretary may'' and inserting
the following:
``(A) In general.--The Secretary may'';
(C) in clause (i) of such subparagraph (A), as so
redesignated, by striking ``drug with due diligence''
and inserting ``product with due diligence, including
with respect to conditions specified by the Secretary
under paragraph (2)(C)'';
(D) in clause (iii) of such subparagraph (A), as so
redesignated, by inserting ``shown to be'' after
``product is not''; and
(E) by adding at the end the following:
``(B) Expedited procedures described.--Expedited
procedures described in this subparagraph shall consist
of, prior to the withdrawal of accelerated approval--
``(i) providing the sponsor with--
``(I) due notice;
``(II) an explanation for the
proposed withdrawal;
``(III) an opportunity for a
meeting with the Commissioner or the
Commissioner's designee; and
``(IV) an opportunity for written
appeal to--
``(aa) the Commissioner; or
``(bb) a designee of the
Commissioner who has not
participated in the proposed
withdrawal of approval (other
than a meeting pursuant to
subclause (III)) and is not
subordinate of an individual
(other than the Commissioner)
who participated in such
proposed withdrawal;
``(ii) providing an opportunity for public
comment on the proposal to withdraw approval;
``(iii) the publication of a summary of the
public comments received, and the Secretary's
response to such comments, on the website of
the Food and Drug Administration; and
``(iv) convening and consulting an advisory
committee on issues related to the proposed
withdrawal, if requested by the sponsor and if
no such advisory committee has previously
advised the Secretary on such issues with
respect to the withdrawal of the product prior
to the sponsor's request.''.
(b) Reports of Postmarketing Studies.--Section 506B(a) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 356b(a)) is amended--
(1) by redesignating paragraph (2) as paragraph (3); and
(2) by inserting after paragraph (1) the following:
``(2) Accelerated approval.--Notwithstanding paragraph (1),
a sponsor of a drug approved pursuant to accelerated approval
shall submit to the Secretary a report of the progress of any
study required under section 506(c), including progress toward
enrollment targets, milestones, and other information as
required by the Secretary, not later than 180 days after the
approval of such drug and not less frequently than every 180
days thereafter, until the study is completed or terminated.
The Secretary shall promptly publish on the website of the Food
and Drug Administration, in an easily searchable format, the
information reported under this paragraph.''.
(c) Enforcement.--Section 301 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 331) is amended by adding at the end the
following:
``(fff) The failure of a sponsor of a product approved under
accelerated approval pursuant to section 506(c)--
``(1) to conduct with due diligence any postapproval study
required under section 506(c) with respect to such product; or
``(2) to submit timely reports with respect to such product
in accordance with section 506B(a)(2).''.
(d) Guidance.--
(1) In general.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall issue
guidance describing--
(A) how sponsor questions related to the
identification of novel surrogate or intermediate
clinical endpoints may be addressed in early-stage
development meetings with the Food and Drug
Administration;
(B) the use of novel clinical trial designs that
may be used to conduct appropriate postapproval studies
as may be required under section 506(c)(2)(A) of the
Federal Food, Drug, and Cosmetic Act, as amended by
subsection (a);
(C) the expedited procedures described in section
506(c)(3)(B) of the Federal Food, Drug, and Cosmetic
Act; and
(D) considerations related to the use of surrogate
or intermediate clinical endpoints that may support the
accelerated approval of an application under
506(c)(1)(A), including considerations in evaluating
the evidence related to any such endpoints.
(2) Final guidance.--The Secretary shall issue--
(A) draft guidance under paragraph (1) not later
than 18 months after the date of enactment of this Act;
and
(B) final guidance not later than 1 year after the
close of the public comment period on such draft
guidance.
(e) Accelerated Approval Council.--
(1) General.--Not later than 1 year after the date of
enactment of this Act, the Secretary shall establish an intra-
agency coordinating council within the Food and Drug
Administration to ensure the consistent and appropriate use of
accelerated approval across the Food and Drug Administration,
pursuant to section 506(c) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 356(c)).
(2) Membership.--The members of the Council shall consist
of the following senior officials, or a designee of such
official, from the Food and Drug Administration and relevant
Centers:
(A) The Director of the Center for Drug Evaluation
and Research.
(B) The Director of the Center for Biologics
Evaluation and Research.
(C) The Director of the Oncology Center of
Excellence.
(D) The Director of the Office of New Drugs.
(E) The Director of the Office of Orphan Products
Development.
(F) The Director of the Office of Tissues and
Advanced Therapies.
(G) The Director of the Office of Medical Policy.
(H) At least 3 directors of review divisions or
offices overseeing products approved under accelerated
approval, including at least one director within the
Office of Neuroscience.
(3) Duties of the council.--
(A) Meetings.--The Council shall convene not fewer
than 3 times per calendar year to discuss issues
related to accelerated approval, including any relevant
cross-disciplinary approaches related to product review
with respect to accelerated approval.
(B) Policy development.--The Council shall directly
engage with product review teams to support the
consistent and appropriate use of accelerated approval
across the Food and Drug Administration. Such
activities may include--
(i) developing guidance for Food and Drug
Administration staff and best practices for,
and across, product review teams, including
with respect to communication between sponsors
and the Food and Drug Administration and the
review of products under accelerated approval;
(ii) providing training for product review
teams; and
(iii) advising review divisions on product-
specific development, review, and withdrawal of
products under accelerated approval.
(4) Publication of a report.--Not later than 1 year after
the date of enactment of this Act, and annually thereafter, the
council shall publish on the public website of the Food and
Drug Administration a report on the activities of the council.
(5) Summary approval information.--With respect to each new
drug application for a new molecular entity approved under
section 505(c) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355(c)) or biological product licensed under section
351(a) of the Public Health Service Act (42 U.S.C. 262(a))
pursuant to accelerated approval under section 506(c) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 356(c)), the
Secretary shall provide for the drug or biologic action package
a summary of the basis for approval, including, as relates to
such new molecular entity, whether an advisory committee
meeting was held and a rationale for a determination by the
Secretary that a surrogate endpoint is reasonably likely to
predict clinical benefit.
(f) Rule of Construction.--Nothing in this section (including the
amendments made by this section) shall be construed to affect products
approved pursuant to section 506(c) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 356(c)) prior to the date of enactment of this
Act.
SEC. 507. RARE DISEASE PILOT PROGRAM.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall establish a
pilot program under which the Secretary establishes procedures to
provide increased interaction with sponsors of rare disease drug
development programs for purposes of advancing the development of
efficacy endpoints, including surrogate and intermediate endpoints, for
drugs intended to treat rare diseases, including through--
(1) determining eligibility of participants for such
program; and
(2) developing and implementing a process for applying to,
and participating in, such a program.
(b) Public Workshops.--The Secretary shall conduct up to 3 public
workshops, which shall be completed not later than September 30, 2026,
to discuss topics relevant to the development of endpoints for rare
diseases, which may include discussions about--
(1) novel endpoints developed through the pilot program
established under this section; and
(2) as appropriate, the use of real world evidence and real
world data to support the validation of efficacy endpoints,
including surrogate and intermediate endpoints, for rare
diseases.
(c) Report.--Not later than September 30, 2026, the Secretary shall
submit to the Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of the House of
Representatives a report describing the outcomes of the pilot program
established under this section.
(d) Guidance.--Not later than September 30, 2027, the Secretary
shall issue guidance describing best practices and strategies for
development of efficacy endpoints, including surrogate and intermediate
endpoints, for rare diseases.
(e) Sunset.--The Secretary may not accept any new application or
request to participate in the program established by this section on or
after October 1, 2027.
SEC. 508. SUPPORTING REVIEW AND DEVELOPMENT OF DRUGS TO TREAT RARE
DISEASES.
(a) GAO Report.--
(1) In general.--Not later than 18 months after the date of
enactment of this Act, the Comptroller General of the United
States shall submit to the Committee on Health, Education,
Labor, and Pensions of the Senate and the Committee on Energy
and Commerce of the House of Representatives, a report
assessing the policies, practices, and programs of the Food and
Drug Administration with respect to the review of applications
for drugs and biological products intended to treat rare
diseases and conditions (as defined in section 526(a)(2) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bb(a)(2))).
(2) Content of report.--The report under paragraph (1)
shall--
(A) describe the activities of the Food and Drug
Administration dedicated to the development and review
of drugs and biological products intended to treat rare
diseases and conditions;
(B) describe challenges with developing and
obtaining approval or licensure of drugs and biological
products intended to treat rare diseases and
conditions, such as challenges related to designing and
conducting clinical trials, clinical trial subject
recruitment and enrollment, study endpoints, and
ensuring data quality, assessing the benefit-risk
profile of drugs and biological products intended to
treat rare diseases and conditions, and meeting
requirements for approval or licensure;
(C) assess the effectiveness of policies and
practices of the Food and Drug Administration related
to the review of applications for drugs and biological
products intended to treat rare diseases and
conditions, including--
(i) initiatives to support the development
and review of drugs and biological products
intended to treat rare diseases and conditions,
including initiatives related to regulatory
science, clinical trial design, statistical
analysis, and other relevant topics;
(ii) consideration of relevant patient-
focused drug development data and information,
including patient experience data and the views
of patients, pursuant to section 569C of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C.
360bbb-8c);
(iii) training and other efforts to ensure
the expertise of personnel of the Food and Drug
Administration regarding the review of
applications for drugs and biological products
intended to treat rare diseases and conditions;
and
(iv) consultations and engagement with
stakeholders, including patients and patient
groups, and external experts pursuant to
section 569 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360bbb-8);
(D) assess the extent to which the Food and Drug
Administration is applying the policies and practices
described in subparagraph (C) consistently across
review divisions, and the factors that influence the
extent to which such application is consistent; and
(E) include recommendations to address challenges
and deficiencies identified, including recommendations
to improve the effectiveness, consistency, and
coordination of policies, practices, and programs of
the Food and Drug Administration related to the review
of applications for drugs and biological products
intended to treat rare diseases and conditions.
(b) FDA Report.--
(1) In general.--Not later than March 31, 2026, the
Secretary of Health and Human Services (referred to in this
subsection as the ``Secretary'') shall submit to the Committee
on Health, Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of
Representatives a report assessing the policies, practices, and
programs of the Food and Drug Administration with respect to
the review of applications for drugs and biological products
intended to treat rare diseases and conditions (as defined in
section 526(a)(2) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 360bb(a)(2))).
(2) Content of report.--The report under paragraph (1)
shall include, with respect to the period of fiscal years 2023
through 2025, broken down by fiscal year and by the responsible
review division of the Food and Drug Administration--
(A) the number of drugs that have been designated
as a drug for a rare disease or condition under section
526 of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 360bb);
(B) the number of applications under section 505(b)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
355(b)) or section 351(a) of the Public Health Service
Act (42 U.S.C. 262(a)) for a drug designated under
section 526 for a rare disease or condition that were
submitted, the number of such applications that were
approved, and the approximate size of the affected
population in the United States upon which the
designation pursuant to section 526 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360bb) was
granted for each such submitted and approved
application;
(C) the number of applications for a drug or
biological product for which the sponsor requested
written recommendations pursuant to section 525 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360aa),
and the number of such applications for which the
sponsor received such written recommendations;
(D) the number of applications for which the
Secretary consulted patients and patient groups
pursuant to subsection (a)(1) of section 569 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-
8) and the number of applications for which the
Secretary consulted experts pursuant to subsection
(a)(2) of such section 569; and
(E) the number of applications for which the
Secretary allowed the sponsor to rely upon data and
information pursuant to section 529A of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360ff-1).
(3) Clarification.--Nothing in this subsection shall be
construed to authorize the disclosure of confidential
commercial information or other information considered
proprietary or trade secret, as prohibited under section 301(j)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 331(j))
or section 1905 of title 18, United States Code.
(c) Guidance.--Not later than 9 months after the date of enactment
of this Act, the Secretary shall publish final guidance related to the
draft guidance titled, ``Rare Diseases: Common Issues in Drug
Development'' issued on February 1, 2019.
(d) Review Process.--
(1) Consultation with stakeholders.--Section 569(a)(1) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-
8(a)(1)) is amended--
(A) by striking ``at a time'' and inserting ``at
any time'';
(B) by striking ``Consistent with sections'' and
inserting the following:
``(A) In general.--Consistent with sections''; and
(C) by adding at the end the following:
``(B) Consultation with patients and patient
groups.--
``(i) In general.--The Secretary may, as
appropriate, consult with patients and relevant
patient groups impacted by the rare disease or
condition, together with at least one expert
included on the list under paragraph (2)(A) and
selected by such groups, as applicable, during
meetings between the Food and Drug
Administration and sponsors prior to the
submission of an application for a new drug or
biological product for a rare disease or
condition or a drug or biological product that
is genetically targeted.
``(ii) Conflicts of interest.--For purposes
of clause (i), to be eligible for consultation
pursuant to clause (i), patients and relevant
patient groups may not have any financial
interest in the applicable drug or biological
product, and external experts shall be in
compliance with applicable law, including
section 208 of title 18, United States Code.
``(C) Consultation with disproportionately affected
communities.--To the extent an application for a new
drug or biological product relates to a rare disease or
condition that disproportionately affects communities
of color or other historically underrepresented and
vulnerable populations, the Secretary is encouraged to
consult with patients of that subpopulation, or one or
more patient groups that represent that
subpopulation.''.
(2) Requiring appropriate expert consultation.--Section
569(a)(2) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 360bbb-8(a)(2)) is amended--
(A) in subparagraph (A), by striking the second
sentence; and
(B) by striking subparagraph (B) and inserting the
following:
``(B) Consultation.--With respect to any
application under section 505 of this Act or section
351 of the Public Health Service Act for a drug
designated under section 526 for a rare disease or
condition or a drug or biological product that is
genetically targeted, the Secretary may, as
appropriate, consult--
``(i) with an expert with respect to the
disease or condition referenced in the
application who appears on the list described
in subparagraph (A); or
``(ii) if no such expert is available,
including because of conflicts of interest,
with an expert on the list described in
subparagraph (A) in the science of small
population studies.
``(C) Availability at meetings.--In connection with
each drug product advisory committee meeting concerning
a drug or biological product for a rare disease or
condition, the Secretary may, as appropriate--
``(i) include--
``(I) an expert in the rare disease
or condition; or
``(II) if no such expert is
available, including because of
conflicts of interest, an expert in the
science of small population studies;
and
``(ii) invite at least one disease or
condition expert identified by the relevant
patient groups to participate as a nonvoting
member of the advisory committee.''.
(3) Additional topic for consultation.--Section 569(b) of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-
8(b)) is amended--
(A) in paragraph (6), by striking ``; and'' and
inserting ``;'';
(B) in paragraph (7), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(8) the science of small population studies.''.
SEC. 509. GENERIC DRUG LABELING CHANGES.
Section 505(j)(10)(A) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 355(j)(10)(A)) is amended by striking clauses (i) through
(iii) and inserting the following:
``(i) a revision to the labeling of the listed drug has
been approved by the Secretary within 90 days of when the
application is otherwise eligible for approval under this
subsection;
``(ii) the sponsor of the application agrees to submit
revised labeling for the drug that is the subject of the
application not later than 60 days after approval under this
subsection of the application;
``(iii) the labeling revision described under clause (i)
does not include a change to the `Warnings' section of the
labeling; and''.
SEC. 510. LIMITATIONS ON EXCLUSIVE APPROVAL OR LICENSURE OF ORPHAN
DRUGS.
(a) In General.--Section 527 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360cc) is amended--
(1) in subsection (a), in the matter following paragraph
(2), by striking ``same disease or condition'' and inserting
``same approved use or indication within such rare disease or
condition'';
(2) in subsection (b)--
(A) in the matter preceding paragraph (1), by
striking ``same rare disease or condition'' and
inserting ``same approved use or indication for which
such 7-year period applies to such already approved
drug''; and
(B) in paragraph (1), by inserting ``, relating to
the approved use or indication,'' after ``the needs'';
(3) in subsection (c)(1), by striking ``same rare disease
or condition as the already approved drug'' and inserting
``same use or indication for which the already approved or
licensed drug was approved or licensed''; and
(4) by adding at the end the following:
``(f) Approved Use or Indication Defined.--In this section, the
term `approved use or indication' means the use or indication approved
under section 505 of this Act or licensed under section 351 of the
Public Health Service Act for a drug designated under section 526 for a
rare disease or condition.''.
(b) Application of Amendments.--The amendments made by subsection
(a) shall apply with respect to any drug designated under section 526
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bb),
regardless of the date on which the drug was so designated, and
regardless of the date on which the drug was approved under section 505
of such Act (21 U.S.C. 355) or licensed under section 351 of the Public
Health Service Act (42 U.S.C. 262).
SEC. 511. ENSURING TIMELY ACCESS TO GENERICS.
Section 505(q) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355(q)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A)(i), by inserting ``,
10.31,'' after ``10.30'';
(B) in subparagraph (E)--
(i) by striking ``application and'' and
inserting ``application or'';
(ii) by striking ``If the Secretary'' and
inserting the following:
``(i) In general.--If the Secretary''; and
(iii) by striking the second sentence and
inserting the following:
``(ii) Primary purpose of delaying.--
``(I) In general.--In determining
whether a petition was submitted with
the primary purpose of delaying an
application, the Secretary may consider
the following factors:
``(aa) Whether the petition
was submitted in accordance
with paragraph (2)(B), based on
when the petitioner knew or
reasonably should have known
the relevant information relied
upon to form the basis of such
petition.
``(bb) Whether the
petitioner has submitted
multiple or serial petitions or
supplements to petitions
raising issues that reasonably
could have been known to the
petitioner at the time of
submission of the earlier
petition or petitions.
``(cc) Whether the petition
was submitted close in time to
a known, first date upon which
an application under subsection
(b)(2) or (j) of this section
or section 351(k) of the Public
Health Service Act could be
approved.
``(dd) Whether the petition
was submitted without relevant
data or information in support
of the scientific positions
forming the basis of such
petition.
``(ee) Whether the petition
raises the same or
substantially similar issues as
a prior petition to which the
Secretary has responded
substantively already,
including if the subsequent
submission follows such
response from the Secretary
closely in time.
``(ff) Whether the petition
requests changing the
applicable standards that other
applicants are required to
meet, including requesting
testing, data, or labeling
standards that are more onerous
or rigorous than the standards
the Secretary has determined to
be applicable to the listed
drug, reference product, or
petitioner's version of the
same drug.
``(gg) The petitioner's
record of submitting petitions
to the Food and Drug
Administration that have been
determined by the Secretary to
have been submitted with the
primary purpose of delay.
``(hh) Other relevant and
appropriate factors, which the
Secretary shall describe in
guidance.
``(II) Guidance.--The Secretary may
issue or update guidance, as
appropriate, to describe factors the
Secretary considers in accordance with
subclause (I).'';
(C) by adding at the end the following:
``(iii) Referral to the federal trade
commission.--The Secretary shall establish
procedures for referring to the Federal Trade
Commission any petition or supplement to a
petition that the Secretary determines was
submitted with the primary purpose of delaying
approval of an application. Such procedures
shall include notification to the petitioner by
the Secretary.'';
(D) by striking subparagraph (F);
(E) by redesignating subparagraphs (G) through (I)
as subparagraphs (F) through (H), respectively; and
(F) in subparagraph (H), as so redesignated, by
striking ``submission of this petition'' and inserting
``submission of this document'';
(2) in paragraph (2)--
(A) by redesignating subparagraphs (A) through (C)
as subparagraphs (C) through (E), respectively;
(B) by inserting before subparagraph (C), as so
redesignated, the following:
``(A) In general.--A person shall submit a petition
to the Secretary under paragraph (1) before filing a
civil action in which the person seeks to set aside,
delay, rescind, withdraw, or prevent submission,
review, or approval of an application submitted under
subsection (b)(2) or (j) of this section or section
351(k) of the Public Health Service Act. Such petition
and any supplement to such a petition shall describe
all information and arguments that form the basis of
the relief requested in any civil action described in
the previous sentence.
``(B) Timely submission of citizen petition.--A
petition and any supplement to a petition shall be
submitted within 60 days after the person knew, or
reasonably should have known, the information that
forms the basis of the request made in the petition or
supplement.'';
(C) in subparagraph (C), as so redesignated--
(i) in the heading, by striking ``within
150 days'';
(ii) in clause (i), by striking ``during
the 150-day period referred to in paragraph
(1)(F),''; and
(iii) by amending clause (ii) to read as
follows:
``(ii) on or after the date that is 151
days after the date of submission of the
petition, the Secretary approves or has
approved the application that is the subject of
the petition without having made such a final
decision.'';
(D) by amending subparagraph (D), as so
redesignated, to read as follows:
``(D) Dismissal of certain civil actions.--
``(i) Petition.--If a person files a civil
action against the Secretary in which a person
seeks to set aside, delay, rescind, withdraw,
or prevent submission, review, or approval of
an application submitted under subsection
(b)(2) or (j) of this section or section 351(k)
of the Public Health Service Act without
complying with the requirements of subparagraph
(A), the court shall dismiss without prejudice
the action for failure to exhaust
administrative remedies.
``(ii) Timeliness.--If a person files a
civil action against the Secretary in which a
person seeks to set aside, delay, rescind,
withdraw, or prevent submission, review, or
approval of an application submitted under
subsection (b)(2) or (j) of this section or
section 351(k) of the Public Health Service Act
without complying with the requirements of
subparagraph (B), the court shall dismiss with
prejudice the action for failure to timely file
a petition.
``(iii) Final response.--If a civil action
is filed against the Secretary with respect to
any issue raised in a petition timely filed
under paragraph (1) in which the petitioner
requests that the Secretary take any form of
action that could, if taken, set aside, delay,
rescind, withdraw, or prevent submission,
review, or approval of an application submitted
under subsection (b)(2) or (j) of this section
or section 351(k) of the Public Health Service
Act before the Secretary has taken final agency
action on the petition within the meaning of
subparagraph (C), the court shall dismiss
without prejudice the action for failure to
exhaust administrative remedies.''; and
(E) in clause (iii) of subparagraph (E), as so
redesignated, by striking ``as defined under
subparagraph (2)(A)'' and inserting ``within the
meaning of subparagraph (C)''; and
(3) in paragraph (4)--
(A) by striking ``Exceptions'' and all that follows
through ``This subsection does'' and inserting
``Exceptions.--This subsection does'';
(B) by striking subparagraph (B); and
(C) by redesignating clauses (i) and (ii) as
subparagraphs (A) and (B), respectively, and adjusting
the margins accordingly.
SEC. 512. INCREASING TRANSPARENCY IN GENERIC DRUG APPLICATIONS.
(a) In General.--Section 505(j)(3) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355(j)(3)) is amended by adding at the end the
following:
``(H)(i) Upon request (in controlled correspondence or otherwise)
by a person that has submitted or intends to submit an abbreviated
application under this subsection for a drug that is generally required
by regulation or recommended in guidance to contain the same inactive
ingredients in the same concentration as the listed drug referred to or
for which there is a scientific justification that an in vitro approach
can be used to demonstrate bioequivalence based on certain qualitative
or quantitative criteria with respect to an inactive ingredient, or on
the Secretary's own initiative during the review of an application
under this subsection for such a drug, the Secretary shall inform the
person whether such drug is qualitatively and quantitatively the same
as the listed drug.
``(ii) If the Secretary determines that such drug is not
qualitatively or quantitatively the same as the listed drug, the
Secretary shall identify and disclose to the person--
``(I) the ingredient or ingredients that cause the drug not
to be qualitatively or quantitatively the same as the listed
drug; and
``(II) for any ingredient for which there is an identified
quantitative deviation, the amount of such deviation.
``(iii) If the Secretary determines that such drug is qualitatively
and quantitatively the same as the listed drug, the Secretary shall not
change or rescind such determination after the submission of an
abbreviated application for such drug under this subsection unless--
``(I) the formulation of the listed drug has been changed
and the Secretary has determined that the prior listed drug
formulation was withdrawn for reasons of safety or
effectiveness; or
``(II) the Secretary makes a written determination that the
prior determination must be changed because an error has been
identified.
``(iv) If the Secretary makes a written determination described in
clause (iii)(II), the Secretary shall provide notice and a copy of the
written determination to the person making the request under clause
(i).
``(v) The disclosures required by this subparagraph are disclosures
authorized by law, including for purposes of section 1905 of title 18,
United States Code.''.
(b) Guidance.--
(1) In general.--Not later than one year after the date of
enactment of this Act, the Secretary of Health and Human
Services shall issue draft guidance, or update guidance,
describing how the Secretary will determine whether a drug is
qualitatively and quantitatively the same as the listed drug
(as such terms are used in section 505(j)(3)(H) of the Federal
Food, Drug, and Cosmetic Act, as added by subsection (a)),
including with respect to assessing pH adjusters.
(2) Process.--In issuing guidance under this subsection,
the Secretary of Health and Human Services shall--
(A) publish draft guidance;
(B) provide a period of at least 60 days for
comment on the draft guidance; and
(C) after considering any comments received and not
later than one year after the close of the comment
period on the draft guidance, publish final guidance.
(c) Applicability.--Section 505(j)(3)(H) of the Federal Food, Drug,
and Cosmetic Act, as added by subsection (a), applies beginning on the
date of enactment of this Act, irrespective of the date on which the
guidance required by subsection (b) is finalized.
SEC. 513. GAO REPORT ON NONPROFIT PHARMACEUTICAL ORGANIZATIONS.
(a) GAO Review.--The Comptroller General of the United States
(referred to in this section as the ``Comptroller General'') shall
prepare a report on--
(1) what is known about nonprofit pharmaceutical
manufacturing organizations, including the impact of such
organizations on the development, availability, and cost of
prescription drugs in the United States, which may include
information with respect to the capacity and capability to help
prevent or mitigate shortages of such drugs, and any challenges
to manufacturing or other operations; and
(2) recommendations to address such challenges.
(b) Report.--Not later than 2 years after the date of enactment of
this Act, the Comptroller General shall submit the report described in
subsection (a) to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce of the
House of Representatives.
SEC. 514. FDA PUBLIC MEETING ON NONPROFIT PRESCRIPTION DRUG
MANUFACTURERS.
(a) In General.--Not later than 1 year after the date of enactment
of this Act, the Secretary of Health and Human Services shall--
(1) hold a public meeting on nonprofit manufacturers of
prescription drugs, which shall include public testimony from
relevant stakeholders and academics; and
(2) open a docket for public comment related to such
meeting.
(b) Topics.--The public meeting under subsection (a) shall focus on
the following topics:
(1) The extent to which growth in the nonprofit
prescription drug sector can help address patient access
challenges in the current prescription drug marketplace, such
as drug shortages, limited medication alternatives and
competition, supply chain resiliency, and specific products
where there is insufficient market demand to induce
manufacturers to continue to offer certain prescription drugs.
(2) Whether, and to what extent, the Secretary of Health
and Human Services should consider changes to future user fee
structures and processes for nonprofit manufacturers of
prescription drugs.
SEC. 515. 180-DAY EXCLUSIVITY PERIOD.
(a) In General.--Section 505(j)(5)(B)(iv) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 355(j)(5)(B)(iv)) is amended--
(1) in subclause (I)--
(A) by inserting ``and subclause (III)'' after
``subparagraph (D)''; and
(B) by inserting before the period at the end the
following: ``or an applicant whose application was
approved pursuant to subclause (III). If an applicant
described in subclause (III) is eligible for effective
approval on the same day a tentatively approved first
applicant who has requested final approval is
determined by the Secretary to be eligible for
effective approval by meeting all the approval
requirements of this subsection, such applicant may not
receive effective approval until 180 days after the
first applicant begins commercial marketing of the
drug.''; and
(2) by adding at the end the following new subclause:
``(III) Applicant approval.--The Secretary may
approve an application containing a certification
described in paragraph (2)(A)(vii)(IV) that is for a
drug for which a first applicant has submitted an
application containing such a certification,
notwithstanding the eligibility of a first applicant
for the 180-day exclusivity period described in
subclause (II)(aa), if each of the following conditions
is met:
``(aa) The approval of such application
could be made effective, but for the
eligibility of a first applicant for 180-day
exclusivity under this clause.
``(bb) The applicant of such application
has submitted a certification to the
abbreviated new drug application that there are
no conditions that would prevent the applicant
from commercial marketing within 75 days after
the date of approval and that the applicant
intends to so market the drug.
``(cc) At least 33 months have passed since
the date of submission of an application for
the drug by at least one first applicant.
``(dd) Approval of an application for the
drug submitted by at least one first applicant
is not precluded under clause (iii).
``(ee) No application for the drug
submitted by any first applicant is effectively
approved on the date that the conditions under
items (aa), (bb), (cc), and (dd) are all met
and maintained.''.
(b) Special Approval Status Rule for Certain Subsequent
Applicants.--Section 505(j)(5)(D) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355 (j)(5)(D)) is amended at the end by adding
the following:
``(v) Special approval status rule for certain
subsequent applicants.--An application that is approved
pursuant to subclause (III) of subparagraph (B)(iv) is
deemed to be tentatively approved and to no longer have
an effective approval pursuant to such subclause (III)
on the date that is 76 days after the date on which the
approval has been made effective pursuant to such
subclause (III) if the applicant fails to commercially
market such drug within the 75-day period after the
date on which the approval is made effective. If the
applicant of an application approved pursuant to such
subclause (III) submits a notification that it can no
longer commence commercial marketing within 75 days
after the date of approval, as required under
subparagraph (B)(iv)(III)(bb), its application is
deemed to be tentatively approved and to no longer be
effectively approved on the date that such a
notification is received. If an applicant does not
commence commercial marketing within the 75-day period,
it shall not be eligible for a subsequent effective
approval for the application under subclause (III) of
subparagraph (B)(iv) unless, in addition to meeting
each of the conditions in such subclause (III), it
submits a certification to its abbreviated new drug
application that an event that could not have been
reasonably foreseen by the applicant prevented it from
commencing commercial marketing and that it has fully
resolved this issue. The applicant shall submit
notification to the abbreviated new drug application
confirming that such applicant has commenced commercial
marketing of the drug not later than one business day
after commencing such marketing.''.
(c) Applicability.--The amendments made by subsections (a) and (b)
shall apply only with respect to an application filed under section
505(j) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355(j))
after the date of enactment of this Act that identifies a listed drug
for which no certification under paragraph (2)(A)(vii)(IV) of such
section was made before such date of enactment.
TITLE VI--OTHER REAUTHORIZATIONS
SEC. 601. REAUTHORIZATION OF THE CRITICAL PATH PUBLIC-PRIVATE
PARTNERSHIP.
Section 566(f) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 360bbb-5(f)) is amended by striking ``2018 through 2022'' and
inserting ``2023 through 2027''.
SEC. 602. REAUTHORIZATION OF THE BEST PHARMACEUTICALS FOR CHILDREN
PROGRAM.
Section 409I(d)(1) of the Public Health Service Act (42 U.S.C.
284m(d)(1)) is amended by striking ``2018 through 2022'' and inserting
``2023 through 2027''.
SEC. 603. REAUTHORIZATION OF THE HUMANITARIAN DEVICE EXEMPTION
INCENTIVE.
Section 520(m)(6)(A)(iv) of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 360j(m)(6)(A)(iv)) is amended by striking ``2022'' and
inserting ``2027''.
SEC. 604. REAUTHORIZATION OF THE PEDIATRIC DEVICE CONSORTIA PROGRAM.
Section 305(e) of the Food and Drug Administration Amendments Act
of 2007 (Public Law 110-85; 42 U.S.C. 282 note) is amended by striking
``$5,250,000 for each of fiscal years 2018 through 2022'' and inserting
``$7,000,000 for each of fiscal years 2023 through 2027''.
SEC. 605. REAUTHORIZATION OF PROVISION PERTAINING TO DRUGS CONTAINING
SINGLE ENANTIOMERS.
Section 505(u) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355(u)) is amended by--
(1) in paragraph (1)(A)(ii)(II), by adding ``(other than
bioavailability studies)'' after ``any clinical
investigations''; and
(2) in paragraph (4), by striking ``October 1, 2022'' and
inserting ``October 1, 2027''.
SEC. 606. REAUTHORIZATION OF ORPHAN DRUG GRANTS.
Section 5(c) of the Orphan Drug Act (21 U.S.C. 360ee(c)) is amended
by striking ``2018 through 2022'' and inserting ``2023 through 2027''.
SEC. 607. REAUTHORIZATION OF CERTAIN DEVICE INSPECTIONS.
Section 704(g)(11) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 374(g)(11)) is amended by striking ``2022'' and inserting
``2027''.
TITLE VII--ENHANCING FDA HIRING AUTHORITIES
SEC. 701. ENHANCING FDA HIRING AUTHORITY FOR SCIENTIFIC, TECHNICAL, AND
PROFESSIONAL PERSONNEL.
Section 714A of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379d-3a) is amended--
(1) in subsection (a)--
(A) by inserting ``, including cross-cutting
operational positions,'' after ``professional
positions''; and
(B) by inserting ``and the regulation of food''
after ``medical products''; and
(2) in subsection (d)(1)--
(A) in the matter preceding subparagraph (A)--
(i) by striking ``the 21st Century Cures
Act'' and inserting ``the Food and Drug
Administration Safety and Landmark Advancements
Act of 2022''; and
(ii) by striking ``that examines the
extent'' and all that follows through ``,
including'' and inserting ``that addresses'';
(B) in subparagraph (A)--
(i) by inserting ``updated'' before
``analysis''; and
(ii) by striking ``; and'' and inserting a
semicolon;
(C) by redesignating subparagraph (B) as
subparagraph (C);
(D) by inserting after subparagraph (A) the
following:
``(B) an analysis of how the Secretary has used the
authorities provided under this section, and a plan for
how the Secretary will use the authority under this
section, and other applicable hiring authorities, for
employees of the Food and Drug Administration; and'';
and
(E) in the matter preceding clause (i) of
subparagraph (C), as so redesignated, by striking ``a
recruitment'' and inserting ``an updated recruitment''.
SEC. 702. STRATEGIC WORKFORCE PLAN AND REPORT.
Chapter VII of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
371 et seq.) is amended by inserting after section 714A the following:
``SEC. 714B. STRATEGIC WORKFORCE PLAN AND REPORT.
``(a) In General.--Not later than September 30, 2023, and at least
every 4 years thereafter, the Secretary shall develop and submit to the
appropriate committees of Congress and post on the website of the Food
and Drug Administration, a coordinated strategy and report to provide
direction for the activities and programs of the Secretary to recruit,
hire, train, develop, and retain the workforce needed to fulfill the
public health mission of the Food and Drug Administration, including to
facilitate collaboration across centers, to keep pace with new
biomedical, technological, and scientific advancements, and support the
development, review, and regulation of medical products. Each such
report shall be known as the `Food and Drug Administration Strategic
Workforce Plan'.
``(b) Use of the Food and Drug Administration Strategic Workforce
Plan.--Each center within the Food and Drug Administration shall
develop and update, as appropriate, a strategic plan that will be
informed by the Food and Drug Administration Strategic Workforce Plan
developed and updated under this subsection.
``(c) Contents of the Food and Drug Administration Strategic
Workforce Plan.--Each Food and Drug Administration Strategic Workforce
Plan under subsection (a) shall--
``(1) include agency-wide strategic goals and priorities
for recruiting, hiring, training, developing, and retaining a
qualified workforce for the Food and Drug Administration;
``(2) establish specific activities the Secretary will take
to achieve its strategic goals and priorities and address the
workforce needs of the Food and Drug Administration in the
forthcoming fiscal years;
``(3) identify challenges and risks the Secretary will face
in meeting its strategic goals and priorities, and the
activities the Secretary will undertake to overcome those
challenges and mitigate those risks;
``(4) establish metrics and milestones that the Secretary
will use to measure progress in achieving its strategic goals
and priorities; and
``(5) define functions, capabilities, and gaps in such
workforce and identify strategies to recruit, hire, train,
develop, and retain such workforce.
``(d) Considerations.--In developing each Food and Drug
Administration Strategic Workforce Plan under subsection (a), the
Secretary shall consider--
``(1) the number of employees, employee expertise, and
employing center of employees, including senior leadership and
non-senior leadership employees, eligible for retirement;
``(2) the vacancy and turnover rates for employees with
different types of expertise and from different centers,
including any changes or trends related to such rates;
``(3) the results of the Federal Employee Viewpoint Survey
for employees of the Food and Drug Administration, including
any changes or trends related to such results;
``(4) rates of pay for different types of positions,
including rates for different types of expertise within the
same field (such as differences in pay between different
medical specialists), and how such rates of pay impact the
ability of the Secretary to achieve strategic goals and
priorities; and
``(5) the statutory hiring authorities used to hire Food
and Drug Administration employees, and the time to hire across
different hiring authorities.
``(e) Evaluation of Progress.--Each Food and Drug Administration
Strategic Workforce Plan issued pursuant to subsection (a), with the
exception of the first such Food and Drug Administration Strategic
Workforce Plan, shall include an evaluation of the progress the
Secretary has made, based on the metrics, benchmarks, and other
milestones that measure successful recruitment, hiring, training,
development, and retention activities; and whether such actions
improved the capacity of the Food and Drug Administration to achieve
the strategic goals and priorities set forth in the previous Food and
Drug Administration Strategic Workforce Plan.
``(f) Additional Considerations.--The Food and Drug Administration
Strategic Workforce Plan issued in fiscal year 2023 shall address the
effect of the COVID-19 pandemic on hiring, retention, and other
workforce challenges for the Food and Drug Administration, including
protecting such workforce during public health emergencies.''.
TITLE VIII--ADVANCING REGULATION OF COSMETICS, DIETARY SUPPLEMENTS, AND
IN VITRO CLINICAL TESTS
Subtitle A--Cosmetics
SEC. 801. SHORT TITLE.
This subtitle may be cited as the ``Modernization of Cosmetics
Regulation Act of 2022''.
SEC. 802. AMENDMENTS TO COSMETIC REQUIREMENTS.
Chapter VI of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
361 et seq.) is amended by adding at the end the following:
``SEC. 604. DEFINITIONS.
``In this chapter:
``(1) Adverse event.--The term `adverse event' means any
health-related event associated with the use of a cosmetic
product that is adverse.
``(2) Cosmetic product.--The term `cosmetic product' means
a preparation of cosmetic ingredients with a qualitatively and
quantitatively set composition for use in a finished product.
``(3) Facility.--
``(A) In general.--The term `facility' includes any
establishment (including an establishment of an
importer) that manufactures or processes cosmetic
products distributed in the United States.
``(B) Such term does not include any of the
following:
``(i) Beauty shops and salons, unless such
establishment manufactures or processes
cosmetic products at that location.
``(ii) Cosmetic product retailers,
including individual sales representatives,
direct sellers (as defined in section
3508(b)(2) of the Internal Revenue Code of
1986), retail distribution facilities, and
pharmacies, unless such establishment
manufactures or processes cosmetic products
that are not sold directly to consumers at that
location.
``(iii) Hospitals, physicians' offices, and
health care clinics.
``(iv) Public health agencies and other
nonprofit entities that provide cosmetic
products directly to the consumer.
``(v) Entities (such as hotels and
airlines) that provide complimentary cosmetic
products to customers incidental to other
services.
``(vi) Trade shows and other venues where
cosmetic product samples are provided free of
charge.
``(vii) An establishment that manufactures
or processes cosmetic products that are solely
for use in research or evaluation, including
for production testing and not offered for
retail sale.
``(viii) An establishment that solely
performs one or more of the following with
respect to cosmetic products:
``(I) Labeling.
``(II) Relabeling.
``(III) Packaging.
``(IV) Repackaging.
``(V) Holding.
``(VI) Distributing.
``(C) Clarification.--For the purposes of
subparagraph (B)(viii), the terms `packaging' and
`repackaging' do not include filling a product
container with a cosmetic product.
``(4) Responsible person.--The term `responsible person'
means the manufacturer, packer, or distributor of a cosmetic
product whose name appears on the label of such cosmetic
product in accordance with section 609(a) of this Act or
section 4(a) of the Fair Packaging and Labeling Act.
``(5) Serious adverse event.--The term `serious adverse
event' means an adverse event that--
``(A) results in--
``(i) death;
``(ii) a life-threatening experience;
``(iii) inpatient hospitalization;
``(iv) a persistent or significant
disability or incapacity;
``(v) a congenital anomaly or birth defect;
or
``(vi) significant disfigurement (including
serious and persistent rashes or infections,
second- or third-degree burns, significant hair
loss, or permanent or significant alteration of
appearance), other than as intended, under
conditions of use that are customary or usual;
or
``(B) requires, based on reasonable medical
judgment, a medical or surgical intervention to prevent
an outcome described in subparagraph (A).
``SEC. 605. ADVERSE EVENTS.
``(a) Serious Adverse Event Reporting Requirements.--The
responsible person shall submit to the Secretary any report received of
a serious adverse event associated with the use, in the United States,
of a cosmetic product manufactured, packed, or distributed by such
person.
``(b) Submission of Reports.--
``(1) Serious adverse event report.--The responsible person
shall submit to the Secretary a serious adverse event report
accompanied by a copy of the label on or within the retail
packaging of such cosmetic product no later than 15 business
days after the report is received by the responsible person.
``(2) New medical information.--The responsible person
shall submit to the Secretary any new and material medical
information, related to a serious adverse event report
submitted to the Secretary in accordance with paragraph (1),
that is received by the responsible person within 1 year of the
initial report to the Secretary, no later than 15 business days
after such information is received by such responsible person.
``(3) Consolidation of reports.--The Secretary shall
develop systems to enable responsible persons to submit a
single report that includes duplicate reports of, or new
medical information related to, a serious adverse event.
``(c) Exemptions.--The Secretary may establish by regulation an
exemption to any of the requirements of this section if the Secretary
determines that such exemption would have no significant adverse effect
on public health.
``(d) Contact Information.--The responsible person shall receive
reports of adverse events through the domestic address, domestic
telephone number, or electronic contact information included on the
label in accordance with section 609(a).
``(e) Maintenance and Inspection of Adverse Event Records.--
``(1) Maintenance.--The responsible person shall maintain
records related to each report of an adverse event associated
with the use, in the United States, of a cosmetic product
manufactured or distributed by such person received by such
person, for a period of 6 years.
``(2) Inspection.--
``(A) In general.-- The responsible person shall
permit an authorized person to have access to records
required to be maintained under this section during an
inspection pursuant to section 704.
``(B) Authorized person.--For purposes of this
paragraph, the term `authorized person' means an
officer or employee of the Department of Health and
Human Services who has--
``(i) appropriate credentials, as
determined by the Secretary; and
``(ii) been duly designated by the
Secretary to have access to the records
required under this section.
``(f) Fragrance and Flavor Ingredients.--If the Secretary has
reasonable grounds to believe that an ingredient or combination of
ingredients in a fragrance or flavor has caused or contributed to a
serious adverse event required to be reported under this section, the
Secretary may request in writing a list of ingredients or categories of
ingredients in the specific fragrances or flavors in the cosmetic
product, from the responsible person. The responsible person shall
ensure that the requested information is submitted to the Secretary
within 30 days of such request. In response to a request under section
552 of title 5, United States Code, information submitted to the
Secretary under this subsection shall be withheld under section
552(b)(3) of title 5, United States Code.
``(g) Protected Information.--A serious adverse event report
submitted to the Secretary under this section, including any new
medical information submitted under subsection (b)(2), or an adverse
event report, or any new information, voluntarily submitted to the
Secretary shall be considered to be--
``(1) a safety report under section 756 and may be
accompanied by a statement, which shall be a part of any report
that is released for public disclosure, that denies that the
report or the records constitute an admission that the product
involved caused or contributed to the adverse event; and
``(2) a record about an individual under section 552a of
title 5, United States Code (commonly referred to as the
`Privacy Act of 1974') and a medical or similar file the
disclosure of which would constitute a violation of section 552
of such title 5 (commonly referred to as the `Freedom of
Information Act'), and shall not be publicly disclosed unless
all personally identifiable information is redacted.
``(h) Effect of Section.--
``(1) In general.--Nothing in this section shall affect the
authority of the Secretary to provide adverse event reports and
information to any health, food, or drug officer or employee of
any State, territory, or political subdivision of a State or
territory, under a memorandum of understanding between the
Secretary and such State, territory, or political subdivision.
``(2) Personally identifiable information.--Notwithstanding
any other provision of law, personally-identifiable information
in adverse event reports provided by the Secretary to any
health, food, or drug officer or employee of any State,
territory, or political subdivision of a State or territory,
shall not--
``(A) be made publicly available pursuant to any
State or other law requiring disclosure of information
or records; or
``(B) otherwise be disclosed or distributed to any
party without the written consent of the Secretary and
the person submitting such information to the
Secretary.
``(3) Use of reports.--Nothing in this section shall permit
a State, territory, or political subdivision of a State or
territory, to use any safety report received from the Secretary
in a manner inconsistent with this section.
``(4) Rule of construction.--The submission of any report
in compliance with this section shall not be construed as an
admission that the cosmetic product involved caused or
contributed to the relevant adverse event.
``SEC. 606. GOOD MANUFACTURING PRACTICE.
``(a) In General.--The Secretary shall by regulation establish good
manufacturing practices for facilities that are consistent, to the
extent practicable, and appropriate, with national and international
standards, in accordance with section 601. Any such regulations shall
be intended to protect the public health and ensure that cosmetic
products are not adulterated. Such regulations may allow for the
Secretary to inspect records necessary to demonstrate compliance with
good manufacturing practices prescribed by the Secretary under this
paragraph during an inspection conducted under section 704.
``(b) Considerations.--In establishing regulations for good
manufacturing practices under this section, the Secretary shall take
into account the size and scope of the businesses engaged in the
manufacture of cosmetics, and the risks to public health posed by such
cosmetics, and provide sufficient flexibility to be practicable for all
sizes and types of facilities to which such regulations will apply.
Such regulations shall include simplified good manufacturing practice
requirements for smaller businesses, as appropriate, to ensure that
such regulations do not impose undue economic hardship for smaller
businesses, and may include longer compliance times for smaller
businesses. Before issuing regulations to implement subsection (a), the
Secretary shall consult with cosmetics manufacturers, including smaller
businesses, consumer organizations, and other experts selected by the
Secretary.
``(c) Timeframe.--The Secretary shall publish a notice of proposed
rulemaking not later than 2 years after the date of enactment of the
Modernization of Cosmetics Regulation Act of 2022 and shall publish a
final such rule not later than 3 years after such date of enactment.
