[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5371 Engrossed in House (EH)]
<DOC>
119th CONGRESS
1st Session
H. R. 5371
_______________________________________________________________________
AN ACT
Making continuing appropriations and extensions for fiscal year 2026,
and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Continuing Appropriations and
Extensions Act, 2026''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. SHORT TITLE.
Sec. 2. TABLE OF CONTENTS.
Sec. 3. REFERENCES.
DIVISION A--CONTINUING APPROPRIATIONS ACT, 2026
DIVISION B--MISCELLANEOUS EXTENSIONS
DIVISION C--HEALTH EXTENDERS
Title I--Public Health Extenders
Title II--Medicare
Title III--Human Services
Title IV--Medicaid
Title V--Food and Drug Administration
Title VI--No Surprises Act Implementation
DIVISION D--DEPARTMENT OF VETERANS AFFAIRS EXTENDERS
Title I--Health Care Matters
Title II--Benefits
Title III--Housing
Title IV--Other Matters
DIVISION E--MISCELLANEOUS
SEC. 3. REFERENCES.
Except as expressly provided otherwise, any reference to ``this
Act'' contained in any division of this Act shall be treated as
referring only to the provisions of that division.
DIVISION A--CONTINUING APPROPRIATIONS ACT, 2026
The following sums are hereby appropriated, out of any money in
the Treasury not otherwise appropriated, and out of applicable
corporate or other revenues, receipts, and funds, for the several
departments, agencies, corporations, and other organizational units of
Government for fiscal year 2026, and for other purposes, namely:
Sec. 101. Such amounts as may be necessary, at a rate for
operations as provided in the applicable appropriations Acts for fiscal
year 2025 and under the authority and conditions provided in such Acts,
for continuing projects or activities (including the costs of direct
loans and loan guarantees) that are not otherwise specifically provided
for in this Act, that were conducted in fiscal year 2025, and for which
appropriations, funds, or other authority were made available in the
Full-Year Continuing Appropriations Act, 2025 (division A of Public Law
119-4), except sections 1110, 1113, 1114, and 1207; the proviso in
paragraph (4) of section 1602; and sections 1708 and 1808; and except
section 11104 shall be applied by substituting ``2020, and 2021'' for
``and 2020''; and except sections 774 and 778 of division B, section
540 of division C, and sections 110 and 112 of division D of Public Law
118-42 as continued in effect by section 1101 of division A of Public
Law 119-4; and except section 7069(b) of division F of Public Law 118-
47, as continued in effect by section 1101 of division A of Public Law
119-4.
Sec. 102. (a) No appropriation or funds made available or authority
granted pursuant to section 101 for the Department of Defense shall be
used for:
(1) the new production of items not funded for production
in fiscal year 2025 or prior years;
(2) the increase in production rates above those sustained
with fiscal year 2025 funds; or
(3) the initiation, resumption, or continuation of any
project, activity, operation, or organization (defined as any
project, subproject, activity, budget activity, program
element, and subprogram within a program element, and for any
investment items defined as a P-1 line item in a budget
activity within an appropriation account and an R-1 line item
that includes a program element and subprogram element within
an appropriation account) for which appropriations, funds, or
other authority were not available during fiscal year 2025.
(b) No appropriation or funds made available or authority granted
pursuant to section 101 for the Department of Defense shall be used to
initiate multi-year procurements utilizing advance procurement funding
for economic order quantity procurement unless specifically
appropriated later.
Sec. 103. Appropriations made by section 101 shall be available to
the extent and in the manner that would be provided by the pertinent
appropriations Act.
Sec. 104. Except as otherwise provided in section 102, no
appropriation or funds made available or authority granted pursuant to
section 101 shall be used to initiate or resume any project or activity
for which appropriations, funds, or other authority were not available
during fiscal year 2025.
Sec. 105. Appropriations made and authority granted pursuant to
this Act shall cover all obligations or expenditures incurred for any
project or activity during the period for which funds or authority for
such project or activity are available under this Act.
Sec. 106. Unless otherwise provided for in this Act or in the
applicable appropriations Act for fiscal year 2026, appropriations and
funds made available and authority granted pursuant to this Act shall
be available until whichever of the following first occurs:
(1) The enactment into law of an appropriation for any
project or activity provided for in this Act.
(2) The enactment into law of the applicable appropriations
Act for fiscal year 2026 without any provision for such project
or activity.
(3) November 21, 2025.
Sec. 107. Expenditures made pursuant to this Act shall be charged
to the applicable appropriation, fund, or authorization whenever a bill
in which such applicable appropriation, fund, or authorization is
contained is enacted into law.
Sec. 108. Appropriations made and funds made available by or
authority granted pursuant to this Act may be used without regard to
the time limitations for submission and approval of apportionments set
forth in section 1513 of title 31, United States Code, but nothing in
this Act may be construed to waive any other provision of law governing
the apportionment of funds.
Sec. 109. Notwithstanding any other provision of this Act, except
section 106, for those programs that would otherwise have high initial
rates of operation or complete distribution of appropriations at the
beginning of fiscal year 2026 because of distributions of funding to
States, foreign countries, grantees, or others, such high initial rates
of operation or complete distribution shall not be made, and no grants
shall be awarded for such programs funded by this Act that would
impinge on final funding prerogatives.
Sec. 110. This Act shall be implemented so that only the most
limited funding action of that permitted in the Act shall be taken in
order to provide for continuation of projects and activities.
Sec. 111. (a) For entitlements and other mandatory payments whose
budget authority was provided in an appropriations Act specified in
section 101, for expenses authorized under section 324 of title 38,
United States Code, and for activities under the Food and Nutrition Act
of 2008, activities shall be continued at the rate to maintain program
levels under current law, under the authority and conditions provided
in the applicable appropriations Act, to be continued through the date
specified in section 106(3) of this Act.
(b) Notwithstanding section 106, obligations for mandatory payments
due on or about the first day of any month that begins after October
2025 but not later than 30 days after the date specified in section
106(3) may continue to be made, and funds shall be available for such
payments.
Sec. 112. Amounts made available under section 101 for civilian
personnel compensation and benefits in each department and agency may
be apportioned up to the rate for operations necessary to avoid
furloughs within such department or agency, consistent with the
applicable appropriations Act for fiscal year 2025, except that such
authority provided under this section shall not be used until after the
department or agency has taken all necessary actions to reduce or defer
non-personnel-related administrative expenses.
Sec. 113. Funds appropriated by this Act may be obligated and
expended notwithstanding section 10 of Public Law 91-672 (22 U.S.C.
2412), section 15 of the State Department Basic Authorities Act of 1956
(22 U.S.C. 2680), section 313 of the Foreign Relations Authorization
Act, Fiscal Years 1994 and 1995 (22 U.S.C. 6212), and section 504(a)(1)
of the National Security Act of 1947 (50 U.S.C. 3094(a)(1)).
Sec. 114. (a)(1) For each amount incorporated by reference in this
Act that was previously designated by the Congress as an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985, each provision of law
designating each such amount as an emergency requirement pursuant to
such section shall not apply.
(2) Each amount incorporated by reference in this Act that
was designated by the Congress as an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and
Emergency Deficit Control Act of 1985 in the following
provisions of law are designated by the Congress as an
emergency requirement pursuant to section 4001(a)(1) of S. Con.
Res. 14 (117th Congress), the concurrent resolution on the
budget for fiscal year 2022, and to legislation establishing
fiscal year 2026 budget enforcement in the House of
Representatives: section 11206(4) of division A of Public Law
119-4 and 7068(b) of division F of Public Law 118-47, as
continued in effect by section 1101 of division A of Public Law
119-4.
(b) Each amount incorporated by reference in this Act that was
previously designated by the Congress as being for disaster relief
pursuant to section 251(b)(2)(D) of the Balanced Budget and Emergency
Deficit Control Act of 1985 is designated by the Congress as being for
disaster relief pursuant to a concurrent resolution on the budget.
(c) Each amount incorporated by reference in this Act that was
previously designated in division B of Public Law 117-159, division J
of Public Law 117-58, or in section 443(b) of division G of Public Law
117-328 by the Congress as an emergency requirement pursuant to a
concurrent resolution on the budget shall continue to be treated as an
amount specified in section 103(b) of division A of Public Law 118-5.
Sec. 115. (a) Rescissions or cancellations of discretionary budget
authority that continue pursuant to section 101 in Treasury
Appropriations Fund Symbols (TAFS)--
(1) to which other appropriations are not provided by this
Act, but for which there is a current applicable TAFS that does
receive an appropriation in this Act; or
(2) which are no-year TAFS and receive other appropriations
in this Act,
may be continued instead by reducing the rate for operations otherwise
provided by section 101 for such current applicable TAFS, as long as
doing so does not impinge on the final funding prerogatives of the
Congress.
(b) Rescissions or cancellations described in subsection (a) shall
continue in an amount equal to the lesser of--
(1) the amount specified for rescission or cancellation in
the applicable appropriations Act referenced in section 101 of
this Act; or
(2) the amount of balances available, as of October 1,
2025, from the funds specified for rescission or cancellation
in the applicable appropriations Act referenced in section 101
of this Act.
(c) No later than November 7, 2025, the Director of the Office of
Management and Budget shall provide to the Committees on Appropriations
of the House of Representatives and the Senate a comprehensive list of
the rescissions or cancellations that will continue pursuant to section
101: Provided, That the information in such comprehensive list shall be
periodically updated to reflect any subsequent changes in the amount of
balances available, as of October 1, 2025, from the funds specified for
rescission or cancellation in the applicable appropriations Act
referenced in section 101, and such updates shall be transmitted to the
Committees on Appropriations of the House of Representatives and the
Senate upon request.
Sec. 116. Amounts made available by section 101 for ``Domestic
Food Programs--Food and Nutrition Service--Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC)'' may be
apportioned at the rate for operations necessary to maintain
participation.
Sec. 117. Section 260 of the Agricultural Marketing Act of 1946 (7
U.S.C. 1636i) and section 942 of the Livestock Mandatory Reporting Act
of 1999 (7 U.S.C. 1635 note; Public Law 106-78) shall be applied by
substituting the date specified in section 106 of this Act for
``September 30, 2025''.
Sec. 118. Section 8302(b) of the Agricultural Act of 2014 (16
U.S.C. 3851a(b)) shall be applied by substituting the date specified in
section 106 of this Act for ``October 1, 2023''.
Sec. 119. (a) Amounts made available by section 101 for
``Department of Justice--United States Marshals Service--Salaries and
Expenses'' may be apportioned up to the rate for operations necessary
to maintain program operations.
(b) In addition to amounts provided by section 101, for
``Department of Justice--United States Marshals Service--Salaries and
Expenses'', there is appropriated $30,000,000, for an additional amount
for fiscal year 2026, to remain available until September 30, 2027, to
carry out protective operations.
