Public Law 115-123 – Bipartisan Budget Act of 2018

Last Updated on June 1, 2019 by LawEuro

[115th Congress Public Law 123]
[From the U.S. Government Publishing Office]

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BIPARTISAN BUDGET ACT OF 2018

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Public Law 115-123
115th Congress

An Act

To amend title 4, United States Code, to provide for the flying of the
flag at half-staff in the event of the death of a first responder in the
line of duty. <<NOTE: Feb. 9, 2018 – [H.R. 1892]>>

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: Bipartisan
Budget Act of 2018.>>
SECTION 1. <<NOTE: 42 USC 1305 note.>> SHORT TITLE.

This Act may be cited as the “Bipartisan Budget Act of 2018”.

DIVISION A– <<NOTE: Honoring Hometown Heroes Act.>> HONORING HOMETOWN
HEROES ACT
SECTION 10101. <<NOTE: 4 USC 1 note.>> SHORT TITLE.

This division may be cited as the “Honoring Hometown Heroes Act”.
SEC. 10102. PERMITTING THE FLAG TO BE FLOWN AT HALF-STAFF IN THE
EVENT OF THE DEATH OF A FIRST
RESPONDER SERVING IN THE LINE OF DUTY.

(a) Amendment.–The sixth sentence of section 7(m) of title 4,
United States Code, is amended–
(1) by striking “or” after “possession of the United
States” and inserting a comma;
(2) by inserting “or the death of a first responder working
in any State, territory, or possession who dies while serving in
the line of duty,” after “while serving on active duty,”;
(3) by striking “and” after “former officials of the
District of Columbia” and inserting a comma; and
(4) by inserting before the period the following: “, and
first responders working in the District of Columbia”.

(b) First Responder Defined.–Such subsection is further amended–
(1) in paragraph (2), by striking “, United States Code;
and” and inserting a semicolon;
(2) in paragraph (3), by striking the period at the end and
inserting “; and”; and
(3) by adding at the end the following new paragraph:
“(4) the term `first responder’ means a `public safety
officer’ as defined in section 1204 of title I of the Omnibus
Crime Control and Safe Streets Act of 1968 (34 U.S.C. 10284).”.

(c) <<NOTE: Applicability. 4 USC 7 note.>> Effective Date.–The
amendments made by this section shall apply with respect to deaths of
first responders occurring on or after the date of the enactment of this
Act.

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DIVISION B–SUPPLEMENTAL APPROPRIATIONS, TAX RELIEF, AND MEDICAID
CHANGES RELATING TO CERTAIN DISASTERS AND FURTHER EXTENSION OF
CONTINUING APPROPRIATIONS

Subdivision 1– <<NOTE: Further Additional Supplemental Appropriations
for Disaster Relief Requirements Act, 2018.>> Further Additional
Supplemental Appropriations for Disaster Relief Requirements Act, 2018

The following sums in this subdivision are appropriated, out of any
money in the Treasury not otherwise appropriated, for the fiscal year
ending September 30, 2018 and for other purposes, namely:

TITLE I

DEPARTMENT OF AGRICULTURE

AGRICULTURAL PROGRAMS

Processing, Research and Marketing

Office of the Secretary

For an additional amount for the “Office of the Secretary”,
$2,360,000,000, which shall remain available until December 31, 2019,
for necessary expenses related to crops, trees, bushes, and vine losses
related to the consequences of Hurricanes Harvey, Irma, Maria, and other
hurricanes and wildfires occurring in calendar year 2017 under such
terms and conditions as determined by the Secretary: Provided, That the
Secretary may provide assistance for such losses in the form of block
grants to eligible states and territories: Provided further, That the
total amount of payments received under this heading and applicable
policies of crop insurance under the Federal Crop Insurance Act (7
U.S.C. 1501 et seq.) or the Noninsured Crop Disaster Assistance Program
(NAP) under section 196 of the Federal Agriculture Improvement and
Reform Act of 1996 (7 U.S.C. 7333) shall not exceed 85 percent of the
loss as determined by the Secretary: Provided further, That the total
amount of payments received under this heading for producers who did not
obtain a policy or plan of insurance for an insurable commodity for the
2017 crop year, or 2018 crop year as applicable, under the Federal Crop
Insurance Act (7 U.S.C. 1501 et seq.) for the crop incurring the losses
or did not file the required paperwork and pay the service fee by the
applicable State filing deadline for a noninsurable commodity for the
2017 crop year, or 2018 crop year as applicable, under NAP for the crop
incurring the losses shall not exceed 65 percent of the loss as
determined by the Secretary: Provided further, That producers receiving
payments under this heading, as determined by the Secretary, shall be
required to purchase crop insurance where crop insurance is available
for the next two available crop years, and producers receiving payments
under this heading shall be required to purchase coverage under NAP
where crop insurance is not available in the next two available crop
years, as determined by the Secretary: Provided
further, <<NOTE: Deadline. Reports.>> That, not later than 90 days
after the end of fiscal year 2018, the Secretary shall submit a report
to the Congress specifying the type, amount, and method of such
assistance by state and territory and the status of the amounts
obligated and plans for

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further expenditure and include improvements that can be made to Federal
Crop Insurance policies, either administratively or legislatively, to
increase participation, particularly among underserved producers, in
higher levels of coverage in future years for crops qualifying for
assistance under this heading: Provided further, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

Office of Inspector General

For an additional amount for “Office of Inspector General”,
$2,500,000, to remain available until expended, for oversight and audit
of programs, grants, and activities funded by this subdivision and
administered by the Department of Agriculture: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Agricultural Research Service

buildings and facilities

For an additional amount for “Buildings and Facilities”,
$22,000,000, to remain available until expended, for necessary expenses
related to the consequences of Hurricanes Harvey, Irma, and Maria:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

Farm Service Agency

emergency conservation program

For an additional amount for the “Emergency Conservation Program”,
for necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria and of wildfires occurring in calendar year 2017, and
other natural disasters, $400,000,000, to remain available until
expended: Provided, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

Natural Resources Conservation Service

watershed and flood prevention operations

For an additional amount for “Watershed and Flood Prevention
Operations”, for necessary expenses for the Emergency Watershed
Protection Program related to the consequences of Hurricanes Harvey,
Irma, and Maria and of wildfires occurring in calendar year 2017, and
other natural disasters, $541,000,000, to remain available until
expended: Provided, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

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RURAL DEVELOPMENT PROGRAMS

Rural Housing Service

rural housing insurance fund program account

For an additional amount for “Rural Housing Insurance Fund Program
Account”, $18,672,000, to remain available until September 30, 2019,
for the cost of direct loans, including the cost of modifying loans as
defined in section 502 of the Congressional Budget Act of 1974, for the
rehabilitation of section 515 rental housing (42 U.S.C. 1485) in areas
impacted by Hurricanes Harvey, Irma, and Maria where owners were not
required to carry national flood insurance: Provided, That such amount
is designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

Rural Utilities Service

rural water and waste disposal program account

For an additional amount for the “Rural Water and Waste Disposal
Program Account”, $165,475,000, to remain available until expended, for
grants to repair drinking water systems and sewer and solid waste
disposal systems impacted by Hurricanes Harvey, Irma, and Maria:
Provided, That not to exceed $2,000,000 of the amount appropriated under
this heading shall be for technical assistance grants for rural water
and waste systems pursuant to section 306(a)(22) of the Consolidated
Farm and Rural Development Act: Provided further, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

DOMESTIC FOOD PROGRAMS

Food and Nutrition Service

special supplemental nutrition program for women, infants, and children
(wic)

For an additional amount for the “Special Supplemental Nutrition
Program for Women, Infants, and Children”, $14,000,000, to remain
available until September 30, 2019, for infrastructure grants to the
Commonwealth of Puerto Rico and the U.S. Virgin Islands to assist in the
repair and restoration of buildings, equipment, technology, and other
infrastructure damaged as a consequence of Hurricanes Irma and Maria:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

commodity assistance program

For an additional amount for “Commodity Assistance Program” for
the emergency food assistance program as authorized by section 27(a) of
the Food and Nutrition Act of 2008 (7 U.S.C. 2036(a))

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and section 204(a)(1) of the Emergency Food Assistance Act of 1983 (7
U.S.C. 7508(a)(1)), $24,000,000, to remain available until September 30,
2019, for necessary expenses of those jurisdictions that received a
major disaster or emergency declaration pursuant to section 401 or 501,
respectively, of the Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5170, 5191) related to the consequences of
Hurricanes Harvey, Irma, and Maria or due to wildfires in 2017:
Provided, That notwithstanding any other provisions of the Emergency
Food Assistance Act of 1983, the Secretary of Agriculture may provide
resources to Puerto Rico, the Virgin Islands of the United States, and
affected States, as determined by the Secretary, to assist affected
families and individuals without regard to sections 204 and 214 of such
Act (7 U.S.C. 7508, 7515) by allocating additional foods and funds for
administrative expenses from resources specifically appropriated,
transferred, or reprogrammed: Provided further, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

RELATED AGENCIES AND FOOD AND DRUG ADMINISTRATION

Department of Health and Human Services

food and drug administration

buildings and facilities

(including transfer of funds)

For an additional amount for “Buildings and Facilities”,
$7,600,000, to remain available until expended, for necessary expenses
related to the consequences of Hurricanes Harvey, Irma, and Maria:
Provided, That such amount may be transferred to “Department of Health
and Human Services–Food and Drug Administration–Salaries and
Expenses” for costs related to repair of facilities, for replacement of
equipment, and for other increases in facility-related costs: Provided
further, That obligations incurred for the purposes provided herein
prior to the date of enactment of this subdivision may be charged to
funds appropriated by this paragraph: Provided further, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

GENERAL PROVISION–THIS TITLE

Sec. 20101. (a) Section 1501(b) of the Agricultural Act of 2014 (7
U.S.C. 9081(b)) is amended–
(1) in paragraph (1), in the matter before subparagraph (A),
by inserting “sold livestock for a reduced sale price, or
both” after “normal mortality,”;
(2) in paragraph (2), by striking “applicable livestock on
the day before the date of death of the livestock, as determined
by the Secretary.” and inserting the following:
“affected livestock, as determined by the Secretary, on, as
applicable–

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“(A) the day before the date of death of the
livestock; or
“(B) the day before the date of the event that
caused the harm to the livestock that resulted in a
reduced sale price.”; and
(3) by adding at the end the following new paragraph:
“(4) A payment made under paragraph (1) to an eligible
producer on a farm that sold livestock for a reduced sale price
shall–
“(A) be made if the sale occurs within a reasonable
period following the event, as determined by the
Secretary; and
“(B) be reduced by the amount that the producer
received for the sale.”.

(b) Section 1501(d)(1) of the Agricultural Act of 2014 (7 U.S.C.
9081(d)(1)) is amended by striking “not more than $20,000,000 of”.
(c) Section 1501(e)(4)(C) of the Agricultural Act of 2014 (7 U.S.C.
9081(e)(4)(C)) is amended by striking “500 acres” and inserting
“1,000 acres”.
(d) Section 1501 of the Agricultural Act of 2014 (7 U.S.C. 9081) is
amended–
(1) in subsection (e)(4)–
(A) by striking subparagraph (B); and
(B) by redesignating subparagraph (C), as amended by
subsection (c), as subparagraph (B); and
(2) in subsection (f)(2), by striking “subsection (e)” and
inserting “subsections (b) and (e)”.

(e) <<NOTE: Applicability. Effective date. 7 USC 9081 note.>>
Section 1501 of the Agricultural Act of 2014 (7 U.S.C. 9081), as amended
by this section, shall apply with respect to losses described in such
section 1501 incurred on or after January 1, 2017.

(f) The amounts provided by subsections (a) through (e) for fiscal
year 2018 are designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

TITLE II

DEPARTMENT OF COMMERCE

Economic Development Administration

economic development assistance programs

(including transfers of funds)

Pursuant to section 703 of the Public Works and Economic Development
Act (42 U.S.C. 3233), for an additional amount for “Economic
Development Assistance Programs” for necessary expenses related to
flood mitigation, disaster relief, long-term recovery, and restoration
of infrastructure in areas that received a major disaster designation as
a result of Hurricanes Harvey, Irma, and Maria, and of wildfires and
other natural disasters occurring in calendar year 2017 under the Robert
T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121
et seq.), $600,000,000, to remain available until expended: Provided,
That

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the amount provided under this heading is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985:
Provided further, That within the amount appropriated, up to 2 percent
of funds may be transferred to the “Salaries and Expenses” account for
administration and oversight activities: Provided further, That within
the amount appropriated, $1,000,000 shall be transferred to the “Office
of Inspector General” account for carrying out investigations and
audits related to the funding provided under this heading.

National Oceanic and Atmospheric Administration

operations, research, and facilities

For an additional amount for “Operations, Research, and
Facilities” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, $120,904,000, to remain available
until September 30, 2019, as follows:
(1) $12,904,000 for repair and replacement of observing
assets, Federal real property, and equipment;
(2) $18,000,000 for marine debris assessment and removal;
(3) $40,000,000 for mapping, charting, and geodesy services;
and
(4) $50,000,000 to improve weather forecasting, hurricane
intensity forecasting and flood forecasting and mitigation
capabilities, including data assimilation from ocean observing
platforms and satellites:

Provided, That the amount provided under this heading is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985: Provided further, <<NOTE: Spending plan. Deadline.>> That the
National Oceanic and Atmospheric Administration shall submit a spending
plan to the Committees on Appropriations of the House of Representatives
and the Senate within 45 days after the date of enactment of this
subdivision.

procurement, acquisition and construction

For an additional amount for “Procurement, Acquisition and
Construction” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, $79,232,000, to remain available
until September 30, 2020, as follows:
(1) $29,232,000 for repair and replacement of Federal real
property and observing assets; and
(2) $50,000,000 for improvements to operational and research
weather supercomputing infrastructure and for improvement of
satellite ground services used in hurricane intensity and track
prediction:

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fisheries disaster assistance

For an additional amount for “Fisheries Disaster Assistance” for
necessary expenses associated with the mitigation of fishery disasters,
$200,000,000, to remain available until expended: Provided, That funds
shall be used for mitigating the effects of commercial fishery failures
and fishery resource disasters declared by the Secretary of Commerce in
calendar year 2017, as well those declared by the Secretary to be a
direct result of Hurricanes Harvey, Irma, or Maria: Provided further,
That the amount provided under this heading is designated by the
Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

DEPARTMENT OF JUSTICE

United States Marshals Service

salaries and expenses

For an additional amount for “Salaries and Expenses” for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria, $2,500,000: Provided, That the amount provided under this
heading is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Federal Bureau of Investigation

salaries and expenses

For an additional amount for “Salaries and Expenses” for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria, $21,200,000: Provided, That the amount provided under this
heading is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Drug Enforcement Administration

salaries and expenses

For an additional amount for “Salaries and Expenses” for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria, $11,500,000: Provided, That the amount provided under this
heading is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Federal Prison System

salaries and expenses

For an additional amount for “Salaries and Expenses” for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria, $16,000,000: Provided, That the amount provided under this
heading is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

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buildings and facilities

For an additional amount for “Buildings and Facilities” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $34,000,000, to remain available until expended:
Provided, That the amount provided under this heading is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

SCIENCE

National Aeronautics and Space Administration

construction and environmental compliance and restoration

For an additional amount for “Construction and Environmental
Compliance and Restoration” for repairs at National Aeronautics and
Space Administration facilities damaged by hurricanes during 2017,
$81,300,000, to remain available until expended: Provided, That the
amount provided under this heading is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

National Science Foundation

research and related activities

For an additional amount for “Research and Related Activities” for
necessary expenses to repair National Science Foundation radio
observatory facilities damaged by hurricanes that occurred during 2017,
$16,300,000, to remain available until expended: Provided, That the
amount provided under this heading is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985:
Provided further, <<NOTE: Spending plan. Deadline.>> That the National
Science Foundation shall submit a spending plan to the Committees on
Appropriations of the House of Representatives and the Senate within 45
days after the date of enactment of this subdivision.

RELATED AGENCIES

Legal Services Corporation

payment to the legal services corporation

For an additional amount for “Payment to the Legal Services
Corporation” to carry out the purposes of the Legal Services
Corporation Act by providing for necessary expenses related to the
consequences of Hurricanes Harvey, Irma, and Maria and of the calendar
year 2017 wildfires, $15,000,000: Provided, That the amount made
available under this heading shall be used only to provide the mobile
resources, technology, and disaster coordinators necessary to provide
storm-related services to the Legal Services Corporation client
population and only in the areas significantly affected by Hurricanes
Harvey, Irma, and Maria and by the calendar year 2017 wildfires:
Provided further, That such amount

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is designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985: Provided further, That none of the funds
appropriated in this subdivision to the Legal Services Corporation shall
be expended for any purpose prohibited or limited by, or contrary to any
of the provisions of, sections 501, 502, 503, 504, 505, and 506 of
Public Law 105-119, and all funds appropriated in this subdivision to
the Legal Services Corporation shall be subject to the same terms and
conditions set forth in such sections, except that all references in
sections 502 and 503 to 1997 and 1998 shall be deemed to refer instead
to 2017 and 2018, respectively, and except that sections 501 and 503 of
Public Law 104-134 (referenced by Public Law 105-119) shall not apply to
the amount made available under this heading: Provided further, That,
for the purposes of this subdivision, the Legal Services Corporation
shall be considered an agency of the United States Government.

GENERAL PROVISION–THIS TITLE

Sec. 20201. <<NOTE: Deadline. Waiver.>> (a) In recognition of the
consistency of the Mid-Barataria Sediment Diversion, Mid-Breton Sound
Sediment Diversion, and Calcasieu Ship Channel Salinity Control Measures
projects, as selected by the 2017 Louisiana Comprehensive Master Plan
for a Sustainable Coast, with the findings and policy declarations in
section 2(6) of the Marine Mammal Protection Act (16 U.S.C. 1361 et
seq., as amended) regarding maintaining the health and stability of the
marine ecosystem, within 120 days of the enactment of this section, the
Secretary of Commerce shall issue a waiver pursuant to section
101(a)(3)(A) and this section to section 101(a) and section 102(a) of
the Act, for such projects that will remain in effect for the duration
of the construction, operations and maintenance of the projects. No
rulemaking, permit, determination, or other condition or limitation
shall be required when issuing a waiver pursuant to this section.

(b) <<NOTE: Louisiana. Consultation.>> Upon issuance of a waiver
pursuant to this section, the State of Louisiana shall, in consultation
with the Secretary of Commerce:
(1) To the extent practicable and consistent with the
purposes of the projects, minimize impacts on marine mammal
species and population stocks; and
(2) Monitor and evaluate the impacts of the projects on such
species and population stocks.

TITLE III

DEPARTMENT OF DEFENSE

DEPARTMENT OF DEFENSE–MILITARY

OPERATION AND MAINTENANCE

Operation and Maintenance, Army

For an additional amount for “Operation and Maintenance, Army”,
$20,110,000, for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria: Provided, That

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such amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Operation and Maintenance, Navy

For an additional amount for “Operation and Maintenance, Navy”,
$267,796,000, for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria: Provided, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

Operation and Maintenance, Marine Corps

For an additional amount for “Operation and Maintenance, Marine
Corps”, $17,920,000, for necessary expenses related to the consequences
of Hurricanes Harvey, Irma, and Maria: Provided, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

Operation and Maintenance, Air Force

For an additional amount for “Operation and Maintenance, Air
Force”, $20,916,000, for necessary expenses related to the consequences
of Hurricanes Harvey, Irma, and Maria: Provided, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

Operation and Maintenance, Defense-Wide

For an additional amount for “Operation and Maintenance, Defense-
Wide”, $2,650,000, for necessary expenses related to the consequences
of Hurricanes Harvey, Irma, and Maria: Provided, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

Operation and Maintenance, Army Reserve

For an additional amount for “Operation and Maintenance, Army
Reserve”, $12,500,000, for necessary expenses related to the
consequences of Hurricanes Harvey, Irma, and Maria: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Operation and Maintenance, Navy Reserve

For an additional amount for “Operation and Maintenance, Navy
Reserve”, $2,922,000, for necessary expenses related to the
consequences of Hurricanes Harvey, Irma, and Maria: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

[[Page 132 STAT. 75]]

Operation and Maintenance, Air Force Reserve

For an additional amount for “Operation and Maintenance, Air Force
Reserve”, $5,770,000, for necessary expenses related to the
consequences of Hurricanes Harvey, Irma, and Maria: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Operation and Maintenance, Army National Guard

For an additional amount for “Operation and Maintenance, Army
National Guard”, $55,471,000, for necessary expenses related to the
consequences of Hurricanes Harvey, Irma, and Maria: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

PROCUREMENT

Other Procurement, Navy

For an additional amount for “Other Procurement, Navy”
$18,000,000, to remain available until September 30, 2020, for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria: Provided, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

REVOLVING AND MANAGEMENT FUNDS

Defense Working Capital Funds

For an additional amount for “Defense Working Capital Funds” for
the Navy Working Capital Fund, $9,486,000, for necessary expenses
related to the consequences of Hurricanes Harvey, Irma, and Maria:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

OTHER DEPARTMENT OF DEFENSE PROGRAMS

Defense Health Program

For an additional amount for operation and maintenance for “Defense
Health Program”, $704,000, for necessary expenses related to the
consequences of Hurricanes Harvey, Irma, and Maria: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

[[Page 132 STAT. 76]]

TITLE IV

CORPS OF ENGINEERS–CIVIL

DEPARTMENT OF THE ARMY

investigations

For an additional amount for “Investigations” for necessary
expenses related to the completion, or initiation and completion, of
flood and storm damage reduction, including shore protection, studies
which are currently authorized or which are authorized after the date of
enactment of this subdivision, to reduce risk from future floods and
hurricanes, at full Federal expense, $135,000,000, to remain available
until expended: Provided, That of such amount, not less than
$75,000,000 is available for such studies in States and insular areas
that were impacted by Hurricanes Harvey, Irma, and Maria: Provided
further, That funds made available under this heading shall be for high-
priority studies of projects in States and insular areas with more than
one flood-related major disaster declared pursuant to the Robert T.
Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et
seq.) in calendar years 2014, 2015, 2016, or 2017: Provided further,
That such amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985: Provided
further, <<NOTE: Deadlines. Reports.>> That the Assistant Secretary of
the Army for Civil Works shall provide a monthly report to the
Committees on Appropriations of the House of Representatives and the
Senate detailing the allocation and obligation of these funds, including
new studies selected to be initiated using funds provided under this
heading, beginning not later than 60 days after the enactment of this
subdivision.

construction

For an additional amount for “Construction” for necessary expenses
to address emergency situations at Corps of Engineers projects, and to
construct, and rehabilitate and repair damages caused by natural
disasters, to Corps of Engineers projects, $15,055,000,000, to remain
available until expended: Provided, <<NOTE: Determination.>> That of
such amount, $15,000,000,000 is available to construct flood and storm
damage reduction, including shore protection, projects which are
currently authorized or which are authorized after the date of enactment
of this subdivision, and flood and storm damage reduction, including
shore protection, projects which have signed Chief’s Reports as of the
date of enactment of this subdivision or which are studied using funds
provided under the heading “Investigations” if the Secretary
determines such projects to be technically feasible, economically
justified, and environmentally acceptable, in States and insular areas
with more than one flood-related major disaster declared pursuant to the
Robert T. Stafford Disaster Relief and Emergency Assistance Act (42
U.S.C. 5121 et seq.) in calendar years 2014, 2015, 2016, or 2017:
Provided further, That of the amounts in the preceding proviso, not less
than $10,425,000,000 shall be available for such projects within States
and insular areas that were impacted by Hurricanes Harvey, Irma, and
Maria: Provided further, <<NOTE: Puerto Rico. Virgin Islands.>> That
all repair, rehabilitation, study, design, and

[[Page 132 STAT. 77]]

construction of Corps of Engineers projects in Puerto Rico and the
United States Virgin Islands, using funds provided under this heading,
shall be conducted at full Federal expense: Provided further, That for
projects receiving funding under this heading, the provisions of section
902 of the Water Resources Development Act of 1986 shall not apply to
these funds: Provided further, That the completion of ongoing
construction projects receiving funds provided under this heading shall
be at full Federal expense with respect to such funds: Provided
further, <<NOTE: Time period.>> That using funds provided under this
heading, the non-Federal cash contribution for projects eligible for
funding pursuant to the first proviso shall be financed in accordance
with the provisions of section 103(k) of Public Law 99-662 over a period
of 30 years from the date of completion of the project or separable
element: Provided further, That up to $50,000,000 of the funds made
available under this heading shall be used for continuing authorities
projects to reduce the risk of flooding and storm damage: Provided
further, That any projects using funds appropriated under this heading
shall be initiated only after non-Federal interests have entered into
binding agreements with the Secretary requiring, where applicable, the
non-Federal interests to pay 100 percent of the operation, maintenance,
repair, replacement, and rehabilitation costs of the project and to hold
and save the United States free from damages due to the construction or
operation and maintenance of the project, except for damages due to the
fault or negligence of the United States or its contractors: Provided
further, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985: Provided
further, <<NOTE: Deadlines. Reports.>> That the Assistant Secretary of
the Army for Civil Works shall provide a monthly report to the
Committees on Appropriations of the House of Representatives and the
Senate detailing the allocation and obligation of these funds, beginning
not later than 60 days after the enactment of this subdivision.

mississippi river and tributaries

For an additional amount for “Mississippi River and Tributaries”
for necessary expenses to address emergency situations at Corps of
Engineers projects, and to construct, and rehabilitate and repair
damages to Corps of Engineers projects, caused by natural disasters,
$770,000,000, to remain available until expended: Provided, That of
such amount, $400,000,000 is available to construct flood and storm
damage reduction projects which are currently authorized or which are
authorized after the date of enactment of this subdivision: Provided
further, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985: Provided
further, <<NOTE: Deadlines. Reports.>> That the Assistant Secretary of
the Army for Civil Works shall provide a monthly report to the
Committees on Appropriations of the House of Representatives and the
Senate detailing the allocation and obligation of these funds, beginning
not later than 60 days after the enactment of this subdivision.

[[Page 132 STAT. 78]]

operation and maintenance

For an additional amount for “Operation and Maintenance” for
necessary expenses to dredge Federal navigation projects in response to,
and repair damages to Corps of Engineers Federal projects caused by,
natural disasters, $608,000,000, to remain available until expended, of
which such sums as are necessary to cover the Federal share of eligible
operation and maintenance costs for coastal harbors and channels, and
for inland harbors shall be derived from the Harbor Maintenance Trust
Fund: Provided, That such amount is designated by the Congress as being
for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985: Provided
further, <<NOTE: Deadlines. Reports.>> That the Assistant Secretary of
the Army for Civil Works shall provide a monthly report to the
Committees on Appropriations of the House of Representatives and the
Senate detailing the allocation and obligation of these funds, beginning
not later than 60 days after the enactment of this subdivision.

flood control and coastal emergencies

For an additional amount for “Flood Control and Coastal
Emergencies”, as authorized by section 5 of the Act of August 18, 1941
(33 U.S.C. 701n), for necessary expenses to prepare for flood, hurricane
and other natural disasters and support emergency operations, repairs,
and other activities in response to such disasters, as authorized by
law, $810,000,000, to remain available until expended: Provided, That
funding utilized for authorized shore protection projects shall restore
such projects to the full project profile at full Federal expense:
Provided further, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985:
Provided further, <<NOTE: Deadlines. Reports.>> That the Assistant
Secretary of the Army for Civil Works shall provide a monthly report to
the Committees on Appropriations of the House of Representatives and the
Senate detailing the allocation and obligation of these funds, beginning
not later than 60 days after the enactment of this subdivision.

expenses

For an additional amount for “Expenses” for necessary expenses to
administer and oversee the obligation and expenditure of amounts
provided in this title for the Corps of Engineers, $20,000,000, to
remain available until expended: Provided, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985: Provided
further, <<NOTE: Deadlines. Reports.>> That the Assistant Secretary of
the Army for Civil Works shall provide a monthly report to the
Committees on Appropriations of the House of Representatives and the
Senate detailing the allocation and obligation of these funds, beginning
not later than 60 days after enactment of this subdivision.

[[Page 132 STAT. 79]]

DEPARTMENT OF ENERGY

ENERGY PROGRAMS

Electricity Delivery and Energy Reliability

For an additional amount for “Electricity Delivery and Energy
Reliability”, $13,000,000, to remain available until expended, for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, including technical assistance related to electric
grids: Provided, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

Strategic Petroleum Reserve

For an additional amount for “Strategic Petroleum Reserve”,
$8,716,000, to remain available until expended, for necessary expenses
related to damages caused by Hurricanes Harvey, Irma, and Maria:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

GENERAL PROVISIONS–THIS TITLE

Sec. 20401. <<NOTE: Deadlines. Reports. 33 USC 701n-2.>> In fiscal
year 2018, and each fiscal year thereafter, the Chief of Engineers of
the U.S. Army Corps of Engineers shall transmit to the Congress, after
reasonable opportunity for comment, but without change, by the Assistant
Secretary of the Army for Civil Works, a monthly report, the first of
which shall be transmitted to Congress not later than 2 days after the
date of enactment of this subdivision and monthly thereafter, which
includes detailed estimates of damages to each Corps of Engineers
project, caused by natural disasters or otherwise.

Sec. 20402. From the unobligated balances of amounts made available
to the U.S. Army Corps of Engineers, $518,900,000 under the heading
“Corps of Engineers–Civil, Flood Control and Coastal Emergencies” and
$210,000,000 under the heading “Corps of Engineers–Civil, Operations
and Maintenance” in title X of the Disaster Relief Appropriations Act,
2013 (Public Law 113-2; 127 Stat. 25) shall be transferred to “Corps of
Engineers–Civil, Construction”, to remain available until expended, to
rehabilitate, repair and construct Corps of Engineers projects:
Provided, That those projects may only include construction expenses,
including cost sharing, as described under the heading “Corps of
Engineers–Civil, Construction” in title X of that Act or other
construction expenses related to the consequences of Hurricane Sandy:
Provided further, That amounts transferred pursuant to this section that
were previously designated by the Congress as an emergency requirement
pursuant to the Balanced Budget and Emergency Deficit Control Act are
designated by the Congress as an emergency requirement pursuant to
section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit
Control Act of 1985: Provided further, <<NOTE: Deadlines. Reports.>>
That the Assistant Secretary of the Army for Civil Works shall provide a
monthly report to the Committees on Appropriations of the House of
Representatives and the Senate detailing the allocation and

[[Page 132 STAT. 80]]

obligation of these funds, beginning not later than 60 days after the
enactment of this subdivision.