``SEC. 607. REGISTRATION AND PRODUCT LISTING.
``(a) Submission of Registration.--
``(1) Initial registration.--
``(A) Existing facilities.--Every person that, on
the date of enactment of the Modernization of Cosmetics
Regulation Act of 2022, owns or operates a facility
that engages in the manufacturing or processing of a
cosmetic product for distribution in the United States
shall register each facility with the Secretary not
later than 1 year after date of enactment of such Act.
``(B) New facilities.--Every person that owns or
operates a facility that first engages, after the date
of enactment of the Modernization of Cosmetics
Regulation Act of 2022, in manufacturing or processing
of a cosmetic product for distribution in the United
States, shall register with the Secretary such facility
within 60 days of first engaging in such activity or 60
days after the deadline for registration under
subparagraph (A), whichever is later.
``(2) Biennial renewal of registration.--A person required
to register a facility under paragraph (1) shall renew such
registrations with the Secretary biennially.
``(3) Contract manufacturers.--If a facility manufactures
or processes cosmetic products on behalf of a responsible
person, the Secretary shall require only a single registration
for such facility even if such facility is manufacturing or
processing its own cosmetic products or cosmetic products on
behalf of more than one responsible person. Such single
registration may be submitted to the Secretary by such facility
or any responsible person whose products are manufactured or
processed at such facility.
``(4) Updates to content.--A person that is required to
register under subsection (a)(1) shall notify the Secretary
within 60 days of any changes to information required under
subsection (b)(2).
``(5) Abbreviated renewal registrations.--The Secretary
shall provide for an abbreviated registration renewal process
for any person that owns or operates a facility that has not
been required to submit updates under paragraph (4) for a
registered facility since submission of the most recent
registration of such facility under paragraph (1) or (2).
``(b) Format; Contents of Registration.--
``(1) In general.--Registration information under this
section may be submitted at such time and in such manner as the
Secretary may prescribe.
``(2) Contents.--The registration under subsection (a)
shall contain--
``(A) the facility's name, physical address, email
address, and telephone number;
``(B) with respect to any foreign facility, the
contact for the United States agent of the facility,
and, if available, the electronic contact information;
``(C) the facility registration number, if any,
previously assigned by the Secretary under subsection
(d);
``(D) all brand names under which cosmetic products
manufactured or processed in the facility are sold; and
``(E) the product category or categories and
responsible person for each cosmetic product
manufactured or processed at the facility.
``(c) Cosmetic Product Listing.--
``(1) In general.--For each cosmetic product, the
responsible person shall submit to the Secretary a cosmetic
product listing, or ensure that such submission is made, at
such time and in such manner as the Secretary may prescribe.
``(2) Cosmetic product listing.--The responsible person of
a cosmetic product that is marketed on the date of enactment of
the Modernization of Cosmetics Regulation Act of 2022 shall
submit to the Secretary a cosmetic product listing not later
than 1 year after the date of enactment of the Modernization of
Cosmetics Regulation Act of 2022, or for a cosmetic product
that is first marketed after the date of enactment of such Act,
within 120 days of marketing such product in interstate
commerce. Thereafter, any updates to such listing shall be made
annually, consistent with paragraphs (4) and (5).
``(3) Abbreviated renewal.--The Secretary shall provide for
an abbreviated process for the renewal of any cosmetic product
listing under this subsection with respect to which there has
been no change since the responsible person submitted the
previous listing.
``(4) Contents of listing.--
``(A) In general.--Each such cosmetic product
listing shall include--
``(i) the facility registration number of
each facility where the cosmetic product is
manufactured or processed;
``(ii) the name and contact number of the
responsible person and the name for the
cosmetic product, as such name appears on the
label;
``(iii) the applicable cosmetic category or
categories for the cosmetic product;
``(iv) a list of ingredients in the
cosmetic product, including any fragrances,
flavors, or colors, with each ingredient
identified by the name, as required under
section 701.3 of title 21, Code of Federal
Regulations (or any successor regulations), or
by the common or usual name of the ingredient;
and
``(v) the product listing number, if any
previously assigned by the Secretary under
subsection (d).
``(B) Flexible listings.--A single listing
submission for a cosmetic product may include multiple
cosmetic products with identical formulations, or
formulations that differ only with respect to colors,
fragrances or flavors, or quantity of contents.
``(5) Updates to content.--A responsible person that is
required to submit a cosmetic product listing shall submit any
updates to such cosmetic product listing annually.
``(6) Submission.--A responsible person may submit product
listing information as part of a facility registration or
separately.
``(d) Facility Registration and Product Listing Numbers.--At the
time of the initial registration of any facility under subsection
(a)(1) or initial listing of any cosmetic product under (c)(1), the
Secretary shall assign a facility registration number to the facility
and a product listing number to each cosmetic product. The Secretary
shall not make such product listing number publicly available.
``(e) Confidentiality.--In response to a request under section 552
of title 5, United States Code, information described in subsection
(b)(2)(D) or (c)(4)(A)(i) that is derived from a registration or
listing under this section shall be withheld under section 552(b)(3) of
title 5, United States Code.
``(f) Suspensions.--
``(1) Suspension of registration of a facility.--The
Secretary may suspend the registration of a facility if the
Secretary determines that a cosmetic product manufactured or
processed by a registered facility and distributed in the
United States has a reasonable probability of causing serious
adverse health consequences or death to humans and the
Secretary has a reasonable belief that other products
manufactured or processed by the facility may be similarly
affected because of a failure that cannot be isolated to a
product or products, or is sufficiently pervasive to raise
concerns about other products manufactured in the facility.
``(2) Notice of suspension.--Before suspending a facility
registration under this section, the Secretary shall provide--
``(A) notice to the facility registrant of the
cosmetic product or other responsible person, as
appropriate, of the intent to suspend the facility
registration, which shall specify the basis of the
determination by the Secretary that the facility
registration should be suspended; and
``(B) an opportunity, within 5 business days of the
notice provided under subparagraph (A), for the
responsible person to provide a plan for addressing the
reasons for possible suspension of the facility
registration.
``(3) Hearing on suspension.--The Secretary shall provide
the registrant subject to an order under paragraph (1) or (2)
with an opportunity for an informal hearing, to be held as soon
as possible but not later than 5 business days after the
issuance of the order, or such other time period agreed upon by
the Secretary and the registrant, on the actions required for
reinstatement of registration and why the registration that is
subject to the suspension should be reinstated. The Secretary
shall reinstate a registration if the Secretary determines,
based on evidence presented, that adequate grounds do not exist
to continue the suspension of the registration.
``(4) Post-hearing corrective action plan.--If, after
providing opportunity for an informal hearing under paragraph
(3), the Secretary determines that the suspension of
registration remains necessary, the Secretary shall require the
registrant to submit a corrective action plan to demonstrate
how the registrant plans to correct the conditions found by the
Secretary. The Secretary shall review such plan not later than
14 business days after the submission of the corrective action
plan or such other time period as determined by the Secretary,
in consultation with the registrant.
``(5) Vacating of order; reinstatement.--Upon a
determination by the Secretary that adequate grounds do not
exist to continue the suspension actions, the Secretary shall
promptly vacate the suspension and reinstate the registration
of the facility.
``(6) Effect of suspension.--If the registration of the
facility is suspended under this section, no person shall
introduce or deliver for introduction into commerce in the
United States cosmetic products from such facility.
``(7) No delegation.--The authority conferred by this
section to issue an order to suspend a registration or vacate
an order of suspension shall not be delegated to any officer or
employee other than the Commissioner.
``SEC. 608. SAFETY SUBSTANTIATION.
``(a) Substantiation of Safety.--A responsible person for a
cosmetic product shall ensure, and maintain records supporting, that
there is adequate substantiation of safety of such cosmetic product.
``(b) Coal-Tar Hair Dye.--Subsection (a) shall not apply to coal-
tar hair dye that otherwise complies with the requirements of section
601(a). A responsible person for a coal-tar hair dye shall maintain
records related to the safety of such product.
``(c) Definitions.--For purposes of this section:
``(1) Adequate substantiation of safety.--The term
`adequate substantiation of safety' means tests or studies,
research, analyses, or other evidence or information that is
considered, among experts qualified by scientific training and
experience to evaluate the safety of cosmetic products and
their ingredients, sufficient to support a reasonable certainty
that a cosmetic product is safe.
``(2) Safe.--The term `safe' means that the cosmetic
product, including any ingredient thereof, is not injurious to
users under the conditions of use prescribed in the labeling
thereof, or under such conditions of use as are customary or
usual. The Secretary shall not consider a cosmetic ingredient
or cosmetic product injurious to users solely because it can
cause minor and transient reactions or minor and transient skin
irritations in some users. In determining for purposes of this
section whether a cosmetic product is safe, the Secretary may
consider, as appropriate and available, the cumulative or other
relevant exposure to the cosmetic product, including any
ingredient thereof.
``SEC. 609. LABELING.
``(a) General Requirement.--Each cosmetic product shall bear a
label that includes a domestic address, domestic phone number, or
electronic contact information, which may include a website, through
which the responsible person can receive adverse event reports with
respect to such cosmetic product.
``(b) Fragrance Allergens.--The responsible person shall identify
on the label of a cosmetic product each fragrance allergen included in
such cosmetic product. Substances that are fragrance allergens for
purposes of this subsection shall be determined by the Secretary by
regulation. The Secretary shall issue a notice of proposed rulemaking
promulgating the regulation implementing this requirement not later
than 18 months after the date of enactment of the Modernization of
Cosmetics Regulation Act of 2022, and not later than 180 days after the
date on which the public comment period on the proposed rulemaking
closes, shall issue a final rulemaking. In promulgating regulations
implementing this subsection, the Secretary shall consider
international, State, and local requirements for allergen disclosure,
including the substance and format of requirements in the European
Union, and may establish threshold levels of amounts of substances
subject to disclosure pursuant to such regulations.
``(c) Cosmetic Products for Professional Use.--
``(1) Definition of professional.--For purposes of this
subsection, the term `professional' means an individual who is
licensed by an official State authority to practice in the
field of cosmetology, nail care, barbering, or esthetics.
``(2) Professional use labeling.--A cosmetic product
introduced into interstate commerce and intended to be used
only by a professional shall bear a label that--
``(A) contains a clear and prominent statement that
the product shall be administered or used only by
licensed professionals; and
``(B) is in conformity with the requirements of the
Secretary for cosmetics labeling under this Act and
section 4(a) of the Fair Packaging and Labeling Act.
``SEC. 610. RECORDS.
``(a) In General.--If the Secretary has a reasonable belief that a
cosmetic product, including an ingredient in such cosmetic product, and
any other cosmetic product that the Secretary reasonably believes is
likely to be affected in a similar manner, is likely to be adulterated
such that the use or exposure to such product presents a threat of
serious adverse health consequences or death to humans, each
responsible person and facility shall, at the request of an officer or
employee duly designated by the Secretary, permit such officer or
employee, upon presentation of appropriate credentials and a written
notice to such person, at reasonable times and within reasonable limits
and in a reasonable manner, to have access to and copy all records
relating to such cosmetic product, and to any other cosmetic product
that the Secretary reasonably believes is likely to be affected in a
similar manner, that are needed to assist the Secretary in determining
whether the cosmetic product is adulterated and presents a threat of
serious adverse health consequences or death to humans. This subsection
shall not be construed to extend to recipes or formulas for cosmetics,
financial data, pricing data, personnel data (other than data as to
qualification of technical and professional personnel performing
functions subject to this Act), research data (other than safety
substantiation data for cosmetic products and their ingredients), or
sales data (other than shipment data regarding sales).
``(b) Rule of Construction.--Nothing in this section shall be
construed to limit the authority of the Secretary to inspect records or
require establishment and maintenance of records under any other
provision of this Act, including section 605 or 606.
``SEC. 611. MANDATORY RECALL AUTHORITY.
``(a) In General.--If the Secretary determines that there is a
reasonable probability that a cosmetic is adulterated under section 601
or misbranded under section 602 and the use of or exposure to such
cosmetic will cause serious adverse health consequences or death, the
Secretary shall provide the responsible person with an opportunity to
voluntarily cease distribution and recall such article. If the
responsible person refuses to or does not voluntarily cease
distribution or recall such cosmetic within the time and manner
prescribed by the Secretary (if so prescribed), the Secretary may, by
order, require, as the Secretary determines necessary, such person to
immediately cease distribution of such article.
``(b) Hearing.--The Secretary shall provide the responsible person
who is subject to an order under subsection (a) with an opportunity for
an informal hearing, to be held not later than 10 days after the date
of issuance of the order, on whether adequate evidence exists to
justify the order.
``(c) Order Resolution.--After an order is issued according to the
process under subsections (a) and (b), the Secretary shall, except as
provided in subsection (d)--
``(1) vacate the order, if the Secretary determines that
inadequate grounds exist to support the actions required by the
order;
``(2) continue the order ceasing distribution of the
cosmetic until a date specified in such order; or
``(3) amend the order to require a recall of the cosmetic,
including any requirements to notify appropriate persons, a
timetable for the recall to occur, and a schedule for updates
to be provided to the Secretary regarding such recall.
``(d) Action Following Order.--Any person who is subject to an
order pursuant to paragraph (2) or (3) of subsection (c) shall
immediately cease distribution of or recall, as applicable, the
cosmetic and provide notification as required by such order.
``(e) Notice to Persons Affected.--If the Secretary determines
necessary, the Secretary may require the person subject to an order
pursuant to subsection (a) or an amended order pursuant to paragraph
(2) or (3) of subsection (c) to provide either a notice of a recall
order for, or an order to cease distribution of, such cosmetic, as
applicable, under this section to appropriate persons, including
persons who manufacture, distribute, import, or offer for sale such
product that is the subject of an order and to the public.
``(f) Public Notification.--In conducting a recall under this
section, the Secretary shall--
``(1) ensure that a press release is published regarding
the recall, and that alerts and public notices are issued, as
appropriate, in order to provide notification--
``(A) of the recall to consumers and retailers to
whom such cosmetic was, or may have been, distributed;
and
``(B) that includes, at a minimum--
``(i) the name of the cosmetic subject to
the recall;
``(ii) a description of the risk associated
with such article; and
``(iii) to the extent practicable,
information for consumers about similar
cosmetics that are not affected by the recall;
and
``(2) ensure publication, as appropriate, on the website of
the Food and Drug Administration of an image of the cosmetic
that is the subject of the press release described in paragraph
(1), if available.
``(g) No Delegation.--The authority conferred by this section to
order a recall or vacate a recall order shall not be delegated to any
officer or employee other than the Commissioner.
``(h) Effect.--Nothing in this section shall affect the authority
of the Secretary to request or participate in a voluntary recall, or to
issue an order to cease distribution or to recall under any other
provision of this chapter.
``SEC. 612. SMALL BUSINESSES.
``(a) In General.--Responsible persons, and owners and operators of
facilities, whose average gross annual sales in the United States of
cosmetic products for the previous 3-year period is less than
$1,000,000, adjusted for inflation, and who do not engage in the
manufacturing or processing of the cosmetic products described in
subsection (b), shall be considered small businesses and not subject to
the requirements of section 606 or 607.
``(b) Requirements Applicable to All Manufacturers and Processors
of Cosmetics.--The exemptions under subsection (a) shall not apply to
any responsible person or facility engaged in the manufacturing or
processing of any of the following products:
``(1) Cosmetic products that regularly come into contact
with mucus membrane of the eye under conditions of use that are
customary or usual.
``(2) Cosmetic products that are injected.
``(3) Cosmetic products that are intended for internal use.
``(4) Cosmetic products that are intended to alter
appearance for more than 24 hours under conditions of use that
are customary or usual and removal by the consumer is not part
of such conditions of use that are customary or usual.
``SEC. 613. EXEMPTION FOR CERTAIN PRODUCTS AND FACILITIES.
``(a) In General.--Notwithstanding any other provision of law,
except as provided in subsection (b), a cosmetic product or facility
that is also subject to the requirements of chapter V shall be exempt
from the requirements of sections 605, 606, 607, 608, 609(a), 610, and
611.
``(b) Exception.--A facility described in subsection (a) that also
manufactures or processes cosmetic products that are not subject to the
requirements of chapter V shall not be exempt from the requirements of
sections 605, 606, 607, 608, 609(a), 610, and 611, with respect to such
cosmetic products.
``SEC. 614. PREEMPTION.
``(a) In General.--No State or political subdivision of a State may
establish or continue in effect any law, regulation, order, or other
requirement for cosmetics that is different from or in addition to, or
otherwise not identical with, any requirement applicable under this
chapter with respect to registration and product listing, good
manufacturing practice, recordkeeping, recalls, adverse event
reporting, or safety substantiation.
``(b) Limitation.--Nothing in the amendments to this Act made by
the Modernization of Cosmetics Regulation Act of 2022 shall be
construed to preempt any State statute, public initiative, referendum,
regulation, or other State action, except as expressly provided in
subsection (a). Notwithstanding subsection (a), nothing in this section
shall be construed to prevent any State from prohibiting the use or
limiting the amount of an ingredient in a cosmetic product, or from
continuing in effect a requirement of any State that is in effect at
the time of enactment of the Modernization of Cosmetics Regulation Act
of 2022 for the reporting to the State of an ingredient in a cosmetic
product.
``(c) Savings.--Nothing in the amendments to this Act made by the
Modernization of Cosmetics Regulation Act of 2022, nor any standard,
rule, requirement, regulation, or adverse event report shall be
construed to modify, preempt, or displace any action for damages or the
liability of any person under the law of any State, whether statutory
or based in common law.
``(d) Rule of Construction.--Nothing in this section shall be
construed to amend, expand, or limit the provisions under section
752.''.
SEC. 803. ENFORCEMENT AND CONFORMING AMENDMENTS.
(a) In General.--
(1) Prohibited acts.--Section 301 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 331), as amended by section
506, is further amended--
(A) by adding at the end the following:
``(ggg) The failure to register or submit listing information in
accordance with section 607.
``(hhh) The refusal or failure to follow an order under section
611.''; and
(B) in paragraph (d), by striking ``or 564'' and
inserting ``, 564, or 607''.
(2) Adulterated products.--Section 601 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 361) is amended by adding at
the end the following:
``(f) If it has been manufactured or processed under conditions
that do not meet good manufacturing practice regulations, as prescribed
by the Food and Drug Administration in accordance with section 606.
``(g) If it is a cosmetic product, and the cosmetic product,
including each ingredient in the cosmetic product, does not have
adequate substantiation for safety, as defined in section 608(c).''.
(3) Misbranded cosmetics.--Section 602(b) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 362(b)) is amended--
(A) by striking ``and (2)'' and inserting ``(2)'';
and
(B) by inserting after ``numerical count'' the
following: ``; and (3) the information required under
section 609''.
(4) Adverse event reporting.--The Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 301 et seq.) is amended--
(A) in section 301(e) (21 U.S.C. 331(e))--
(i) by striking ``564, 703'' and inserting
``564, 605, 703''; and
(ii) by striking ``564, 760'' and inserting
``564, 605, 611, 760'';
(B) in section 301(ii) (21 U.S.C. 331(ii))--
(i) by striking ``760 or 761) or'' and
inserting ``604, 760, or 761) or''; and
(ii) by inserting ``or required under
section 605(a)'' after ``report (as defined
under section 760 or 761'';
(C) in section 801(a) (21 U.S.C. 381(a))--
(i) by striking ``under section 760 or
761'' and inserting ``under section 605, 760,
or 761'';
(ii) by striking ``defined in such section
760 or 761'' and inserting ``defined in section
604, 760, or 761'';
(iii) by striking ``of such section 760 or
761'' and inserting ``of such section 605, 760,
or 761''; and
(iv) by striking ``described in such
section 760 or 761'' and inserting ``described
in such section 605, 760, or 761''; and
(D) in section 801(b) (21 U.S.C. 381(b))--
(i) by striking ``requirements of sections
760 or 761,'' and inserting ``requirements of
section 605, 760, or 761'';
(ii) by striking ``as defined in section
760 or 761'' and inserting ``as defined in
section 604, 760, or 761''; and
(iii) by striking ``with section 760 or
761'' and inserting ``with section 605, 760, or
761''.
(b) Effective Dates.--
(1) In general.--The amendments made by subsection (a)
shall take effect on the date that is 1 year after the date of
enactment of this Act.
(2) Labeling requirement.--Section 609(a) of the Federal
Food, Drug, and Cosmetic Act, as added by section 802, shall
take effect on the date that is 2 years after the date of
enactment of this Act.
(c) Confidentiality.--
(1) In general.--The Secretary shall take appropriate
measures to ensure that there are in effect effective
procedures to prevent the unauthorized disclosure of any trade
secret or confidential commercial information that is obtained
by the Secretary of Health and Human Services pursuant to this
subtitle, including the amendments made by this subtitle.
(2) Clarification.--Nothing in this subtitle, including the
amendments made by this subtitle, shall be construed to
authorize the disclosure of information that is prohibited from
disclosure under section 301(j) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 331(j)) or section 1905 of title 18,
United States Code, or that is subject to withholding under
section 552(b)(4) of title 5, United States Code.
SEC. 804. RECORDS INSPECTION.
Section 704(a)(1) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 374(a)(1)) is amended by inserting after the second sentence the
following: ``In the case of a facility (as defined in section 604) that
manufactures or processes cosmetic products, the inspection shall
extend to all records and other information described in sections 605,
606, and 610, when the standard for records inspection under such
section applies.''.
SEC. 805. TALC-CONTAINING COSMETICS.
The Secretary of Health and Human Services--
(1) not later than one year after the date of enactment of
this Act, shall promulgate proposed regulations to establish
and require standardized testing methods for detecting and
identifying asbestos in talc-containing cosmetic products; and
(2) not later than 180 days after the date on which the
public comment period on the proposed regulations closes, shall
issue such final regulations.
SEC. 806. PFAS IN COSMETICS.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall assess the use
of perfluoroalkyl and polyfluoroalkyl substances in cosmetic products
and the scientific evidence regarding the safety of such use in
cosmetic products, including any risks associated with such use. In
conducting such assessment, the Secretary may, as appropriate, consult
with the National Center for Toxicological Research.
(b) Report.--Not later than 3 years after enactment of this Act,
the Secretary shall publish on the website of the Food and Drug
Administration a report summarizing the results of the assessment
conducted under subsection (a).
SEC. 807. SENSE OF THE SENATE ON ANIMAL TESTING.
It is the sense of the Senate that animal testing should not be
used for the purposes of safety testing on cosmetic products and should
be phased out with the exception of appropriate allowances.
SEC. 808. FUNDING.
There is authorized to be appropriated $14,200,000 for fiscal year
2023, $25,960,000 for fiscal year 2024, and $41,890,000 for each of
fiscal years 2025 through 2027, for purposes of conducting the
activities under this subtitle (including the amendments made by this
subtitle) and hiring personnel required to carry out this subtitle
(including the amendments made by this subtitle).
Subtitle B--Dietary Supplements
SEC. 811. REGULATION OF DIETARY SUPPLEMENTS.
(a) In General.--Chapter IV of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 341 et seq.) is amended by adding after section 403C of
such Act (21 U.S.C. 343-3) the following:
``SEC. 403D. DIETARY SUPPLEMENT LISTING REQUIREMENT.
``(a) In General.--Beginning on the date specified in subsection
(b)(4), each dietary supplement marketed in the United States shall be
listed with the Secretary in accordance with this section. Each such
listing shall include, with respect to the dietary supplement, the
information specified in subsection (b)(1).
``(b) Requirements.--
``(1) In general.--The manufacturer, packer, or distributor
of a dietary supplement whose name (pursuant to section
403(e)(1)) appears on the label of a dietary supplement
marketed in the United States (referred to in this section as
the `responsible person'), or if the responsible person is a
foreign entity, the United States agent of such person, shall
submit to the Secretary in accordance with this section the
following information for a dietary supplement that is
marketed:
``(A) Any name of the dietary supplement and the
statement of identity, including brand name and
specified flavors, if applicable.
``(B) The name and address of the responsible
person and the name and email address of the owner,
operator, or agent in charge of the responsible person.
``(C) The name, domestic address, and email address
for the United States agent, if the responsible person
is a foreign entity.
``(D) The business name and full address of all
locations at which the responsible person manufactures,
packages, labels, or holds the dietary supplement.
``(E) A list of all ingredients in each such
dietary supplement required under sections 101.4 and
101.36, title 21, Code of Federal Regulations (or any
successor regulations) to appear on the label of a
dietary supplement, including--
``(i) where applicable, ingredients in a
proprietary blend as described in section
101.36(c) of title 21, Code of Federal
Regulations (or any successor regulations);
``(ii) the amount per serving of each
listed dietary ingredient;
``(iii) if required by section 101.36 of
title 21, Code of Federal Regulations (or any
successor regulations), the percent of the
daily value of each listed dietary ingredient;
and
``(iv) the amount per serving of dietary
ingredients within a proprietary blend.
``(F) The number of servings per container for each
container size.
``(G) The directions for use.
``(H) Warnings, notice, and safe handling
statements, as required by section 101.17 of title 21,
Code of Federal Regulations (or any successor
regulations).
``(I) Allergen statements for major food allergens
(pursuant to sections 403(w) and 403(x)).
``(J) The form of the dietary supplement (such as
tablets, capsules, powders, liquids, softgels, and
gummies).
``(K) Any health claims or structure or function
claims.
``(L) The dietary supplement product listing number
for the dietary supplement provided by the Secretary in
accordance with subsection (c).
``(2) Format.--The Secretary may require that a listing
submitted under paragraph (1) be submitted in an electronic
format. Upon receipt of a complete listing under paragraph (1),
the Secretary shall promptly notify the responsible person of
the receipt of such listing.
``(3) Listing content.--A single listing submission for a
dietary supplement under paragraph (1) may include multiple
dietary supplements with identical formulations and forms, or
formulations of the same form, that differ only with respect to
color, excipients, or flavorings, whether offered in a single
package size or in multiple package sizes.
``(4) Timing.--
``(A) In general.--
``(i) Dietary supplements on the market.--
In the case of a dietary supplement that is
being offered in interstate commerce on or
before January 1, 2024, a listing for each such
dietary supplement introduced or delivered for
introduction into interstate commerce shall be
submitted by the responsible person to the
Secretary under this subsection not later than
18 months after the date of enactment of the
Food and Drug Administration Safety and
Landmark Advancements Act of 2022.
``(ii) New dietary supplements.--In the
case of a dietary supplement that is not being
offered in interstate commerce on or before
January 1, 2024, a listing for each such
dietary supplement introduced or delivered for
introduction into interstate commerce that has
not been included in any listing previously
submitted by the responsible person to the
Secretary under this subsection shall be
submitted to the Secretary at the time of
introduction into interstate commerce.
``(B) Discontinued dietary supplements.--The
responsible person shall notify the Secretary within
one year of the date of discontinuance of a dietary
supplement required to be listed with the Secretary
under paragraph (1) for which the responsible person
has discontinued commercial marketing.
``(C) Changes to existing listings.--The
responsible person shall submit to the Secretary a
change or modification to listing information submitted
under paragraph (1) included on the label for a dietary
supplement at the time the dietary supplement with the
change or modification is introduced into interstate
commerce.
``(5) Additional information.--The responsible person shall
provide upon request from the Secretary, within 10 calendar
days of such request, the full business name and physical and
mailing address from which the responsible person receives a
dietary ingredient or combination of dietary ingredients that
the responsible person uses in the manufacture of the dietary
supplement or, if applicable, from which the responsible person
receives the dietary supplement.
``(c) Product Listing Number and Dietary Supplement Electronic
Database.--
``(1) Dietary supplement product listing number.--The
Secretary shall provide each dietary supplement listed in
accordance with subsection (b)(1) a dietary supplement product
listing number, which may apply to multiple dietary supplements
with identical formulations, or formulations that differ only
with respect to color, excipients, or flavorings, including
dietary supplements offered in a single package size or in
multiple package sizes. The Secretary shall provide a process
for a responsible person to reserve dietary supplement listing
numbers in advance of listing under subsection (b)(1).
``(2) Electronic database.--Not later than 2 years after
the date of enactment of the Food and Drug Administration
Safety and Landmark Advancements Act of 2022, the Secretary
shall establish and maintain an electronic database that is
publicly available and contains information submitted under
subsection (b)(1) (except for the information submitted under
subparagraphs (D) and (E)(iv) of such subsection). The
Secretary shall make such information maintained in the
electronic database publicly searchable, including by dietary
supplement product listing number, and by any field of
information or combination of fields of information provided
under subsection (b)(1).
``(3) Confidential information.--In response to a request
under section 552 of title 5, United States Code, information
described in subparagraph (D) or (E)(iv) of subsection (b)(1)
that is derived from a listing under this section shall be
withheld under section 552(b)(3) of title 5, United States
Code.
``(d) Rule of Construction.--Nothing in this section shall be
construed--
``(1) to limit the authority of the Secretary to inspect or
copy records or to require the establishment and maintenance of
records under any other provision of this Act;
``(2) to authorize the disclosure of information that is
prohibited from disclosure under section 301(j) of this Act or
section 1905 of title 18, United States Code, or that is
subject to withholding under section 552(b)(4) of title 5,
United States Code; or
``(3) to grant the Secretary authority to require the
approval of a dietary supplement prior to marketing.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated $7,498,080 for fiscal year 2023, and $6,300,000 for each
of fiscal years 2024 through 2027, for purposes of conducting the
activities under this section and hiring personnel required to carry
out this section.''.
(b) Guidance.--Not later than 18 months after the date of enactment
of this Act, the Secretary of Health and Human Services shall publish
final guidance related to the draft guidance titled, ``Dietary
Supplements: New Dietary Ingredient Notifications and Related Issues;
Revised Draft Guidance for Industry'', issued August 12, 2016,
consistent with section 403D of the Federal Food, Drug, and Cosmetic
Act, as added by subsection (a).
(c) Inspections for Certain Dietary Supplements.--The Secretary of
Health and Human Services shall direct resources to inspections of
facilities, suppliers, and dietary supplement types that present a high
risk to public health (as identified by the Secretary).
(d) Misbranding.--Section 403 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 343) is amended by adding at the end the
following:
``(z) If it is a dietary supplement for which a responsible person
or the United States agent of such a person is required under section
403D to file a listing, file a change to an existing listing, or
provide additional information to the Secretary, and such person or
agent has failed to comply with any such requirements under section
403D with respect to such dietary supplement.''.
(e) New Prohibited Act.--Section 301 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 331), as amended by section 803(a), is further
amended by adding at the end the following:
``(iii) The introduction or delivery for introduction into
interstate commerce of any product marketed as a dietary supplement
that does not meet the definition of a dietary supplement under section
201(ff).
``(jjj) The introduction or delivery for introduction into
interstate commerce of a dietary supplement that has been prepared,
packed, or held using the assistance of, or at the direction of, a
person debarred under section 306.''.
Subtitle C--In Vitro Clinical Tests
SEC. 821. SHORT TITLE.
(a) Short Title.--This subtitle may be cited as the ``Verifying
Accurate Leading-edge IVCT Development Act of 2022'' or the ``VALID Act
of 2022''.
SEC. 822. DEFINITIONS.
(a) In General.--Section 201 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 321) is amended--
(1) by adding at the end the following:
``(ss)(1) The term `in vitro clinical test' means an article
specified in subparagraph (2) that is intended to be used in the
collection, preparation, analysis, or in vitro clinical examination of
specimens taken or derived from the human body for the purpose of--
``(A) identifying or diagnosing a disease or condition;
``(B) providing information for diagnosing, screening,
measuring, detecting, predicting, prognosing, analyzing, or
monitoring a disease or condition, including by making a
determination of an individual's state of health; or
``(C) selecting, monitoring, or informing therapy or
treatment for a disease or condition.
``(2) An article specified in this subparagraph is--
``(A) a test kit;
``(B) a test system;
``(C) a test protocol or laboratory test protocol;
``(D) an instrument (as defined in section 587(11));
``(E) a specimen receptacle (as defined in section
587(16));
``(F) software, excluding software that is excluded by
section 520(o) from the definition of a device under section
201(h), that--
``(i) is a component or part of another in vitro
clinical test or analyzes, processes, or interprets a
signal or pattern from another in vitro clinical test;
and
``(ii) does not analyze, process, or interpret a
signal, pattern, or medical image from a device; and
``(G) subject to subparagraph (3), a component or part of a
test, a test protocol, an instrument, an article, or software
described in any of clauses (A) through (D) of such
subparagraph, whether alone or in combination, including
reagents, calibrators, and controls.
``(3) Notwithstanding subparagraph (2)(G), an article intended to
be used as a component or part of an in vitro clinical test described
in subparagraph (1) is excluded from the definition in subparagraph (1)
if the article consists of any of the following:
``(A) Blood, blood components, or human cells or tissues,
from the time of acquisition, donation, or recovery of such
article, including determination of donor eligibility, as
applicable, until such time as the article is released as a
component or part of an in vitro clinical test by the
establishment that collected such article.
``(B) An article used for invasive sampling, a needle, or a
lancet, except to the extent such article, needle, or lancet is
an integral component of an article for holding, storing, or
transporting a specimen.
``(C) General purpose laboratory equipment.'';
(2) by adding at the end of section 201(g) the following:
``(3) The term `drug' does not include an in vitro clinical
test.''; and
(3) in section 201(h)(1), in the matter following clause
(C), by striking ``section 520(o)'' and inserting ``section
520(o) or an in vitro clinical test''.
(b) Exclusion From Definition of Biological Product.--Section
351(i)(1) of the Public Health Service Act (42 U.S.C. 262(i)(1)) is
amended--
(1) by striking ``(1) The term `biological product' means''
and inserting ``(1)(A) The term `biological product' means'';
and
(2) by adding at the end the following:
``(B) The term `biological product' does not include an in
vitro clinical test as defined in section 201(ss) of the
Federal Food, Drug, and Cosmetic Act.''.
(c) In Vitro Clinical Test Definition.--In this subtitle, the term
``in vitro clinical test'' has the meaning given such term in section
201(ss) of the Federal Food, Drug, and Cosmetic Act, as added by
subsection (a).
SEC. 823. REGULATION OF IN VITRO CLINICAL TESTS.
The Federal Food, Drug, and Cosmetic Act (21 U.S.C. 301 et seq.) is
amended--
(1) by amending the heading of chapter V to read as
follows: ``DRUGS, DEVICES, AND IN VITRO CLINICAL TESTS''; and
(2) by adding at the end of chapter V the following:
``Subchapter J--In Vitro Clinical Tests
``SEC. 587. DEFINITIONS.
``In this subchapter:
``(1) Analytical validity.--The term `analytical validity'
means, with respect to an in vitro clinical test, the ability
of the in vitro clinical test, to identify, measure, detect,
calculate, or analyze (or assist in such identification,
measurement, detection, calculation, or analysis of) one or
more analytes, biomarkers, substances, or other targets
intended to be identified, measured, detected, calculated, or
analyzed by the test.
``(2) Applicable standard.--The term `applicable standard',
with respect to an in vitro clinical test, means a reasonable
assurance of analytical and clinical validity for its
indications for use, and a reasonable assurance of safety for
individuals who come into contact with such in vitro clinical
test, except that such term, with respect to specimen
receptacles and test instruments, means a reasonable assurance
of analytical validity for its indications for use and safety
for individuals who come into contact with such specimen
receptacle or test instrument.
``(3) Clinical use.--The term `clinical use' means the
operation, application, or functioning of an in vitro clinical
test for the purpose for which it is intended as described in
section 201(ss)(1).
``(4) Clinical validity.--The term `clinical validity'
means the ability of an in vitro clinical test to achieve the
purpose for which it is intended as described in section
201(ss)(1).
``(5) Component or part.--The term `component or part'
means a substance, piece, part, raw material, software,
firmware, labeling, or assembly, including reagents, that is
intended to be included as an aspect of an in vitro clinical
test described in section 201(ss)(1).
``(6) Develop.--The term `develop', with respect to an in
vitro clinical test, means--
``(A) designing, validating, producing,
manufacturing, remanufacturing, labeling, advertising,
propagating, importing, or assembling an in vitro
clinical test;
``(B) modifying an in vitro clinical test,
including modifying the indications for use of the in
vitro clinical test, or modifying an article to be an
in vitro clinical test; or
``(C) establishing a test system as described or
included in a test protocol developed by another entity
unless such test protocol is listed as an in vitro
clinical test in the comprehensive test information
system established under section 587T by that other
entity.
``(7) Developer.--The term `developer' means a person who
engages in development as described in paragraph (6), except
the term does not include a laboratory that--
``(A) is certified by the Secretary under section
353 of the Public Health Service Act; and
``(B) assembles for use solely within that
laboratory, without otherwise developing, an in vitro
clinical test appropriately listed in the comprehensive
test information system established under section 587T
by a different person.
``(8) First-of-a-kind.--The term `first-of-a-kind', with
respect to an in vitro clinical test, means that such test has
any novel combination of the elements specified in paragraph
(10) that differs from in vitro clinical tests that already are
legally available in the United States, except for such tests
offered under section 587C(a)(3), 587C(a)(4), or 587G.
``(9) High-risk.--The term `high-risk', with respect to an
in vitro clinical test or category of in vitro clinical tests,
means that an undetected inaccurate result from such test, or
such category of tests, when used as intended--
``(A)(i) has the substantial likelihood to result
in serious or irreversible harm or death to a patient
or patients, or would otherwise cause serious harm to
the public health; or
``(ii) is reasonably likely to result in the
absence, significant delay, or discontinuation of life-
supporting or life-sustaining medical treatment; and
``(B) sufficient mitigating measures are not able
to be established and applied to prevent, mitigate, or
detect the inaccurate result, or otherwise mitigate the
risk resulting from an undetected inaccurate result
described in subparagraph (A), such that the test would
be moderate-risk or low-risk.
``(10) Indications for use.--The term `indications for
use', with respect to an in vitro clinical test, means the
following elements:
``(A) Substance or substances measured by the in
vitro clinical test, such as an analyte, protein, or
pathogen.
``(B) Test method.
``(C) Test purpose or purposes, as described in
section 201(ss)(1).
``(D) Diseases or conditions for which the in vitro
clinical test is intended for use, including intended
patient populations.
``(E) Context of use, such as in a clinical
laboratory, in a health care facility, prescription
home use, over-the-counter use, or direct-to-consumer
testing.
``(11) Instrument.--
``(A) In general.--The term `instrument' means an
analytical or pre-analytical instrument.
``(B) Analytic instrument.--The term `analytic
instrument' means an in vitro clinical test that is
hardware intended by the hardware developer to be used
with one or more other in vitro clinical tests to
generate a clinical test result, including software
used to effectuate the functionality of the hardware.
``(C) Pre-analytical instrument.--The term `pre-
analytical instrument' means an in vitro clinical test
that is hardware intended by the hardware developer
solely to generate an output for use exclusively with
one or more analytical instruments as defined in
subparagraph (B) and which does not itself generate a
clinical test result. Such term may include software
used to effectuate the hardware's functionality.
``(12) Instrument family.--The term `instrument family'
means more than one instrument developed by the same developer
for which the developer demonstrates and documents, with
respect to all such instruments, that all--
``(A) have the same basic architecture, design, and
performance characteristics;
``(B) have the same indications for use and
capabilities;
``(C) share the same measurement principles,
detection methods, and reaction conditions, as
applicable; and
``(D) produce the same or similar analytical
results from samples of the same specimen type or
types.
``(13) Laboratory operations.--The term `laboratory
operations'--
``(A) means the conduct of a laboratory examination
or other laboratory procedure on materials derived from
the human body, including the conduct of an in vitro
clinical test and associated activities within or under
the oversight of a laboratory and not related to the
design of an in vitro clinical test; and
``(B) includes--
``(i) performing pre-analytical and post-
analytical processes for an in vitro clinical
test;
``(ii) standard operating procedures and
the conduct thereof; and
``(iii) preparing reagents or other test
materials that do not meet the definition of an
in vitro clinical test for clinical use under
section 201(ss).
``(14) Low-risk.--The term `low-risk', with respect to an
in vitro clinical test or category of in vitro clinical tests,
means that an undetected inaccurate result from such in vitro
clinical test, or such category of in vitro clinical tests,
when used as intended--
``(A) would cause only minimal or immediately
reversible harm, and would lead to only a remote risk
of adverse patient impact or adverse public health
impact; or
``(B) sufficient mitigating measures are able to be
established and applied such that the in vitro clinical
test meets the standard described in subparagraph (A).
``(15) Mitigating measures.--The term `mitigating
measures'--
``(A) means controls, standards, and other
requirements that the Secretary determines, based on
evidence, are necessary--
``(i) for an in vitro clinical test, or a
category of in vitro clinical tests, to meet
the applicable standard; or
``(ii) to mitigate the risk of harm ensuing
from an undetected inaccurate result or
misinterpretation of a result; and
``(B) may include, as required by the Secretary, as
appropriate, applicable requirements regarding
labeling, conformance to performance standards and
consensus standards, performance testing, submission of
clinical data, advertising, website posting of
information, clinical studies, postmarket surveillance,
user comprehension studies, training, and confirmatory
laboratory, clinical findings, the role of a health
professional in the testing process, or testing.
``(16) Moderate-risk.--The term `moderate-risk', with
respect to an in vitro clinical test or category of in vitro
clinical tests, means a test or category of tests--
``(A) that, when used as intended, meets the
criteria specified in paragraph (9)(A) for
classification as high-risk, but one or more mitigating
measures are able to be established and applied to
prevent or detect an inaccurate result or otherwise
sufficiently mitigate such risk, but are not sufficient
such that the test is low-risk under the criteria in
paragraph (13); or
``(B) for which, when used as intended--
``(i) an undetected inaccurate result would
cause only non-life-threatening harm, harm that
is medically reversible, or the absence,
significant delay, or discontinuation of
necessary treatment that is not life-supporting
or life-sustaining; and
``(ii) mitigating measures are not able to
be established and applied to prevent or detect
such inaccurate result or otherwise
sufficiently mitigate the risk of such
inaccurate result such that the test would be
low-risk under the criteria in paragraph (13).
``(17) Specimen receptacle.--The term `specimen receptacle'
means an in vitro clinical test intended for taking,
collecting, holding, storing, or transporting of specimens
derived from the human body or for in vitro examination for
purposes described in subparagraph (A) or (B) of section
201(ss)(1).
``(18) Technology.--The term `technology'--
``(A) means a set of control mechanisms, energy
sources, or operating principles--
``(i) that do not differ significantly
among multiple in vitro clinical tests; and
``(ii) for which design and development
(including analytical and clinical validation,
as applicable) of the tests would be addressed
in a similar manner or through similar
procedures; and
``(B) may include clot detection, colorimetric
(non-immunoassay), electrochemical (non-immunoassay),
enzymatic (non-immunoassay), flow cytometry,
fluorometry (non-immunoassay), immunoassay, mass
spectrometry or chromatography, microbial culture, next
generation sequencing, nephlometric or turbidimetric
(non-immunoassay), singleplex or multiplex non-NGS
nucleic acid analysis, slide-based technology,
spectroscopy, and any other technology, as the
Secretary determines appropriate.
``(19) Test.--The term `test', unless otherwise provided,
means an in vitro clinical test.
``(20) Valid scientific evidence.--The term `valid
scientific evidence'--
``(A) means, with respect to an in vitro clinical
test, evidence that--
``(i) has been generated and evaluated by
persons qualified by training or experience to
do so, using procedures generally accepted by
other persons so qualified; and
``(ii) forms an appropriate basis for
concluding by qualified experts whether the
applicable standard has been met by the in
vitro clinical test; and
``(B) may include evidence described in
subparagraph (A) consisting of--
``(i) peer-reviewed literature;
``(ii) clinical guidelines;
``(iii) reports of significant human
experience with an in vitro clinical test;
``(iv) bench studies;
``(v) case studies or histories;
``(vi) clinical data;
``(vii) consensus standards;
``(viii) reference standards;
``(ix) data registries;
``(x) postmarket data;
``(xi) real world data;
``(xii) clinical trials; and
``(xiii) data collected in countries other
than the United States if such data are
demonstrated to be appropriate for the purpose
of making a regulatory determination under this
subchapter.
``SEC. 587A. REGULATION OF IN VITRO CLINICAL TESTS.
``(a) In General.--No person shall introduce or deliver for
introduction into interstate commerce any in vitro clinical test,
unless--
``(1) an approval of an application filed pursuant to
subsection (a) or (b) of section 587B is effective with respect
to such in vitro clinical test;
``(2) the in vitro clinical test is offered under a
technology certification order in effect under section
587D(b)(1); or
``(3) the test is exempt under sections 587C or 587G from
the requirements of section 587B.
``(b) Transfer or Sale of In Vitro Clinical Tests.--
``(1) Transfer and assumption of regulatory obligations.--
If ownership of an in vitro clinical test is sold or
transferred in such manner that the developer transfers the
regulatory submissions and obligations applicable under this
subchapter with respect to the test, the transferee or
purchaser becomes the developer of the test and shall have all
regulatory obligations applicable to such a test under this
subchapter. The transferee or purchaser shall update the
registration and listing information under section 587J for the
in vitro clinical test.
``(2) Transfer or sale of premarket approval.--
``(A) Notice required.--If a developer of an in
vitro clinical test transfers or sells the approval of
the in vitro clinical test, the transferor or seller
shall--
``(i) submit a notice of the transfer or
sale to the Secretary and update the
registration and listing information under
section 587J for the in vitro clinical test;
and
``(ii) submit a supplement to an
application if required under section 587B(h).
``(B) Effective date of approval transfer.--A
transfer or sale described in subparagraph (A) shall
become effective upon completion of a transfer or sale
described in paragraph (1) or the approval of a
supplement to an application under section 587B(h) if
required, whichever is later. The transferee or
purchaser shall update the registration and listing
information under section 587J for the in vitro
clinical test within 15 calendar days of the effective
date of the transfer or sale.
``(3) Transfer or sale of technology certification.--
``(A) Requirements for transfer or sale of
technology certification.--An unexpired technology
certification can be transferred or sold if the
transferee or purchaser--
``(i) is an eligible person under section
587D(a)(2); and
``(ii) maintains, upon such transfer or
sale, test design and quality requirements,
processes and procedures under the scope of
technology certification, and scope of the
technology certification identified in the
applicable technology certification order.