Sec. 120. (a) For the closeout of all Space Shuttle contracts and
associated programs, amounts that have expired but have not been
cancelled in the Exploration, Space Operations, Human Space Flight,
Space Flight Capabilities, and Exploration Capabilities appropriations
accounts shall remain available through fiscal year 2030 for the
liquidation of valid obligations incurred during the period of fiscal
year 2001 through fiscal year 2013.
(b)(1) Subject to paragraph (2), this section shall become
effective immediately upon enactment of this Act.
(2) If this Act is enacted after September 30, 2025, this
section shall be applied as if it were in effect on September
30, 2025.
Sec. 121. Section 3014(a) of title 18, United States Code, shall
be applied by substituting the date specified in section 106 of this
Act for ``September 30, 2025''.
Sec. 122. Notwithstanding section 101, the first proviso in each
of sections 8092 and 8096 of title VIII of division A of Public Law
118-47 shall be applied by substituting ``advances'' for
``reimbursements''.
Sec. 123. Notwithstanding sections 102 and 104, amounts made
available by section 101 to the Department of Defense for ``Research,
Development, Test and Evaluation, Air Force'' shall be apportioned up
to the rate for operations necessary for the E-7 Wedgetail program, in
an amount not to exceed $199,676,000, only for the purpose of continued
rapid prototyping activities to maintain program schedule and
transition to production for the E-7 Wedgetail program.
Sec. 124. Of the unobligated balance of funds available to the
Department of Defense for the E-7 program under the heading ``Aircraft
Procurement, Air Force'' in Public Law 119-4, $200,000,000 is hereby
transferred to and merged with amounts available for the E-7 program
under the heading ``Research, Development, Test and Evaluation, Air
Force'' only for the purpose of continued rapid prototyping activities
to maintain program schedule and transition to production for the E-7
Wedgetail program.
Sec. 125. Section 717(a) of the Defense Production Act of 1950 (50
U.S.C. 4564(a)) shall be applied by substituting the date specified in
section 106 of this Act for ``September 30, 2025''.
Sec. 126. Notwithstanding sections 102 and 104, amounts made
available by section 101 of this Act to the Department of Defense for
``Shipbuilding and Conversion, Navy'' may be apportioned up to the rate
for operations necessary to fund completion of prior year shipbuilding
programs for the fiscal year 2016 and fiscal year 2018 Virginia Class
Submarine Programs, in an amount not to exceed $154,000,000.
Sec. 127. During the period covered by this Act, section
103(f)(4)(A) of Public Law 108-361 (the Calfed Bay-Delta Authorization
Act) shall be applied by substituting ``$32,600,000'' for
``$30,000,000''.
Sec. 128. (a) Amounts made available by section 101 in the first
proviso under the heading ``Department of Energy--Atomic Energy Defense
Activities--National Nuclear Security Administration--Weapons
Activities'' may be apportioned up to the rate for operations necessary
to maintain current operations for the safe, secure transport of
nuclear weapons.
(b) The Director of the Office of Management and Budget and the
Secretary of Energy shall notify the Committees on Appropriations of
the House of Representatives and the Senate not later than 3 days after
each use of the authority provided in subsection (a).
Sec. 129. Notwithstanding section 101, the matter preceding the
first proviso under the heading ``Office of Personnel Management--
Salaries and Expenses'' in title V of division B of Public Law 118-47
shall be applied by substituting ``$197,446,000'' for ``$219,076,000'',
and the second proviso under such heading in such title of such
division of such Act shall be applied by substituting ``$214,605,000''
for ``$192,975,000''.
Sec. 130. Notwithstanding any other provision of this Act, except
section 106, the District of Columbia may expend local funds made
available under the heading ``District of Columbia--District of
Columbia Funds'' for such programs and activities under the District of
Columbia Appropriations Act, 2024 (title IV of division B of Public Law
118-47) at the rate set forth in the Fiscal Year 2026 Local Budget Act
of 2025 (D.C. Bill No. 26-260) as modified as of the date of enactment
of this Act.
Sec. 131. Notwithstanding section 101, paragraph (1) under the
heading ``Department of the Treasury--Departmental Offices--Salaries
and Expenses'' in title I of division B of Public Law 118-47 shall be
applied by substituting ``$1,350,000'' for ``$350,000'': Provided,
That such amounts may be obligated in the account and budget structure
set forth in the fiscal year 2026 President's Budget, submitted
pursuant to section 1105(a) of title 31, United States Code, and
accompanying justification materials.
Sec. 132. Amounts made available by section 101 for ``Small
Business Administration--Business Loans Program Account'' may be
apportioned up to the rate for operations necessary to accommodate
increased demand for commitments for general business loans authorized
under paragraphs (1) through (35) of section 7(a) of the Small Business
Act (15 U.S.C. 636(a)), for commitments to guarantee trust certificates
authorized by section 5(g) of the Small Business Act (15 U.S.C.
634(g)), for commitments to guarantee loans under section 503 of the
Small Business Investment Act of 1958 (15 U.S.C. 697), and for
commitments to guarantee debentures under section 303(b) of the Small
Business Investment Act of 1958 (15 U.S.C. 683(b)).
Sec. 133. Notwithstanding section 101, amounts are provided for
``Department of the Treasury--Office of Terrorism and Financial
Intelligence--Salaries and Expenses'' at a rate for operations of
$237,662,000.
Sec. 134. Notwithstanding section 101, section 1605 of Public Law
119-4 shall be applied by substituting ``through the end of the last
applicable pay period that commences on or before the date specified in
section 106(3) of the Continuing Appropriations Act, 2026'' for
``through the date specified in section 1106 of this Act''.
Sec. 135. Section 1(b) of Public Law 117-25 (135 Stat. 297; 136
Stat. 2133; 136 Stat. 5984; 138 Stat. 1771; 139 Stat. 46) shall be
applied in each of paragraphs (3) and (4) by substituting the date
specified in section 106 of this Act for ``September 30, 2025''.
Sec. 136. In addition to amounts otherwise provided by section 101
for ``The Judiciary--Supreme Court of the United States--Salaries and
Expenses'', there is appropriated $28,000,000, for an additional amount
for fiscal year 2026, to remain available until expended, for the
protection of the Supreme Court Justices, including the purchase and
hire of passenger motor vehicles as authorized by 31 U.S.C. 1343 and
1344, to be expended as the Chief Justice may approve.
Sec. 137. Section 210G(i) of the Homeland Security Act of 2002 (6
U.S.C. 124n(i)) shall be applied by substituting the date specified in
section 106 of this Act for ``September 30, 2025''.
Sec. 138. Section 225(e) of division A of Public Law 116-6 (49
U.S.C. 44901 note) shall be applied by substituting ``fiscal year 2019
through the date specified in section 106 of the Continuing
Appropriations Act, 2026'' for ``fiscal years 2019 through 2025''.
Sec. 139. Amounts made available by section 101 to the Department
of Homeland Security under the heading ``Federal Emergency Management
Agency--Disaster Relief Fund'' may be apportioned up to the rate for
operations necessary to carry out response and recovery activities
under the Robert T. Stafford Disaster Relief and Emergency Assistance
Act (42 U.S.C. 5121 et seq.).
Sec. 140. Section 227(a) of the Federal Cybersecurity Enhancement
Act of 2015 (6 U.S.C. 1525(a)) shall be applied by substituting the
date specified in section 106 of this Act for ``September 30, 2025''.
Sec. 141. Section 111(a) of the Cybersecurity Information Sharing
Act of 2015 (6 U.S.C. 1510(a)) shall be applied by substituting the
date specified in section 106 of this Act for ``September 30, 2025''.
Sec. 142. Section 2220A(s)(1) of the Homeland Security Act of 2002
(6 U.S.C. 665g(s)(1)) shall be applied by substituting the date
specified in section 106 of this Act for ``September 30, 2025''.
Sec. 143. During the period covered by this Act, section
3(b)(2)(C) of the Pittman-Robertson Wildlife Restoration Act (16 U.S.C.
669b(b)(2)(C)) shall be applied by substituting ``2027'' for ``2026''.
Sec. 144. During the period covered by this Act, section 1701 of
title VII of division B of Public Law 117-43, as amended, shall be
applied by substituting ``calendar years 2021 through 2026'' for ``2021
or 2022 or 2023 or 2024'' each place it appears.
Sec. 145. Amounts made available by section 101 for ``Department
of the Interior--Department-Wide Programs--Wildland Fire Management''
and ``Department of Agriculture--Forest Service--Wildland Fire
Management'' may be apportioned up to the rate for operations necessary
for wildfire suppression activities.
Sec. 146. (a) In addition to amounts otherwise provided by section
101, amounts are provided for ``Department of Health and Human
Services--Indian Health Service--Indian Health Services'' at a rate for
operations of $72,265,000, for an additional amount for costs of
staffing and operating facilities that were opened, renovated, or
expanded in fiscal years 2025 and 2026, and such amounts may be
apportioned up to the rate for operations necessary to staff and
operate such facilities.
(b) In addition to amounts otherwise provided by section 101,
amounts are provided for ``Department of Health and Human Services--
Indian Health Service--Indian Health Facilities'' at a rate for
operations of $8,050,000, for an additional amount for costs of
staffing and operating facilities that were opened, renovated, or
expanded in fiscal years 2025 and 2026, and such amounts may be
apportioned up to the rate for operations necessary to staff and
operate such facilities.
Sec. 147. Of the amounts made available in the third paragraph
under the heading ``Environmental Protection Agency--State and Tribal
Assistance Grants'' in the Disaster Relief Supplemental Appropriations
Act, 2023 (division N of Public Law 117-328), up to $54,000,000 shall
be available for technical assistance and grants under section 1442(b)
of the Safe Drinking Water Act (42 U.S.C. 300j-1(b)) in areas where the
President declared an emergency in August of fiscal year 2022 pursuant
to the Robert T. Stafford Disaster Relief and Emergency Assistance Act
(42 U.S.C. 5121 et seq.): Provided, That amounts repurposed pursuant
to this section that were previously designated by the Congress as
being for an emergency requirement pursuant to section 4001(a)(1) of S.
Con. Res 14 (117th Congress), the concurrent resolution on the budget
for fiscal year 2022, and section 1(e) of H. Res. 1151 (117th
Congress), as engrossed in the House of Representatives on June 8,
2022, are designated as being for an emergency requirement pursuant to
section 4001(a)(1) of S. Con. Res. 14 (117th Congress), the concurrent
resolution on the budget for fiscal year 2022, and to legislation
establishing fiscal year 2026 budget enforcement in the House of
Representatives.
Sec. 148. Notwithstanding section 101, the matter under the
heading ``Department of Health and Human Services--Administration for
Children and Families--Children and Families Services Programs'' in
title II of division D of Public Law 118-47 shall be applied by adding
the following after the second proviso: ``Provided further, That for
purposes of section 640(a)(2)(B)(v) of such Act, the base grant for
each of the Federated States of Micronesia and the Republic of the
Marshall Islands shall be $8,000,000, and shall be considered equal to
the amount provided for base grants for such jurisdictions under such
Act for the prior fiscal year:''.