TITLE V

INDEPENDENT AGENCIES

General Services Administration

real property activities

federal buildings fund

For an additional amount to be deposited in the “Federal Buildings
Fund”, $126,951,000, to remain available until expended, for necessary
expenses related to the consequences of Hurricanes Harvey, Maria, and
Irma for repair and alteration of buildings under the custody and
control of the Administrator of General Services, and real property
management and related activities not otherwise provided for: Provided,
That funds may be used to reimburse the “Federal Buildings Fund” for
obligations incurred for this purpose prior to enactment of this
subdivision: Provided further, That not more than $15,000,000 shall be
available for tenant improvements in damaged U.S. courthouses: Provided
further, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

Small Business Administration

office of inspector general

For an additional amount for the “Office of Inspector General”,
$7,000,000, to remain available until expended: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

disaster loans program account

(including transfer of funds)

For an additional amount for the “Disaster Loans Program Account”
for the cost of direct loans authorized by section 7(b) of the Small
Business Act, $1,652,000,000, to remain available until expended:
Provided, That up to $618,000,000 may be transferred to and merged with
“Salaries and Expenses” for administrative expenses to carry out the
disaster loan program authorized by section 7(b) of the Small Business
Act: Provided further, That none of the funds provided under this
heading may be used for indirect administrative expenses: Provided
further, That the amount provided under this heading is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

[[Page 132 STAT. 81]]

TITLE VI

DEPARTMENT OF HOMELAND SECURITY

DEPARTMENTAL MANAGEMENT, OPERATIONS, INTELLIGENCE, AND OVERSIGHT

Office of Inspector General

operations and support

For an additional amount for “Operations and Support” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $25,000,000, to remain available until September 30,
2020, for audits and investigations of activities funded by this title:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

SECURITY, ENFORCEMENT, AND INVESTIGATIONS

U.S. Customs and Border Protection

operations and support

For an additional amount for “Operations and Support” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $104,494,000, to remain available until September 30,
2019: Provided, That such amount is designated by the Congress as being
for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985: Provided
further, That not more than $39,400,000 may be used to carry out U.S.
Customs and Border Protection activities in fiscal year 2018 in Puerto
Rico and the United States Virgin Islands, in addition to any other
amounts available for such purposes.

procurement, construction, and improvements

For an additional amount for “Procurement, Construction, and
Improvements” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, including for the reconstruction of
facilities affected, $45,000,000, to remain available until September
30, 2022: Provided, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985:
Provided further, <<NOTE: Puerto Rico. Virgin Islands.>> That funds are
provided to carry out U.S. Customs and Border Protection activities in
Puerto Rico and the United States Virgin Islands, in addition to any
other amounts available for such purposes.

U.S. Immigration and Customs Enforcement

operations and support

For an additional amount for “Operations and Support” for
necessary expenses related to the consequences of Hurricanes

[[Page 132 STAT. 82]]

Harvey, Irma, and Maria, $30,905,000, to remain available until
September 30, 2019: Provided, That such amount is designated by the
Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

procurement, construction, and improvements

For an additional amount for “Procurement, Construction, and
Improvements” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, $33,052,000, to remain available
until September 30, 2022: Provided, That such amount is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

Transportation Security Administration

operations and support

For an additional amount for “Operations and Support” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $10,322,000, to remain available until September 30,
2019: Provided, That such amount is designated by the Congress as being
for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

Coast Guard

operating expenses

For an additional amount for “Operating Expenses” for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria, $112,136,000, to remain available until September 30, 2019:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

environmental compliance and restoration

For an additional amount for “Environmental Compliance and
Restoration” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, $4,038,000, to remain available
until September 30, 2022: Provided, That such amount is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

acquisition, construction, and improvements

For an additional amount for Acquisition, Construction, and
Improvements” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, Maria, and Matthew, $718,919,000, to remain
available until September 30, 2022:
Provided, <<NOTE: Deadline. Expenditure plan.>> That, not later than 60
days after enactment of this subdivision, the Secretary

[[Page 132 STAT. 83]]

of Homeland Security, or her designee, shall submit to the Committees on
Appropriations of the House of Representatives and the Senate a detailed
expenditure plan for funds appropriated under this heading: Provided
further, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

PROTECTION, PREPAREDNESS, RESPONSE, AND RECOVERY

Federal Emergency Management Agency

operations and support

For an additional amount for “Operations and Support” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $58,800,000, to remain available until September 30,
2019: Provided, That such amount is designated by the Congress as being
for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

procurement, construction, and improvements

For an additional amount for “Procurement, Construction, and
Improvements” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, $1,200,000, to remain available
until September 30, 2020: Provided, That such amount is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

disaster relief fund

<<NOTE: Web postings. Deadlines. Missions. Cost estimates.>> For an
additional amount for “Disaster Relief Fund” for major disasters
declared pursuant to the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C. 5121 et seq.), $23,500,000,000, to
remain available until expended: Provided, <<NOTE: Grants.>> That the
Administrator of the Federal Emergency Management Agency shall publish
on the Agency’s website not later than 5 days after an award of a public
assistance grant under section 406 or 428 of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act (42 U.S.C. 5172 or 5189f)
that is in excess of $1,000,000, the specifics of each such grant award:
Provided further, That for any mission assignment or mission assignment
task order to another Federal department or agency regarding a major
disaster in excess of $1,000,000, not later than 5 days after the
issuance of such mission assignment or mission assignment task order,
the Administrator shall publish on the Agency’s website the following:
the name of the impacted State, the disaster declaration for such State,
the assigned agency, the assistance requested, a description of the
disaster, the total cost estimate, and the amount obligated: Provided
further, <<NOTE: Updates.>> That not later than 10 days after the last
day of each month until a mission assignment or mission assignment task
order described in the preceding proviso is completed and closed out,
the Administrator shall update any changes to the total cost estimate
and the amount obligated: Provided further, That <<NOTE: Hurricane
Harvey. Hurricane Irma. Hurricane Maria.>> for a disaster declaration
related to Hurricanes Harvey, Irma,

[[Page 132 STAT. 84]]

or Maria, the Administrator shall submit to the Committees on
Appropriations of the House of Representatives and the Senate, not later
than 5 days after the first day of each month beginning after the date
of enactment of this subdivision, and shall publish on the Agency’s
website, not later than 10 days after the first day of each such month,
an estimate or actual amount, if available, for the current fiscal year
of the cost of the following categories of spending: public assistance,
individual assistance, operations, mitigation, administrative, and any
other relevant category (including emergency measures and disaster
resources): Provided, further, <<NOTE: Reports.>> That not later than
10 days after the first day of each month, the Administrator shall
publish on the Agency’s website the report (referred to as the Disaster
Relief Monthly Report) as required by Public Law 114-4: Provided
further, That of the amounts provided under this heading for the
Disaster Relief Fund, up to $150,000,000 shall be transferred to the
Disaster Assistance Direct Loan Program Account for the cost to lend a
territory or possession of the United States that portion of assistance
for which the territory or possession is responsible under the cost-
sharing provisions of the major disaster declaration for Hurricanes Irma
or Maria, as authorized under section 319 of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act (42 U.S.C. 5162): Provided
further, That of the amount provided under this paragraph for transfer,
up to $1,000,000 may be transferred to the Disaster Assistance Direct
Loan Program Account for administrative expenses to carry out the
Advance of Non-Federal Share program, as authorized by section 319 of
the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42
U.S.C. 5162): Provided further, That such amount is designated by the
Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

RESEARCH, DEVELOPMENT, TRAINING, AND SERVICES

Federal Law Enforcement Training Centers

operations and support

For an additional amount for “Operations and Support” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $5,374,000, to remain available until September 30,
2019: Provided, That such amount is designated by the Congress as being
for an emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

procurement, construction, and improvements

For an additional amount for “Procurement, Construction, and
Improvements” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, $5,000,000, to remain available
until September 30, 2022: Provided, That such amount is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

[[Page 132 STAT. 85]]

GENERAL PROVISIONS–THIS TITLE

Sec. 20601. The Administrator of the Federal Emergency Management
Agency may provide assistance, pursuant to section 428 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et
seq.), for critical services as defined in section 406 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act for the duration
of the recovery for incidents DR-4336-PR, DR-4339-PR, DR-4340-USVI, and
DR-4335-USVI to–
(1) replace or restore the function of a facility or system
to industry standards without regard to the pre-disaster
condition of the facility or system; and
(2) replace or restore components of the facility or system
not damaged by the disaster where necessary to fully effectuate
the replacement or restoration of disaster-damaged components to
restore the function of the facility or system to industry
standards.

Sec. 20602. <<NOTE: President.>> Notwithstanding section 404 or
420 of the Robert T. Stafford Disaster Relief and Emergency Assistance
Act (42 U.S.C. 5170c and 8187), for fiscal years 2017 and 2018, the
President shall provide hazard mitigation assistance in accordance with
such section 404 in any area in which assistance was provided under such
section 420.

Sec. 20603. The third proviso of the second paragraph in title I of
Public Law 115-72 under the heading “Federal Emergency Management
Agency–Disaster Relief Fund” <<NOTE: 131 Stat. 1225.>> shall be
amended by striking “180 days” and inserting “365 days”: Provided,
That amounts repurposed pursuant to this section that were previously
designated by the Congress as an emergency requirement pursuant to the
Balanced Budget and Emergency Deficit Control Act are designated by the
Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

Sec. 20604. (a) Definition of Private Nonprofit Facility.–Section
102(11)(B) of the Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5122(11)(B)) is amended to read as follows:
“(A) In general.–The term `private nonprofit
facility’ means private nonprofit educational (without
regard to the religious character of the facility),
utility, irrigation, emergency, medical,
rehabilitational, and temporary or permanent custodial
care facilities (including those for the aged and
disabled) and facilities on Indian reservations, as
defined by the President.
“(B) Additional facilities.–In addition to the
facilities described in subparagraph (A), the term
`private nonprofit facility’ includes any private
nonprofit facility that provides essential social
services to the general public (including museums, zoos,
performing arts facilities, community arts centers,
community centers, libraries, homeless shelters, senior
citizen centers, rehabilitation facilities, shelter
workshops, broadcasting facilities, houses of worship,
and facilities that provide health and safety services
of a governmental nature), as defined by the President.
No house of worship may be excluded from this definition
because leadership or membership in the

[[Page 132 STAT. 86]]

organization operating the house of worship is limited
to persons who share a religious faith or practice.”.

(b) Repair, Restoration, and Replacement of Damaged Facilities.–
Section 406(a)(3) of the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C. 5172(a)(3)) is amended by adding at
the end the following:
“(C) Religious facilities.–A church, synagogue,
mosque, temple, or other house of worship, educational
facility, or any other private nonprofit facility, shall
be eligible for contributions under paragraph (1)(B),
without regard to the religious character of the
facility or the primary religious use of the facility.
No house of worship, educational facility, or any other
private nonprofit facility may be excluded from
receiving contributions under paragraph (1)(B) because
leadership or membership in the organization operating
the house of worship is limited to persons who share a
religious faith or practice.”.

(c) <<NOTE: 42 USC 5122 note.>> Applicability.–This section and
the amendments made by this section shall apply–
(1) <<NOTE: Effective date.>> to the provision of
assistance in response to a major disaster or emergency declared
on or after August 23, 2017; or
(2) with respect to–
(A) any application for assistance that, as of the
date of enactment of this Act, is pending before Federal
Emergency Management Agency; and
(B) any application for assistance that has been
denied, where a challenge to that denial is not yet
finally resolved as of the date of enactment of this
Act.

Sec. 20605. (a) The Federal share of assistance, including direct
Federal assistance, provided under section 407 of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act (42 U.S.C. 5173), with
respect to a major disaster declared pursuant to such Act for damages
resulting from a wildfire in calendar year 2017, shall be 90 percent of
the eligible costs under such section.
(b) <<NOTE: Applicability. Effective date.>> The Federal share
provided by subsection (a) shall apply to assistance provided before,
on, or after the date of enactment of this Act.

federal cost-share adjustments for repair, restoration, and replacement
of damaged facilities

Sec. 20606. Section 406(b) of the Robert T. Stafford Disaster
Relief and Emergency Assistance Act (42 U.S.C. 5172(b)) is amended by
inserting after paragraph (2) the following:
“(3) Increased federal share.–
“(A) Incentive measures.–The President may provide
incentives to a State or Tribal government to invest in
measures that increase readiness for, and resilience
from, a major disaster by recognizing such investments
through a sliding scale that increases the minimum
Federal share to 85 percent. Such measures may include–
“(i) the adoption of a mitigation plan
approved under section 322;
“(ii) investments in disaster relief,
insurance, and emergency management programs;

[[Page 132 STAT. 87]]

“(iii) encouraging the adoption and
enforcement of the latest published editions of
relevant consensus-based codes, specifications,
and standards that incorporate the latest hazard-
resistant designs and establish minimum acceptable
criteria for the design, construction, and
maintenance of residential structures and
facilities that may be eligible for assistance
under this Act for the purpose of protecting the
health, safety, and general welfare of the
buildings’ users against disasters;
“(iv) facilitating participation in the
community rating system; and
“(v) funding mitigation projects or granting
tax incentives for projects that reduce risk.
“(B) <<NOTE: Deadline. President.>> Comprehensive
guidance.–Not later than 1 year after the date of
enactment of this paragraph, the President, acting
through the Administrator, shall issue comprehensive
guidance to State and Tribal governments regarding the
measures and investments, weighted appropriately based
on actuarial assessments of eligible actions, that will
be recognized for the purpose of increasing the Federal
share under this section. Guidance shall ensure that the
agency’s review of eligible measures and investments
does not unduly delay determining the appropriate
Federal cost share.
“(C) Report.–One year after the issuance of the
guidance required by subparagraph (B), the Administrator
shall submit to the Committee on Transportation and
Infrastructure of the House of Representatives and the
Committee on Homeland Security and Governmental Affairs
of the Senate a report regarding the analysis of the
Federal cost shares paid under this section.
“(D) Savings clause.–Nothing in this paragraph
prevents the President from increasing the Federal cost
share above 85 percent.”.

Sec. 20607. Division F of the Consolidated Appropriations Act,
2017, <<NOTE: 131 Stat. 433.>> is amended by inserting the following at
the end of Title V:

“Sec. 545. (a) Premium Pay Authority.–During calendar year 2017,
any premium pay that is funded, either directly or through
reimbursement, by the `Federal Emergency Management Agency–Disaster
Relief Fund’ shall be exempted from the aggregate of basic pay and
premium pay calculated under section 5547(a) of title 5, United States
Code, and any other provision of law limiting the aggregate amount of
premium pay payable on a biweekly or calendar year basis.
“(b) Overtime Authority.–During calendar year 2017, any overtime
that is funded, either directly or through reimbursement, by the
`Federal Emergency Management Agency–Disaster Relief Fund’ shall be
exempted from any annual limit on the amount of overtime payable in a
calendar or fiscal year.
“(c) Applicability of Aggregate Limitation on Pay.–In determining
whether an employee’s pay exceeds the applicable annual rate of basic
pay payable under section 5307 of title 5, United States Code, the head
of an Executive agency shall not include pay exempted under this
section.

[[Page 132 STAT. 88]]

“(d) Limitation of Pay Authority.–Pay exempted from otherwise
applicable limits under subsection (a) shall not cause the aggregate pay
earned for the calendar year in which the exempted pay is earned to
exceed the rate of basic pay payable for a position at level II of the
Executive Schedule under section 5313 of title 5, United States Code.
“(e) Effective Date.–This section shall take effect as if enacted
on December 31, 2016.”.

TITLE VII

DEPARTMENT OF THE INTERIOR

United States Fish and Wildlife Service

construction

For an additional amount for “Construction” for necessary expenses
related to the consequences of Hurricanes Harvey, Irma, and Maria,
$210,629,000, to remain available until expended: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

National Park Service

historic preservation fund

For an additional amount for the “Historic Preservation Fund” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $50,000,000, to remain available until September 30,
2019, including costs to States and territories necessary to complete
compliance activities required by section 306108 of title 54, United
States Code (formerly section 106 of the National Historic Preservation
Act) and costs needed to administer the program: Provided, That grants
shall only be available for areas that have received a major disaster
declaration pursuant to the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C. 5121 et seq.): Provided further,
That individual grants shall not be subject to a non-Federal matching
requirement: Provided further, That such amount is designated by the
Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

construction

For an additional amount for “Construction” for necessary expenses
related to the consequences of Hurricanes Harvey, Irma, and Maria,
$207,600,000, to remain available until expended: Provided, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

[[Page 132 STAT. 89]]

United States Geological Survey

surveys, investigations, and research

For an additional amount for “Surveys, Investigations, and
Research” for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, and in those areas impacted by a
major disaster declared pursuant to the Robert T. Stafford Disaster
Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.) with
respect to wildfires in 2017, $42,246,000, to remain available until
expended: Provided, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

Departmental Offices

Insular Affairs

assistance to territories

For an additional amount for “Technical Assistance” for financial
management expenses related to the consequences of Hurricanes Irma and
Maria, $3,000,000, to remain available until expended: Provided, That
such amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Office of Inspector General

salaries and expenses

For an additional amount for “Salaries and Expenses” for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria, $2,500,000, to remain available until expended: Provided, That
such amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Environmental Protection Agency

hazardous substance superfund

For an additional amount for “Hazardous Substance Superfund” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $6,200,000, to remain available until expended:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

leaking underground storage tank trust fund program

For an additional amount for “Leaking Underground Storage Tank
Fund” for necessary expenses related to the consequences of Hurricanes
Harvey, Irma, and Maria, $7,000,000, to remain

[[Page 132 STAT. 90]]

available until expended: Provided, That such amount is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

state and tribal assistance grants

For an additional amount for “State and Tribal Assistance Grants”
for necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria for the hazardous waste financial assistance grants
program and for other solid waste management activities, $50,000,000, to
remain available until expended: Provided, That none of these funds
allocated within Region 2 shall be subject to cost share requirements
under section 3011(b) of the Solid Waste Disposal Act: Provided
further, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

Administrative Provision–Environmental Protection Agency

Of amounts previously appropriated for capitalization grants for the
State Revolving Funds under title VI of the Federal Water Pollution
Control Act or under section 1452 of the Safe Drinking Water Act to a
State or territory included as part of a disaster declaration related to
Hurricanes Irma and Maria, all existing grant funds that are available
but not drawn down shall not be subject to the matching or cost share
requirements of sections 602(b)(2), 602(b)(3) of the Federal Water
Pollution Control Act nor the matching requirements of section 1452(e)
of the Safe Drinking Water Act and shall be awarded to such state or
territory: Provided, That, notwithstanding the requirements of section
603(d) of the Federal Water Pollution Control Act or section 1452(f) of
the Safe Drinking Water Act, the state or territory shall utilize the
full amount of such funds, excluding existing loans, to provide
additional subsidization to eligible recipients in the form of
forgiveness of principal, negative interest loans or grants or any
combination of these: Provided further, That such funds may be used for
eligible projects whose purpose is to repair damage incurred as a result
of Hurricanes Irma and Maria, reduce flood damage risk and vulnerability
or to enhance resiliency to rapid hydrologic change or a natural
disaster at treatment works as defined by section 212 of the Federal
Water Pollution Control Act or a public drinking water system under
section 1452 of the Safe Drinking Water Act: Provided further, That any
project involving the repair or replacement of a lead service line shall
replace the entire lead service line, not just a portion.

RELATED AGENCIES

DEPARTMENT OF AGRICULTURE

Forest Service

state and private forestry

For an additional amount for “State and Private Forestry” for
necessary expenses related to the consequences of Hurricanes

[[Page 132 STAT. 91]]

Harvey, Irma, and Maria, $7,500,000, to remain available until expended:
Provided, That such amount is designated by the Congress as being for
an emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

national forest system

For an additional amount for “National Forest System” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, $20,652,000, to remain available until expended:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

capital improvement and maintenance

For an additional amount for “Capital Improvement and Maintenance”
for necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, and the 2017 fire season, $91,600,000, to remain
available until expended: Provided, That such amount is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

GENERAL PROVISION–THIS TITLE

Sec. 20701. Agencies <<NOTE: Reports. Deadline.>> receiving funds
appropriated by this title shall each provide a monthly report to the
Committees on Appropriations of the House of Representatives and the
Senate detailing the allocation and obligation of these funds by
account, beginning not later than 90 days after enactment of this Act.

TITLE VIII

DEPARTMENT OF LABOR

Employment and Training Administration

training and employment services

(including transfers of funds)

For an additional amount for “Training and Employment Services”,
$100,000,000, for the dislocated workers assistance national reserve for
necessary expenses directly related to the consequences of Hurricanes
Harvey, Maria, and Irma and those jurisdictions that received a major
disaster declaration pursuant to the Robert T. Stafford Disaster Relief
and Emergency Assistance Act (42 U.S.C. 5121 et seq.) due to wildfires
in 2017, which shall be available from the date of enactment of this
subdivision through September 30, 2019: Provided, That the Secretary of
Labor may transfer up to $2,500,000 of such funds to any other
Department of Labor account for reconstruction and recovery needs,
including worker protection activities: Provided further, That these
sums may be used to replace grant funds previously obligated to the
impacted areas: Provided further, That of the amount provided, up to

[[Page 132 STAT. 92]]

$500,000, to remain available until expended, shall be transferred to
“Office of Inspector General”for oversight of activities responding to
such hurricanes and wildfires: Provided further, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

job corps

For an additional amount for “Job Corps” for construction,
rehabilitation and acquisition for Job Corps Centers in Puerto Rico,
$30,900,000, which shall be available upon the date of enactment of this
subdivision and remain available for obligation through June 30, 2021:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

General Provisions–Department of Labor

deferral of interest payments for virgin islands

Sec. 20801. Notwithstanding <<NOTE: Deadline. Time period.>> any
other provision of law, the interest payment of the Virgin Islands that
was due under section 1202(b)(1) of the Social Security Act on September
29, 2017, shall not be due until September 28, 2018, and no interest
shall accrue on such amount through September 28, 2018: Provided, That
such amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

flexibility in use of funds under wioa

Sec. 20802. (a) In General.–Notwithstanding section 133(b)(4) of
the Workforce Innovation and Opportunity Act, in States, as defined by
section 3(56) of such Act, affected by Hurricanes Harvey, Irma, and
Maria, a local board, as defined by section 3(33) of such Act, in a
local area, as defined by section 3(32) of such Act, affected by such
Hurricanes may transfer, if such transfer is approved by the Governor,
up to 100 percent of the funds allocated to the local area for Program
Years 2016 and 2017 for Youth Workforce Investment activities under
paragraphs (2) or (3) of section 128(b) of such Act, for Adult
employment and training activities under paragraphs (2)(A) or (3) of
section 133(b) of such Act, or for Dislocated Worker employment and
training activities under paragraph (2)(B) of section 133(b) of such Act
among–
(1) adult employment and training activities;
(2) dislocated worker employment and training activities;
and
(3) youth workforce investment activities.

(b) The Virgin Islands.–Except for the funds reserved to carry out
required statewide activities under sections 127(b) and 134(a)(2) of the
Workforce Innovation and Opportunity Act, the Governor of the Virgin
Islands may authorize the transfer of up to 100 percent of the remaining
funds provided to the Virgin Islands for Program Years 2016 and 2017 for
Youth Workforce Investment activities under section 127(b)(1)(B) of such
Act, for Adult employment and training activities under section
132(b)(1)(A) of such

[[Page 132 STAT. 93]]

Act, or for Dislocated Worker employment and training activities under
section 133(b)(2)(A) of such Act among–
(1) adult employment and training activities;
(2) dislocated worker employment and training activities;
and
(3) youth workforce investment activities.

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

cdc-wide activities and program support

(including transfer of funds)

For an additional amount for “CDC-Wide Activities and Program
Support”, $200,000,000, to remain available until September 30, 2020,
for response, recovery, preparation, mitigation, and other expenses
directly related to the consequences of Hurricanes Harvey, Irma, and
Maria: Provided, That obligations incurred for the purposes provided
herein prior to the date of enactment of this subdivision may be charged
to funds appropriated by this paragraph: Provided further, That of the
amount provided, not less than $6,000,000 shall be transferred to the
“Buildings and Facilities” account for the purposes provided herein:
Provided further, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

National Institutes of Health

office of the director

For an additional amount for fiscal year 2018 for “Office of the
Director”, $50,000,000, to remain available until September 30, 2020,
for response, recovery, and other expenses directly related to the
consequences of Hurricanes Harvey, Irma, and Maria: Provided, That
obligations incurred for these purposes prior to the date of enactment
of this subdivision may be charged to funds appropriated by this
paragraph: Provided further, That funds appropriated by this paragraph
may be used for construction grants or contracts under section 404I of
the Public Health Service Act without regard to section 404I(c)(2):
Provided further, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

Administration for Children and Families

children and families services programs

For an additional amount for “Children and Families Services
Programs”, $650,000,000, to remain available until September 30, 2021,
for Head Start programs, for necessary expenses directly related to the
consequences of Hurricanes Harvey, Irma, and Maria, including making
payments under the Head Start Act: Provided, That none of the funds
appropriated in this paragraph shall be included in the calculation of
the “base grant” in subsequent fiscal

[[Page 132 STAT. 94]]

years, as such term is defined in sections 640(a)(7)(A), 641A(h)(1)(B),
or 645(d)(3) of the Head Start Act: Provided further, That funds
appropriated in this paragraph are not subject to the allocation
requirements of section 640(a) of the Head Start Act: Provided further,
That funds appropriated in this paragraph shall not be available for
costs that are reimbursed by the Federal Emergency Management Agency,
under a contract for insurance, or by self-insurance: Provided further,
That up to $12,500,000 shall be available for Federal administrative
expenses: Provided further, That obligations incurred for the purposes
provided herein prior to the date of enactment of this subdivision may
be charged to funds appropriated under this heading: Provided further,
That such amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Office of the Secretary

public health and social services emergency fund

(including transfers of funds)

For an additional amount for the “Public Health and Social Services
Emergency Fund”, $162,000,000, to remain available until September 30,
2020, for response, recovery, preparation, mitigation and other expenses
directly related to the consequences of Hurricanes Harvey, Irma, and
Maria, including activities authorized under section 319(a) of the
Public Health Service Act (referred to in this subdivision as the “PHS
Act”): Provided, That of the amount provided, $60,000,000 shall be
transferred to “Health Resources and Services Administration–Primary
Health Care”, for expenses related to the consequences of Hurricanes
Harvey, Irma, and Maria for disaster response and recovery, for the
Health Centers Program under section 330 of the PHS Act: Provided
further, That not less than $50,000,000, of amounts transferred under
the preceding proviso, shall be available for alteration, renovation,
construction, equipment, and other capital improvement costs as
necessary to meet the needs of areas affected by Hurricanes Harvey,
Irma, and Maria: Provided further, That the time limitation in section
330(e)(3) of the PHS Act shall not apply to funds made available under
the preceding proviso: Provided further, That of the amount provided,
not less than $20,000,000 shall be transferred to “Substance Abuse and
Mental Health Services Administration–Health Surveillance and Program
Support” for grants, contracts, and cooperative agreements for
behavioral health treatment, crisis counseling, and other related
helplines, and for other similar programs to provide support to
individuals impacted by Hurricanes Harvey, Irma, and Maria: Provided
further, That of the amount provided, up to $2,000,000, to remain
available until expended, shall be transferred to “Office of the
Secretary–Office of Inspector General” for oversight of activities
responding to such hurricanes: Provided further, That obligations
incurred for the purposes provided herein prior to the date of enactment
of this subdivision may be charged to funds appropriated under this
heading: Provided further, That funds appropriated in this paragraph
shall not be available for costs that are reimbursed by the Federal
Emergency Management Agency, under a contract for insurance, or by self-

[[Page 132 STAT. 95]]

insurance: Provided further, That such amount is designated by the
Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

General Provision–Department of Health and Human Services

direct hire authority for certain emergency response positions

Sec. 20803. (a) <<NOTE: Determination. Notice.>> In General.–As
the Secretary of Health and Human Services determines necessary to
respond to a critical hiring need for emergency response positions,
after providing public notice and without regard to the provisions of
sections 3309 through 3319 of title 5, United States Code, the Secretary
may appoint candidates directly to the following positions, consistent
with subsection (b), to perform critical work directly relating to the
consequences of Hurricanes Harvey, Irma, and Maria:
(1) Intermittent disaster-response personnel in the National
Disaster Medical System, under section 2812 of the Public Health
Service Act (42 U.S.C. 300hh-11).
(2) Term or temporary related positions in the Centers for
Disease Control and Prevention and the Office of the Assistant
Secretary for Preparedness and Response.

(b) Expiration.–The authority under subsection (a) shall expire 270
days after the date of enactment of this section.