``(B) Notice required.--If a developer of an in
vitro clinical test transfers or sells a technology
certification order that has not expired, the
transferor or seller shall submit a notice of the
transfer or sale to the Secretary and shall update the
registration and listing information under section 587J
for all in vitro clinical tests covered by the
technology certification.
``(C) Effective date of technology certification
transfer.--The transfer of a technology certification
shall become effective upon completion of a transfer or
sale described in subparagraph (A). The transferee or
purchaser shall update the registration and listing
information under section 587J for the in vitro
clinical test within 30 calendar days of the effective
date of the technology certification transfer.
``(D) New technology certification required.--If
the requirements of subparagraph (A)(ii) are not met,
the technology certification order may not be
transferred and the transferee or purchaser of an in
vitro clinical test is required to submit an
application for technology certification and obtain a
technology certification order prior to offering the
test for clinical use.
``(c) Regulations.--The Secretary may issue regulations to
implement this subchapter.
``SEC. 587B. PREMARKET REVIEW.
``(a) Application.--
``(1) Filing.--Any developer may file with the Secretary an
application for premarket approval of an in vitro clinical test
under this subsection.
``(2) Transparency and predictability.--If a developer
files a premarket application under this section and provides
any additional documentation required under section 587D, the
in vitro clinical test that is the subject of the premarket
application may be utilized as the representative in vitro
clinical test reviewed by the Secretary to support a technology
certification order under section 587D.
``(3) Application content.--An application submitted under
paragraph (1) shall include the following, in such format as
the Secretary specifies:
``(A) General information regarding the in vitro
clinical test, including--
``(i) the name and address of the
applicant;
``(ii) the table of contents for the
application and the identification of the
information the applicant claims as trade
secret or confidential commercial or financial
information;
``(iii) a description of the test's design
and intended use, including the indications for
use; and
``(iv) a description regarding test
function and performance characteristics.
``(B) A summary of the data and information in the
application for the in vitro clinical test, including--
``(i) a brief description of the foreign
and domestic marketing history of the test, if
any, including a list of all countries in which
the test has been marketed and a list of all
countries in which the test has been withdrawn
from marketing for any reason related to the
ability of the in vitro clinical test to meet
the applicable standard, if known by the
applicant;
``(ii) a description of benefit and risk
considerations related to the in vitro clinical
test, including a description of any applicable
adverse effects of the test on health and how
such adverse effects have been, or will be,
mitigated;
``(iii) a risk assessment of the test; and
``(iv) a description of how the data and
information in the application constitute valid
scientific evidence and support a showing that
the test meets the applicable standard under
section 587(2).
``(C) The signature of the developer filing the
premarket application or an authorized representative.
``(D) A bibliography of applicable published
reports relied upon by the applicant and a description
of any studies conducted, including any unpublished
studies related to such test, that are known or that
should reasonably be known to the applicant, and a
description of data and information relevant to the
evaluation of whether the test meets the applicable
standard.
``(E) Applicable information regarding the methods
used in, and the facilities or controls used for, the
development of the test to demonstrate compliance with
the applicable quality requirements under section 587K.
``(F) Information demonstrating compliance with any
relevant and applicable--
``(i) mitigating measures under section
587E; and
``(ii) standards established or recognized
under section 514 prior to the date of
enactment of the VALID Act of 2022, or, after
applicable standards are established or
recognized under section 587Q, with such
standards.
``(G) Valid scientific evidence to support that the
test meets the applicable standard, which shall
include--
``(i) summary information for all
supporting validation studies performed,
including a description of the objective of the
study, a description of the experimental design
of the study, a description of any limitations
of the study, a brief description of how the
data were collected and analyzed, a brief
description of the results of each study, and
conclusions drawn from each study;
``(ii) raw data for each study, which may
include, as applicable, tabulations of data and
results; and
``(iii) for nonclinical laboratory studies
involving the test, if applicable, a statement
that studies were conducted in compliance with
applicable good laboratory practices.
``(H) To the extent the application seeks
authorization to make modifications to the test within
the scope of the approval that are not otherwise
permitted without premarket review under this
subchapter, a proposed change protocol that includes
validation procedures and acceptance criteria for
anticipated modifications that could be made to the
test within the scope of the approval.
``(I) Proposed labeling, in accordance with the
requirements of section 587L.
``(J) Such other data or information as the
Secretary may require in accordance with the least
burdensome requirements under section 587AA(c).
``(4) Guidance for premarket and abbreviated premarket
applications.--In accordance with section 825 of the VALID Act
of 2022, the Secretary shall issue draft guidance detailing the
information to be provided in a premarket application and
abbreviated premarket application under this section. The
Secretary shall issue final guidance detailing the information
to be provided in a premarket application and abbreviated
premarket application under this section not later than 1 year
prior to the effective date of such Act.
``(5) Refuse to file a premarket or abbreviated premarket
application.--The Secretary may refuse to file an application
under this section only for lack of completeness or legibility
of the application. If, after receipt of an application under
this section, the Secretary refuses to file such an
application, the Secretary shall provide to the developer,
within 45 calendar days of receipt of such application
submitted under this subsection or within 30 calendar days of
receipt of an application submitted under subsection (b), a
description of the reason for such refusal, and identify the
information required, if any, to allow for the filing of the
application.
``(6) Substantive review for deficient application.--If,
after receipt of an application under this section, the
Secretary determines that any portion of such application is
materially deficient, the Secretary shall provide to the
applicant a description of such material deficiencies and the
information required to resolve such deficiencies.
``(7) Inspections.--With respect to an application under
paragraph (1), preapproval inspections authorized by an
employee of the Food and Drug Administration or a person
accredited under section 587Q need not occur unless requested
by the Secretary.
``(b) Abbreviated Premarket Review.--
``(1) In general.--Any developer may file with the
Secretary an application for abbreviated premarket approval
for--
``(A) an instrument;
``(B) a specimen receptacle;
``(C) an in vitro clinical test that is moderate-
risk; or
``(D) an in vitro clinical test that is determined
by the Secretary to be eligible for abbreviated
premarket review under section 587F(a)(1)(B).
``(2) Application content.--An application under paragraph
(1) shall include--
``(A) the information required for applications
submitted under subsection (a)(3), except that
applications under paragraph (1) need not include--
``(i) quality requirement information; or
``(ii) raw data, unless explicitly
requested by the Secretary; and
``(B) data, as applicable, to support software
validation, electromagnetic compatibility, and
electrical safety, and information demonstrating
compliance with maintaining quality systems
documentation.
``(3) Safety information.--The developer of an in vitro
clinical test specimen receptacle reviewed under this
subsection shall maintain safety information for such specimen
receptacle.
``(4) Inspections.--With respect to an application under
paragraph (1), preapproval inspections authorized by an
employee of the Food and Drug Administration or a person
accredited under section 587Q need not occur unless requested
by the Secretary.
``(c) Instruments and Instrument Families.--
``(1) In general.--A developer of an instrument family
shall file with the Secretary an application for premarket
approval of one version of an instrument under this subsection.
Any modified versions of the instrument that generate a new
instrument within the same instrument family shall be exempt
from premarket review requirements of this section, provided
that the developer of such instrument or instrument family--
``(A) maintains documentation that the new
instrument is part of the instrument family, as defined
in section 587;
``(B) performs, documents, and maintains a risk
assessment (as described in subsection (a)(3)(B)(iii))
of the new instrument compared to the instrument
approved under subsection (b) and no new risks are
identified;
``(C) performs, documents, and maintains validation
and verification activities for the new instrument;
``(D) makes such documentation available to the
Secretary upon request; and
``(E) registers and lists the new instrument in
accordance with section 587J.
``(2) Test kits and test protocols.--A test kit or test
protocol that is approved under this section for use on an
approved instrument or an instrument exempt from premarket
review, including an instrument within an instrument family
under this section, a submission under this section shall not
be required for such test kit or test protocol in order for it
to be used on a new instrument within its instrument family,
provided that--
``(A) use of the test kit or test protocol with the
new instrument does not--
``(i) change the claims for the test kit or
test protocol, except as applicable, claims
regarding an instrument or instruments that can
be used with such test kit or test protocol;
``(ii) adversely affect performance of the
test kit or test protocol; or
``(iii) cause the test kit or test protocol
to no longer conform with performance standards
required under section 587R or comply with any
applicable mitigating measures under section
587E, conditions of approval under subsection
(e)(2)(B), or restrictions under section 587O;
``(B) the test developer does not identify any new
risks for the test kit or test protocol when using the
new instrument;
``(C) the test developer validates the use of the
new instrument with the test kit or test protocol and
maintains validation documentation;
``(D) the test kit or test protocol is not intended
for use--
``(i) in settings for which a certificate
of waiver is in effect under section 353 of the
Public Health Service Act;
``(ii) without a prescription;
``(iii) at home; or
``(iv) in testing donors, donations, and
recipients of blood, blood components, human
cells, tissues, cellular-based products, or
tissue-based products;
``(E) the test developer makes the documentation
described under subparagraph (C) available to the
Secretary upon request; and
``(F) the test developer updates the listing
information for the test kit or test protocol, as
applicable.
``(d) Amendments to an Application.--An applicant shall amend an
application submitted under subsection (a), (b), or (f) if the
applicant becomes aware of information that could reasonably affect an
evaluation under subsection (e) of whether the approval standard has
been met.
``(e) Action on an Application for Premarket Approval.--
``(1) Review.--
``(A) Disposition.--As promptly as possible, but
not later than 90 calendar days after an application
under subsection (a) is accepted for submission (unless
the Secretary determines that an extension is necessary
to review one or more major amendments to the
application), or not later than 60 calendar days after
an application under subsection (b) is accepted for
submission or a supplemental application under
subsection (f) is accepted for submission, the
Secretary, after considering any applicable report and
recommendations pursuant to advisory committees under
section 587H, shall issue an order approving the
application, unless the Secretary finds that the
grounds for approval in paragraph (2) are not met.
``(B) Reliance on proposed labeling.--In
determining whether to approve or deny an application
under paragraph (1), the Secretary shall rely on the
indications for use included in the proposed labeling,
provided that such labeling is not false or misleading
based on a fair evaluation of all material facts.
``(2) Approval of an application.--
``(A) In general.--The Secretary shall approve an
application submitted under subsection (a) or (b) with
respect to an in vitro clinical test if the Secretary
finds that the applicable standard is met, and--
``(i) the applicant is in compliance with
applicable quality requirements in section
587K;
``(ii) the application does not contain a
false statement or misrepresentation of
material fact;
``(iii) based on a fair evaluation of all
material facts, the proposed labeling is
truthful and non-misleading and complies with
the requirements of section 587L;
``(iv) the applicant permits, if requested,
authorized employees of the Food and Drug
Administration and persons accredited under
section 587Q an opportunity to inspect pursuant
to section 704;
``(v) the test conforms with any applicable
performance standards required under section
587R and any applicable mitigating measures
under section 587E;
``(vi) all nonclinical laboratory studies
and clinical investigations involving human
subjects that are described in the application
were conducted in a manner that meets the
applicable requirements of this subchapter; and
``(vii) other data and information the
Secretary may require under subsection
(a)(3)(J) support approval.
``(B) Conditions of approval.--An order approving
an application pursuant to this section may require
reasonable conditions of approval for the in vitro
clinical test, which may include conformance with
applicable mitigating measures under section 587E,
restrictions under section 587O, and performance
standards under section 587R.
``(C) Publication.--The Secretary shall publish an
order for each application approved pursuant to this
paragraph on the public website of the Food and Drug
Administration and make publicly available a summary of
the data used to approve such application. In making
the order and summary publicly available, the Secretary
shall not disclose any information that--
``(i) is confidential commercial
information or trade secret information subject
to section 552(b)(4) of title 5, United States
Code, or section 1905 of title 18, United
States Code; or
``(ii) could compromise national security.
``(3) Review of denials.--An applicant whose application
submitted under this section has been denied approval under
this subsection may, by petition filed not more than 60
calendar days after the date on which the applicant receives
notice of such denial, obtain review of the denial in
accordance with section 587P.
``(f) Supplements to an Approved Application.--
``(1) Risk analysis.--Prior to implementing any
modification to an in vitro clinical test, the holder of the
application approved under subsection (e) for such test shall
perform risk analyses in accordance with this subsection,
unless such modification is included in the change protocol
submitted by the applicant and approved under this section or
exempt under section 587C.
``(2) Supplement requirement.--
``(A) In general.--If the holder of an application
of an approved in vitro clinical test makes a
modification to such in vitro clinical test, except as
provided in subparagraph (C), or otherwise specified by
the Secretary, the holder of the application approved
under subsection (e) for an in vitro clinical test
shall submit a supplemental application to the
Secretary. The holder of the application may not
implement such modification to the in vitro clinical
test until such supplemental application is approved.
The information required in a supplemental application
is limited to what is needed to support the change.
``(B) Adjustments to change protocol.--The holder
of an approved application may submit under this
paragraph a supplemental application to modify the
change protocol of the test at any time after the
application is submitted under subsection (a) or (b).
``(C) Exceptions.--Notwithstanding subparagraphs
(A) and (B), and so long as the holder of an approved
application submitted under subsection (a) or (b) for
an in vitro clinical test does not add a manufacturing
site, or change activities at an existing manufacturing
site, with respect to the test, the holder of an
approved application may, without submission of a
supplemental application, implement the following
modifications to the test:
``(i) Modifications in accordance with an
approved change protocol under subsection
(a)(3)(H).
``(ii) Modifications that are exempt under
section 587C(a)(6).
``(iii) Labeling changes that are
appropriate to address a safety concern, except
such labeling changes that include any of the
following remain subject to subparagraph (A):
``(I) A change to the indications
for use of the test.
``(II) A change to the performance
claims made with respect to the test.
``(III) A change that adversely
affects performance of the test.
``(D) Reporting for certain modifications made
pursuant to a change protocol.--The holder of an
application approved under subsection (e), with an
approved change protocol under subsection (a)(2)(H) for
such in vitro clinical test shall--
``(i) report any modification to such test
made pursuant to such change protocol approved
under subsection (a)(3)(H) in a submission
under section 587J(c)(2)(B); and
``(ii) include in such report--
``(I) a description of the
modification;
``(II) the rationale for
implementing such modification; and
``(III) as applicable, a summary of
the evidence supporting that the test,
as modified, meets the applicable
standard, complies with performance
standards required under section 587Q,
and complies with any mitigating
measures established under section 587E
and any restrictions under section
587O.
``(E) Reporting for certain safety related labeling
changes.--The holder of the application for an in vitro
clinical test approved under subsection (e) shall--
``(i) report to the Secretary any
modification to the test described in
subparagraph (C)(iii) not more than 30 days
after the date on which the test, with the
modification, is introduced into interstate
commerce; and
``(ii) include in the report--
``(I) a description of the change
or changes;
``(II) the rationale for
implementing such change or changes;
and
``(III) a description of how the
change or changes were evaluated.
``(3) Contents of supplement.--Unless otherwise specified
by the Secretary, a supplement under this subsection shall
include--
``(A) for modifications other than manufacturing
site changes requiring a supplement--
``(i) a description of the modification;
``(ii) data relevant to the modification to
demonstrate that the applicable standard is
met, not to exceed data requirements for the
original submission;
``(iii) acceptance criteria; and
``(iv) any revised labeling; and
``(B) for manufacturing site changes--
``(i) the information listed in
subparagraph (A); and
``(ii) information regarding the methods
used in, or the facilities or controls used
for, the development of the test to demonstrate
compliance with the applicable quality
requirements under section 587K.
``(4) Additional data.--The Secretary may require, when
necessary, data to evaluate a modification to an in vitro
clinical test that is in addition to the data otherwise
required under the preceding paragraphs if the data request is
in accordance with the least burdensome requirements under
section 587AA(c).
``(5) Conditions of approval.--In an order approving a
supplement under this subsection, the Secretary may require
conditions of approval for the in vitro clinical test,
including compliance with restrictions under section 587O and
conformance to performance standards under section 587R.
``(6) Approval.--The Secretary shall approve a supplement
under this subsection if--
``(A) the data demonstrate that the modified in
vitro clinical test meets the applicable standard; and
``(B) the holder of the application approved under
subsection (e) for the test has demonstrated compliance
with applicable quality and inspection requirements, as
applicable and appropriate.
``(7) Publication.--The Secretary shall publish on the
public website of the Food and Drug Administration notice of
any order approving a supplement under this subsection provided
that doing so does not disclose any information that--
``(A) is trade secret or confidential commercial or
financial information; or
``(B) could compromise national security.
``(8) Review of denial.--An applicant whose supplement
under this subsection has been denied approval may, by petition
filed on or before the 60th calendar day after the date upon
which the applicant receives notice of such denial, obtain
review of the denial in accordance with section 587P.
``(g) Withdrawal and Temporary Suspension of Approval.--
``(1) Order withdrawing approval.--
``(A) In general.--The Secretary may, after
providing due notice and an opportunity for an informal
hearing to the holder of an approved application for an
in vitro clinical test under this section, issue an
order withdrawing approval of the application if the
Secretary finds that--
``(i) the grounds for approval under
subsection (e) are no longer met;
``(ii) there is a reasonable likelihood
that the test would cause death or serious
adverse health consequences, including by
causing the absence, significant delay, or
discontinuation of life-saving or life
sustaining medical treatment;
``(iii) the holder of the approved
application--
``(I) has failed to, or repeatedly
or deliberately failed to, maintain
records to make reports, as required
under section 587M;
``(II) has refused to permit access
to, or copying or verification of such
records, as required under section 704;
``(III) has not complied with the
requirements of section 587K; or
``(IV) has not complied with any
mitigating measure required under
section 587E or restriction under
section 587O; or
``(iv) the labeling of such in vitro
clinical test, based on a fair evaluation of
all material facts, is false or misleading in
any particular and was not corrected within a
reasonable time after receipt of written notice
from the Secretary of such fact.
``(B) Content.--An order under subparagraph (A)
withdrawing approval of an application shall state each
ground for withdrawal and shall notify the holder of
such application 60 calendar days prior to issuing such
order.
``(C) Publication.--The Secretary shall publish any
order under subparagraph (A) on the public website of
the Food and Drug Administration provided that doing so
does not disclose--
``(i) any information that is trade secret
or confidential commercial or financial
information; or
``(ii) any other information that the
Secretary determines, if published, could
compromise national security.
``(2) Order of temporary suspension.--If, after providing
due notice and an opportunity for an informal hearing to the
holder of an approved application for an in vitro clinical test
under this section, the Secretary determines, based on
scientific evidence, that there is a reasonable likelihood that
the in vitro clinical test would cause death or serious adverse
health consequences, such as by causing the absence,
significant delay, or discontinuation of life-saving or life-
sustaining medical treatment, the Secretary shall, by order,
temporarily suspend the approval of the application. If the
Secretary issues such an order, the Secretary shall proceed
expeditiously under paragraph (1) to withdraw approval of such
application.
``(3) Appeal withdrawing approval and orders of temporary
suspensions.--An order of withdrawal or an order of temporary
suspension may be appealed under 587P.
``SEC. 587C. EXEMPTIONS.
``(a) In General.--The following in vitro clinical tests are exempt
from premarket review under section 587B, and may be lawfully marketed
subject to other applicable requirements of this Act:
``(1) Tests exempt from section 510(k).--
``(A) Exemption.--An in vitro clinical test is
exempt from premarket review under section 587B and may
be lawfully marketed subject to the other applicable
requirements of this Act, if the developer of the in
vitro clinical test--
``(i) maintains documentation demonstrating
that the test meets and continues to meet the
criteria set forth in subparagraph (B); and
``(ii) makes such documentation available
to the Secretary upon request.
``(B) Criteria for exemption.--An in vitro clinical
test is exempt as specified in subparagraph (A) if such
test--
``(i)(I)(aa) was offered for clinical use
prior to the date of enactment of the VALID Act
of 2022; and
``(bb) immediately prior to such date of
enactment was exempt pursuant to subsection (l)
or (m)(2) of section 510 from the requirements
for submission of a report under section
510(k); or
``(II)(aa) was not offered for clinical use
prior to such date of enactment;
``(bb) is not an instrument; and
``(cc) falls within a category of tests
that was exempt from the requirements for
submission of a report under section 510(k) as
of such date of enactment (including class II
devices and excluding class I devices described
in section 510(l));
``(ii) meets the applicable standard as
described in section 587(2);
``(iii) is not offered with labeling and
advertising that is false or misleading; and
``(iv) is not likely to cause or contribute
to serious adverse health consequences.
``(C) Effect on special controls.--For any in vitro
clinical test, or category of in vitro clinical tests,
that is exempt from premarket review based on the
criteria in subparagraph (B), any special control that
applied to a device within a predecessor category
immediately prior to the date of enactment of the VALID
Act of 2022 shall be deemed a mitigating measure
applicable under section 587E to an in vitro clinical
test within the successor category, except to the
extent such mitigating measure is withdrawn or changed
in accordance with section 587E.
``(D) Near-patient testing.--Not later than 1 year
after the date of enactment of the VALID Act of 2022,
the Secretary shall issue draft guidance indicating
categories of tests that shall be exempt from premarket
review under section 587B when offered for near-patient
testing (point of care), which were not exempt from
submission of a report under section 510(k) pursuant to
subsection (l) or (m)(2) of section 510 and regulations
imposing limitations on exemption for in vitro devices
intended for near-patient testing (point of care).
``(2) Low-risk tests.--
``(A) Exemption.--An in vitro clinical test is
exempt from premarket review under section 587B and may
be lawfully marketed subject to the other applicable
requirements of this Act, including section 587J(b), if
such test meets the definition of low-risk under
section 587 and if the developer of the test--
``(i) maintains documentation demonstrating
that the in vitro clinical test meets and
continues to meet the criteria set forth in
subparagraph (B); and
``(ii) makes such documentation available
to the Secretary upon request.
``(B) Criteria for exemption.--An in vitro clinical
test is exempt as specified in subparagraph (A) if--
``(i) the in vitro clinical test meets the
applicable standard as described in 587(2);
``(ii) the labeling and advertising are not
false or misleading;
``(iii) the in vitro clinical test is not
likely to cause or contribute to serious
adverse health consequences; and
``(iv) the in vitro clinical test falls
within a category of tests listed as described
in subparagraph (C).
``(C) List of low-risk tests.--
``(i) In general.--The Secretary shall
maintain, and make publicly available on the
website of the Food and Drug Administration, a
list of in vitro clinical tests, and categories
of in vitro clinical tests, that are low-risk
in vitro clinical tests for purposes of the
exemption under this paragraph.
``(ii) Inclusion.--The list under clause
(i) shall consist of--
``(I) all in vitro clinical tests
and categories of in vitro clinical
tests that are exempt from premarket
review pursuant to paragraph (1) or
this paragraph; and
``(II) all in vitro clinical tests
and categories of in vitro clinical
tests that are designated by the
Secretary pursuant to subparagraph (D)
as low-risk for purposes of this
paragraph.
``(D) Designation of tests and categories.--Without
regard to subchapter II of chapter 5 of title 5, United
States Code, the Secretary may designate, in addition
to the tests and categories described in subparagraph
(C)(i), additional in vitro clinical tests, and
categories of in vitro clinical tests, as low-risk in
vitro clinical tests for purposes of the exemption
under this paragraph. The Secretary may make such a
designation on the Secretary's own initiative or in
response to a request by a developer pursuant to
subsection (a) or (b) of section 587F. In making such a
designation for a test or category of tests, the
Secretary shall consider--
``(i) whether the test, or category of
tests, is low-risk;
``(ii) the existence of and ability to
develop mitigating measures sufficient for such
test category to meet the low-risk standard;
and
``(iii) such other factors as the Secretary
determines to be appropriate for the protection
of the public health.
``(3) Humanitarian test exemption.--
``(A) In general.--An in vitro clinical test that
meets the criteria under subparagraph (B) is exempt
from premarket review under section 587B and may be
lawfully offered subject to the other applicable
requirements of this subchapter, if the developer of
the test--
``(i) maintains documentation (which may
include literature citations in specialized
medical journals, textbooks, specialized
medical society proceedings, and governmental
statistics publications, or, if no such studies
or literature citations exist, credible
conclusions from appropriate research or
surveys) demonstrating that such test meets and
continues to meet the criteria described in
this subsection; and
``(ii) makes such documentation available
to the Secretary upon request.
``(B) Criteria for exemption.--An in vitro clinical
test is exempt as described in subparagraph (A) if--
``(i) the in vitro clinical test is
intended by the developer for use for a
diagnostic purpose for a disease or condition
that affects not more than 10,000 (or such
other higher number determined by the
Secretary) individuals in the United States per
year;
``(ii) the in vitro clinical test meets the
applicable standard described in section
587(2);
``(iii) the labeling and advertising for
the in vitro clinical test are not false or
misleading;
``(iv) the in vitro clinical test is not
likely to cause or contribute to serious
adverse health consequences; and
``(v) the in vitro clinical test is not
intended for screening.
``(C) Exception for certain tests.--An in vitro
clinical test intended to inform the use of a specific
individual or specific type of biological product,
drug, or device shall be eligible for an exemption from
premarket review under this subsection only if, the
developer submits a request under section 587F(e) for
informal feedback and the Secretary determines that
such in vitro clinical test is eligible for an
exemption from premarket review under this subsection.
``(4) Custom tests and low-volume tests.--An in vitro
clinical test is exempt from premarket review under section
587B, quality requirements under section 587K, and listing
requirements under section 587J, and may be lawfully marketed
subject to the other applicable requirements of this Act, if--
``(A) such in vitro clinical test--
``(i) is a test protocol performed for not
more than 5 patients per year (or such other
higher number determined by the Secretary), in
a laboratory certified by the Secretary under
section 353 of the Public Health Service Act
that--
``(I) meets the requirements to
perform tests of high-complexity in
which the test protocol was developed;
or
``(II) meets the requirements to
perform tests of high-complexity within
the same corporate organization and
having common ownership by the same
parent corporation as the laboratory in
which such test protocol was developed;
or
``(ii) is an in vitro clinical test
developed or modified to diagnose a unique
pathology or physical condition of a specific
patient or patients, upon order of a health
professional or other specially qualified
person designated under regulations, for which
no other in vitro clinical test is commercially
available in the United States, and is--
``(I) not intended for use with
respect to more than 5 (or such other
higher number determined by the
Secretary) other patients; and
``(II) after the development of
such test, not included in any test
menu or template test report or other
promotional materials, and is not
otherwise advertised; and
``(B) the developer of the in vitro clinical test--
``(i) maintains documentation demonstrating
that such test meets the applicable criteria
described in subparagraph (A);
``(ii) makes such documentation, such as a
prescription order requesting the custom test
for an individual patient, available to the
Secretary upon request; and
``(iii) informs the Secretary, on an annual
basis, in a manner prescribed by the Secretary
by guidance, that such test was offered.
``(5) In vitro clinical tests under a technology
certification order.--An in vitro clinical test that is within
the scope of a technology certification order, as described in
section 587D(a), is exempt from premarket review under section
587B.''.
``(6) Modified tests.--
``(A) In general.--An in vitro clinical test that
is modified is exempt from premarket review under
section 587B if--
``(i) the modification is made by--
``(I) the developer that obtained
premarket approval for the unmodified
version of the test under section 587B;
or
``(II) a clinical laboratory
certified by the Secretary under
section 353 of the Public Health
Service Act that meets the requirements
for performing high complexity testing,
to a lawfully offered in vitro clinical
test, including another developer's
lawfully offered in vitro clinical
test, excluding investigational in
vitro clinical tests offered under
section 587S, and the modified test is
performed--
``(aa) in the same clinical
laboratory in which it was
developed for which a
certification is still in
effect under section 353 that
meets the requirements to
perform tests of high
complexity;
``(bb) by another clinical
laboratory for which a
certificate is in effect under
section 353 that meets the
requirements to perform tests
of high complexity, is within
the same corporate
organization, and has common
ownership by the same parent
corporation as the laboratory
in which the test was
developed; or
``(cc) by a clinical
laboratory for which a
certificate is in effect under
section 353 that meets the
requirements to perform tests
of high complexity and is
within a public health
laboratory network coordinated
or managed by the Centers for
Disease Control and Prevention,
if the test was developed by
the Centers for Disease Control
and Prevention or another
laboratory within such public
health laboratory network; and
``(ii) the modification does not--
``(I) constitute a significant
change to the indications for use;
``(II) cause the test to no longer
comply with applicable mitigating
measures under section 587E or
restrictions under section 587O;
``(III) significantly and adversely
change performance claims or
significantly and adversely change
performance, unless provided for under
an approved change protocol under
section 587B(a)(3)(H); or
``(IV) constitute an adverse change
in the safety of the in vitro clinical
test for individuals who come in
contact with the in vitro clinical
test;
``(iii) the test meets the applicable
standard as described in section 587(2);
``(iv) the labeling and advertising are not
false or misleading; and
``(v) the test is not likely to cause or
contribute to serious adverse health
consequences.
``(B) Certain modifications.--A modification to
extend specimen stability is exempt from premarket
review under section 587B if the modified test meets
the requirements in clauses (ii) through (iv) of
subparagraph (A).
``(C) Modifications under a change protocol.--
Notwithstanding subparagraph (A), a modification made
under a change protocol pursuant to subsection
(a)(2)(H) of section 587B is exempt from review under
such section.
``(D) Documentation.--A person who modifies an in
vitro clinical test in a manner that is a modification
described in subparagraph (A) shall--
``(i) document the modification that was
made and the basis for determining that the
modification, considering the changes
individually and collectively, is a type of
modification described in subparagraph (A),
(B), or (C); and
``(ii) provide such documentation to the
Secretary upon request or inspection.
``(E) Guidance.--Not later than 30 months after the
date of enactment of the VALID Act of 2022, the
Secretary shall issue guidance regarding the in vitro
clinical tests that are modified and exempt from
premarket review under section 587B pursuant to this
paragraph.
``(b) Manual Tests.--
``(1) Exemption.--An in vitro clinical test is exempt from
all requirements of this subchapter if the output of such in
vitro clinical test is the result of direct, manual
observation, without the use of automated instrumentation or
software for intermediate or final interpretation, by a
qualified laboratory professional, and such in vitro clinical
test--
``(A) is developed and used within a single
clinical laboratory for which a certificate is in
effect under section 353 of the Public Health Service
Act that meets the requirements under section 353 for
performing high-complexity testing;
``(B) is not a specimen receptacle, instrument, or
an in vitro clinical test that includes an instrument
or specimen receptacle that is not approved under or
exempt from section 587B;
``(C) is not a high-risk test, or is a high-risk
test that the Secretary has determined meets at least
one condition in paragraph (2) and is otherwise
appropriate for this exemption; and
``(D) is not intended for testing donors,
donations, or recipients of blood, blood components,
human cells, tissues, cellular-based products, or
tissue-based products.
``(2) High-risk test limitation or condition.--A high-risk
test may be exempt under paragraph (1) from the requirements of
this subchapter only if--
``(A) no components or parts of such test,
including any reagent, is introduced into interstate
commerce under the exemption under subsection (e), and
any article for taking or deriving specimens from the
human body used in conjunction with the test remains
subject to the requirements of this subchapter; or
``(B) the test has been developed in accordance
with the applicable test design and quality
requirements under section 587K.
``(c) Public Health Surveillance Activities.--
``(1) In general.--The provisions of this subchapter shall
not apply to a test intended by the developer to be used solely
for public health surveillance activities.
``(2) Exclusion.--An in vitro clinical test used for public
health surveillance activities is not excluded from the
provisions of this subchapter pursuant to this subsection if
such test is intended for use in making clinical decisions for
individual patients.
``(d) General Laboratory Equipment.--Any instrument that does not
produce an analytical result, and that functions as a component of pre-
analytical procedures related to in vitro clinical tests, is not
subject to the requirements of this subchapter, provided that the
instrument is operating in a clinical laboratory that is certified
under section 353 of the Public Health Service Act.
``(e) Components and Parts.--
``(1) In general.--Subject to paragraph (2), a component or
part described in section 201(ss)(2)(G) is--
``(A) exempt from the requirements of this
subchapter if it is intended for further development as
described in paragraph (3); or
``(B) subject to the requirements of this
subchapter and regulated based on its risk when used as
intended by the developer, notwithstanding its
subsequent use by a developer as a component, part, or
raw material of another in vitro clinical test.
``(2) Inapplicability to other tests.--Notwithstanding
paragraph (1), an in vitro clinical test that is described in
section 201(ss)(1)(B) and that uses a component or part
described in such subparagraph shall be subject to the
requirements of this subchapter, unless the test is otherwise
exempt under this section.
``(3) Further development.--A component, part, or raw
material (as described in paragraph (1)) is intended for
further development (for purposes of such paragraph) if--
``(A) it is intended solely for use in the
development of another in vitro clinical test; and
``(B) in the case of such a test that is introduced
or delivered for introduction into interstate commerce
after the date of enactment of the VALID Act of 2022,
the labeling of such test bears the following
statement: `This product is intended solely for further
development of an in vitro clinical test and is exempt
from FDA regulation. This product must be evaluated by
the in vitro clinical test developer if it is used with
or in the development of an in vitro clinical test.'.
``(f) General Exemption Authority.--The Secretary may, by order
published in the Federal Register following notice and an opportunity
for comment, exempt a class of persons from any section under this
subchapter upon a finding that such exemption is appropriate for the
protection of the public health and other relevant considerations.
``(g) Exemption.--An in vitro clinical test that is intended solely
for use in forensic analysis or law enforcement activity is exempt from
the requirements of this subchapter. An in vitro clinical test that is
intended for use in making clinical decisions for individual patients,
or whose individually identifiable results may be reported back to an
individual patient or the patient's health care provider, even if also
intended for forensic analysis or law enforcement purposes, is not
intended solely for forensic analysis or law enforcement for purposes
of this subsection.
``(h) Revocation.--
``(1) In general.--The Secretary may revoke any exemption
under this section with respect to in vitro clinical tests with
the same indications for use if new clinical information
indicates that the exemption of an in vitro clinical test or
tests from premarket review under section 587B has a reasonable
probability of severe adverse health consequences, including
the absence, delay, or discontinuation of appropriate medical
treatment.
``(2) Process.--Any action under paragraph (1) shall be
made by publication of a notice of such proposed action on the
website of the Food and Drug Administration, the consideration
of comments to a public docket on such proposal, and
publication of a final action on such website within 60
calendar days of the close of the comment period posted to such
public docket, notwithstanding subchapter II of chapter 5 of
title 5, United States Code.
``(i) Pre-Analytical Instrument.--A pre-analytical instrument is
exempt from premarket review under section 587B and may be lawfully
offered subject to the other applicable requirements of this Act, if
either of the following applies:
``(1) Such instrument provides additional information
regarding the sample or performs an action on the sample but is
not preparing or processing the sample and does not perform any
function of an analytical instrument. Such types of pre-
analytical instruments include barcode readers, sample movers,
and sample identifiers.
``(2) Such instrument processes or prepares the sample
prior to use on an analytical instrument, does not perform any
function of an analytical instrument, and does not select,
isolate, or prepare a part of a sample based on specific
properties. Such types of pre-analytical instruments may
include sample mixers, DNA extractors and those used to dilute
samples.
``SEC. 587D. TECHNOLOGY CERTIFICATION.
``(a) Definitions.--In this section:
``(1) Eligible in vitro clinical test.--The term `eligible
in vitro clinical test' means an in vitro clinical test that is
not--
``(A) a component or part of an in vitro clinical
test as described in section 201(ss)(2)(G) unless it is
a component or part and is regulated based on its own
risk under section 587C(e)(1)(B) or as part of an
otherwise eligible in vitro clinical test;
``(B) an instrument under section 201(ss)(2)(D) or
an in vitro clinical test that includes an instrument
that is subject to section 587B, but is not approved
under, or exempt from, section 587B;
``(C) a specimen receptacle under section
201(ss)(2)(E) or an in vitro clinical test that
includes a specimen receptacle that is subject to
section 587B, but is not approved under, or exempt
from, section 587B;
``(D) an in vitro clinical test, including reagents
used in such tests, intended for use for testing
donors, donations, and recipients of blood, blood
components, human cells, tissues, cellular-based
products, or tissue-based products;
``(E) high-risk;
``(F) a combination product unless such test has
been determined to be eligible to be introduced into
interstate commerce under a technology certification
order pursuant to the regulatory pathway designation
process described in section 587F, or as described in
subsection (k); or
``(G) a first-of-a-kind in vitro clinical test,
unless such test has been determined to be eligible to
be introduced into interstate commerce under a
technology certification order pursuant to the
regulatory pathway designation process described in
section 587F, or as described in subsection (k).
``(2) Eligible person.--The term `eligible person' means an
in vitro clinical test developer unless such developer--
``(A) is a laboratory subject to section 353 of the
Public Health Service Act and does not have in effect a
certificate applicable to the category of laboratory
examination or other procedure;
``(B) was a laboratory, or an owner or operator or
any employee of a laboratory, found to have committed a
significant violation of section 353 of the Public
Health Service Act that resulted in a suspended,
revoked, or limited certificate within the 2-year
period preceding the date of the submission of the
application for a technology certificate under
subsection (c) and such violation has not been
resolved; or
``(C) has been found to have submitted information
to the Secretary, or otherwise disseminated
information, that--
``(i) made false or misleading statements
relevant to the requirements of this
subchapter; or
``(ii) violated any requirement of this
Act, where such violation exposed individuals
to serious risk of illness, injury, or death,
unless--
``(I) such violation has been
resolved; or
``(II) such violation is not
pertinent to any in vitro clinical test
within the scope of the technology
certification that such developer
seeks.
``(b) Applicability.--
``(1) In general.--An in vitro clinical test is not subject
to section 587B and may be introduced into interstate commerce
if the in vitro clinical test--
``(A) is an eligible in vitro clinical test;
``(B) is developed by an eligible person;
``(C) falls within the scope of a technology
certification order issued under this section and that
is in effect;
``(D) complies with the conditions of the
technology certification order, including with
applicable mitigating measures under section 587E,
restrictions under section 587O, and performance
standards under section 587R; and
``(E) meets the applicable standard described in
section 587(2).
``(2) Scope.--
``(A) In general.--Subject to subparagraph (B), the
scope of a technology certification order issued under
this section shall apply to one or more technologies
with multiple in vitro clinical tests utilizing a
technology that does not significantly differ in
control mechanisms, energy sources, or operating
principles and for which development, including design,
and analytical and clinical validation, of the in vitro
clinical tests would be addressed through similar
procedures, and be no broader than--
``(i) a single technology type; or
``(ii) a fixed combination of technologies.
``(B) Technology type.--A technology type described
in this paragraph may include clot detection,
colorimetric (non-immunoassay), electrochemical (non-
immunoassay), enzymatic (non-immunoassay), flow
cytometry, fluorometry (non-immunoassay), immunoassay,
mass spectrometry or chromatography, microbial culture,
next generation sequencing, nephlometric or
turbidimetric (non-immunoassay), singleplex or
multiplex non-NGS nucleic acid analysis, slide-based
technology, spectroscopy, and any other technology, as
the Secretary determines appropriate.
``(c) Application for Technology Certification.--
``(1) In general.--A developer seeking a technology
certification order shall submit an application under this
subsection, which shall contain the information specified under
paragraph (2).
``(2) Content of application.--A developer that submits an
application for a technology certification shall include all
necessary information to make a showing that all eligible in
vitro clinical tests developed within the scope of the
technology certification order will meet the applicable
standard, including--
``(A) the name and address of the developer;
``(B) a table of contents for the application and
the identification of the information the developer
claims as trade secret or confidential commercial or
financial information;
``(C) the signature of the individual filing the
application or an authorized representative;
``(D) a statement identifying the scope of the
proposed technology certification intended to be
introduced into interstate commerce under the
application;
``(E) information establishing that the developer
submitting the application is an eligible person;
``(F) quality procedures showing that eligible in
vitro clinical tests covered under the technology
certification will conform to the applicable quality
requirements of section 587K with respect to--
``(i) design controls, including related
purchasing controls and acceptance activities;
``(ii) complaint investigation, adverse
event reporting, and corrections and removals;
and
``(iii) process validation, as applicable;
``(G) procedures for analytical and clinical
validation, including all procedures for validation,
verification, and acceptance criteria, and an
explanation as to how such procedures, when used,
provide a showing that eligible in vitro clinical tests
within the proposed scope of the technology
certification order are analytically and clinically
valid;
``(H) procedures that provide a showing that in
vitro clinical tests covered by the proposed scope of
the technology certification order will be safe for
individuals who come into contact with in vitro
clinical tests covered by such order;
``(I) a proposed listing submission under section
587J(b) for in vitro clinical tests that the developer
intends to introduce into interstate commerce upon
receiving a technology certification order, which shall
not be construed to limit the developer from
introducing additional tests not included in such
submission under the same technology certification
order;
``(J) information concerning one or more
representative in vitro clinical tests, including--
``(i) a test within the scope of the
technology certification application with the
appropriate analytical complexity at the time
of the submission of the application under this
section to serve as the representative test;
``(ii) the information specified in
subsection (a) or (b) of section 587B, as
applicable, for the representative in vitro
clinical test or tests, including information
and data required pursuant to subsection
(a)(2)(G) of section 587B, unless the Secretary
determines that such information is not
necessary;
``(iii) a summary of a risk assessment of
the in vitro clinical test;
``(iv) an explanation of the choice of the
representative in vitro clinical test or tests
for the technology certification application
and how such test adequately demonstrates the
range of procedures that the developer includes
in the application under subparagraphs (F),
(G), (H), and (I); and
``(v) a brief explanation of the ways in
which the procedures included in the
application under subparagraphs (F), (G), (H),
and (I) have been applied to the representative
in vitro clinical test or tests; and
``(K) such other information necessary to make a
determination on a technology certification application
as the Secretary may determine necessary.
``(3) Reference to existing applications.--With respect to
the content requirements in the technology certification
application described in paragraph (2), a developer may
incorporate by reference any content of an application
previously submitted by the developer.
``(d) Action on an Application for Technology Certification.--
``(1) Secretary response.--
``(A) In general.--As promptly as practicable, and
not later than 90 days after receipt of an application
under subsection (c), the Secretary shall--
``(i) issue a technology certification
order granting the application, which shall
specify the scope of the technology
certification, if the Secretary finds that all
of the grounds in paragraph (3) are met; or
``(ii) deny the application if the
Secretary finds (and sets forth the basis of
such finding as part of or accompanying such
denial) that one or more grounds for granting
the application specified in paragraph (3) are
not met.
``(B) Extension.--The timeline described in
subparagraph (A) may be extended by mutual agreement
between the Secretary and the applicant.
``(2) Deficient applications.--
``(A) In general.--If, after receipt of an
application under this section, the Secretary
determines that any portion of such application is
deficient, the Secretary, not later than 60 days after
receipt of such application, shall provide to the
applicant a description of such deficiencies and
identify the information required to resolve such
deficiencies.
``(B) Converting to premarket applications.--When
responding to the deficiency letter, the developer may
convert the application for technology certification
under subsection (c) into a premarket application under
section 587B.
``(3) Technology certification order.--The Secretary shall
issue an order granting a technology certification under this
section if, on the basis of the information submitted to the
Secretary as part of the application and any other information
with respect to such applicant, the Secretary finds that--
``(A) there is a showing that in vitro clinical
tests within the scope of the technology certification
order will meet the applicable standard;
``(B) the methods used in, and the facilities or
controls used for, the development of eligible in vitro
clinical tests covered by the proposed scope of the
technology certification conform to the applicable
requirements of section 587K with respect to--
``(i) design controls, including related
purchasing controls and acceptance activities;
``(ii) complaint investigation, adverse
event reporting, and corrections and removals;
and
``(iii) process validation, as applicable;
``(C) based on a fair evaluation of all material
facts, the applicant's proposed labeling and
advertising are not false or misleading in any
particular;
``(D) the application does not contain a false
statement of material fact;
``(E) there is a showing that the representative in
vitro clinical test or tests--
``(i) meet the applicable standard; and
``(ii) reasonably represent the range of
procedures required to be submitted in the
application;
``(F) the applicant has agreed to permit, upon
request, authorized employees of the Food and Drug
Administration or persons accredited, or recognized
under this Act, an opportunity to inspect at a
reasonable time and in a reasonable manner the
facilities and all pertinent equipment, finished and
unfinished materials, containers, and labeling therein,
including all things (including records, files, papers,
and controls) bearing on whether an in vitro clinical
test is adulterated, misbranded, or otherwise in
violation of this Act, and permits such authorized
employees or persons accredited under this Act to view
and to copy and verify all records pertinent to the
application and the in vitro clinical test; and
``(G) based on other data and information the
Secretary may require under subsection (c)(2)(K), the
Secretary finds that such data and information support
granting a technology certification order.
``(4) Review of denials.--An applicant whose application
has been denied under this subsection may obtain review of such
denial under section 587P.
``(e) Supplements.--
``(1) Supplemental applications.--
``(A) In general.--With respect to any of the
following changes related to an in vitro clinical test
under a technology certification order, a supplemental
application to a technology certification order shall
be submitted by the holder of the technology
certification order describing such proposed changes,
prior to introducing the in vitro clinical test that is
the subject of the technology certification order into
interstate commerce--
``(i) any significant change to the
procedures provided in support of the
application for technology certification
submitted under subparagraph (G) or (H) of
subsection (c)(2); or
``(ii) any significant change to the
procedures provided in support of the
application for technology certification
submitted under subparagraph (F) of subsection
(c)(2).
``(B) Secretary action on supplemental
applications.--Any action by the Secretary on a
supplemental application shall be in accordance with
subsection (d), and any order resulting from such
supplement shall be treated as an amendment to a
technology certification order.
``(2) Content of application.--
``(A) In general.--A supplemental application for a
change to an in vitro clinical test under a technology
certification order shall--
``(i) contain all necessary information to
make a showing that any in vitro clinical test
affected by such change that is within the
scope of the technology certification order
will meet the applicable standard; and
``(ii) be limited to such information that
is needed to support the change.
``(B) Content.--Unless otherwise specified by the
Secretary, a supplemental application under this
subsection shall include--
``(i) a description of the change,
including a rationale for implementing such
change;
``(ii) a description of how the change was
evaluated;
``(iii) data from a representative in vitro
clinical test or tests that supports a showing
that, in using the modified procedure or
procedures, all eligible in vitro clinical
tests within the scope of the technology
certification will meet the applicable
standard;
``(iv) as applicable, information to
demonstrate that the modified procedure or
procedures submitted under subsection (c)(2)(F)
continue to conform to applicable requirements
under section 587K; and
``(v) any other information requested by
the Secretary.