Sec. 149. Notwithstanding any other provision of this Act, there
is appropriated--
(1) For payment to Ashley Paige Turner, heir of Sylvester
Turner, late a Representative from the State of Texas,
$174,000.
(2) For payment to Ramona Grijalva, widow of Raul M.
Grijalva, late a Representative from the State of Arizona,
$174,000.
(3) For payment to Catherine M. Smith, widow of Gerald E.
Connolly, late a Representative from the Commonwealth of
Virginia, $174,000.
Sec. 150. Notwithstanding any other provision of law, no
adjustment shall be made under section 601(a) of the Legislative
Reorganization Act of 1946 (2 U.S.C. 4501) (relating to cost of living
adjustments for Members of Congress) during the period covered by this
Act.
Sec. 151. In addition to amounts otherwise provided by section
101, for ``Capitol Police--United States Capitol Police Mutual Aid
Reimbursements'', there is appropriated $30,000,000, for an additional
amount for fiscal year 2026, to remain available until expended, for
reimbursements for mutual aid and related training provided under the
agreements described in section 7302 of Public Law 108-458:
Provided,That obligation of the funds made available in this section in
this Act shall be subject to notification to the Chairmen and Ranking
Members of the Committees on Appropriations of both Houses of Congress,
the Senate Committee on Rules and Administration, and the Committee on
House Administration of the amount and purpose of the expense within 15
days of obligation.
Sec. 152. Notwithstanding section 101, the matter under the
heading ``Native American Veteran Housing Loan Program Account'' in
title II of division A of Public Law 118-42 shall be applied by adding
the following new paragraph:In addition, for the cost of direct loans,
$6,865,235, as authorized by subchapter V of chapter 37 of title 38,
United States Code: Provided, That such costs, including the cost of
modifying such loans, shall be as defined in section 502 of the
Congressional Budget Act of 1974: Provided further, That funds made
available under this heading are available to subsidize gross
obligations for the principal amount of direct loans not to exceed
$75,000,000.''.
Sec. 153. Section 1424(a) of the Better Utilization of Investments
Leading to Development Act of 2018 (22 U.S.C. 9624(a)) shall be applied
by substituting the date specified in section 106 of this Act for ``the
date that is 7 years after the date of the enactment of this Act''.
Sec. 154. Notwithstanding sections 101 and 106, and sections 1101,
1106, and 11201 of Public Law 119-4, the fifth and sixth provisos under
the heading ``Millennium Challenge Corporation'' in title III of
division F of Public Law 118-47 shall be amended by substituting
``December 31, 2026'' for ``December 31, 2024'' each place it appears.
Sec. 155. Notwithstanding section 106, during fiscal year 2026,
the Secretary of Housing and Urban Development may use the unobligated
balances of amounts made available in prior fiscal years in paragraphs
(2), (3), and (8) under the heading ``Public and Indian Housing--
Tenant-Based Rental Assistance'' to support additional allocations
under subparagraph (D) of paragraph (1) and subparagraph (B) of
paragraph (4) of such heading to prevent the termination of rental
assistance for families as the result of insufficient funding in the
calendar year 2025 funding cycle: Provided,That amounts repurposed
pursuant to this section that were previously designated by the
Congress as an emergency requirement pursuant to a concurrent
resolution on the budget or the Balanced Budget and Emergency Deficit
Control Act of 1985 are designated by the Congress as being for an
emergency requirement pursuant to section 4001(a)(1) of S. Con. Res. 14
(117th Congress), the concurrent resolution on the budget for fiscal
year 2022, and to legislation establishing fiscal year 2026 budget
enforcement in the House of Representatives.
Sec. 156. Amounts made available by section 101 for ``Department
of Transportation--Office of the Secretary--Payments to Air Carriers''
may be apportioned up to the rate for operations necessary to maintain
Essential Air Service program operations.
Sec. 157. Section 4144(d) of the Motor Carrier Safety
Reauthorization Act of 2005 (49 U.S.C. 31100 note) shall be applied by
substituting the date specified in section 106 of this Act for
``September 30, 2025''.
This division may be cited as the ``Continuing Appropriations Act,
2026''.
DIVISION B--MISCELLANEOUS EXTENSIONS
SEC. 101. UNITED STATES GRAIN STANDARDS.
The authorities (including any limitations on the authorities)
provided by each provision of the United States Grain Standards Act
(Public Law 90-487; 7 U.S.C. 74 et seq.) and each provision of law
amended by that Act, as in effect on September 30, 2025, shall
continue, and the authorities (and any such limitations) shall be
carried out, until the later of--
(1) November 21, 2025; and
(2) the date specified in the provision of that Act or the
provision of law amended by that Act.
DIVISION C--HEALTH EXTENDERS
TITLE I--PUBLIC HEALTH EXTENDERS
SEC. 101. EXTENSION FOR COMMUNITY HEALTH CENTERS, NATIONAL HEALTH
SERVICE CORPS, AND TEACHING HEALTH CENTERS THAT OPERATE
GME PROGRAMS.
(a) Extension for Community Health Centers.--Section 10503(b)(1) of
the Patient Protection and Affordable Care Act (42 U.S.C. 254b-2(b)(1))
is amended--
(1) in subparagraph (I), by striking ``and'' at the end;
and
(2) by adding at the end the following:
``(K) $606,904,110 for the period beginning on
October 1, 2025, and ending on November 21, 2025;
and''.
(b) Extension for the National Health Service Corps.--Section
10503(b)(2) of the Patient Protection and Affordable Care Act (42
U.S.C. 254b-2(b)(2)) is amended--
(1) in subparagraph (J), by striking ``and'' at the end;
(2) in subparagraph (K), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(L) $49,150,685 for the period beginning on
October 1, 2025, and ending on November 21, 2025.''.
(c) Teaching Health Centers That Operate Graduate Medical Education
Programs.--Section 340H(g)(1) of the Public Health Service Act (42
U.S.C. 256h(g)(1)) is amended--
(1) in subparagraph (E), by striking ``and'' at the end;
(2) in subparagraph (F), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(G) $24,931,507 for the period beginning on
October 1, 2025, and ending on November 21, 2025.''.
(d) Application of Provisions.--Amounts appropriated pursuant to
the amendments made by this section shall be subject to the
requirements contained in Public Law 117-328 for funds for programs
authorized under sections 330 through 340 of the Public Health Service
Act (42 U.S.C. 254b et seq.).
(e) Conforming Amendment.--Section 3014(h)(4) of title 18, United
States Code, is amended by striking ``and section 2101(d) of division B
of the Full-Year Continuing Appropriations and Extensions Act, 2025''
and inserting ``section 2101(d) of division B of the Full-Year
Continuing Appropriations and Extensions Act, 2025, and section 101(d)
of title I of division C of the Continuing Appropriations and
Extensions Act, 2026''.
SEC. 102. EXTENSION OF SPECIAL DIABETES PROGRAMS.
(a) Extension of Special Diabetes Programs for Type I Diabetes.--
Section 330B(b)(2) of the Public Health Service Act (42 U.S.C. 254c-
2(b)(2)) is amended--
(1) in subparagraph (F), by striking ``and'' at the end;
(2) in subparagraph (G), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(H) $22,652,055 for the period beginning on
October 1, 2025, and ending on November 21, 2025, to
remain available until expended.''.
(b) Extending Funding for Special Diabetes Programs for Indians.--
Section 330C(c)(2) of the Public Health Service Act (42 U.S.C. 254c-
3(c)(2)) is amended--
(1) in subparagraph (F), by striking ``and'' at the end;
(2) in subparagraph (G), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(H) $22,652,055 for the period beginning on
October 1, 2025, and ending on November 21, 2025, to
remain available until expended.''.
SEC. 103. NATIONAL HEALTH SECURITY EXTENSIONS.
(a) Section 319(e)(8) of the Public Health Service Act (42 U.S.C.
247d(e)(8)) is amended by striking ``September 30, 2025'' and inserting
``November 21, 2025''.
(b) Section 319L(e)(1)(D) of the Public Health Service Act (42
U.S.C. 247d-7e(e)(1)(D)) is amended by striking ``September 30, 2025''
and inserting ``November 21, 2025''.
(c) Section 319L-1(b) of the Public Health Service Act (42 U.S.C.
247d-7f(b)) is amended by striking ``September 30, 2025'' and inserting
``November 21, 2025''.
(d)(1) Section 2811A(g) of the Public Health Service Act (42 U.S.C.
300hh-10b(g)) is amended by striking ``September 30, 2025'' and
inserting ``November 21, 2025''.
(2) Section 2811B(g)(1) of the Public Health Service Act (42 U.S.C.
300hh-10c(g)(1)) is amended by striking ``September 30, 2025'' and
inserting ``November 21, 2025''.
(3) Section 2811C(g)(1) of the Public Health Service Act (42 U.S.C.
300hh-10d(g)(1)) is amended by striking ``September 30, 2025'' and
inserting ``November 21, 2025''.
(e) Section 2812(c)(4)(B) of the Public Health Service Act (42
U.S.C. 300hh-11(c)(4)(B)) is amended by striking ``September 30, 2025''
and inserting ``November 21, 2025''.
TITLE II--MEDICARE
SEC. 201. EXTENSION OF INCREASED INPATIENT HOSPITAL PAYMENT ADJUSTMENT
FOR CERTAIN LOW-VOLUME HOSPITALS.
(a) In General.--Section 1886(d)(12) of the Social Security Act (42
U.S.C. 1395ww(d)(12)) is amended--
(1) in subparagraph (B), by striking ``in fiscal year
2026'' and inserting ``during the portion of fiscal year 2026
beginning on November 22, 2025, and ending on September 30,
2026, and in fiscal year 2027'';
(2) in subparagraph (C)(i)--
(A) in the matter preceding subclause (I)--
(i) by inserting ``or portion of a fiscal
year'' after ``for a fiscal year''; and
(ii) by inserting ``and the portion of
fiscal year 2026 beginning on October 1, 2025,
and ending on November 21, 2025'' after
``through 2025'';
(B) in subclause (III), by inserting ``and the
portion of fiscal year 2026 beginning on October 1,
2025, and ending on November 21, 2025'' after ``through
2025''; and
(C) in subclause (IV), by striking ``fiscal year
2026'' and inserting ``the portion of fiscal year 2026
beginning on November 22, 2025, and ending on September
30, 2026, and fiscal year 2027''; and
(3) in subparagraph (D)--
(A) in the matter preceding clause (i), by
inserting ``or during the portion of fiscal year 2026
beginning on October 1, 2025, and ending on November
21, 2025'' after ``through 2025''; and
(B) in clause (ii), by inserting ``and the portion
of fiscal year 2026 beginning on October 1, 2025, and
ending on November 21, 2025'' after ``through 2025''.
(b) Implementation.--Notwithstanding any other provision of law,
the Secretary of Health and Human Services may implement the amendments
made by this section by program instruction or otherwise.
SEC. 202. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL (MDH) PROGRAM.