DEPARTMENT OF EDUCATION

Hurricane Education Recovery

(including transfer of funds)

For an additional amount for “Hurricane Education Recovery” for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria, or wildfires in 2017 for which a major disaster or
emergency has been declared under sections 401 or 501 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5170
and 5190) (referred to under this heading as “covered disaster or
emergency”), $2,700,000,000, to remain available through September 30,
2022, for assisting in meeting the educational needs of individuals
affected by a covered disaster or emergency: Provided, That such amount
is designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985: Provided further, That–
(1) such funds shall be used–
(A) to make awards to eligible entities for
immediate aid to restart school operations, in
accordance with paragraph (2);
(B) for temporary emergency impact aid for displaced
students, in accordance with paragraph (2);
(C) for emergency assistance to institutions of
higher education and students attending institutions of
higher education in an area directly affected by a
covered disaster or emergency in accordance with
paragraph (3);

[[Page 132 STAT. 96]]

(D) for payments to institutions of higher education
to help defray the unexpected expenses associated with
enrolling displaced students from institutions of higher
education directly affected by a covered disaster or
emergency, in accordance with paragraph (4); and
(E) to provide assistance to local educational
agencies serving homeless children and youth in
accordance with paragraph (5);
(2) immediate aid to restart school operations and temporary
emergency impact aid for displaced students described in
subparagraphs (A) and (B) of paragraph (1) shall be provided
under the statutory terms and conditions that applied to
assistance under sections 102 and 107 of title IV of division B
of Public Law 109-148, respectively, except that such sections
shall be applied so that–
(A) each reference to a major disaster declared in
accordance with section 401 of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act (42 U.S.C.
5170) shall be to a major disaster or emergency declared
by the President in accordance with section 401 or 501,
respectively, of such Act;
(B) each reference to Hurricane Katrina or Hurricane
Rita shall be a reference to a covered disaster or
emergency;
(C) each reference to August 22, 2005 shall be to
the date that is one week prior to the date that the
major disaster or emergency was declared for the area;
(D) each reference to the States of Louisiana,
Mississippi, Alabama, and Texas shall be to the States
or territories affected by a covered disaster or
emergency, and each reference to the State educational
agencies of Louisiana, Mississippi, Alabama, or Texas
shall be a reference to the State educational agencies
that serve the states or territories affected by a
covered disaster or emergency;
(E) each reference to the 2005-2006 school year
shall be to the 2017-2018 school year;
(F) the references in section 102(h)(1) of title IV
of division B of Public Law 109-148 to the number of
non-public and public elementary schools and secondary
schools in the State shall be to the number of students
in non-public and public elementary schools and
secondary schools in the State, and the reference in
such section to the National Center for Data Statistics
Common Core of Data for the 2003-2004 school year shall
be to the most recent and appropriate data set for the
2016-2017 school year;
(G) in determining the amount of immediate aid
provided to restart school operations as described in
section 102(b) of title IV of division B of Public Law
109-148, the Secretary shall consider the number of
students enrolled, during the 2016-2017 school year, in
elementary schools and secondary schools that were
closed as a result of a covered disaster or emergency;
(H) in determining the amount of emergency impact
aid that a State educational agency is eligible to
receive under paragraph (1)(B), the Secretary shall,
subject to section 107(d)(1)(B) of such title, provide–

[[Page 132 STAT. 97]]

(i) $9,000 for each displaced student who is
an English learner, as that term is defined in
section 8101 of the Elementary and Secondary
Education Act of 1965 (20 U.S.C. 7801);
(ii) $10,000 for each displaced student who is
a child with a disability (regardless of whether
the child is an English learner); and
(iii) $8,500 for each displaced student who is
not a child with a disability or an English
learner;
(I) with respect to the emergency impact aid
provided under paragraph (1)(B), the Secretary may
modify the State educational agency and local
educational agency application timelines in section
107(c) of such title; and
(J) each reference to a public elementary school may
include, as determined by the local educational agency,
a publicly-funded preschool program that enrolls
children below the age of kindergarten entry and is part
of an elementary school;
(3) $100,000,000 of the funds made available under this
heading shall be for programs authorized under subpart 3 of Part
A, part C of title IV and part B of title VII of the Higher
Education Act of 1965 (20 U.S.C. 1087-51 et seq., 1138 et seq.)
for institutions located in an area affected by a covered
disaster or emergency, and students enrolled in such
institutions, except that–
(A) any requirements relating to matching, Federal
share, reservation of funds, or maintenance of effort
under such parts that would otherwise be applicable to
that assistance shall not apply;
(B) such assistance may be used for student
financial assistance;
(C) such assistance may also be used for faculty and
staff salaries, equipment, student supplies and
instruments, or any purpose authorized under the Higher
Education Act of 1965, by institutions of higher
education that are located in areas affected by a
covered disaster or emergency; and
(D) the Secretary shall prioritize, to the extent
possible, students who are homeless or at risk of
becoming homeless as a result of displacement, and
institutions that have sustained extensive damage, by a
covered disaster or emergency;
(4) up to $75,000,000 of the funds made available under this
heading shall be for payments to institutions of higher
education to help defray the unexpected expenses associated with
enrolling displaced students from institutions of higher
education at which operations have been disrupted by a covered
disaster or emergency, in accordance with criteria established
by the Secretary and made publicly available;
(5) $25,000,000 of the funds made available under this
heading shall be available to provide assistance to local
educational agencies serving homeless children and youths
displaced by a covered disaster or emergency, consistent with
section 723 of the McKinney-Vento Homeless Assistance Act (42
U.S.C. 11431-11435) and with section 106 of title IV of division
B of Public Law 109-148, except that funds shall be disbursed
based on demonstrated need and the number

[[Page 132 STAT. 98]]

of homeless children and youth enrolled as a result of
displacement by a covered disaster or emergency;
(6) section 437 of the General Education Provisions Act (20
U.S.C. 1232) and section 553 of title 5, United States Code,
shall not apply to activities under this heading;
(7) $4,000,000 of the funds made available under this
heading, to remain available until expended, shall be
transferred to the Office of the Inspector General of the
Department of Education for oversight of activities supported
with funds appropriated under this heading, and up to $3,000,000
of the funds made available under this heading shall be for
program administration;
(8) up to $35,000,000 of the funds made available under this
heading shall be to carry out activities authorized under
section 4631(b) of the Elementary and Secondary Education Act of
1965 (20 U.S.C. 7281(b)): Provided, That obligations incurred
for the purposes provided herein prior to the date of enactment
of this subdivision may be charged to funds appropriated under
this paragraph;
(9) <<NOTE: Waiver authority.>> the Secretary may waive,
modify, or provide extensions for certain requirements of the
Higher Education Act of 1965 (20 U.S.C. 1001 et seq.) for
affected individuals, affected students, and affected
institutions in covered disaster or emergency areas in the same
manner as the Secretary was authorized to waive, modify, or
provide extensions for certain requirements of such Act under
provisions of subtitle B of title IV of division B of Public Law
109-148 for affected individuals, affected students, and
affected institutions in areas affected by Hurricane Katrina and
Hurricane Rita, except that the cost associated with any action
taken by the Secretary under this paragraph is designated by the
Congress as being for an emergency requirement pursuant to
section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985; and
(10) if any provision under this heading or application of
such provision to any person or circumstance is held to be
unconstitutional, the remainder of the provisions under this
heading and the application of such provisions to any person or
circumstance shall not be affected thereby.

General Provision–Department of Education

Sec. 20804. (a) <<NOTE: Loan forgiveness.>> Notwithstanding any
other provision of law, the Secretary of Education is hereby authorized
to forgive any outstanding balance owed to the Department of Education
under the HBCU Hurricane Supplemental Loan program established pursuant
to section 2601 of Public Law 109-234, as modified by section 307 of
title III of division F of the Consolidated Appropriations Act, 2012
(Public Law 112-74), as carried forward by the Continuing Appropriations
Resolution, 2013 (Public Law 112-175).

(b) There are authorized to be appropriated, and there are hereby
appropriated, such sums as may be necessary to carry out subsection (a):
Provided, That such amount is designated by the Congress as an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the Balance
Budget and Emergency Deficit Control Act of 1985.

[[Page 132 STAT. 99]]

GENERAL PROVISIONS–THIS TITLE

(including transfer of funds)

Sec. 20805. Funds <<NOTE: Consultation.>> appropriated to the
Department of Health and Human Services by this title may be transferred
to, and merged with, other appropriation accounts under the headings
“Centers for Disease Control and Prevention” and “Public Health and
Social Services Emergency Fund” for the purposes specified in this
title following consultation with the Office of Management and Budget:
Provided, That <<NOTE: Notification.>> the Committees on Appropriations
in the House of Representatives and the Senate shall be notified 10 days
in advance of any such transfer: Provided further,
That, <<NOTE: Determination.>> upon a determination that all or part of
the funds transferred from an appropriation are not necessary, such
amounts may be transferred back to that appropriation: Provided
further, That none of the funds made available by this title may be
transferred pursuant to the authority in section 205 of division H of
Public Law 115-31 or section 241(a) of the PHS Act.

Sec. 20806. Not <<NOTE: Deadlines. Spending plan. Cost
estimates.>> later than 30 days after enactment of this subdivision,
the Secretary of Health and Human Services shall provide a detailed
spend plan of anticipated uses of funds made available in this title,
including estimated personnel and administrative costs, to the
Committees on Appropriations: <<NOTE: Updates.>> Provided, That such
plans shall be updated and submitted to the Committees on Appropriations
every 60 days until all funds are expended or expire.

Sec. 20807. Unless otherwise provided for by this title, the
additional amounts appropriated by this title to appropriations accounts
shall be available under the authorities and conditions applicable to
such appropriations accounts for fiscal year 2018.

TITLE IX

LEGISLATIVE BRANCH

GOVERNMENT ACCOUNTABILITY OFFICE

Salaries and Expenses

For an additional amount for “Salaries and Expenses”, $14,000,000,
to remain available until expended, for audits and investigations
relating to Hurricanes Harvey, Irma, and Maria and the 2017 wildfires:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

TITLE X

DEPARTMENT OF DEFENSE

Military Construction, Navy and Marine Corps

For an additional amount for “Military Construction, Navy and
Marine Corps”, $201,636,000, to remain available until September 30,
2022, for necessary expenses related to the consequences of Hurricanes
Harvey, Irma, and Maria: Provided, That none of

[[Page 132 STAT. 100]]

the funds made available to the Navy and Marine Corps for recovery
efforts related to Hurricanes Harvey, Irma, and Maria in this
subdivision shall be available for obligation until the Committees on
Appropriations of the House of Representatives and the Senate receive
form 1391 for each specific request: <<NOTE: Deadline. Expenditure
plan.>> Provided further, That, not later than 60 days after enactment
of this subdivision, the Secretary of the Navy, or his designee, shall
submit to the Committees on Appropriations of House of Representatives
and the Senate a detailed expenditure plan for funds provided under this
heading: Provided further, That such funds may be obligated or expended
for planning and design and military construction projects not otherwise
authorized by law: Provided further, That such amount is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

Military Construction, Army National Guard

For an additional amount for “Military Construction, Army National
Guard”, $519,345,000, to remain available until September 30, 2022, for
necessary expenses related to the consequences of Hurricanes Harvey,
Irma, and Maria: Provided, That none of the funds made available to the
Army National Guard for recovery efforts related to Hurricanes Harvey,
Irma, and Maria in this subdivision shall be available for obligation
until the Committees on Appropriations of the House of Representatives
and the Senate receive form 1391 for each specific
request: <<NOTE: Deadline. Expenditure plan.>> Provided further, That,
not later than 60 days after enactment of this subdivision, the Director
of the Army National Guard, or his designee, shall submit to the
Committees on Appropriations of the House of Representatives and the
Senate a detailed expenditure plan for funds provided under this
heading: Provided further, That such funds may be obligated or expended
for planning and design and military construction projects not otherwise
authorized by law: Provided further, That such amount is designated by
the Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

DEPARTMENT OF VETERANS AFFAIRS

Veterans Health Administration

medical services

For an additional amount for “Medical Services”, $11,075,000, to
remain available until September 30, 2019, for necessary expenses
related to the consequences of Hurricanes Harvey, Irma, and Maria:
Provided, That such amount is designated by the Congress as being for an
emergency requirement pursuant to section 251(b)(2)(A)(i) of the
Balanced Budget and Emergency Deficit Control Act of 1985.

medical support and compliance

For an additional amount for “Medical Support and Compliance”,
$3,209,000, to remain available until September 30, 2019, for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria: Provided, That such amount is designated

[[Page 132 STAT. 101]]

by the Congress as being for an emergency requirement pursuant to
section 251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit
Control Act of 1985.

medical facilities

For an additional amount for “Medical Facilities”, $75,108,000, to
remain available until September 30, 2022, for necessary expenses
related to the consequences of Hurricanes Harvey, Irma, and
Maria: <<NOTE: Expenditure plan.>> Provided, That none of these funds
shall be available for obligation until the Secretary of Veterans
Affairs submits to the Committees on Appropriations of the House of
Representatives and the Senate a detailed expenditure plan for funds
provided under this heading: Provided further, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

Departmental Administration

construction, minor projects

For an additional amount for “Construction, Minor Projects”,
$4,088,000, to remain available until September 30, 2022, for necessary
expenses related to the consequences of Hurricanes Harvey, Irma, and
Maria: Provided, That such amount is designated by the Congress as
being for an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

GENERAL PROVISION–THIS TITLE

Sec. 21001. Notwithstanding <<NOTE: Puerto Rico.>> section
18236(b) of title 10, United States Code, the Secretary of Defense shall
contribute to Puerto Rico, 100 percent of the total cost of construction
(including the cost of architectural, engineering and design services)
for the acquisition, construction, expansion, rehabilitation, or
conversion of the Arroyo readiness center under paragraph (5) of section
18233(a) of title 10, United States Code.

TITLE XI

DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration

operations

(airport and airway trust fund)

For an additional amount for “Operations”, $35,000,000, to be
derived from the Airport and Airway Trust Fund and to remain available
until expended, for necessary expenses related to the consequences of
Hurricanes Harvey, Irma, and Maria, and other hurricanes occurring in
calendar year 2017: Provided, That such amount is designated by the
Congress as being for an emergency requirement pursuant to section
251(b)(2)(A)(i) of the Balanced Budget and Emergency Deficit Control Act
of 1985.

[[Page 132 STAT. 102]]

facilities and equipment

(airport and airway trust fund)

For an additional amount for “Facilities and Equipment”,
$79,589,000, to be derived from the Airport and Airway Trust Fund and to
remain available until expended, for necessary expenses related to the
consequences of Hurricanes Harvey, Irma, and Maria, and other hurricanes
occurring in calendar year 2017: Provided, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

Federal Highway Administration

federal-aid highways

emergency relief program

For an additional amount for the “Emergency Relief Program” as
authorized under section 125 of title 23, United States Code,
$1,374,000,000, to remain available until
expended: <<NOTE: Applicability.>> Provided, That notwithstanding
section 125(d)(4) of title 23, United States Code, no limitation on the
total obligations for projects under section 125 of such title shall
apply to the Virgin Islands, Guam, American Samoa, and the Commonwealth
of the Northern Mariana Islands for fiscal year 2018 and fiscal year
2019: Provided further, That notwithstanding subsection (e) of section
120 of title 23, United States Code, for this fiscal year and hereafter,
the Federal share for Emergency Relief funds made available under
section 125 of such title to respond to damage caused by Hurricanes Irma
and Maria, shall be 100 percent for Puerto Rico: Provided further, That
such amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985.

Federal Transit Administration

public transportation emergency relief program

For an additional amount for the “Public Transportation Emergency
Relief Program” as authorized under section 5324 of title 49, United
States Code, $330,000,000 to remain available until expended, for
transit systems affected by Hurricanes Harvey, Irma, and Maria with
major disaster declarations in 2017: Provided, That not more than
three-quarters of one percent of the funds for public transportation
emergency relief shall be available for administrative expenses and
ongoing program management oversight as authorized under sections 5334
and 5338(f)(2) of such title and shall be in addition to any other
appropriations for such purpose: Provided further, That such amount is
designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

[[Page 132 STAT. 103]]

Maritime Administration

operations and training

For an additional amount for “Operations and Training”,
$10,000,000, to remain available until expended, for necessary expenses,
including for dredging, related to damage to Maritime Administration
facilities resulting from Hurricane Harvey: Provided, That such amount
is designated by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985.

General Provision–Department of Transportation

Sec. 21101. Notwithstanding 49 U.S.C. 5302, for fiscal years 2018,
2019, and 2020 the Secretary of Transportation shall treat an area as an
“urbanized area” for purposes of 49 U.S.C. 5307 and 5336(a) until the
next decennial census following the enactment of this Act if the area
was defined and designated as an “urbanized” area by the Secretary of
Commerce in the 2000 decennial census and the population of such area
fell below 50,000 after the 2000 decennial census as a result of a major
disaster: Provided, That an area treated as an “urbanized area” for
purposes of this section shall be assigned the population and square
miles of the urbanized area designated by the Secretary of Commerce in
the 2000 decennial census: Provided further, That the term “major
disaster” has the meaning given such term in section 102(2) of the
Disaster Relief Act of 1974 (42 U.S.C. 5122(2)).

DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

Community Planning and Development

community development fund

(including transfers of funds)

For an additional amount for “Community Development Fund”,
$28,000,000,000, to remain available until expended, for necessary
expenses for activities authorized under title I of the Housing and
Community Development Act of 1974 (42 U.S.C. 5301 et seq.) related to
disaster relief, long-term recovery, restoration of infrastructure and
housing, economic revitalization, and mitigation in the most impacted
and distressed areas resulting from a major declared disaster that
occurred in 2017 (except as otherwise provided under this heading)
pursuant to the Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5121 et seq.): Provided, That funds shall be
awarded directly to the State, unit of general local government, or
Indian tribe (as such term is defined in section 102 of the Housing and
Community Development Act of 1974) at the discretion of the Secretary:
Provided further, That of the amounts made available under this heading,
up to $16,000,000,000 shall be allocated to meet unmet needs for
grantees that have received or will receive allocations under this
heading for major declared disasters that occurred in 2017 or under the
same heading of Division B of Public Law 115-56, except that, of the
amounts made available under this proviso, no less than $11,000,000,000
shall be allocated to the States and units

[[Page 132 STAT. 104]]

of local government affected by Hurricane Maria, and of such amounts
allocated to such grantees affected by Hurricane Maria, $2,000,000,000
shall be used to provide enhanced or improved electrical power systems:
Provided further, That to the extent amounts under the previous proviso
are insufficient to meet all unmet needs, the allocation amounts related
to infrastructure shall be reduced proportionally based on the total
infrastructure needs of all grantees: <<NOTE: Determination.>>
Provided further, That of the amounts made available under this heading,
no less than $12,000,000,000 shall be allocated for mitigation
activities to all grantees of funding provided under this heading,
section 420 of division L of Public Law 114-113, section 145 of division
C of Public Law 114-223, section 192 of division C of Public Law 114-223
(as added by section 101(3) of division A of Public Law 114-254),
section 421 of division K of Public Law 115-31, and the same heading in
division B of Public Law 115-56, and that such mitigation activities
shall be subject to the same terms and conditions under this
subdivision, as determined by the Secretary: Provided further, That all
such grantees shall receive an allocation of funds under the preceding
proviso in the same proportion that the amount of funds each grantee
received or will receive under the second proviso of this heading or the
headings and sections specified in the previous proviso bears to the
amount of all funds provided to all grantees specified in the previous
proviso: <<NOTE: Deadlines.>> Provided further, That of the amounts
made available under the second and fourth provisos of this heading, the
Secretary shall allocate to all such grantees an aggregate amount not
less than 33 percent of each such amounts of funds provided under this
heading within 60 days after the enactment of this subdivision based on
the best available data (especially with respect to data for all such
grantees affected by Hurricanes Harvey, Irma, and Maria), and shall
allocate no less than 100 percent of the funds provided under this
heading by no later than December 1, 2018: Provided further, That the
Secretary shall not prohibit the use of funds made available under this
heading and the same heading in division B of Public Law 115-56 for non-
federal share as authorized by section 105(a)(9) of the Housing and
Community Development Act of 1974 (42 U.S.C. 5305(a)(9)): Provided
further, That of the amounts made available under this heading, grantees
may establish grant programs to assist small businesses for working
capital purposes to aid in recovery: Provided further,
That <<NOTE: Certification.>> as a condition of making any grant, the
Secretary shall certify in advance that such grantee has in place
proficient financial controls and procurement processes and has
established adequate procedures to prevent any duplication of benefits
as defined by section 312 of the Robert T. Stafford Disaster Relief and
Emergency Assistance Act (42 U.S.C. 5155), to ensure timely expenditure
of funds, to maintain comprehensive websites regarding all disaster
recovery activities assisted with these funds, and to detect and prevent
waste, fraud, and abuse of funds: Provided further, That with respect
to any such duplication of benefits, the Secretary and any grantee under
this section shall not take into consideration or reduce the amount
provided to any applicant for assistance from the grantee where such
applicant applied for and was approved, but declined assistance related
to such major declared disasters that occurred in 2014, 2015, 2016, and
2017 from the Small Business Administration under section 7(b) of the
Small Business Act (15 U.S.C. 636(b)): <<NOTE: Web
posting. Records. Contracts. Determination.>> Provided further, That
the

[[Page 132 STAT. 105]]

Secretary shall require grantees to maintain on a public website
information containing common reporting criteria established by the
Department that permits individuals and entities awaiting assistance and
the general public to see how all grant funds are used, including copies
of all relevant procurement documents, grantee administrative contracts
and details of ongoing procurement processes, as determined by the
Secretary: <<NOTE: Plan.>> Provided further, That prior to the
obligation of funds a grantee shall submit a plan to the Secretary for
approval detailing the proposed use of all funds, including criteria for
eligibility and how the use of these funds will address long-term
recovery and restoration of infrastructure and housing, economic
revitalization, and mitigation in the most impacted and distressed
areas: Provided further, That such funds may not be used for activities
reimbursable by, or for which funds are made available by, the Federal
Emergency Management Agency or the Army Corps of Engineers: Provided
further, That funds allocated under this heading shall not be considered
relevant to the non-disaster formula allocations made pursuant to
section 106 of the Housing and Community Development Act of 1974 (42
U.S.C. 5306): Provided further, That a State, unit of general local
government, or Indian tribe may use up to 5 percent of its allocation
for administrative costs: Provided further, That the sixth proviso
under this heading in the Supplemental Appropriations for Disaster
Relief Requirements Act, 2017 (division B of Public Law 115-56) is
amended <<NOTE: 131 Stat. 1138.>> by striking “State or subdivision
thereof” and inserting “State, unit of general local government, or
Indian tribe (as such term is defined in section 102 of the Housing and
Community Development Act of 1974 (42 U.S.C. 5302))”: Provided
further, That in administering <<NOTE: Waiver authority.>> the funds
under this heading, the Secretary of Housing and Urban Development may
waive, or specify alternative requirements for, any provision of any
statute or regulation that the Secretary administers in connection with
the obligation by the Secretary or the use by the recipient of these
funds (except for requirements related to fair housing,
nondiscrimination, labor standards, and the environment), if the
Secretary finds that good cause exists for the waiver or alternative
requirement and such waiver or alternative requirement would not be
inconsistent with the overall purpose of title I of the Housing and
Community Development Act of 1974: Provided further, That,
notwithstanding the preceding proviso, recipients of funds provided
under this heading that use such funds to supplement Federal assistance
provided under section 402, 403, 404, 406, 407, 408(c)(4), or 502 of the
Robert T. Stafford Disaster Relief and Emergency Assistance Act (42
U.S.C. 5121 et seq.) may adopt, without review or public comment, any
environmental review, approval, or permit performed by a Federal agency,
and such adoption shall satisfy the responsibilities of the recipient
with respect to such environmental review, approval or permit: Provided
further, That, notwithstanding section 104(g)(2) of the Housing and
Community Development Act of 1974 (42 U.S.C. 5304(g)(2)), the Secretary
may, upon receipt of a request for release of funds and certification,
immediately approve the release of funds for an activity or project
assisted under this heading if the recipient has adopted an
environmental review, approval or permit under the preceding proviso or
the activity or project is categorically excluded from review under the
National Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.):
Provided further, That the Secretary <<NOTE: Notice. Federal
Register, publication. Deadline.>> shall publish via notice in the
Federal Register

[[Page 132 STAT. 106]]

any waiver, or alternative requirement, to any statute or regulation
that the Secretary administers pursuant to title I of the Housing and
Community Development Act of 1974 no later than 5 days before the
effective date of such waiver or alternative requirement: Provided
further, That the eighth proviso under this heading in the Supplemental
Appropriations for Disaster Relief Requirements Act, 2017 (division B of
Public Law 115-56) <<NOTE: 131 Stat. 1138.>> is amended by inserting
“408(c)(4),” after “407,”: Provided further, That of the amounts
made available under this heading, up to $15,000,000 shall be made
available for capacity building and technical assistance, including
assistance on contracting and procurement processes, to support States,
units of general local government, or Indian tribes (and their
subrecipients) that receive allocations pursuant to this heading,
received disaster recovery allocations under the same heading in Public
Law 115-56, or may receive similar allocations for disaster recovery in
future appropriations Acts: Provided further, That of the amounts made
available under this heading, up to $10,000,000 shall be transferred, in
aggregate, to “Department of Housing and Urban Development–Program
Office Salaries and Expenses–Community Planning and Development” for
necessary costs, including information technology costs, of
administering and overseeing the obligation and expenditure of amounts
under this heading: Provided further, That the amount specified in the
preceding proviso shall be combined with funds appropriated under the
same heading and for the same purpose in Public Law 115-56 and the
aggregate of such amounts shall be available for any of the purposes
specified under this heading or the same heading in Public Law 115-56
without limitation: Provided further, That, of the funds made available
under this heading, $10,000,000 shall be transferred to the Office of
the Inspector General for necessary costs of overseeing and auditing
funds made available under this heading: Provided further, That such
amount is designated by the Congress as being for an emergency
requirement pursuant to section 251(b)(2)(A)(i) of the Balanced Budget
and Emergency Deficit Control Act of 1985: Provided further, That
amounts repurposed pursuant to this section that were previously
designated by the Congress as an emergency requirement pursuant to the
Balanced Budget and Emergency Deficit Control Act are designated by the
Congress as an emergency requirement pursuant to section 251(b)(2)(A)(i)
of the Balanced Budget and Emergency Deficit Control Act of 1985.

General Provisions–Department of Housing and Urban Development

Sec. 21102. Any funds made available under the heading “Community
Development Fund” under this subdivision that remain available, after
the other funds under such heading have been allocated for necessary
expenses for activities authorized under such heading, shall be used for
additional mitigation activities in the most impacted and distressed
areas resulting from a major declared disaster that occurred in 2014,
2015, 2016 or 2017: Provided, That such remaining funds shall be
awarded to grantees of funding provided for disaster relief under the
heading “Community Development Fund” in this subdivision, section 420
of division L of Public Law 114-113, section 145 of division C of Public
Law 114-223, section 192 of division C of Public Law 114-223 (as added
by section 101(3) of division A of Public Law 114-254),

[[Page 132 STAT. 107]]

section 421 of division K of Public Law 115-31, and the same heading in
division B of Public Law 115-56 subject to the same terms and conditions
under this subdivision and such Acts respectively: Provided further,
That each such grantee shall receive an allocation from such remaining
funds in the same proportion that the amount of funds such grantee
received under this subdivision and under the Acts specified in the
previous proviso bears to the amount of all funds provided to all
grantees specified in the previous proviso.
Sec. 21103. For <<NOTE: Consultation.>> 2018, the Secretary of
Housing and Urban Development may make temporary adjustments to the
section 8 housing choice voucher annual renewal funding allocations and
administrative fee eligibility determinations for public housing
agencies located in the most impacted and distressed areas in which a
major Presidentially declared disaster occurred during 2017 under title
IV of the Robert T. Stafford Disaster Relief and Emergency Assistance
Act (42 U.S.C. 5170 et seq.), to avoid significant adverse funding
impacts that would otherwise result from the disaster, or to facilitate
leasing up to a public housing agency’s authorized level of units under
contract (but not to exceed such level), upon request by and in
consultation with a public housing agency and supported by documentation
as required by the Secretary that demonstrates the need for the
adjustment.

TITLE XII

GENERAL PROVISIONS–THIS SUBDIVISION

Sec. 21201. Each amount appropriated or made available by this
subdivision is in addition to amounts otherwise appropriated for the
fiscal year involved.
Sec. 21202. No part of any appropriation contained in this
subdivision shall remain available for obligation beyond the current
fiscal year unless expressly so provided herein.
Sec. 21203. Unless otherwise provided for by this subdivision, the
additional amounts appropriated by this subdivision to appropriations
accounts shall be available under the authorities and conditions
applicable to such appropriations accounts for fiscal year 2018.
Sec. 21204. Each <<NOTE: President.>> amount designated in this
subdivision by the Congress as being for an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985 shall be available (or rescinded or
transferred, if applicable) only if the President subsequently so
designates all such amounts and transmits such designations to the
Congress.

Sec. 21205. For purposes of this subdivision, the consequences or
impacts of any hurricane shall include damages caused by the storm at
any time during the entirety of its duration as a cyclone, as defined by
the National Hurricane Center.
Sec. 21206. Any <<NOTE: President.>> amount appropriated by this
subdivision, designated by the Congress as an emergency requirement
pursuant to section 251(b)(2)(A)(i) of the Balanced Budget and Emergency
Deficit Control Act of 1985 and subsequently so designated by the
President, and transferred pursuant to transfer authorities provided by
this subdivision shall retain such designation.

[[Page 132 STAT. 108]]

Sec. 21207. The <<NOTE: Applicability.>> terms and conditions
applicable to the funds provided in this subdivision, including those
provided by this title, shall also apply to the funds made available in
division B of Public Law 115-56 and in division A of Public Law 115-72.

Sec. 21208. (a) Section 305 of division A of the Additional
Supplemental Appropriations for Disaster Relief Requirements Act, 2017
(Public Law 115-72) <<NOTE: 131 Stat. 1227.>> is amended–
(1) in subsection (a)–
(A) <<NOTE: Deadline.>> by striking “(1) Not later
than December 31, 2017,” and inserting “Not later than
March 31, 2018,”; and
(B) by striking paragraph (2); and
(2) in subsection (b), by striking “receiving funds under
this division” and inserting “expending more than $10,000,000
of funds provided by this division and division B of Public Law
115-56 in any one fiscal year”.

(b) <<NOTE: Applicability.>> Section 305 of division A of the
Additional Supplemental Appropriations for Disaster Relief Requirements
Act, 2017 (Public Law 115-72), as amended by this section, shall apply
to funds appropriated by this division as if they had been appropriated
by that division.

(c) <<NOTE: Disaster assistance. Deadline. Guidance. 31 USC 501
note.>> In order to proactively prepare for oversight of future
disaster relief funding, not later than one year after the date of
enactment of this Act, the Director of the Office of Management and
Budget shall issue standard guidance for Federal agencies to use in
designing internal control plans for disaster relief funding. This
guidance shall leverage existing internal control review processes and
shall include, at a minimum, the following elements:
(1) <<NOTE: Criteria.>> Robust criteria for identifying and
documenting incremental risks and mitigating controls related to
the funding.
(2) Guidance for documenting the linkage between the
incremental risks related to disaster funding and efforts to
address known internal control risks.

Sec. 21209. Any <<NOTE: Reports.>> agency or department provided
funding in excess of $3,000,000,000 by this subdivision, including the
Federal Emergency Management Agency, the Department of Housing and Urban
Development, and the Corps of Engineers, is directed to provide a report
to the Committees on Appropriations of the House of Representatives and
the Senate regarding its efforts to provide adequate resources and
technical assistance for small, low-income communities affected by
natural disasters.

Sec. 21210. (a) <<NOTE: Deadline. Coordination. Puerto
Rico. Reports. Plan.>> Not later than 180 days after the date of
enactment of this subdivision and in coordination with the Administrator
of the Federal Emergency Management Agency, with support and
contributions from the Secretary of the Treasury, the Secretary of
Energy, and other Federal agencies having responsibilities defined under
the National Disaster Recovery Framework, the Governor of the
Commonwealth of Puerto Rico shall submit to Congress a report describing
the Commonwealth’s 12- and 24-month economic and disaster recovery plan
that–
(1) defines the priorities, goals, and expected outcomes of
the recovery effort for the Commonwealth, based on damage
assessments prepared pursuant to Federal law, if applicable,
including–
(A) housing;
(B) economic issues, including workforce development
and industry expansion and cultivation;
(C) health and social services;

[[Page 132 STAT. 109]]

(D) natural and cultural resources;
(E) governance and civic institutions;
(F) electric power systems and grid restoration;
(G) environmental issues, including solid waste
facilities; and
(H) other infrastructure systems, including repair,
restoration, replacement, and improvement of public
infrastructure such water and wastewater treatment
facilities, communications networks, and transportation
infrastructure;
(2) is consistent with–
(A) the Commonwealth’s fiscal capacity to provide
long-term operation and maintenance of rebuilt or
replaced assets;
(B) alternative procedures and associated
programmatic guidance adopted by the Administrator of
the Federal Emergency Management Agency pursuant to
section 428 of the Robert T. Stafford Disaster Relief
and Emergency Assistance Act (42 U.S.C. 5189f); and
(C) actions as may be necessary to mitigate
vulnerabilities to future extreme weather events and
natural disasters and increase community resilience,
including encouraging the adoption and enforcement of
the latest published editions of relevant consensus-
based codes, specifications, and standards that
incorporate the latest hazard-resistant designs and
establish minimum acceptable criteria for the design,
construction, and maintenance of residential structures
and facilities for the purpose of protecting the health,
safety, and general welfare of the buildings’ users
against disasters;
(3) promotes transparency and accountability through
appropriate public notification, outreach, and hearings;
(4) identifies performance metrics for assessing and
reporting on the progress toward achieving the Commonwealth’s
recovery goals, as identified under paragraph (1);
(5) is developed in coordination with the Oversight Board
established under PROMESA; and
(6) <<NOTE: Certification.>> is certified by that Oversight
Board to be consistent with the purpose set forth in section
101(a) of PROMESA (48 U.S.C. 2121(a)).