``(3) Changes in response to a public health risk.--
``(A) In general.--If the holder of a technology
certification makes a change to an in vitro clinical
test or tests to address a potential risk to public
health by adding a new specification or test method,
such holder may immediately implement such change and
shall submit a notification for such change to the
Secretary within 30 days.
``(B) Content.--Any notification to the Secretary
under this paragraph shall include--
``(i) a summary of the relevant change;
``(ii) the rationale for implementing such
change;
``(iii)(I) if such a change necessitates a
change to the procedures reviewed as part of
the granted technology certification order, the
modified procedures; or
``(II) if the procedures were not changed,
an explanation as to why they were not changed;
and
``(iv) if such a change necessitates a
change to the procedures reviewed as part of
the granted technology certification order,
data from a representative in vitro clinical
test or tests that support a showing that, in
using the modified procedures, all eligible in
vitro clinical tests within the scope of the
technology certification will meet the
applicable standard.
``(f) Temporary Hold.--
``(1) In general.--Subject to the process specified in
paragraph (2), and based on one or more findings under
paragraph (4), the Secretary may issue a temporary hold
prohibiting any holder of a technology certification order
issued under this section from introducing into interstate
commerce an in vitro clinical test that was not previously the
subject of a listing under section 587J. The temporary hold
shall identify the grounds for the temporary hold under
paragraph (4) and the rationale for such finding.
``(2) Process for issuing a temporary hold.--If the
Secretary makes a finding that a temporary hold may be
warranted based on one or more grounds specified in paragraph
(4), the Secretary shall promptly notify the holder of the
technology certification order of such finding and provide 30
calendar days for the developer to come into compliance with or
otherwise resolve the finding.
``(3) Written requests.--Any written request to the
Secretary from the holder of a technology certification order
that a temporary hold under paragraph (1) be removed shall
receive a decision, in writing and specifying the reasons
therefore, within 90 days after receipt of such request. Any
such request shall include information to support the removal
of the temporary hold.
``(4) Grounds for temporary hold.--The Secretary may
initiate a temporary hold under this subsection upon a finding
that the holder of a technology certification order--
``(A) is not in compliance with the conditions of
the technology certification order pursuant to
subsection (b)(1)(D);
``(B) offers one or more in vitro clinical tests
with advertising or labeling that is false or
misleading;
``(C) has reported a correction or removal of an in
vitro clinical test that is offered under a technology
certification order under this section and has failed
to demonstrate that the issue or issues causing the
correction or removal does not adversely impact the
ability of other in vitro clinical tests offered under
the same technology certification order to meet the
applicable standard; or
``(D) has introduced into interstate commerce an in
vitro clinical test under a technology certification
order and such test is adulterated or misbranded, based
on a determination by the Secretary, and has failed to
demonstrate that the issue or issues causing the
adulteration or misbranding does not adversely impact
the ability of other in vitro clinical tests offered
under the same technology certification granted under
this section to meet the applicable standard.
``(g) Withdrawal.--The Secretary may, after due notice and
opportunity for an informal hearing, issue an order withdrawing a
technology certification order including all tests introduced into
interstate commerce under the technology certification order if the
Secretary finds that--
``(1) the application, supplement, or report under
subsection (h) contains false or misleading information or
fails to reveal a material fact;
``(2) such holder fails to correct false or misleading
labeling or advertising upon the request of the Secretary;
``(3) in connection with a technology certification, the
holder provides false or misleading information to the
Secretary; or
``(4) the holder of such technology certification order
fails to correct the grounds for a temporary hold within a
timeframe specified in the temporary hold order.
``(h) Reports to Congress.--
``(1) In general.--Not later than 1 year after the
effective date of the VALID Act of 2022, and annually
thereafter for the next 4 years, the Secretary shall submit to
the Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives, and make publicly available, including through
posting on the website of the Food and Drug Administration, a
report containing the information described in paragraph (2).
``(2) Content.--
``(A) In general.--Each report under paragraph (1)
shall address, at a minimum--
``(i) the total number of applications for
technology certifications filed, issued,
withdrawn, and denied;
``(ii) the total number of technology
certification orders the Secretary put on
temporary hold under subsection (h) and the
number of technology certification orders
withdrawn under subsection (i);
``(iii) the types of technologies for which
the Secretary issued technology certification
orders;
``(iv) the total number of holders of
technology certification orders that are in
effect; and
``(v) the total number of in vitro clinical
test categories that required premarket review
under section 587B that were redesignated as
eligible in vitro clinical tests under this
section.
``(B) Final report.--The fifth report submitted
under paragraph (1) shall include a summary of, and
responses to, comments raised in the docket.
``(C) Performance reports.--The reports required
under this section may be issued with performance
reports as required under section 829 of the VALID Act
of 2022.
``(i) Public Meeting and Input.--
``(1) Public docket.--Not later than 30 days after the date
of enactment of the VALID Act of 2022, the Secretary shall
establish a public docket to receive comments concerning
recommendations for implementation of this section, including
criteria and procedures for subsections (c) through (h). The
public docket shall remain open for at least 1 year after the
establishment of the public docket.
``(2) Public meeting.--Not later than 180 days after the
date of enactment of the VALID Act of 2022, the Secretary shall
convene a public meeting to which stakeholders from
organizations representing patients and consumers, academia,
and the in vitro clinical test industry are invited to discuss
the technology certification process including application
requirements, inspections, alignment with third-party
accreditors, and the definition of the term `technology' under
section 587.
``(j) Regulations.--The Secretary shall issue regulations regarding
the technology certification process, including describing criteria or
procedures relating to technology certification under this section,
which shall be subject to public comment for a minimum of 60 days from
issuance prior to finalizing such regulations after considering the
comments received. The regulation shall include an outline of the
application process, opportunities to meet with officials of the Food
and Drug Administration, and plans to streamline inspections.
``(k) Notification.--
``(1) In general.--Notwithstanding subsection (a)(1), a
first-of-a-kind in vitro clinical test or a combination product
that meets the definition of a moderate-risk test under section
587A may be introduced into interstate commerce under a
technology certification order that has been issued by the
Secretary, subject to other applicable requirements if--
``(A) the developer provides notification to the
Secretary 60 days prior to introducing such tests into
interstate commerce that includes information
demonstrating that the test is moderate-risk and within
the scope of the applicable technology certification
order; and
``(B) the Secretary has not issued a notification
to the developer under paragraph (2) before such time
has elapsed.
``(2) Notification from secretary.--The Secretary shall
issue a notification to the developer that such test may not be
introduced into interstate commerce under such order if the
Secretary determines that--
``(A) such test--
``(i) does not meet the definition of a
moderate-risk test under section 587A;
``(ii) is not eligible to be introduced
into interstate commerce under any of
subparagraphs (A) through (E) of subsection
(a)(1); or
``(iii) is not eligible to be introduced
into interstate commerce under the referenced
technology certification order issued by the
Secretary because it is not within the scope of
the technology certification order under
subsection (b)(2); or
``(B) based on the information included in the
notification submitted by the developer pursuant to
this subsection, there is insufficient information for
the Secretary to make the determinations described in
clauses (i), (ii), and (iii) of subparagraph (A).
``SEC. 587E. MITIGATING MEASURES.
``(a) Establishment of Mitigating Measures.--
``(1) Establishing, changing, or withdrawing.--
``(A) Establishment.--The Secretary may establish
and require, on the basis of evidence, mitigating
measures for any in vitro clinical test or category of
in vitro clinical tests with the same indications for
use that is introduced or delivered for introduction
into interstate commerce after the establishment of
such mitigating measures.
``(B) Methods of establishment.--The Secretary may
establish mitigating measures--
``(i) under the process set forth in
subparagraph (D);
``(ii) as provided under section 587F; or
``(iii) through a premarket approval or
technology certification order, which may
establish mitigating measures for an individual
in vitro clinical test or a category of in
vitro clinical tests.
``(C) Methods of change or withdrawal.--The
Secretary may change or withdraw mitigating measures--
``(i) under the process set forth in
subparagraph (D); or
``(ii) as provided under section 587F.
``(D) Process for establishment, change, or
withdrawal.--Notwithstanding subchapter II of chapter 5
of title 5, United States Code, the Secretary may, upon
the initiative of the Secretary or upon petition of an
interested person--
``(i) establish, change, or withdraw
mitigating measures for an in vitro clinical
test or category of in vitro clinical tests
by--
``(I) publishing a proposed order
in the Federal Register;
``(II) providing an opportunity for
public comment for a period of not less
than 30 60 calendar days; and
``(III) after consideration of any
comments submitted, publishing a final
order in the Federal Register that
responds to the comments submitted, and
which shall include a reasonable
transition period.
``(E) Effect of mitigating measures on
grandfathered tests.--A mitigating measure shall not be
required by the Secretary for an in vitro clinical test
subject to section 587G(a).
``(2) In vitro clinical tests previously cleared or exempt
as devices with special controls.--
``(A) In general.--Any special controls applicable
to an in vitro clinical test previously cleared or
exempt under section 510(k), or classified under
section 513(f)(2) prior to date of enactment of the
VALID Act of 2022, including any such special controls
established during the period beginning on the date of
enactment of the VALID Act of 2022 and ending on the
effective date of such Act (as described in section
5(b) of such Act)--
``(i) shall continue to apply to such in
vitro clinical test after such effective date;
and
``(ii) are deemed to be mitigating measures
as of the effective date specified in section
825(a)(1)(A) of the VALID Act of 2022.
``(B) Changes.--Notwithstanding subparagraph (A),
the Secretary may establish, change, or withdraw
mitigating measures for such tests or category of tests
using the procedures under paragraph (1).
``(b) Documentation.--
``(1) In vitro clinical tests subject to premarket
review.--The developer of an in vitro clinical test subject to
premarket review under section 587B and to which mitigating
measures apply shall--
``(A) in accordance with section 587B(c)(2)(G)(i),
submit documentation to the Secretary as part of the
application for the test under subsection (c) or (d) of
section 587B demonstrating that such mitigating
measures have been met;
``(B) if such application is approved, maintain
documentation demonstrating that such mitigating
measures continue to be met following a test
modification by the developer; and
``(C) make such documentation available to the
Secretary upon request or inspection.
``(2) Other tests.--The developer of an in vitro clinical
test that is offered under a technology certification order or
other exemption from premarket review under section 587B and to
which mitigating measures apply shall--
``(A) maintain documentation in accordance with the
applicable quality requirements under section 587J
demonstrating that such mitigating measures continue to
be met following a test modification by the developer;
``(B) make such documentation available to the
Secretary upon request or inspection; and
``(C) include in the performance summary for such
test a brief description of how such mitigating
measures are met, if applicable.
``SEC. 587F. REGULATORY PATHWAY DESIGNATION.
``(a) Pathway Determinations.--
``(1) In general.--After considering available evidence
with respect to an in vitro clinical test or category of in
vitro clinical tests with the same intended use, including the
identification, establishment, and implementation of mitigating
measures under section 587E, as appropriate, the Secretary may,
upon the initiative of the Secretary or upon request of a
developer, determine that--
``(A) such in vitro clinical test is high-risk and
subject to premarket review under section 587B;
``(B) such in vitro clinical tests, including a
first-of-a-kind test, is moderate-risk and subject to
abbreviated premarket review under section 587B(b) or
technology certification under section 587D(a)(1); or
``(C) such in vitro clinical test, including a
first-of-a-kind test is low-risk or otherwise exempt
from premarket review under section 587B.
``(2) Requests.--
``(A) Submissions by developers.--
``(i) Abbreviated premarket review;
technology certification.--A developer
submitting a request that the Secretary make a
determination as described in paragraph (1)(B)
shall submit information to support that the in
vitro clinical test is moderate-risk or propose
mitigating measures, if applicable, that would
support such a determination.
``(ii) Low-risk; exempt from premarket
review.--A developer submitting a request that
the Secretary make a determination as described
in paragraph (1)(C) shall submit information
that the in vitro clinical test is low-risk, or
otherwise appropriate for exemption from
premarket review under section 587B and propose
mitigating measures, if applicable, that would
support such a determination.
``(B) Response by the secretary.--Not later than 30
days after receiving a request under clause (i) or (ii)
of subparagraph (A), the Secretary shall provide a
timely response describing whether or not the Secretary
will initiate the process for making a determination
under paragraph (1)(B) or (1)(C) as described in
paragraph (4).
``(3) Sufficiency of mitigating measures.--When determining
whether mitigating measures for an in vitro clinical test, or
category of in vitro clinical tests, are sufficient to make
such test moderate-risk or low-risk, the Secretary shall take
into account the following:
``(A) The degree to which the technology for the
intended use of the in vitro clinical test is well-
characterized, taking into consideration factors that
include one or more of the following:
``(i) Peer-reviewed literature.
``(ii) Practice guidelines.
``(iii) Consensus standards.
``(iv) Recognized standards of care.
``(v) Use of such technology, including
historical use.
``(vi) Multiple scientific publications by
different authors.
``(vii) Adoption by the scientific or
clinical community.
``(viii) Real world evidence.
``(B) Whether the criteria for performance of the
test are well-established to be sufficient for the
intended use.
``(C) The clinical circumstances under which the in
vitro clinical test is used, including whether the in
vitro clinical test is the sole determinate for the
diagnosis or treatment of the targeted disease, and the
availability of other tests (such as confirmatory or
adjunctive tests) or relevant material standards.
``(D) Whether such mitigating measures sufficiently
mitigate the risk of harm such that the test or
category of tests is moderate-risk or low-risk.
``(4) Process.--
``(A) In general.--For a test that is not first-of-
a-kind, any action under paragraph (1) shall be made by
publication of a notice of such proposed action on the
website of the Food and Drug Administration, the
consideration of comments to a public docket on such
proposal, and publication of a final action on such
website within 60 calendar days of the close of the
comment period posted to such public docket,
notwithstanding subchapter II of chapter 5 of title 5,
United States Code.
``(B) Process for first-of-a-kind test.--In the
case of an in vitro clinical test that is first-of-a-
kind, the process is as follows:
``(i) Any determination that the test is
subject to premarket approval or abbreviated
premarket review under subparagraph (A) or (B)
of paragraph (1) shall be published on the
website of the Food and Drug Administration,
notwithstanding subclause II of chapter 5 of
title 5, United States Code, only after the in
vitro clinical test is approved under section
587B. Until that time, the determination shall
not be binding on other in vitro clinical
tests.
``(ii) Any determination other than those
made under clause (i) shall be made by
publication of a notice of final action on the
website of the Food and Drug Administration,
notwithstanding subchapter II of chapter 5 of
title 5, United States Code.
``(5) No effect on grandfathering determinations.--A
determination under paragraph (1) shall have no effect on the
applicability of section 587G to an in vitro clinical tests.
``(b) Transition Period.--Upon a decision by the Secretary to
change a regulatory pathway designation, or reclassifies an in vitro
clinical test, or category of in vitro clinical tests, the Secretary
shall provide an appropriate transition period with respect to any new
requirements.
``(c) Appeals.--A decision by the Secretary under this section
shall be deemed a significant decision subject to appeal under section
587P.
``(d) Advisory Committee.--The Secretary may request
recommendations from an advisory committee under section 587H pursuant
to carrying out this section.
``(e) Request for Informal Feedback.--Before submitting a premarket
application or technology certification application for an in vitro
clinical test--
``(1) the developer of the test may submit to the Secretary
a written request for a meeting, conference, or written
feedback to discuss and provide information relating to the
regulation of such in vitro clinical test which may include--
``(A) the submission process and the type and
amount of evidence expected to demonstrate the
applicable standard;
``(B) which regulatory pathway is appropriate for
an in vitro clinical test; and
``(C) an investigation plan for an in vitro
clinical test, including a clinical protocol; and
``(2) upon receipt of such a request, the Secretary shall--
``(A) if a meeting is requested--
``(i) within 60 calendar days after such
receipt, or within such time period as may be
agreed to by the developer, meet or confer with
the developer submitting the request; and
``(ii) within 15 calendar days after such
meeting or conference, provide to the developer
a written record or response describing the
issues discussed and conclusions reached in the
meeting or conference; and
``(B) if written feedback is requested, provide
feedback to the requestor within 75 days after such
receipt.
``SEC. 587G. GRANDFATHERED IN VITRO CLINICAL TESTS.
``(a) In General.--Subject to subsection (d), an in vitro clinical
test is exempt from the requirements of this subchapter specified in
subsection (b) if--
``(1) the test was first offered for clinical use, and was
not intended solely for investigational use, before the date of
enactment of the VALID Act of 2022;
``(2) the test was developed by a clinical laboratory for
which a certificate was in effect under section 353 of the
Public Health Service Act that meets the requirements for
performing tests of high complexity;
``(3) the test is performed--
``(A) in the same clinical laboratory in which the
test was developed for which a certification is still
in effect under section 353 of the Public Health
Service Act that meets the requirements to perform
tests of high complexity;
``(B) by another clinical laboratory for which a
certificate is in effect under section 353 of such Act
that meets the requirements to perform tests of high
complexity, and that is within the same corporate
organization and having common ownership by the same
parent corporation as the laboratory in which the test
was developed; or
``(C) in the case of a test that was developed by
the Centers for Disease Control and Prevention or
another laboratory in a public health laboratory
network coordinated or managed by the Centers for
Disease Control and Prevention, by a clinical
laboratory for which a certificate is in effect under
section 353 of such Act that meets the requirements to
perform tests of high complexity, and that is within a
public health laboratory network coordinated or managed
by the Centers for Disease Control and Prevention;
``(4) the test does not have in effect an approval under
section 515, a clearance under section 510(k), an authorization
under section 513(f)(2), or an exemption under section 520(m),
or licensure under section 351 of the Public Health Service
Act;
``(5) any modification to the test on or after the date of
enactment of the VALID Act of 2022 is made by the initial
developer, conforms with section 587C(a)(6)(A)(ii), and does
not meet the criteria in subsection (d)(1);
``(6) when used as an investigational in vitro clinical
test, such test complies with section 587S, as applicable;
``(7) the test is offered with an order from an authorized
person as required under section 353 of the Public Health
Service Act, and was offered with a prescription required under
section 809.30(f) of title 21, Code of Federal Regulations
prior to the effective date of this subchapter;
``(8) the test is not for use with home specimen
collection, unless the specimen is collected with a collection
container, receptacle, or kit that--
``(A) has been approved, cleared, or authorized by
the Secretary for home specimen collection and the
collection is performed pursuant to the approved,
cleared, or authorized labeling, including any
indication for use as prescription use or over-the-
counter use, or
``(B) is exempt from premarket review and its use
is consistent with applicable limitations on the
exemption;
``(9) the test is not a specimen receptacle or instrument;
``(10) each test report for the test bears a statement that
reads as follows: `This in vitro clinical test was introduced
into commerce prior to the application of the VALID Act and is
exempt from FDA premarket review.'; and
``(11) the developer of the test--
``(A) maintains documentation demonstrating that
the test meets and continues to meet the criteria set
forth in this subsection; and
``(B) makes such documentation available to the
Secretary upon request.
``(b) Exemptions Applicable to Grandfathered Tests.--An in vitro
clinical test that meets the criteria specified in subsection (a) is
exempt from premarket review under 587B, labeling requirements under
587L, and test design requirements and quality requirements under 587K,
and may be lawfully offered subject to the other applicable
requirements of this Act.
``(c) Modifications.--In the case of an in vitro clinical test that
meets the criteria specified in subsection (a), such test continues to
qualify for the exemptions described in subsection (b) if the test is
modified and the modification is of a type described in subsection
(a)(5), and the person modifying such in vitro clinical test--
``(1) documents each such modification and maintains
documentation of the basis for such determination;
``(2) provides such documentation relating to the change to
the Secretary upon request or inspection; and
``(3) does not modify the in vitro clinical test such that
it no longer meets the criteria under subsection (a).
``(d) Request for Information.--
``(1) Criteria.--The criteria described in this paragraph
are any of the following:
``(A) There is a lack of valid scientific evidence
to support that the in vitro clinical test is
analytically valid or clinically valid.
``(B) Such in vitro clinical test is being offered
by its developer with any false or misleading
analytical or clinical claims.
``(C) It is probable that such in vitro clinical
test will cause serious adverse health consequences.
``(2) Process.--
``(A) Written request for information.--The
Secretary may issue a written request to a developer
identifying specific scientific concerns, based on
credible information, with an in vitro clinical test,
which indicate that one or more of the criteria
described in paragraph (1) apply to such in vitro
clinical test. Such written request shall include
specific information requests pertaining to such
criteria.
``(B) Deadline for submitting information.--Not
later than 45 days after receiving a request for
information under subparagraph (A)--
``(i) the developer of an in vitro clinical
test--
``(I) may seek a teleconference
prior to the submission of information
under subclause (II) to discuss the
Secretary's request; and
``(II) shall submit the information
requested pursuant to subparagraph (A),
and may include in such submission a
request for a teleconference; and
``(ii) the Secretary shall--
``(I) schedule a teleconference
requested under clause (i)(I); and
``(II) hold a teleconference if
requested within 10 days of the
Secretary's receipt of the information
submitted under clause (i)(II).
``(C) Review deadline.--Upon receiving a submission
under subparagraph (B), the Secretary shall--
``(i) review the submitted information
within 45 calendar days of such receipt, which
may include communication with the developer;
and
``(ii) determine whether the criteria
listed in paragraph (1) apply to the in vitro
clinical test and communicate such
determination to the developer as described in
subparagraph (D).
``(D) Communication and results of determination.--
The Secretary shall notify the developer, in writing,
of the Secretary's determination under subparagraph
(C), as follows:
``(i) If the Secretary determines that none
of the criteria listed in paragraph (1) apply
to the in vitro clinical test, such test shall
be exempt from relevant requirements of this
subchapter, as set forth in subsection (b),
subject to applicable limitation.
``(ii) If the Secretary determines that one
or more of the criteria listed in subparagraph
(1) apply to the test but such a determination
may be resolved within a reasonable time, and
the test has not been previously subject to
this subsection on the basis of the same or
substantially similar scientific concerns
identified in the written request issued under
paragraph (d)(2)(A)--
``(I) the Secretary shall notify
the developer of such a determination
and allow the developer to seek a
teleconference to discuss the finding;
``(II) the developer shall submit
information demonstrating resolution of
the determination within 15 days of
receiving the notification; and
``(III) the Secretary shall make a
determination within 30 days of the
submission of information as to whether
the criteria under paragraph (1) apply
to the test.
``(iii) If the Secretary determines that
none of the criteria listed in paragraph (1)
apply to the test, such test shall be exempt
from relevant requirements of the subchapter as
set forth in subsection (b), subject to
applicable limitations.
``(iv) If the Secretary determines that one
or more of the criteria listed in paragraph (1)
apply to the in vitro clinical test, such test
is not exempt as set forth in this section and
shall not be offered unless approved under
section 587B, or, upon a determination by the
Secretary pursuant to section 587F, offered
under a technology certification order under
section 587D or offered as a low-risk test.
``(v) If the Secretary determines that one
or more of the criteria listed in paragraph (1)
apply to the in vitro clinical test and clause
(ii) does not apply, the in vitro clinical test
is not exempt as set forth in section and shall
not be offered unless approved under section
587B, or upon a determination by the Secretary
pursuant to section 587F, offered under a
technology certification order under section
587D or offered as a low-risk test.
``SEC. 587H. ADVISORY COMMITTEES.
``(a) In General.--The Secretary may establish advisory committees
or use advisory committee panels of experts established before the date
of enactment of the VALID Act of 2022 (including a device
classification panel under section 513) for the purposes of providing
expert scientific advice and making recommendations related to--
``(1) the approval of an application for an in vitro
clinical test submitted under this subchapter, including for
evaluating, as applicable, the analytical validity, clinical
validity, and safety of in vitro clinical tests;
``(2) the potential effectiveness of mitigating measures
for a determination of the applicable regulatory pathway under
section 587F(b) or risk evaluation for an in vitro clinical
test or tests;
``(3) quality requirements under section 587K or applying
such requirements to in vitro clinical tests developed or
imported by developers;
``(4) appeals under section 587P; or
``(5) such other purposes as the Secretary determines
appropriate.
``(b) Appointments.--
``(1) Voting members.--The Secretary shall appoint to each
committee established under subsection (a), as voting members,
individuals who are qualified by training and experience to
evaluate in vitro clinical tests referred to the committee for
the purposes specified in subsection (a), including individuals
with, to the extent feasible, scientific expertise in the
development of such in vitro clinical tests, laboratory
operations, and the use of in vitro clinical tests. The
Secretary shall designate one member of each committee to serve
as chair.
``(2) Nonvoting members.--In addition to the individuals
appointed pursuant to paragraph (1), the Secretary shall
appoint to each committee established under subsection (a), as
nonvoting members--
``(A) a representative of consumer interests; and
``(B) a representative of interests of in vitro
clinical test developers not directly affected by the
matter to be brought before the committee.
``(3) Limitation.--No individual who is a regular full-time
employee of the United States and engaged in the administration
of this Act may be a member of any advisory committee
established under subsection (a).
``(4) Education and training.--The Secretary shall, as
appropriate, provide education and training to each new
committee member before such member participates in a
committee's activities, including education regarding
requirements under this Act and related regulations of the
Secretary, and the administrative processes and procedures
related to committee meetings.
``(5) Meetings.--The Secretary shall ensure that scientific
advisory committees meet regularly and at appropriate intervals
so that any matter to be reviewed by such a committee can be
presented to the committee not more than 60 calendar days after
the matter is ready for such review. Meetings of the committee
may be held using electronic or telephonic communication to
convene the meetings.
``(6) Compensation.--Members of an advisory committee
established under subsection (a), while attending meetings or
conferences or otherwise engaged in the business of the
advisory committee--
``(A) shall be entitled to receive compensation at
rates to be fixed by the Secretary, but not to exceed
the daily equivalent of the rate in effect for
positions classified above level GS-15 of the General
Schedule; and
``(B) may be allowed travel expenses as authorized
by section 5703 of title 5, United States Code, for
employees serving intermittently in the Government
service.
``(c) Guidance.--The Secretary may issue guidance on the policies
and procedures governing advisory committees established under
subsection (a).
``SEC. 587I. BREAKTHROUGH IN VITRO CLINICAL TESTS.
``(a) In General.--The purpose of this section is to encourage the
Secretary, and provide the Secretary with sufficient authority, to
apply efficient and flexible approaches to expedite the development of,
and prioritize the review of, in vitro clinical tests that represent
breakthrough technologies.
``(b) Establishment of Program.--The Secretary shall establish a
program to expedite the development of, and provide for the priority
review of, in vitro clinical tests.
``(c) Eligibility.--The program developed under subsection (b)
shall be available for any in vitro clinical test that--
``(1) provides or enables more effective treatment or
diagnosis of life-threatening or irreversibly debilitating
human disease or conditions compared to existing approved or
cleared in vitro clinical tests, including an in vitro clinical
test offered under a technology certification order; and
``(2) is a test--
``(A) that represents a breakthrough technology;
``(B) for which no approved or cleared alternative
in vitro clinical test exists, including no in vitro
clinical test offered under a technology certification
order;
``(C) that offers a clinically meaningful advantage
over existing alternative in vitro clinical tests that
are approved or cleared (including in vitro clinical
tests offered under a technology certification order),
including the potential to reduce or eliminate the need
for hospitalization, improve patient quality of life,
facilitate patients' ability to manage their own care
(such as through self-directed personal assistance), or
establish long-term clinical efficiencies; or
``(D) the availability of which is in the best
interest of patients or public health.
``(d) Designation.--
``(1) Request.--To receive breakthrough designation under
this section, an applicant may request that the Secretary
designate the in vitro clinical test for expedited development
and priority review. Any such request for designation may be
made at any time prior to, or at the time of, the submission of
an application under section 587B or 587D, and shall include
information demonstrating that the test meets the criteria
described in subsection (c).
``(2) Determination.--Not later than 60 calendar days after
the receipt of a request under paragraph (1), the Secretary
shall determine whether the in vitro clinical test that is the
subject of the request meets the criteria described in
subsection (c). If the Secretary determines that the test meets
the criteria, the Secretary shall designate the test for
expedited development and priority review.
``(3) Review.--Review of a request under paragraph (1)
shall be undertaken by a team that is composed of experienced
staff and senior managers of the Food and Drug Administration.
``(4) Withdrawal.--
``(A) In general.--The designation of an in vitro
clinical test under this subsection is deemed to be
withdrawn, and such in vitro clinical test shall no
longer be eligible for designation under this section,
if an application for approval for such test under
section 587B or 587D is denied. Such test shall be
eligible for breakthrough designation upon a new
request for such designation.
``(B) Exception.--The Secretary may not withdraw a
designation granted under this subsection based on the
subsequent approval or technology certification of
another in vitro clinical test that--
``(i) is designated under this section; or
``(ii) was given priority review under
section 515B.
``(e) Actions.--For purposes of expediting the development and
review of in vitro clinical tests under this section, the Secretary may
take the actions and additional actions set forth in paragraphs (1) and
(2), respectively, of section 515B(e) when reviewing such tests. Any
reference or authorization in section 515B(e) with respect to a device
shall be deemed a reference or authorization with respect to an in
vitro clinical test for purposes of this section.
``(f) Guidance.--Not later than the date specified for final
guidance under section 825 of the VALID Act of 2022, the Secretary
shall issue final guidance on the implementation of this section. Such
guidance shall--
``(1) set forth the process by which a person may seek a
designation under subsection (d);
``(2) provide a template for request under subsection (d);
``(3) identify the criteria the Secretary will use in
evaluating a request for designation; and
``(4) identify the criteria and processes the Secretary
will use to assign a team of staff, including team leaders, to
review in vitro clinical tests designated for expedited
development and priority review, including any training
required for such personnel to ensure effective and efficient
review.
``(g) Rules of Construction.--Nothing in this section shall be
construed to affect--
``(1) the criteria and standards for evaluating an
application pursuant to section 587B or 587D, including the
recognition of valid scientific evidence as described in
section 587(20) and consideration and application of the least
burdensome means described under section 587AA(c);
``(2) the authority of the Secretary with respect to
clinical holds under section 587S;
``(3) the authority of the Secretary to act on an
application pursuant to section 587B before completion of an
establishment inspection, as the Secretary determines
appropriate; or
``(4) the authority of the Secretary with respect to
postmarket surveillance under section 587X.
``SEC. 587J. REGISTRATION AND LISTING.
``(a) Registration Requirement.--
``(1) In general.--Each person described in subsection
(b)(1) shall--
``(A) during the period beginning on October 1 and
ending on December 31 of each year, register with the
Secretary the name of such person, places of business
of such person, all establishments engaged in the
activities specified under this paragraph, the
establishment registration number of each such
establishment, and a point of contact for each such
establishment, including an electronic point of
contact; and
``(B) submit an initial registration containing the
information required under subparagraph (A) not later
than--
``(i) the effective date of this section if
such establishment is engaged in any activity
described in subsection (b)(1) on such
effective date, unless the Secretary
establishes by guidance a date later than such
implementation date for all or a category of
such establishments; or
``(ii) 30 days prior to engaging in any
activity described in subsection (b)(1), if
such establishment is not engaged in any
activity described in this paragraph on such
effective date.
``(2) Registration numbers.--The Secretary may assign a
registration number to any person or an establishment
registration number to any establishment registered in
accordance with this section. Registration information shall be
made publicly available by publication on the website
maintained by the Food and Drug Administration, in accordance
with subsection (d).
``(3) Inspection.--Each person or establishment that is
required to be registered with the Secretary under this section
shall be subject to inspection pursuant to section 704.
``(b) Listing Information for In Vitro Clinical Tests.--
``(1) In general.--Each person who--
``(A) is a developer; and
``(B) introduces or proposes to begin the
introduction or delivery for introduction into
interstate commerce through an exemption under
subsection (a)(1), (a)(2), (a)(3), or (g) of section
587C or section 587G or through the filing of an
application under section 587B or section 587D,
shall submit a listing to the Secretary containing the
information described in paragraph (2), (4), or (5), as
applicable, in accordance with the applicable schedule
described under subsection (c). Such listing shall be prepared
in such form and manner as the Secretary may specify in
guidance. Listing information shall be submitted through the
comprehensive test information system in accordance with
section 587T, as appropriate.
``(2) Submissions.--Each developer submitting a listing
under paragraph (1) shall electronically submit to the
comprehensive test information system described in section 587T
the following information, as applicable, for each in vitro
clinical test for which such person is a developer in the form
and manner prescribed by the Secretary, taking into account the
least burdensome requirements under section 587AA(c):
``(A) Name of the establishment and its
establishment registration number.
``(B) Contact information for the official
correspondent for the listing.
``(C) Name (common name and trade name, if
applicable) of the in vitro clinical test and its test
listing number (when available).
``(D) The certificate number for any laboratory
certified by the Secretary under section 353 of the
Public Health Service Act that meets the requirements
to perform high-complexity testing and that is the
developer of the in vitro clinical test, and the
certificate number under such section for any
laboratory that is performing the test, is within the
same corporate organization, and has common ownership
by the same parent corporation.
``(E) Whether the in vitro clinical test is, as
applicable, offered as a test approved under section
587B, cleared to be offered under a granted technology
certification order, or offered as an exempt in vitro
clinical test under section 587C of 587G.
``(F) Indications for use information under section
587(10).
``(G) A brief summary of the analytical and
clinical performance of the in vitro clinical test, and
as applicable, the lot release criteria.
``(H) A brief description of conformance with any
applicable mitigating measures, restrictions, and
standards.
``(I) Representative labeling for the in vitro
clinical test, as appropriate.
``(3) Test listing number.--The Secretary may assign a test
listing number to each in vitro clinical test that is the
subject of a listing under this section. The process for
assigning test listing numbers may be established through
guidance, and may include the recognition of standards,
formats, or conventions developed by a third-party
organization.
``(4) Abbreviated listing.--A person who is not a developer
but is otherwise required to register pursuant to subsection
(a) shall submit an abbreviated listing to the Secretary
containing the information described in subparagraphs (A)
through (C) of paragraph (2), and the name of the developer.
The information shall be submitted in accordance with the
applicable schedule described under subsection (c). Such
abbreviated listing shall be prepared in such form and manner
as the Secretary may specify through guidance. Listing
information shall be submitted to the comprehensive test
information system in accordance with section 587T, as
appropriate.
``(5) Grandfathered tests.--A developer offering a test
that is a grandfathered in vitro clinical test under section
587G(a) shall submit listing information required under
subparagraphs (A) through (F) of paragraph (2), and may submit
a statement of the performance specifications for such in vitro
clinical tests.
``(6) Exempt tests.--A developer of an in vitro clinical
test who introduces or proposes to begin the introduction or
delivery for introduction into interstate commerce that is
otherwise exempt from the requirement to submit listing
information pursuant to an exemption under section 587C may
submit listing information under this subsection.
``(c) Timelines for Submission of Listing Information.--
``(1) In general.--The timelines for submission of
registration and listing under subsections (a) and (b) are as
follows:
``(A) For an in vitro clinical test that was listed
as a device under section 510(j) prior to the effective
date of this section, a person shall maintain a device
listing under section 510 until such time as the system
for submitting the listing information required under
subsection (b) becomes available and thereafter shall
submit the listing information not later than the later
of 1 year after the system for submitting the listing
under this section becomes available or the effective
date of this section.
``(B) For an in vitro clinical test that is subject
to grandfathering under section 587G(a) a person shall
submit the listing information required under
subsection (b)(5) not later that the later of 1 year
after the system for submitting the listing under this
section becomes available or the effective date of this
section.
``(C) For an in vitro clinical test that is not
described in subparagraph (A) or (B), a person shall
submit the required listing information as follows:
``(i) For an in vitro clinical test that is
not exempt from premarket approval under
section 587B, a person shall submit the
required listing information, prior to offering
the in vitro clinical test and not later than
30 business days after the date of approval of
the premarket approval application.
``(ii) For an in vitro clinical test that
is exempt from premarket review under section
587C, the required listing information shall be
submitted prior to offering the in vitro
clinical test.
``(2) Updates.--
``(A) Updates after changes.--Each developer
required to submit listing information under this
section shall update such information within 10
business days of any change that causes any previously
listed information to be inaccurate or incomplete.
``(B) Annual updates.--Each developer required to
submit listing information under this section shall
update its information annually during the period
beginning on October 1 and ending on December 31 of
each year.
``(d) Public Availability of Listing Information.--
``(1) In general.--Listing information submitted pursuant
to this section shall be made publicly available on the website
of the Food and Drug Administration in accordance with
paragraph (3).
``(2) Confidentiality.--Listing information for an in vitro
clinical test that is subject to premarket approval or
technology certification shall remain confidential until such
date as the in vitro clinical test receives the applicable
premarket approval or the developer receives a technology
certification order and for subsequent tests introduced under a
technology certification order until their introduction.
``(3) Exceptions from public availability requirements.--
The public listing requirements of this subsection shall not
apply to any registration and listing information submitted
under subsection (a) or (b), if the Secretary determines that
such information--
``(A) is a trade secret or confidential commercial
or financial information; or
``(B) if posted, would present a risk to national
security.
``(e) Submission of Information by Accredited Persons.--If agreed
upon by the developer, the information required under this section may
be submitted by a person accredited under section 587Q.
``SEC. 587K. TEST DESIGN AND QUALITY REQUIREMENTS.
``(a) Applicability.--
``(1) In general.--Each developer and each other person
required to register under section 587J(b)(1) shall establish
and maintain quality requirements in accordance with the
applicable requirements set forth in subsection (b).
``(2) Certified laboratory requirements.--A developer shall
establish and maintain quality requirement under subsection
(b)(2) or (b)(3), as applicable, if such developer is a
clinical laboratory certified by the Secretary under section
353 of the Public Health Service Act that--
``(A) is certified to perform high-complexity
testing;
``(B) develops an in vitro clinical test that is
for use only--
``(i) within the laboratory certified by
the Secretary under such section 353 in which
such test was developed; or
``(ii) within another laboratory certified
by the Secretary under such section 353 if such
laboratory is--
``(I) within the same corporate
organization and has common ownership
by the same parent corporation as the
laboratory in which the test was
developed; or
``(II) within a public health
laboratory network coordinated or
managed by the Centers for Disease
Control and Prevention, if the test is
developed by a public health laboratory
or the Centers for Disease Control and
Prevention; and
``(C) does not manufacture, produce, or distribute
in vitro clinical tests other than laboratory test
protocols.
``(3) Regulations.--The Secretary shall promulgate quality
system regulations implementing this section. In promulgating
such regulations under this section, the Secretary shall
consider whether, and to what extent, international
harmonization is appropriate.
``(4) Quality systems for hybrid developers of both
laboratory test protocols and other in vitro clinical tests.--
An entity that develops both finished products and laboratory
test protocols and other in vitro clinical tests shall comply
with subsection (b)(1) for activities related to the
development of any in vitro clinical test that is not a
laboratory test protocol and with subsection (b)(2) or (b)(3),
as applicable, for activities related to the development of any
laboratory test protocol.
``(b) Quality Requirements.--
``(1) In general.--The quality requirements applicable
under this section shall--
``(A) avoid duplication of regulations and guidance
under section 353 of the Public Health Service Act;
``(B) not apply to laboratory operations; and
``(C) include the following, as applicable, subject
to subparagraphs (A) and (B) and paragraphs (2) and
(3)--
``(i) management responsibilities;
``(ii) quality audits;
``(iii) personnel;
``(iv) design controls;
``(v) document controls;
``(vi) purchasing controls;
``(vii) identification and traceability;
``(viii) production and process controls;
``(ix) acceptance activities;
``(x) nonconforming in vitro clinical
tests;
``(xi) corrective and preventive action;
``(xii) labeling and packaging controls;
``(xiii) handling, storage, distribution,
and installation;
``(xiv) complaints and records;
``(xv) servicing; and
``(xvi) statistical techniques.
``(2) Exception for laboratory test protocols.--Developers
that are developing test protocols for use as described in
subsection (a)(2)(B)(i) are exempt from the requirements under
paragraph (1)(C) except for the requirements described in
clauses (iv), (ix), (xi), and (xiv) of such paragraph.
``(3) Quality requirements for certain laboratories
distributing laboratory test protocols within organizations or
public health networks.--Quality requirements applicable to the
developer who is distributing a laboratory test protocol as
described in subsection (a)(2)(B)(ii) shall consist of the
following:
``(A) Clauses (iv), (ix), (xi), (xiv), (xii) of
paragraph (1)(B).
``(B) The requirement to maintain records of the
laboratories to which the laboratory test protocol is
distributed.
``(c) Regulations.--In implementing quality requirements for test
developers that participate in international audit programs under this
section, the Secretary shall--
``(1) for purposes of facilitating international
harmonization, consider whether the developer participates in
an international audit program in which the United States
participates and recognizes compliance with, or conformance to,
such standards recognized by the Secretary; and
``(2) ensure a least burdensome approach described in
section 587AA(c) by leveraging, to the extent applicable, the
quality assurance requirements applicable to developers
certified by the Secretary under section 353 of the Public
Health Service Act.
``SEC. 587L. LABELING REQUIREMENTS.
``(a) In General.--An in vitro clinical test shall bear or be
accompanied by labeling, as applicable, that meets the requirements set
forth in subsections (b) and (c), unless such test is exempt under
subsection (d) or (e).
``(b) Labels.--
``(1) In general.--The label of an in vitro clinical test,
shall meet the requirements set forth in paragraph (2) if there
is an immediate container to which the label is applied.
``(2) Regulations.--The label of an in vitro clinical test
shall state the name and place of business of its developer and
meet the requirements set forth in regulations promulgated in
accordance with this section.
``(c) Labeling.--
``(1) In general.--Labeling of an in vitro clinical test,
including labeling in the form of a package insert, website,
standalone laboratory reference document, or other similar
document shall include--
``(A) adequate directions for use and shall meet
the requirements set forth in regulations promulgated
under this section, except as provided in subsection
(d) or (e); and
``(B) the information described in paragraph (2),
as applicable.
``(2) Content.--Labeling of an in vitro clinical test shall
include--
``(A) the test listing number that was provided to
the developer at the time of listing;
``(B) information to facilitate reporting an
adverse event;
``(C) information regarding accessing the
performance summary data displayed in the listing
database for the test;
``(D) the indications for use of the in vitro
clinical test; and
``(E) any warnings, contraindications, or
limitations.
``(3) Public availability of information.--The Secretary
shall make all of the information described in paragraph (2)
with respect to each in vitro clinical test available to the
public, as applicable, in accordance with section 587T, except
to the extent that the Secretary determines that such
information--
``(A) is trade secret or confidential commercial or
financial information; or
``(B) if posted, could compromise national
security.
``(4) Additional requirements.--Labeling for an in vitro
clinical test used for immunohematology testing shall meet the
applicable requirements set forth in part 660 of title 21, Code
of Federal Regulations (or any successor regulations), related
to the labeling of blood grouping reagents, reagent red blood
cells, and anti-human globulin.
``(d) Exemptions and Alternative Requirements.--
``(1) In general.--
``(A) In general.--With respect to an in vitro
clinical test that meets the criteria of subparagraph
(B), the `state in one place' regulations under section
809.10(b) of title 21, Code of Federal Regulations (or
any successor regulations) may be satisfied by the
laboratory posting such information on its website or
in multiple documents, if such documents are maintained
and accessible in one place.
``(B) Applicable tests.--An in vitro clinical test
meets the criteria of this subparagraph if such test
is--
``(i) developed by a laboratory certified
by the Secretary under section 353 of the
Public Health Service Act that meets the
requirements to perform tests of high-
complexity; and
``(ii) performed in--
``(I) the same laboratory in which
such test was developed; or
``(II) by another laboratory
certified by the Secretary under
section 353 of the Public Health
Service Act that--
``(aa) meets the
requirements to perform tests
of high complexity; and
``(bb) is under common
ownership and control as the
laboratory that developed the
test.
``(2) Test instrument labeling.--Unless the instrument is
the entire test system, the labeling for an instrument is not
required to bear the information indicated in paragraphs (3),
(4), (5), (7), (8), (9), (10), (11), (12), and (13) of section
809.10(b) of title 21, Code of Federal Regulations (or any
successor regulations).
``(3) Reagent labeling.--For purposes of compliance with
subsection (c)(1), the labeling for a reagent intended for use
as a replacement in an in vitro clinical test may be limited to
that information necessary to identify the reagent adequately
and to describe its proper use in the test.
``(4) Investigational use.--A shipment or other delivery of
an in vitro clinical test for investigational use pursuant to
section 587S shall be exempt from the labeling requirements of
subsections (b) and (c)(1) and from any standard promulgated
through regulations, except as required under section 353 of
the Public Health Service Act or section 587R of this Act.
``(5) General purpose laboratory reagents.--The labeling of
general purpose laboratory reagents (such as hydrochloric acid)
whose uses are generally known by persons trained in their use
need not bear the directions for use required by subsection
(c)(1)(A).
``(6) Over-the-counter test specimen receptacle labeling.--
The labeling for over-the-counter test specimen receptacles for
drugs of abuse testing shall bear the name and place of
business of the developer included in the registration under
section 587J and any information specified in applicable
regulations promulgated under this section, in language
appropriate for the intended users.
``(e) Tests in the Strategic National Stockpile.--
``(1) In general.--The Secretary may grant an exception or
alternative to any provision listed in this section, unless
explicitly required by a statutory provision outside this
subchapter, for specified lots, batches, or other units of an
in vitro clinical test, if the Secretary determines that
compliance with such labeling requirement could adversely
affect the availability of such products that are, or will be,
included in the Strategic National Stockpile under section
319F-2 of the Public Health Service Act.
``(2) Regulations.--The Secretary may issue regulations
amending section 809.11 of title 21, Code of Federal
Regulations (or any successor regulation) to apply in full or
in part to in vitro clinical tests and in vitro clinical test
developers.
``(f) Regulations.--The Secretary shall issue or revise regulations
related to standardized, general content and format for in vitro
clinical test labeling pursuant to this subsection.
``SEC. 587M. ADVERSE EVENT REPORTING.
``(a) In General.--Each in vitro clinical test developer shall
establish and maintain a system for establishing and maintaining
records of adverse events and reporting adverse events in accordance
with this section.
``(b) Submission of Individual Reports.--A developer shall submit
an individual adverse event not later than 5 calendar days after the
developer receives or becomes aware of an adverse event that reasonably
suggests that an in vitro clinical test may--
``(1) have caused or contributed to a patient or user
death; or
``(2) present an imminent threat to public health.