(a) In General.--Section 1886(d)(5)(G) of the Social Security Act
(42 U.S.C. 1395ww(d)(5)(G)) is amended--
(1) in clause (i), by striking ``October 1, 2025'' and
inserting ``November 22, 2025''; and
(2) in clause (ii)(II), by striking ``October 1, 2025'' and
inserting ``November 22, 2025''.
(b) Conforming Amendments.--
(1) In general.--Section 1886(b)(3)(D) of the Social
Security Act (42 U.S.C. 1395ww(b)(3)(D)) is amended--
(A) in the matter preceding clause (i), by striking
``October 1, 2025'' and inserting ``November 22,
2025''; and
(B) in clause (iv), by inserting ``and the portion
of fiscal year 2026 beginning on October 1, 2025, and
ending on November 21, 2025'' after ``through fiscal
year 2025''.
(2) Permitting hospitals to decline reclassification.--
Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of
1993 (42 U.S.C. 1395ww note) is amended by inserting ``, or the
portion of fiscal year 2026 beginning on October 1, 2025, and
ending on November 21, 2025'' after ``through fiscal year
2025''.
SEC. 203. EXTENSION OF ADD-ON PAYMENTS FOR AMBULANCE SERVICES.
Section 1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) is
amended--
(1) in paragraph (12)(A), by striking ``October 1, 2025''
and inserting ``November 22, 2025''; and
(2) in paragraph (13), by striking ``October 1, 2025'' each
place it appears and inserting ``November 22, 2025'' in each
such place.
SEC. 204. EXTENSION OF FUNDING FOR QUALITY MEASURE ENDORSEMENT, INPUT,
AND SELECTION.
Section 1890(d)(2) of the Social Security Act (42 U.S.C.
1395aaa(d)(2)) is amended--
(1) in the first sentence, by striking ``September 30,
2025'' and inserting ``November 21, 2025''; and
(2) in the third sentence, by striking ``September 30,
2025'' and inserting ``November 21, 2025''.
SEC. 205. EXTENSION OF FUNDING OUTREACH AND ASSISTANCE FOR LOW-INCOME
PROGRAMS.
(a) State Health Insurance Assistance Programs.--Subsection
(a)(1)(B)(xiv) of section 119 of the Medicare Improvements for Patients
and Providers Act of 2008 (42 U.S.C. 1395b-3 note) is amended by
striking ``September 30, 2025, $30,000,000'' and inserting ``November
21, 2025, $32,136,986''.
(b) Area Agencies on Aging.--Subsection (b)(1)(B)(xiv) of such
section 119 is amended by striking ``September 30, 2025, $30,000,000''
and inserting ``November 21, 2025, $32,136,986''.
(c) Aging and Disability Resource Centers.--Subsection
(c)(1)(B)(xiv) of such section 119 is amended by striking ``September
30, 2025, $10,000,000'' and inserting ``November 21, 2025,
$10,712,329''.
(d) Coordination of Efforts To Inform Older Americans About
Benefits Available Under Federal and State Programs.--Subsection
(d)(2)(xiv) of such section 119 is amended by striking ``September 30,
2025, $30,000,000'' and inserting ``November 21, 2025, $32,136,986''.
SEC. 206. EXTENSION OF THE WORK GEOGRAPHIC INDEX FLOOR.
Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w-
4(e)(1)(E)) is amended by striking ``October 1, 2025'' and inserting
``November 22, 2025''.
SEC. 207. EXTENSION OF CERTAIN TELEHEALTH FLEXIBILITIES.
(a) Removing Geographic Requirements and Expanding Originating
Sites for Telehealth Services.--Section 1834(m) of the Social Security
Act (42 U.S.C. 1395m(m)) is amended--
(1) in paragraph (2)(B)(iii), by striking ``ending
September 30, 2025'' and inserting ``ending November 21,
2025''; and
(2) in paragraph (4)(C)(iii), by striking ``ending on
September 30, 2025'' and inserting ``ending on November 21,
2025''.
(b) Expanding Practitioners Eligible To Furnish Telehealth
Services.--Section 1834(m)(4)(E) of the Social Security Act (42 U.S.C.
1395m(m)(4)(E)) is amended by striking ``ending on September 30, 2025''
and inserting ``ending on November 21, 2025''.
(c) Extending Telehealth Services for Federally Qualified Health
Centers and Rural Health Clinics.--Section 1834(m)(8)(A) of the Social
Security Act (42 U.S.C. 1395m(m)(8)(A)) is amended by striking ``ending
on September 30, 2025'' and inserting ``ending on November 21, 2025''.
(d) Delaying the In-Person Requirements Under Medicare for Mental
Health Services Furnished Through Telehealth and Telecommunications
Technology.--
(1) Delay in requirements for mental health services
furnished through telehealth.--Section 1834(m)(7)(B)(i) of the
Social Security Act (42 U.S.C. 1395m(m)(7)(B)(i)) is amended,
in the matter preceding subclause (I), by striking ``on or
after October 1, 2025'' and inserting ``on or after November
22, 2025''.
(2) Mental health visits furnished by rural health
clinics.--Section 1834(y)(2) of the Social Security Act (42
U.S.C. 1395m(y)(2)) is amended by striking ``October 1, 2025''
and inserting ``November 22, 2025''.
(3) Mental health visits furnished by federally qualified
health centers.--Section 1834(o)(4)(B) of the Social Security
Act (42 U.S.C. 1395m(o)(4)(B)) is amended by striking ``October
1, 2025'' and inserting ``November 22, 2025''.
(e) Allowing for the Furnishing of Audio-Only Telehealth
Services.--Section 1834(m)(9) of the Social Security Act (42 U.S.C.
1395m(m)(9)) is amended by striking ``ending on September 30, 2025''
and inserting ``ending on November 21, 2025''.
(f) Extending Use of Telehealth To Conduct Face-to-Face Encounter
Prior to Recertification of Eligibility for Hospice Care.--Section
1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C.
1395f(a)(7)(D)(i)(II)) is amended by striking ``ending on September 30,
2025'' and inserting ``ending on November 21, 2025''.
(g) Program Instruction Authority.--The Secretary of Health and
Human Services may implement the amendments made by this section
through program instruction or otherwise.
SEC. 208. EXTENDING ACUTE HOSPITAL CARE AT HOME WAIVER AUTHORITIES.
Section 1866G(a)(1) of the Social Security Act (42 U.S.C. 1395cc-
7(a)(1)) is amended by striking ``September 30, 2025'' and inserting
``November 21, 2025''.
SEC. 209. EXTENSION OF TEMPORARY INCLUSION OF AUTHORIZED ORAL ANTIVIRAL
DRUGS AS COVERED PART D DRUGS.
Section 1860D-2(e)(1)(C) of the Social Security Act (42 U.S.C.
1395w-102(e)(1)(C)) is amended by striking ``September 30, 2025'' and
inserting ``November 21, 2025''.
SEC. 210. EXTENSION OF FUNDING FOR MEDICARE HOSPICE SURVEYS.
Section 3(a)(2) of the IMPACT Act of 2014 (Public Law 113-185) is
amended--
(1) in subparagraph (A), by striking ``and'' at the end;
(2) in subparagraph (B), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following new subparagraph:
``(C) $6,000,000 for the period beginning on
October 1, 2025, and ending on November 21, 2025.''.
SEC. 211. MEDICARE IMPROVEMENT FUND.
Section 1898(b)(1) of the Social Security Act (42 U.S.C.
1395iii(b)(1)) is amended--
(1) by striking ``fiscal year 2026'' and inserting ``fiscal
year 2027''; and
(2) by striking ``$1,804,000,000'' and inserting
``$664,000,000''.
TITLE III--HUMAN SERVICES
SEC. 301. SEXUAL RISK AVOIDANCE EDUCATION EXTENSION.
Section 510 of the Social Security Act (42 U.S.C. 710) is amended--
(1) in subsection (a)--
(A) in paragraph (1)--
(i) by striking ``2023, for the period
beginning on October 1, 2023, and ending on
November 17, 2023, for the period beginning on
November 18, 2023, and ending on January 19,
2024, for the period beginning on January 20,
2024, and ending on March 8, 2024, for the
period beginning on March 9, 2024, and ending
on September 30, 2024, and for fiscal year
2025'' and inserting ``2025, and for the period
beginning on October 1, 2025, and ending on
November 21, 2025''; and
(ii) by striking ``fiscal year 2024'' and
inserting ``fiscal year 2026''; and
(B) in paragraph (2)--
(i) in subparagraph (A)--
(I) by striking ``through 2023''
and inserting ``through 2025'';
(II) by striking ``fiscal year 2024
or 2025'' and inserting ``fiscal year
2026''; and
(III) by inserting ``(or, with
respect to the applicable period, for
fiscal year 2026)'' after ``an
application for the fiscal year''; and
(ii) in subparagraph (B)(i), by striking
``2024 or 2025'' and inserting ``2026''; and
(2) in subsection (f)(1) by striking ``2023, for the period
beginning on October 1, 2023, and ending on November 17, 2023,
an amount equal to the pro rata portion of the amount
appropriated for the corresponding period for fiscal year 2023,
for the period beginning on November 18, 2023, and ending on
January 19, 2024, an amount equal to the pro rata portion of
the amount appropriated for the corresponding period for fiscal
year 2023, for the period beginning on January 20, 2024, and
ending on March 8, 2024, an amount equal to the pro rata
portion of the amount appropriated for the period at the end of
the corresponding sentence for fiscal year 2023, for the period
beginning on March 9, 2024, and ending on September 30, 2024,
an amount equal to the pro rata portion of the amount
appropriated for the corresponding period for fiscal year 2023,
and for fiscal year 2025, an amount equal to the amount
appropriated for fiscal year 2024'' and inserting ``2025, and
for the period beginning on October 1, 2025, and ending on
November 21, 2025, an amount equal to the pro rata portion of
the amount appropriated for the corresponding period for fiscal
year 2025''.
SEC. 302. PERSONAL RESPONSIBILITY EDUCATION EXTENSION.
Section 513 of the Social Security Act (42 U.S.C. 713) is amended--
(1) in subsection (a)(1)--
(A) in subparagraph (A), in the matter preceding
clause (i), by striking ``2023, for the period
beginning on October 1, 2023, and ending on November
17, 2023, for the period beginning on November 18,
2023, and ending on January 19, 2024, for the period
beginning on January 20, 2024, and ending on March 8,
2024, for the period beginning on March 9, 2024, and
ending on September 30, 2024, and for fiscal year
2025'' and inserting ``2025, and for the period
beginning on October 1, 2025, and ending on November
21, 2025''; and
(B) in subparagraph (B)(i), by striking ``the
period beginning on October 1, 2023, and ending on
November 17, 2023, for the period beginning on November
18, 2023, and ending on January 19, 2024, for the
period beginning on January 20, 2024, and ending on
March 8, 2024, for the period beginning on March 9,
2024, and ending on September 30, 2024, and for fiscal
year 2025'' and inserting ``fiscal years 2024 and 2025,
and for the period beginning on October 1, 2025, and
ending on November 21, 2025'';
(2) in subsection (c)(3), by striking ``2024 or 2025'' and
inserting ``2026''; and
(3) in subsection (f), by striking ``2023, for the period
beginning on October 1, 2023, and ending on November 17, 2023,
an amount equal to the pro rata portion of the amount
appropriated for the corresponding period for fiscal year 2023,
for the period beginning on November 18, 2023, and ending on
January 19, 2024, an amount equal to the pro rata portion of
the amount appropriated for the corresponding period for fiscal
year 2023, for the period beginning on January 20, 2024, and
ending on March 8, 2024, an amount equal to the pro rata
portion of the amount appropriated for the corresponding period
for fiscal year 2023, for the period beginning on March 9,
2024, and ending on September 30, 2024, an amount equal to the
pro rata portion of the amount appropriated for the
corresponding period for fiscal year 2023, and for fiscal year
2025, an amount equal to the amount appropriated for fiscal
year 2024 for fiscal year 2024'' and inserting ``2025, and for
the period beginning on October 1, 2025, and ending on November
21, 2025, an amount equal to the pro rata portion of the amount
appropriated for the corresponding period for fiscal year
2025''.