(b) <<NOTE: Time period. Updates.>> At the end of every 30-day
period before the submission of the report described in subsection (a),
the Governor of the Commonwealth of Puerto Rico, in coordination with
the Administrator of the Federal Emergency Management Agency, shall
provide to Congress interim status updates on progress developing such
report.

(c) <<NOTE: Time period.>> At the end of every 180-day period after
the submission of the report described in subsection (a), the Governor
of the Commonwealth of Puerto Rico, in coordination with the
Administrator of the Federal Emergency Management Agency, shall make
public a report on progress achieving the goals set forth in such
report.

(d) During the development, and after the submission, of the report
required in subsection (a), the Oversight Board may provide to Congress
reports on the status of coordination with the Governor of Puerto Rico.

[[Page 132 STAT. 110]]

(e) Amounts made available by this subdivision to a covered
territory for response to or recovery from Hurricane Irma or Hurricane
Maria in an aggregate amount greater than $10,000,000 may be reviewed by
the Oversight Board under the Oversight Board’s authority under
204(b)(2) of PROMESA (48 U.S.C. 2144(b)(2)).
(f) <<NOTE: Assessments.>> When developing a Fiscal Plan while the
recovery plan required under subsection (a) is in development and in
effect, the Oversight Board shall use and incorporate, to the greatest
extent feasible, damage assessments prepared pursuant to Federal law.

(g) For purposes of this section, the terms “covered territory”
and “Oversight Board” have the meaning given those term in section 5
of PROMESA (48 U.S.C. 2104).
This subdivision may be cited as the “Further Additional
Supplemental Appropriations for Disaster Relief Requirements Act,
2018”.

SUBDIVISION 2–TAX RELIEF AND MEDICAID CHANGES RELATING TO CERTAIN
DISASTERS

TITLE I–CALIFORNIA FIRES

SEC. 20101. DEFINITIONS.

For purposes of this title–
(1) California wildfire disaster zone.–The term
“California wildfire disaster zone” means that portion of the
California wildfire disaster area determined by the President to
warrant individual or individual and public assistance from the
Federal Government under the Robert T. Stafford Disaster Relief
and Emergency Assistance Act by reason of wildfires in
California.
(2) <<NOTE: Time period. President.>> California wildfire
disaster area.–The term “California wildfire disaster area”
means an area with respect to which between January 1, 2017
through January 18, 2018 a major disaster has been declared by
the President under section 401 of such Act by reason of
wildfires in California.
SEC. 20102. SPECIAL DISASTER-RELATED RULES FOR USE OF RETIREMENT
FUNDS.

(a) Tax-Favored Withdrawals From Retirement Plans.–
(1) In general.–Section 72(t) of the Internal Revenue Code
of 1986 shall not apply to any qualified wildfire distribution.
(2) Aggregate dollar limitation.–
(A) In general.–For purposes of this subsection,
the aggregate amount of distributions received by an
individual which may be treated as qualified wildfire
distributions for any taxable year shall not exceed the
excess (if any) of–
(i) $100,000, over
(ii) the aggregate amounts treated as
qualified wildfire distributions received by such
individual for all prior taxable years.

[[Page 132 STAT. 111]]

(B) Treatment of plan distributions.–If a
distribution to an individual would (without regard to
subparagraph (A)) be a qualified wildfire distribution,
a plan shall not be treated as violating any requirement
of the Internal Revenue Code of 1986 merely because the
plan treats such distribution as a qualified wildfire
distribution, unless the aggregate amount of such
distributions from all plans maintained by the employer
(and any member of any controlled group which includes
the employer) to such individual exceeds $100,000.
(C) <<NOTE: Definition.>> Controlled group.–For
purposes of subparagraph (B), the term “controlled
group” means any group treated as a single employer
under subsection (b), (c), (m), or (o) of section 414 of
the Internal Revenue Code of 1986.
(3) Amount distributed may be repaid.–
(A) <<NOTE: Time period. Effective date.>> In
general.–Any individual who receives a qualified
wildfire distribution may, at any time during the 3-year
period beginning on the day after the date on which such
distribution was received, make one or more
contributions in an aggregate amount not to exceed the
amount of such distribution to an eligible retirement
plan of which such individual is a beneficiary and to
which a rollover contribution of such distribution could
be made under section 402(c), 403(a)(4), 403(b)(8),
408(d)(3), or 457(e)(16), of the Internal Revenue Code
of 1986, as the case may be.
(B) Treatment of repayments of distributions from
eligible retirement plans other than iras.–
<<NOTE: Deadline.>> For purposes of the Internal Revenue
Code of 1986, if a contribution is made pursuant to
subparagraph (A) with respect to a qualified wildfire
distribution from an eligible retirement plan other than
an individual retirement plan, then the taxpayer shall,
to the extent of the amount of the contribution, be
treated as having received the qualified wildfire
distribution in an eligible rollover distribution (as
defined in section 402(c)(4) of such Code) and as having
transferred the amount to the eligible retirement plan
in a direct trustee to trustee transfer within 60 days
of the distribution.
(C) Treatment of repayments for distributions from
iras.–For purposes <<NOTE: Deadline.>> of the Internal
Revenue Code of 1986, if a contribution is made pursuant
to subparagraph (A) with respect to a qualified wildfire
distribution from an individual retirement plan (as
defined by section 7701(a)(37) of such Code), then, to
the extent of the amount of the contribution, the
qualified wildfire distribution shall be treated as a
distribution described in section 408(d)(3) of such Code
and as having been transferred to the eligible
retirement plan in a direct trustee to trustee transfer
within 60 days of the distribution.
(4) Definitions.–For purposes of this subsection–
(A) <<NOTE: Time periods.>> Qualified wildfire
distribution.–Except as provided in paragraph (2), the
term “qualified wildfire distribution” means any
distribution from an eligible retirement plan made on or
after October 8, 2017, and before January 1, 2019, to an
individual whose principal place of abode during any
portion of the period from October 8, 2017,

[[Page 132 STAT. 112]]

to December 31, 2017, is located in the California
wildfire disaster area and who has sustained an economic
loss by reason of the wildfires to which the declaration
of such area relates.
(B) Eligible retirement plan.–The term “eligible
retirement plan” shall have the meaning given such term
by section 402(c)(8)(B) of the Internal Revenue Code of
1986.
(5) Income inclusion spread over 3-year period.–
(A) In general.–In the case of any qualified
wildfire distribution, unless the taxpayer elects not to
have this paragraph apply for any taxable year, any
amount required to be included in gross income for such
taxable year shall be so included ratably over the 3-
taxable-year period beginning with such taxable year.
(B) <<NOTE: Applicability.>> Special rule.–For
purposes of subparagraph (A), rules similar to the rules
of subparagraph (E) of section 408A(d)(3) of the
Internal Revenue Code of 1986 shall apply.
(6) Special rules.–
(A) Exemption of distributions from trustee to
trustee transfer and withholding rules.–For purposes of
sections 401(a)(31), 402(f), and 3405 of the Internal
Revenue Code of 1986, qualified wildfire distributions
shall not be treated as eligible rollover distributions.
(B) Qualified wildfire distributions treated as
meeting plan distribution requirements.–For purposes
the Internal Revenue Code of 1986, a qualified wildfire
distribution shall be treated as meeting the
requirements of sections 401(k)(2)(B)(i),
403(b)(7)(A)(ii), 403(b)(11), and 457(d)(1)(A) of such
Code.

(b) Recontributions of Withdrawals for Home Purchases.–
(1) Recontributions.–
(A) <<NOTE: Time period.>> In general.–Any
individual who received a qualified distribution may,
during the period beginning on October 8, 2017, and
ending on June 30, 2018, make one or more contributions
in an aggregate amount not to exceed the amount of such
qualified distribution to an eligible retirement plan
(as defined in section 402(c)(8)(B) of the Internal
Revenue Code of 1986) of which such individual is a
beneficiary and to which a rollover contribution of such
distribution could be made under section 402(c),
403(a)(4), 403(b)(8), or 408(d)(3), of such Code, as the
case may be.
(B) <<NOTE: Applicability.>> Treatment of
repayments.–Rules similar to the rules of subparagraphs
(B) and (C) of subsection (a)(3) shall apply for
purposes of this subsection.
(2) <<NOTE: Definition.>> Qualified distribution.–For
purposes of this subsection, the term “qualified distribution”
means any distribution–
(A) described in section 401(k)(2)(B)(i)(IV),
403(b)(7)(A)(ii) (but only to the extent such
distribution relates to financial hardship),
403(b)(11)(B), or 72(t)(2)(F), of the Internal Revenue
Code of 1986,
(B) <<NOTE: Time period.>> received after March 31,
2017, and before January 15, 2018, and

[[Page 132 STAT. 113]]

(C) which was to be used to purchase or construct a
principal residence in the California wildfire disaster
area but which was not so purchased or constructed on
account of the wildfires to which the declaration of
such area relates.

(c) Loans From Qualified Plans.–
(1) <<NOTE: Time period. Applicability.>> Increase in limit
on loans not treated as distributions.–In the case of any loan
from a qualified employer plan (as defined under section
72(p)(4) of the Internal Revenue Code of 1986) to a qualified
individual made during the period beginning on the date of the
enactment of this Act and ending on December 31, 2018–
(A) clause (i) of section 72(p)(2)(A) of such Code
shall be applied by substituting “$100,000” for
“$50,000”, and
(B) clause (ii) of such section shall be applied by
substituting “the present value of the nonforfeitable
accrued benefit of the employee under the plan” for
“one-half of the present value of the nonforfeitable
accrued benefit of the employee under the plan”.
(2) <<NOTE: Effective date. Time periods.>> Delay of
repayment.–In the case of a qualified individual with an
outstanding loan on or after October 8, 2017, from a qualified
employer plan (as defined in section 72(p)(4) of the Internal
Revenue Code of 1986)–
(A) if the due date pursuant to subparagraph (B) or
(C) of section 72(p)(2) of such Code for any repayment
with respect to such loan occurs during the period
beginning on October 8, 2017, and ending on December 31,
2018, such due date shall be delayed for 1 year,
(B) any subsequent repayments with respect to any
such loan shall be appropriately adjusted to reflect the
delay in the due date under paragraph (1) and any
interest accruing during such delay, and
(C) in determining the 5-year period and the term of
a loan under subparagraph (B) or (C) of section 72(p)(2)
of such Code, the period described in subparagraph (A)
shall be disregarded.
(3) <<NOTE: Definition. Time period.>> Qualified
individual.–For purposes of this subsection, the term
“qualified individual” means any individual whose principal
place of abode during any portion of the period from October 8,
2017, to December 31, 2017, is located in the California
wildfire disaster area and who has sustained an economic loss by
reason of wildfires to which the declaration of such area
relates.

(d) Provisions Relating to Plan Amendments.–
(1) <<NOTE: Applicability.>> In general.–If this
subsection applies to any amendment to any plan or annuity
contract, such plan or contract shall be treated as being
operated in accordance with the terms of the plan during the
period described in paragraph (2)(B)(i).
(2) Amendments to which subsection applies.–
(A) In general.–This subsection shall apply to any
amendment to any plan or annuity contract which is
made–
(i) <<NOTE: Regulation.>> pursuant to any
provision of this section, or pursuant to any
regulation issued by the Secretary or the
Secretary of Labor under any provision of this
section, and

[[Page 132 STAT. 114]]

(ii) <<NOTE: Effective date.>> on or before
the last day of the first plan year beginning on
or after January 1, 2019, or such later date as
the Secretary may prescribe.
In the case of a governmental plan (as defined in
section 414(d) of the Internal Revenue Code of 1986),
clause (ii) shall be applied by substituting the date
which is 2 years after the date otherwise applied under
clause (ii).
(B) Conditions.–This subsection shall not apply to
any amendment unless–
(i) <<NOTE: Time period.>> during the
period–
(I) beginning on the date that this
section or the regulation described in
subparagraph (A)(i) takes effect (or in
the case of a plan or contract amendment
not required by this section or such
regulation, the effective date specified
by the plan), and
(II) ending on the date described in
subparagraph (A)(ii) (or, if earlier,
the date the plan or contract amendment
is adopted),
the plan or contract is operated as if such plan or
contract amendment were in effect, and
(ii) such plan or contract amendment applies
retroactively for such period.
SEC. 20103. EMPLOYEE RETENTION CREDIT FOR EMPLOYERS AFFECTED BY
CALIFORNIA WILDFIRES.

(a) In General.–For purposes of section 38 of the Internal Revenue
Code of 1986, in the case of an eligible employer, the California
wildfire employee retention credit shall be treated as a credit listed
in subsection (b) of such section. For purposes of this subsection, the
California wildfire employee retention credit for any taxable year is an
amount equal to 40 percent of the qualified wages with respect to each
eligible employee of such employer for such taxable year. For purposes
of the preceding sentence, the amount of qualified wages which may be
taken into account with respect to any individual shall not exceed
$6,000.
(b) <<NOTE: Effective date. Time periods.>> Definitions.–For
purposes of this section–
(1) Eligible employer.–The term “eligible employer” means
any employer–
(A) which conducted an active trade or business on
October 8, 2017, in the California wildfire disaster
zone, and
(B) with respect to whom the trade or business
described in subparagraph (A) is inoperable on any day
after October 8, 2017, and before January 1, 2018, as a
result of damage sustained by reason of the wildfires to
which such declaration of such area relates.
(2) Eligible employee.–The term “eligible employee” means
with respect to an eligible employer an employee whose principal
place of employment on October 8, 2017, with such eligible
employer was in the California wildfire disaster zone.
(3) Qualified wages.–The term “qualified wages” means
wages (as defined in section 51(c)(1) of the Internal Revenue
Code of 1986, but without regard to section 3306(b)(2)(B) of
such Code) paid or incurred by an eligible employer with respect
to an eligible employee on any day after October 8, 2017, and
before January 1, 2018, which occurs during the period–

[[Page 132 STAT. 115]]

(A) beginning on the date on which the trade or
business described in paragraph (1) first became
inoperable at the principal place of employment of the
employee immediately before the wildfires to which the
declaration of the California wildfire disaster area
relates, and
(B) ending on the date on which such trade or
business has resumed significant operations at such
principal place of employment.
Such term shall include wages paid without regard to whether the
employee performs no services, performs services at a different
place of employment than such principal place of employment, or
performs services at such principal place of employment before
significant operations have resumed.

(c) Certain Rules To Apply.–For purposes of this section, rules
similar to the rules of sections 51(i)(1), 52, and 280C(a) of the
Internal Revenue Code of 1986, shall apply.
(d) Employee Not Taken Into Account More Than Once.–An employee
shall not be treated as an eligible employee for purposes of this
section for any period with respect to any employer if such employer is
allowed a credit under section 51 of the Internal Revenue Code of 1986
with respect to such employee for such period.
SEC. 20104. <<NOTE: Applicability. Definitions. Time periods.>>
ADDITIONAL DISASTER-RELATED TAX RELIEF
PROVISIONS.

(a) Temporary Suspension of Limitations on Charitable
Contributions.–
(1) In general.–Except as otherwise provided in paragraph
(2), subsection (b) of section 170 of the Internal Revenue Code
of 1986 shall not apply to qualified contributions and such
contributions shall not be taken into account for purposes of
applying subsections (b) and (d) of such section to other
contributions.
(2) Treatment of excess contributions.–For purposes of
section 170 of the Internal Revenue Code of 1986–
(A) Individuals.–In the case of an individual–
(i) Limitation.–Any qualified contribution
shall be allowed only to the extent that the
aggregate of such contributions does not exceed
the excess of the taxpayer’s contribution base (as
defined in subparagraph (H) of section 170(b)(1)
of such Code) over the amount of all other
charitable contributions allowed under section
170(b)(1) of such Code.
(ii) Carryover.–If the aggregate amount of
qualified contributions made in the contribution
year (within the meaning of section 170(d)(1) of
such Code) exceeds the limitation of clause (i),
such excess shall be added to the excess described
in the portion of subparagraph (A) of such section
which precedes clause (i) thereof for purposes of
applying such section.
(B) Corporations.–In the case of a corporation–
(i) Limitation.–Any qualified contribution
shall be allowed only to the extent that the
aggregate of such contributions does not exceed
the excess of the taxpayer’s taxable income (as
determined under paragraph (2) of section 170(b)
of such Code) over the amount of all other
charitable contributions allowed under such
paragraph.

[[Page 132 STAT. 116]]

(ii) Carryover.–Rules similar to the rules of
subparagraph (A)(ii) shall apply for purposes of
this subparagraph.
(3) Exception to overall limitation on itemized
deductions.–So much of any deduction allowed under section 170
of the Internal Revenue Code of 1986 as does not exceed the
qualified contributions paid during the taxable year shall not
be treated as an itemized deduction for purposes of section 68
of such Code.
(4) Qualified contributions.–
(A) In general.–For purposes of this subsection,
the term “qualified contribution” means any charitable
contribution (as defined in section 170(c) of the
Internal Revenue Code of 1986) if–
(i) such contribution–
(I) is paid during the period
beginning on October 8, 2017, and ending
on December 31, 2018, in cash to an
organization described in section
170(b)(1)(A) of such Code, and
(II) is made for relief efforts in
the California wildfire disaster area,
(ii) the taxpayer obtains from such
organization contemporaneous written
acknowledgment (within the meaning of section
170(f)(8) of such Code) that such contribution was
used (or is to be used) for relief efforts
described in clause (i)(II), and
(iii) the taxpayer has elected the application
of this subsection with respect to such
contribution.
(B) Exception.–Such term shall not include a
contribution by a donor if the contribution is–
(i) to an organization described in section
509(a)(3) of the Internal Revenue Code of 1986, or
(ii) for the establishment of a new, or
maintenance of an existing, donor advised fund (as
defined in section 4966(d)(2) of such Code).
(C) Application of election to partnerships and s
corporations.–In the case of a partnership or S
corporation, the election under subparagraph (A)(iii)
shall be made separately by each partner or shareholder.

(b) Special Rules for Qualified Disaster-Related Personal Casualty
Losses.–
(1) In general.–If an individual has a net disaster loss
for any taxable year–
(A) the amount determined under section
165(h)(2)(A)(ii) of the Internal Revenue Code of 1986
shall be equal to the sum of–
(i) such net disaster loss, and
(ii) so much of the excess referred to in the
matter preceding clause (i) of section
165(h)(2)(A) of such Code (reduced by the amount
in clause (i) of this subparagraph) as exceeds 10
percent of the adjusted gross income of the
individual,
(B) section 165(h)(1) of such Code shall be applied
by substituting “$500” for “$500 ($100 for taxable
years beginning after December 31, 2009)”,

[[Page 132 STAT. 117]]

(C) the standard deduction determined under section
63(c) of such Code shall be increased by the net
disaster loss, and
(D) section 56(b)(1)(E) of such Code shall not apply
to so much of the standard deduction as is attributable
to the increase under subparagraph (C) of this
paragraph.
(2) Net disaster loss.–For purposes of this subsection, the
term “net disaster loss” means the excess of qualified
disaster-related personal casualty losses over personal casualty
gains (as defined in section 165(h)(3)(A) of the Internal
Revenue Code of 1986).
(3) Qualified disaster-related personal casualty losses.–
For purposes of this subsection, the term “qualified disaster-
related personal casualty losses” means losses described in
section 165(c)(3) of the Internal Revenue Code of 1986 which
arise in the California wildfire disaster area on or after
October 8, 2017, and which are attributable to the wildfires to
which the declaration of such area relates.

(c) Special Rule for Determining Earned Income.–
(1) In general.–In the case of a qualified individual, if
the earned income of the taxpayer for the taxable year which
includes any portion of the period from October 8, 2017, to
December 31, 2017, is less than the earned income of the
taxpayer for the preceding taxable year, the credits allowed
under sections 24(d) and 32 of the Internal Revenue Code of 1986
may, at the election of the taxpayer, be determined by
substituting–
(A) such earned income for the preceding taxable
year, for
(B) such earned income for the taxable year which
includes any portion of the period from October 8, 2017,
to December 31, 2017.
(2) Qualified individual.–For purposes of this subsection,
the term “qualified individual” means any individual whose
principal place of abode during any portion of the period from
October 8, 2017, to December 31, 2017, was located–
(A) in the California wildfire disaster zone, or
(B) in the California wildfire disaster area (but
outside the California wildfire disaster zone) and such
individual was displaced from such principal place of
abode by reason of the wildfires to which the
declaration of such area relates.
(3) Earned income.–For purposes of this subsection, the
term “earned income” has the meaning given such term under
section 32(c) of the Internal Revenue Code of 1986.
(4) Special rules.–
(A) Application to joint returns.–For purposes of
paragraph (1), in the case of a joint return for a
taxable year which includes any portion of the period
from October 8, 2017, to December 31, 2017–
(i) such paragraph shall apply if either
spouse is a qualified individual, and
(ii) the earned income of the taxpayer for the
preceding taxable year shall be the sum of the
earned income of each spouse for such preceding
taxable year.
(B) Uniform application of election.–Any election
made under paragraph (1) shall apply with respect to
both

[[Page 132 STAT. 118]]

sections 24(d) and 32, of the Internal Revenue Code of
1986.
(C) Errors treated as mathematical error.–For
purposes of section 6213 of the Internal Revenue Code of
1986, an incorrect use on a return of earned income
pursuant to paragraph (1) shall be treated as a
mathematical or clerical error.
(D) No effect on determination of gross income,
etc.–Except as otherwise provided in this subsection,
the Internal Revenue Code of 1986 shall be applied
without regard to any substitution under paragraph (1).

TITLE II–TAX RELIEF FOR HURRICANES HARVEY, IRMA, AND MARIA

SEC. 20201. TAX RELIEF FOR HURRICANES HARVEY, IRMA, AND MARIA.

(a) Modification of Hurricanes Harvey and Irma Disaster Areas.–
Subsections (a)(2) and (b)(2) of section 501 of the Disaster Tax Relief
and Airport and Airway Extension Act of 2017 (Public Law 115-63; 131
Stat. 1173) are both amended by striking “September 21, 2017” and
inserting “October 17, 2017”.
(b) Employee Retention Credit.–Subsections (a)(3), (b)(3), and
(c)(3) of section 503 of the Disaster Tax Relief and Airport and Airway
Extension Act of 2017 (Public Law 115-63; 131 Stat. 1181) are each
amended by striking “sections 51(i)(1) and 52” and inserting
“sections 51(i)(1), 52, and 280C(a)”.
(c) Effective Date.–The amendments made by this section shall take
effect as if included in the provisions of title V of the Disaster Tax
Relief and Airport and Airway Extension Act of 2017 to which such
amendments relate.

TITLE III–HURRICANE MARIA RELIEF FOR PUERTO RICO AND THE VIRGIN ISLANDS
MEDICAID PROGRAMS

SEC. 20301. HURRICANE MARIA RELIEF FOR PUERTO RICO AND THE VIRGIN
ISLANDS MEDICAID PROGRAMS.

(a) Increased Caps.–Section 1108(g)(5) of the Social Security Act
(42 U.S.C. 1308(g)(5)) is amended–
(1) in subparagraph (A), by striking “subparagraph (B)”
and inserting “subparagraphs (B), (C), (D), and (E)”; and
(2) by adding at the end the following new subparagraphs:
“(C) <<NOTE: Time period.>> Subject to subparagraphs (D)
and (E), for the period beginning January 1, 2018, and ending
September 30, 2019–
“(i) the amount of the increase otherwise provided
under subparagraphs (A) and (B) for Puerto Rico shall be
further increased by $3,600,000,000; and
“(ii) the amount of the increase otherwise provided
under subparagraph (A) for the Virgin Islands shall be
further increased by $106,931,000.
“(D) <<NOTE: Certifications.>> For the period described in
subparagraph (C), the amount of the increase otherwise provided
under subparagraph (A)–

[[Page 132 STAT. 119]]

“(i) for Puerto Rico shall be further increased by
$1,200,000,000 if the Secretary certifies that Puerto
Rico has taken reasonable and appropriate steps during
such period, in accordance with a timeline established
by the Secretary, to–
“(I) implement methods, satisfactory to the
Secretary, for the collection and reporting of
reliable data to the Transformed Medicaid
Statistical Information System (T-MSIS) (or a
successor system); and
“(II) demonstrate progress in establishing a
State medicaid fraud control unit described in
section 1903(q); and
“(ii) for the Virgin Islands shall be further
increased by $35,644,000 if the Secretary certifies that
the Virgin Islands has taken reasonable and appropriate
steps during such period, in accordance with a timeline
established by the Secretary, to meet the conditions for
certification specified in subclauses (I) and (II) of
clause (i).
“(E) Notwithstanding any other provision of title XIX,
during the period in which the additional funds provided under
subparagraphs (C) and (D) are available for Puerto Rico and the
Virgin Islands, respectively, with respect to payments from such
additional funds for amounts expended by Puerto Rico and the
Virgin Islands under such title, the Secretary shall increase
the Federal medical assistance percentage or other rate that
would otherwise apply to such payments to 100 percent.”.

(b) Disregard of Certain Expenditures From Spending Cap.–Section
1108(g)(4) of the Social Security Act (42 U.S.C. 1308(g)(4)) is
amended–
(1) by inserting “for a calendar quarter of such fiscal
year,” after “section 1903(a)(3)”; and
(2) by striking “of such fiscal year for a calendar quarter
of such fiscal year,” and inserting “of such fiscal year, and
with respect to fiscal years beginning with fiscal year 2018, if
the Virgin Islands qualifies for a payment under section
1903(a)(6) for a calendar quarter (beginning on or after January
1, 2018) of such fiscal year,”.

(c) Report to Congress.–Not later than July 1, 2018, the Secretary
of Health and Human Services shall submit a report to the Committee on
Energy and Commerce of the House of Representatives and the Committee on
Finance of the Senate that–
(1) describes the steps taken by Puerto Rico and the Virgin
Islands to meet the conditions for certification specified in
clauses (i) and (ii), respectively, of section 1108(g)(5)(D) of
the Social Security Act (42 U.S.C. 1308(g)(5)(D)) (as amended by
subsection (a) of this section); and
(2) specifies timelines for each such territory to, as a
condition of eligibility for any additional increases in the
amounts determined for Puerto Rico or the Virgin Islands,
respectively, under subsection (g) of section 1108 of such Act
(42 U.S.C. 1308) for purposes of payments under title XIX of
such Act for fiscal year 2019, complete–
(A) implementation of methods, satisfactory to the
Secretary, for the collection and reporting of reliable
data to the Transformed Medicaid Statistical Information
System (T-MSIS) (or a successor system); and

[[Page 132 STAT. 120]]

(B) the establishment of a State medicaid fraud
control unit described in section 1903(q) of the Social
Security Act (42 U.S.C. 1396d(q)).

TITLE IV–BUDGETARY EFFECTS

SEC. 20401. EMERGENCY DESIGNATION.

This subdivision is designated as an emergency requirement pursuant
to section 4(g) of the Statutory Pay-As-You-Go Act of 2010 (2 U.S.C.
933(g)).
SEC. 20402. DESIGNATION IN SENATE.

In the Senate, this subdivision is designated as an emergency
requirement pursuant to section 4112(a) of H. Con. Res. 71 (115th
Congress), the concurrent resolution on the budget for fiscal year 2018.

Subdivision 3– <<NOTE: Further Extension of Continuing Appropriations
Act, 2018.>> Further Extension of Continuing Appropriations Act, 2018

Sec. 20101. <<NOTE: 131 Stat. 1141.>> The Continuing
Appropriations Act, 2018 (division D of Public Law 115-56) is further
amended by–
(1) striking the date specified in section 106(3) and
inserting “March 23, 2018”; and
(2) inserting after section 155 <<NOTE: Ante, p. 30.>> the
following new sections:

“Sec. 156. In addition to amounts provided by section 101, amounts
are provided for `Department of Commerce–Bureau of the Census–Periodic
Census and Programs’ at a rate for operations of $182,000,000 for an
additional amount for the 2020 Decennial Census Program; and such
amounts may be apportioned up to the rate for operations necessary to
maintain the schedule and deliver the required data according to
statutory deadlines in the 2020 Decennial Census Program.
“Sec. 157. Notwithstanding <<NOTE: Applicability.>> section 101,
the matter preceding the first proviso and the first proviso under the
heading `Power Marketing Administrations–Operation and Maintenance,
Southeastern Power Administration’ in division D of Public Law 115-31
shall be applied by substituting `$6,379,000′ for `$1,000,000′ each
place it appears.

“Sec. 158. <<NOTE: 42 USC 6241 note.>> As authorized by section
404 of the Bipartisan Budget Act of 2015 (Public Law 114-74; 42 U.S.C.
6239 note), the Secretary of Energy shall draw down and sell not to
exceed $350,000,000 of crude oil from the Strategic Petroleum Reserve in
fiscal year 2018: Provided, That the proceeds from such drawdown and
sale shall be deposited into the `Energy Security and Infrastructure
Modernization Fund’ (in this section referred to as the `Fund’) during
fiscal year 2018: Provided further, That in addition to amounts
otherwise made available by section 101, any amounts deposited in the
Fund shall be made available and shall remain available until expended
at a rate for operations of $350,000,000, for necessary expenses in
carrying out the Life Extension II project for the Strategic Petroleum
Reserve.

“Sec. 159. Amounts made available by section 101 for `The
Judiciary–Courts of Appeals, District Courts, and Other Judicial
Services–Fees of Jurors and Commissioners’ may be apportioned up to the
rate for operations necessary to accommodate increased juror usage.

[[Page 132 STAT. 121]]

“Sec. 160. Section 144 of the Continuing Appropriations Act, 2018
(division D of Public Law 115-56), as amended by the Further Additional
Continuing Appropriations Act, 2018 (division A of Public Law 115-
96) <<NOTE: 131 Stat. 2044.>> , is amended by (1) striking `$11,761,000′
and inserting `$22,247,000′, and (2) striking `$1,104,000′ and inserting
`$1,987,000′.

“Sec. 161. Section <<NOTE: Applicability.>> 458(a)(4) of the
Higher Education Act of 1965 (20 U.S.C. 1087h(a)(4)) shall be applied by
substituting `2018′ for `2017′.

“Sec. 162. For <<NOTE: Waiver authority.>> the purpose of
carrying out section 435(a)(2) of the Higher Education Act of 1965 (HEA)
(20 U.S.C. 1085(a)(2)), during the period covered by this Act the
Secretary of Education may waive the requirement under section
435(a)(5)(A)(ii) of the HEA (20 U.S.C. 1085(a)(5)(A)(ii)) for an
institution of higher education that offers an associate degree, is a
public institution, and is located in an economically distressed county,
defined as a county that ranks in the lowest 5 percent of all counties
in the United States based on a national index of county economic
status: Provided, That <<NOTE: Applicability.>> this section shall
apply to an institution of higher education that otherwise would be
ineligible to participate in a program under part A of title IV of the
HEA on or after the date of enactment of this Act due to the application
of section 435(a)(2) of the HEA.