``(c) Submission of Quarterly Reports.--As applicable, a developer
shall submit quarterly reports that include any in vitro clinical test
errors and serious injuries that occurred during the applicable
quarter. Such quarterly reports shall be submitted not later than the
end of the quarter following the quarter in which the developer
receives or becomes aware of such adverse events.
``(d) Definitions.--For the purposes of this section--
``(1) the term `in vitro clinical test error' means a
failure of an in vitro clinical test to meet its performance
specifications, or to otherwise perform as intended by the
developer, including an inaccurate result resulting from such
failure; and
``(2) the term `serious injury' means--
``(A) a significant delay in a diagnosis that
results in the absence, delay, or discontinuation of
critical medical treatment or that irreversibly or
seriously and negatively alters the course of a disease
or condition; or
``(B) an injury that--
``(i) is life threatening;
``(ii) results in permanent impairment of a
body function or permanent damage to a body
structure; or
``(iii) necessitates medical or surgical
intervention to preclude permanent impairment
of a body function or permanent damage to a
body structure.
``(e) Regulations.--The Secretary shall promulgate regulations to
implement this section.
``SEC. 587N. CORRECTIONS AND REMOVALS.
``(a) Regulations.--The Secretary shall promulgate regulations, or
amend existing regulations, as appropriate, to implement this section.
``(b) Reports of Corrections and Removals.--
``(1) In general.--Each in vitro clinical test developer
shall report to the Secretary any correction or removal of an
in vitro clinical test undertaken by such developer if the
correction or removal was undertaken--
``(A) to reduce the risk to health posed by the in
vitro clinical test; or
``(B) to remedy a violation of this Act caused by
the in vitro clinical test which may present a risk to
health.
``(2) Exception for in vitro clinical tests offered under a
technology certification order.--For any eligible test offered
under a technology certification order under section 587D, a
correction and removal report for any correction or removal of
an in vitro clinical test should demonstrate that the issue or
issues causing the correction or removal do not adversely
impact the ability of other in vitro clinical tests offered
under the same technology certification order to meet the
applicable standard.
``(c) Timing.--A developer shall submit any report required under
this subsection to the Secretary within 15 business days of initiating
such correction or removal.
``(d) Recordkeeping.--A developer of an in vitro clinical test that
undertakes a correction or removal of an in vitro clinical test which
is not required to be reported under this subsection shall keep a
record of such correction or removal.
``(e) Recall Communications.--Upon the reporting of a correction or
removal by the developer--
``(1) the Secretary shall classify such correction or
removal under this section within 45 calendar days; and
``(2) not later than 70 calendar days after the developer
or other responsible party notifies the Secretary that it has
completed a recall action, the Secretary shall provide the
developer or other responsible party with a written statement
closing the recall action or stating the reasons the Secretary
cannot close the recall at that time.
``SEC. 587O. RESTRICTED IN VITRO CLINICAL TESTS.
``(a) Applicability.--
``(1) In general.--For the types of in vitro clinical tests
described in paragraph (3), the Secretary may require, in
issuing an approval of an in vitro clinical test under section
587B, granting a technology certification order under section
587D, or in issuing a determination under section 587F(a), or
by issuing a regulation, that such test, or category of tests,
be restricted to sale, distribution, or use upon such
conditions as the Secretary may prescribe under paragraph (2).
``(2) Conditions.-- The Secretary may prescribe conditions
under this section, based on available evidence, with respect
to an in vitro clinical test described in paragraph (3), that
are determined to be needed due to the potential for harmful
effect of such test (including any resulting absence,
significant delay, or discontinuation of appropriate medical
treatment), and are necessary to ensure that the test meets the
applicable standard.
``(3) In vitro clinical tests subject to restrictions.--The
restrictions or conditions authorized under this section may be
applied by the Secretary to any high-risk or moderate-risk in
vitro clinical test, prescription home-use in vitro clinical
test, direct-to-consumer in vitro clinical test, or over-the-
counter in vitro clinical test.
``(b) Labeling and Advertising of a Restricted in Vitro Clinical
Test.--The labeling and advertising of an in vitro clinical test to
which restrictions apply under subsection (a) shall bear such
appropriate statements of the restrictions as the Secretary may
prescribe in an approval under section 587B, an order under section
587D, a determination under section 587F(a), or in regulation, as
applicable.
``(c) Device Restrictions.--An in vitro clinical test that was
offered as a restricted device prior to the date of enactment of this
subchapter--
``(1) shall continue to comply with the applicable
restrictions under section 515 or section 520(e) until this
subchapter takes effect; and
``(2) except for in vitro clinical tests required to meet
the requirements of section 809.30 of title 21, Code of Federal
Regulations prior to the effective date of this subchapter
specified in section 825(a)(1)(A) of the VALID Act of 2022,
such restrictions described in paragraph (1) shall be deemed to
be restrictions under this subchapter as of such effective
date.
``SEC. 587P. APPEALS.
``(a) Significant Decision.--
``(1) In general.--The Secretary shall--
``(A) maintain a substantive summary of the
scientific and regulatory rationale for any significant
decision of the Food and Drug Administration pursuant
to section 587F, regarding--
``(i) the submission of an application for,
or a review of, an in vitro clinical test under
section 587B or section 587D;
``(ii) an exemption under section 587C; or
``(iii) any requirements for mitigation
measures to an in vitro clinical test or
category of in vitro clinical tests; and
``(B) include in such summaries documentation of
significant controversies or differences of opinion and
the resolution of such controversies or differences of
opinion.
``(2) Provision of documentation.--Upon request, the
Secretary shall furnish a substantive summary described in
paragraph (1) to the person who has made, or is seeking to
make, a submission described in such paragraph.
``(3) Application of least burdensome requirements.--The
substantive summary required under this subsection shall
include a brief statement regarding how the least burdensome
requirements were considered and applied consistent with
section 587AA(c), as applicable.
``(b) Review of Significant Decisions.--
``(1) Request for supervisory review of significant
decision.--A developer may request a supervisory review of the
significant decision described in subsection (a)(1). Such
review may be conducted at the next supervisory level or higher
above the agency official who made the significant decision.
``(2) Submission of request.--A developer requesting a
supervisory review under paragraph (1) shall submit such
request to the Secretary not later than 30 days after the
decision for which the review is requested and shall indicate
in the request whether such developer seeks an in-person
meeting or a teleconference review.
``(3) Timeframe.--The Secretary shall schedule an in-person
or teleconference review, if so requested, not later than 30
days after such request is made. The Secretary shall issue a
decision to the developer requesting a review under this
subsection not later than 45 days after the request is made
under paragraph (1), or, in the case of a developer who
requests an in-person meeting or teleconference, 30 days after
such meeting or teleconference.
``(c) Advisory Panels.--The process established under subsection
(a) shall permit the appellant to request review by an advisory
committee established under section 587G when there is a dispute
involving substantial scientific fact. If an advisory panel meeting is
held, the Secretary shall make a determination under this subsection
not later than 45 days after the requested advisory committee meeting
has concluded.
``(d) Least Burdensome Review.--Any developer who has submitted an
application under section 587B or 587D may request a supervisory review
of a request for additional information during an evaluation of such
submission within 60 calendar days of receipt of the additional
information request from the Secretary.
``(e) Availability of All Remedies.--The procedures set forth in
this section shall be in addition to, and not in lieu of, other
remedies available to the developer.
``SEC. 587Q. ACCREDITED PERSONS.
``(a) In General.--
``(1) Authorization.--Beginning on the date of enactment of
the VALID Act of 2022, the Secretary shall accredit persons for
any of the following purposes:
``(A) Reviewing applications for premarket approval
under section 587B and making findings with respect to
such applications.
``(B) Reviewing applications for technology
certification under section 587D and making
recommendations to the Secretary with respect to such
applications.
``(C) Conducting inspections as specified in
subsection (c) of in vitro clinical test developers and
other persons required to register pursuant to section
587J.
``(2) Persons submitting applications.--A person submitting
an application for premarket approval under section 587B or an
application for technology certification under section 587D may
submit such application to the Secretary or to a person
accredited pursuant to subparagraph (A) or (B) of paragraph
(1).
``(b) Accredited Persons Application Reviews, Findings and
Recommendations.--
``(1) Requirements for premarket application.--
``(A) Review and finding requirements.--An
accredited person receiving an application for
premarket approval under section 587B shall either--
``(i) provide to the Secretary, together
with the application for premarket approval
submitted by the applicant, a finding that the
criteria for approval of the application under
section 587B(e)(2)(A) are met and issue a copy
of such finding to the applicant, which finding
shall plainly state--
``(I) the basis for the accredited
person's finding that the criteria
under section 587B(e)(2)(A) are met;
and
``(II) any proposed restrictions,
mitigating measures, or conditions of
approval under section 587B(e)(2)(B),
as applicable; or
``(ii) provide a notification to the
applicant that the accredited person cannot
find that the criteria for approval of the
application under section 587B(e)(2)(A) are met
and the reasons for such decision.
``(B) Requesting missing or clarifying
information.--After receipt of an application from a
developer under this section, the Secretary may request
missing or clarifying information from the applicant
concerning the application, which the developer shall
promptly provide.
``(C) Secretary action on finding that approval
criteria are met.--If the accredited person transmits a
finding to the Secretary under subparagraph (A)(i),
then prior to the date that is 45 calendar days after
the transmittal date, the Secretary shall--
``(i) approve the application for premarket
approval under section 587B(e)(2) with
appropriate restrictions, mitigating measures,
or conditions of approval, as applicable; or
``(ii) deny approval of the application by
issuing a written notice that reflects
appropriate management input and concurrence to
the accredited person and the applicant
detailing the scientific basis for the
Secretary's determination that the criteria for
issuance of an approval under section
587B(e)(2)(A) have not been met.
``(D) Effect of inaction on finding.--If the
Secretary fails to take an action under subparagraph
(C) the Secretary shall--
``(i) within 45 calendar days after the
transmittal date, provide written feedback to
the applicant that--
``(I) includes all outstanding
issues with the application preventing
the Secretary from taking an action
under subparagraph (B);
``(II) reflects appropriate
management input and concurrence; and
``(III) includes action items for
the Secretary, the applicant, or both,
as appropriate, with an estimated date
of completion for the Secretary and the
applicant to complete their respective
tasks, as applicable; and
``(ii) promptly schedule a meeting or
teleconference to discuss the feedback provided
under clause (i), unless the Secretary and
applicant agree that the outstanding issues are
adequately presented through written
correspondence and a meeting or teleconference
is not necessary.
``(2) Requirements for technology certification.--
``(A) Review and recommendation requirements.--An
accredited person receiving an application for
technology certification under section 587D shall
either--
``(i) provide to the Secretary, together
with the application for technology
certification submitted by the applicant, a
recommendation that the criteria for issuance
of a technology certification order under
section 587D(d)(3) are met and issue a copy of
such recommendation to the applicant, which
recommendation shall plainly state the basis
for the accredited person's recommendation that
the criteria under section 587D(d)(3) are met;
or
``(ii) provide a notification to the
applicant that the accredited person cannot
recommend that the criteria for issuance of a
technology certification order under section
587D(d)(3) are met and the reasons for such
decision.
``(B) Requesting missing or clarifying
information.--After receipt of an application under
this section, the accredited person may request missing
or clarifying information from the applicant concerning
the application, which the applicant shall promptly
provide.
``(C) Secretary action on recommendation for
issuance of a technology certification order.--If the
accredited person transmits a recommendation to the
Secretary under clause (i) of subparagraph (A), then
prior to the date that is 60 calendar days after the
transmittal date the Secretary shall--
``(i) issue the technology certification
order under section 587D(d)(3), consistent with
such recommendation from the accredited person;
or
``(ii) deny approval of the application by
issuing a written notice to the accredited
person and the applicant detailing the
scientific basis for a determination by the
Secretary that the criteria for issuance of a
technology certification order under section
587D(d)(3) have not been met.
``(c) Requirements for Inspections.--
``(1) In general.--When conducting inspection, persons
accredited under subsection (a)(1)(B) shall record in writing
their specific observations and shall present their
observations to the designated representative of the inspected
establishment.
``(2) Inspection report requirements.--Each person
accredited under subsection (a)(1)(C) shall prepare and submit
to the Secretary an inspection report in a form and manner
designated by the Secretary for conducting inspections. Any
statement or representation made by an employee or agent of an
establishment to a person accredited to conduct inspections
under subsection (a)(1)(C) shall be subject to section 1001 of
title 18, United States Code.
``(3) Savings clause.--Nothing in this section affects the
authority of the Secretary to inspect any in vitro clinical
test developer or other person registered under section 587J or
recognize inspections conducted by auditing organizations as
described under section 704(g)(15).
``(4) Inspection limitations.--The Secretary shall ensure
that inspections carried out under this section are not
duplicative of inspections carried out under section 353 of the
Public Health Service Act. Inspections under this section shall
be limited to the data and information necessary--
``(A) for routine surveillance activities of
facilities associated with an approved application
under section 587B or issuance of a technology
certification order under section 587D; or
``(B) to meet the requirements for premarket
approval under section 587B or issuance of a technology
certification order under section 587D, as applicable.
``(d) Accreditation.--
``(1) Accreditation program.--The Secretary may provide for
accreditation under this section through programs administered
by the Food and Drug Administration, by other non-Federal
government agencies, or by qualified nongovernmental
organizations. A person may be accredited for the review of
applications submitted under sections 587B as described in
subsection (a)(1)(A), for the review of applications submitted
under section 587D as described in subsection (a)(1)(B), and to
conduct inspection activities under subsection (a)(1)(C), or
for a subset of such reviews or activities.
``(2) Eligible persons.--
``(A) Minimum qualifications.--An accredited
person, at a minimum, shall--
``(i) not be an employee of the Federal
Government;
``(ii) not engage in the activities of a
developer, as defined in section 587(7);
``(iii) not be a person required to
register under section 587J, unless such person
has established sufficient processes and
protocols to separate activities to develop in
vitro clinical tests and the activities for
which such person would be accredited under
subsection (a) and discloses applicable
information under this section;
``(iv) not be owned or controlled by, and
shall have no organizational, material, or
financial affiliation with, an in vitro
clinical test developer or other person
required to register under section 587J;
``(v) be a legally constituted entity
permitted to conduct the activities for which
it seeks accreditation;
``(vi) ensure that the operations of such
person are in accordance with generally
accepted professional and ethical business
practices; and
``(vii) include in its request for
accreditation a commitment to, at the time of
accreditation and at any time it is performing
activities pursuant to this section--
``(I) certify that the information
reported to the Secretary accurately
reflects the data or protocol reviewed,
and the documented inspection findings,
as applicable;
``(II) limit work to that for which
competence and capacity are available;
``(III) treat information received
or learned, records, reports, and
recommendations as proprietary
information of the person submitting
such information; and
``(IV) in conducting the activities
for which the person is accredited in
respect to a particular in vitro
clinical test, protect against the use
of any employee or consultant who has a
financial conflict of interest
regarding that in vitro clinical test.
``(B) Waiver.--The Secretary may waive any
requirements in clauses (i), (ii), (iii), or (iv) of
subparagraph (A) upon making a determination that such
person has implemented other appropriate controls
sufficient to ensure a competent and impartial review.
``(3) Accreditation process.--
``(A) Accreditation process guidance and
regulations.--Not later than 180 days after the date of
enactment of the VALID Act of 2022, the Secretary shall
issue draft guidance specifying the process for
submitting a request for accreditation and
reaccreditation under this section, including the form
and content of information to be submitted, including
the criteria that the Secretary will consider to
accredit or deny accreditation and, not later than 1
year after the close of the comment period for the
draft guidance, issue final guidance.
``(B) Response to request.--The Secretary shall
respond to a request for accreditation or
reaccreditation within 60 calendar days of the receipt
of the request. The Secretary's response may be to
accredit or reaccredit the person, to deny
accreditation, or to request additional information in
support of the request. If the Secretary requests
additional information, the Secretary shall respond
within 60 calendar days of receipt of such additional
information to accredit or deny the accreditation.
``(C) Type of accreditation.--The accreditation or
reaccreditation of a person shall specify the
particular activity or activities under subsection (a)
for which such person is accredited, and shall include
any limitation to certain eligible in vitro clinical
tests.
``(D) Public list.--The Secretary shall publish on
the website of the Food and Drug Administration a list
of persons who are accredited under this section. Such
list shall be updated on at least a monthly basis. The
list shall specify the particular activity or
activities under this section for which the person is
accredited.
``(E) Audit.--The Secretary may audit the
performance of persons accredited under this section
for purposes of ensuring that such persons continue to
meet the published criteria for accreditation, and may
modify the scope or particular activities for which a
person is accredited if the Secretary determines that
such person fails to meet one or more criteria for
accreditation.
``(F) Suspension or withdrawal.--The Secretary may
suspend or withdraw accreditation of any person
accredited under this section, after providing notice
and an opportunity for an informal hearing, when such
person is substantially not in compliance with the
requirements of this section or the published criteria
for accreditation, or poses a threat to public health,
or fails to act in a manner that is consistent with the
purposes of this section.
``(G) Reaccreditation.--Accredited persons may be
initially accredited for up to 3 years. After
expiration of such initial period, persons may be
reaccredited for unlimited additional 5-year periods,
as determined by the Secretary.
``(e) Compensation of Accredited Persons.--Compensation of an
accredited person shall be determined by agreement between the
accredited person and the person who engages the services of the
accredited person, and shall be paid by the person who engages such
services.
``(f) International Harmonization.--Notwithstanding any other
provision of this section, to facilitate international harmonization
the Secretary may recognize persons accredited or recognized by
governments, who have also entered into information sharing agreements,
including confidentiality commitments, with the Commissioner of Food
and Drugs.
``(g) Information Sharing Agreements.--An accredited person may
enter into an agreement with a test developer to provide information to
the comprehensive test information system under section 587T, including
any requirements under section 587J.
``(h) Reports.--Not later than 2 years after the effective date of
the VALID Act of 2022, and annually thereafter for the next 4 years,
the Secretary shall post on the website of the Food and Drug
Administration, a report describing the Secretary's performance in
implementing this section, including the Secretary's progress in
minimizing duplicative reviews of applications for which an accredited
person finds the criteria for approval are met. Such reports shall
include, for each period--
``(1) with regard to premarket approval applications--
``(A) the total number of findings transmitted to
the Secretary under subsection (b)(1)(A)(i);
``(B) the total number of determinations made by
the Secretary under subsection (b)(1)(B)(i) within 30
calendar days of the transmittal date to approve an
application;
``(C) the total number of determinations made by
the Secretary under subsection (b)(1)(B)(ii) within 30
calendar days of the transmittal date to deny approval
of an application; and
``(D) the total number of applications that were
approved and the total number of applications that were
denied approval, after the Secretary failed to make a
determination within 30 calendar days of the
transmittal date under subsection (b)(1)(B); and
``(2) with regard to applications for technology
certification--
``(A) the total number of recommendations
transmitted to the Secretary under subsection
(b)(2)(A)(i);
``(B) the total number of determinations made by
the Secretary under subsection (b)(2)(B)(i) to issue a
technology certification order, including
determinations made within 30 days of the transmittal
date;
``(C) the total number of determinations made by
the Secretary under subsection (b)(2)(B)(ii) to deny
the application for technology certification, including
determinations made within 30 calendar days of the
transmittal date; and
``(D) the total number of technology certification
orders issued, and the total number of applications for
technology certification that were denied, including
applications denied after the Secretary failed to make
a determination within 30 calendar days of the
transmittal date under subsection (b)(2)(B).
``SEC. 587R. RECOGNIZED STANDARDS.
``(a) In General.--The Secretary may recognize all or part of
appropriate standards established by nationally or internationally
recognized standards development organizations for which a person may
submit a declaration of conformity in order to meet a requirement under
this subchapter to which that standard is applicable. Standards for in
vitro diagnostic devices previously recognized under section 514(c)
shall be considered recognized standards under this section. Recognized
and proposed standards shall be accessible to the public at no charge.
The application of any such consensus standard shall only apply
prospectively. The Secretary shall issue regulations establishing the
criteria and process, for such recognition and adoption.
``(b) Amendment Process.--The procedures established in this
section or in regulation or guidance issued under this section shall
apply to amendment of an existing standard.
``SEC. 587S. INVESTIGATIONAL USE.
``(a) In General.--Subject to the conditions prescribed in
subsections (c), (d), (e), (f), and (g), an in vitro clinical test for
investigational use shall be exempt from the requirements of this
subchapter, other than sections 587A, 587P, 587T, and 587V. The
Secretary may amend parts 50, 54, and 56 of title 21 of the Code of
Federal Regulations to apply to in vitro clinical tests to permit the
investigational use of such tests by experts qualified by scientific
training and experience.
``(b) Regulations.--
``(1) In general.--Not later than 2 years after the date of
enactment of the VALID Act of 2022, the Secretary shall
promulgate regulations, or amend existing regulations, to
implement this section.
``(2) Variation.--The requirements in the regulations
promulgated under this section shall take into account
variations based on--
``(A) the scope and duration of clinical testing to
be conducted under investigation that is the subject of
such application;
``(B) the number of human subjects that are to be
involved in such testing;
``(C) the need to permit changes to be made to the
in vitro clinical test involved during testing
conducted in accordance with a plan required under
subsection (c)(6); or
``(D) whether the clinical testing of such in vitro
clinical test is for the purpose of developing data to
obtain approval to offer such test.
``(c) Application for Investigational Use.--The following shall
apply with respect to in vitro clinical tests for investigational use:
``(1) Significant risk and other studies.--In the case of
an in vitro clinical test the investigational use of which
poses a significant risk to the human subject or involves an
exception from informed consent for emergency research, a
sponsor of an investigation of such a test seeking an
investigational use exemption shall submit to the Secretary an
investigational use application with respect to the in vitro
clinical test in accordance with paragraphs (3) and (4).
``(2) Non-significant risk studies.--In the case of an in
vitro clinical test, the investigational use of which is not
described in paragraph (1)--
``(A) the sponsor of such investigation shall--
``(i) ensure such investigation is
conducted in compliance with an investigational
plan approved by an institutional review
committee and the labeling of the in vitro
clinical test involved clearly and
conspicuously states, `For investigational use
only', as specified in paragraph (4)(A)(ii);
``(ii) ensure each investigator obtains
informed consent as required under part 50, 54,
and 56 of title 21, Code of Federal Regulations
(or any successor regulations), subject to the
exceptions set forth in paragraph (6)(C);
``(iii) establish and maintain records with
respect to all requirements in this
subparagraph;
``(iv) maintain records and make reports as
required by the Secretary pursuant to
regulations issued under subsection (b); and
``(v) ensure that investigators monitor
investigations, maintain records and make
reports as required by the Secretary pursuant
to regulations issued under subsection (b); and
``(B) the sponsor may rely on any exception or
exemption described in paragraph (4) or as established
by the Secretary in regulations issued under subsection
(b).
``(3) Application.--An investigational use application
shall be submitted in such time and manner and contain such
information as the Secretary may require in regulation, and
shall include an investigational plan for proposed clinical
testing and assurances that the sponsor submitting the
application will--
``(A) establish and maintain records relevant to
the investigation of such in vitro clinical test; and
``(B) submit to the Secretary annual reports of
data obtained as a result of the investigational use of
the in vitro clinical test during the period covered by
the exemption that the Secretary reasonably determines
will enable the Secretary--
``(i) to ensure compliance with the
conditions for the exemption specified in
paragraph (4);
``(ii) to review the progress of the
investigation involved; and
``(iii) to evaluate the ability to meet the
applicable standard.
``(4) Conditions for exemption.--
``(A) In general.--An application for an
investigational use exemption with respect to a
significant risk study shall be granted if each of the
following conditions is met:
``(i) The risks to the subjects of the in
vitro clinical test are outweighed by the
anticipated benefits of the test to the
subjects and the importance of the knowledge to
be gained, and adequate assurance of informed
consent is provided in accordance with
paragraphs (6)(B) and (6)(C).
``(ii) The proposed labeling for the in
vitro clinical test involved clearly and
conspicuously states `For investigational use
only'.
``(iii) Such other requirements the
Secretary determines--
``(I) are necessary for the
protection of the public health and
safety; and
``(II) do not unduly delay
investigation.
``(B) Certain significant risk studies of in vitro
clinical tests for an unmet need.--The Secretary shall
not impose a limit on the sample size for a significant
risk study of an in vitro clinical test that has
received breakthrough designation under section 587I.
``(5) Coordination with investigational new drug
applications.--Any requirement for the submission of a report
to the Secretary pursuant to an application for an
investigational new drug exemption involving an in vitro
clinical test shall supersede the reporting requirement under
paragraph (3)(B), but only to the extent the requirement with
respect to the application for exemption with respect to the
drug is duplicative of the reporting requirement under such
paragraph.
``(6) Investigational plan, procedures, and conditions.--
With respect to an investigational plan submitted under
paragraph (3), the sponsor submitting such plan shall--
``(A) promptly notify the Secretary of the approval
or the suspension or termination of the approval of
such plan by an institutional review committee;
``(B) in the case of an in vitro clinical test made
available to investigators for clinical testing, obtain
agreements from each investigator that any testing of
the in vitro clinical test involving human subjects
will be under such investigator's supervision and in
accordance with paragraph (C) and submit such
agreements to the Secretary that ensure--
``(i) all investigators will comply with
this section, regulations promulgated or
revised under this section, and applicable
human subjects regulations; and
``(ii) the investigator will ensure that--
``(I) informed consent is obtained
as required under part 50 of title 21,
Code of Federal Regulations (or any
successor regulations), amended to
apply to in vitro clinical tests; and
``(II) the requirements for
institutional review board under part
56 of title 21 of the Code of Federal
Regulations (or successor regulations),
amended to apply to in vitro clinical
tests, are met; and
``(C) ensure that informed consent will be obtained
from each human subject (or the representative of such
subject) of proposed clinical testing involving such in
vitro clinical test, except where, subject to such
other conditions as the Secretary may prescribe--
``(i) the proposed clinical testing poses
no more than minimal risk to the human subject
and includes appropriate safeguards to protect
the rights, safety, and welfare of the human
subject; or
``(ii) the investigator conducting or
supervising the clinical testing determines in
writing that there exists a life-threatening
situation involving the human subject of such
testing which necessitates the use of such in
vitro clinical test and it is not feasible to
obtain informed consent from the subject and
there is not sufficient time to obtain such
consent from a representative of such subject.
``(7) Concurred by licensed physician.--The determination
required by paragraph (6)(C)(ii) shall be concurred in writing
by a licensed physician who is not involved in the testing of
the human subject with respect to which such determination is
made unless immediate use of the in vitro clinical test is
required to save the life of the human subject of such testing
and there is not sufficient time to obtain such concurrence.
``(8) Significant risk.--For purposes of this subsection,
the term `significant risk' means, with respect to an in vitro
clinical test, that the use of such in vitro clinical test--
``(A) is of substantial importance in performing an
activity or activities described in section 201(ss)(1)
for, a serious or life-threatening disease or condition
without confirmation of the diagnosis by a medically
established diagnostic product or procedure;
``(B) requires an invasive sampling procedure that
presents a significant risk to the human subject,
provided that routine venipuncture shall not be
considered an invasive sampling procedure; or
``(C) otherwise presents a potential for serious
risk to the health of a human subject.
``(d) Review of Applications.--
``(1) In general.--The Secretary may issue an order
approving an investigation as proposed, approving it with
conditions or modifications, or disapproving it.
``(2) Failure to act.--Unless the Secretary, not later than
30 calendar days after the date of the submission of an
application for an investigational use exemption that meets the
requirements of subsection (c), issues an order under paragraph
(1) and notifies the sponsor submitting the application, the
application shall be treated as approved as of such date
without further action by the Secretary.
``(3) Denial.--The Secretary may deny an investigational
use application submitted under this subsection if the
Secretary determines that the investigation with respect to
which the application is submitted does not conform to the
requirements of subsection (c). A notification of such denial
submitted to the sponsor with respect to such a request shall
contain the order of disapproval and a complete statement of
the reasons for the Secretary's denial of the application.
``(e) Withdrawal of Exemption.--
``(1) In general.--The Secretary may, by administrative
order, withdraw an exemption approved under this section with
respect to an in vitro clinical test, including an exemption
treated as approved based on the Secretary's failure to act
pursuant to subsection (d)(2), if the Secretary determines that
an investigation conducted under such an exemption does not
meet the applicable conditions under subsection (c)(3) for such
exemption.
``(2) Opportunity to be heard.--
``(A) In general.--Subject to subparagraph (B), an
order withdrawing an investigational use exemption
granted under this section may be issued only after the
Secretary provides the sponsor of the in vitro clinical
test with an opportunity for an informal hearing.
``(B) Exception.--An order referred to in
subparagraph (A) with respect to an investigational use
exemption granted under this section may be issued on a
preliminary basis before the provision of an
opportunity for an informal hearing if the Secretary
determines that the continuation of testing under the
exemption will result in an unreasonable risk to the
public health. The Secretary will provide an
opportunity for an informal hearing promptly following
any preliminary action under this subparagraph.
``(f) Changes.--
``(1) In general.--The regulations promulgated under
subsection (b) shall provide, with respect to an in vitro
clinical test for which an exemption under this subsection is
in effect, procedures and conditions under which changes are
allowed without the additional approval of an application for
an exemption or submission of a supplement to such an
application. Such regulations shall provide that such a change
may be made if--
``(A) the sponsor determines, on the basis of
credible information (as defined in regulations) that
the change meets the conditions specified in paragraph
(2); and
``(B) the sponsor submits to the Secretary, not
later than 5 calendar days after making the change, a
notice of the change.
``(2) Conditions.--The conditions specified in this
paragraph are that--
``(A) in the case of developmental changes to an in
vitro clinical test, including manufacturing changes,
the changes--
``(i) do not constitute a significant
change in design or in basic principles of
operation;
``(ii) do not affect the rights, safety, or
welfare of the human subjects involved in the
investigation; and
``(iii) are made in response to information
gathered during the course of an investigation;
and
``(B) in the case of changes to clinical protocols
applicable to the test, the changes do not affect--
``(i) the validity of data or information
resulting from the completion of an approved
clinical protocol, or the relationship of
likely patient risk to benefit relied upon to
approve a product;
``(ii) the scientific soundness of a plan
submitted under subsection (c)(3); or
``(iii) the rights, safety, or welfare of
the human subjects involved in the
investigation.
``(g) Clinical Hold.--
``(1) In general.--At any time, the Secretary may impose a
clinical hold with respect to an investigation of an in vitro
clinical test if the Secretary makes a written determination
described in paragraph (2). The Secretary shall, in imposing
such clinical hold, specify the basis for the clinical hold,
including the specific information available to the Secretary
which served as the basis for such clinical hold, and confirm
such determination in writing. The applicant may immediately
appeal any such determination pursuant to section 587P.
``(2) Determination.--
``(A) In general.--For purposes of paragraph (1), a
determination described in this subparagraph with
respect to a clinical hold is a determination that,
based on credible evidence, the in vitro clinical test
involved represents an unreasonable risk to the safety
of the persons who are the subjects of the clinical
investigation, taking into account the qualifications
of the clinical investigators, information about the in
vitro clinical test, the design of the clinical
investigation, the condition for which the in vitro
clinical test is to be investigated, and the health
status of the subjects involved.
``(B) Removal of clinical hold.--Any written
request to the Secretary from the sponsor of an
investigation that a clinical hold be removed shall
receive a decision, in writing and specifying the
reasons therefor, within 30 days after receipt of such
request. Any such request shall include sufficient
information to support the removal of such clinical
hold.
``SEC. 587T. COMPREHENSIVE TEST INFORMATION SYSTEM.
``(a) Establishment.--Not later than 2 years after the date of
enactment of the VALID Act of 2022, the Secretary shall make available
a comprehensive test information system for in vitro clinical tests
that is designed to--
``(1) provide a transparent interface on the website of the
Food and Drug Administration for stakeholders, to the extent
permitted by applicable law, which may include access to the--
``(A) regulatory pathway designation information
for each in vitro clinical test or tests with the same
indications for use;
``(B) registration and listing information provided
by developers under section 587J, including the use of
a link for labels;
``(C) adverse event reports submitted under section
587M, as appropriate;
``(D) reports of corrections and removals submitted
under section 587N; and
``(E) other information pertaining to an in vitro
clinical test or tests with the same indications for
use, as the Secretary determines appropriate; and
``(2) provide a secure portal for electronic submission,
including applications and other in vitro clinical test
submissions, registration and listing information, and adverse
event reports, which provides protections from unauthorized
disclosure of information, including of--
``(A) trade secret or confidential commercial or
financial information; and
``(B) information that could compromise national
security.
``(b) Submission Function.--The comprehensive test information
system shall serve as the electronic submission service for test
developers submitting information for applications under sections 587B
and 587D.
``SEC. 587U. PREEMPTION.
``(a) In General.--Except as provided in subsection (b), no State,
Tribal, or local government (or political subdivision thereof) may
establish or continue in effect any requirement--
``(1) that is different from, or in addition to, any
requirement applicable to an in vitro clinical test under this
Act; or
``(2) with respect to the analytical validity, clinical
validity, or safety for individuals who come into contact with
such an in vitro clinical test.
``(b) Exceptions.--Subsection (a) shall not be construed to affect
the authority of a State, Tribal, or local government to do any of the
following:
``(1) To license laboratory personnel, health care
practitioners, or health care facilities or to regulate any
aspect of a health care practitioner-patient relationship.
``(2) To enforce laws of general applicability, such as
zoning laws, environmental laws, labor laws, and general
business laws.
``(3) To authorize laboratories to develop and perform an
in vitro clinical test, pursuant to a law enacted by a State
prior to January 1, 2022, as long as such law does not impose
requirements that are different from any requirement applicable
to an in vitro clinical test under this Act. If a State has
enacted such a law, the Secretary shall exempt such test for
laboratories in that State from compliance with this
subchapter.
``(c) Clarification.--Nothing in this section shall be construed
to--
``(1) modify any action for damages or the liability of any
person under the law of any State; or
``(2) shift liability to health care practitioners or other
users.
``SEC. 587V. ADULTERATION.
``An in vitro clinical test shall be deemed to be adulterated:
``(1) If it consists in whole or in part of any filthy,
putrid, or decomposed substance.
``(2) If it has been developed, prepared, packed, or held
under insanitary conditions whereby it may have been
contaminated with filth, or whereby it may have been rendered
injurious to health.
``(3) If its container or package is composed, in whole or
in part, of any poisonous or deleterious substance which may
render the contents injurious to health.
``(4) If it bears or contains, for purposes of coloring
only, a color additive which is unsafe within the meaning of
section 721(a).
``(5) If its analytical or clinical validity, as
applicable, or with respect to a specimen receptacle, its
safety, falls below that which it purports or is represented to
possess.
``(6) If it is required to be, declared to be, purports to
be, or is represented as being, in conformity with any
performance standard established or recognized under section
587R and is not in conformity with such standard.
``(7) If it is required to be in compliance with mitigating
measures established under section 587E and is not in
conformity with such mitigating measures.
``(8) If it fails to have in effect an approved premarket
application under section 587B, unless such in vitro clinical
test is in compliance with the requirements for--
``(A) offering without an approved premarket
application under section 587D(b)(1);
``(B) an exemption from premarket approval under
section 587C or 587G; or
``(C) investigational use pursuant to section 587S.
``(9) If it is not in conformity with any condition
established under section 587B or 587D.
``(10) If it purports to be an in vitro clinical test
subject to an exemption under section 587C and it fails to meet
or maintain any criteria, condition, or requirement of such
exemption.
``(11) If it has been granted an exemption under section
587S for investigational use, and the person granted such
exemption or any investigator who uses such in vitro clinical
test under such exemption fails to comply with a requirement
prescribed by or under such section.
``(12) If it fails to meet the quality requirements
prescribed in or established under section 587K (as
applicable), or the methods used in, or facilities or controls
used for, its development, packaging, storage, or installation
are not in conformity with applicable requirements established
under such section.
``(13) If it has been developed, processed, packaged, or
held in any establishment, factory, or warehouse and the owner,
operator or agent of such establishment, factory, or warehouse
delays, denies, or limits an inspection, or refuses to permit
entry or inspection.
``(14) If it is not in compliance with any restriction
required under section 587O.
``SEC. 587W. MISBRANDING.
``An in vitro clinical test shall be deemed to be misbranded:
``(1) If its labeling is false or misleading in any
particular.
``(2) If in a package form unless it bears a label
containing--
``(A) the name and place of business of the test
developer, packager, or distributor; and
``(B) an accurate statement of the quantity of
contents in terms of weight, measure, or numerical
count with respect to small packages, unless an
exemption is granted by the Secretary by the issuance
of guidance.
``(3) If any word, statement, or other information required
by or under authority of this Act to appear on the label or
labeling, including a test report, is not prominently placed
thereon with such conspicuousness (as compared with other
words, statements, designs, or devices, in the labeling) and in
such terms as to render it likely to be read and understood by
the ordinary individual under customary conditions of purchase
and use.
``(4) Unless its labeling bears adequate directions for use
and such adequate warnings as are necessary for the protection
of users of the in vitro clinical test and recipients of the
results of such in vitro clinical test, including patients,
consumers, donors, and related health care professionals.
Required labeling for in vitro clinical tests intended for use
in health care facilities, blood establishments, or by a health
care professional may be made available solely by electronic
means, provided that the labeling complies with all applicable
requirements of law, and that the test developer, or
distributor affords such users the opportunity to request the
labeling in paper form, and after such request, promptly
provides the requested information without additional cost.
``(5) If there is a reasonable probability that it could
cause serious or adverse health consequences or death,
including through absence, delay, or discontinuation in
diagnosis or treatment, when used in the manner prescribed,
recommended, or suggested in the labeling thereof.
``(6) If it was developed, sterilized, packaged,
repackaged, relabeled, installed, or imported in an
establishment not duly registered under section 587J or it was
not included in a listing under section 587J, in accordance
with timely reporting requirements under this subchapter.
``(7) In the case of any in vitro clinical test subject to
restrictions under section 587O, (1) if its advertising is
false or misleading in any particular, (2) if it is offered for
clinical use, sold, distributed, or used in violation of such
restrictions, or (3) unless the test developer or distributor
includes in all advertisements and other descriptive printed
matter that such person issues or causes to be issued, a brief
statement of the indications for use of the in vitro clinical
test and relevant warnings, precautions, side effects, and
contraindications. This paragraph shall not be applicable to
any printed matter that the Secretary determines to be labeling
as defined in section 201(m).
``(8) If it is subject to a mitigating measure established
under section 587E and does not bear such labeling as may be
prescribed in such mitigating measure.
``(9) If it is subject to a standard established under
section 587R and it does not bear such labeling as may be
prescribed in such standard.
``(10) Unless it bears such labeling as may be required by
or established under an applicable labeling requirement under
this Act.
``(11) If there was a failure to comply with any
requirement prescribed in or under section 587D, 587J, 587K,
587L, 587M, 587N, 587X, 587Y, 587Z, or to provide any report,
material, or other information required with respect to in
vitro clinical tests under this subchapter.
``SEC. 587X. POSTMARKET SURVEILLANCE.
``(a) In General.--
``(1) In general.--In addition to other applicable
requirements under this Act, the Secretary may issue an order
requiring a developer of a high-risk or moderate-risk in vitro
clinical test to conduct postmarket surveillance of such in
vitro clinical test, if the failure of the in vitro clinical
test is reasonably likely to result in serious adverse health
consequences or death from use of such in vitro clinical test.
``(2) Consideration.--In determining whether to require a
developer to conduct postmarket surveillance of an in vitro
clinical test, the Secretary shall take into consideration the
benefits and risks for the patient and the least burdensome
requirements under section 587AA(c).
``(b) Surveillance Approval.--
``(1) In general.--Each developer required to conduct
surveillance of an in vitro clinical test shall submit, within
30 days of receiving an order from the Secretary, a plan for
the required surveillance. The Secretary, within 60 days of the
receipt of such plan, shall determine if the person designated
to conduct the surveillance has the appropriate qualifications
and experience to undertake such surveillance and if the plan
will result in useful data that can reveal unforeseen adverse
events or other information necessary to protect the health of
patients or the public.
``(2) Timeline.--The developer shall commence surveillance
under this section not later than 15 months after the day on
which the Secretary orders such postmarket surveillance, unless
the Secretary determines more time is needed to commence
surveillance.
``(3) Prospective surveillance.--The Secretary may order a
prospective surveillance period of up to 3 years. Any
determination by the Secretary that a longer period is
necessary shall be made by mutual agreement between the
Secretary and the developer or, if no agreement can be reached,
upon the completion of a dispute resolution process pursuant to
section 562.
``SEC. 587Y. ELECTRONIC FORMAT FOR SUBMISSIONS.
``(a) In General.--All submissions to the Food and Drug
Administration with respect to an in vitro clinical test, unless
otherwise agreed to by the Secretary, shall--
``(1) be made electronically; and
``(2) with respect to the information required under
sections 587B and 587D, utilize the system described in section
587T.
``(b) Electronic Format.--Beginning on such date as the Secretary
specifies in final guidance issued under subsection (c), submissions
for in vitro clinical tests, including recommendations submitted by
accredited and recognized persons under section 587Q, and any appeals
of action taken by the Secretary with respect to such submissions,
shall be submitted in such electronic format as specified by the
Secretary in such guidance.
``(c) Guidance.--The Secretary shall issue guidance implementing
this section. Such guidance may--
``(1) provide standards for the electronic submission
required under subsection (a) or the submission in electronic
format required under subsection (b);
``(2) set forth criteria for waivers of, or exemptions
from, the requirements of subsection (a) or (b); and
``(3) provide any other information for the efficient
implementation and enforcement of this section.
``SEC. 587Z. POSTMARKET REMEDIES.
``(a) Safety Notice.--
``(1) In general.--If the Secretary determines that an in
vitro clinical test presents an unreasonable risk of
substantial harm to the public health, and notification under
this subsection is necessary to eliminate the unreasonable risk
of such harm and no more practicable means is available under
the provisions of this Act (other than this section) to
eliminate the risk, the Secretary may issue such order as may
be necessary to ensure that adequate safety notice is provided
in an appropriate form, by the persons and means best suited
under the circumstances, to all health care professionals who
prescribe, order, or use the in vitro clinical test and to any
other person (including developers, importers, distributors,
retailers, and users) who should properly receive such notice.
``(2) Notice to individuals.--An order under this
subsection shall require that the individuals subject to the
risk with respect to which the order is to be issued be
included in the persons to be notified of the risk unless the
Secretary determines that notice to such individuals would
present a greater danger to the health of such individuals than
no such notice. If the Secretary makes such a determination
with respect to such individuals, the order shall require the
health care professionals who prescribed, ordered, or used the
in vitro clinical test provide notification to the individuals
for whom the health professionals prescribed, ordered, or used
such test, of the risk presented by such in vitro clinical test
and of any action which may be taken by or on behalf of such
individuals to eliminate or reduce such risk. Before issuing an
order under this subsection, the Secretary shall consult with
the persons required to give notice under the order.
``(b) Repair, Replacement, or Refund.--
``(1) Determination after an informal hearing.--
``(A) In general.--If, after affording opportunity
for an informal hearing, the Secretary determines
that--
``(i) an in vitro clinical test presents an
unreasonable risk of substantial harm to the
public health;
``(ii) there are reasonable grounds to
believe that the in vitro clinical test was not
properly developed or manufactured considering
the state of the art as it existed at the time
of its development;
``(iii) there are reasonable grounds to
believe that the unreasonable risk was not
caused by failure of a person other than a
developer, importer, distributor, or retailer
of the in vitro clinical test to exercise due
care in the installation, maintenance, repair,
or use of the in vitro clinical test; and
``(iv) the notice authorized by subsection
(a) would not by itself be sufficient to
eliminate the unreasonable risk and action
described in paragraph (2) of this subsection
is necessary to eliminate such risk,
the Secretary may order the developer, importer, or any
distributor of such in vitro clinical test, or any
combination of such persons, to submit to him within a
reasonable time a plan for taking one or more of the
actions described in paragraph (2). An order issued
under the preceding sentence which is directed to more
than one person shall specify which person may decide
which action shall be taken under such plan and the
person specified shall be the person who the Secretary
determines bears the principal, ultimate financial
responsibility for action taken under the plan unless
the Secretary cannot determine who bears such
responsibility or the Secretary determines that the
protection of the public health requires that such
decision be made by a person (including a health
professional or user of the in vitro clinical test)
other than the person the Secretary determines bears
such responsibility.
``(B) Secretary approval of plan.--The Secretary
shall approve a plan submitted pursuant to an order
issued under subparagraph (A) unless the Secretary
determines (after affording opportunity for an informal
hearing) that the action or actions to be taken under
the plan or the manner in which such action or actions
are to be taken under the plan will not assure that the
unreasonable risk with respect to which such order was
issued will be eliminated. If the Secretary disapproves
a plan, the Secretary shall order a revised plan to be
submitted within a reasonable time. If the Secretary
determines (after affording opportunity for an informal
hearing) that the revised plan is unsatisfactory or if
no revised plan or no initial plan has been submitted
to the Secretary within the prescribed time, the
Secretary shall--
``(i) prescribe a plan to be carried out by
the person or persons to whom the order issued
under subparagraph (A) was directed; or
``(ii) after affording an opportunity for
an informal hearing, by order prescribe a plan
to be carried out by a person who is a
developer, importer, distributor, or retailer
of the in vitro clinical test with respect to
which the order was issued but to whom the
order under subparagraph (A) was not directed.
``(2) Actions on a plan.--The actions that may be taken
under a plan submitted under an order issued under paragraph
(1)(A) are as follows:
``(A) To repair the in vitro clinical test so that
it does not present the unreasonable risk of
substantial harm with respect to which the order under
paragraph (1)(A) was issued.
``(B) To replace the in vitro clinical test with a
like or equivalent test which is in conformity with all
applicable requirements of this Act.
``(C) To refund the purchase price of the in vitro
clinical test (less a reasonable allowance for use if
such in vitro clinical test has been in the possession
of the user for one year or more at the time of notice
ordered under subsection (a), or at the time the user
receives actual notice of the unreasonable risk with
respect to which the order was issued under paragraph
(1)(A), whichever occurs first).