SEC. 303. EXTENSION OF FUNDING FOR FAMILY-TO-FAMILY HEALTH INFORMATION
CENTERS.
Section 501(c)(1)(A) of the Social Security Act (42 U.S.C.
701(c)(1)(A)) is amended--
(1) in clause (vii), by striking ``and'' at the end;
(2) in clause (viii), by adding ``; and'' at the end; and
(3) by adding at the end the following new clause:
``(ix) $854,795 for the portion of fiscal year 2026
beginning on October 1, 2025, and ending on November 21,
2025.''.
TITLE IV--MEDICAID
SEC. 401. MODIFYING CERTAIN DISPROPORTIONATE SHARE HOSPITAL ALLOTMENTS.
(a) Extending Tennessee DSH Allotments.--Section 1923(f)(6)(A)(vi)
of the Social Security Act (42 U.S.C. 1396r-4(f)(6)(A)(vi)) is
amended--
(1) in the heading, by inserting ``and a portion of fiscal
year 2026'' after ``2025''; and
(2) by inserting ``, and the DSH allotment for Tennessee
for the portion of fiscal year 2026 beginning October 1, 2025,
and ending November 21, 2025, shall be $7,564,932'' before the
period.
(b) Delaying DSH Allotment Reductions.--Section 1923(f) of the
Social Security Act (42 U.S.C. 1396r-4(f)) is amended--
(1) in paragraph (7)(A)--
(A) in clause (i)--
(i) in the matter preceding subclause (I),
by striking ``For each of fiscal years 2026
through 2028'' and inserting ``For the period
beginning November 22, 2025, and ending
September 30, 2026, and for each of fiscal
years 2027 and 2028'';
(ii) in subclause (I), by inserting ``or
period'' after ``the fiscal year''; and
(iii) in subclause (II), by inserting ``or
period'' after ``in the fiscal year''; and
(B) in clause (ii), by striking ``for each of
fiscal years 2026 through 2028'' and inserting ``for
the period beginning November 22, 2025, and ending
September 30, 2026, and for each of fiscal years 2027
and 2028''; and
(2) in paragraph (8), by striking ``2027'' and inserting
``2028''.
TITLE V--FOOD AND DRUG ADMINISTRATION
SEC. 501. SHORT TITLE.
This title may be cited as the ``Over-the-Counter Monograph Drug
User Fee Amendments''.
SEC. 502. FINDING.
Congress finds that the fees authorized by the amendments made in
this title will be dedicated to over-the-counter (OTC) monograph drug
activities, as set forth in the goals identified for purposes of part
10 of subchapter C of chapter VII of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 379j-71 et seq.), in the letters from the
Secretary of Health and Human Services to the Chairman of the Committee
on Energy and Commerce of the House of Representatives and the Chairman
of the Committee on Health, Education, Labor, and Pensions of the
Senate, as set forth in the Congressional Record.
SEC. 503. DEFINITIONS.
Section 744L(9)(A) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 379j-71(9)(A)) is amended--
(1) in clause (v), by striking ``; or'' and inserting a
semicolon;
(2) in clause (vi)--
(A) by striking ``addition'' and inserting ``the
addition''; and
(B) by striking the period and inserting ``; or'';
and
(3) by adding at the end the following:
``(vii) the addition or modification of a testing
procedure applicable to one or more OTC monograph
drugs, provided that such additional or modified
testing procedure reflects a voluntary consensus
standard with respect to pharmaceutical quality that
is--
``(I) established by a national or
international standards development
organization; and
``(II) recognized by the Secretary through
a process described in guidance for industry,
initially published in July 2023, or any
successor guidance, publicly available on the
website of the Food and Drug Administration,
which addresses voluntary consensus standards
for pharmaceutical quality.''.
SEC. 504. AUTHORITY TO ASSESS AND USE OTC MONOGRAPH FEES.
(a) Types of Fees.--Section 744M(a)(1) of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379j-72(a)(1)) is amended--
(1) in subparagraph (A)--
(A) by striking ``on December 31 of the fiscal year
or at any time during the preceding 12-month period''
and inserting ``at any time during the applicable
period specified in clause (ii) for a fiscal year'';
(B) by striking ``Each person'' and inserting the
following:
``(i) Assessment of fees.--Each person'';
and
(C) by adding at the end the following:
``(ii) Applicable period.--For purposes of
clause (i), the applicable period is--
``(I) for fiscal year 2026, the 12-
month period ending on December 31,
2025;
``(II) for fiscal year 2027, the 9-
month period ending on September 30,
2026; and
``(III) for fiscal year 2028 and
each subsequent fiscal year, the 12-
month period ending on September 30 of
the preceding fiscal year.'';
(2) in subparagraph (B)(i), by amending subclause (I) to
read as follows:
``(I) has ceased all activities
related to OTC monograph drugs prior
to--
``(aa) for purposes of
fiscal year 2026, January 1,
2025;
``(bb) for purposes of
fiscal year 2027, January 1,
2026; and
``(cc) for purposes of
fiscal year 2028 and each
subsequent fiscal year, October
1 of the preceding fiscal year;
and''; and
(3) by amending subparagraph (D) to read as follows:
``(D) Due date.--
``(i) Fiscal year 2026.--For fiscal year
2026, the facility fees required under
subparagraph (A) shall be due on the later of--
``(I) the first business day of
June of such year; or
``(II) the first business day after
the enactment of an appropriations Act
providing for the collection and
obligation of fees under this section
for such year.
``(ii) Fiscal year 2027.--For fiscal year
2027, the facility fees required under
subparagraph (A) shall be due--
``(I) in a first installment
representing 50 percent of such fee, on
the later of--
``(aa) October 1, 2026; or
``(bb) the first business
day after the enactment of an
appropriations Act providing
for the collection and
obligation of fees under this
section for such year; and
``(II) in a second installment
representing the remaining 50 percent
of such fee, on--
``(aa) February 1, 2027; or
``(bb) if an appropriations
Act described in subclause
(I)(bb) is not in effect on
February 1, 2027, the first
business day after enactment of
such an appropriations Act.
``(iii) Subsequent fiscal years.--For
fiscal year 2028 and each subsequent fiscal
year, the facility fees required under
subparagraph (A) shall be due on the later of--
``(I) the first business day on or
after October 1 of the fiscal year; or
``(II) the first business day after
the date of enactment of an
appropriations Act providing for the
collection and obligation of fees under
this section for the fiscal year.''.
(b) Fee Revenue Amounts.--Section 744M(b) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-72(b)) is amended to read as
follows:
``(b) Fee Revenue Amounts.--
``(1) In general.--For each of the fiscal years 2026
through 2030, fees under subsection (a)(1) shall be established
to generate a total facility fee revenue amount equal to the
sum of--
``(A) the annual base revenue for the fiscal year
(as determined under paragraph (2));
``(B) the dollar amount equal to the inflation
adjustment for the fiscal year (as determined under
subsection (c)(1));
``(C) the dollar amount equal to the operating
reserve adjustment for the fiscal year, if applicable
(as determined under subsection (c)(2));
``(D) additional direct cost adjustments (as
determined under subsection (c)(3));
``(E) an additional dollar amount equal to--
``(i) $2,373,000 for fiscal year 2026;
``(ii) $1,233,000 for fiscal year 2027; and
``(iii) $854,000 for fiscal year 2028; and
``(F) in the case of a fiscal year for which the
Secretary applies the one-time facility fee workload
adjustment under subsection (c)(4), the dollar amount
equal to such adjustment.
``(2) 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 2026, the dollar amount of
the total revenue amount established for fiscal year
2025 under this subsection as in effect on the day
before the date of enactment of the Over-the-Counter
Monograph Drug User Fee Amendments, not including any
adjustments made for such fiscal year 2025 under
subsection (c)(2), as so in effect; and
``(B) for fiscal years 2027 through 2030, the
dollar amount of the total revenue amount established
under this subsection for the previous fiscal year, not
including any adjustments made for such previous fiscal
year under subsection (c)(2) or (c)(3).''.
(c) Adjustments; Annual Fee Setting.--Section 744M(c) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-72(c)) is
amended--
(1) in paragraph (1)--
(A) in subparagraph (A), in the matter preceding
clause (i)--
(i) by striking ``subsection (b)(2)(B)''
and inserting ``subsection (b)(1)(B)''; and
(ii) by striking ``fiscal year 2022 and
each subsequent fiscal year'' and inserting
``each fiscal year'';
(B) in subparagraph (B), by striking ``fiscal year
2022'' and all that follows through the period at the
end and inserting the following: ``a fiscal year shall
be equal to the product of--
``(i) for fiscal year 2026--
``(I) the fee for fiscal year 2025
under subsection (a)(2); and
``(II) the inflation adjustment
percentage under subparagraph (C); and
``(ii) for each of fiscal years 2027
through 2030--
``(I) the applicable fee under
subsection (a)(2) for the preceding
fiscal year; and
``(II) the inflation adjustment
percentage under subparagraph (C).'';
and
(C) in subparagraph (C)--
(i) in the matter preceding clause (i), by
inserting ``the sum of'' after ``is equal to'';
(ii) by striking clause (i);
(iii) by redesignating subclauses (I) and
(II) of clause (ii) as clauses (i) and (ii),
respectively, and adjusting the margins
accordingly;
(iv) by striking ``(ii) for each of fiscal
years 2024 and 2025, the sum of--''; and
(v) in clause (ii), as so redesignated, by
striking ``Washington-Baltimore, DC-MD-VA-WV''
and inserting ``Washington-Arlington-
Alexandria-DC-VA-MD-WV'';
(2) in paragraph (2)--
(A) in subparagraph (A)--
(i) by striking ``fiscal year 2021 and
subsequent fiscal years'' and inserting ``each
fiscal year'';
(ii) by striking ``subsections (b)(1)(B)
and (b)(2)(C)'' and inserting ``subsection
(b)(1)(C)''; and
(iii) by striking ``the number of weeks
specified in subparagraph (B)'' and inserting
``10 weeks'';
(B) by striking subparagraph (B);
(C) by redesignating subparagraphs (C) and (D) as
subparagraphs (B) and (C), respectively; and
(D) in subparagraph (C), as so redesignated, by
striking ``paragraph (4) establishing'' and inserting
``paragraph (5) publishing'';
(3) in paragraph (3)--
(A) in the matter preceding subparagraph (A), by
striking ``subsection (b)(2)(D)'' and inserting
``subsection (b)(1)(D)''; and
(B) by striking subparagraphs (A) through (E) and
inserting the following:
``(A) $135,000 for fiscal year 2026;
``(B) $300,000 for fiscal year 2027;
``(C) $55,000 for fiscal year 2028;
``(D) $30,000 for fiscal year 2029; and
``(E) $0 for fiscal year 2030.''; and
(4) by striking paragraph (4) and inserting the following:
``(4) One-time facility fee workload adjustment.--
``(A) In general.--In addition to the adjustments
under paragraphs (1), (2), and (3), the Secretary may
further increase the fee revenues and fees through a
one-time adjustment made for fiscal year 2028, 2029, or
2030, in accordance with this paragraph.