“Sec. 163. Notwithstanding any other provision of law, funds made
available by this Act for military construction, land acquisition, and
family housing projects and activities may be obligated and expended to
carry out planning and design and military construction projects
authorized by law: Provided, That funds and authority provided by this
section may be used notwithstanding sections 102 and 104: Provided
further, That such funds may be used only for projects identified by the
Department of the Air Force in its January 29, 2018, letter sent to the
Committees on Appropriations of both Houses of Congress detailing
urgently needed fiscal year 2018 construction requirements.
“Sec. 164. (a) Section 116(h)(3)(D) of title 49, United States
Code, is amended–
“(1) in clause (i), by striking `During the 2-year period
beginning on the date of enactment of this section, the’;
inserting `The’; and inserting the following after the first
sentence: `Any such funds or limitation of obligations or
portions thereof transferred to the Bureau may be transferred
back to and merged with the original account.’; and
“(2) in clause (ii) by striking `During the 2-year period
beginning on the date of enactment of this section, the’;
inserting `The’; and inserting the following after the first
sentence: `Any such funds or limitation of obligations or
portions thereof transferred to the Bureau may be transferred
back to and merged with the original account.’.

“(b) Section 503(l)(4) of the Railroad Revitalization and
Regulatory Reform Act of 1976 (45 U.S.C. 823(l)(4)) is amended–
“(1) in the heading by striking `Safety and operations
account’ and inserting `National Surface Transportation and
Innovative Finance Bureau account’; and
“(2) in subparagraph (A) by striking `Safety and Operations
account of the Federal Railroad Administration’ and inserting
`National Surface Transportation and Innovative Finance Bureau
account’.

[[Page 132 STAT. 122]]

“Sec. 165. Section <<NOTE: Applicability.>> 24(o) of the United
States Housing Act of 1937 (42 U.S.C. 1437v) shall be applied by
substituting the date specified in section 106(3) for `September 30,
2017′.”.

This subdivision may be cited as the “Further Extension of
Continuing Appropriations Act, 2018”.

DIVISION C–BUDGETARY AND OTHER MATTERS

SEC. 30001. TABLE OF CONTENTS.

The table of contents for this division is as follows:

DIVISION C–BUDGETARY AND OTHER MATTERS

Sec. 30001. Table of contents.

TITLE I–BUDGET ENFORCEMENT

Sec. 30101. Amendments to the Balanced Budget and Emergency Deficit
Control Act of 1985.
Sec. 30102. Balances on the PAYGO Scorecards.
Sec. 30103. Authority for fiscal year 2019 budget resolution in the
Senate.
Sec. 30104. Authority for fiscal year 2019 budget resolution in the
House of Representatives.
Sec. 30105. Exercise of rulemaking powers.

TITLE II–OFFSETS

Sec. 30201. Customs user fees.
Sec. 30202. Aviation security service fees.
Sec. 30203. Extension of certain immigration fees.
Sec. 30204. Strategic Petroleum Reserve drawdown.
Sec. 30205. Elimination of surplus funds of Federal reserve banks.
Sec. 30206. Reemployment services and eligibility assessments.

TITLE III–TEMPORARY EXTENSION OF PUBLIC DEBT LIMIT

Sec. 30301. Temporary extension of public debt limit.

TITLE IV–JOINT SELECT COMMITTEES

Subtitle A–Joint Select Committee on Solvency of Multiemployer Pension
Plans

Sec. 30421. Definitions.
Sec. 30422. Establishment of Joint Select Committee.
Sec. 30423. Funding.
Sec. 30424. Consideration of joint committee bill in the Senate.

Subtitle B–Joint Select Committee on Budget and Appropriations Process
Reform

Sec. 30441. Definitions.
Sec. 30442. Establishment of Joint Select Committee.
Sec. 30443. Funding.
Sec. 30444. Consideration of joint committee bill in the Senate.

TITLE I–BUDGET ENFORCEMENT

SEC. 30101. AMENDMENTS TO THE BALANCED BUDGET AND EMERGENCY
DEFICIT CONTROL ACT OF 1985.

(a) <<NOTE: Time periods.>> Revised Discretionary Spending
Limits.–Section 251(c) of the Balanced Budget and Emergency Deficit
Control Act of 1985 (2 U.S.C. 901(c)) is amended by striking paragraphs
(5) and (6) and inserting the following:
“(5) for fiscal year 2018–
“(A) for the revised security category,
$629,000,000,000 in new budget authority; and
“(B) for the revised nonsecurity category
$579,000,000,000 in new budget authority;

[[Page 132 STAT. 123]]

“(6) for fiscal year 2019–
“(A) for the revised security category,
$647,000,000,000 in new budget authority; and
“(B) for the revised nonsecurity category,
$597,000,000,000 in new budget authority;”.

(b) Direct Spending Adjustments for Fiscal Years 2018 and 2019.–
Section 251A of the Balanced Budget and Emergency Deficit Control Act of
1985 (2 U.S.C. 901a), is amended–
(1) in paragraph (5)(B), in the matter preceding clause (i),
by striking “and (11)” and inserting “, (11), and (12)”; and
(2) by adding at the end the following:
“(12) Implementing direct spending reductions for fiscal
years 2018 and 2019.–(A) OMB shall make the calculations
necessary to implement the direct spending reductions calculated
pursuant to paragraphs (3) and (4) without regard to the
amendment made to section 251(c) revising the discretionary
spending limits for fiscal years 2018 and 2019 by the Bipartisan
Budget Act of 2018.
“(B) Paragraph (5)(B) shall not be implemented for fiscal
years 2018 and 2019.”.

(c) Extension of Direct Spending Reductions Through Fiscal Year
2027.–Section 251A(6) of the Balanced Budget and Emergency Deficit
Control Act of 1985 (2 U.S.C. 901a(6)) is amended–
(1) in subparagraph (B), in the matter preceding clause (i),
by striking “for fiscal year 2022, for fiscal year 2023, for
fiscal year 2024, and for fiscal year 2025” and inserting “for
each of fiscal years 2022 through 2027”; and
(2) in subparagraph (C), in the matter preceding clause (i),
by striking “fiscal year 2025” and inserting “fiscal year
2027”.
SEC. 30102. BALANCES ON THE PAYGO SCORECARDS.

Effective on <<NOTE: Effective date.>> the date of enactment of
this Act, the balances on the PAYGO scorecards established pursuant to
paragraphs (4) and (5) of section 4(d) of the Statutory Pay-As-You-Go
Act of 2010 (2 U.S.C. 933(d)) shall be zero.
SEC. 30103. AUTHORITY FOR FISCAL YEAR 2019 BUDGET RESOLUTION IN
THE SENATE.

(a) <<NOTE: Effective date. Applicability.>> Fiscal Year 2019.–For
purposes of enforcing the Congressional Budget Act of 1974 (2 U.S.C. 621
et seq.) after April 15, 2018, and enforcing budgetary points of order
in prior concurrent resolutions on the budget, the allocations,
aggregates, and levels provided for in subsection (b) shall apply in the
Senate in the same manner as for a concurrent resolution on the budget
for fiscal year 2019 with appropriate budgetary levels for fiscal years
2020 through 2028.

(b) <<NOTE: Time periods. Deadline.>> Committee Allocations,
Aggregates, and Levels.–After April 15, 2018, but not later than May
15, 2018, the Chairman of the Committee on the Budget of the Senate
shall file–
(1) for the Committee on Appropriations, committee
allocations for fiscal year 2019 consistent with discretionary
spending limits set forth in section 251(c)(6) of the Balanced
Budget and Emergency Deficit Control Act of 1985, as amended by
this Act, for the purposes of enforcing section 302 of the
Congressional Budget Act of 1974 (2 U.S.C. 633);

[[Page 132 STAT. 124]]

(2) for all committees other than the Committee on
Appropriations, committee allocations for fiscal years 2019,
2019 through 2023, and 2019 through 2028 consistent with the
most recent baseline of the Congressional Budget Office, as
adjusted for the budgetary effects of any provision of law
enacted during the period beginning on the date such baseline is
issued and ending on the date of submission of such statement,
for the purposes of enforcing section 302 of the Congressional
Budget Act of 1974 (2 U.S.C. 633);
(3) aggregate spending levels for fiscal year 2019 in
accordance with the allocations established under paragraphs (1)
and (2), for the purpose of enforcing section 311 of the
Congressional Budget Act of 1974 (2 U.S.C. 642);
(4) aggregate revenue levels for fiscal years 2019, 2019
through 2023, and 2019 through 2028 consistent with the most
recent baseline of the Congressional Budget Office, as adjusted
for the budgetary effects of any provision of law enacted during
the period beginning on the date such baseline is issued and
ending on the date of submission of such statement, for the
purpose of enforcing section 311 of the Congressional Budget Act
of 1974 (2 U.S.C. 642); and
(5) levels of Social Security revenues and outlays for
fiscal years 2019, 2019 through 2023, and 2019 through 2028
consistent with the most recent baseline of the Congressional
Budget Office, as adjusted for the budgetary effects of any
provision of law enacted during the period beginning on the date
such baseline is issued and ending on the date of submission of
such statement, for the purpose of enforcing sections 302 and
311 of the Congressional Budget Act of 1974 (2 U.S.C. 633 and
642).

(c) Additional Matter.–The filing referred to in subsection (b) may
also include for fiscal year 2019 the deficit-neutral reserve funds
contained in title III of H. Con. Res. 71 (115th Congress) updated by
one fiscal year.
(d) Expiration.–This section shall expire if a concurrent
resolution on the budget for fiscal year 2019 is agreed to by the Senate
and the House of Representatives pursuant to section 301 of the
Congressional Budget Act of 1974 (2 U.S.C. 632).
SEC. 30104. AUTHORITY FOR FISCAL YEAR 2019 BUDGET RESOLUTION IN
THE HOUSE OF REPRESENTATIVES.

(a) <<NOTE: Deadline.>> Fiscal Year 2019.–If a concurrent
resolution on the budget for fiscal year 2019 has not been adopted by
April 15, 2018, for the purpose of enforcing the Congressional Budget
Act of 1974, the allocations, aggregates, and levels provided for in
subsection (b) shall <<NOTE: Applicability. Effective date.>> apply in
the House of Representatives after April 15, 2018, in the same manner as
for a concurrent resolution on the budget for fiscal year 2019 with
appropriate budgetary levels for fiscal year 2019 and for fiscal years
2020 through 2028.

(b) <<NOTE: Congressional Record, publication. Time
periods. Deadline.>> Committee Allocations, Aggregates, and Levels.–In
the House of Representatives, the Chair of the Committee on the Budget
shall submit a statement for publication in the Congressional Record
after April 15, 2018, but not later than May 15, 2018, containing–
(1) for the Committee on Appropriations, committee
allocations for fiscal year 2019 for discretionary budget
authority at the total level set forth in section 251(c)(6) of
the Balanced

[[Page 132 STAT. 125]]

Budget and Emergency Deficit Control Act of 1985, as amended by
this Act, and the outlays flowing therefrom, and committee
allocations for fiscal year 2019 for current law mandatory
budget authority and outlays, for the purpose of enforcing
section 302 of the Congressional Budget Act of 1974;
(2) for all committees other than the Committee on
Appropriations, committee allocations for fiscal year 2019 and
for the period of fiscal years 2019 through 2028 at the levels
included in the most recent baseline of the Congressional Budget
Office, as adjusted for the budgetary effects of any provision
of law enacted during the period beginning on the date such
baseline is issued and ending on the date of submission of such
statement, for the purpose of enforcing section 302 of the
Congressional Budget Act of 1974; and
(3) aggregate spending levels for fiscal year 2019 and
aggregate revenue levels for fiscal year 2019 and for the period
of fiscal years 2019 through 2028, at the levels included in the
most recent baseline of the Congressional Budget Office, as
adjusted for the budgetary effects of any provision of law
enacted during the period beginning on the date such baseline is
issued and ending on the date of submission of such statement,
for the purpose of enforcing section 311 of the Congressional
Budget Act of 1974.

(c) Additional Matter.–The statement referred to in subsection (b)
may also include for fiscal year 2019, the matter contained in the
provisions referred to in subsection (f)(1).
(d) Fiscal Year 2019 Allocation to the Committee on
Appropriations.–If the statement <<NOTE: Deadline. Congressional
Record, publication.>> referred to in subsection (b) is not filed by
May 15, 2018, then the matter referred to in subsection (b)(1) shall be
submitted by the Chair of the Committee on the Budget for publication in
the Congressional Record on the next day that the House of
Representatives is in session.

(e) Adjustments.–The chair of the Committee on the Budget of the
House of Representatives may adjust the levels included in the statement
referred to in subsection (b) to reflect the budgetary effects of any
legislation enacted during the 115th Congress that reduces the deficit
or as otherwise necessary.
(f) Application.–Upon submission of the statement referred to in
subsection (b)–
(1) all references in sections 5101 through 5112, sections
5201 through 5205, section 5301, and section 5401 of House
Concurrent Resolution 71 (115th Congress) to a fiscal year shall
be considered for all purposes in the House to be references to
the succeeding fiscal year; and
(2) all references in the provisions referred to in
paragraph (1) to allocations, aggregates, or other appropriate
levels in “this concurrent resolution”, “the most recently
agreed to concurrent resolution on the budget”, or “this
resolution” shall be considered for all purposes in the House
to be references to the allocations, aggregates, or other
appropriate levels contained in the statement referred to in
subsection (b), as adjusted.

(g) Expiration.–Subsections (a) through (f) shall no longer apply
if a concurrent resolution on the budget for fiscal year 2019 is agreed
to by the Senate and House of Representatives.

[[Page 132 STAT. 126]]

SEC. 30105. EXERCISE OF RULEMAKING POWERS.

Sections 30103 and 30104 are enacted by the Congress–
(1) as an exercise of the rulemaking power of the Senate and
the House of Representatives, respectively, and as such they
shall be considered as part of the rules of each House,
respectively, or of that House to which they specifically apply,
and such rules shall supersede other rules only to the extent
that they are inconsistent therewith; and
(2) with full recognition of the constitutional right of
either House to change such rules (so far as relating to such
House) at any time, in the same manner, and to the same extent
as in the case of any other rule of such House.

TITLE II–OFFSETS

SEC. 30201. CUSTOMS USER FEES.

(a) In General.–Section 13031(j)(3) of the Consolidated Omnibus
Budget Reconciliation Act of 1985 (19 U.S.C. 58c(j)(3)) is amended–
(1) in subparagraph (A), by striking “January 14, 2026”
and inserting “February 24, 2027”; and
(2) in subparagraph (B)(i), by striking “September 30,
2025” and inserting “September 30, 2027”.

(b) Rate for Merchandise Processing Fees.–Section 503 of the United
States-Korea Free Trade Agreement Implementation Act (Public Law 112-41;
19 U.S.C. 3805 note) is amended by striking “January 14, 2026” and
inserting “February 24, 2027”.
SEC. 30202. AVIATION SECURITY SERVICE FEES.

Paragraph (4) of section 44940(i) of title 49, United States Code,
is amended by adding at the end the following new subparagraphs:
“(M) $1,640,000,000 for fiscal year 2026.
“(N) $1,680,000,000 for fiscal year 2027.”.
SEC. 30203. EXTENSION OF CERTAIN IMMIGRATION FEES.

(a) Visa Waiver Program.–Section 217(h)(3)(B)(iii) of the
Immigration and Nationality Act (8 U.S.C. 1187(h)(3)(B)(iii)) is amended
by striking “September 30, 2020” and inserting “September 30, 2027”.
(b) L-1 and H-1b Visas.–Section 411 of the Air Transportation
Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended by
striking “September 30, 2025” each place it appears and inserting
“September 30, 2027”.
SEC. 30204. STRATEGIC PETROLEUM RESERVE DRAWDOWN.

(a) <<NOTE: 42 USC 6241 note.>> Drawdown and Sale.–
(1) In general.–Notwithstanding section 161 of the Energy
Policy and Conservation Act (42 U.S.C. 6241), except as provided
in subsection (b), the Secretary of Energy shall draw down and
sell from the Strategic Petroleum Reserve–
(A) 30,000,000 barrels of crude oil during the
period of fiscal years 2022 through 2025;
(B) 35,000,000 barrels of crude oil during fiscal
year 2026; and
(C) 35,000,000 barrels of crude oil during fiscal
year 2027.

[[Page 132 STAT. 127]]

(2) Deposit of amounts received from sale.–Amounts received
from a sale under paragraph (1) shall be deposited in the
general fund of the Treasury during the fiscal year in which the
sale occurs.

(b) <<NOTE: 42 USC 6241 note.>> Emergency Protection.–The
Secretary of Energy may not draw down and sell crude oil under this
section in quantities that would limit the authority to sell petroleum
products under subsection (h) of section 161 of the Energy Policy and
Conservation Act (42 U.S.C. 6241) in the full quantity authorized by
that subsection.

(c) Strategic Petroleum Drawdown Conditions and Limitations.–
(1) Conditions.–Section 161(h)(1) of the Energy Policy and
Conservation Act (42 U.S.C. 6241(h)(1)) is amended in
subparagraph (B) by striking “shortage; and” and all that
follows through “Secretary of” in subparagraph (C) and
inserting the following: “shortage;
“(C) the Secretary has found that action taken
under this subsection will not impair the ability of the
United States to carry out obligations of the United
States under the international energy program; and
“(D) the Secretary of”.
(2) Limitations.–Section 161(h)(2) of the Energy Policy and
Conservation Act (42 U.S.C. 6241(h)(2)) is amended by striking
“450,000,000” each place it appears and inserting
“350,000,000”.
SEC. 30205. ELIMINATION OF SURPLUS FUNDS OF FEDERAL RESERVE BANKS.

Section 7(a)(3)(A) of the Federal Reserve Act (12 U.S.C.
289(a)(3)(A)) is amended by striking “$10,000,000,000” and inserting
“$7,500,000,000”.
SEC. 30206. REEMPLOYMENT SERVICES AND ELIGIBILITY ASSESSMENTS.

(a) In General.–Title III of the Social Security Act (42 U.S.C. 501
et seq.) is amended by adding at the end the following:
“SEC. 306. <<NOTE: 42 USC 506.>> GRANTS TO STATES FOR
REEMPLOYMENT SERVICES AND ELIGIBILITY
ASSESSMENTS.

“(a) In General.–The Secretary of Labor (in this section referred
to as the `Secretary’) shall award grants under this section for a
fiscal year to eligible States to conduct a program of reemployment
services and eligibility assessments for individuals referred to
reemployment services as described in section 303(j) for weeks in such
fiscal year for which such individuals receive unemployment
compensation.
“(b) Purposes.–The purposes of this section are to accomplish the
following goals:
“(1) To improve employment outcomes of individuals that
receive unemployment compensation and to reduce the average
duration of receipt of such compensation through employment.
“(2) To strengthen program integrity and reduce improper
payments of unemployment compensation by States through the
detection and prevention of such payments to individuals who are
not eligible for such compensation.
“(3) To promote alignment with the broader vision of the
Workforce Innovation and Opportunity Act (29 U.S.C. 3101

[[Page 132 STAT. 128]]

et seq.) of increased program integration and service delivery
for job seekers, including claimants for unemployment
compensation.
“(4) To establish reemployment services and eligibility
assessments as an entry point for individuals receiving
unemployment compensation into other workforce system partner
programs.

“(c) Evidence-based Standards.–
“(1) In general.–In carrying out a State program of
reemployment services and eligibility assessments using grant
funds awarded to the State under this section, a State shall use
such funds only for interventions demonstrated to reduce the
number of weeks for which program participants receive
unemployment compensation by improving employment outcomes for
program participants.
“(2) <<NOTE: Time period.>> Expanding evidence-based
interventions.–In addition to the requirement imposed by
paragraph (1), a State shall–
“(A) for fiscal years 2023 and 2024, use no less
than 25 percent of the grant funds awarded to the State
under this section for interventions with a high or
moderate causal evidence rating that show a demonstrated
capacity to improve employment and earnings outcomes for
program participants;
“(B) for fiscal years 2025 and 2026, use no less
than 40 percent of such grant funds for interventions
described in subparagraph (A); and
“(C) <<NOTE: Effective date.>> for fiscal years
beginning after fiscal year 2026, use no less than 50
percent of such grant funds for interventions described
in subparagraph (A).

“(d) Evaluations.–
“(1) Required evaluations.–Any intervention without a high
or moderate causal evidence rating used by a State in carrying
out a State program of reemployment services and eligibility
assessments under this section shall be under evaluation at the
time of use.
“(2) Funding limitation.–A State shall use not more than
10 percent of grant funds awarded to the State under this
section to conduct or cause to be conducted evaluations of
interventions used in carrying out a program under this section
(including evaluations conducted pursuant to paragraph (1)).

“(e) State Plan.–
“(1) In general.–As a condition of eligibility to receive
a grant under this section for a fiscal year, a State shall
submit to the Secretary, at such time and in such manner as the
Secretary may require, a State plan that outlines how the State
intends to conduct a program of reemployment services and
eligibility assessments under this section, including–
“(A) assurances that, and a description of how, the
program will provide–
“(i) proper notification to participating
individuals of the program’s eligibility
conditions, requirements, and benefits, including
the issuance of warnings and simple, clear
notifications to ensure that participating
individuals are fully aware of the consequences of

[[Page 132 STAT. 129]]

failing to adhere to such requirements, including
policies related to non-attendance or non-
fulfillment of work search requirements; and
“(ii) reasonable scheduling accommodations to
maximize participation for eligible individuals;
“(B) assurances that, and a description of how, the
program will conform with the purposes outlined in
subsection (b) and satisfy the requirement to use
evidence-based standards under subsection (c),
including–
“(i) a description of the evidence-based
interventions the State plans to use to speed
reemployment;
“(ii) an explanation of how such
interventions are appropriate to the population
served; and
“(iii) if applicable, a description of the
evaluation structure the State plans to use for
interventions without at least a moderate or high
causal evidence rating, which may include national
evaluations conducted by the Department of Labor
or by other entities; and
“(C) a description of any reemployment activities
and evaluations conducted in the prior fiscal year, and
any data collected on–
“(i) characteristics of program participants;
“(ii) the number of weeks for which program
participants receive unemployment compensation;
and
“(iii) employment and other outcomes for
program participants consistent with State
performance accountability measures provided by
the State unemployment compensation program and in
section 116(b) of the Workforce Innovation and
Opportunity Act (29 U.S.C. 3141(b)).
“(2) Approval.–The Secretary shall approve any State plan,
that is timely submitted to the Secretary, in such manner as the
Secretary may require, that satisfies the conditions described
in paragraph (1).
“(3) <<NOTE: Determination.>> Disapproval and revision.–
If the Secretary determines that a State plan submitted pursuant
to this subsection fails to satisfy the conditions described in
paragraph (1), the Secretary shall–
“(A) disapprove such plan;
“(B) <<NOTE: Deadline. Notice.>> provide to the
State, not later than 30 days after the date of receipt
of the State plan, a written notice of such disapproval
that includes a description of any portion of the plan
that was not approved and the reason for the disapproval
of each such portion; and
“(C) provide the State with an opportunity to
correct any such failure and submit a revised State
plan.

“(f) Allocation of Funds.–
“(1) Base funding.–
“(A) <<NOTE: Time periods. Determination.>> In
general.–For each fiscal year after fiscal year 2020,
the Secretary shall allocate a percentage equal to the
base funding percentage for such fiscal year of the
funds made available for grants under this section among
the States awarded such a grant for such fiscal year
using a formula prescribed by the Secretary based on the
rate of insured unemployment (as defined in section
203(e)(1) of the Federal-State Extended Unemployment
Compensation Act of 1970 (26 U.S.C. 3304 note)) in the
State for

[[Page 132 STAT. 130]]

a period to be determined by the Secretary. In
developing such formula with respect to a State, the
Secretary shall consider the importance of avoiding
sharp reductions in grant funding to a State over time.
“(B) <<NOTE: Definition.>> Base funding
percentage.–For purposes of subparagraph (A), the term
`base funding percentage’ means–
“(i) for fiscal years 2021 through 2026, 89
percent; and
“(ii) for fiscal years after 2026, 84
percent.
“(2) Reservation for outcome payments.–
“(A) In general.–Of the amounts made available for
grants under this section for each fiscal year after
2020, the Secretary shall reserve a percentage equal to
the outcome reservation percentage for such fiscal year
for outcome payments to increase the amount otherwise
awarded to a State under paragraph (1). Such outcome
payments shall be paid to States conducting reemployment
services and eligibility assessments under this section
that, during the previous fiscal year, met or exceeded
the outcome goals provided in subsection (b)(1) related
to reducing the average duration of receipt of
unemployment compensation by improving employment
outcomes.
“(B) <<NOTE: Definition.>> Outcome reservation
percentage.–For purposes of subparagraph (A), the term
`outcome reservation percentage’ means–
“(i) for fiscal years 2021 through 2026, 10
percent; and
“(ii) for fiscal years after 2026, 15
percent.
“(3) Reservation for research and technical assistance.–Of
the amounts made available for grants under this section for
each fiscal year after 2020, the Secretary may reserve not more
than 1 percent to conduct research and provide technical
assistance to States.
“(4) <<NOTE: Deadline.>> Consultation and public
comment.–Not later than September 30, 2019, the Secretary
shall–
“(A) consult with the States and seek public
comment in developing the allocation formula under
paragraph (1) and the criteria for carrying out the
reservations under paragraph (2); and
“(B) <<NOTE: Criteria.>> make publicly available
the allocation formula and criteria developed pursuant
to subclause (A).

“(g) <<NOTE: Deadline.>> Notification to Congress.–Not later than
90 days prior to making any changes to the allocation formula or the
criteria developed pursuant to subsection (f)(5)(A), the Secretary shall
submit to Congress, including to the Committee on Ways and Means and the
Committee on Appropriations of the House of Representatives and the
Committee on Finance and the Committee on Appropriations of the Senate,
a notification of any such change.

“(h) Supplement Not Supplant.–Funds made available to carry out
this section shall be used to supplement the level of Federal, State,
and local public funds that, in the absence of such availability, would
be expended to provide reemployment services and eligibility assessments
to individuals receiving unemployment compensation, and in no case to
supplant such Federal, State, or local public funds.
“(i) Definitions.–In this section:

[[Page 132 STAT. 131]]

“(1) Causal evidence rating.–The terms `high causal
evidence rating’ and `moderate causal evidence rating’ shall
have the meaning given such terms by the Secretary of Labor.
“(2) Eligible state.–The term `eligible State’ means a
State that has in effect a State plan approved by the Secretary
in accordance with subsection (e).
“(3) Intervention.–The term `intervention’ means a service
delivery strategy for the provision of State reemployment
services and eligibility assessment activities under this
section.
“(4) State.–The term `State’ has the meaning given the
term in section 205 of the Federal-State Extended Unemployment
Compensation Act of 1970 (26 U.S.C. 3304 note).
“(5) Unemployment compensation.–The term unemployment
compensation means `regular compensation’, `extended
compensation’, and `additional compensation’ (as such terms are
defined by section 205 of the Federal-State Extended
Unemployment Compensation Act of 1970 (26 U.S.C. 3304 note)).”.

(b) Report.–Not later than 3 years after the date of enactment of
this Act, the Secretary of Labor shall submit to Congress a report to
describe promising interventions used by States to provide reemployment
assistance.
(c) Adjustment to Discretionary Spending Limits.–Section 251(b)(2)
of the Balanced Budget and Emergency Deficit Control Act of 1985 (2
U.S.C. 901(b)(2)) is amended by adding at the end the following:
“(E) Reemployment services and eligibility
assessments.–
“(i) In general.–If a bill or joint
resolution making appropriations for a fiscal year
is enacted that specifies an amount for grants to
States under section 306 of the Social Security
Act, then the adjustment for that fiscal year
shall be the additional new budget authority
provided in that Act for such grants for that
fiscal year, but shall not exceed–
“(I) for fiscal year 2018, $0;
“(II) for fiscal year 2019,
$33,000,000;
“(III) for fiscal year 2020,
$58,000,000; and
“(IV) for fiscal year 2021,
$83,000,000.
“(ii) Definition.–As used in this
subparagraph, the term `additional new budget
authority’ means the amount provided for a fiscal
year, in excess of $117,000,000, in an
appropriation Act and specified to pay for grants
to States under section 306 of the Social Security
Act.”.

(d) Other Budgetary Adjustments.–Section 314 of the Congressional
Budget Act of 1974 (2 U.S.C. 645) is amended by adding at the end the
following:
“(g) Adjustment for Reemployment Services and Eligibility
Assessments.–
“(1) In general.–
“(A) Adjustments.–If the Committee on
Appropriations of either House reports an appropriation
measure for any of fiscal years 2022 through 2027 that
provides budget authority for grants under section 306
of the Social

[[Page 132 STAT. 132]]

Security Act, or if a conference committee submits a
conference report thereon, the chairman of the Committee
on the Budget of the House of Representatives or the
Senate shall make the adjustments referred to in
subparagraph (B) to reflect the additional new budget
authority provided for such grants in that measure or
conference report and the outlays resulting therefrom,
consistent with subparagraph (D).
“(B) Types of adjustments.–The adjustments
referred to in this subparagraph consist of adjustments
to–
“(i) the discretionary spending limits for
that fiscal year as set forth in the most recently
adopted concurrent resolution on the budget;
“(ii) the allocations to the Committees on
Appropriations of the Senate and the House of
Representatives for that fiscal year under section
302(a); and
“(iii) the appropriate budget aggregates for
that fiscal year in the most recently adopted
concurrent resolution on the budget.
“(C) Enforcement.–The adjusted discretionary
spending limits, allocations, and aggregates under this
paragraph shall be considered the appropriate limits,
allocations, and aggregates for purposes of
congressional enforcement of this Act and concurrent
budget resolutions under this Act.
“(D) Limitation.–No adjustment may be made under
this subsection in excess of–
“(i) for fiscal year 2022, $133,000,000;
“(ii) for fiscal year 2023, $258,000,000;
“(iii) for fiscal year 2024, $433,000,000;
“(iv) for fiscal year 2025, $533,000,000;
“(v) for fiscal year 2026, $608,000,000; and
“(vi) for fiscal year 2027, $633,000,000.
“(E) Definition.–As used in this subsection, the term
`additional new budget authority’ means the amount provided for
a fiscal year, in excess of $117,000,000, in an appropriation
measure or conference report (as the case may be) and specified
to pay for grants to States under section 306 of the Social
Security Act.
“(2) Report on 302(b) level.–Following any adjustment made
under paragraph (1), the Committees on Appropriations of the
Senate and the House of Representatives may report appropriately
revised suballocations pursuant to section 302(b) to carry out
this subsection.”.

TITLE III–TEMPORARY EXTENSION OF PUBLIC DEBT LIMIT

SEC. 30301. <<NOTE: 31 USC 3101 note. Time period.>> TEMPORARY
EXTENSION OF PUBLIC DEBT LIMIT.