``(3) No charge.--No charge shall be made to any person
(other than a developer, importer, distributor, or retailer)
for using a remedy described in paragraph (2) and provided
under an order issued under paragraph (1), and the person
subject to the order shall reimburse each person (other than a
developer, manufacturer, importer, distributor, or retailer)
who is entitled to such a remedy for any reasonable and
foreseeable expenses actually incurred by such person in using
such remedy.
``(c) Reimbursement.--An order issued under subsection (b)(1)(A)
with respect to an in vitro clinical test may require any person who is
a developer, importer, distributor, or retailer of the in vitro
clinical test to reimburse any other person who is a developer,
importer, distributor, or retailer of such in vitro clinical test for
such other person's expenses actually incurred in connection with
carrying out the order if the Secretary determines such reimbursement
is required for the protection of the public health. Any such
requirement shall not affect any rights or obligations under any
contract to which the person receiving reimbursement or the person
making such reimbursement is a party.
``(d) Recall Authority.--
``(1) In general.--If the Secretary finds that there is a
reasonable probability that an in vitro clinical test approved
under section 587B or offered under a technology certification
order under section 587D would cause serious, adverse health
consequences or death, including by the absence, significant
delay, or discontinuation of appropriate medical treatment, the
Secretary shall issue an order requiring the appropriate person
(including the developers, importers, distributors, or
retailers of the in vitro clinical test)--
``(A) to immediately cease distribution of such in
vitro clinical test; and
``(B) to immediately notify health professionals
and applicable in vitro clinical test user facilities
of the order and to instruct such professionals and
facilities to cease use of such in vitro clinical test.
``(2) Informal hearing.--The order issued under paragraph
(1)(A), shall provide the person subject to the order with an
opportunity for an informal hearing, to be held not later than
10 calendar days after the date of the issuance of the order,
on the actions required by the order and on whether the order
should be amended to require a recall of such in vitro clinical
test. If, after providing an opportunity for such a hearing,
the Secretary determines that inadequate grounds exist to
support the actions required by the order, the Secretary shall
vacate the order.
``(3) Amended order.--
``(A) In general.--If, after providing an
opportunity for an informal hearing under paragraph
(2), the Secretary determines that the order should be
amended to include a recall of the in vitro clinical
test with respect to which the order was issued, the
Secretary shall, except as provided in subparagraph
(B), amend the order to require a recall. The Secretary
shall specify a timetable in which the recall will
occur and shall require periodic reports describing the
progress of the recall.
``(B) Requirements.--An amended order under
subparagraph (A)--
``(i) shall not include recall of the in
vitro clinical test from individuals;
``(ii) shall not include recall of an in
vitro clinical test from test user facilities
if the Secretary determines that the risk of
recalling such in vitro clinical test from the
facilities presents a greater health risk than
the health risk of not recalling the in vitro
clinical test from use; and
``(iii) shall provide for notice to
individuals subject to the risks associated
with the use of such in vitro clinical test. In
providing the notice required by this clause,
the Secretary may use the assistance of health
professionals who prescribed, ordered, or used
such an in vitro clinical test for individuals.
``(4) Clarification.--The remedy provided by this
subsection shall be in addition to remedies provided by
subsections (a), (b), and (c).
``SEC. 587AA. APPLICABILITY.
``(a) In General.--An in vitro clinical test shall be subject to
the requirements of this subchapter, except as otherwise provided in
this subchapter. Laboratory operations shall not be subject to the
requirements of this subchapter.
``(b) Interstate Commerce.--Any in vitro clinical test that is
offered, including by making available for clinical use in the United
States is deemed to be an act that constitutes introduction into
interstate commerce for purposes of enforcing the requirements of this
Act.
``(c) Least Burdensome Requirements.--
``(1) In general.--In carrying out this subchapter, the
Secretary shall consider the least burdensome means necessary
to meet the applicable standard, and other regulatory
requirements, as determined by the Secretary.
``(2) Necessary defined.--For purposes of paragraph (1),
the term `necessary' means the minimum required information
that would support a determination by the Secretary that the
application meet the applicable standard or regulatory
requirement, as determined by the Secretary.
``(d) Service of Orders.--Orders of the Secretary under this
section with respect to applications under subsection (a) or (b) of
section 587B or supplements under subsection (f) of such section shall
be served--
``(1) in person by any officer or employee of the
Department of Health and Human Services designated by the
Secretary; or
``(2) by mailing the order by registered mail or certified
mail or electronic equivalent addressed to the applicant at the
last known address in the records of the Secretary.
``(e) Laboratories and Blood and Tissue Establishments.--
``(1) Relation to laboratory certification pursuant to
section 353 of the public health service act.--Nothing in this
subchapter shall be construed to modify the authority of the
Secretary with respect to laboratories or clinical laboratories
under section 353 of the Public Health Service Act.
``(2) Avoiding duplication.--In implementing this
subchapter, the Secretary shall avoid issuing or enforcing
regulations or guidance that are duplicative of regulations or
guidance under section 353 of the Public Health Service Act.
``(3) Blood and tissue.--Nothing in this subchapter shall
be construed to modify the authority of the Secretary with
respect to laboratories, establishments, or other facilities to
the extent they are engaged in the propagation, manufacture, or
preparation, including filling, labeling, packaging, and
storage, of blood, blood components, human cells, tissues, or
tissue products pursuant to any requirements under this Act or
section 351 or 361 of the Public Health Service Act.
``(f) Not Combination Product.--A product constituted of a device
and an in vitro clinical test is not a combination product and shall be
regulated as a device.
``(g) Practice of Medicine.--Nothing in this subchapter shall be
construed to limit or interfere with the authority of a health care
practitioner to prescribe or administer any lawfully offered in vitro
clinical test for any condition or disease within a legitimate health
care practitioner-patient relationship pursuant to applicable Federal
or State law.
``(h) Sale, Distribution, Labeling.--Nothing in this section shall
be construed to limit the authority of the Secretary to establish or
enforce restrictions on the sale, distribution, or labeling of an in
vitro clinical test under this Act.
``(i) Promotion of Unapproved Uses.--Nothing in this section shall
be construed to alter any prohibition on the promotion of unapproved
uses of legally marketed in vitro clinical tests.
``SEC. 587BB. JUDICIAL REVIEW.
``(a) In General.--Not later than 30 days after an order issued
pursuant to sections 587B or 587D, any person adversely affected by
such order may file a petition with the United States Court of Appeals
for the District of Columbia or for the circuit wherein such person
resides or has a principal place of business for judicial review of
such order, in accordance with the procedure set forth in section
517(a).
``(b) Application of Provisions.--Subsections (a) through (e) of
section 517 shall apply with respect to a petition under subsection (a)
of this section in the same manner such subsections apply to a petition
under section 517. Subsection (f) of section 517 shall apply to an
order issued under section 587B or 587D.''.
SEC. 824. ENFORCEMENT AND OTHER PROVISIONS.
(a) Prohibited Acts.--Section 301 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 331), as amended by section 811, is further
amended--
(1) in paragraphs (a), (b), (c), (g), (h), (k), (q), (r),
and (y), by inserting ``in vitro clinical test,'' after
``device,'' each place it appears;
(2) in paragraph (g), by inserting after ``misbranded'',
``, and the development within any Territory of any in vitro
clinical test that is adulterated or misbranded'';
(3) in paragraph (y), by inserting ``or 587Q'' after
``section 523'' each place it appears;
(4) in paragraph (ff), by striking ``or device'' and
inserting ``, device, or in vitro clinical test''; and
(5) by adding at the end, the following:
``(kkk)(1) Forging, counterfeiting, simulating, or falsely
representing, or without proper authority using any mark, stamp, tag,
label, or other identification upon any in vitro clinical test or
container, packaging, or labeling thereof so as to render such in vitro
clinical test a counterfeit in vitro clinical test.
``(2) Making, selling, disposing of, or keeping in possession,
control, or custody, or concealing any punch, die, plate, stone, or
other thing designed to print, imprint, or reproduce the trademark,
trade name, or other identifying mark or imprint of another or any
likeness of any of the foregoing upon any in vitro clinical test or
container, packaging, or labeling thereof so as to render such in vitro
clinical test a counterfeit in vitro clinical test.
``(3) The doing of any act which causes an in vitro clinical test
to be a counterfeit in vitro clinical test, or the sale or dispensing,
or the holding for sale or dispensing, of a counterfeit in vitro
clinical test.
``(lll)(1) The introduction or delivery for introduction into
interstate commerce of an in vitro clinical test in violation of
section 587A(a).
``(2) The making of a false, fraudulent, or deceptive statement
about an in vitro clinical test that is exempt from premarket review
under section 587C.
``(3) The failure to maintain complete and accurate documentation
for an exemption as required under section 587C or the failure to
provide labeling required under section 587L.
``(4) With respect to an in vitro clinical test, the submission of
any report or listing under this Act that is false or misleading in any
material respect.
``(5) The failure to comply with a condition of approval, or
restriction required under an approved application under section 587B;
the failure to perform a risk analysis required by section 587B; the
failure to submit an annual update required under section
587J(c)(2)(B); or the failure to complete postmarket surveillance as
required under section 587X.
``(6) The failure to comply with applicable requirements to submit
an application or report under section 587D(e).
``(7) The failure to comply with applicable mitigating measures
established under section 587E or to submit, maintain, or make
available the documentation required under section 587E(b); or the
failure to comply with applicable performance standards established
under section 587R.
``(8) The failure to register in accordance with section 587J, the
failure to provide information required under section 587J(b), or the
failure to maintain or submit information required under section
587J(c).
``(9) The failure to comply with requirements under section 587M or
587N, the failure to comply with a restriction required under section
587O, or the failure to comply with labeling and advertising
requirements under section 587O(b).
``(10) The failure to comply with the requirements of section 587Q.
``(11) The failure to comply with any requirement of section 587S;
the failure to furnish any notification, information, material, or
report required under section 587S; or the failure to comply with an
order issued under section 587S.
``(12) The failure to furnish information requested by the
Secretary under 587G(d)(2).''.
(b) Penalties.--Section 303 of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 333) is amended--
(1) in subsection (b)(8), by inserting ``or counterfeit in
vitro clinical test'' after ``counterfeit drug'';
(2) in subsection (c)--
(A) by striking ``; or (5)'' and inserting ``;
(5)''; and
(B) by inserting before the period at the end the
following: ``; or (6) for having violated section
301(kkk)(2) if such person acted in good faith and had
no reason to believe that use of the punch, die, plate,
stone, or other thing involved would result in an in
vitro clinical test being a counterfeit in vitro
clinical test, or for having violated section
301(kkk)(3) if the person doing the act or causing it
to be done acted in good faith and had no reason to
believe that the in vitro clinical test was a
counterfeit in vitro clinical test''; and
(3) in subsection (f)(1)--
(A) in subparagraph (A)--
(i) by inserting ``or in vitro clinical
tests'' after ``which relates to devices'';
(ii) by inserting ``or section 587Q(a)(1)''
after ``section 704(g)''; and
(iii) by inserting ``or in vitro clinical
tests, as applicable'' before the period at the
end of the second sentence; and
(B) in subparagraph (B)(i), by striking ``or
520(f)'' and inserting ``, 520(f), 587K, or 587M,''.
(c) Seizure.--Section 304 of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 334) is amended--
(1) in subsection (a)(2)--
(A) by striking ``, and (E)'' and inserting ``,
(E)''; and
(B) by inserting before the period at the end the
following: ``, and (F) Any in vitro clinical test that
is a counterfeit in vitro clinical test, (G) Any
container, packaging, or labeling of a counterfeit in
vitro clinical test, and (H) Any punch, die, plate,
stone, labeling, container, or other thing used or
designed for use in making a counterfeit in vitro
clinical test'';
(2) in subsection (d)(1), by inserting ``in vitro clinical
test,'' after ``device,''; and
(3) in subsection (g)--
(A) in paragraph (1), by inserting ``, in vitro
clinical test,'' after ``device'' each place it
appears; and
(B) in paragraph (2)--
(i) in subparagraph (A), by inserting ``,
in vitro clinical test,'' after ``device''; and
(ii) in subparagraph (B), by inserting ``or
in vitro clinical test'' after ``device'' each
place it appears.
(d) Debarment, Temporary Denial of Approval, and Suspension.--
Section 306 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
335a) is amended by adding at the end the following:
``(n) In Vitro Clinical Tests; Mandatory Debarment Regarding Third-
Party Inspections and Reviews.--
``(1) In general.--If the Secretary finds that a person has
been convicted of a felony for a violation of section 301(gg)
or 301(kkk)(1), the Secretary shall debar such person from
being accredited under section 587Q and from carrying out
activities under an agreement described in section 803(b).
``(2) Debarment period.--The Secretary shall debar a person
under paragraph (1) for the following periods:
``(A) The period of debarment of a person (other
than an individual) shall not be less than 1 year or
more than 10 years, but if an act leading to a
subsequent debarment under such paragraph occurs within
10 years after such person has been debarred under such
paragraph, the period of debarment shall be permanent.
``(B) The debarment of an individual shall be
permanent.
``(3) Termination of debarment; judicial review; other
matters.--Subsections (c)(3), (d), (e), (i), (j), and (l)(1)
apply with respect to a person (other than an individual) or an
individual who is debarred under paragraph (1) to the same
extent and in the same manner as such subsections apply with
respect to a person who is debarred under subsection (a)(1), or
an individual who is debarred under subsection (a)(2),
respectively.''.
(e) Expanded Access to Unapproved Therapies and Diagnostics.--
Section 561 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
360bbb) is amended--
(1) in subsections (a) through (d)--
(A) by striking ``or investigational devices'' each
place it appears and inserting ``, investigational
devices, or investigational in vitro clinical tests'';
and
(B) by striking ``or investigational device'' each
place it appears (other than the second such place in
paragraph (3)(A)) of subsection (c)) and inserting ``,
investigational device, or investigational in vitro
clinical test'';
(2) in subsection (b)(4) by striking ``or 520(g)'' each
place it appears and inserting ``, 520(g), or 587S'';
(3) in subsection (c)--
(A) by amending the subsection heading to read:
``Treatment Investigational New Drug Applications,
Treatment Investigational Device Exemptions, and
Treatment Investigational in Vitro Clinical Test
Exemptions.'';
(B) in paragraph (3)(A), by striking ``or
investigational device exemption in effect under
section 520(g)'' and inserting ``, investigational
device exemption in effect under section 520(g), or
investigational in vitro clinical test exemption under
section 587S'';
(C) by striking ``or treatment investigational
device exemption'' each place it appears and inserting
``, treatment investigational device exemption, or
treatment investigational in vitro clinical test
exemption'';
(D) in paragraph (5), by striking ``or 520(g)'' and
inserting ``, 520(g), or 587S''; and
(E) in the matter following paragraph (7) by
striking ``or 520(g)'' each place it appears and
inserting ``, 520(g), or 587S''; and
(4) by amending subsection (e) to read as follows:
``(e) Definitions.--In this section, the terms `investigational
drug', `investigational device', `investigational in vitro clinical
test', `treatment investigational new drug application', `treatment
investigational device exemption', and `treatment investigational in
vitro clinical test exemption' shall have the meanings given the terms
in regulations prescribed by the Secretary.''.
(f) Optimizing Global Clinical Trials.--Section 569A(b) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-8a(b)) is
amended--
(1) by striking ``subsection'' each place it appears and
inserting ``paragraph''; and
(2) by inserting ``an in vitro clinical test, as defined in
paragraph (ss) of such section,'' before ``or a biological
product''.
(g) Patient Participation in Medical Product Discussion.--The
heading of subsection (a) of section 569C of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 360bbb-8c) is amended by striking ``Drugs
and Devices'' and inserting ``Drugs, Devices, and in Vitro Clinical
Tests''.
(h) Regulations and Hearings.--Clause (ii) of section 701(h)(1)(C)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 371(h)(1)(C)) is
amended--
(1) by inserting ``and in vitro clinical tests'' after
``devices''; and
(2) by moving the margin of such clause 2 ems to the left.
(i) Records.--Section 703 of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 373) is amended--
(1) by inserting ``in vitro clinical tests,'' after
``devices,'' each place such term appears; and
(2) by inserting ``in vitro clinical test,'' after
``device,'' each place such term appears.
(j) Factory Inspection.--Section 704 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 374) (other than subsection (g)) is amended--
(1) by striking ``drugs or devices'' each place it appears
and inserting ``drugs, devices, or in vitro clinical tests'';
(2) in subsection (a)(1), in the fourth sentence, by
striking ``or chapter IX'' and inserting ``section 587S,
section 587M, section 587N, or chapter IX'';
(3) after making the amendments in paragraphs (1) and (2),
by inserting ``in vitro clinical tests,'' after ``devices,''
each place it appears;
(4) in subsection (a)(2)(B)--
(A) by inserting ``or in vitro clinical tests''
after ``prescribe or use devices''; and
(B) by inserting ``or in vitro clinical tests''
after ``process devices'';
(5) by inserting ``in vitro clinical test,'' after
``device,'' each place it appears;
(6) in subsection (e), by inserting ``, or section 587M,
587N, or 587S,'' after ``section 519 or 520(g)'';
(7) in subsection (f)(3)--
(A) in subparagraph (A), by striking ``or'' at the
end;
(B) in subparagraph (B), by striking the period at
the end and inserting ``; or''; and
(C) after subparagraph (B), by inserting the
following:
``(C) is accredited under section 587Q.''; and
(8) by adding at the end the following:
``(i) For purposes of this section, the term `establishment'
includes a laboratory performing an in vitro clinical test.''.
(k) Publicity.--Section 705(b) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 375(b)) is amended by inserting ``in vitro
clinical tests,'' after ``devices,''.
(l) Presumption.--Section 709 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379a) is amended by inserting ``in vitro
clinical test,'' after ``device,''.
(m) Listing and Certification of Color Additives for Foods, Drugs,
and Cosmetics.--Section 721(a) of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 379e(a)) is amended--
(1) in the matter preceding paragraph (1), by inserting
``or in vitro clinical tests'' after ``or devices''; and
(2) in the flush text following paragraph (2)--
(A) by inserting ``or an in vitro clinical test''
after ``a device''; and
(B) by inserting ``or in vitro clinical tests''
after ``devices''.
(n) Imports and Exports.--Section 801 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 381) is amended--
(1) in subsection (a)--
(A) by inserting ``in vitro clinical tests,'' after
``devices,'' each place it appears; and
(B) by inserting ``in the case of an in vitro
clinical test, the test does not conform to the
applicable requirements of section 587K, or'' after
``requirements of section 520(f), or'';
(2) in subsection (d)(3)--
(A) in subparagraph (A)--
(i) in the matter preceding clause (i), by
inserting ``and no component of an in vitro
clinical test or other article of in vitro
clinical test that requires further
processing,'' after ``health-related
purposes'';
(ii) in clause (i), by striking ``drug or
device'' and inserting ``drug, device, or in
vitro clinical test''; and
(iii) in clause (i)(I), by inserting ``in
vitro clinical test,'' after ``device,''; and
(B) in subparagraph (B), by inserting ``in vitro
clinical test,'' after ``device,'';
(3) in subsection (e)(1), by inserting ``in vitro clinical
test,'' after ``device,''; and
(4) in subsection (o)--
(A) by inserting ``or in vitro clinical test''
after ``device''; and
(B) by inserting ``, or under section 587J of each
foreign establishment,'' after ``section 510(i) of each
establishment''.
(o) Office of International Relations.--Section 803 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 383) is amended--
(1) in subsection (b)--
(A) in the matter preceding paragraph (1), by
inserting ``and in vitro clinical tests'' after
``devices''; and
(B) in paragraph (1), by striking ``, and'' and
inserting ``and quality requirements established under
section 587K; and''; and
(2) in subsection (c)--
(A) in paragraph (2), by inserting ``in vitro
clinical tests,'' after ``devices,''; and
(B) in paragraph (4), by inserting ``or in vitro
clinical tests'' after ``devices''.
(p) Recognition of Foreign Government Inspections.--Section
809(a)(1) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
384e(a)(1)) is amended by inserting ``, or of foreign establishments
registered under section 587J'' after ``510(h)''.
(q) Food and Drug Administration.--Section 1003(b)(2) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 393(b)(2)) is amended--
(1) in subparagraph (D), by striking ``and'' at the end;
(2) in subparagraph (E), by striking the semicolon at the
end and inserting ``; and''; and
(3) by adding at the end the following:
``(F) in vitro clinical tests are analytically and
clinically valid;''.
(r) Office of Women's Health.--Section 1011(b) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 399b(b)) is amended--
(1) in paragraph (1), by inserting ``in vitro clinical
tests,'' after ``devices,''; and
(2) in paragraph (4), by striking ``and device
manufacturers'' and inserting ``device manufacturers, and in
vitro clinical test developers''.
(s) Countermeasure Provisions of the Public Health Service Act.--
Title III of the Public Health Service Act is amended--
(1) in section 319F-1(a)(2)(A) (42 U.S.C. 247d-
6a(a)(2)(A))--
(A) in the matter preceding clause (i)--
(i) by striking ``or device'' and inserting
``device''; and
(ii) by inserting ``or an in vitro clinical
tests (as that term is defined in section
201(ss) of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 321(ss))),'' after ``Act (21
U.S.C. 321(h))),''; and
(B) in each of clauses (ii) and (iii), by striking
``or device'' and inserting ``device, or in vitro
clinical test'';
(2) in section 319F-2(c)(1)(B) (42 U.S.C. 247d-
6b(c)(1)(B))--
(A) by striking ``or device'' and inserting
``device''; and
(B) by inserting ``, or an in vitro clinical test
(as that term is defined in section 201(ss) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C.
321(ss)))'' after ``Act (21 U.S.C. 321(h))),''; and
(3) in section 319F-3(i)(7) (42 U.S.C. 247d-6d(i)(7))--
(A) in the matter preceding subparagraph (A)--
(i) by striking ``or device'' and inserting
``device''; and
(ii) by inserting ``or an in vitro clinical
tests (as that term is defined in section
201(ss) of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 321(ss))),'' after ``Act (21
U.S.C. 321(h))'';
(B) in subparagraph (A)--
(i) by moving the margin of clause (iii) 2
ems to the left; and
(ii) in clause (iii), by striking ``or
device'' and inserting ``device, or in vitro
clinical test''; and
(C) in subparagraph (B)--
(i) in clause (i), by inserting ``or
offered under a technology certification
order'' after ``approved or cleared''; and
(ii) in clause (ii), by striking ``or
520(g)'' and inserting ``, 520(g), or 587S''.
SEC. 825. TRANSITION.
(a) Implementation.--
(1) Effective date.--
(A) In general.--Except as otherwise provided in
this section, the amendments made by this Act shall
take effect on October 1, 2027 (in this section and in
subchapter J of chapter V of the Federal Food, Drug,
and Cosmetic Act, as added by this Act, referred to in
this section as the ``effective date of this Act'').
(B) Exceptions.--
(i) In general.--The Secretary of Health
and Human Services (in this section referred to
as the ``Secretary'') may take the actions
described in paragraph (2), and may expend such
funds as the Secretary determines necessary to
ensure an orderly transition, including prior
to the effect date of this Act.
(ii) Implementation of certain
provisions.--The Secretary may implement
sections 587J and 587U of the Federal Food,
Drug, and Cosmetic Act (as added by section
823) beginning on October 1, 2024, and such
sections may take effect not earlier than
October 1, 2027, to the extent and for the
purposes indicated in such sections. In the
case of a developer who, between October 1,
2024, and the effective date of this Act,
registers under such section 587J with respect
to an article that is an in vitro clinical
test, such developer shall not be required to
register with respect to such article under
section 510 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360).
(2) Actions.--The Secretary--
(A) shall--
(i) within 1 year of the date of enactment
of this Act, hold the public meetings described
in section 587D(i) of the Federal Food, Drug,
and Cosmetic Act (as added by section 823);
(ii) within 3 years of the date of
enactment of this Act, promulgate final
regulations required under the amendments made
by this Act; and
(iii) within 30 months of the date of
enactment of this Act, issue final guidance on
applicability requirements under amendments
made by this Act; and
(B) may take additional actions after the date of
enactment that the Secretary determines necessary to
ensure an orderly transition, including--
(i) establishment of mitigating measures
for an in vitro clinical test or category of in
vitro clinical tests, which may not take effect
until after the effective date described in
paragraph (1)(A); and
(ii) establishment of the comprehensive
test information system under section 587T of
the Federal Food, Drug, and Cosmetic Act, as
added by section 823.
(3) Applicability of guidance and regulations.--
Notwithstanding the date on which guidance or regulations are
issued under paragraph (2) and section 587K of the Federal
Food, Drug, and Cosmetic Act, as added by section 823, no
guidance or regulations issued pursuant to the amendments made
by this Act shall be implemented or take effect until the
effective date of this Act, except as otherwise specified in
this Act (including the amendments made by this Act).
(b) Application of Authorities to in Vitro Clinical Tests Under
Review on the Effective Date of This Act.--For any in vitro clinical
test for which a submission for approval under section 515 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360e), clearance under
section 510(k) of such Act (21 U.S.C. 360(k)), authorization under
section 513(f)(2) of such Act (21 U.S.C. 360c(f)(2)), or licensure
under section 351 of the Public Health Service Act (42 U.S.C. 262) is
pending on the effective date of this Act, including transitional in
vitro clinical tests as described in subsection (c), the Secretary may
review and take action on such submission after the effective date of
this Act according to the statutory provision under which such
submission was submitted.
(c) Application of Authorities to Transitional In Vitro Clinical
Tests.--
(1) Definition.--For purposes of this section, the term
``transitional in vitro clinical test'' means an in vitro
clinical test that--
(A) is first offered for clinical use during the
period beginning on the date of enactment of this Act
and ending on the effective date of this Act;
(B) is developed by a clinical laboratory certified
by the Secretary under section 353 of the Public Health
Service Act (42 U.S.C. 263a) that meets the
requirements for performing high-complexity testing and
performed--
(i) in the same clinical laboratory in
which the test was developed and for which a
certification is still in effect under such
section 353 that meets the requirements to
perform tests of high complexity;
(ii) by another laboratory for which a
certificate is in effect under such section 353
that meets the requirements to perform tests of
high complexity, is within the same corporate
organization, and has common ownership by the
same parent corporation as the laboratory in
which the test was developed; or
(iii) in the case of a test that was
developed by the Centers for Disease Control
and Prevention or another laboratory in a
public health laboratory network coordinated or
managed by the Centers for Disease Control and
Prevention, by a clinical laboratory for which
a certificate is in effect under such section
353 that meets the requirements to perform
tests of high complexity, and that is within a
public health laboratory network coordinated or
managed by the Centers for Disease Control and
Prevention; and
(C) when first offered, is not approved under
section 515 of the Federal Food, Drug, and Cosmetic
Act, cleared under section 510(k) of such Act,
authorized under section 513(f)(2) of such Act, subject
to a humanitarian device exemption under section 520(m)
of such Act (21 U.S.C. 360j(m)), subject to an
exemption for investigation use under section 520(g) of
such Act (21 U.S.C. 360j(g)), authorized under section
564 of such Act (21 U.S.C. 360bbb-3), or licensed under
section 351 of the Public Health Service Act (42 U.S.C.
262).
(2) Premarket review or technology certification.--A
transitional in vitro clinical test that is the subject of an
application for premarket review under section 587B of the
Federal Food, Drug, and Cosmetic Act or technology
certification application under section 587D of such Act, as
added by this Act, may continue to be offered, sold, or
distributed without marketing authorization until completion of
the Secretary's review of the premarket application or
technology certification application, if such application is
submitted no later than 90 days after the effective date of
this Act.
(3) Tests approved by new york state.--Notwithstanding
paragraph (2), a transitional in vitro clinical test that has
been approved by the New York State Department of Health may
continue to be offered, sold, or distributed after the
effective date if--
(A) starting on the effective date of this Act, the
in vitro clinical test complies with the requirements
of subchapter J of the Federal Food, Drug, and Cosmetic
Act, as added by this Act, except for section 587B of
the Federal Food, Drug, and Cosmetic Act, as added by
section 823, and design control provisions of section
587K of such Act;
(B) each test report template for the test bears a
statement of adequate prominence that reads as follows:
``This in vitro clinical test was developed and first
introduced prior to the effective date of the VALID Act
of 2022. This test was approved by the New York State
Department of Health, but the test has not been
reviewed by the Food and Drug Administration.'';
(C) a premarket application under section 587B of
the Federal Food, Drug, and Cosmetic Act, as added by
section 823, or technology certification application
under section 587D of such Act, as added by section
823, is submitted no later than--
(i) 5 years after the effective date of
this Act, if the in vitro clinical test is
approved by the New York State Department of
Health as a genetic testing molecular test, a
microbiology molecular test, an oncology
molecular test, or any other type of molecular
test; or
(ii) 2 years after the effective date of
this Act, if the in vitro clinical test is
approved by the New York State Department of
Health as a type of test not described in
clause (i); and
(D) a test in compliance with this paragraph may
continue to be offered, sold, or distributed until the
completion of the Secretary's review of the premarket
application or technology certification application
described in subparagraph (C).
(d) Conversion.--
(1) Deemed premarket approval.--Beginning on the effective
date of this Act--
(A) any in vitro clinical test with a premarket
approval under section 515 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 360e) or a licensure under
section 351 of the Public Health Service Act (42 U.S.C.
262) is deemed to be approved pursuant to an
application under section 587B(a) of the Federal Food,
Drug, and Cosmetic Act, as added by this Act; and
(B) any in vitro clinical test (as so defined) that
was cleared under section 510(k) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 360(k)) or authorized
under section 513(f)(2) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360c(f)(2)) is deemed to be
approved pursuant to an application under section
587B(b) of the Federal Food, Drug, and Cosmetic Act, as
added by this Act.
(2) Deemed investigational use exemption.--Any in vitro
clinical test that has an investigational device exemption in
effect under section 520(g) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360j(g)) is deemed to have an
investigational use exemption in effect under section 587S of
such Act, as added by this Act, beginning on the effective date
of this Act.
(3) Deemed humanitarian device exemption.--Any in vitro
clinical test that has an approved humanitarian device
exemption under section 520(m) of such Act is deemed to have a
humanitarian test exemption under section 587A(g) of such Act,
as added by this Act, beginning on the effective date of this
Act.
(4) Deemed designated breakthrough.--Any in vitro clinical
test that has received a breakthrough device designation under
section 515B(e)(1)(D) of such Act (21 U.S.C. 360e-3(e)(1)(D))
is deemed to have a breakthrough in vitro clinical test
designation under section 587C of such Act, as added by this
Act, beginning on the effective date of this Act.
(5) Deemed request for informal feedback.--With regard to
any in vitro clinical test that is the subject of a pre-
submission request described in the guidance, ``Requests for
Feedback and Meetings for Medical Device Submissions: The Q-
Submission Program'', issued by the Food and Drug
Administration on January 6, 2021, such request is deemed to
constitute a request for informal feedback under section 587F
of the Federal Food, Drug, and Cosmetic Act, as added by
section 823, beginning on the effective date of this Act.
(e) Previously Classified Devices.--Notwithstanding section 587 of
the Federal Food, Drug, and Cosmetic Act, as added by section 823, for
purposes of subchapter J of chapter V of such Act, as added by section
823, the following apply:
(1) In the case of an in vitro clinical test type that has
been classified by the Secretary as a class I device pursuant
to section 513 of such Act (21 U.S.C. 360c), such in vitro
clinical test shall be low-risk, unless the in vitro clinical
test is a test described in section 510(l) of such Act or the
test is redesignated by the Secretary pursuant to section 587F
of such Act.
(2) In the case of an in vitro clinical test type that has
been classified by the Secretary as a class II device pursuant
to section 513 of such Act (21 U.S.C. 360c), such in vitro
clinical test shall be moderate-risk, unless inaccurate results
from the test would be immediately life threatening or the test
is redesignated by the Secretary pursuant to section 587F of
such Act.
(3) In the case of an in vitro clinical test type that has
been classified by the Secretary as a class III device pursuant
to section 513 of such Act (21 U.S.C. 360c) or an in vitro
clinical test licensed pursuant to section 351 of the Public
Health Service Act (42 U.S.C. 262), such in vitro clinical test
shall be high-risk, unless redesignated by the Secretary
pursuant to section 587F of the Federal Food, Drug, and
Cosmetic Act.
SEC. 826. EMERGENCY USE AUTHORIZATION.
(a) In General.--Section 564 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360bbb-3) is amended--
(1) by inserting ``or developer'' after ``manufacturer'',
each place such term appears;
(2) in subsection (a)--
(A) in paragraphs (1) and (4)(C), by inserting ``in
vitro clinical test,'' before ``or biological product''
each place such term appears;
(B) in paragraph (2)(A), by striking ``or 515'' and
inserting ``515, or 587B''; and
(C) by adding at the end the following:
``(F) The terms `develop' and `developer', with
respect to an in vitro clinical test, have the meanings
given such terms in section 587.'';
(3) in subsection (b), by inserting ``or developer'' after
``manufacturer'' each place such term appears;
(4) in subsection (e)--
(A) by inserting ``or developers'' after
``manufacturers'' each place such term appears;
(B) in paragraph (2)(B)(ii), by inserting ``or
develop'' after ``not manufacture'';
(C) in paragraph (3)--
(i) in subparagraph (A), by striking ``or
520(f)(1)'' and inserting ``, 520(f)(1), or
587V'';
(ii) in subparagraph (B), by striking
``and'' at the end;
(iii) in subparagraph (C), by striking the
period and inserting `` or 587O; and''; and
(iv) by adding at the end the following:
``(D) quality requirements (with respect to in
vitro clinical tests) under section 587K.''; and
(D) in paragraph (4)--
(i) in subparagraph (A), by striking ``;
or'' and inserting a semicolon;
(ii) in subparagraph (B), by striking the
period and inserting ``; or''; and
(iii) by adding at the end the following:
``(C) with respect to in vitro clinical tests,
requirements applicable to restricted in vitro clinical
tests pursuant to section 587O.'';
(5) in subsection (k), by striking ``or 520(g)'' and
inserting ``520(g), or 587S''; and
(6) in subsection (m)--
(A) in the subsection heading, by striking
``Laboratory Tests Associated With Devices'' inserting
``in Vitro Clinical Tests'' after ``Devices''; and
(B) in paragraph (1)--
(i) by striking ``to a device'' and
inserting ``to an in vitro clinical test''; and
(ii) by striking ``such device'' and
inserting ``such in vitro clinical test''.
(b) Emergency Use of Medical Products.--Section 564A of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-3a) is amended--
(1) in subsection (a)--
(A) in paragraph (2), by inserting ``in vitro
clinical test,'' after ``device,''; and
(B) by adding at the end the following:
``(3) Developer.--The term `developer', with respect to an
in vitro clinical test, has the meaning given such term in
section 587.'';
(2) by inserting ``or developer'' after ``manufacturer''
each place it appears; and
(3) in subsection (c)(1)--
(A) by inserting ``or quality requirements'' after
``good manufacturing practice requirements''; and
(B) by striking ``or 520(f)(1)'' and inserting ``,
520(f)(1), or 587K''.
(c) Products Held for Emergency Use.--Section 564B(2) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-3b(2)) is
amended--
(1) in subparagraph (A), by striking ``or 515'' and
inserting ``515, or 587B''; and
(2) in subparagraph (B), by striking ``or 520'' and
inserting 520, or 587S.
SEC. 827. ANTIMICROBIAL SUSCEPTIBILITY TESTS.
Section 511A of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
360a-2) is amended--
(1) in subsection (a)(1)(C)--
(A) by striking ``clear under section 510(k),
classify under section 513(f)(2), or approve under
section 515'' and inserting ``approve under section
587B, exempt from premarket review under section 587C,
or grant a technology certification order under section
587D''; and
(B) by striking ``testing devices'' and inserting
``in vitro clinical tests'';
(2) in subsection (c)(5)--
(A) by striking ``drug or device'' and inserting
``drug, device, or in vitro clinical test''; and
(B) by striking ``the drug or the device'' and
inserting ``the drug, device, or in vitro clinical
test'';
(3) in subsection (e)--
(A) in the heading, by striking ``Testing Devices''
and inserting ``In Vitro Clinical Tests'';
(B) in paragraph (1)--
(i) by striking ``510, 513, and 515,'' and
inserting ``587B, and 587D'';
(ii) by striking ``antimicrobial
susceptibility testing device'' and inserting
``antimicrobial susceptibility in vitro
clinical test''; and
(iii) by striking ``such device'' and
inserting ``such in vitro clinical test''; and
(C) in paragraph (2)--
(i) in the heading, by striking ``testing
devices'' and inserting ``in vitro clinical
tests'';
(ii) in subparagraphs (A) and (B) (other
than clause (iii) of such subparagraph (B)), by
striking ``device'' each place it appears and
inserting ``in vitro clinical test'';
(iii) in subparagraph (B)(iii), by striking
``a device'' and inserting ``an in vitro
clinical test''; and
(iv) by amending subparagraph (C) to read
as follows:
``(C) The antimicrobial susceptibility in vitro
clinical test meets all other requirements to be
approved under section 587B, to be exempted from
premarket review under section 587C, or to be offered
under a technology certification order under section
587D.'';
(4) in subsection (f), by amending paragraph (1) to read as
follows:
``(1) The term `antimicrobial susceptibility in vitro
clinical test' means an in vitro clinical test that utilizes
susceptibility test interpretive criteria to determine and
report the in vitro susceptibility of certain microorganisms to
a drug (or drugs).''; and
(5) in subsection (g)(2)--
(A) by amending the matter preceding subparagraph
(A) to read as follows:
``(2) with respect to approving an application under
section 587B or granting a technology certification order under
section 587D--''; and
(B) in subparagraph (A)--
(i) by striking ``device'' and inserting
``in vitro clinical test''; and
(ii) by striking ``antimicrobial
susceptibility testing device'' and inserting
``antimicrobial susceptibility in vitro
clinical test''.
SEC. 828. COMBINATION PRODUCTS.
(a) In General.--Section 503(g) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 353(g)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A), by striking ``or
biological product'' and inserting ``in vitro clinical
test, or biological product (except for a product
constituted of a device and an in vitro clinical
test)'';
(B) in subparagraph (B), by adding at the end the
following: ``For purposes of this Act, a product that
constitutes a combination of a device and an in vitro
clinical test is not a combination product within the
meaning of this subsection.''; and
(C) in subparagraph (D)(ii)--
(i) by inserting ``or in vitro clinical
test'' after ``device''; and
(ii) by inserting ``and in vitro clinical
tests'' before ``shall'';
(2) in paragraph (3), by striking ``safety and
effectiveness or substantial equivalence'' and inserting
``safety and effectiveness, substantial equivalence, or
analytical validity and clinical validity'' before ``for the
approved constituent part'';
(3) in paragraph (4)--
(A) in subparagraph (A), by striking ``or 513(f)(2)
(submitted in accordance with paragraph (5))'' and
inserting ``513(f)(2) (submitted in accordance with
paragraph (5)), 587B, or 587D, or an exempt test under
section 587C, as applicable''; and
(B) in subparagraph (B), by inserting ``, 587B, or
587D'' after ``section 515'';
(4) in paragraph (5)(A), by striking ``or 510(k)'' and
inserting ``, 510(k), 587B, or 587D'';
(5) in paragraph (7), by striking ``or substantial
equivalence'' and inserting ``, substantial equivalence, or
analytical validity and clinical validity'';
(6) in paragraph (8), by adding at the end the following:
``(I) This paragraph shall not apply to a product
constituted of a device and an in vitro clinical
test.''; and
(7) in paragraph (9)--
(A) in subparagraph (C)(i), by striking ``or
520(g)'' and inserting ``520(g), 587B, or 587D''; and
(B) in subparagraph (D), by striking ``or 520'' and
inserting ``520, 587B, or 587D''.
(b) Classification of Products.--Section 563 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 360bbb-2) is amended by adding at the
end the following:
``(d) Exemption.--This section shall not apply to a product
constituted of a device and an in vitro clinical test.''.
SEC. 829. RESOURCES.
(a) Findings.--Congress finds that the fees authorized by this
section will be dedicated to meeting the goals identified in the
letters from the Secretary of Health and Human Services to the
Committee on Health, Education, Labor, and Pensions of the Senate and
the Committee on Energy and Commerce of the House of Representatives,
as set forth in the Congressional Record.
(b) Establishment of User Fee Program.--
(1) Development of user fees for in vitro clinical tests.--
(A) In general.--Beginning not later than October
1, 2025, the Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall
develop recommendations to present to Congress with
respect to the goals, and plans for meeting the goals,
for the process for the review of in vitro clinical
test submissions and applications under subchapter J of
chapter V of the Federal Food, Drug, and Cosmetic Act,
as added by this Act, for the first 5 fiscal years
after fiscal year 2027 and for the authorization of the
In Vitro Clinical Test User Fee Program, as described
in this section, for such fiscal years. In developing
such recommendations, the Secretary shall consult
with--
(i) the Committee on Health, Education,
Labor, and Pensions of the Senate;
(ii) the Committee on Energy and Commerce
of the House of Representatives;
(iii) scientific and academic experts;
(iv) health care professionals;
(v) representatives of patient and consumer
advocacy groups; and
(vi) the regulated industry.
(B) Prior public input.--Prior to beginning
negotiations with the regulated industry on the
authorization of the In Vitro Clinical Test User Fee
Program, as described in this section, the Secretary
shall--
(i) publish a notice in the Federal
Register requesting public input on the
authorization of user fees;
(ii) hold a public meeting at which the
public may present its views on the
authorization, including specific suggestions
for the recommendations submitted under
subparagraph (E);
(iii) provide a period of 30 days after the
public meeting to obtain written comments from
the public suggesting changes to the
authorization of the In Vitro Clinical Test
User Fee Program, as described in this section;
and
(iv) publish any comments received under
clause (iii) on the website of the Food and
Drug Administration.
(C) Periodic consultation.--Not less frequently
than once every month during negotiations with the
regulated industry, the Secretary shall hold
discussions with representatives of patient and
consumer advocacy groups to continue discussions of the
authorization of the In Vitro Clinical Test User Fee
Program and to solicit suggestions to be included in
the recommendations transmitted to Congress under
subparagraph (E).
(D) Public review of recommendations.--After
negotiations with the regulated industry, the Secretary
shall--
(i) present the recommendations developed
under subparagraph (A) to the Committee on
Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce
of the House of Representatives;
(ii) publish such recommendations in the
Federal Register;
(iii) provide for a period of 30 days for
the public to provide written comments on such
recommendations;
(iv) hold a meeting at which the public may
present its views on such recommendations; and
(v) after consideration of such public
views and comments, revise such recommendations
as necessary.
(E) Transmittal of recommendations.--
(i) In general.--Not later than January 15,
2027, the Secretary shall transmit to Congress
the revised recommendations under subparagraph
(A), a summary of the views and comments
received under such subparagraph, and any
changes made to the recommendations in response
to such views and comments.
(ii) Recommendation requirements.--The
recommendations transmitted under this
subparagraph shall--
(I) include the number of full-time
equivalent employees per fiscal year
that are agreed to be hired to carry
out the goals included in such
recommendations for each year of the 5-
year period;
(II) provide that the amount of
operating reserve balance in the user
fee program established under this
section is not more than the equivalent
of 10 weeks of operating reserve;
(III) require the development of a
strategic plan for any surplus within
the operating reserve account above the
10-week operating reserve within 2
years of the establishment of the
program;
(IV) include an operating reserve
adjustment such that, if the Secretary
has an operating reserve balance in
excess of 10 weeks of such operating
reserves, the Secretary shall decrease
such fee revenue and fees to provide
for not more than 10 weeks of such
operating reserves;
(V) if an adjustment is made as
described in subclause (IV), provide
the rationale for the amount of the
decrease in fee revenue and fees shall
be contained in the Federal Register;
and
(VI) provide that the fees assessed
and collected for the full-time
equivalent employees at the Center for
Devices and Radiological Health, with
respect to which the majority of time
reporting data indicates are dedicated
to the process for the review of in
vitro clinical test submissions and
applications under paragraph (5), are
not supported by the funds authorized
to be collected and assessed under
section 738 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379j).
(F) Publication of recommendations.--The Secretary
shall publish on the website of the Food and Drug
Administration the revised recommendations under
subparagraph (A), a summary of the views and comments
received under subparagraphs (B) through (D), and any
changes made to the recommendations originally proposed
by the Secretary in response to such views and
comments.
(G) Minutes of negotiation meetings.--
(i) Public availability.--The Secretary
shall make publicly available, on the website
of the Food and Drug Administration, minutes of
all negotiation meetings conducted under this
subsection between the Food and Drug
Administration and the regulated industry not
later than 30 days after such meeting.
(ii) Content.--The minutes described under
clause (i) shall summarize any substantive
proposal made by any party to the negotiations,
any significant controversies or differences of
opinion during the negotiations, and the
resolution of any such controversy or
difference of opinion.
(2) Establishment of user fee program.--Effective on
October 1, 2027, provided that the Secretary transmits the
recommendations under paragraph (1)(E), the Secretary is
authorized to collect user fees relating to the review of in
vitro clinical test submissions and applications submitted
under subchapter J of chapter V of the Federal Food, Drug, and
Cosmetic Act, as added by this Act. Fees under such program
shall be assessed and collected only if the requirements under
paragraph (4) are met.
(3) Audit.--
(A) In general.--On the date that is 2 years after
first receiving a user fee applicable to submission of
an in vitro clinical test application submitted under
subchapter J of chapter V of the Federal Food, Drug,
and Cosmetic Act, as added by this Act, and on a
biennial basis thereafter, the Secretary shall perform
an audit of the costs of reviewing such applications
under such subchapter J. Such an audit shall compare
the costs of reviewing such applications under such
subchapter J to the amount of the user fee applicable
to such applications.
(B) Alteration of user fee.--If the audit performed
under subparagraph (A) indicates that the user fees
applicable to applications submitted under such
subchapter J exceed 49 percent of the costs of
reviewing such applications, the Secretary shall alter
the user fees applicable to applications submitted
under such subchapter J such that the user fees do not
exceed such percentage.
(C) Accounting standards.--The Secretary shall
perform an audit under subparagraph (A) in conformance
with the accounting principles, standards, and
requirements prescribed by the Comptroller General of
the United States under section 3511 of title 31,
United States Code, to ensure the validity of any
potential variability.