``(B) Adjustment described.--
``(i) Conditions for adjustment.--An
adjustment under this paragraph may be made for
a fiscal year only if--
``(I) an adjustment under this
paragraph had not been made for any
prior fiscal year;
``(II) the average number of OTC
monograph drug facilities subject to a
facility fee under subsection (a)(1)
over the period of the preceding 3
fiscal years exceeds 1,625; and
``(III) with respect to facilities
described in subclause (II), the
average number of such facilities
(expressed as a percentage) that
appeared on the arrears lists pursuant
to subsection (e)(1)(A)(i) over the
period of the preceding 3 fiscal years
is less than 30 percent.
``(ii) Amount of adjustment.--An adjustment
under this paragraph for a fiscal year shall
equal the product of--
``(I) the total facility revenue
amount determined under subsection (b)
for the fiscal year, exclusive of the
adjustment under this paragraph for
such fiscal year; and
``(II) the excess facility
percentage described in clause (iii).
``(iii) Excess facility percentage.--The
excess facility percentage described in this
clause is--
``(I) the amount by which the
average number of OTC monograph drug
facilities subject to a facility fee
under subsection (a)(1) over the
preceding 3 fiscal years exceeds 1,625;
divided by
``(II) 1,625.
``(5) Annual fee setting.--The Secretary shall, not later
than 60 days before the first day of each fiscal year--
``(A) establish for such fiscal year, based on the
revenue amounts under subsection (b) and the
adjustments provided under this subsection--
``(i) OTC monograph drug facility fees
under subsection (a)(1); and
``(ii) OTC monograph order request fees
under subsection (a)(2); and
``(B) publish such fee revenue amounts, facility
fees, and OTC monograph order request fees in the
Federal Register.''.
(d) Crediting and Availability of Fees.--Section 744M(f) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-72(f)) is
amended--
(1) in paragraph (2)(D)--
(A) in the subparagraph heading, by striking ``in
subsequent years''; and
(B) by striking ``(after fiscal year 2021)''; and
(2) in paragraph (3), by striking ``2021 through 2025'' and
inserting ``2026 through 2030''.
SEC. 505. REAUTHORIZATION; REPORTING REQUIREMENTS.
(a) Performance Report.--Section 744N of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 379j-73) is amended--
(1) in subsection (a)--
(A) by striking ``Beginning with fiscal year 2021,
and not later than 120 calendar days after the end of
each fiscal year thereafter'' and inserting the
following:
``(1) In general.--Not later than 120 calendar days after
the end of each fiscal year'';
(B) by striking ``section 3861(b) of the CARES
Act'' and inserting ``section 2 of the Over-the-Counter
Monograph Drug User Fee Amendments''; and
(C) by adding at the end the following:
``(2) Additional information.--Beginning with fiscal year
2026, the annual report under this subsection shall include--
``(A) the progress of the Food and Drug
Administration in achieving the goals, and future plans
for meeting the goals, including--
``(i) the number of Tier 1 OTC monograph
order requests for which a proposed order was
issued, and the number of such requests for
which a final order was issued, in the previous
fiscal year;
``(ii) the number of Tier 2 OTC monograph
order requests for which a proposed order was
issued, and the number of such requests for
which a final order was issued, in the previous
fiscal year;
``(iii) the number of specified safety OTC
monograph order requests for which a proposed
order was issued, and the number of such
requests for which a final order was issued, in
the previous fiscal year;
``(iv) the number of generally recognized
as safe and effective finalization OTC
monograph order requests for which a proposed
order was issued, and the number of such
requests for which a final order was issued, in
the previous fiscal year;
``(v) the average timeline for processing
OTC monograph order requests, in the aggregate
and by submission type, in the previous fiscal
year; and
``(vi) postmarket safety activities with
respect to OTC monograph drugs, including--
``(I) collecting, developing, and
reviewing safety information on OTC
monograph drugs, including adverse
event reports;
``(II) developing and using
improved analytical tools, adverse
event data-collection systems,
including information technology
systems, to assess potential safety
problems, including access to external
databases; and
``(III) activities under section
760;
``(B) information regarding registration of OTC
monograph drug facilities and contract manufacturing
organization facilities and payment of registration
fees by such facilities, including--
``(i) the OTC monograph drug facilities and
contract manufacturing organization facilities
that were first registered under section 510(c)
or 510(i) in the fiscal year; and
``(ii) for each OTC monograph drug facility
and contract manufacturing organization
facility that was assessed a facility fee under
section 744M(a) in the fiscal year, whether the
facility paid such fee;
``(C) the status of implementation of evidence and
testing standards under section 505G(r) for
nonprescription drugs intended for topical
administration, including--
``(i) the application of evidence or
testing standards; and
``(ii) the number of active ingredient
requests for nonprescription drugs intended for
topical administration reviewed using the
standards under section 505G(b); and
``(D) the progress of the Food and Drug
Administration in allowing nonclinical testing
alternatives to animal testing for the consideration of
sunscreen active ingredients.
``(3) Confidentiality.--Nothing in paragraph (2) 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.'';
(2) in subsection (b), by striking ``fiscal year 2021 and
each subsequent fiscal year'' and inserting ``each fiscal
year''; and
(3) in subsection (d)--
(A) by striking ``2025'' each place it appears and
inserting ``2030''; and
(B) by adding at the end the following:
``(4) Minutes of negotiation meetings.--
``(A) Public availability.--The Secretary shall
make publicly available, on the public website of the
Food and Drug Administration, robust written 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 robust written minutes
described under subparagraph (A) shall contain, in
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.''.
(b) GAO Report.--
(1) In general.--Not later than September 30, 2027, 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 supply chain of over-
the-counter monograph drugs.
(2) Contents.--The report required under paragraph (1)
shall include an assessment of--
(A) the overall stability of the supply chain of
over-the-counter monograph drugs;
(B) what information is collected by the Food and
Drug Administration with respect to the supply chain of
over-the-counter monograph drugs;
(C) how the Food and Drug Administration uses
information collected on the supply chain of over-the-
counter monograph drugs to inform regulatory decisions;
(D) how the Food and Drug Administration
coordinates with other Federal agencies to monitor and
mitigate disruptions to the supply chain of over-the-
counter monograph drugs; and
(E) the unique characteristics of the over-the-
counter monograph drug marketplace and what additional
authorities or information the Food and Drug
Administration may need to ensure the stability of the
supply chain of over-the-counter monograph drugs.
SEC. 506. TREATMENT OF ACTIVE INGREDIENTS FOR TOPICAL ADMINISTRATION.
(a) In General.--Section 505G of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355h) is amended by adding at the end the
following:
``(r) Evidence and Testing Standards for Active Ingredients for
Topical Administration.--
``(1) Evidence and testing standards for active ingredients
for topical administration.--The Secretary shall--
``(A) in evaluating the generally recognized as
safe and effective status of active ingredients used in
nonprescription drugs intended for topical
administration for purposes of subsection (a), utilize
standards that allow for the use of real world evidence
(as defined in section 505F(b)), as appropriate, as
part of a comprehensive evaluation of scientific
evidence to demonstrate the safety and effectiveness of
such active ingredients, to supplement evidence from
traditional clinical trials, provided that such
standards allow the Secretary to evaluate whether the
benefits of such active ingredients outweigh the risks;
and
``(B) apply subsection (b)(6)(C) to the regulation
of active ingredients used in drugs intended for
topical administration.
``(2) Non-animal testing methods for topical active
ingredients.--
``(A) In general.--The Secretary shall consider the
types of nonclinical tests described in paragraphs (1)
through (4) of the first subsection (z) of section 505
(as inserted by section 3209(a)(2) of the Health
Extenders, Improving Access to Medicare, Medicaid, and
CHIP, and Strengthening Public Health Act of 2022
(division FF of Public Law 117-328)), or any other
alternative to animal testing that the Secretary
determines appropriate, in the consideration of drugs
intended for topical administration under this section.
``(B) Guidance.--Not later than 1 year after the
date of enactment of this subsection, the Secretary
shall issue new draft guidance on how sponsors can use
nonclinical testing alternatives to animal testing, as
appropriate, to meet safety and efficacy standards
under this section for drugs intended for topical
administration.
``(3) Clarification.--Nothing in this subsection shall be
construed to alter, supersede, or limit the standards for
making determinations of whether a drug is generally recognized
as safe and effective under section 201(p) or the standards set
forth under section 505 for determining the safety and
effectiveness of drugs.''.
(b) Sunscreen Final Administrative Order.--A final administrative
order on nonprescription sunscreen active ingredients issued under
section 3854 of the Coronavirus Aid, Relief, and Economic Security Act
(Public Law 116-136; 21 U.S.C. 360fff-3 note) shall--
(1) account for historical data regarding the safety of
sunscreen active ingredients that have previously been accepted
for marketing in the United States;
(2) account for the role of broad spectrum sunscreens with
a Sun Protection Factor of 15 or higher in effective skin
cancer prevention; and
(3) incorporate the evidence and testing standards for
sunscreen active ingredients detailed in section 505G(r) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355h) (as added
by subsection (a)).
SEC. 507. INCREASING THE CLARITY AND PREDICTABILITY OF THE PROCESS FOR
DEVELOPING APPLICATIONS FOR RX-TO-NONPRESCRIPTION
SWITCHES.
(a) In General.--Section 505(b) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355(b)) is amended by adding at the end the
following:
``(7) Rx-to-nonprescription switches.--
``(A) Meetings.--Any person planning to submit an
application for an Rx-to-nonprescription switch may
submit to the Secretary a written request for a
meeting, for purposes of developing a plan for such
application that addresses the potential risks to
public health of such switch and the evidence necessary
to support such application, including the design of
any necessary studies, and the format and content of
the planned application. The Secretary may grant such a
meeting, as appropriate, consistent with established
procedures for granting meetings with, and providing
written responses to, applications under this section.
Each such meeting shall be documented in meeting
minutes.