(a) In General.–Section 3101(b) of title 31, United States Code,
shall not apply for the period beginning on the date of the enactment of
this Act and ending on March 1, 2019.
(b) <<NOTE: Effective date.>> Special Rule Relating to Obligations
Issued During Extension Period.–Effective on March 2, 2019, the
limitation

[[Page 132 STAT. 133]]

in effect under section 3101(b) of title 31, United States Code, shall
be increased to the extent that–
(1) the face amount of obligations issued under chapter 31
of such title and the face amount of obligations whose principal
and interest are guaranteed by the United States Government
(except guaranteed obligations held by the Secretary of the
Treasury) outstanding on March 2, 2019, exceeds
(2) the face amount of such obligations outstanding on the
date of the enactment of this Act.

(c) Restoring Congressional Authority Over the National Debt.–
(1) Extension limited to necessary obligations.–An
obligation shall not be taken into account under subsection
(b)(1) unless the issuance of such obligation was necessary to
fund a commitment incurred pursuant to law by the Federal
Government that required payment before March 2, 2019.
(2) Prohibition on creation of cash reserve during extension
period.–The Secretary of the Treasury shall not issue
obligations during the period specified in subsection (a) for
the purpose of increasing the cash balance above normal
operating balances in anticipation of the expiration of such
period.

TITLE IV–JOINT SELECT COMMITTEES

Subtitle A–Joint Select Committee on Solvency of Multiemployer Pension
Plans

SEC. 30421. DEFINITIONS.

In this subtitle–
(1) the term “joint committee” means the Joint Select
Committee on Solvency of Multiemployer Pension Plans established
under section 30422(a); and
(2) the term “joint committee bill” means a bill
consisting of the proposed legislative language of the joint
committee recommended in accordance with section
30422(b)(2)(B)(ii) and introduced under section 30424(a).
SEC. 30422. ESTABLISHMENT OF JOINT SELECT COMMITTEE.

(a) Establishment of Joint Select Committee.–There is established a
joint select committee of Congress to be known as the “Joint Select
Committee on Solvency of Multiemployer Pension Plans”.
(b) Implementation.–
(1) Goal.–The goal of the joint committee is to improve the
solvency of multiemployer pension plans and the Pension Benefit
Guaranty Corporation.
(2) Duties.–
(A) <<NOTE: Recommenda- tions.>> In general.–The
joint committee shall provide recommendations and
legislative language that will significantly improve the
solvency of multiemployer pension plans and the Pension
Benefit Guaranty Corporation.
(B) Report, recommendations, and legislative
language.–

[[Page 132 STAT. 134]]

(i) <<NOTE: Deadline.>> In general.–Not
later than November 30, 2018, the joint committee
shall vote on–
(I) a report that contains a
detailed statement of the findings,
conclusions, and recommendations of the
joint committee; and
(II) proposed legislative language
to carry out the recommendations
described in subclause (I).
(ii) Approval of report and legislative
language.–
(I) In general.–The report of the
joint committee and the proposed
legislative language described in clause
(i) shall only be approved upon
receiving the votes of–
(aa) a majority of joint
committee members appointed by
the Speaker of the House of
Representatives and the Majority
Leader of the Senate; and
(bb) a majority of joint
committee members appointed by
the Minority Leader of the House
of Representatives and the
Minority Leader of the Senate.
(II) <<NOTE: Public information. Web
posting.>> Availability.–The text of
any report and proposed legislative
language shall be publicly available in
electronic form at least 24 hours prior
to its consideration.
(iii) Additional views.–A member of the joint
committee who gives notice of an intention to file
supplemental, minority, or additional views at the
time of the final joint committee vote on the
approval of the report and legislative language
under clause (ii) shall be entitled to 2 calendar
days after the day of such notice in which to file
such views in writing with the co-chairs. Such
views shall then be included in the joint
committee report and printed in the same volume,
or part thereof, and their inclusion shall be
noted on the cover of the report. In the absence
of timely notice, the joint committee report may
be printed and transmitted immediately without
such views.
(iv) Transmission of report and legislative
language.–If the report and legislative language
are approved by the joint committee pursuant to
clause (ii), the joint committee shall submit the
joint committee report and legislative language
described in clause (i) to the President, the Vice
President, the Speaker of the House of
Representatives, and the majority and minority
leaders of each House of Congress not later than
15 calendar days after such approval.
(v) <<NOTE: Records.>> Report and legislative
language to be made public.–Upon the approval of
the joint committee report and legislative
language pursuant to clause (ii), the joint
committee shall promptly make the full report and
legislative language, and a record of any vote,
available to the public.
(3) Membership.–

[[Page 132 STAT. 135]]

(A) In general.–The joint committee shall be
composed of 16 members appointed pursuant to
subparagraph (B).
(B) Appointment.–Members of the joint committee
shall be appointed as follows:
(i) The Speaker of the House of
Representatives shall appoint 4 members from among
Members of the House of Representatives.
(ii) The Minority Leader of the House of
Representatives shall appoint 4 members from among
Members of the House of Representatives.
(iii) The Majority Leader of the Senate shall
appoint 4 members from among Members of the
Senate.
(iv) The Minority Leader of the Senate shall
appoint 4 members from among Members of the
Senate.
(C) Co-chairs.–Two of the appointed members of the
joint committee will serve as co-chairs. The Speaker of
the House of Representatives and the Majority Leader of
the Senate shall jointly appoint one co-chair, and the
Minority Leader of the House of Representatives and the
Minority Leader of the Senate shall jointly appoint the
second co-chair. <<NOTE: Deadline.>> The co-chairs
shall be appointed not later than 14 calendar days after
the date of enactment of this Act.
(D) <<NOTE: Deadline.>> Date.–Members of the joint
committee shall be appointed not later than 14 calendar
days after the date of enactment of this Act.
(E) <<NOTE: Deadline.>> Period of appointment.–
Members shall be appointed for the life of the joint
committee. Any vacancy in the joint committee shall not
affect its powers, but shall be filled not later than 14
calendar days after the date on which the vacancy
occurs, in the same manner as the original appointment
was made. If a member of the joint committee ceases to
be a Member of the House of Representatives or the
Senate, as the case may be, the member is no longer a
member of the joint committee and a vacancy shall exist.
(4) Administration.–
(A) <<NOTE: Time periods.>> General authority.–For
purposes of enabling the joint committee to exercise its
powers, functions, and duties under this subtitle, and
consistent with the Standing Rules of the Senate, there
is authorized from the date of enactment of this Act
through February 28, 2019, $500,000 to be allocated–
(i) in total during the period October 1, 2017
through September 30, 2018; and
(ii) any remaining amounts shall be carried
forward for the period October 1, 2018 through
February 28, 2019.
(B) Expenses.–Expenses of the joint committee shall
be paid from the contingent fund of the Senate upon
vouchers approved by the co-chairs, subject to the rules
and regulations of the Senate.
(C) Quorum.–Nine members of the joint committee
shall constitute a quorum for purposes of voting and

[[Page 132 STAT. 136]]

meeting, and 5 members of the joint committee shall
constitute a quorum for holding hearings.
(D) Voting.–No proxy voting shall be allowed on
behalf of the members of the joint committee.
(E) <<NOTE: Deadlines.>> Meetings.–
(i) Initial meeting.–Not later than 30
calendar days after the date of enactment of this
Act, the joint committee shall hold its first
meeting.
(ii) Agenda.–The co-chairs of the joint
committee shall provide an agenda to the joint
committee members not less than 48 hours in
advance of any meeting.
(F) Hearings.–
(i) In general.–The joint committee may, for
the purpose of carrying out this section, hold
such hearings, sit and act at such times and
places, require attendance of witnesses and
production of books, papers, and documents, take
such testimony, receive such evidence, and
administer such oaths as the joint committee
considers advisable.
(ii) Hearing procedures and responsibilities
of co-chairs.–
(I) <<NOTE: Time period.>>
Announcement.–The co-chairs of the
joint committee shall make a public
announcement of the date, place, time,
and subject matter of any hearing to be
conducted, not less than 7 days in
advance of such hearing, unless the co-
chairs determine that there is good
cause to begin such hearing at an
earlier date.
(II) Equal representation of
witnesses.–Each co-chair shall be
entitled to select an equal number of
witnesses for each hearing held by the
joint committee.
(III) <<NOTE: Time period.>>
Written statement.–A witness appearing
before the joint committee shall file a
written statement of proposed testimony
at least 2 calendar days before the
appearance of the witness, unless the
requirement is waived by the co-chairs,
following their determination that there
is good cause for failure to comply with
such requirement.
(G) Minimum number of public meetings and
hearings.–The joint committee shall hold–
(i) not less than a total of 5 public meetings
or public hearings; and
(ii) not less than 3 public hearings, which
may include field hearings.
(H) Technical assistance.–Upon written request of
the co-chairs, a Federal agency, including legislative
branch agencies, shall provide technical assistance to
the joint committee in order for the joint committee to
carry out its duties.
(I) Staffing.–
(i) Details.–Employees of the legislative
branch may be detailed to the joint committee on a
nonreimbursable basis, consistent with the rules
and regulations of the Senate.

[[Page 132 STAT. 137]]

(ii) Staff director.–The co-chairs, acting
jointly, may designate one such employee as staff
director of the joint committee.

(c) Ethical Standards.–Members on the joint committee who serve in
the House of Representatives shall be governed by the ethics rules and
requirements of the House. Members of the Senate who serve on the joint
committee shall comply with the ethics rules of the Senate.
(d) Termination.–The joint committee shall terminate on December
31, 2018 or 30 days after submission of its report and legislative
recommendations pursuant to this section whichever occurs first.
SEC. 30423. FUNDING.

(a) Special Reserve.–To enable the joint committee to exercise its
powers, functions, and duties under this subtitle, within the funds in
the account for “Expenses of Inquiries and Investigations” of the
Senate, not more than $500,000 shall be allocated from the special
reserve established in S. Res. 62, agreed to February 28, 2017 (115th
Congress), for use by the joint committee.
(b) Expiration.–None of the funds made available by this section
may be available for obligation by the joint committee after January 2,
2019.
(c) Availability Requirements.–For purposes of the joint committee,
section 20(b) of S. Res. 62, agreed to February 28, 2017 (115th
Congress), shall not apply.
SEC. 30424. CONSIDERATION OF JOINT COMMITTEE BILL IN THE SENATE.

(a) Introduction.–Upon receipt of proposed legislative language
approved in accordance with section 30422(b)(2)(B)(ii), the language
shall be introduced in the Senate (by request) on the next day on which
the Senate is in session by the Majority Leader of the Senate or by a
Member of the Senate designated by the Majority Leader of the Senate.
(b) <<NOTE: Deadline.>> Committee Consideration.–A joint committee
bill introduced in the Senate under subsection (a) shall be jointly
referred to the Committee on Finance and the Committee on Health,
Education, Labor, and Pensions, which committees shall report the bill
without any revision and with a favorable recommendation, an unfavorable
recommendation, or without recommendation, no later than 7 session days
after introduction of the bill. If either committee fails to report the
bill within that period, that committee shall be automatically
discharged from consideration of the bill, and the bill shall be placed
on the appropriate calendar.

(c) Motion to Proceed to Consideration.–
(1) <<NOTE: Deadline.>> In general.–Notwithstanding rule
XXII of the Standing Rules of the Senate, it is in order, not
later than 2 days of session after the date on which a joint
committee bill is reported or discharged from the Committee on
Finance and the Committee on Health, Education, Labor, and
Pensions, for the Majority Leader of the Senate or the Majority
Leader’s designee to move to proceed to the consideration of the
joint committee bill. It shall also be in order for any Member
of the Senate to move to proceed to the consideration of the
joint committee bill at any time after the conclusion of such 2-
day period.

[[Page 132 STAT. 138]]

(2) Consideration of motion.–Consideration of the motion to
proceed to the consideration of the joint committee bill and all
debatable motions and appeals in connection therewith shall not
exceed 10 hours, which shall be divided equally between the
Majority and Minority Leaders or their designees. A motion to
further limit debate is in order, shall require an affirmative
vote of three-fifths of Members duly chosen and sworn, and is
not debatable.
(3) Vote threshold.–The motion to proceed to the
consideration of the joint committee bill shall only be agreed
to upon an affirmative vote of three-fifths of Members duly
chosen and sworn.
(4) Limitations.–The motion is not subject to a motion to
postpone. All points of order against the motion to proceed to
the joint committee bill are waived. A motion to reconsider the
vote by which the motion is agreed to or disagreed to shall not
be in order.
(5) Deadline.–Not later than the last day of the 115th
Congress, the Senate shall vote on a motion to proceed to the
joint committee bill.
(6) <<NOTE: Definition.>> Companion measures.–For purposes
of this subsection, the term “joint committee bill” includes a
bill of the House of Representatives that is a companion measure
to the joint committee bill introduced in the Senate.

(d) Rules of Senate.–This section is enacted by Congress–
(1) as an exercise of the rulemaking power of the Senate,
and as such is deemed a part of the rules of the Senate, but
applicable only with respect to the procedure to be followed in
the Senate in the case of a joint committee bill, and supersede
other rules only to the extent that they are inconsistent with
such rules; and
(2) with full recognition of the constitutional right of the
Senate to change the rules (so far as relating to the procedure
of the Senate) at any time, in the same manner, and to the same
extent as in the case of any other rule of the Senate.

Subtitle B–Joint Select Committee on Budget and Appropriations Process
Reform

SEC. 30441. DEFINITIONS.

In this subtitle–
(1) the term “joint committee” means the Joint Select
Committee on Budget and Appropriations Process Reform
established under section 30442(a); and
(2) the term “joint committee bill” means a bill
consisting of the proposed legislative language of the joint
committee recommended in accordance with section
30442(b)(2)(B)(ii) and introduced under section 30444(a).
SEC. 30442. ESTABLISHMENT OF JOINT SELECT COMMITTEE.

(a) Establishment of Joint Select Committee.–There is established a
joint select committee of Congress to be known as the “Joint Select
Committee on Budget and Appropriations Process Reform”.

[[Page 132 STAT. 139]]

(b) Implementation.–
(1) Goal.–The goal of the joint committee is to reform the
budget and appropriations process.
(2) Duties.–
(A) In general.–The joint committee shall provide
recommendations and legislative language that will
significantly reform the budget and appropriations
process.
(B) Report, recommendations, and legislative
language.–
(i) In general.–Not later than November 30,
2018, the joint committee shall vote on–
(I) a report that contains a
detailed statement of the findings,
conclusions, and recommendations of the
joint committee; and
(II) proposed legislative language
to carry out the recommendations
described in subclause (I).
(ii) Approval of report and legislative
language.–
(I) In general.–The report of the
joint committee and the proposed
legislative language described in clause
(i) shall only be approved upon
receiving the votes of–
(aa) a majority of joint
committee members appointed by
the Speaker of the House of
Representatives and the Majority
Leader of the Senate; and
(bb) a majority of joint
committee members appointed by
the Minority Leader of the House
of Representatives and the
Minority Leader of the Senate.
(II) <<NOTE: Public information. Web
posting.>> Availability.–The text of
any report and proposed legislative
language shall be publicly available in
electronic form at least 24 hours prior
to its consideration.
(iii) <<NOTE: Time period.>> Additional
views.–A member of the joint committee who gives
notice of an intention to file supplemental,
minority, or additional views at the time of the
final joint committee vote on the approval of the
report and legislative language under clause (ii)
shall be entitled to 2 calendar days after the day
of such notice in which to file such views in
writing with the co-chairs. Such views shall then
be included in the joint committee report and
printed in the same volume, or part thereof, and
their inclusion shall be noted on the cover of the
report. In the absence of timely notice, the joint
committee report may be printed and transmitted
immediately without such views.
(iv) Transmission of report and legislative
language.–If the report and legislative language
are approved by the joint committee pursuant to
clause (ii), the joint committee shall submit the
joint committee report and legislative language
described in clause (i) to the President, the Vice
President, the Speaker of the House of
Representatives, and the

[[Page 132 STAT. 140]]

majority and minority leaders of each House of
Congress not later than 15 calendar days after
such approval.
(v) Report and legislative language to be made
public.–Upon the approval of the joint committee
report and legislative language pursuant to clause
(ii), the joint committee shall promptly make the
full report and legislative language, and a record
of any vote, available to the public.
(3) Membership.–
(A) In general.–The joint committee shall be
composed of 16 members appointed pursuant to
subparagraph (B).
(B) Appointment.–Members of the joint committee
shall be appointed as follows:
(i) The Speaker of the House of
Representatives shall appoint 4 members from among
Members of the House of Representatives.
(ii) The Minority Leader of the House of
Representatives shall appoint 4 members from among
Members of the House of Representatives.
(iii) The Majority Leader of the Senate shall
appoint 4 members from among Members of the
Senate.
(iv) The Minority Leader of the Senate shall
appoint 4 members from among Members of the
Senate.
(C) Co-chairs.–Two of the appointed members of the
joint committee will serve as co-chairs. The Speaker of
the House of Representatives and the Majority Leader of
the Senate shall jointly appoint one co-chair, and the
Minority Leader of the House of Representatives and the
Minority Leader of the Senate shall jointly appoint the
second co-chair. <<NOTE: Deadline.>> The co-chairs
shall be appointed not later than 14 calendar days after
the date of enactment of this Act.
(D) <<NOTE: Deadline.>> Date.–Members of the joint
committee shall be appointed not later than 14 calendar
days after the date of enactment of this Act.
(E) <<NOTE: Deadline.>> Period of appointment.–
Members shall be appointed for the life of the joint
committee. Any vacancy in the joint committee shall not
affect its powers, but shall be filled not later than 14
calendar days after the date on which the vacancy
occurs, in the same manner as the original appointment
was made. If a member of the joint committee ceases to
be a Member of the House of Representatives or the
Senate, as the case may be, the member is no longer a
member of the joint committee and a vacancy shall exist.
(4) Administration.–
(A) <<NOTE: Time periods.>> General authority.–For
purposes of enabling the joint committee to exercise its
powers, functions, and duties under this subtitle, and
consistent with the Standing Rules of the Senate, there
is authorized from the date of enactment of this Act
through February 28, 2019, $500,000 to be allocated–

[[Page 132 STAT. 141]]

(i) in total during the period October 1, 2017
through September 30, 2018; and
(ii) any remaining amounts shall be carried
forward for the period October 1, 2018 through
February 28, 2019.
(B) Expenses.–Expenses of the joint committee shall
be paid from the contingent fund of the Senate upon
vouchers approved by the co-chairs, subject to the rules
and regulations of the Senate.
(C) Quorum.–Nine members of the joint committee
shall constitute a quorum for purposes of voting and
meeting, and 5 members of the joint committee shall
constitute a quorum for holding hearings.
(D) Voting.–No proxy voting shall be allowed on
behalf of the members of the joint committee.
(E) Meetings.–
(i) <<NOTE: Deadline.>> Initial meeting.–Not
later than 30 calendar days after the date of
enactment of this Act, the joint committee shall
hold its first meeting.
(ii) <<NOTE: Time period.>> Agenda.–The co-
chairs of the joint committee shall provide an
agenda to the joint committee members not less
than 48 hours in advance of any meeting.
(F) Hearings.–
(i) In general.–The joint committee may, for
the purpose of carrying out this section, hold
such hearings, sit and act at such times and
places, require attendance of witnesses and
production of books, papers, and documents, take
such testimony, receive such evidence, and
administer such oaths as the joint committee
considers advisable.
(ii) <<NOTE: Time periods.>> Hearing
procedures and responsibilities of co-chairs.–
(I) <<NOTE: Public information.>>
Announcement.–The co-chairs of the
joint committee shall make a public
announcement of the date, place, time,
and subject matter of any hearing to be
conducted, not less than 7 days in
advance of such hearing, unless the co-
chairs determine that there is good
cause to begin such hearing at an
earlier date.
(II) Equal representation of
witnesses.–Each co-chair shall be
entitled to select an equal number of
witnesses for each hearing held by the
joint committee.
(III) Written statement.–A witness
appearing before the joint committee
shall file a written statement of
proposed testimony at least 2 calendar
days before the appearance of the
witness, unless the requirement is
waived by the co-chairs, following their
determination that there is good cause
for failure to comply with such
requirement.
(G) Minimum number of public meetings and
hearings.–The joint committee shall hold–
(i) not less than a total of 5 public meetings
or public hearings; and
(ii) not less than 3 public hearings, which
may include field hearings.

[[Page 132 STAT. 142]]

(H) Technical assistance.–Upon written request of
the co-chairs, a Federal agency, including legislative
branch agencies, shall provide technical assistance to
the joint committee in order for the joint committee to
carry out its duties.
(I) Staffing.–
(i) Details.–Employees of the legislative
branch may be detailed to the joint committee on a
nonreimbursable basis, consistent with the rules
and regulations of the Senate.
(ii) Staff director.–The co-chairs, acting
jointly, may designate one such employee as staff
director of the joint committee.

(a) Special Reserve.–To enable the joint committee to exercise its
powers, functions, and duties under this subtitle, within the funds in
the account for “Expenses of Inquiries and Investigations” of the
Senate, not more than $500,000 shall be allocated from the special
reserve established in S. Res. 62, agreed to February 28, 2017 (115th
Congress), for use by the joint committee.
(b) Expiration.–None of the funds made available by this section
may be available for obligation by the joint committee after January 2,
2019.
(c) Availability Requirements.–For purposes of the joint committee,
section 20(b) of S. Res. 62, agreed to February 28, 2017 (115th
Congress), shall not apply.
SEC. 30444. CONSIDERATION OF JOINT COMMITTEE BILL IN THE SENATE.

(a) Introduction.–Upon receipt of proposed legislative language
approved in accordance with section 30442(b)(2)(B)(ii), the language
shall be introduced in the Senate (by request) on the next day on which
the Senate is in session by the Majority Leader of the Senate or by a
Member of the Senate designated by the Majority Leader of the Senate.
(b) <<NOTE: Deadline.>> Committee Consideration.–A joint committee
bill introduced in the Senate under subsection (a) shall be referred to
the Committee on the Budget, which shall report the bill without any
revision and with a favorable recommendation, an unfavorable
recommendation, or without recommendation, no later than 7 session days
after introduction of the bill. If the Committee on the Budget fails to
report the bill within that period, the committee shall be automatically
discharged from consideration of the bill, and the bill shall be placed
on the appropriate calendar.

[[Page 132 STAT. 143]]

bill is reported or discharged from the Committee on the Budget,
for the Majority Leader of the Senate or the Majority Leader’s
designee to move to proceed to the consideration of the joint
committee bill. It shall also be in order for any Member of the
Senate to move to proceed to the consideration of the joint
committee bill at any time after the conclusion of such 2-day
period.
(2) <<NOTE: Time period.>> Consideration of motion.–
Consideration of the motion to proceed to the consideration of
the joint committee bill and all debatable motions and appeals
in connection therewith shall not exceed 10 hours, which shall
be divided equally between the Majority and Minority Leaders or
their designees. A motion to further limit debate is in order,
shall require an affirmative vote of three-fifths of Members
duly chosen and sworn, and is not debatable.
(3) Vote threshold.–The motion to proceed to the
consideration of the joint committee bill shall only be agreed
to upon an affirmative vote of three-fifths of Members duly
chosen and sworn.
(4) Limitations.–The motion is not subject to a motion to
postpone. <<NOTE: Waiver.>> All points of order against the
motion to proceed to the joint committee bill are waived. A
motion to reconsider the vote by which the motion is agreed to
or disagreed to shall not be in order.
(5) Deadline.–Not later than the last day of the 115th
Congress, the Senate shall vote on a motion to proceed to the
joint committee bill.

DIVISION D–REVENUE MEASURES

SECTION 40001. TABLE OF CONTENTS.

The table of contents for this division is as follows:

DIVISION D–REVENUE MEASURES

Sec. 40001. Table of contents.

TITLE I–EXTENSION OF EXPIRING PROVISIONS

Sec. 40101. Amendment of Internal Revenue Code of 1986.

Subtitle A–Tax Relief for Families and Individuals

Sec. 40201. Extension of exclusion from gross income of discharge of
qualified principal residence indebtedness.
Sec. 40202. Extension of mortgage insurance premiums treated as
qualified residence interest.
Sec. 40203. Extension of above-the-line deduction for qualified tuition
and related expenses.

[[Page 132 STAT. 144]]

Subtitle B–Incentives for Growth, Jobs, Investment, and Innovation

Sec. 40301. Extension of Indian employment tax credit.
Sec. 40302. Extension of railroad track maintenance credit.
Sec. 40303. Extension of mine rescue team training credit.
Sec. 40304. Extension of classification of certain race horses as 3-year
property.
Sec. 40305. Extension of 7-year recovery period for motorsports
entertainment complexes.
Sec. 40306. Extension of accelerated depreciation for business property
on an Indian reservation.
Sec. 40307. Extension of election to expense mine safety equipment.
Sec. 40308. Extension of special expensing rules for certain
productions.
Sec. 40309. Extension of deduction allowable with respect to income
attributable to domestic production activities in Puerto
Rico.
Sec. 40310. Extension of special rule relating to qualified timber gain.
Sec. 40311. Extension of empowerment zone tax incentives.
Sec. 40312. Extension of American Samoa economic development credit.

Subtitle C–Incentives for Energy Production and Conservation

Sec. 40401. Extension of credit for nonbusiness energy property.
Sec. 40402. Extension and modification of credit for residential energy
property.
Sec. 40403. Extension of credit for new qualified fuel cell motor
vehicles.
Sec. 40404. Extension of credit for alternative fuel vehicle refueling
property.
Sec. 40405. Extension of credit for 2-wheeled plug-in electric vehicles.
Sec. 40406. Extension of second generation biofuel producer credit.
Sec. 40407. Extension of biodiesel and renewable diesel incentives.
Sec. 40408. Extension of production credit for Indian coal facilities.
Sec. 40409. Extension of credits with respect to facilities producing
energy from certain renewable resources.
Sec. 40410. Extension of credit for energy-efficient new homes.
Sec. 40411. Extension and phaseout of energy credit.
Sec. 40412. Extension of special allowance for second generation biofuel
plant property.
Sec. 40413. Extension of energy efficient commercial buildings
deduction.
Sec. 40414. Extension of special rule for sales or dispositions to
implement FERC or State electric restructuring policy for
qualified electric utilities.
Sec. 40415. Extension of excise tax credits relating to alternative
fuels.
Sec. 40416. Extension of Oil Spill Liability Trust Fund financing rate.

Subtitle D–Modifications of Energy Incentives

Sec. 40501. Modifications of credit for production from advanced nuclear
power facilities.

TITLE II–MISCELLANEOUS PROVISIONS

Sec. 41101. Amendment of Internal Revenue Code of 1986.
Sec. 41102. Modifications to rum cover over.
Sec. 41103. Extension of waiver of limitations with respect to excluding
from gross income amounts received by wrongfully incarcerated
individuals.
Sec. 41104. Individuals held harmless on improper levy on retirement
plans.
Sec. 41105. Modification of user fee requirements for installment
agreements.
Sec. 41106. Form 1040SR for seniors.
Sec. 41107. Attorneys fees relating to awards to whistleblowers.
Sec. 41108. Clarification of whistleblower awards.
Sec. 41109. Clarification regarding excise tax based on investment
income of private colleges and universities.
Sec. 41110. Exception from private foundation excess business holding
tax for independently-operated philanthropic business
holdings.
Sec. 41111. Rule of construction for Craft Beverage Modernization and
Tax Reform.
Sec. 41112. Simplification of rules regarding records, statements, and
returns.
Sec. 41113. Modification of rules governing hardship distributions.
Sec. 41114. Modification of rules relating to hardship withdrawals from
cash or deferred arrangements.
Sec. 41115. Opportunity Zones rule for Puerto Rico.
Sec. 41116. Tax home of certain citizens or residents of the United
States living abroad.
Sec. 41117. Treatment of foreign persons for returns relating to
payments made in settlement of payment card and third party
network transactions.
Sec. 41118. Repeal of shift in time of payment of corporate estimated
taxes.
Sec. 41119. Enhancement of carbon dioxide sequestration credit.

[[Page 132 STAT. 145]]

TITLE I–EXTENSION OF <<NOTE: Applicability.>> EXPIRING PROVISIONS
SEC. 40101. AMENDMENT OF INTERNAL REVENUE CODE OF 1986.

Except as otherwise expressly provided, whenever in this title an
amendment or repeal is expressed in terms of an amendment to, or repeal
of, a section or other provision, the reference shall be considered to
be made to a section or other provision of the Internal Revenue Code of
1986.

Subtitle A–Tax Relief for Families and Individuals

SEC. 40201. EXTENSION OF EXCLUSION FROM GROSS INCOME OF DISCHARGE
OF QUALIFIED PRINCIPAL RESIDENCE
INDEBTEDNESS.

(a) In General.–Section 108(a)(1)(E) <<NOTE: 26 USC 108.>> is
amended by striking “January 1, 2017” each place it appears and
inserting “January 1, 2018”.

(b) <<NOTE: 26 USC 108 note.>> Effective Date.–The amendments made
by this section shall apply to discharges of indebtedness after December
31, 2016.
SEC. 40202. EXTENSION OF MORTGAGE INSURANCE PREMIUMS TREATED AS
QUALIFIED RESIDENCE INTEREST.

(a) In General.–Subclause (I) of section 163(h)(3)(E)(iv) is
amended by striking “December 31, 2016” and inserting “December 31,
2017”.
(b) <<NOTE: 26 USC 163 note.>> Effective Date.–The amendment made
by this section shall apply to amounts paid or accrued after December
31, 2016.
SEC. 40203. EXTENSION OF ABOVE-THE-LINE DEDUCTION FOR QUALIFIED
TUITION AND RELATED EXPENSES.

(a) In General.–Section 222(e) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 222 note.>> Effective Date.–The amendment made
by this section shall apply to taxable years beginning after December
31, 2016.

Subtitle B–Incentives for Growth, Jobs, Investment, and Innovation

SEC. 40301. EXTENSION OF INDIAN EMPLOYMENT TAX CREDIT.

(a) In General.–Section 45A(f) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 45A note.>> Effective Date.–The amendment made
by this section shall apply to taxable years beginning after December
31, 2016.
SEC. 40302. EXTENSION OF RAILROAD TRACK MAINTENANCE CREDIT.

(a) In General.–Section 45G(f) is amended by striking “January 1,
2017” and inserting “January 1, 2018”.
(b) <<NOTE: 26 USC 45G note.>> Effective Date.–
(1) In general.–The amendment made by this section shall
apply to expenditures paid or incurred in taxable years
beginning after December 31, 2016.

[[Page 132 STAT. 146]]

(2) <<NOTE: Time period. Deadline.>> Safe harbor
assignments.–Assignments, including related expenditures paid
or incurred, under paragraph (2) of section 45G(b) of the
Internal Revenue Code of 1986 for taxable years ending after
January 1, 2017, and before January 1, 2018, shall be treated as
effective as of the close of such taxable year if made pursuant
to a written agreement entered into no later than 90 days
following the date of the enactment of this Act.
SEC. 40303. EXTENSION OF MINE RESCUE TEAM TRAINING CREDIT.