(4) Conditions.--The user fee program described in this
subsection shall take effect only if the Food and Drug
Administration issues draft guidance related to the review
requirements for in vitro diagnostic tests that would be
subject to premarket review under section 587B of the Federal
Food, Drug, and Cosmetic Act, as added by section 823, the
review requirements for test categories eligible for technology
certification under section 587D of such Act, as added by
section 823, and the parameters for the test categories that
would be exempt from any review under subchapter J of chapter V
of such Act.
(5) User fee program definitions and resource
requirements.--
(A) In general.--The term ``process for the review
of in vitro clinical test submissions and
applications'' means the following activities of the
Secretary with respect to the review of in vitro
clinical test premarket and technology certification
applications including supplements for such
applications:
(i) The activities necessary for the review
of premarket applications, premarket reports,
technology certification applications, and
supplements to such applications.
(ii) Actions related to submissions in
connection with in vitro clinical test
development, the issuance of action letters
that allow the marketing of in vitro clinical
tests or which set forth in detail the specific
deficiencies in such applications, reports,
supplements, or submissions and, where
appropriate, the actions necessary to support
the development of in vitro clinical tests.
(iii) The inspection of manufacturing
establishments and other facilities undertaken
as part of the Secretary's review of pending
premarket applications, technology
certifications, and supplements.
(iv) Monitoring of research conducted in
connection with the review of such
applications, supplements, and submissions.
(v) Review of in vitro clinical test
applications subject to section 351 of the
Public Health Service Act (42 U.S.C. 262) and
activities conducted in anticipation of the
submission of such applications for
investigational use under section 587S of the
Federal Food, Drug, and Cosmetic Act (as added
by section 823).
(vi) The development of guidance, policy
documents, or regulations to improve the
process for the review of premarket
applications, technology certification
applications, and supplements.
(vii) The development of voluntary test
methods, consensus standards, or mandatory
performance standards in connection with the
review of such applications, supplements, or
submissions and related activities.
(viii) The provision of technical
assistance to in vitro clinical test developers
in connection with the submission of such
applications, reports, supplements, or
submissions.
(ix) Any activity undertaken in connection
with the initial classification or
reclassification of an in vitro clinical test
in connection with any requirement for approval
or eligibility for an exemption from premarket
review of an in vitro clinical test.
(x) Any activity undertaken in connection
with making a pathway determination of an in
vitro clinical test, including the
identification, establishment, and
implementation of mitigation measures.
(xi) Evaluation of postmarket studies
required as a condition of an approval of a
premarket application of an in vitro clinical
test and ensuring such studies are conducted as
required.
(xii) Any activity undertaken in connection
with ensuring in vitro clinical tests marketed
under an exemption from premarket review
pursuant to section 587C or 587G meet the
criteria for such exemption and the applicable
standard.
(xiii) Compiling, developing, and reviewing
information on in vitro clinical tests
necessary to identify issues with the ability
of in vitro clinical tests to meet the
applicable standard, as applicable.
(B) Resource requirements.--Fees collected and
assessed under this section shall be used for the
process for the review of in vitro clinical test
applications, as described in subparagraph (A), and
shall--
(i) be subject to the limitation under
section 738(g)(3) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379j(g)(3)), in the
same manner that fees collected and assessed
under section 737(9)(C) of such Act (21 U.S.C.
379i(9)(C)) are subject to such limitation;
(ii) include travel expenses for officers
and employees of the Food and Drug
Administration only if the Secretary determines
that such travel is directly related to an
activity described in subparagraph (A); and
(iii) not be allocated to purposes
described under section 722(a) of the
Consolidated Appropriations Act, 2018 (Public
Law 115-141).
(c) Reports.--
(1) Performance report.--
(A) In general.--
(i) General requirements.--Beginning with
fiscal year 2028, for each fiscal year for
which fees are collected under this section,
the Secretary shall prepare and submit to the
Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on
Energy and Commerce of the House of
Representatives annual reports concerning the
progress of the Food and Drug Administration in
achieving the goals identified in the
recommendations transmitted to Congress by the
Secretary pursuant to subsection (b)(1)(E)
during such fiscal year and the future plans of
the Food and Drug Administration for meeting
the goals.
(ii) Additional information.--Beginning
with fiscal year 2028, the annual report under
this subparagraph shall include the progress of
the Food and Drug Administration in achieving
the goals, and future plans for meeting the
goals, including--
(I) the number of premarket
applications filed under section 587B
of the Federal Food, Drug, and Cosmetic
Act during the applicable fiscal year;
(II) the number of technology
certification applications submitted
under section 587D of the Federal Food,
Drug, and Cosmetic Act during the
applicable fiscal year for each review
division;
(III) the number of breakthrough
designations under section 587I of the
Federal Food, Drug, and Cosmetic Act
during the applicable fiscal year; and
(IV) the number of information
requests requested by the Secretary
pursuant to section 587G(d) of such
Act.
(iii) Real-time reporting.--
(I) In general.--Not later than 30
calendar days after the end of the
second quarter of fiscal year 2028, and
not later than 30 calendar days after
the end of each quarter of each fiscal
year thereafter, the Secretary shall
post the data described in subclause
(II) on the website of the Food and
Drug Administration for such quarter
and on a cumulative basis for such
fiscal year, and may remove duplicative
data from the annual report under this
subparagraph.
(II) Data.--The Secretary shall
post the following data in accordance
with subclause (I):
(aa) The number and titles
of draft and final regulations
on topics related to the
process for the review of in
vitro clinical test submissions
and applications, and whether
such regulations were required
by statute or pursuant to the
recommendations transmitted to
Congress by the Secretary
pursuant to subsection
(b)(1)(E).
(bb) The number and titles
of draft and final guidance on
topics related to the process
for the review of in vitro
clinical test submissions and
applications, and whether such
guidances were issued as
required by statute or pursuant
to the recommendations
transmitted to Congress by the
Secretary pursuant to
subsection (b)(1)(E).
(cc) The number and titles
of public meetings held on
topics related to the process
for the review of in vitro
clinical tests, and if such
meetings were required by
statute or pursuant to the
recommendations transmitted to
Congress by the Secretary
pursuant to subsection
(b)(1)(E).
(iv) Rationale for ivct user fee program
changes.--Beginning with fiscal year 2028, the
Secretary shall include in the annual
performance report under paragraph (1)--
(I) data, analysis, and discussion
of the changes in the number of full-
time equivalents hired as agreed upon
in the recommendations transmitted to
Congress by the Secretary pursuant to
subsection (b)(1)(E) and the number of
full-time equivalents funded by budget
authority at the Food and Drug
Administration by each division within
the Center for Devices and Radiological
Health, the Center for Biologics
Evaluation and Research, the Office of
Regulatory Affairs, and the Office of
the Commissioner;
(II) data, analysis, and discussion
of the changes in the fee revenue
amounts and costs for the process for
the review of in vitro clinical test
submissions and applications, including
identifying drivers of such changes;
and
(III) for each of the Center for
Devices and Radiological Health, the
Center for Biologics Evaluation and
Research, the Office of Regulatory
Affairs, and the Office of the
Commissioner, the number of employees
for whom time reporting is required and
the number of employees for whom time
reporting is not required.
(v) Analysis.--For each fiscal year, the
Secretary shall include in the report under
clause (i) an analysis of the following:
(I) The difference between the
aggregate number of premarket
applications filed under section 587B
or section 587D of the Federal Food,
Drug, and Cosmetic Act and the
aggregate number of major deficiency
letters, not approvable letters, and
denials for such applications issued by
the agency, accounting for--
(aa) the number of
applications filed under each
of sections 587B and 587D of
the Federal Food, Drug, and
Cosmetic Act during one fiscal
year for which a decision is
not scheduled to be made until
the following fiscal year; and
(bb) the aggregate number
of applications under each of
sections 587B and 587D of the
Federal Food, Drug, and
Cosmetic Act for each fiscal
year that did not meet the
goals as identified by the
recommendations transmitted to
Congress by the Secretary
pursuant to subsection
(b)(1)(E).
(II) Relevant data to determine
whether the Center for Devices and
Radiological Health has met performance
enhancement goals identified by the
recommendations transmitted to Congress
by the Secretary pursuant to subsection
(b)(1)(E).
(III) The most common causes and
trends for external or other
circumstances affecting the ability of
the Food and Drug Administration to
meet review time and performance
enhancement goals identified by the
recommendations transmitted to Congress
by the Secretary pursuant to subsection
(b)(1)(E).
(B) Publication.--With regard to information to be
reported by the Food and Drug Administration to
industry on a quarterly and annual basis pursuant to
recommendations transmitted to Congress by the
Secretary pursuant to subsection (b)(1)(E), the
Secretary shall make such information publicly
available on the website of the Food and Drug
Administration not later than 60 days after the end of
each quarter or 120 days after the end of each fiscal
year, respectively, to which such information applies.
(C) Updates.--The Secretary shall include in each
report under subparagraph (A) information on all
previous cohorts for which the Secretary has not given
a complete response on all in vitro clinical test
premarket applications and technology certification
orders and supplements, premarket, and technology
certification notifications in the cohort.
(2) Corrective action report.--Beginning with fiscal year
2022, for each fiscal year for which fees are collected under
this section, the Secretary shall prepare and submit a
corrective action report to the Committee on Health, Education,
Labor, and Pensions and the Committee on Appropriations of the
Senate and the Committee on Energy and Commerce and the
Committee on Appropriations of the House of Representatives.
The report shall include the following information, as
applicable:
(A) Goals met.--For each fiscal year, if the
Secretary determines, based on the analysis under
paragraph (1)(A)(v), that each of the goals identified
by the recommendations transmitted to Congress by the
Secretary pursuant to subsection (b)(1)(E) for the
applicable fiscal year have been met, the corrective
action report shall include recommendations on ways in
which the Secretary can improve and streamline the in
vitro clinical test premarket application and
technology certification review process.
(B) Goals missed.--For each of the goals identified
by the letters described in recommendations transmitted
to Congress by the Secretary pursuant to subsection
(b)(1)(E) for the applicable fiscal year that the
Secretary determines to not have been met, the
corrective action report shall include--
(i) a justification for such determination;
(ii) a description of the types of
circumstances, in the aggregate, under which
applications or reports submitted under
sections 587B and 587D of the Federal Food,
Drug, and Cosmetic Act missed the review goal
times but were approved during the first cycle
review, as applicable;
(iii) a summary and any trends with regard
to the circumstances for which a review goal
was missed; and
(iv) the performance enhancement goals that
were not achieved during the previous fiscal
year and a description of efforts the Food and
Drug Administration has put in place for the
fiscal year in which the report is submitted to
improve the ability of such agency to meet each
such goal for the such fiscal year.
(3) Fiscal report.--
(A) In general.--For fiscal years 2028 and annually
thereafter, not later than 120 days after the end of
each fiscal year during which fees are collected under
this section, the Secretary shall prepare and submit to
the Committee on Health, Education, Labor, and Pensions
of the Senate and the Committee on Energy and Commerce
of the House of Representatives, a report on the
implementation of the authority for such fees during
such fiscal year and the use, by the Food and Drug
Administration, of the fees collected during such
fiscal year for which the report is made.
(B) Contents.--Such report shall include
expenditures delineated by budget authority and user
fee dollars related to administrative expenses and
information technology infrastructure contracts and
expenditures.
(C) Operating reserve.--Such report shall provide
the amount of operating reserves of carryover user fees
available each year, and any planned allocations or
obligations of such balance of operating reserves for
the program.
(4) Public availability.--The Secretary shall make the
reports required under paragraphs (1) through (3) available to
the public on the website of the Food and Drug Administration.
(5) Enhanced communication.--
(A) Communications with congress.--Each fiscal
year, as applicable and requested, representatives from
the Centers with expertise in the review of in vitro
clinical tests shall meet with representatives from the
Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of
the House of Representatives to report on the contents
described in the reports under this section.
(B) Participation in congressional hearing.--Each
fiscal year, as applicable and requested,
representatives from the Food and Drug Administration
shall participate in a public hearing before the
Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of
the House of Representatives, to report on the contents
described in the reports under this section. Such
hearing shall occur not later than 120 days after the
end of each fiscal year for which fees are collected
under this section.
SEC. 830. AUTHORIZATION OF APPROPRIATIONS.
For purposes of funding implementation of this subtitle (including
the amendments made by this subtitle), including undertaking activities
for the development of regulations and guidances, hiring of necessary
staff, and the development of technology systems to implement this
subtitle (including the amendments made by this subtitle) in a timely,
effective, and efficient manner, there is authorized to be appropriated
$480,000,000, to remain available through the end of fiscal year 2028.
SEC. 831. GUIDANCE ON DIAGNOSTIC INNOVATION.
Not later than January 1, 2025, the Secretary shall issue guidance
to assist developers of in vitro clinical tests intended to identify or
diagnose rare diseases and in vitro clinical tests intended to address
an unmet medical need. Such guidance shall include considerations for
addressing barriers to developing sufficient data to demonstrate
clinical validity for such tests, such as challenges associated with
data collection and obstacles to the timely generation of evidence.
SEC. 832. GAO REPORT ON UNIQUE CONSIDERATIONS.
Not later than 3 years after the date of enactment of this Act, the
Comptroller General of the United States shall submit to the Committee
on Health, Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of Representatives a
report--
(1) evaluating the unique considerations for hospital-based
laboratories, laboratories serving academic medical centers,
and other health care practitioners, as appropriate, in
implementing this subtitle, including the amendments made by
this subtitle; and
(2) including recommendations based on the findings of the
report.
TITLE IX--OTHER PROVISIONS
SEC. 901. FACILITIES MANAGEMENT.
(a) PDUFA Authority.--Section 736(g)(2) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379h(g)(2)) is amended--
(1) in subparagraph (A)(ii)--
(A) by striking ``shall be available to defray''
and inserting the following: ``shall be available--
``(I) for fiscal year 2023, to
defray'';
(B) by striking the period and inserting ``; and'';
and
(C) by adding at the end the following:
``(II) for fiscal year 2024 and
each subsequent fiscal year, to defray
the costs of the resources allocated
for the process for the review of human
drug applications (including such costs
for an additional number of full-time
equivalent positions in the Department
of Health and Human Services to be
engaged in such process), only if the
sum of the amounts allocated by the
Secretary for such costs, excluding
costs paid from fees collected under
this section, plus other costs for the
maintenance, renovation, and repair of
facilities and acquisition,
maintenance, and repair of fixtures,
furniture, and other necessary
materials and supplies in connection
with the process for the review of
human drug applications, is no less
than the amount allocated for such
costs, excluding any such costs paid
from fees collected under this section,
for fiscal year 1997, multiplied by the
adjustment factor.''; and
(2) in subparagraph (B), by striking ``for the process for
the review of human drug applications'' and inserting ``as
described in subclause (I) or (II) of such subparagraph, as
applicable''.
(b) BsUFA Authority.--Section 744H(f)(2) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379j-52(f)(2)) is amended--
(1) in subparagraph (B)(i)--
(A) by striking ``available for a fiscal year
beginning after fiscal year 2012'' and inserting the
following: ``available--
``(I) for fiscal year 2023'';
(B) by striking ``the fiscal year involved.'' and
inserting ``such fiscal year; and''; and
(C) by adding at the end the following:
``(II) for fiscal year 2024 and
each subsequent fiscal year, to defray
the costs of the process for the review
of biosimilar biological product
applications (including such costs for
an additional number of full-time
equivalent positions in the Department
of Health and Human Services to be
engaged in such process), only if the
sum of the amounts allocated by the
Secretary for such costs, excluding
costs paid from fees collected under
this section, plus other costs for the
maintenance, renovation, and repair of
facilities and acquisition,
maintenance, and repair of fixtures,
furniture, and other necessary
materials and supplies in connection
with the process for the review of
biosimilar biological product
applications, is no less than
$20,000,000, multiplied by the
adjustment factor applicable to the
fiscal year involved.''; and
(2) in subparagraph (C), by striking ``subparagraph (B) in
any fiscal year if the costs described in such subparagraph''
and inserting ``subparagraph (B)(i) in any fiscal year if the
costs allocated as described in subclause (I) or (II) of such
subparagraph, as applicable,''.
(c) GDUFA Authority.--Section 744B of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j-42) is amended--
(1) in subsection (e)(2), by striking ``744A(11)(C)'' and
inserting ``744A(12)(C)''; and
(2) in subsection (i)(2)--
(A) in subparagraph (A)(ii)--
(i) by striking ``available for a fiscal
year beginning after fiscal year 2012'' and
inserting the following: ``available--
``(I) for fiscal year 2023'';
(ii) by striking ``the fiscal year
involved.'' and inserting ``such fiscal year;
and''; and
(iii) by adding at the end the following:
``(II) for fiscal year 2024 and
each subsequent fiscal year, to defray
the costs of human generic drug
activities (including such costs for an
additional number of full-time
equivalent positions in the Department
of Health and Human Services to be
engaged in such activities), only if
the sum of the amounts allocated by the
Secretary for such costs, excluding
costs paid from fees collected under
this section, plus other costs for the
maintenance, renovation, and repair of
facilities and acquisition,
maintenance, and repair of fixtures,
furniture, and other necessary
materials and supplies in connection
with human generic drug activities, is
no less than $97,000,000 multiplied by
the adjustment factor defined in
section 744A(3) applicable to the
fiscal year involved.''; and
(B) in subparagraph (B), by striking ``for human
generic activities'' and inserting ``as described in
subclause (I) or (II) of such subparagraph, as
applicable,''.
(d) MDUFA Authority.--Section 738 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j) is amended--
(1) in subsection (h)(2)--
(A) in subparagraph (A)(ii)--
(i) by striking ``shall be available to
defray'' and inserting the following: ``shall
be available--
``(I) for fiscal year 2023, to
defray'';
(ii) by striking the period and inserting
``; and''; and
(iii) by adding at the end the following:
``(II) for fiscal year 2024 and
each subsequent fiscal year, to defray
the costs of the resources allocated
for the process for the review of
device applications (including such
costs for an additional number of full-
time equivalent positions in the
Department of Health and Human Services
to be engaged in such process), only if
the sum of the amounts allocated by the
Secretary for such costs, excluding
costs paid from fees collected under
this section, plus other costs for the
maintenance, renovation, and repair of
facilities and acquisition,
maintenance, and repair of fixtures,
furniture and other necessary materials
and supplies in connection with the
process for the review of device
applications, is no less than the
amount allocated for such costs,
excluding any such costs paid from fees
collected under this section, for
fiscal year 2009 multiplied by the
adjustment factor.''; and
(B) in subparagraph (B)(i), in the matter preceding
subclause (I), by striking ``for the process for the
review of device applications'' and inserting ``as
described in subclause (I) or (II) of such
subparagraph, as applicable''; and
(2) in subsection (g)(3), by striking ``737(9)(C)'' and
inserting ``737(10)(C)''.
(e) Technical Correction.--
(1) In general.--Section 905(b)(2) of the FDA
Reauthorization Act of 2017 (Public Law 115-52) is amended by
striking ``Section 738(h) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j(h)) is amended'' and inserting
``Subsection (g) of section 738 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j), as so redesignated by section
203(f)(2)(B)(i), is amended''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect as though included in the enactment of
section 905 of the FDA Reauthorization Act of 2017 (Public Law
115-52).
SEC. 902. USER FEE PROGRAM TRANSPARENCY AND ACCOUNTABILITY.
(a) PDUFA.--
(1) Reauthorization; reporting requirements.--Section
736B(a) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
379h-2(a)) is amended--
(A) in paragraph (1)--
(i) in subparagraph (B)--
(I) in clause (vii), by striking
``; and'' and inserting a semicolon;
(II) in clause (viii), by striking
the period and inserting ``; and''; and
(III) by adding at the end the
following:
``(ix) the number of investigational new
drug applications submitted per fiscal year,
including for each review division.''; and
(ii) by adding at the end the following
flush text:
``Nothing in subparagraph (B) shall be construed to authorize
the disclosure of information that is prohibited from
disclosure under section 301(j) of this Act or section 1905 of
title 18, United States Code, or that is subject to withholding
under section 552(b)(4) of title 5, United States Code.''; and
(B) in paragraph (4)--
(i) by amending subparagraph (A) to read as
follows:
``(A) data, analysis, and discussion of the changes
in the number of individuals hired as agreed upon in
the letters described in section 101(b) of the
Prescription Drug User Fee Amendments of 2022 and the
number of remaining vacancies, the number of full-time
equivalents funded by fees collected pursuant to
section 736, and the number of full-time equivalents
funded by budget authority at the Food and Drug
Administration by each division within the Center for
Drug Evaluation and Research, the Center for Biologics
Evaluation and Research, the Office of Regulatory
Affairs, and the Office of the Commissioner;'';
(ii) by amending subparagraph (B) to read
as follows:
``(B) data, analysis, and discussion of the changes
in the fee revenue amounts and costs for the process
for the review of human drug applications, including
identifying--
``(i) drivers of such changes; and
``(ii) changes in the average total cost
per full-time equivalent in the prescription
drug review program;'';
(iii) in subparagraph (C), by striking the
period and inserting ``; and''; and
(iv) by adding at the end the following:
``(D) data, analysis, and discussion of the changes
in the average full-time equivalent hours required to
complete review of each type of human drug
application.''.
(2) Reauthorization.--Section 736B(f) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379h-2(f)) is amended--
(A) by redesignating paragraphs (4) through (6) as
paragraphs (5) through (7), respectively;
(B) by inserting after paragraph (3) the following:
``(4) Updates to congress.--The Secretary, in consultation
with regulated industry, shall provide regular updates on
negotiations on the reauthorization of this part to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.''; and
(C) in paragraph (7), as so redesignated--
(i) in subparagraph (A)--
(I) by striking ``Before presenting
the recommendations developed under
paragraphs (1) through (5) to the
Congress, the'' and inserting ``The'';
and
(II) by inserting ``, not later
than 30 days after each such
negotiation meeting'' before the period
at the end; and
(ii) in subparagraph (B), by inserting ``,
in sufficient detail,'' after ``shall
summarize''.
(b) MDUFA.--
(1) Reauthorization; reporting requirements.--Section
738A(a)(1)(A) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 379j-1(a)(1)(A)), as amended by section 204, is further
amended--
(A) in clause (ii)--
(i) in subclause (II), by striking ``;
and'' and inserting a semicolon;
(ii) in subclause (III), by striking the
period and inserting a semicolon; and
(iii) by adding at the end the following:
``(IV) the number of
investigational device exemption
applications submitted under section
520(g) per fiscal year, including for
each review division; and
``(V) the number of expedited
development and priority review
requests and designations under section
515B per fiscal year, including for
each review division.
Nothing in this clause shall be construed to
authorize the disclosure of information that is
prohibited from disclosure under section 301(j)
of this Act or section 1905 of title 18, United
States Code, or that is subject to withholding
under section 552(b)(4) of title 5, United
States Code.''; and
(B) in clause (iv) (relating to rationale for MDUFA
program changes)--
(i) by amending subclause (I) to read as
follows:
``(I) data, analysis, and
discussion of the changes in the number
of individuals hired as agreed upon in
the letters described in section 201(b)
of the Medical Device User Fee
Amendments of 2022 and the number of
remaining vacancies, the number of
full-time equivalents funded by fees
collected pursuant to section 738, and
the number of full time equivalents
funded by budget authority at the Food
and Drug Administration by each
division within the Center for Devices
and Radiological Health, the Center for
Biologics Evaluation and Research, the
Office of Regulatory Affairs, and the
Office of the Commissioner;'';
(ii) by amending subclause (II) to read as
follows:
``(II) data, analysis, and
discussion of the changes in the fee
revenue amounts and costs for the
process for the review of device
applications, including identifying--
``(aa) drivers of such
changes; and
``(bb) changes in the
average total cost per full-
time equivalent in the medical
device review program;'';
(iii) in subclause (III), by striking the
period and inserting ``; and''; and
(iv) by adding at the end the following:
``(IV) data, analysis, and
discussion of the changes in the
average full-time equivalent hours
required to complete review of medical
device application types.''.
(2) Reauthorization.--Section 738A(b) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-1(b)), as amended by
section 204, is further amended--
(A) by redesignating paragraphs (4) through (6) as
paragraphs (5) through (7), respectively;
(B) by inserting after paragraph (3) the following:
``(4) Updates to congress.--The Secretary, in consultation
with regulated industry, shall provide regular updates on
negotiations on the reauthorization of this part to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.''; and
(C) in paragraph (7), as so redesignated--
(i) in subparagraph (A)--
(I) by striking ``Before presenting
the recommendations developed under
paragraphs (1) through (5) to the
Congress, the'' and inserting ``The'';
and
(II) by inserting ``, not later
than 30 days after each such
negotiation meeting'' before the period
at the end; and
(ii) in subparagraph (B), by inserting ``,
in sufficient detail,'' after ``shall
summarize''.
(c) GDUFA.--
(1) Reauthorization; reporting requirements.--Section
744C(a)(3) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 379j-43(a)(3)) is amended--
(A) in the matter preceding subparagraph (A), by
striking ``fiscal year 2020'' and inserting ``fiscal
year 2023'';
(B) by amending subparagraph (A) to read as
follows:
``(A) data, analysis, and discussion of the changes
in the number of individuals hired as agreed upon in
the letters described in section 301(b) of the Generic
Drug User Fee Amendments of 2022 and the number of
remaining vacancies, the number of full-time
equivalents funded by fees collected pursuant to
section 744B, and the number of full time equivalents
funded by budget authority at the Food and Drug
Administration by each division within the Center for
Drug Evaluation and Research, the Center for Biologics
Evaluation and Research, the Office of Regulatory
Affairs, and the Office of the Commissioner;'';
(C) by amending subparagraph (B) to read as
follows:
``(B) data, analysis, and discussion of the changes
in the fee revenue amounts and costs for human generic
drug activities, including--
``(i) identifying drivers of such changes;
and
``(ii) changes in the total average cost
per full-time equivalent in the generic drug
review program;'';
(D) in subparagraph (C), by striking the period at
the end and inserting ``; and''; and
(E) by adding at the end the following:
``(D) data, analysis, and discussion of the changes
in the average full-time equivalent hours required to
complete review of each type of abbreviated new drug
application.''.
(2) Reauthorization.--Section 744C(f) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-43(f)) is amended--
(A) by redesignating paragraphs (4) through (6) as
paragraphs (5) through (7), respectively;
(B) by inserting after paragraph (3) the following:
``(4) Updates to congress.--The Secretary, in consultation
with regulated industry, shall provide regular updates on
negotiations on the reauthorization of this part to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.''; and
(C) in paragraph (7), as so redesignated--
(i) in subparagraph (A)--
(I) by striking ``Before presenting
the recommendations developed under
paragraphs (1) through (5) to the
Congress, the'' and inserting ``The'';
and
(II) by inserting ``, not later
than 30 days after each such
negotiation meeting'' before the period
at the end; and
(ii) in subparagraph (B), by inserting ``,
in sufficient detail,'' after ``shall
summarize''.
(d) BsUFA.--
(1) Reauthorization; reporting requirements.--Section
744I(a)(4) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 379j-53(a)(4)) is amended--
(A) by amending subparagraph (A) to read as
follows:
``(A) data, analysis, and discussion of the changes
in the number of individuals hired as agreed upon in
the letters described in section 401(b) of the
Biosimilar User Fee Amendments of 2022 and the number
of remaining vacancies, the number of full-time
equivalents funded by fees collected pursuant to
section 744H, and the number of full time equivalents
funded by budget authority at the Food and Drug
Administration by each division within the Center for
Drug Evaluation and Research, the Center for Biologics
Evaluation and Research, the Office of Regulatory
Affairs, and the Office of the Commissioner;'';
(B) by amending subparagraph (B) to read as
follows:
``(B) data, analysis, and discussion of the changes
in the fee revenue amounts and costs for the process
for the review of biosimilar biological product
applications, including identifying--
``(i) drivers of such changes; and
``(ii) changes in the average total cost
per full-time equivalent in the biosimilar
biological product review program;'';
(C) in subparagraph (C), by striking the period at
the end and inserting ``; and''; and
(D) by adding at the end the following:
``(D) data, analysis, and discussion of the changes
in the average full-time equivalent hours required to
complete review of each type of biosimilar biological
product application.''.
(2) Reauthorization.--Section 744I(f) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-53(f)) is amended--
(A) by redesignating paragraphs (2) and (3) as
paragraphs (5) and (6), respectively;
(B) by inserting after paragraph (1) the following:
``(2) Prior public input.--Prior to beginning negotiations
with the regulated industry on the reauthorization of this
part, the Secretary shall--
``(A) publish a notice in the Federal Register
requesting public input on the reauthorization;
``(B) hold a public meeting at which the public may
present its views on the reauthorization;
``(C) provide a period of 30 days after the public
meeting to obtain written comments from the public
suggesting changes to this part; and
``(D) publish the comments on the Food and Drug
Administration's website.
``(3) Periodic consultation.--Not less frequently than once
every month during negotiations with the regulated industry,
the Secretary shall hold discussions with representatives of
patient and consumer advocacy groups to continue discussions of
their views on the reauthorization and their suggestions for
changes to this part as expressed under paragraph (2).
``(4) Updates to congress.--The Secretary, in consultation
with regulated industry, shall provide regular updates on
negotiations on the reauthorization of this part to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.''; and
(C) by adding at the end the following:
``(7) Minutes of negotiation meetings.--
``(A) Public availability.--The Secretary shall
make publicly available, on the public website of the
Food and Drug Administration, minutes of all
negotiation meetings conducted under this subsection
between the Food and Drug Administration and the
regulated industry, not later than 30 days after each
such negotiation meeting.
``(B) Content.--The minutes described under
subparagraph (A) shall summarize, in sufficient detail,
any substantive proposal made by any party to the
negotiations as well as significant controversies or
differences of opinion during the negotiations and
their resolution.''.
SEC. 903. OTC HEARING AIDS FINAL RULE.
Not later than 30 days after the date of enactment of this Act, the
Secretary of Health and Human Services shall issue a final rule to
establish a category of over-the-counter hearing aids, as defined in
subsection (q) of section 520 of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 360j), as described in section 709(b) of the FDA
Reauthorization Act of 2017 (Public Law 115-52).
SEC. 904. ENHANCING COORDINATION AND TRANSPARENCY ON INSPECTIONS.
(a) Coordination.--Section 506D of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 356d) is amended--
(1) by adding at the end the following:
``(g) Coordination.--The Secretary shall ensure timely and
effective internal coordination and alignment among the field
investigators of the Food and Drug Administration and the staff of the
Center for Drug Evaluation and Research's Office of Compliance and Drug
Shortage Program regarding the reviews of reports shared pursuant to
section 704(b)(2), and any feedback or corrective or preventive actions
in response to such reports.''; and
(2) by amending subsection (f) to read as follows:
``(f) Temporary Sunset.--Subsection (a) shall cease to be effective
on the date that is 5 years after the date of enactment of the Food and
Drug Administration Safety and Innovation Act. Subsections (b), (c),
and (e) shall not be in effect during the period beginning 5 years
after the date of enactment of the Food and Drug Administration Safety
and Innovation Act and ending on the date of enactment of the Food and
Drug Administration Safety and Landmark Advancements Act of 2022.
Subsections (b), (c), and (e) shall be in effect beginning on the date
of enactment of the Food and Drug Administration Safety and Landmark
Advancements Act of 2022.''.
(b) Reporting.--Section 506C-1(a) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 356c-1(a)) is amended--
(1) by redesignating paragraphs (3) through (7) as
paragraphs (4) through (8), respectively;
(2) by inserting after paragraph (2) the following:
``(3) provides the number of reports that were required
under section 704(b)(2) to be sent to the appropriate offices
of the Food and Drug Administration with expertise regarding
drug shortages, and the number of such reports that were
sent;''; and
(3) in paragraph (4)(A), as so redesignated, by striking
``paragraph (7)'' and inserting ``paragraph (8)''.
(c) Applicability.--
(1) Subsection (a).--The amendments made by subsection (a)
shall apply beginning on the date of enactment of this Act.
(2) Subsection (b).--The amendments made by subsection (b)
shall apply beginning on the date that is 1 year after the date
of enactment of this Act.
(d) Reporting of Mutual Recognition Agreements for Inspections and
Review Activities.--Section 510(h) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360(h)) is amended--
(1) in paragraph (6)--
(A) in subparagraph (A), by striking clauses (i)
and (ii) and inserting the following:
``(i) the number of domestic and foreign
establishments registered pursuant to this section in
the previous fiscal year;
``(ii) the number of such registered establishments
in each region of interest;
``(iii) the number of such domestic establishments
and the number of such foreign establishments,
including the number of establishments in each region
of interest, that the Secretary inspected in the
previous fiscal year;
``(iv) the number of inspections to support actions
by the Secretary on applications under section 505 of
this Act or section 351 of the Public Health Service
Act, including the number of inspections to support
actions by the Secretary on supplemental applications,
including changes to manufacturing processes, the
Secretary conducted in the previous fiscal year;
``(v) the number of routine surveillance
inspections the Secretary conducted in the previous
fiscal year, including in each region of interest;
``(vi) the number of for-cause inspections the
Secretary conducted in the previous fiscal year, not
including inspections described in clause (iv),
including in each region of interest; and
``(vii) the number of inspections the Secretary has
recognized pursuant to an agreement entered into
pursuant to section 809, or otherwise recognized, for
each of the types of inspections described in clauses
(v) and (vi), including for inspections of
establishments in each region of interest.'';
(B) in subparagraph (B), by striking ``; and'' and
inserting a semicolon;
(C) in subparagraph (C), by striking the period and
inserting ``; and''; and
(D) by adding at the end the following:
``(D) the status of the efforts of the Food and
Drug Administration to expand its recognition of
inspections conducted or recognized by foreign
regulatory authorities under section 809, including any
obstacles to expanding the use of such recognition.'';
and
(2) by adding at the end the following:
``(7) Region of interest.--For purposes of paragraph
(6)(A), the term `region of interest' means a foreign
geographic region or country, including the People's Republic
of China, India, the European Union, the United Kingdom, and
any other country or geographic region, as the Secretary
determines appropriate.''.
(e) Enhancing Transparency of Drug Facility Inspection Timelines.--
Section 902 of the FDA Reauthorization Act of 2017 (21 U.S.C. 355 note)
is amended to read as follows:
``SEC. 902. ANNUAL REPORT ON INSPECTIONS.
``Not later than 120 days after the end of each fiscal year, the
Secretary of Health and Human Services shall post on the website of the
Food and Drug Administration information related to inspections of
facilities necessary for approval of a drug under subsection (c) or (j)
of section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
355) or approval of a device under section 515 of such Act (21 U.S.C.
360e) that were conducted during the previous fiscal year. Such
information shall include the following:
``(1) The median time following a request from staff of the
Food and Drug Administration reviewing an application or report
to the beginning of the inspection, including--
``(A) the median time for drugs described in
505(j)(11)(A)(i) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355(j)(11)(A)(i));
``(B) the median time for drugs for which a
notification has been submitted in accordance with
section 506C(a) of such Act (21 U.S.C. 356c(a)) during
the previous fiscal year; and
``(C) the median time for drugs on the drug
shortage list in effect under section 506E of such Act
(21 U.S.C. 356e) at the time of such request.
``(2) The median time from the issuance of a report
pursuant to section 704(b) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 374(b)) to the sending of a warning
letter, issuance of an import alert, or holding of a regulatory
meeting for inspections for which the Secretary concluded that
regulatory or enforcement action was indicated, including the
median time for each category of drugs listed in subparagraphs
(A) through (C) of paragraph (1).
``(3) The median time from the sending of a warning letter,
issuance of an import alert, or holding of a regulatory meeting
related to conditions observed by the Secretary during an
inspection, to the time at which the Secretary concludes that
corrective actions to resolve such conditions have been taken.
``(4) The median time spent by staff of the Food and Drug
Administration at a facility during an inspection, including--
``(A) the median time when records were provided
remotely in accordance with a request under section
704(a)(4) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 374(a)(4)) in advance of the inspection; and
``(B) the median time when a request for records
pursuant to such section 704(a)(4) was not issued, or
complied with, in advance of the inspection.
``(5) The number and type of violations identified during
inspections when a request for records pursuant to such section
704(a)(4) was issued and complied with in advance of the
inspection, versus when a request for records pursuant to such
section 704(a)(4) was not issued or complied with.
``(6) The number of facilities that did not implement
adequate corrective or preventive actions following a report
issued pursuant to such section 704(b), resulting in a withhold
recommendation for an application under review, including the
number of such facilities manufacturing each category of drugs
listed in subparagraphs (A) through (C) of paragraph (1).''.
SEC. 905. CERTIFICATES TO FOREIGN GOVERNMENTS.
Section 801(e)(4) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 381(e)(4)) is amended--
(1) in subparagraph (E), by striking clause (iii); and
(2) by adding at the end the following:
``(F)(i) This paragraph applies to requests for certification under
this subparagraph of a device manufactured by a device establishment
located outside of the United States that is registered under section
510, if the device is listed pursuant to section 510(j), the device has
been cleared, approved, or is not required to submit a premarket report
pursuant to subsection (l) or (m) of section 510, and the device is
imported or offered for import into the United States.
``(ii) The Secretary shall issue the certification as described in
clause (iii) if the device or devices for which certification is
requested under this subparagraph meet the applicable requirements of
this Act.
``(iii)(I) A certification for a device described in clause (i)
shall be subject to the fee described in subparagraph (B).
``(II) Notwithstanding subparagraph (C), a certification for a
device described in clause (i) shall address and include the same
material information as a `Certificate to Foreign Government' and shall
have a document title including the words `Certificate to Foreign
Government'.
``(iv) The requirements and procedures of subparagraph (E) shall
apply to a denial of a certification under this subparagraph.''.
SEC. 906. IMPORTATION OF DRUGS.
(a) In General.--Section 804 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 384) is amended to read as follows:
``SEC. 804. IMPORTATION OF PRESCRIPTION DRUGS.
``(a) Definitions.--In this section:
``(1) Foreign seller.--The term `foreign seller' means an
establishment within Canada engaged in the distribution of an
eligible prescription drug that is imported or offered for
importation into the United States, that--
``(A) has an active Drug Establishment License to
wholesale drugs by the appropriate Canadian regulatory
authority;
``(B) is registered with the applicable regulatory
authorities to distribute drugs approved by the
appropriate Canadian regulatory authority;
``(C) is not licensed by a regulatory authority
with an international pharmacy license that allows it
to distribute drugs that are approved by countries
other than Canada and that are not approved by the
appropriate Canadian regulatory authority for
distribution in Canada; and
``(D) is registered with the Secretary under this
section.
``(2) Importer.--The term `importer' means a pharmacist or
wholesaler.
``(3) Pharmacist.--The term `pharmacist' means a person
licensed by a State to practice pharmacy, including the
dispensing and selling of prescription drugs.
``(4) Prescription drug.--The term `prescription drug'
means a drug subject to section 503(b), other than--
``(A) a controlled substance (as defined in section
102 of the Controlled Substances Act (21 U.S.C. 802));
``(B) a biological product (as defined in section
351 of the Public Health Service Act (42 U.S.C. 262));
``(C) an infused drug (including a peritoneal
dialysis solution);
``(D) an intravenously injected drug;
``(E) a drug that is inhaled during surgery;
``(F) an intrathecally or intraocularly injected
drug;
``(G) a drug that is subject to a risk evaluation
and mitigation strategy under section 505-1;
``(H) a drug that is not a `product' for purposes
of section 582 as defined in section 581(13);
``(I) a compounded drug; or
``(J) a drug the importation of which pursuant to
subsection (b) is determined by the Secretary to pose a
threat to the public health.
``(5) Qualifying laboratory.--The term `qualifying
laboratory' means a laboratory in the United States that
complies with the applicable current good manufacturing
practice requirements and has been approved by the Secretary
for the purposes of this section.
``(6) Section 804 importation program sponsor.--The term
`section 804 importation program sponsor' means a State or
Indian Tribe that regulates wholesale drug distribution and the
practice of pharmacy, or a pharmacist or wholesaler that is not
the importer, as the Secretary may determine, that submits a
proposal to the Secretary that describes a program to
facilitate the importation of prescription drugs from Canada
under this section and is responsible for oversight of the
implementation of the program.
``(7) Wholesaler.--The term `wholesaler'--
``(A) means a person licensed (as defined in
section 581(9)(A)) as a wholesale distributor (as
defined in section 581(29)); and
``(B) excludes a person authorized to import drugs
under section 801(d)(1).
``(b) Regulations.--The Secretary, after consultation with the
United States Trade Representative and the Commissioner of Customs,
shall promulgate regulations permitting time-limited section 804
importation programs, which shall be authorized by the Secretary and
managed by States or Indian Tribes, or in certain circumstances by
pharmacists and wholesalers, to import prescription drugs from Canada
into the United States. The time limit for a section 804 importation
program authorized by the Secretary may be extended for a period not to
exceed the initial time limit authorized by the Secretary.
``(c) Limitation.--The regulations under subsection (b) shall--
``(1) require that safeguards be in place to ensure that
each prescription drug imported under the regulations complies
with section 505 (including with respect to being safe and
effective for the intended use of the prescription drug), with
sections 501 and 502, and with other applicable requirements of
this Act;
``(2) require that a section 804 importation program
sponsor and an importer of a prescription drug under the
regulations comply with subsections (d)(1), (d)(2), (d)(3), and
(e);
``(3) require that the section 804 importation program
sponsor demonstrates that the importation program meets the
certification requirements under subsection (l)(1); and
``(4) contain any additional provisions determined by the
Secretary to be appropriate as a safeguard to protect the
public health or as a means to facilitate the importation of
prescription drugs.
``(d) Information and Records.--
``(1) In general.--The regulations under subsection (b)
shall require an importer of a prescription drug under
subsection (b) to submit to the Secretary the following
information and documentation:
``(A) The name and quantity of the active
ingredient of the prescription drug.
``(B) A description of the dosage form of the
prescription drug.
``(C) The date on which the prescription drug is
shipped.
``(D) The quantity of the prescription drug that is
shipped.
``(E) The point of origin and destination of the
prescription drug.
``(F) The price paid by the importer for the
prescription drug.
``(G) Documentation from the foreign seller
specifying--
``(i) the original source of the
prescription drug; and
``(ii) the quantity of each lot of the
prescription drug originally received by the
seller from that source.
``(H) The lot or control number assigned to the
prescription drug by the manufacturer of the
prescription drug.
``(I) The name, address, telephone number, and
professional license number (if any) of the importer.
``(J) Documentation demonstrating that the
prescription drug was received by the foreign seller
from the manufacturer and subsequently shipped by the
foreign seller to the importer.
``(K) Documentation of the quantity of each lot of
the prescription drug received by the foreign seller
demonstrating that the quantity being imported into the
United States is not more than the quantity that was
received by the foreign seller.
``(L)(i) In the case of an initial imported
shipment, documentation demonstrating that each batch
of the prescription drug in the shipment was
statistically sampled and tested for authenticity and
degradation.
``(ii) In the case of any subsequent shipment,
documentation demonstrating that a statistically valid
sample of the shipment was tested for authenticity and
degradation.
``(M) Documentation that each supply chain under a
section 804 importation program proposal is limited to
one manufacturer, one foreign seller, and one importer.
``(N) For each prescription drug imported under a
section 804 importation program, documentation that the
prescription drug was purchased directly from the
manufacturer by the foreign seller and that the foreign
seller sold the prescription drug directly to the
importer.
``(O) Certification from the importer that the
prescription drug--
``(i) is approved for marketing in the
United States and is not adulterated or
misbranded; and
``(ii) is relabeled after the Secretary has
accepted the results of testing required by
subparagraphs (J) through (P)) and meets all
labeling requirements under this Act.
``(P) Laboratory records, including complete data
derived from all tests necessary to ensure that the
prescription drug is in compliance with established
specifications and standards.
``(Q) Documentation demonstrating that the testing
required by subparagraphs (J) through (P) was conducted
at a qualifying laboratory in the United States.
``(R) Any other information that the Secretary
determines is necessary to ensure the protection of the
public health.
``(2) Section 804 importation program proposal.--The
regulations under subsection (b) shall require a sponsor of a
time-limited section 804 importation program authorized under
such subsection to submit to the Secretary the following
information and documentation in its proposal to the Secretary:
``(A) The names of all participants in the supply
chain, including--
``(i) the foreign seller;
``(ii) the importer;
``(iii) the repackager or relabeler, if
different from the importer, that will relabel
the eligible prescription drugs; and
``(iv) the qualifying laboratory that will
conduct testing for the importer.
``(B) Information about how the section 804
importation program sponsor will ensure that--
``(i) the prescription drug meets the
testing requirements in subparagraphs (J)
through (P) of paragraph (1);
``(ii) the supply chain is secure;
``(iii) the prescription drug will meet the
labeling requirements of this Act;
``(iv) the adverse event-related
requirements of this Act are met; and
``(v) the section 804 importation program
will result in a significant reduction in the
cost to the American consumer of the
prescription drug.
``(C) A compliance plan.
``(D) Information about how the section 804
importation sponsor will ensure that any trade secrets
or commercial or financial information that is
privileged or confidential that the manufacturer
supplies are kept in strict confidence and used only
for the purposes of testing or otherwise complying with
Federal law.
``(3) Pre -import request.--The regulations under
subsection (b) shall require an importer under a program
authorized under such subsection to submit a pre-import request
to the Secretary at least 30 calendar days before the scheduled
date of arrival or entry for consumption of a shipment
containing a prescription drug covered by the section 804
importation program, whichever is earlier.
``(4) Maintenance by the secretary.--The Secretary shall
maintain information and documentation submitted under
paragraphs (1), (2), and (3) for such period of time as the
Secretary determines to be necessary.
``(e) Testing.--The regulations under subsection (b) shall
require--
``(1) that testing described in subparagraphs (J) through
(P) of subsection (d)(1) be conducted by the importer or by the
manufacturer of the prescription drug at a qualified
laboratory;
``(2) if the tests are conducted by the importer--
``(A) that information needed to--
``(i) authenticate the prescription drug
being tested; and
``(ii) confirm that the labeling of the
prescription drug complies with labeling
requirements under this Act,
be supplied by the manufacturer of the prescription
drug to the pharmacist or wholesaler; and
``(B) that the information supplied under
subparagraph (A) be kept in strict confidence and used
only for purposes of testing or otherwise complying
with this Act; and
``(3) such additional provisions as the Secretary
determines to be appropriate to provide for the protection of
trade secrets and commercial or financial information that is
privileged or confidential.