``(B) Guidance.--
``(i) In general.--Not later than 18 months
after the date of enactment of this paragraph,
the Secretary shall issue guidance to increase
the clarity and predictability of the process
and standards for approval of applications for
nonprescription drugs under this section,
including in the case of applications for an
Rx-to-nonprescription switch, especially with
respect to prescription drugs with well-
established safety profiles for which an
applicant may seek approval for nonprescription
use.
``(ii) Contents.--The guidance under clause
(i) shall--
``(I) describe how published
reports in medical literature, any
previous finding of safety or
effectiveness for the drug under this
section, the results of significant
human experience with the drug,
unpublished studies and other data, and
other sources of information may be
used to support an application for a
nonprescription drug, including in the
context of an application for an Rx-to-
nonprescription switch;
``(II) set forth procedures for
sponsors to request meetings described
in subparagraph (A) and document the
recommendations made in such meetings;
``(III) describe evidentiary
expectations to support approval of an
application for a nonprescription drug,
including in the context of an
application for an Rx-to-
nonprescription switch, including how
sponsors can demonstrate that consumers
can appropriately self-select and use
the drug and comprehend the
nonprescription drug label; and
``(IV) provide recommendations for
how mechanisms, in addition to the
required Drug Facts Label, such as
mobile applications and decisions aids,
can be incorporated into the
information submitted in support of an
application for an Rx-to-
nonprescription switch.
``(C) Plan to engage with stakeholders.--Not later
than 1 year after the date of enactment of this
paragraph, the Secretary shall develop and make
publicly available on the website of the Food and Drug
Administration a plan to engage stakeholders on steps
and factors for application holders and other
stakeholders to consider in identifying approved
prescription drugs that may be promising candidates for
applications for an Rx-to-nonprescription switch.
``(D) Definition.--For purposes of this paragraph,
the term `Rx-to-nonprescription switch' means the
approval of an application, or supplemental
application, as applicable, submitted under this
section by the holder of an approved application for a
prescription drug seeking approval to market such drug
as a nonprescription drug, including for--
``(i) a full Rx-to-nonprescription switch,
under which a drug previously approved for
prescription use only is--
``(I) approved for nonprescription
use under the same conditions as
applied to the drug when approved for
prescription use; or
``(II) approved for nonprescription
use subject to one or more additional
conditions for nonprescription use; and
``(ii) a partial Rx-to-nonprescription
switch, under which the drug is approved for
nonprescription use only under certain
conditions described in the approved labeling,
while the drug otherwise remains approved for
prescription use only.
``(E) Rule of construction.--Nothing in this
paragraph shall be construed to--
``(i) supersede or modify the authority of
the Secretary under section 505G with respect
to the regulation of OTC monograph drugs; or
``(ii) authorize the disclosure by the
Secretary of confidential commercial
information or trade secrets.''.
(b) GAO Report.--
(1) In general.--Not later than 1 year 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 that
evaluates--
(A) the number of applications for an Rx-to-
nonprescription switch approved during the period
beginning on October 1, 2022, and ending on the date of
the report;
(B) the number of drugs for which an application
for an Rx-to-nonprescription switch was approved during
such period subject to an additional condition for
nonprescription use;
(C) among the drugs for which an application for a
full or partial Rx-to-nonprescription switch was
approved during such period, the average length of time
from receipt by the Food and Drug Administration of the
application to the approval of such application;
(D) the number of partial Rx-to-nonprescription
switch applications approved during such period, and
the number of applications for such a partial switch
not approved;
(E) any barriers to timely and predictable review
of applications for an Rx-to-nonprescription switch;
(F) engagement by the Food and Drug Administration
with public stakeholders, including public meetings or
additional activities to support review of applications
for an Rx-to-nonprescription switch; and
(G) opportunities for collaboration between the
Center for Drug Evaluation and Research and the Centers
for Medicare & Medicaid Services for the purpose of
analyzing health insurance claims data for commonly
prescribed drugs that appear to be suitable for an Rx-
to-nonprescription switch.
(2) Definition.--In this subsection, the term ``Rx-to-
nonprescription switch'' has the meaning given such term in
paragraph (7) of section 505(b) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 244(b)), as added by subsection (a).
SEC. 508. REGULATION OF CERTAIN NONPRESCRIPTION DRUGS THAT ARE MARKETED
WITHOUT AN APPROVED DRUG APPLICATION.
(a) Development Advice to Sponsors or Requestors.--Section 505G(h)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355h(h)) is
amended by striking ``sponsors or requestors'' and inserting
``sponsors, requestors, or organizations nominated by sponsors or
requestors to represent their interests in a proceeding''.
(b) Technical Correction.--Section 505G(b)(2)(A)(iv)(III) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355h(b)(2)(A)(iv)(III))
is amended by striking ``requestors'' and inserting ``sponsors or
requestors''.
SEC. 509. SUNSET DATES.
(a) Authorization.--Sections 744L and 744M of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-71; 379j-72) shall cease to be
effective October 1, 2030.
(b) Reporting Requirements.--Section 744N of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 379j-73) shall cease to be effective
January 31, 2031.
SEC. 510. EFFECTIVE DATE.
The amendments made by this title shall take effect on October 1,
2025, or the date of the enactment of this Act, whichever is later,
except that fees under part 10 of subchapter C of chapter VII of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-71 et seq.) shall
be assessed beginning October 1, 2025, regardless of the date of the
enactment of this Act.
SEC. 511. SAVINGS CLAUSE.
Notwithstanding the amendments made by this title, part 10 of
subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 379j-71 et seq.), as in effect on the day before the date of
enactment of this Act, shall continue to be in effect with respect to
assessing and collecting any fee required by such part for a fiscal
year prior to fiscal year 2026.
TITLE VI--NO SURPRISES ACT IMPLEMENTATION
SEC. 601. EXTENDING AVAILABILITY OF FUNDING FOR NO SURPRISES ACT
IMPLEMENTATION.
Section 118(a) of division BB of the Consolidated Appropriations
Act, 2021 (Public Law 116-260) is amended--
(1) by striking ``otherwise appropriated, to the Secretary
of Health and Human Services'' and inserting the following:
``otherwise appropriated--
``(1) to the Secretary of Health and Human Services'';
(2) in paragraph (1), as so inserted, by striking
``September 30, 2025.'' and inserting ``November 21, 2025;
and''; and
(3) by adding at the end the following new paragraph:
``(2) to the Secretary of Health and Human Services, in
addition to amounts otherwise appropriated under paragraph (1),
$15,000,000 for the period beginning on October 1, 2025, and
ending on November 21, 2025.''.
DIVISION D--DEPARTMENT OF VETERANS AFFAIRS EXTENDERS
TITLE I--HEALTH CARE MATTERS
SEC. 101. EXTENSION OF AUTHORITY FOR COLLECTION OF COPAYMENTS FOR
HOSPITAL CARE AND NURSING HOME CARE.
Section 1710(f)(2)(B) of title 38, United States Code, is amended
by striking ``September 30, 2025'' and inserting ``November 21, 2025''.
SEC. 102. EXTENSION OF REQUIREMENT TO PROVIDE NURSING HOME CARE TO
CERTAIN VETERANS WITH SERVICE-CONNECTED DISABILITIES.
Section 1710A(d) of title 38, United States Code, is amended by
striking ``September 30, 2025'' and inserting ``November 21, 2025''.
SEC. 103. EXTENSION OF STAFF SERGEANT PARKER GORDON FOX SUICIDE
PREVENTION GRANT PROGRAM.
Section 201(j) of the Commander John Scott Hannon Veterans Mental
Health Care Improvement Act of 2019 (Public Law 116-171; 38 U.S.C.
1720F note) is amended by striking ``the date that is three years after
the date on which the first grant is awarded under this section'' and
inserting ``November 21, 2025''.
SEC. 104. EXTENSION OF FUNDING FOR EXPANSION OF RURAL ACCESS NETWORK
FOR GROWTH ENHANCEMENT PROGRAM.
Section 2(d) of the Sgt. Ketchum Rural Veterans Mental Health Act
of 2021 (Public Law 117-21; 38 U.S.C. 1712A note) is amended by
striking ``2025'' and inserting ``2026''.
TITLE II--BENEFITS
SEC. 201. EXTENSION OF REQUIREMENT FOR QUARTERLY BRIEFINGS ON
ADMINISTRATION OF AUTHORITIES RELATING TO DETERMINATIONS
REGARDING PRESUMPTIONS OF SERVICE CONNECTION BASED ON
TOXIC EXPOSURE.
Section 202(b)(2) of the Sergeant First Class Heath Robinson
Honoring our Promise to Address Comprehensive Toxics Act of 2022
(Public Law 117-168) is amended by striking ``On a quarterly basis
during the two-year period beginning on the date of the enactment of
this Act,'' and inserting ``On a quarterly basis during the period
beginning on the date of the enactment of this Act and ending on
December 31, 2026,''.
SEC. 202. EXTENSION OF REQUIREMENT RELATING TO RESTORATION OF
ENTITLEMENT TO EDUCATIONAL ASSISTANCE IN CASES OF CLOSURE
OR DISAPPROVAL OF EDUCATIONAL INSTITUTIONS.
Section 3699(c)(2)(C) of title 38, United States Code, is amended
by striking ``September 30, 2025'' and inserting ``November 21, 2025''.
SEC. 203. EXTENSION OF TEMPORARY CLARIFICATION OF LICENSURE
REQUIREMENTS FOR CONTRACTOR MEDICAL PROFESSIONALS TO
PERFORM MEDICAL DISABILITY EXAMINATIONS FOR THE
DEPARTMENT OF VETERANS AFFAIRS UNDER PILOT PROGRAM FOR
USE OF CONTRACT PHYSICIANS FOR DISABILITY EXAMINATIONS.
Section 2002(a)(4) of the Johnny Isakson and David P. Roe, M.D.
Veterans Health Care and Benefits Improvement Act of 2020 (Public Law
116-315; 38 U.S.C. 5101 note) is amended by striking ``five years'' and
inserting ``six years''.
SEC. 204. EXTENSION OF AUTHORITY TO MAINTAIN REGIONAL OFFICE IN
REPUBLIC OF PHILIPPINES.
Section 315(b) of title 38, United States Code, is amended by
striking ``September 30, 2025'' and inserting ``November 21, 2025''.
TITLE III--HOUSING
SEC. 301. EXTENSION OF AUTHORIZATION OF APPROPRIATIONS FOR HOMELESS
WOMEN VETERANS AND HOMELESS VETERANS WITH CHILDREN
REINTEGRATION GRANT PROGRAM.
Section 2021A(f)(1) of title 38, United States Code, is amended by
striking ``2025'' and inserting ``2026''.
SEC. 302. EXTENSION OF AUTHORITY FOR TREATMENT AND REHABILITATION FOR
SERIOUSLY MENTALLY ILL AND HOMELESS VETERANS.
(a) General Treatment.--Section 2031(b) of title 38, United States
Code, is amended by striking ``September 30, 2025'' and inserting
``November 21, 2025''.