(a) In General.–Section 45N(e) <<NOTE: 26 USC 45N.>> is amended by
striking “December 31, 2016” and inserting “December 31, 2017”.

(b) <<NOTE: 26 USC 45N note.>> Effective Date.–The amendment made
by this section shall apply to taxable years beginning after December
31, 2016.
SEC. 40304. EXTENSION OF CLASSIFICATION OF CERTAIN RACE HORSES AS
3-YEAR PROPERTY.

(a) In General.–Section 168(e)(3)(A)(i) is amended–
(1) by striking “January 1, 2017” in subclause (I) and
inserting “January 1, 2018”, and
(2) by striking “December 31, 2016” in subclause (II) and
inserting “December 31, 2017”.

(b) <<NOTE: 26 USC 168 note.>> Effective Date.–The amendments made
by this section shall apply to property placed in service after December
31, 2016.
SEC. 40305. EXTENSION OF 7-YEAR RECOVERY PERIOD FOR MOTORSPORTS
ENTERTAINMENT COMPLEXES.

(a) In General.–Section 168(i)(15)(D) is amended by striking
“December 31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 168 note.>> Effective Date.–The amendment made
by this section shall apply to property placed in service after December
31, 2016.
SEC. 40306. EXTENSION OF ACCELERATED DEPRECIATION FOR BUSINESS
PROPERTY ON AN INDIAN RESERVATION.

(a) In General.–Section 168(j)(9) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 168 note.>> Effective Date.–The amendment made
by this section shall apply to property placed in service after December
31, 2016.
SEC. 40307. EXTENSION OF ELECTION TO EXPENSE MINE SAFETY
EQUIPMENT.

(a) In General.–Section 179E(g) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 179E note.>> Effective Date.–The amendment made
by this section shall apply to property placed in service after December
31, 2016.
SEC. 40308. EXTENSION OF SPECIAL EXPENSING RULES FOR CERTAIN
PRODUCTIONS.

(a) In General.–Section 181(g) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 181 note.>> Effective Date.–The amendment made
by this section shall apply to productions commencing after December 31,
2016.
SEC. 40309. <<NOTE: 26 USC 199 note.>> EXTENSION OF DEDUCTION
ALLOWABLE WITH RESPECT TO INCOME
ATTRIBUTABLE TO DOMESTIC PRODUCTION
ACTIVITIES IN PUERTO RICO.

For purposes of applying section 199(d)(8)(C) of the Internal
Revenue Code of 1986 with respect to taxable years beginning during
2017, such section shall be applied–

[[Page 132 STAT. 147]]

(1) by substituting “first 12 taxable years” for “first
11 taxable years”, and
(2) by substituting “January 1, 2018” for “January 1,
2017”.
SEC. 40310. <<NOTE: 26 USC 1201 note.>> EXTENSION OF SPECIAL RULE
RELATING TO QUALIFIED TIMBER GAIN.

For purposes of applying section 1201(b) of the Internal Revenue
Code of 1986 with respect to taxable years beginning during 2017, such
section shall be applied by substituting “2016 or 2017” for “2016”.
SEC. 40311. EXTENSION OF EMPOWERMENT ZONE TAX INCENTIVES.

(a) In General.–
(1) Extension.–Section 1391(d)(1)(A)(i) <<NOTE: 26 USC
1391.>> is amended by striking “December 31, 2016” and
inserting “December 31, 2017”.
(2) <<NOTE: 26 USC 1391 note.>> Treatment of certain
termination dates specified in nominations.–In the case of a
designation of an empowerment zone the nomination for which
included a termination date which is contemporaneous with the
date specified in subparagraph (A)(i) of section 1391(d)(1) of
the Internal Revenue Code of 1986 (as in effect before the
enactment of this Act), subparagraph (B) of such section shall
not apply with respect to such designation if, after the date of
the enactment of this section, the entity which made such
nomination amends the nomination to provide for a new
termination date in such manner as the Secretary of the Treasury
(or the Secretary’s designee) may provide.

(b) <<NOTE: 26 USC 1391 note.>> Effective Date.–The amendment made
by subsection (a)(1) shall apply to taxable years beginning after
December 31, 2016.
SEC. 40312. EXTENSION OF AMERICAN SAMOA ECONOMIC DEVELOPMENT
CREDIT.

(a) In General.–Section 119 of division A of the Tax Relief and
Health Care Act of 2006 <<NOTE: 26 USC 30A note.>> is amended–
(1) in subsection (d)–
(A) by striking “January 1, 2017” each place it
appears and inserting “January 1, 2018”,
(B) by striking “first 11 taxable years” in
paragraph (1) and inserting “first 12 taxable years”,
and
(C) by striking “first 5 taxable years” in
paragraph (2) and inserting “first 6 taxable years”,
and
(2) in subsection (e), by adding at the end the following:
“References in this subsection to section 199 of the Internal
Revenue Code of 1986 shall be treated as references to such
section as in effect before its repeal.”.

(b) <<NOTE: 26 USC 30A note.>> Effective Date.–The amendments made
by this section shall apply to taxable years beginning after December
31, 2016.

[[Page 132 STAT. 148]]

Subtitle C–Incentives for Energy Production and Conservation

SEC. 40401. EXTENSION OF CREDIT FOR NONBUSINESS ENERGY PROPERTY.

(a) In General.–Section 25C(g)(2) <<NOTE: 26 USC 25C.>> is amended
by striking “December 31, 2016” and inserting “December 31, 2017”.

(b) <<NOTE: 26 USC 25C note.>> Effective Date.–The amendment made
by this section shall apply to property placed in service after December
31, 2016.
SEC. 40402. EXTENSION AND MODIFICATION OF CREDIT FOR RESIDENTIAL
ENERGY PROPERTY.

(a) In General.–Section 25D(h) is amended by striking “December
31, 2016” and all that follows and inserting “December 31, 2021.”.
(b) Phaseout.–
(1) In general.–Section 25D(a) is amended by striking “the
sum of–” and all that follows and inserting “the sum of the
applicable percentages of–
“(1) the qualified solar electric property expenditures,
“(2) the qualified solar water heating property
expenditures,
“(3) the qualified fuel cell property expenditures,
“(4) the qualified small wind energy property expenditures,
and
“(5) the qualified geothermal heat pump property
expenditures,

made by the taxpayer during such year.”.
(2) Conforming amendment.–Section 25D(g) is amended by
striking “paragraphs (1) and (2) of”.

(c) <<NOTE: 26 USC 25D note.>> Effective Date.–The amendment made
by this section shall apply to property placed in service after December
31, 2016.
SEC. 40403. EXTENSION OF CREDIT FOR NEW QUALIFIED FUEL CELL MOTOR
VEHICLES.

(a) In General.–Section 30B(k)(1) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 30B note.>> Effective Date.–The amendment made
by this section shall apply to property purchased after December 31,
2016.
SEC. 40404. EXTENSION OF CREDIT FOR ALTERNATIVE FUEL VEHICLE
REFUELING PROPERTY.

(a) In General.–Section 30C(g) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 30C note.>> Effective Date.–The amendment made
by this section shall apply to property placed in service after December
31, 2016.
SEC. 40405. EXTENSION OF CREDIT FOR 2-WHEELED PLUG-IN ELECTRIC
VEHICLES.

(a) In General.–Section 30D(g)(3)(E)(ii) is amended by striking
“January 1, 2017” and inserting “January 1, 2018”.
(b) <<NOTE: 26 USC 30D note.>> Effective Date.–The amendment made
by this section shall apply to vehicles acquired after December 31,
2016.

[[Page 132 STAT. 149]]

SEC. 40406. EXTENSION OF SECOND GENERATION BIOFUEL PRODUCER
CREDIT.

(a) In General.–Section 40(b)(6)(J)(i) <<NOTE: 26 USC 40.>> is
amended by striking “January 1, 2017” and inserting “January 1,
2018”.

(b) <<NOTE: 26 USC 40 note.>> Effective Date.–The amendment made
by this section shall apply to qualified second generation biofuel
production after December 31, 2016.
SEC. 40407. EXTENSION OF BIODIESEL AND RENEWABLE DIESEL
INCENTIVES.

(a) Income Tax Credit.–
(1) In general.–Subsection (g) of section 40A is amended by
striking “December 31, 2016” and inserting “December 31,
2017”.
(2) <<NOTE: 26 USC 40A note.>> Effective date.–The
amendment made by this subsection shall apply to fuel sold or
used after December 31, 2016.

(b) Excise Tax Incentives.–
(1) In general.–Section 6426(c)(6) is amended by striking
“December 31, 2016” and inserting “December 31, 2017”.
(2) Payments.–Section 6427(e)(6)(B) is amended by striking
“December 31, 2016” and inserting “December 31, 2017”.
(3) <<NOTE: 26 USC 6426 note.>> Effective date.–The
amendments made by this subsection shall apply to fuel sold or
used after December 31, 2016.
(4) <<NOTE: Time periods. Deadlines. 26 USC 6426 note.>>
Special rule for 2017.–Notwithstanding any other provision of
law, in the case of any biodiesel mixture credit properly
determined under section 6426(c) of the Internal Revenue Code of
1986 for the period beginning on January 1, 2017, and ending on
December 31, 2017, such credit shall be allowed, and any refund
or payment attributable to such credit (including any payment
under section 6427(e) of such Code) shall be made, only in such
manner as the Secretary of the Treasury (or the Secretary’s
delegate) shall provide. Such
Secretary <<NOTE: Guidance. Claims.>> shall issue guidance
within 30 days after the date of the enactment of this Act
providing for a one-time submission of claims covering periods
described in the preceding sentence. Such guidance shall provide
for a 180-day period for the submission of such claims (in such
manner as prescribed by such Secretary) to begin not later than
30 days after such guidance is issued. Such claims shall be paid
by such Secretary not later than 60 days after receipt. If such
Secretary has not paid pursuant to a claim filed under this
subsection within 60 days after the date of the filing of such
claim, the claim shall be paid with interest from such date
determined by using the overpayment rate and method under
section 6621 of such Code.
SEC. 40408. EXTENSION OF PRODUCTION CREDIT FOR INDIAN COAL
FACILITIES.

(a) In General.–Section 45(e)(10)(A) is amended by striking “11-
year period” each place it appears and inserting “12-year period”.
(b) <<NOTE: 26 USC 45 note.>> Effective Date.–The amendment made
by this section shall apply to coal produced after December 31, 2016.

[[Page 132 STAT. 150]]

SEC. 40409. EXTENSION OF CREDITS WITH RESPECT TO FACILITIES
PRODUCING ENERGY FROM CERTAIN
RENEWABLE RESOURCES.

(a) In General.–The following provisions of section
45(d) <<NOTE: 26 USC 45.>> are each amended by striking “January 1,
2017” each place it appears and inserting “January 1, 2018”:
(1) Paragraph (2)(A).
(2) Paragraph (3)(A).
(3) Paragraph (4)(B).
(4) Paragraph (6).
(5) Paragraph (7).
(6) Paragraph (9).
(7) Paragraph (11)(B).

(b) Extension of Election To Treat Qualified Facilities as Energy
Property.–Section 48(a)(5)(C)(ii) is amended by striking “January 1,
2017” and inserting “January 1, 2018”.
(c) <<NOTE: 26 USC 45 note.>> Effective Date.–The amendments made
by this section shall take effect on January 1, 2017.
SEC. 40410. EXTENSION OF CREDIT FOR ENERGY-EFFICIENT NEW HOMES.

(a) In General.–Section 45L(g) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 45L note.>> Effective Date.–The amendment made
by this section shall apply to homes acquired after December 31, 2016.
SEC. 40411. EXTENSION AND PHASEOUT OF ENERGY CREDIT.

(a) Extension of Solar and Thermal Energy Property.–Section
48(a)(3)(A) is amended–
(1) by striking “periods ending before January 1, 2017” in
clause (ii) and inserting “property the construction of which
begins before January 1, 2022”, and
(2) by striking “periods ending before January 1, 2017” in
clause (vii) and inserting “property the construction of which
begins before January 1, 2022”.

(b) Phaseout of 30-Percent Credit Rate for Fiber-optic Solar,
Qualified Fuel Cell, and Qualified Small Wind Energy Property.–
(1) In general.–Section 48(a) is amended by adding at the
end the following new paragraph:
“(7) Phaseout for fiber-optic solar, qualified fuel cell,
and qualified small wind energy property.–
“(A) <<NOTE: Time periods.>> In general.–Subject
to subparagraph (B), in the case of any qualified fuel
cell property, qualified small wind property, or energy
property described in paragraph (3)(A)(ii), the energy
percentage determined under paragraph (2) shall be equal
to–
“(i) in the case of any property the
construction of which begins after December 31,
2019, and before January 1, 2021, 26 percent, and
“(ii) in the case of any property the
construction of which begins after December 31,
2020, and before January 1, 2022, 22 percent.
“(B) Placed in service deadline.–In the case of
any energy property described in subparagraph (A) which
is not placed in service before January 1, 2024, the
energy

[[Page 132 STAT. 151]]

percentage determined under paragraph (2) shall be equal
to 0 percent.”.
(2) Conforming amendment.–Section 48(a)(2)(A) <<NOTE: 26
USC 48.>> is amended by striking “paragraph (6)” and
inserting “paragraphs (6) and (7)”.
(3) Clarification relating to phaseout for wind
facilities.–Section 48(a)(5)(E) is amended by inserting “which
is treated as energy property by reason of this paragraph”
after “using wind to produce electricity”.

(c) Extension of Qualified Fuel Cell Property.–Section 48(c)(1)(D)
is amended by striking “for any period after December 31, 2016” and
inserting “the construction of which does not begin before January 1,
2022”.
(d) Extension of Qualified Microturbine Property.–Section
48(c)(2)(D) is amended by striking “for any period after December 31,
2016” and inserting “the construction of which does not begin before
January 1, 2022”.
(e) Extension of Combined Heat and Power System Property.–Section
48(c)(3)(A)(iv) is amended by striking “which is placed in service
before January 1, 2017” and inserting “the construction of which
begins before January 1, 2022”.
(f) Extension of Qualified Small Wind Energy Property.–Section
48(c)(4)(C) is amended by striking “for any period after December 31,
2016” and inserting “the construction of which does not begin before
January 1, 2022”.
(g) <<NOTE: 26 USC 48 note.>> Effective Date.–
(1) In general.–Except as otherwise provided in this
subsection, the amendments made by this section shall apply to
periods after December 31, 2016, under rules similar to the
rules of section 48(m) of the Internal Revenue Code of 1986 (as
in effect on the day before the date of the enactment of the
Revenue Reconciliation Act of 1990).
(2) Extension of combined heat and power system property.–
The amendment made by subsection (e) shall apply to property
placed in service after December 31, 2016.
(3) Phaseouts and terminations.–The amendments made by
subsection (b) shall take effect on the date of the enactment of
this Act.
SEC. 40412. EXTENSION OF SPECIAL ALLOWANCE FOR SECOND GENERATION
BIOFUEL PLANT PROPERTY.

(a) In General.–Section 168(l)(2)(D) is amended by striking
“January 1, 2017” and inserting “January 1, 2018”.
(b) <<NOTE: 26 USC 168 note.>> Effective Date.–The amendment made
by this section shall apply to property placed in service after December
31, 2016.
SEC. 40413. EXTENSION OF ENERGY EFFICIENT COMMERCIAL BUILDINGS
DEDUCTION.

(a) In General.–Section 179D(h) is amended by striking “December
31, 2016” and inserting “December 31, 2017”.
(b) <<NOTE: 26 USC 179D note.>> Effective Date.–The amendment made
by this section shall apply to property placed in service after December
31, 2016.

[[Page 132 STAT. 152]]

SEC. 40414. EXTENSION OF SPECIAL RULE FOR SALES OR DISPOSITIONS TO
IMPLEMENT FERC OR STATE ELECTRIC
RESTRUCTURING POLICY FOR QUALIFIED
ELECTRIC UTILITIES.

(a) In General.–Section 451(k)(3), as amended by section 13221 of
Public Law 115-97, <<NOTE: 26 USC 451.>> is amended by striking
“January 1, 2017” and inserting “January 1, 2018”.

(b) <<NOTE: 26 USC 451 note.>> Effective Date.–The amendment made
by this section shall apply to dispositions after December 31, 2016.
SEC. 40415. EXTENSION OF EXCISE TAX CREDITS RELATING TO
ALTERNATIVE FUELS.

(a) Extension of Alternative Fuels Excise Tax Credits.–
(1) In general.–Sections 6426(d)(5) and 6426(e)(3) are each
amended by striking “December 31, 2016” and inserting
“December 31, 2017”.
(2) Outlay payments for alternative fuels.–Section
6427(e)(6)(C) is amended by striking “December 31, 2016” and
inserting “December 31, 2017”.
(3) <<NOTE: 26 USC 6426 note.>> Effective date.–The
amendments made by this subsection shall apply to fuel sold or
used after December 31, 2016.

(b) <<NOTE: Time periods. Deadlines. 26 USC 6426 note.>> Special
Rule for 2017.–Notwithstanding any other provision of law, in the case
of any alternative fuel credit properly determined under section 6426(d)
of the Internal Revenue Code of 1986 for the period beginning on January
1, 2017, and ending on December 31, 2017, such credit shall be allowed,
and any refund or payment attributable to such credit (including any
payment under section 6427(e) of such Code) shall be made, only in such
manner as the Secretary of the Treasury (or the Secretary’s delegate)
shall provide. Such Secretary shall issue guidance within 30 days after
the date of the enactment of this Act providing for a one-time
submission of claims covering periods described in the preceding
sentence. Such <<NOTE: Guidance. Claims.>> guidance shall provide for a
180-day period for the submission of such claims (in such manner as
prescribed by such Secretary) to begin not later than 30 days after such
guidance is issued. Such claims shall be paid by such Secretary not
later than 60 days after receipt. If such Secretary has not paid
pursuant to a claim filed under this subsection within 60 days after the
date of the filing of such claim, the claim shall be paid with interest
from such date determined by using the overpayment rate and method under
section 6621 of such Code.
SEC. 40416. EXTENSION OF OIL SPILL LIABILITY TRUST FUND FINANCING
RATE.

(a) In General.–Section 4611(f)(2) is amended by striking
“December 31, 2017” and inserting “December 31, 2018”.
(b) <<NOTE: 26 USC 4611 note.>> Effective Date.–The amendment made
by this section shall apply on and after the first day of the first
calendar month beginning after the date of the enactment of this Act.

[[Page 132 STAT. 153]]

Subtitle D–Modifications of Energy Incentives

SEC. 40501. MODIFICATIONS OF CREDIT FOR PRODUCTION FROM ADVANCED
NUCLEAR POWER FACILITIES.

(a) Treatment of Unutilized Limitation Amounts.–Section
45J(b) <<NOTE: 26 USC 45J.>> is amended–
(1) by inserting “or any amendment to” after “enactment
of” in paragraph (4), and
(2) by adding at the end the following new paragraph:
“(5) Allocation of unutilized limitation.–
“(A) In general.–Any unutilized national megawatt
capacity limitation shall be allocated by the Secretary
under paragraph (3) as rapidly as is practicable after
December 31, 2020–
“(i) first to facilities placed in service on
or before such date to the extent that such
facilities did not receive an allocation equal to
their full nameplate capacity, and
“(ii) then to facilities placed in service
after such date in the order in which such
facilities are placed in service.
“(B) Unutilized national megawatt capacity
limitation.–The term <<NOTE: Definition.>> `unutilized
national megawatt capacity limitation’ means the excess
(if any) of–
“(i) 6,000 megawatts, over
“(ii) the aggregate amount of national
megawatt capacity limitation allocated by the
Secretary before January 1, 2021, reduced by any
amount of such limitation which was allocated to a
facility which was not placed in service before
such date.
“(C) Coordination with other provisions.–In the
case of any unutilized national megawatt capacity
limitation allocated by the Secretary pursuant to this
paragraph–
“(i) such allocation shall be treated for
purposes of this section in the same manner as an
allocation of national megawatt capacity
limitation, and
“(ii) subsection (d)(1)(B) shall not apply to
any facility which receives such allocation.”.

(b) Transfer of Credit by Certain Public Entities.–
(1) In general.–Section 45J is amended–
(A) by redesignating subsection (e) as subsection
(f), and
(B) by inserting after subsection (d) the following
new subsection:

“(e) Transfer of Credit by Certain Public Entities.–
“(1) In general.–If, with respect to a credit under
subsection (a) for any taxable year–
“(A) a qualified public entity would be the
taxpayer (but for this paragraph), and
“(B) such entity elects the application of this
paragraph for such taxable year with respect to all (or
any portion specified in such election) of such credit,
the eligible project partner specified in such election, and not
the qualified public entity, shall be treated as the taxpayer

[[Page 132 STAT. 154]]

for purposes of this title with respect to such credit (or such
portion thereof).
“(2) Definitions.–For purposes of this subsection–
“(A) Qualified public entity.–The term `qualified
public entity’ means–
“(i) a Federal, State, or local government
entity, or any political subdivision, agency, or
instrumentality thereof,
“(ii) a mutual or cooperative electric
company described in section 501(c)(12) or
1381(a)(2), or
“(iii) a not-for-profit electric utility
which had or has received a loan or loan guarantee
under the Rural Electrification Act of 1936.
“(B) Eligible project partner.–The term `eligible
project partner’ means any person who–
“(i) is responsible for, or participates in,
the design or construction of the advanced nuclear
power facility to which the credit under
subsection (a) relates,
“(ii) participates in the provision of the
nuclear steam supply system to such facility,
“(iii) participates in the provision of
nuclear fuel to such facility,
“(iv) is a financial institution providing
financing for the construction or operation of
such facility, or
“(v) has an ownership interest in such
facility.
“(3) Special rules.–
“(A) Application to partnerships.–In the case of a
credit under subsection (a) which is determined at the
partnership level–
“(i) for purposes of paragraph (1)(A), a
qualified public entity shall be treated as the
taxpayer with respect to such entity’s
distributive share of such credit, and
“(ii) the term `eligible project partner’
shall include any partner of the partnership.
“(B) Taxable year in which credit taken into
account.–In the case of any credit (or portion thereof)
with respect to which an election is made under
paragraph (1), such credit shall be taken into account
in the first taxable year of the eligible project
partner ending with, or after, the qualified public
entity’s taxable year with respect to which the credit
was determined.
“(C) Treatment of transfer under private use
rules.–For purposes of section 141(b)(1), any benefit
derived by an eligible project partner in connection
with an election under this subsection shall not be
taken into account as a private business use.”.
(2) Special rule for proceeds of transfers for mutual or
cooperative electric companies.–Section 501(c)(12) <<NOTE: 26
USC 501.>> is amended by adding at the end the following new
subparagraph:
“(I) In the case of a mutual or cooperative
electric company described in this paragraph or an
organization described in section 1381(a)(2), income
received or accrued in connection with an election under
section 45J(e)(1) shall be treated as an amount
collected from members for the sole purpose of meeting
losses and expenses.”.

[[Page 132 STAT. 155]]

(1) Treatment of unutilized limitation amounts.–The
amendment made by subsection (a) shall take effect on the date
of the enactment of this Act.
(2) Transfer of credit by certain public entities.–The
amendments made by subsection (b) shall apply to taxable years
beginning after the date of the enactment of this Act.

TITLE <<NOTE: Applicability.>> II–MISCELLANEOUS PROVISIONS
SEC. 41101. AMENDMENT OF INTERNAL REVENUE CODE OF 1986.

(a) Extension.–
(1) In general.–Section 7652(f)(1) <<NOTE: 26 USC 7652.>>
is amended by striking “January 1, 2017” and inserting
“January 1, 2022”.
(2) <<NOTE: 26 USC 7652 note.>> Effective date.–The
amendment made by this subsection shall apply to distilled
spirits brought into the United States after December 31, 2016.

(b) Determination of Taxes on Rum.–
(1) In general.–Section 7652(e) is amended by adding at the
end the following new paragraph:
“(5) Determination of amount of taxes collected.–For
purposes of this subsection, the amount of taxes collected under
section 5001(a)(1) shall be determined without regard to section
5001(c).”.
(2) <<NOTE: 26 USC 7652 note.>> Effective date.–The
amendment made by this subsection shall apply to distilled
spirits brought into the United States after December 31, 2017.
SEC. 41103. EXTENSION OF WAIVER OF LIMITATIONS WITH RESPECT TO
EXCLUDING FROM GROSS INCOME AMOUNTS
RECEIVED BY WRONGFULLY INCARCERATED
INDIVIDUALS.

(a) In General.–Section 304(d) of the Protecting Americans from Tax
Hikes Act of 2015 (26 U.S.C. 139F note) is amended by striking “1-
year” and inserting “3-year”.
(b) <<NOTE: 26 USC 139F note.>> Effective Date.–The amendment made
by this section shall take effect on the date of the enactment of this
Act.
SEC. 41104. INDIVIDUALS HELD HARMLESS ON IMPROPER LEVY ON
RETIREMENT PLANS.

(a) In General.–Section 6343 is amended by adding at the end the
following new subsection:
“(f) Individuals Held Harmless on Wrongful Levy, etc. on Retirement
Plan.–
“(1) <<NOTE: Determination.>> In general.–If the
Secretary determines that an individual’s account or benefit
under an eligible retirement plan (as defined in section
402(c)(8)(B)) has been levied upon in a case to which subsection
(b) or (d)(2)(A) applies and property or an amount of money is
returned to the individual–

[[Page 132 STAT. 156]]

“(A) the individual may contribute such property or
an amount equal to the sum of–
“(i) the amount of money so returned by the
Secretary, and
“(ii) interest paid under subsection (c) on
such amount of money,
into such eligible retirement plan if such contribution
is permitted by the plan, or into an individual
retirement plan (other than an endowment contract) to
which a rollover contribution of a distribution from
such eligible retirement plan is permitted, but only if
such contribution is made not later than the due date
(not including extensions) for filing the return of tax
for the taxable year in which such property or amount of
money is returned, and
“(B) the Secretary shall, at the time such property
or amount of money is returned, notify such individual
that a contribution described in subparagraph (A) may be
made.
“(2) Treatment as rollover.–The distribution on account of
the levy and any contribution under paragraph (1) with respect
to the return of such distribution shall be treated for purposes
of this title as if such distribution and contribution were
described in section 402(c), 402A(c)(3), 403(a)(4), 403(b)(8),
408(d)(3), 408A(d)(3), or 457(e)(16), whichever is applicable;
except that–
“(A) the contribution shall be treated as having
been made for the taxable year in which the distribution
on account of the levy occurred, and the interest paid
under subsection (c) shall be treated as earnings within
the plan after the contribution and shall not be
included in gross income, and
“(B) such contribution shall not be taken into
account under section 408(d)(3)(B).
“(3) Refund, etc., of income tax on levy.–
“(A) In general.–If any amount is includible in
gross income for a taxable year by reason of a
distribution on account of a levy referred to in
paragraph (1) and any portion of such amount is treated
as a rollover contribution under paragraph (2), any tax
imposed by chapter 1 on such portion shall not be
assessed, and if assessed shall be abated, and if
collected shall be credited or refunded as an
overpayment made on the due date for filing the return
of tax for such taxable year.
“(B) Exception.–Subparagraph (A) shall not apply
to a rollover contribution under this subsection which
is made from an eligible retirement plan which is not a
Roth IRA or a designated Roth account (within the
meaning of section 402A) to a Roth IRA or a designated
Roth account under an eligible retirement plan.
“(4) Interest.–Notwithstanding subsection (d), interest
shall be allowed under subsection (c) in a case in which the
Secretary makes a determination described in subsection
(d)(2)(A) with respect to a levy upon an individual retirement
plan.
“(5) Treatment of inherited accounts.–For purposes of
paragraph (1)(A), section 408(d)(3)(C) shall be disregarded in
determining whether an individual retirement plan is a

[[Page 132 STAT. 157]]

plan to which a rollover contribution of a distribution from the
plan levied upon is permitted.”.

(b) <<NOTE: 26 USC 6343 note.>> Effective Date.–The amendment made
by this section shall apply to amounts paid under subsections (b), (c),
and (d)(2)(A) of section 6343 of the Internal Revenue Code of 1986 in
taxable years beginning after December 31, 2017.
SEC. 41105. MODIFICATION OF USER FEE REQUIREMENTS FOR INSTALLMENT
AGREEMENTS.

(a) In General.–Section 6159 <<NOTE: 26 USC 6159.>> is amended by
redesignating subsection (f) as subsection (g) and by inserting after
subsection (e) the following new subsection:

“(f) Installment Agreement Fees.–
“(1) Limitation on fee amount.–The amount of any fee
imposed on an installment agreement under this section may not
exceed the amount of such fee as in effect on the date of the
enactment of this subsection.
“(2) Waiver or reimbursement.–In the case of any taxpayer
with an adjusted gross income, as determined for the most recent
year for which such information is available, which does not
exceed 250 percent of the applicable poverty level (as
determined by the Secretary)–
“(A) if the taxpayer has agreed to make payments
under the installment agreement by electronic payment
through a debit instrument, no fee shall be imposed on
an installment agreement under this section, and
“(B) if the taxpayer is unable to make payments
under the installment agreement by electronic payment
through a debit instrument, the Secretary shall, upon
completion of the installment agreement, pay the
taxpayer an amount equal to any such fees imposed.”.

(b) <<NOTE: 26 USC 6159 note.>> Effective Date.–The amendments
made by this section shall apply to agreements entered into on or after
the date which is 60 days after the date of the enactment of this Act.
SEC. 41106. <<NOTE: 26 USC 7805 note.>> FORM 1040SR FOR SENIORS.

(a) In General.–The Secretary of the Treasury (or the Secretary’s
delegate) shall make available a form, to be known as “Form 1040SR”,
for use by individuals to file the return of tax imposed by chapter 1 of
the Internal Revenue Code of 1986. Such form shall be as similar as
practicable to Form 1040EZ, except that–
(1) the form shall be available only to individuals who have
attained age 65 as of the close of the taxable year,
(2) the form may be used even if income for the taxable year
includes–
(A) social security benefits (as defined in section
86(d) of the Internal Revenue Code of 1986),
(B) distributions from qualified retirement plans
(as defined in section 4974(c) of such Code), annuities
or other such deferred payment arrangements,
(C) interest and dividends, or
(D) capital gains and losses taken into account in
determining adjusted net capital gain (as defined in
section 1(h)(3) of such Code), and
(3) the form shall be available without regard to the amount
of any item of taxable income or the total amount of taxable
income for the taxable year.

[[Page 132 STAT. 158]]

(b) Effective Date.–The form required by subsection (a) shall be
made available for taxable years beginning after the date of the
enactment of this Act.
SEC. 41107. ATTORNEYS FEES RELATING TO AWARDS TO WHISTLEBLOWERS.