``(f) Registration of Foreign Sellers.--Any establishment within
Canada engaged in the distribution of a prescription drug that is
imported or offered for importation into the United States shall
register with the Secretary the name and place of business of the
establishment and the name of the United States agent for the
establishment.
``(g) Suspension of Importation.--The Secretary shall require that
importations of a specific prescription drug or importations by a
specific importer under subsection (b) be immediately suspended on
discovery of a pattern of importation of that specific prescription
drug or by that specific importer of drugs that are counterfeit or in
violation of any requirement under this section, until an investigation
is completed and the Secretary determines that the public is adequately
protected from counterfeit and violative prescription drugs being
imported under subsection (b).
``(h) Approved Labeling.--The manufacturer of a prescription drug
shall provide an importer written authorization for the importer to
use, at no cost, the approved labeling for the prescription drug.
``(i) Charitable Contributions.--Notwithstanding any other
provision of this section, section 801(d)(1) continues to apply to a
prescription drug that is donated or otherwise supplied at no charge by
the manufacturer of the drug to a charitable or humanitarian
organization (including the United Nations and affiliates) or to a
government of a foreign country.
``(j) Importation for Personal Use.--
``(1) Declarations.--Congress declares that, in
implementing the provisions under this section, the Secretary
may--
``(A) focus enforcement on cases in which the
importation by an individual poses a significant threat
to public health; and
``(B) exercise discretion to permit individuals to
make such importations in circumstances in which--
``(i) the importation is clearly for
personal use; and
``(ii) the prescription drug or device
imported does not appear to present an
unreasonable risk to the individual.
``(2) Regulations.--
``(A) In general.--The Secretary may, by
regulation, permit importation of a prescription drug,
or class of prescription drugs, for personal use,
provided that such importation--
``(i) does not increase the public's
exposure to counterfeit prescription drug
products;
``(ii) does not pose a risk of creating,
exacerbating, or prolonging an opioid epidemic,
including by increasing the public's exposure
to counterfeit prescription opioid drug
products, such as counterfeit fentanyl, or
increasing the public's misuse of prescription
opioid drug products;
``(iii) meets the certification
requirements under subsection (l)(1); and
``(iv) meets such other conditions as the
Secretary determines to be appropriate.
``(B) Requirements.--Regulations described in
subparagraph (A) may permit importation into the United
States of a prescription drug that--
``(i) is imported in a quantity that does
not exceed a 90-day supply;
``(ii) is for personal use by an
individual, not for resale;
``(iii) is accompanied by a copy of a valid
prescription issued by a health care
practitioner licensed by a State to practice in
the United States to administer the drug, and
is not distributed to anyone other than the
individual for whom such prescription is
written;
``(iv) is imported from Canada, from a
licensed pharmacy physically located in Canada
and registered with the Secretary;
``(v) is a prescription drug that complies
with section 505 (including with respect to
being safe and effective for the intended use
of the prescription drug), with sections 501
and 502, and with other applicable requirements
of this Act;
``(vi) is accompanied by an electronic
import entry for such prescription drug
regardless of its values, submitted using an
authorized electronic data interchange system;
``(vii) is in the form of a final finished
dosage that was manufactured in an
establishment registered under section 510; and
``(viii) is imported under such other
conditions as the Secretary determines to be
necessary to ensure public safety.
``(C) Procedure.--The Secretary shall--
``(i) proceed in accordance with section
553 of title 5 (without regard to any reference
in such section to sections 556 and 557 of such
title) when promulgating a regulation under
subparagraph (A), and shall--
``(I) publish a notice of proposed
rulemaking stating with particularity
the reason for the proposed rule;
``(II) allow interested persons to
submit written data, views, and
arguments, and make all such
submissions publicly available;
``(III) hold a public meeting; and
``(IV) promulgate a final rule
based on the matter in the rulemaking
record;
``(ii) consult with the United States Trade
Representative, the Commissioner of the U.S.
Customs and Border Protection, and the
Administrator of the Drug Enforcement
Administration prior to proposing and
finalizing a rule under subparagraph (A);
``(iii) include in the preamble to the
proposed rule under subparagraph (A) a clear
and complete description of how the Secretary
made each of the determinations in subparagraph
(A), including associated analyses,
assumptions, and information sources used to
make each such determination, and a description
of any key limitations or uncertainties that
could affect each determination; and
``(iv) publish the proposed rule and final
rule under subparagraph (A) in the Federal
Register and concurrently publish the record of
the consultations described in clause (ii) and
the descriptions described in clause (iii).
``(k) Construction.--Nothing in this section limits the authority
of the Secretary relating to the importation of prescription drugs,
including the Secretary's authority to refuse admission of a drug under
section 801(a), other than with respect to section 801(d)(1) as
provided in this section.
``(l) Effectiveness of Section.--
``(1) Commencement of program.--This section shall become
effective only if the Secretary certifies to Congress that the
implementation of this section will--
``(A) pose no additional risk to the public's
health and safety;
``(B) result in a significant reduction in the cost
of covered products to the American consumer; and
``(C) be subject to adequate and consistent
oversight by the Secretary.
``(m) Termination of Program.--If, after the date that is 1 year
after the effective date of the regulations under subsection (b) or
(j), the Secretary submits to Congress a certification that, in the
option of the Secretary, the benefits of implementation of either or
both such subsections do not outweigh any detriment of implementation
of such subsection or subsections and any regulations promulgated
thereunder, such subsection or subsections shall cease to be effective
as of the date that is 30 days after the date on which the Secretary
submits the certification.
``(n) Authorization of Appropriations.--There are authorized to be
appropriated such sums as are necessary to carry out this section.''.
(b) Requirement.--The Secretary of Health and Human Services shall
reissue, or amend, as appropriate, the regulations published at part
251 of title 21 of the Code of Federal Regulations pursuant to section
804(b) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 384(b)),
as in effect on the day before the date of enactment of this Act.
SEC. 907. IMPROVING INFORMATION TECHNOLOGY SYSTEMS OF THE FOOD AND DRUG
ADMINISTRATION.
(a) FDA Strategic Information Technology Plan.--
(1) In general.--Not later than September 30, 2023, and at
least every 4 years thereafter, the Secretary of Health and
Human Services shall develop and submit to the appropriate
committees of Congress and post on the website of the Food and
Drug Administration, a coordinated information technology
strategic plan to modernize the information technology systems
of the Food and Drug Administration. Each such report shall be
known as the ``Food and Drug Administration Strategic
Information Technology Plan.''. The first such report may
include the Data and Technology Modernization Strategy, as set
forth in the letters described in section 101(b) of the Food
and Drug Administration Safety and Landmark Advancements Act of
2022.
(2) Content of strategic plan.--The Food and Drug
Administration Strategic Information Technology Plan under
paragraph (1) shall include--
(A) agency-wide strategic goals and priorities for
modernizing the information technology systems of the
Food and Drug Administration to maximize the efficiency
and effectiveness of such systems for enabling the Food
and Drug Administration to fulfill its public health
mission;
(B) specific activities and strategies for
achieving the goals and priorities identified under
subparagraph (A), and specific milestones, metrics, and
performance measures for assessing progress against the
strategic goals and priorities in subparagraph (A);
(C) specific activities and strategies for
improving and streamlining internal coordination and
communication within the Food and Drug Administration,
including for activities and communications related to
signals of potential public health concerns;
(D) challenges and risks the Food and Drug
Administration will face in meeting its strategic goals
and priorities, and the activities the Food and Drug
Administration will undertake to overcome those
challenges and mitigate those risks;
(E) the ways in which the Food and Drug
Administration will use the plan to guide and
coordinate the projects and activities of the Food and
Drug Administration across its offices and centers; and
(F) a skills inventory, needs assessment, gap
analysis, and initiatives to address skills gaps as
part of a strategic approach to information technology
human capital planning.
(3) Evaluation of progress.--Each Food and Drug
Administration Strategic Information Technology Plan issued
pursuant to this subsection, with the exception of the first
such Food and Drug Administration Strategic Information
Technology Plan, shall include an evaluation of--
(A) the progress the Secretary has made, based on
the metrics, benchmarks, and other milestones that
measure successful development and implementation of
information technology systems; and
(B) whether such actions improved the capacity of
the Food and Drug Administration to achieve the
strategic goals and priorities set forth in the
previous Food and Drug Administration Strategic
Information Technology Plan.
(b) GAO Report.--
(1) In general.--Not later than September 30, 2026, the
Comptroller General of the United States shall submit to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives a report assessing the implementation of the
Food and Drug Administration Strategic Information Technology
Plan adopted pursuant to subsection (a).
(2) Content of report.--The report required under paragraph
(1) shall include an assessment of--
(A) the development and implementation of the Food
and Drug Administration Strategic Information
Technology Plan, including the sufficiency of the plan,
progress of the Food and Drug Administration in meeting
the results-oriented goals, milestones, and performance
measures identified in such plan and any gaps in such
implementation;
(B) the efficiency and effectiveness of the Food
and Drug Administration's expenditures on information
technology systems over the preceding 10 fiscal years,
including the implementation by the Food and Drug
Administration of the Technology Modernization Action
Plan and Data Modernization Action Plan;
(C) challenges posed by the information technology
systems of the Food and Drug Administration for
carrying out the Food and Drug Administration's public
health mission, including on meeting user fee agreement
performance goals, conducting inspections, responding
to identified safety concerns, and keeping pace with
new scientific and medical advances; and
(D) recommendations for the Food and Drug
Administration to address the identified challenges,
improve its implementation of the Food and Drug
Administration Strategic Information Technology Plan,
and to otherwise improve the Food and Drug
Administration's information technology systems.
SEC. 908. REGULATION OF CERTAIN PRODUCTS AS DRUGS.
Section 503 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
353) is amended by adding at the end the following:
``(h) Deeming Certain Products as Drugs.--
``(1) In general.--Any contrast agent, radioactive drug,
OTC monograph drug, or ophthalmic drug article shall be deemed
to be a drug under section 201(g) and not a device under
section 201(h).
``(2) Definitions.--For purposes of this subsection--
``(A) the term `contrast agent' means an article
that is intended for use in conjunction with a medical
imaging device, and that--
``(i) is a diagnostic radiopharmaceutical,
as defined in section 315.2 and 601.31 of title
21, Code of Federal Regulations (or any
successor regulations), including PET drugs, as
defined in section 212.1 of title 21, Code of
Federal Regulations (or any successor
regulations) and positron emission tomography
radiotracers; or
``(ii) is a diagnostic agent that improves
the visualization of structure or function
within the body by increasing the relative
difference in signal intensity within the
target tissue, structure, or fluid;
``(B) the term `ophthalmic drug article' means any
eye cup, eye dropper, or other similar dispenser
intended for ophthalmic use if packaged with the drug
with which such article is intended to be used;
``(C) the term `OTC monograph drug' has the meaning
given such term in section 744L; and
``(D) the term `radioactive drug' has the meaning
given such term in section 310.3(n) of title 21, Code
of Federal Regulations (or any successor regulations),
except that such term does not include--
``(i) implants or articles similar to an
implant;
``(ii) articles that apply radiation from
outside of the body; or
``(iii) the radiation source of an article
described in clause (i) or (ii).
``(3) Rule of construction.--Nothing in this subsection
shall be construed as allowing for the classification of a
product as a drug (as defined in section 201(g)) if such
product--
``(A) is not described in paragraph (1); and
``(B) meets the definition of a device under
section 201(h), unless another provision of this Act
otherwise indicates a different classification.
``(4) Fees.--The Secretary shall waive the application fee
under sections 736 and 744B for applications for products that
are, on the date of enactment of the Food and Drug
Administration Safety and Landmark Advancements Act of 2022,
legally marketed as medical devices and that are deemed drugs
pursuant to paragraph (1).''.
SEC. 909. REPORTING ON MAILROOM AND OFFICE OF THE EXECUTIVE SECRETARIAT
OF THE FOOD AND DRUG ADMINISTRATION.
(a) Report.--Not later than 90 days after the date of enactment of
this Act, the Secretary of Health and Human Services (referred to in
this section as the ``Secretary'') shall report to the Committee on
Health, Education, Labor, and Pensions of the Senate and the Committee
on Energy and Commerce of the House of Representatives on--
(1) information related to policies, procedures, and
activities of the mailroom and the Office of the Executive
Secretariat of the Food and Drug Administration, including--
(A) taking receipt, tracking, managing, and
prioritizing confidential informant complaints;
(B) taking receipt of common carrier packages to
the Food and Drug Administration;
(C) the organizational structure and management of
the mailroom;
(D) the organizational structure and management of
the Office of the Executive Secretariat;
(E) the total number of employees and contractors
in the mailroom including those working remotely and
those working in person;
(F) the total number of employees and contractors
in the Office of the Executive Secretariat;
(G) the number of vacant positions in the mailroom;
(H) the number of vacant positions in the Office of
the Executive Secretariat;
(I) the average number of days for response to
correspondence received by the Office of the
Secretariat;
(J) the extent to which there is a backlog of
common carrier packages received by the mailroom and
the number of common carrier packages in any backlog;
(K) the extent to which there is a backlog of
correspondence in the Office of the Executive
Secretariat that has not been appropriately responded
to by the Food and Drug Administration and the number
of correspondence or common carrier packages in any
backlog;
(L) a rationale for the failure of the Office of
the Executive Secretariat to respond to correspondence
in any backlog and the position of the decision-making
official who determined not to respond to such
correspondence;
(M) the number of whistleblower correspondence
received, including within each agency center;
(N) the amount of resources expended for the
mailroom, including a breakdown of budget authority and
user fee dollars;
(O) the amount of resources expended for the Office
of the Executive Secretariat and correspondence-related
activities, including a breakdown of budget authority
and user fee dollars; and
(P) the performance of third-party contractors
responsible for correspondence-related activities with
respect to the receipt and tracking of correspondence,
and efforts by the Food and Drug Administration to
improve performance by such contractors; and
(2) the development and implementation of new or revised
policies and procedures of the Food and Drug Administration to
monitor and ensure--
(A) the effective receipt, tracking, managing, and
prioritization of such complaints; and
(B) the effective receipt of common carrier
packages to the Food and Drug Administration.
(b) Quarterly Reporting.-- Beginning on the date of enactment of
this Act, the Secretary shall issue a report each quarter through
September 30, 2024, to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce of the
House of Representatives on the implementation of the new or revised
policies of the Food and Drug Administration reported under subsection
(a)(2), and since such implementation--
(1) the volume of incoming common carrier packages to the
mailroom;
(2) the volume of incoming correspondence to the Office of
the Executive Secretariat;
(3) the extent to which new backlogs occur in the
processing of common carrier packages received by the mailroom;
(4) the extent to which new backlogs occur in the
processing of correspondence received by the Office of the
Executive Secretariat;
(5) the length of time required to resolve each such
backlog;
(6) any known issues of unreasonable delays in
correspondence being provided to the intended recipient, or in
correspondence being lost, and the measures taken to remedy
such delays or lost items;
(7) the average number of days it takes to respond to
correspondence received by the Office of the Executive
Secretariat;
(8) the resources expended by the mailroom, including a
breakdown of budget authority and user fee dollars; and
(9) the resources expended by the Office of the Executive
Secretariat on correspondence-related activities, including a
breakdown of budget authority and user fee dollars.
(c) GAO Report.--Not later than 18 months after the date of
enactment of this Act, the Comptroller General of the United States
shall submit to the Committee on Health, Education, Labor, and Pensions
of the Senate and the Committee on Energy and Commerce of the House of
Representatives a report assessing the policies and practices of the
Division of Executive Operations of the Office of the Executive
Secretariat of the Food and Drug Administration with respect to the
receipt, tracking, managing, and prioritization of correspondence.
SEC. 910. PROTECTING INFANTS AND IMPROVING FORMULA SUPPLY.
(a) Definitions.--
(1) In general.--In this section--
(A) the term ``infant formula'' has the meaning
given such term in section 201 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 321); and
(B) the term ``Secretary'' means the Secretary of
Health and Human Services.
(2) Critical food.--Section 201 of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 321), as amended by section 822, is
further amended by adding at the end the following:
``(tt) The term `critical food' means a food that--
``(1) is an infant formula;
``(2) is a medical food, as defined in section 5(b)(3) of
the Orphan Drug Act; or
``(3) is intended for use by individuals with certain
inborn errors of metabolism or other conditions requiring a
medical food.''.
(b) Office of Critical Foods.--
(1) In general.--The Secretary shall establish within the
Center for Food Safety and Applied Nutrition an office to be
known as the Office of Critical Foods. The Secretary shall
appoint a Director to lead such Office.
(2) Duties.--The Office of Critical Foods shall be
responsible for oversight, coordination, and facilitation of
activities related to critical foods, as defined in section
201(tt) of the Federal Food, Drug, and Cosmetic Act, as added
by subsection (a)(2), and any other food determined by the
Secretary to be critical.
(c) Premarket Submissions of Infant Formula to Address Shortages.--
Section 412 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
350a) is amended by adding at the end the following:
``(j) Premarket Submissions to Address Shortages.--
``(1) In general.--The Secretary shall waive the 90 day
premarket submission requirement under section 412(c) and apply
a 30-day premarket submission requirement, for any person who
intends to introduce or deliver for introduction into
interstate commerce any new infant formula.
``(2) Effective period.--The waiver authority under this
subsection shall remain in effect for 90 days beginning on the
date that the Secretary distributes information under section
424(a)(2), or such longer period as the Secretary determines
appropriate to prevent or mitigate a shortage of infant
formula.
``(3) Report.--Not later than one year after the date of
enactment of the Food and Drug Administration Safety and
Landmark Advancements Act of 2022, the Secretary shall submit a
report to the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce
of the House of Representatives that includes--
``(A) the number of premarket submissions for new
infant formula the Secretary has received under
subsection (d) each year since 2012;
``(B) how many of such submissions received
requests from the Secretary for additional information;
``(C) how long after receiving such submissions the
Secretary sent such requests for additional
information;
``(D) what additional information the Secretary
requested of the persons submitting such submissions;
and
``(E) the date each new infant formula product
described in subparagraph (A) was first marketed, if
available.''.
(d) Infant Formula Flexibilities.--The Secretary shall publish a
list on the website of the Food and Drug Administration detailing which
infant formula products may be appropriate substitutes for infant
formula products in shortage that are relied upon by infants and other
individuals with amino-acid and metabolic conditions.
(e) International Harmonization of Infant Formula Requirements.--
(1) In general.--The Secretary--
(A) shall participate in meetings with
representatives from other countries to discuss methods
and approaches to harmonizing regulatory requirements
for infant formula, including with respect to
inspections, labeling, and nutritional requirements;
and
(B) may enter into agreements regarding such
requirements with other countries, as appropriate.
(2) Study on infant formula.--
(A) In general.--Not later than 60 days after the
date of enactment of this Act, the Secretary shall seek
to enter into an agreement with the National Academies
of Sciences, Engineering, and Medicine (referred to in
this paragraph as the ``National Academies'') to
examine and report on challenges in supply, market
competition, and regulation of infant formula in the
United States.
(B) Requirements of foreign countries.--The report
developed pursuant to the agreement under subparagraph
(A) shall assess and evaluate infant formula marketed
in the United States, any challenges in supply, market
competition, and any differences in infant formula
marketed in the European Union, including with respect
to nutritional content and applicable labeling and
other regulatory requirements.
(C) Final report.--The agreement under subparagraph
(A) shall specify that the National Academies shall,
not later than 1 year after the date of enactment of
this Act, complete such study and submit a report on
the results of such study to the Committee on Health,
Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of
Representatives.
(f) Transparency and Accountability to Support Infant Formula
Innovation.--
(1) Congressional notification of recall.--
(A) In general.--Not later than 24 hours after the
initiation of a recall of infant formula as described
in section 412(e) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 350e(e)), the Secretary of
Health and Human Services, acting through the
Commissioner of Food and Drugs, shall submit to
Congress a notification of such recall.
(B) Contents.--A notification under subparagraph
(A) shall include the following:
(i) If the recall is required by the Food
and Drug Administration, a summary of the
determination of a case of adulterated or
misbranded infant formula that presents a risk
to human health.
(ii) If the recall is voluntarily initiated
by the manufacturer, a summary of the
information provided to the Food and Drug
Administration by the manufacturer regarding
infant formula that has left the control of the
manufacturer that may be adulterated or
misbranded.
(iii) Specification of when the Food and
Drug Administration was first made aware of the
instance or circumstances surrounding the
recall.
(iv) An initial estimate of the disruption
in domestic production that may result from the
recall.
(2) Annual report to congress.--Section 412 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 350a), as amended by
subsection (c), is further amended by adding at the end the
following:
``(k) Annual Report to Congress.--
``(1) In general.--Not later than March 30 of each year,
the Secretary shall submit a report to Congress containing,
with respect to the preceding calendar year, the following
information:
``(A) The number of submissions received by the
Secretary under subsection (d).
``(B) The number of submissions that included any
new ingredients that were not included in any infant
formula already on the market.
``(C) The number of inspections conducted by the
Food and Drug Administration or any agent thereof to
evaluate compliance with the requirements for infant
formulas under subsection (b)(2).
``(D) The time between any inspection referred to
in subparagraph (C) and any necessary reinspection to
evaluate compliance with the requirements for infant
formulas under subsection (b)(2).
``(E) A breakdown of the information described in
subparagraphs (A) through (D) between foreign and
domestic manufacturers and facilities.
``(2) Confidentiality.--The Secretary shall ensure that the
reports under paragraph (1) do not include any information that
is a trade secret or confidential information subject to
section 552(b)(4) of title 5, United States Code, or section
1905 of title 18, United States Code.''.
(3) Marketing submissions.--Section 412 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 350a), as amended by
paragraph (2), is further amended by adding at the end the
following:
``(l) Marketing Submissions.--
``(1) In general.--Subject to paragraph (2), the Secretary
shall respond to a submission under subsection (d) for infant
formula not later than 65 days after receiving such submission.
``(2) Expedited response.--The Secretary shall respond to a
submission under subsection (d) for infant formula not later
than 45 days after receiving such notification if it--
``(A) is submitted by a manufacturer that is not
already marketing infant formula in the United States;
or
``(B) is a new infant formula, as defined in
subsection (c)(2).''.
(4) List of nutrients.--Section 412(i)(1) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 350a(i)) is amended by
striking ``or, if revised by the Secretary under paragraph (3),
as so revised'' and inserting the following: ``, which shall be
reviewed by the Secretary every 4 years as appropriate. In
reviewing such table, the Secretary shall consider any new
scientific data or information related to infant formula
nutrients, including international infant formula standards.
The Secretary may revise the list of nutrients and the required
level for any nutrient required by the table''.
(5) Technical correction.--Section 412(c)(1)(B) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 350a(c)(1)(B))
is amended by striking ``subsection (c)(1)'' and inserting
``subsection (d)(1)''.
(g) Response to Recall.--
(1) Manufacturer submission.--
(A) In general.--Promptly after the initiation of a
recall of infant formula, the manufacturer of the
recalled infant formula shall submit information to the
Secretary regarding such recall.
(B) Contents.--A submission under subparagraph (A)
shall include the following:
(i) A plan (including an estimated
timeline, as applicable) of actions the
manufacturer will take, suited to the
individual circumstances of the particular
recall, including--
(I) to identify and address any
cause of adulteration or misbranding;
and
(II) if appropriate, to restore
operation of the impacted facilities.
(ii) In the case that a recall of the
manufacturer's infant formula products, and
subsequent actions to respond to such recall,
impacts over 10 percent of the production of
the infant formula intended for sale in the
United States, a plan to backfill the supply of
the manufacturer's infant formula supply if the
current domestic supply of such infant formula
has fallen, or is expected to fall, below the
expected demand for the formula.
(2) Report to congress.--
(A) In general.--Promptly after a submission under
paragraph (1) is received, the Secretary shall provide
such submission, together with the information
specified in subparagraph (B), in a report to the
Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of
the House of Representatives.
(B) Contents.--A submission under subparagraph (A)
shall include the following:
(i) Information concerning the current
domestic supply of infant formula, including--
(I) a breakdown of the specific
types of formula involved; and
(II) an estimate of how long
current supplies will last.
(ii) In the case that a submission or
submissions under paragraph (1) show that the
recall and subsequent actions to respond to the
recall impact over 10 percent of the domestic
production of infant formula intended for sale
in the United States--
(I) actions to work with the
impacted manufacturer or other
manufacturers to increase production;
and
(II) specification of--
(aa) any additional
authorities needed regarding
production or importation to
fill a supply gap; and
(bb) any supplemental
funding necessary to address
the shortage.
(3) Sunset.--This subsection shall cease to have force or
effect on of September 30, 2026.
(h) Coordination With Manufacturer.--
(1) In general.--
(A) Communication following inspection.--Upon
completing an inspection of an infant formula
manufacturing facility impacted by a recall, the
Secretary, acting through the Commissioner of Food and
Drugs, shall provide the manufacturer involved a list
of any actions necessary to--
(i) address deficiencies contributing to
the potential adulteration or misbranding of
product at the facility; and
(ii) safely restart production at the
facility.
(B) Response to manufacturer.--Not later than 7
days after receiving a written communication from a
manufacturer of infant formula regarding safely
restoring production following a recall of such
product, the Secretary, acting through the Commissioner
of Food and Drugs, shall provide a substantive response
to such communication, including any necessary next
steps.
(2) Inspections.--The Secretary shall ensure timely
communication with a manufacturer of infant formula following
an inspection of a facility engaged in the manufacturing of
infant formula for consumption in the United States. If a
reinspection of a manufacturer of an infant formula is required
to ensure that such manufacturer completed any remediation
actions or addressed any deficiencies, the Secretary shall
reinspect such facility in a timely manner. The Secretary shall
prioritize and expedite an inspection or reinspection of an
establishment that could help mitigate or prevent a shortage of
an infant formula.
(3) Annual inspections.--Not later than 6 months after the
date of enactment of this Act, and not less than once per
calendar year thereafter, the Secretary shall conduct
inspections, including unannounced inspections, of the
facilities (including foreign facilities) of each manufacturer
of an infant formula required to be registered under section
412(c)(1)(A) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 350a(c)(1)(A)), in accordance with a risk based approach
and ensure timely and effective internal coordination and
alignment among the investigators and the Center for Food
Safety and Applied Nutrition.
(i) National Strategy on Infant Formula.--
(1) In general.--The Secretary, in consultation with the
Secretary of Agriculture and other heads of relevant
departments and agencies, shall develop and issue, not later
than 90 days after the date of enactment of this Act, a
national strategy on infant formula to increase the resiliency
of the infant formula supply chain, protect against future
contamination and other potential causes of shortages, and
ensure parents and caregivers have access to formula and
information they need.
(2) National strategy.--The national strategy under
paragraph (1) shall--
(A) increase the resiliency of the infant formula
supply chain in the short-term by--
(i) assessing causes of the current
shortage and potential causes of future
shortages,
(ii) assessing and addressing immediate
infant formula needs associated with the
shortage, and
(iii) developing a plan to increase infant
formula supply, including through increased
competition;
(B) improve preparedness against infant formula
shortages in the long-term by--
(i) outlining methods to improve
information-sharing between the Federal
Government and State and local governments, and
other entities as appropriate, regarding
shortages;
(ii) recommending measures for protecting
the integrity of infant formula supply and
preventing contamination;
(iii) outlining methods to incentivize new
infant formula manufacturers to increase supply
and mitigate future shortages; and
(iv) recommending other necessary
authorities to gain insight into the supply
chain and risk for shortages, and to
incentivize new infant formula manufacturers;
and
(C) ensure the development and updating of
education and communication materials for parents and
caregivers that cover--
(i) where and how to find infant formula;
(ii) comparable infant formulas on the
market,
(iii) what to do if a medical or specialty
infant formula is unavailable;
(iv) safe practices for handling infant
formula; and
(v) other topics, as appropriate.
(j) Meaningful Disruption in the Production of Critical Food.--
Chapter IV of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 341
et seq.) is amended by adding at the end the following:
``SEC. 424. REQUIREMENTS FOR CRITICAL FOOD.
``(a) Notification of Meaningful Disruption for Critical Food.--
``(1) In general.--A manufacturer of a critical food (as
defined in section 201(tt)) shall notify the Secretary of a
permanent discontinuance in the manufacture or an interruption
of the manufacture of such food that is likely to lead to a
meaningful disruption in the supply of such food in the United
States, and the reasons for such discontinuance or
interruption, as soon as practicable, but not later than 5
business days after such discontinuance or such interruption.
``(2) Distribution of information.--Not later than 5
calendar days after receiving a notification under paragraph
(1), the Secretary shall distribute, to the Secretary of
Agriculture and to the maximum extent practicable to the
appropriate entities, as determined by the Secretary through
such means as the Secretary determines appropriate, information
on the meaningful disruption of a critical food reported under
this subsection.
``(3) Confidentiality.--Nothing in this subsection
authorizes the Secretary to disclose any information that is a
trade secret or confidential information subject to section
552(b)(4) of title 5, United States Code, or section 1905 of
title 18, United States Code.
``(4) Meaningful disruption.--In this subsection, the term
`meaningful disruption'--
``(A) means a change in production that is
reasonably likely to lead to a significant reduction in
the supply of a critical food by a manufacturer that
affects the ability of the manufacturer to meet
expected demand for its product; and
``(B) does not include interruptions in
manufacturing due to matters such as routine
maintenance or insignificant changes in manufacturing
so long as the manufacturer expects to resume
operations in a short period of time.
``(b) Risk Management Plans.--Each manufacturer of a critical food
shall develop, maintain, and implement, as appropriate, a redundancy
risk management plan that identifies and evaluates risks to the supply
of the food, as applicable, for each establishment in which such food
is manufactured. A risk management plan under this subsection--
``(1) may identify and evaluate risks to the supply of more
than one critical food, or critical food category, manufactured
at the same establishment; and
``(2) shall be subject to inspection and copying by the
Secretary pursuant to an inspection under section 704.
``(c) Failure to Meet Requirements.--
``(1) In general.--If a person fails to submit information
required under, and in accordance with, subsection (a)--
``(A) the Secretary shall issue a letter to such
person informing such person of such failure; and
``(B) not later than 45 calendar days after the
issuance of a letter under subparagraph (A), subject to
paragraph (2), the Secretary shall make available to
the public on the website of the Food and Drug
Administration, with appropriate redactions made to
protect the information described in subsection
(a)(3)--
``(i) the letter issued under subparagraph
(A); and
``(ii) at the request of such person, any
response to such letter such person submitted
to the Secretary.
``(2) Exception.--If the Secretary determines that the
letter under paragraph (1) was issued in error or, after review
of such response, the person had a reasonable basis for not
submitting a notification as required under subsection (m), the
requirements of paragraph (1)(B) shall not apply.''.
(k) Specialty Infant Formula for Importation.--Section 412 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 350a), as amended by
subsection (f)(2), is further amended by adding at the end the
following:
``(m) Waiver of Requirements for Importation of Specialty Infant
Formula.--
``(1) In general.--The Secretary may, during a shortage of
specialty infant formula as determined by the Secretary, waive
any requirement under this Act applicable to facilitate the
importation of specialty infant formula. Such a waiver may be
applicable to--
``(A) the importation of specialty infant formula
from any country that is determined by the Secretary to
be implementing and enforcing requirements for infant
formula that provide a similar assurance of safety as
the regulatory requirements of this Act; or
``(B) the distribution and sale of such imported
specialty infant formula.
``(2) Rule of construction.--Nothing in paragraph (1) shall
be construed to limit the authority of the Secretary to require
a recall of, or otherwise impose restrictions and requirements
under this Act with respect to, specialty infant formula that
is subject to a waiver under paragraph (1).
``(3) Definition of specialty infant formula.--In this
subsection, the term `specialty infant formula' means infant
formula, including amino acid-based formula, intended for use
by individuals who have inborn errors of metabolism or low
birth weight, or who otherwise have unusual medical or dietary
problems.''.
(l) Importation for Personal Use.--
(1) In general.--Notwithstanding any other provision of
law, during the 90-day period beginning on the date of
enactment of this Act, a person may, without prior notice to
the Food and Drug Administration, import up to a 3-month supply
of infant formula for personal use from--
(A) Canada;
(B) any country in the European Union; or
(C) any other country that is determined by the
Secretary, acting through the Commissioner of Food and
Drugs, to have safety standards for infant formula
similar to such standards applicable under the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 301 et seq.).
(2) Limitations.--Infant formula may be imported pursuant
to paragraph (1) only if the infant formula--
(A) is exclusively for personal use and will not be
commercialized or promoted; and
(B) does not present an unreasonable risk to human
health.
(3) Reporting of adverse events.--If a health care provider
becomes aware of any adverse event which the health care
provider reasonably suspects to be associated with infant
formula imported pursuant to paragraph (1), the health care
provider shall report such adverse event to the Commissioner of
Food and Drugs.
(4) Public notice.--The Secretary, acting through the
Commissioner of Food and Drugs, shall post on the public
website of the Food and Drug Administration notice that--
(A) infant formula imported pursuant to paragraph
(1) may not have been manufactured in a facility that
has been inspected by the Food and Drug Administration;
(B) the labeling of such infant formula may not
meet the standards and other requirements applicable
with respect to infant formula under the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 301 et seq.); and
(C) the nutritional content of the infant formula
may vary from that of infant formula meeting such
standards and other requirements.
(5) Sense of congress.--It is the sense of Congress that
persons considering the personal importation of infant formula
should consult with their pediatrician about such importation.
SEC. 911. PREDETERMINED CHANGE CONTROL PLANS FOR DEVICES.
(a) In General.--Chapter V of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 351 et seq.) is amended by inserting after section 515B
(21 U.S.C. 360e-3) the following:
``SEC. 515C. PREDETERMINED CHANGE CONTROL PLANS FOR DEVICES.
``(a) Approved Devices.--
``(1) In general.--Notwithstanding section 515(d)(5)(A), a
supplemental application shall not be required for a change to
a device approved under section 515, if such change is
consistent with a predetermined change control plan that is
approved pursuant to paragraph (2).
``(2) Predetermined change control plan.--The Secretary may
approve a predetermined change control plan submitted in an
application, including a supplemental application, under
section 515 that describes planned changes that may be made to
the device (and that would otherwise require a supplemental
application under section 515), if the device remains safe and
effective without any change.
``(3) Scope.--The Secretary may require that a change
control plan include labeling required for safe and effective
use of the device as such device changes pursuant to such plan,
notification requirements if the device does not function as
intended pursuant to such plan, and performance requirements
for changes made under the plan.
``(b) Cleared Devices.--
``(1) In general.--Notwithstanding section 510(k), a
premarket notification shall not be required for a change to a
device cleared under section 510(k), if such change is
consistent with an established predetermined change control
plan granted pursuant to paragraph (2).
``(2) Predetermined change control plan.--The Secretary may
clear a predetermined change control plan submitted in a
notification submitted under section 510(k) that describes
planned changes that may be made to the device (and that would
otherwise require a new notification), if--
``(A) the device remains safe and effective without
any such change; and
``(B) the device would remain substantially
equivalent to the predicate.
``(3) Scope.--The Secretary may require that a change
control plan include labeling required for safe and effective
use of the device as such device changes pursuant to such plan,
notification requirements if the device does not function as
intended pursuant to such plan, and performance requirements
for changes made under the plan.
``(c) Predicate Devices.--In making a determination of substantial
equivalence pursuant to section 513(i), the Secretary shall not compare
a device to changed versions of a device implemented in accordance with
an established predetermined change control plan as a predicate device.
Only the version of the device cleared or approved, prior to changes
made under the predetermined change control plan, may be used by a
sponsor as a predicate device.''.
(b) Conforming Amendments.--
(1) Cleared devices.--Section 510(l)(1) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360(l)(1)) is amended,
in the first sentence, by inserting ``, or with respect to a
change that is consistent with a predetermined change control
plan cleared under section 515C'' before the period at the end.
(2) Approved devices.--Section 515(d)(5)(A)(i) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C.
360e(d)(5)(A)(i)) is amended by striking ``A supplemental'' and
inserting ``Unless the change is consistent with a
predetermined change control plan approved under section 515C,
a supplemental''.
(3) Documentation of rationale for significant decisions.--
Section 517A(a)(1) of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 360g-1(a)(1)) is amended to read as follows:
``(1) In general.--The Secretary shall provide a
substantive summary of the scientific and regulatory rationale
for any significant decision of the Center for Devices and
Radiological Health regarding submission or review of a report
under section 510(k), a petition for classification under
section 513(f), an application under section 515, or an
application for an exemption under section 520(g), including
documentation of significant controversies or differences of
opinion and the resolution of such controversies or differences
of opinion.''.
SEC. 912. PROHIBITION AGAINST FOOD PACKAGING CONTAINING INTENTIONALLY
ADDED PFAS.
(a) In General.--Section 301 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 331), as amended by section 824(a), is further
amended by adding at the end the following:
``(mmm)(1) The introduction or delivery for introduction into
interstate commerce of food packaging containing intentionally added
PFAS.
``(2) The term `PFAS' means a perfluoroalkyl substance or a
polyfluoroalkyl substance that is man-made with at least 1 fully
fluorinated carbon atom.''.
(b) Applicability.--The amendment made by subsection (a) applies
beginning on January 1, 2024.
SEC. 913. REQUIREMENTS REGARDING CONFLICTS OF INTEREST.
(a) Ongoing Reporting of Contractor Conflicts of Interest.--
(1) In general.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall
require entities that contract with the Food and Drug
Administration--
(A) to disclose, on an ongoing basis during the
term of the contract, any information related to
potential and actual conflicts of interest, including
conflicts of interest concerning the contractor's
personnel, consultants, and subcontractors; and
(B) during the term of the contract, to refrain
from entering into consulting or other contractual
arrangements with any person to perform work that may
reasonably create a potential or actual conflict of
interest, without receiving the written approval of the
contracting officer before the execution of the
contractual arrangement.
(2) Regulations.--Not later than 18 months after the date
of enactment of this Act, the Secretary, in consultation with
the Federal Acquisition Regulatory Council, shall issue
regulations to carry out paragraph (1).
(b) Restrictions on FDA Contractors.--
(1) Prohibition against certain contracts.--
(A) In general.--Subject to subparagraph (B), the
Secretary shall not award a contract relating to the
duties of the Food and Drug Administration to any
person providing consulting services (referred to in
this subsection as a ``consulting firm'') unless such
contract provides that, during the restricted period
described in subparagraph (C), subject to subparagraph
(B), no individual employee or subcontractor of such
consulting firm may provide services to both--
(i) the Food and Drug and Administration
under the consulting firm's contract; and
(ii)(I) a person engaged in the development
or manufacturing of a device, drug, or
biological product; or
(II) any other private entity engaged in
activities regulated by the Food and Drug
Administration.
(B) Exception.--
(i) In general.--The Secretary may issue an
exception to the requirement under subparagraph
(A) with respect to an employee or
subcontractor of a consulting firm only if the
Secretary or designee determines in writing
that there is a compelling reason to award a
contract with such consulting firm with such
exception. The Secretary shall not delegate the
authority to issue exceptions under this clause
below the level of head of a contracting
activity.
(ii) Reporting.--Not later than 14 days
after issuing an exception under clause (i),
the Secretary shall publish, on the website of
the Food and Drug Administration, a
notification of the exception. Such
notification shall be made publicly available
in an easily accessible format, and shall
include--
(I) the name of the contract;
(II) the consulting firm receiving
the exception, and the employee or
subcontractor to whom the exception
applies;
(III) the other contracts or
clients that would, in the absence of
the exception, cause the consulting
firm to be in violation of subparagraph
(A); and
(IV) the efforts that the
consulting firm plans to take to
mitigate any potential or actual
conflict of interest arising from the
other work of its employees or
subcontractors.
(C) Restricted period.--
(i) In general.--For purposes of
subparagraph (A), the restricted period is the
period that--
(I) begins when the applicable
employee or subcontractor of the
consulting firm first provides services
under the consulting firm's contract;
and
(II) ends not less than the
applicable period specified in clause
(ii) after the last date on which such
employee or subcontractor provides
services under the consulting firm's
contract.
(ii) Applicable period specified.--For
purposes of clause (i)(II), the applicable
period specified in this clause is--
(I) 30 days; or
(II) such longer period of time as
the Secretary may specify after
consultation with the Federal
Acquisition Regulatory Council, which
shall apply with respect to all
exceptions issued under subparagraph
(B).
(2) Regulations.--Not later than 18 months after the date
of enactment of this Act, the Secretary, in consultation with
the Federal Acquisition Regulatory Council, shall issue
regulations to carry out paragraph (1).
(c) Requirements Regarding Waivers Relating to Organizational
Conflicts of Interest.--
(1) In general.--The Secretary shall, not later than 14
days after awarding a contract relating to the Food and Drug
Administration, publish, on the website of the Food and Drug
Administration, a notification of any waiver of any
requirements regarding a potential or actual organizational
conflict of interest granted to the contractor. Such
notification shall be made publicly available in an easily
accessible format, and shall include the name of the contract,
the contractor receiving the waiver, the other contracts or
clients that created the potential or actual organizational
conflict of interest, and the efforts that the contractor plans
to take to mitigate the potential or actual organizational
conflict of interest.
(2) Regulations.--Not later than 18 months after the date
of enactment of this Act, the Secretary, in consultation with
the Federal Acquisition Regulatory Council, shall issue
regulations to carry out paragraph (1).
SEC. 914. THIRD PARTY DATA TRANSPARENCY.
(a) In General.--To the extent the Secretary of Health and Human
Services (referred to in this section as the ``Secretary'') seeks to
rely on any data, analysis, or other information or findings provided
by entities that has been funded in whole or in part by, or otherwise
performed under contract with, the Food and Drug Administration, in
regulatory decision-making with respect to devices, the Secretary
shall--
(1) request access to the datasets, inputs, clinical or
other assumptions, methods, analytical code, results, and other
components underlying or comprising the analysis, conclusions,
or other findings upon which the Secretary seeks to rely; and
(2) in the event that information described in paragraph
(1) is used to support regulatory decision-making, and as
otherwise appropriate, to the extent practicable, provide the
manufacturer or manufacturers subject to such decision a
summary of such information, subject to protection of
confidential commercial information or trade secret information
or personally identifiable information.
(b) Report.--Not later than September 30, 2023, and biennially
thereafter, the Secretary shall submit to the Committee on Health,
Education, Labor, and Pensions of the Senate and the Committee on
Energy and Commerce of the House of Representatives, and publish on the
website of the Food and Drug Administration, a report on the number of
postmarket device signals communications issued by the Secretary, the
sources of data for such signals, and how such signals were revised or
resolved.
SEC. 915. BANNED DEVICES.
(a) In General.--Section 516 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360f) is amended--
(1) in subsection (a)--
(A) in paragraph (1), by inserting ``for one or
more of its intended uses'' before the semicolon; and
(B) in the flush text following paragraph (2), by
inserting ``for any such intended use or uses'' before
the period; and
(2) by adding at the end the following:
``(c) Specific Devices.--Adverse conditioning devices, including
electrical stimulation devices, that apply a noxious electrical
stimulation to an individual's skin intended to reduce or cease self-
injurious or aggressive behavior are deemed to be banned devices, as
described in subsection (a), without the need for the Secretary to
promulgate a regulation with respect to such devices as described in
such subsection.''.
(b) Rule of Construction.--Nothing in this section shall be
construed to limit the authority of the Secretary of Health and Human
Services to amend, in accordance with section 516 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 360f) and chapter 5 of title 5,
United States Code, regulations promulgated pursuant to such section
516.
SEC. 916. DEVICE CYBERSECURITY.
(a) Guidance for Industry and FDA Staff on Device Cybersecurity.--
Not later than 2 years after the date of enactment of this Act, and
periodically thereafter as appropriate, the Secretary of Health and
Human Services (referred to in this section as the ``Secretary''), in
consultation with the Director of the Cybersecurity and Infrastructure
Security Agency, shall review and, as appropriate and after soliciting
and receiving feedback from device manufacturers, health care
providers, third party device servicers, patient advocates, and other
appropriate stakeholders, update the guidance entitled ``Content of
Premarket Submissions for Management of Cybersecurity in Medical
Devices'' (or a successor document).
(b) Resources Regarding Cybersecurity of Devices.--Not later than
180 days after the date of enactment of this Act, and not less than
annually thereafter, the Secretary shall update public information
provided by the Food and Drug Administration, including on the website
of the Food and Drug Administration, with information regarding
improving cybersecurity of devices. Such information shall include
information on identifying and addressing cyber vulnerabilities for
health care providers, health systems, and device manufacturers, and
how such entities may access support through the Cybersecurity and
Infrastructure Security Agency and other Federal entities, including
the Department of Health and Human Services, to improve cybersecurity
of devices.
(c) GAO Report.--Not later than 1 year after the date of enactment
of this Act, the Comptroller General of the United States shall publish
a report identifying challenges in cybersecurity for devices, including
legacy devices that may not support certain software security updates.
Through such report, the Comptroller General shall examine--
(1) challenges for device manufacturers, health care
providers, health systems, and patients in accessing Federal
support to address vulnerabilities across Federal agencies;
(2) how Federal agencies can strengthen coordination to
better support cybersecurity for devices; and
(3) statutory limitations and opportunities for improving
cybersecurity for devices.
(d) Definition.--In this section, the term ``device'' has the
meaning given such term in section 201(h) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 321(h)).
SEC. 917. WOMEN'S HEALTH RESEARCH ROADMAP.
Not later than 2 years after the date of enactment of this Act, the
Office of Women's Health of the Food and Drug Administration,
established under section 1011 of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 399b), shall--
(1) review and, as appropriate, update the Women's Health
Research Roadmap issued in December 2015; and
(2) brief the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Energy and Commerce
of the House of Representatives on the review and, as
appropriate, any resulting update.
SEC. 918. GAO REPORT ON DEATHS DUE TO THE COST OF DRUGS IN THE UNITED
STATES.
Not later than 1 year after the date of enactment of this Act, the
Comptroller General of the United States shall publish a study on the
number of individuals in the United States who die each year because
they cannot afford to purchase the medicine prescribed by their health
care providers.
Calendar No. 444
117th CONGRESS
2d Session
S. 4348
_______________________________________________________________________
A BILL
To amend the Federal Food, Drug, and Cosmetic Act to revise and extend
the user-fee programs for prescription drugs, medical devices, generic
drugs, and biosimilar biological products, and for other purposes.
_______________________________________________________________________
July 13, 2022
Reported with an amendment