(b) Additional Services at Certain Locations.--Section 2033(d) of
title 38, United States Code, is amended by striking ``September 30,
2025'' and inserting ``November 21, 2025''.
SEC. 303. EXTENSION OF FUNDING FOR FINANCIAL ASSISTANCE FOR SUPPORTIVE
SERVICES FOR VERY LOW-INCOME VETERAN FAMILIES IN
PERMANENT HOUSING.
Of the amounts appropriated to the Department of Veterans Affairs
for fiscal year 2026 for ``Medical Services'', $92,000,000 shall be
available until November 21, 2025, to carry out subsections (a), (b),
and (c) of section 2044 of title 38, United States Code.
SEC. 304. EXTENSION OF FUNDING FOR GRANT PROGRAM FOR HOMELESS VETERANS
WITH SPECIAL NEEDS.
Of the amounts appropriated to the Department of Veterans Affairs
for fiscal year 2026 for ``Medical Services'', $833,333 shall be
available until November 21, 2025, for the purposes of the program
under section 2061 of title 38, United States Code.
SEC. 305. EXTENSION OF AUTHORITY TO PROVIDE ASSISTANCE FOR SPECIALLY
ADAPTED HOUSING FOR DISABLED VETERANS RESIDING
TEMPORARILY IN HOUSING OWNED BY A FAMILY MEMBER.
Section 2102A(e) of title 38, United States Code, is amended by
striking ``September 30, 2025'' and inserting ``November 21, 2025''.
SEC. 306. EXTENSION OF AUTHORITY FOR SPECIALLY ADAPTED HOUSING
ASSISTIVE TECHNOLOGY GRANT PROGRAM.
Section 2108(g) of title 38, United States Code, is amended by
striking ``September 30, 2025'' and inserting ``November 21, 2025''.
SEC. 307. IMPROVEMENTS TO PARTIAL CLAIM PROGRAM OF THE DEPARTMENT OF
VETERANS AFFAIRS.
(a) Clarification of Relationship to Other Powers of Secretary.--
Section 3720(h) of title 38, United States Code, is amended by striking
``of subsection (a)'' and all that follows through the period at the
end and inserting ``of subsection (a) in conjunction with the purchase
of a loan under section 3732(a)(2) of this title unless the Secretary
determines the purchase would be made consistent with section 3732(d)
of this title.''.
(b) Administration of Partial Claim Program.--Section 3737 of such
title is amended--
(1) in subsection (b)(2), by striking ``first lien
guaranteed loan for such property'' and inserting ``amount of
indebtedness under the guaranteed loan that the Secretary does
not purchase''; and
(2) in subsection (c)--
(A) in paragraph (2)(B)(ii), by striking ``120
days'' and inserting ``180 days''; and
(B) by amending paragraph (3) to read as follows:
``(3) An amount paid to the holder of a loan as a partial claim--
``(A) shall not alter the guaranty calculation specified by
section 3703 of this title;
``(B) shall be included, for the purpose of a liquidation
sale, in the same manner as any other advance allowed by the
Secretary; and
``(C) shall not be claimed under the guaranty or increase
the Secretary's cost of acquisition of the property securing
the defaulted loan.''.
(c) Requirements of Loan Holder.--Section (d)(1) of such section is
amending by inserting ``and servicing the loan'' after ``documents''.
(d) Default and Foreclosure.--Subsection (e) of such section is
amended--
(1) in paragraph (1)--
(A) in subparagraph (A), by striking ``an
individual who'' and all that follows through the
period at the end and inserting the following: ``a
borrower who defaults on a partial claim shall be
liable to the Secretary for any loss suffered by the
Secretary with respect to such default, and such loss
may be recovered in the same manner as any other debt
due the United States. The Secretary shall not restore
housing loan entitlement under section 3702(b) of this
title until such loss is repaid in full.''; and
(B) by amending subparagraph (B) to read as
follows:
``(B) The Secretary may charge administrative costs, fees, and
interest, as appropriate, with respect to any default under a partial
claim in a manner similar to the interest and administrative costs
charged under section 5315 of this title.''; and
(2) by amending paragraph (2) to read as follows:
``(2) Notwithstanding section 2410 of title 28, a nonjudicial sale
of real property to satisfy a loan guaranteed under this chapter shall
discharge the property from a partial claim interest held by the
Secretary, provided that the holder of the guaranteed loan conducts the
non-judicial sale and distributes the sale proceeds, if any, in
accordance with the State or local law where such property is
situated.''.
(e) Guidance in Advance of Regulations.--Subsection (h) of such
section is amended to read as follows:
``(h) Guidance in Advance of Regulations.--Notwithstanding any
other provision of law, the Secretary may, before prescribing
regulations, issue administrative guidance with respect to the Partial
Claim Program under this section and the loss mitigation options
prescribed under section 3732(d) of this title, including any
additional terms, conditions, and requirements the Secretary determines
necessary.''.
SEC. 308. GOVERNMENT ACCOUNTABILITY OFFICE REPORTS ON PARTIAL CLAIM
PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS AND OTHER
MATTERS.
(a) Annual Reports.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, and every year thereafter until the
Partial Claim Program terminates, the Comptroller General of
the United States shall submit to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs of
the House of Representatives a report.
(2) Elements.--Each report required by paragraph (1) shall
include, for the period covered by the report and disaggregated
by quarter, the following:
(A) Key data on the performance of the Partial
Claim Program, including--
(i) the number of partial claims filed and
approved; and
(ii) the redefault and foreclosure rates of
loans for which a partial claim was made.
(B) A comparison of the data described in
subparagraph (A) with data on the performance of other
loss mitigation options provided by the Department of
Veterans Affairs.
(C) The number of housing loans insured,
guaranteed, or made by the Secretary of Veterans
Affairs under chapter 37 of title 38, United States
Code.
(D) The number of applications for housing loan
benefits under such chapter denied.
(E) The number of housing loans insured,
guaranteed, or made by the Secretary under such chapter
refinanced under section 3710(a)(8) or 3712 of title
38, United States Code.
(F) The number of veterans who owe a payment on a
mortgage associated with a loan insured, guaranteed, or
made by the Secretary under such chapter that is at
least--
(i) 60 days late; and
(ii) 90 days late.
(b) Assessment.--
(1) In general.--Not later than one year before the Partial
Claim Program terminates, the Comptroller General shall--
(A) conduct an assessment of the benefits and
challenges of the Partial Claim Program; and
(B) submit to the Committee on Veterans' Affairs of
the Senate and the Committee on Veterans' Affairs of
the House of Representatives a report on the findings
of the Comptroller General with respect to that
assessment.
(2) Considerations.--In conducting the assessment required
by paragraph (1), the Comptroller General shall consider the
following:
(A) The characteristics of borrowers for whom a
partial claim was made compared to the characteristics
of borrowers provided other loss mitigation options by
the Department of Veterans Affairs.
(B) The performance of loans guaranteed under
chapter 37 of title 38, United States Code, following
various loss mitigation actions.
(C) The information the Department considered in
determining whether a borrower would benefit from a
partial claim compared to other loss mitigation
options.
(D) The costs to taxpayers of the Partial Claim
Program compared to the costs of other loss mitigation
options provided by the Department.
(E) Any similarities and differences in the
Department's administration and use of the Partial
Claim Program compared to the Department's
administration and use of the COVID-19 Veterans
Assistance Partial Claim Payment program established
under subpart F of part 36 of title 38, Code of
Regulations.
(F) The information the Department learned from the
COVID-19 Veterans Assistance Partial Claim Payment
program and the extent to which those lessons learned
were applied to the Partial Claim Program.
(G) The types of information the Department
collected to monitor the performance and effectiveness
of the Partial Claim Program and how the Department
used that information to make any needed adjustments to
the program.
(H) How the use by the Department of partial claims
compares to the use of partial claims by other Federal
housing agencies, including, for each partial claim
program--
(i) the volume of loans for which partial
claims have been made;
(ii) the results for borrowers (including
redefault and foreclosure rates); and
(iii) the costs to taxpayers.
(c) Partial Claim Program Defined.--In this section, the term
``Partial Claim Program'' means the Partial Claim Program of the
Department of Veterans Affairs carried out under section 3737 of title
38, United States Code.
TITLE IV--OTHER MATTERS
SEC. 401. EXTENSION OF SUBPOENA AUTHORITY OF INSPECTOR GENERAL OF
DEPARTMENT OF VETERANS AFFAIRS.
Section 312(d)(7)(A) of title 38, United States Code, is amended by
striking ``September 30, 2025'' and inserting ``November 21, 2025''.
SEC. 402. EXTENSION OF AUTHORITY FOR SECRETARY OF VETERANS AFFAIRS TO
TRANSPORT INDIVIDUALS TO AND FROM FACILITIES OF
DEPARTMENT OF VETERANS AFFAIRS.
Section 111A(a)(2) of title 38, United States Code, is amended by
striking ``September 30, 2025'' and inserting ``November 21, 2025''.
SEC. 403. EXTENSION OF AUTHORITY RELATING TO VENDEE LOAN PROGRAM.
Section 3733(a)(8) of title 38, United States Code, is amended--
(1) in the matter preceding subparagraph (A), by striking
``September 30, 2025'' and inserting ``November 21, 2025''; and
(2) in subparagraph (C), by striking ``September 30, 2025''
and inserting ``November 21, 2025''.
SEC. 404. EXTENSION OF AUTHORITY FOR TRANSFER OF REAL PROPERTY.
Section 8118(a)(5) of title 38, United States Code, is amended by
striking ``September 30, 2025'' and inserting ``November 21, 2025''.
DIVISION E--MISCELLANEOUS
SEC. 101. BUDGETARY EFFECTS.
(a) Statutory PAYGO Scorecards.--The budgetary effects of divisions
B through D shall not be entered on either PAYGO scorecard maintained
pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010.
(b) Senate PAYGO Scorecards.--The budgetary effects of divisions B
through D shall not be entered on any PAYGO scorecard maintained for
purposes of section 4106 of H. Con. Res. 71 (115th Congress).
(c) Classification of Budgetary Effects.--Notwithstanding Rule 3 of
the Budget Scorekeeping Guidelines set forth in the joint explanatory
statement of the committee of conference accompanying Conference Report
105-217 and section 250(c)(8) of the Balanced Budget and Emergency
Deficit Control Act of 1985, the budgetary effects of divisions B
through D shall not be estimated--
(1) for purposes of section 251 of such Act;
(2) for purposes of an allocation to the Committee on
Appropriations pursuant to section 302(a) of the Congressional
Budget Act of 1974; and
(3) for purposes of paragraph (4)(C) of section 3 of the
Statutory Pay-As-You-Go Act of 2010 as being included in an
appropriation Act.
Passed the House of Representatives September 19, 2025.
Attest:
Clerk.
119th CONGRESS
1st Session
H. R. 5371
_______________________________________________________________________
AN ACT
Making continuing appropriations and extensions for fiscal year 2026,
and for other purposes.