(a) In General.–Paragraph (21) of section 62(a) <<NOTE: 26 USC
62.>> is amended to read as follows:
“(21) Attorneys’ fees relating to awards to
whistleblowers.–
“(A) In general.–Any deduction allowable under
this chapter for attorney fees and court costs paid by,
or on behalf of, the taxpayer in connection with any
award under–
“(i) section 7623(b), or
“(ii) in the case of taxable years beginning
after December 31, 2017, any action brought
under–
“(I) section 21F of the Securities
Exchange Act of 1934 (15 U.S.C. 78u-6),
“(II) a State false claims act,
including a State false claims act with
qui tam provisions, or
“(III) section 23 of the Commodity
Exchange Act (7 U.S.C. 26).
“(B) May not exceed award.–Subparagraph (A) shall
not apply to any deduction in excess of the amount
includible in the taxpayer’s gross income for the
taxable year on account of such award.”.

(b) <<NOTE: 26 USC 62 note.>> Effective Date.–The amendment made
by this section shall apply to taxable years beginning after December
31, 2017.
SEC. 41108. CLARIFICATION OF WHISTLEBLOWER AWARDS.

(a) Definition of Proceeds.–
(1) In general.–Section 7623 is amended by adding at the
end the following new subsection:

“(c) Proceeds.–For purposes of this section, the term `proceeds’
includes–
“(1) penalties, interest, additions to tax, and additional
amounts provided under the internal revenue laws, and
“(2) any proceeds arising from laws for which the Internal
Revenue Service is authorized to administer, enforce, or
investigate, including–
“(A) criminal fines and civil forfeitures, and
“(B) violations of reporting requirements.”.
(2) Conforming amendments.–Paragraphs (1) and (2)(A) of
section 7623(b) are each amended by striking “collected
proceeds (including penalties, interest, additions to tax, and
additional amounts) resulting from the action” and inserting
“proceeds collected as a result of the action”.

(b) Amount of Proceeds Determined Without Regard to Availability.–
Paragraphs (1) and (2)(A) of section 7623(b) are each amended by
inserting “(determined without regard to whether such proceeds are
available to the Secretary)” after “in response to such action”.
(c) Disputed Amount Threshold.–Section 7623(b)(5)(B) is amended by
striking “tax, penalties, interest, additions to tax, and additional
amounts” and inserting “proceeds”.
(d) <<NOTE: 26 USC 7623 note.>> Effective Date.–The amendments
made by this section shall apply to information provided before, on, or
after the date

[[Page 132 STAT. 159]]

of the enactment of this Act with respect to which a final determination
for an award has not been made before such date of enactment.
SEC. 41109. CLARIFICATION REGARDING EXCISE TAX BASED ON INVESTMENT
INCOME OF PRIVATE COLLEGES AND
UNIVERSITIES.

(a) In General.–Subsection (b)(1) of section 4968, as added by
section 13701(a) of Public Law 115-97, <<NOTE: 26 USC 4968.>> is
amended–
(1) by inserting “tuition-paying” after “500” in
subparagraph (A), and
(2) by inserting “tuition-paying” after “50 percent of
the” in subparagraph (B).

(b) <<NOTE: 26 USC 4968 note.>> Effective Date.–The amendments
made by this section shall apply to taxable years beginning after
December 31, 2017.
SEC. 41110. EXCEPTION FROM PRIVATE FOUNDATION EXCESS BUSINESS
HOLDING TAX FOR INDEPENDENTLY-OPERATED
PHILANTHROPIC BUSINESS HOLDINGS.

(a) In General.–Section 4943 is amended by adding at the end the
following new subsection:
“(g) Exception for Certain Holdings Limited to Independently-
operated Philanthropic Business.–
“(1) In general.–Subsection (a) shall not apply with
respect to the holdings of a private foundation in any business
enterprise which meets the requirements of paragraphs (2), (3),
and (4) for the taxable year.
“(2) Ownership.–The requirements of this paragraph are met
if–
“(A) 100 percent of the voting stock in the
business enterprise is held by the private foundation at
all times during the taxable year, and
“(B) all the private foundation’s ownership
interests in the business enterprise were acquired by
means other than by purchase.
“(3) All profits to charity.–
“(A) In general.–The requirements of this
paragraph are met if the business enterprise, not later
than 120 days after the close of the taxable year,
distributes an amount equal to its net operating income
for such taxable year to the private foundation.
“(B) Net operating income.–For purposes of this
paragraph, the net operating income of any business
enterprise for any taxable year is an amount equal to
the gross income of the business enterprise for the
taxable year, reduced by the sum of–
“(i) the deductions allowed by chapter 1 for
the taxable year which are directly connected with
the production of such income,
“(ii) the tax imposed by chapter 1 on the
business enterprise for the taxable year, and
“(iii) an amount for a reasonable reserve for
working capital and other business needs of the
business enterprise.
“(4) Independent operation.–The requirements of this
paragraph are met if, at all times during the taxable year–
“(A) no substantial contributor (as defined in
section 4958(c)(3)(C)) to the private foundation or
family member

[[Page 132 STAT. 160]]

(as determined under section 4958(f)(4)) of such a
contributor is a director, officer, trustee, manager,
employee, or contractor of the business enterprise (or
an individual having powers or responsibilities similar
to any of the foregoing),
“(B) at least a majority of the board of directors
of the private foundation are persons who are not–
“(i) directors or officers of the business
enterprise, or
“(ii) family members (as so determined) of a
substantial contributor (as so defined) to the
private foundation, and
“(C) there is no loan outstanding from the business
enterprise to a substantial contributor (as so defined)
to the private foundation or to any family member of
such a contributor (as so determined).
“(5) Certain deemed private foundations excluded.–This
subsection shall not apply to–
“(A) any fund or organization treated as a private
foundation for purposes of this section by reason of
subsection (e) or (f),
“(B) any trust described in section 4947(a)(1)
(relating to charitable trusts), and
“(C) any trust described in section 4947(a)(2)
(relating to split-interest trusts).”.

(b) <<NOTE: 26 USC 4943 note.>> Effective Date.–The amendment made
by this section shall apply to taxable years beginning after December
31, 2017.
SEC. 41111. RULE OF CONSTRUCTION FOR CRAFT BEVERAGE MODERNIZATION
AND TAX REFORM.

(a) In General.–Subpart A of part IX of subtitle C of title I of
Public Law 115-97 is amended by adding at the end the following new
section:
“SEC. 13809. <<NOTE: 26 USC 263A note.>> RULE OF CONSTRUCTION.

“Nothing in this subpart, the amendments made by this subpart, or
any regulation promulgated under this subpart or the amendments made by
this subpart, shall be construed to preempt, supersede, or otherwise
limit or restrict any State, local, or tribal law that prohibits or
regulates the production or sale of distilled spirits, wine, or malt
beverages.”.
(b) <<NOTE: 26 USC 263A note.>> Effective Date.–The amendment made
by this section shall take effect as if included in Public Law 115-97.
SEC. 41112. SIMPLIFICATION OF RULES REGARDING RECORDS, STATEMENTS,
AND RETURNS.

(a) <<NOTE: Time period.>> In General.–Subsection (a) of section
5555 is amended by adding at the end the following: “For calendar
quarters beginning after the date of the enactment of this sentence, and
before January 1, 2020, the Secretary shall permit a person to employ a
unified system for any records, statements, and returns required to be
kept, rendered, or made under this section for any beer produced in the
brewery for which the tax imposed by section 5051 has been determined,
including any beer which has been removed for consumption on the
premises of the brewery.”.

(b) <<NOTE: 26 USC 5555 note.>> Effective Date.–The amendment made
by this section shall apply to calendar quarters beginning after the
date of the enactment of this Act.

[[Page 132 STAT. 161]]

SEC. 41113. <<NOTE: 26 USC 401 note.>> MODIFICATION OF RULES
GOVERNING HARDSHIP DISTRIBUTIONS.

(a) <<NOTE: Deadline.>> In General.–Not later than 1 year after
the date of the enactment of this Act, the Secretary of the Treasury
shall modify Treasury Regulation section 1.401(k)-1(d)(3)(iv)(E) to–
(1) delete the 6-month prohibition on contributions imposed
by paragraph (2) thereof, and
(2) make any other modifications necessary to carry out the
purposes of section 401(k)(2)(B)(i)(IV) of the Internal Revenue
Code of 1986.

(b) Effective Date.–The revised regulations under this section
shall apply to plan years beginning after December 31, 2018.
SEC. 41114. MODIFICATION OF RULES RELATING TO HARDSHIP WITHDRAWALS
FROM CASH OR DEFERRED ARRANGEMENTS.

(a) In General.–Section 401(k) <<NOTE: 26 USC 401.>> is amended by
adding at the end the following:
“(14) Special rules relating to hardship withdrawals.–For
purposes of paragraph (2)(B)(i)(IV)–
“(A) Amounts which may be withdrawn.–The following
amounts may be distributed upon hardship of the
employee:
“(i) Contributions to a profit-sharing or
stock bonus plan to which section 402(e)(3)
applies.
“(ii) Qualified nonelective contributions (as
defined in subsection (m)(4)(C)).
“(iii) Qualified matching contributions
described in paragraph (3)(D)(ii)(I).
“(iv) Earnings on any contributions described
in clause (i), (ii), or (iii).
“(B) No requirement to take available loan.–A
distribution shall not be treated as failing to be made
upon the hardship of an employee solely because the
employee does not take any available loan under the
plan.”.

(b) Conforming Amendment.–Section 401(k)(2)(B)(i)(IV) is amended to
read as follows:
“(IV) subject to the provisions of
paragraph (14), upon hardship of the
employee, or”.

(c) <<NOTE: 26 USC 401 note.>> Effective Date.–The amendments made
by this section shall apply to plan years beginning after December 31,
2018.
SEC. 41115. OPPORTUNITY ZONES RULE FOR PUERTO RICO.

(a) In General.–Subsection (b) of section 1400Z-1 is amended by
adding at the end the following new paragraph:
“(3) <<NOTE: Certification. Effective date.>> Special rule
for puerto rico.–Each population census tract in Puerto Rico
that is a low- income community shall be deemed to be certified
and designated as a qualified opportunity zone, effective on the
date of the enactment of Public Law 115-97.”.

(b) Conforming Amendment.–Section 1400Z-1(d)(1) is amended by
inserting “and subsection (b)(3)” after “paragraph (2)”.
SEC. 41116. TAX HOME OF CERTAIN CITIZENS OR RESIDENTS OF THE
UNITED STATES LIVING ABROAD.

(a) In General.–Paragraph (3) of section 911(d) is amended by
inserting before the period at the end of the second sentence the
following: “, unless such individual is serving in an area designated
by the President of the United States by Executive order

[[Page 132 STAT. 162]]

as a combat zone for purposes of section 112 in support of the Armed
Forces of the United States”.
(b) <<NOTE: 26 USC 911 note.>> Effective Date.–The amendment made
by this section shall apply to taxable years beginning after December
31, 2017.
SEC. 41117. TREATMENT OF FOREIGN PERSONS FOR RETURNS RELATING TO
PAYMENTS MADE IN SETTLEMENT OF PAYMENT
CARD AND THIRD PARTY NETWORK
TRANSACTIONS.

(a) In General.–Section 6050W(d)(1)(B) <<NOTE: 26 USC 6050W.>> is
amended by adding at the end the following: “Notwithstanding the
preceding sentence, a person with only a foreign address shall not be
treated as a participating payee with respect to any payment settlement
entity solely because such person receives payments from such payment
settlement entity in dollars.”.

(b) <<NOTE: 26 USC 6050W note.>> Effective Date.–The amendment
made by this section shall apply to returns for calendar years beginning
after December 31, 2017.
SEC. 41118. REPEAL OF SHIFT IN TIME OF PAYMENT OF CORPORATE
ESTIMATED TAXES.

The Trade Preferences Extension Act of 2015 is amended by striking
section 803 <<NOTE: 26 USC 6655 note.>> (relating to time for payment
of corporate estimated taxes).
SEC. 41119. ENHANCEMENT OF CARBON DIOXIDE SEQUESTRATION CREDIT.

(a) In General.–Section 45Q is amended to read as follows:
“SEC. 45Q. CREDIT FOR CARBON OXIDE SEQUESTRATION.

“(a) General Rule.–For purposes of section 38, the carbon oxide
sequestration credit for any taxable year is an amount equal to the sum
of–
“(1) $20 per metric ton of qualified carbon oxide which
is–
“(A) captured by the taxpayer using carbon capture
equipment which is originally placed in service at a
qualified facility before the date of the enactment of
the Bipartisan Budget Act of 2018, and
“(B) disposed of by the taxpayer in secure
geological storage and not used by the taxpayer as
described in paragraph (2)(B),
“(2) $10 per metric ton of qualified carbon oxide which
is–
“(A) captured by the taxpayer using carbon capture
equipment which is originally placed in service at a
qualified facility before the date of the enactment of
the Bipartisan Budget Act of 2018, and
“(B)(i) used by the taxpayer as a tertiary
injectant in a qualified enhanced oil or natural gas
recovery project and disposed of by the taxpayer in
secure geological storage, or
“(ii) utilized by the taxpayer in a manner
described in subsection (f)(5),
“(3) <<NOTE: Time period.>> the applicable dollar amount
(as determined under subsection (b)(1)) per metric ton of
qualified carbon oxide which is–

[[Page 132 STAT. 163]]

“(A) captured by the taxpayer using carbon capture
equipment which is originally placed in service at a
qualified facility on or after the date of the enactment
of the Bipartisan Budget Act of 2018, during the 12-year
period beginning on the date the equipment was
originally placed in service, and
“(B) disposed of by the taxpayer in secure
geological storage and not used by the taxpayer as
described in paragraph (4)(B), and
“(4) the applicable dollar amount (as determined under
subsection (b)(1)) per metric ton of qualified carbon oxide
which is–
“(A) captured by the taxpayer using carbon capture
equipment which is originally placed in service at a
qualified facility on or after the date of the enactment
of the Bipartisan Budget Act of 2018, during the 12-year
period beginning on the date the equipment was
originally placed in service, and
“(B)(i) used by the taxpayer as a tertiary
injectant in a qualified enhanced oil or natural gas
recovery project and disposed of by the taxpayer in
secure geological storage, or
“(ii) utilized by the taxpayer in a manner
described in subsection (f)(5).

“(b) <<NOTE: Time periods.>> Applicable Dollar Amount; Additional
Equipment; Election.–
“(1) Applicable dollar amount.–
“(A) In general.–The applicable dollar amount
shall be an amount equal to–
“(i) for any taxable year beginning in a
calendar year after 2016 and before 2027–
“(I) for purposes of paragraph (3)
of subsection (a), the dollar amount
established by linear interpolation
between $22.66 and $50 for each calendar
year during such period, and
“(II) for purposes of paragraph (4)
of such subsection, the dollar amount
established by linear interpolation
between $12.83 and $35 for each calendar
year during such period, and
“(ii) for any taxable year beginning in a
calendar year after 2026–
“(I) for purposes of paragraph (3)
of subsection (a), an amount equal to
the product of $50 and the inflation
adjustment factor for such calendar year
determined under section 43(b)(3)(B) for
such calendar year, determined by
substituting `2025′ for `1990′, and
“(II) for purposes of paragraph (4)
of such subsection, an amount equal to
the product of $35 and the inflation
adjustment factor for such calendar year
determined under section 43(b)(3)(B) for
such calendar year, determined by
substituting `2025′ for `1990′.
“(B) Rounding.–The applicable dollar amount
determined under subparagraph (A) shall be rounded to
the nearest cent.

[[Page 132 STAT. 164]]

“(2) Installation of additional carbon capture equipment on
existing qualified facility.–In the case of a qualified
facility placed in service before the date of the enactment of
the Bipartisan Budget Act of 2018, for which additional carbon
capture equipment is placed in service on or after the date of
the enactment of such Act, the amount of qualified carbon oxide
which is captured by the taxpayer shall be equal to–
“(A) for purposes of paragraphs (1)(A) and (2)(A)
of subsection (a), the lesser of–
“(i) the total amount of qualified carbon
oxide captured at such facility for the taxable
year, or
“(ii) the total amount of the carbon dioxide
capture capacity of the carbon capture equipment
in service at such facility on the day before the
date of the enactment of the Bipartisan Budget Act
of 2018, and
“(B) for purposes of paragraphs (3)(A) and (4)(A)
of such subsection, an amount (not less than zero) equal
to the excess of–
“(i) the amount described in clause (i) of
subparagraph (A), over
“(ii) the amount described in clause (ii) of
such subparagraph.
“(3) Election.–For purposes of determining the carbon
oxide sequestration credit under this section, a taxpayer may
elect to have the dollar amounts applicable under paragraph (1)
or (2) of subsection (a) apply in lieu of the dollar amounts
applicable under paragraph (3) or (4) of such subsection for
each metric ton of qualified carbon oxide which is captured by
the taxpayer using carbon capture equipment which is originally
placed in service at a qualified facility on or after the date
of the enactment of the Bipartisan Budget Act of 2018.

“(c) <<NOTE: Definition.>> Qualified Carbon Oxide.–For purposes
of this section–
“(1) In general.–The term `qualified carbon oxide’ means–
“(A) any carbon dioxide which–
“(i) is captured from an industrial source by
carbon capture equipment which is originally
placed in service before the date of the enactment
of the Bipartisan Budget Act of 2018,
“(ii) would otherwise be released into the
atmosphere as industrial emission of greenhouse
gas or lead to such release, and
“(iii) is measured at the source of capture
and verified at the point of disposal, injection,
or utilization,
“(B) any carbon dioxide or other carbon oxide
which–
“(i) is captured from an industrial source by
carbon capture equipment which is originally
placed in service on or after the date of the
enactment of the Bipartisan Budget Act of 2018,
“(ii) would otherwise be released into the
atmosphere as industrial emission of greenhouse
gas or lead to such release, and
“(iii) is measured at the source of capture
and verified at the point of disposal, injection,
or utilization, or

[[Page 132 STAT. 165]]

“(C) in the case of a direct air capture facility,
any carbon dioxide which–
“(i) is captured directly from the ambient
air, and
“(ii) is measured at the source of capture
and verified at the point of disposal, injection,
or utilization.
“(2) <<NOTE: Definition.>> Recycled carbon oxide.–The
term `qualified carbon oxide’ includes the initial deposit of
captured carbon oxide used as a tertiary injectant. Such term
does not include carbon oxide that is recaptured, recycled, and
re-injected as part of the enhanced oil and natural gas recovery
process.

“(d) <<NOTE: Definition.>> Qualified Facility.–For purposes of
this section, the term `qualified facility’ means any industrial
facility or direct air capture facility–
“(1) the construction of which begins before January 1,
2024, and–
“(A) construction of carbon capture equipment
begins before such date, or
“(B) the original planning and design for such
facility includes installation of carbon capture
equipment, and
“(2) which captures–
“(A) in the case of a facility which emits not more
than 500,000 metric tons of carbon oxide into the
atmosphere during the taxable year, not less than 25,000
metric tons of qualified carbon oxide during the taxable
year which is utilized in a manner described in
subsection (f)(5),
“(B) in the case of an electricity generating
facility which is not described in subparagraph (A), not
less than 500,000 metric tons of qualified carbon oxide
during the taxable year, or
“(C) in the case of a direct air capture facility
or any facility not described in subparagraph (A) or
(B), not less than 100,000 metric tons of qualified
carbon oxide during the taxable year.

“(e) Definitions.–For purposes of this section–
“(1) Direct air capture facility.–
“(A) In general.–Subject to subparagraph (B), the
term `direct air capture facility’ means any facility
which uses carbon capture equipment to capture carbon
dioxide directly from the ambient air.
“(B) Exception.–The term `direct air capture
facility’ shall not include any facility which captures
carbon dioxide–
“(i) which is deliberately released from
naturally occurring subsurface springs, or
“(ii) using natural photosynthesis.
“(2) Qualified enhanced oil or natural gas recovery
project.–The term `qualified enhanced oil or natural gas
recovery project’ has the meaning given the term `qualified
enhanced oil recovery project’ by section 43(c)(2), by
substituting `crude oil or natural gas’ for `crude oil’ in
subparagraph (A)(i) thereof.
“(3) Tertiary injectant.–The term `tertiary injectant’ has
the same meaning as when used within section 193(b)(1).

“(f) Special Rules.–
“(1) Only qualified carbon oxide captured and disposed of
or used within the united states taken into

[[Page 132 STAT. 166]]

account.– <<NOTE: Applicability.>> The credit under this
section shall apply only with respect to qualified carbon oxide
the capture and disposal, use, or utilization of which is
within–
“(A) the United States (within the meaning of
section 638(1)), or
“(B) a possession of the United States (within the
meaning of section 638(2)).
“(2) <<NOTE: Consultation.>> Secure geological storage.–
The Secretary, in consultation with the Administrator of the
Environmental Protection Agency, the Secretary of Energy, and
the Secretary of the Interior, shall establish regulations for
determining adequate security measures for the geological
storage of qualified carbon oxide under subsection (a) such that
the qualified carbon oxide does not escape into the atmosphere.
Such term shall include storage at deep saline formations, oil
and gas reservoirs, and unminable coal seams under such
conditions as the Secretary may determine under such
regulations.
“(3) Credit attributable to taxpayer.–
“(A) In general.–Except as provided in
subparagraph (B) or in any regulations prescribed by the
Secretary, any credit under this section shall be
attributable to–
“(i) in the case of qualified carbon oxide
captured using carbon capture equipment which is
originally placed in service at a qualified
facility before the date of the enactment of the
Bipartisan Budget Act of 2018, the person that
captures and physically or contractually ensures
the disposal, utilization, or use as a tertiary
injectant of such qualified carbon oxide, and
“(ii) in the case of qualified carbon oxide
captured using carbon capture equipment which is
originally placed in service at a qualified
facility on or after the date of the enactment of
the Bipartisan Budget Act of 2018, the person that
owns the carbon capture equipment and physically
or contractually ensures the capture and disposal,
utilization, or use as a tertiary injectant of
such qualified carbon oxide.
“(B) Election.–If the person described in
subparagraph (A) makes an election under this
subparagraph in such time and manner as the Secretary
may prescribe by regulations, the credit under this
section–
“(i) shall be allowable to the person that
disposes of the qualified carbon oxide, utilizes
the qualified carbon oxide, or uses the qualified
carbon oxide as a tertiary injectant, and
“(ii) shall not be allowable to the person
described in subparagraph (A).
“(4) Recapture.–The Secretary shall, by regulations,
provide for recapturing the benefit of any credit allowable
under subsection (a) with respect to any qualified carbon oxide
which ceases to be captured, disposed of, or used as a tertiary
injectant in a manner consistent with the requirements of this
section.
“(5) Utilization of qualified carbon oxide.–
“(A) <<NOTE: Definition.>> In general.–For
purposes of this section, utilization of qualified
carbon oxide means–
“(i) the fixation of such qualified carbon
oxide through photosynthesis or chemosynthesis,
such as through the growing of algae or bacteria,

[[Page 132 STAT. 167]]

“(ii) the chemical conversion of such
qualified carbon oxide to a material or chemical
compound in which such qualified carbon oxide is
securely stored, or
“(iii) the use of such qualified carbon oxide
for any other purpose for which a commercial
market exists (with the exception of use as a
tertiary injectant in a qualified enhanced oil or
natural gas recovery project), as determined by
the Secretary.
“(B) Measurement.–
“(i) <<NOTE: Determination. Consultation.>>
In general.–For purposes of determining the
amount of qualified carbon oxide utilized by the
taxpayer under paragraph (2)(B)(ii) or (4)(B)(ii)
of subsection (a), such amount shall be equal to
the metric tons of qualified carbon oxide which
the taxpayer demonstrates, based upon an analysis
of lifecycle greenhouse gas emissions and subject
to such requirements as the Secretary, in
consultation with the Secretary of Energy and the
Administrator of the Environmental Protection
Agency, determines appropriate, were–
“(I) captured and permanently
isolated from the atmosphere, or
“(II) displaced from being emitted
into the atmosphere,
through use of a process described in subparagraph
(A).
“(ii) <<NOTE: Definition.>> Lifecycle
greenhouse gas emissions.–For purposes of clause
(i), the term `lifecycle greenhouse gas emissions’
has the same meaning given such term under
subparagraph (H) of section 211(o)(1) of the Clean
Air Act (42 U.S.C. 7545(o)(1)), as in effect on
the date of the enactment of the Bipartisan Budget
Act of 2018, except that `product’ shall be
substituted for `fuel’ each place it appears in
such subparagraph.
“(6) Election for applicable facilities.–
“(A) In general.–For purposes of this section, in
the case of an applicable facility, for any taxable year
in which such facility captures not less than 500,000
metric tons of qualified carbon oxide during the taxable
year, the person described in paragraph (3)(A)(ii) may
elect to have such facility, and any carbon capture
equipment placed in service at such facility, deemed as
having been placed in service on the date of the
enactment of the Bipartisan Budget Act of 2018.
“(B) <<NOTE: Definition.>> Applicable facility.–
For purposes of this paragraph, the term `applicable
facility’ means a qualified facility–
“(i) which was placed in service before the
date of the enactment of the Bipartisan Budget Act
of 2018, and
“(ii) for which no taxpayer claimed a credit
under this section in regards to such facility for
any taxable year ending before the date of the
enactment of such Act.
“(7) Inflation adjustment.–In the case of any taxable year
beginning in a calendar year after 2009, there shall be
substituted for each dollar amount contained in paragraphs

[[Page 132 STAT. 168]]

(1) and (2) of subsection (a) an amount equal to the product
of–
“(A) such dollar amount, multiplied by
“(B) the inflation adjustment factor for such
calendar year determined under section 43(b)(3)(B) for
such calendar year, determined by substituting `2008′
for `1990′.

“(g) Application of Section for Certain Carbon Capture Equipment.–
<<NOTE: Consultation. Certification. Time period.>> In the case of any
carbon capture equipment placed in service before the date of the
enactment of the Bipartisan Budget Act of 2018, the credit under this
section shall apply with respect to qualified carbon oxide captured
using such equipment before the end of the calendar year in which the
Secretary, in consultation with the Administrator of the Environmental
Protection Agency, certifies that, during the period beginning after
October 3, 2008, a total of 75,000,000 metric tons of qualified carbon
oxide have been taken into account in accordance with–
“(1) subsection (a) of this section, as in effect on the
day before the date of the enactment of the Bipartisan Budget
Act of 2018, and
“(2) paragraphs (1) and (2) of subsection (a) of this
section.

“(h) Regulations.–The Secretary may prescribe such regulations and
other guidance as may be necessary or appropriate to carry out this
section, including regulations or other guidance to–
“(1) ensure proper allocation under subsection (a) for
qualified carbon oxide captured by a taxpayer during the taxable
year ending after the date of the enactment of the Bipartisan
Budget Act of 2018, and
“(2) <<NOTE: Determination.>> determine whether a facility
satisfies the requirements under subsection (d)(1) during such
taxable year.”.

(b) Effective Date.– <<NOTE: Applicability. 26 USC 45Q note.>> The
amendment made by this section shall apply to taxable years beginning
after December 31, 2017.

DIVISION E– <<NOTE: Advancing Chronic Care, Extenders, and Social
Services (ACCESS) Act.>> HEALTH AND HUMAN SERVICES EXTENDERS
SEC. 50100. SHORT TITLE; TABLE OF CONTENTS.

(a) <<NOTE: 42 USC 1305 note.>> Short Title.–This division may be
cited as the “Advancing Chronic Care, Extenders, and Social Services
(ACCESS) Act”

(b) Table of Contents.–The table of contents for this division is
as follows:

DIVISION E–HEALTH AND HUMAN SERVICES EXTENDERS

Sec. 50100. Short title; table of contents.

TITLE I–CHIP

Sec. 50101. Funding extension of the Children’s Health Insurance Program
through fiscal year 2027.
Sec. 50102. Extension of pediatric quality measures program.
Sec. 50103. Extension of outreach and enrollment program.

TITLE II–MEDICARE EXTENDERS

Sec. 50201. Extension of work GPCI floor.
Sec. 50202. Repeal of Medicare payment cap for therapy services;
limitation to ensure appropriate therapy.
Sec. 50203. Medicare ambulance services.
Sec. 50204. Extension of increased inpatient hospital payment adjustment
for certain low-volume hospitals.
Sec. 50205. Extension of the Medicare-dependent hospital (MDH) program.
Sec. 50206. Extension of funding for quality measure endorsement, input,
and selection; reporting requirements.

[[Page 132 STAT. 169]]

Sec. 50207. Extension of funding outreach and assistance for low-income
programs; State health insurance assistance program reporting
requirements.
Sec. 50208. Extension of home health rural add-on.

TITLE III–CREATING HIGH-QUALITY RESULTS AND OUTCOMES NECESSARY TO
IMPROVE CHRONIC (CHRONIC) CARE

Subtitle A–Receiving High Quality Care in the Home

Sec. 50301. Extending the Independence at Home Demonstration Program.
Sec. 50302. Expanding access to home dialysis therapy.

Subtitle B–Advancing Team-Based Care

Sec. 50311. Providing continued access to Medicare Advantage special
needs plans for vulnerable populations.

Subtitle C–Expanding Innovation and Technology

Sec. 50321. Adapting benefits to meet the needs of chronically ill
Medicare Advantage enrollees.
Sec. 50322. Expanding supplemental benefits to meet the needs of
chronically ill Medicare Advantage enrollees.
Sec. 50323. Increasing convenience for Medicare Advantage enrollees
through telehealth.
Sec. 50324. Providing accountable care organizations the ability to
expand the use of telehealth.
Sec. 50325. Expanding the use of telehealth for individuals with stroke.

Subtitle D–Identifying the Chronically Ill Population

Sec. 50331. Providing flexibility for beneficiaries to be part of an
accountable care organization.

Subtitle E–Empowering Individuals and Caregivers in Care Delivery

Sec. 50341. Eliminating barriers to care coordination under accountable
care organizations.
Sec. 50342. GAO study and report on longitudinal comprehensive care
planning services under Medicare part B.

Subtitle F–Other Policies to Improve Care for the Chronically Ill

Sec. 50351. GAO study and report on improving medication
synchronization.
Sec. 50352. GAO study and report on impact of obesity drugs on patient
health and spending.
Sec. 50353. HHS study and report on long-term risk factors for chronic
conditions among Medicare beneficiaries.
Sec. 50354. Providing prescription drug plans with parts A and B claims
data to promote the appropriate use of medications and
improve health outcomes.

TITLE IV–PART B IMPROVEMENT ACT AND OTHER PART B ENHANCEMENTS

Subtitle A–Medicare Part B Improvement Act

Sec. 50401. Home infusion therapy services temporary transitional
payment.
Sec. 50402. Orthotist’s and prosthetist’s clinical notes as part of the
patient’s medical record.
Sec. 50403. Independent accreditation for dialysis facilities and
assurance of high quality surveys.
Sec. 50404. Modernizing the application of the Stark rule under
Medicare.

Subtitle B–Additional Medicare Provisions

Sec. 50411. Making permanent the removal of the rental cap for durable
medical equipment under Medicare with respect to speech
generating devices.
Sec. 50412. Increased civil and criminal penalties and increased
sentences for Federal health care program fraud and abuse.
Sec. 50413. Reducing the volume of future EHR-related significant
hardship requests.
Sec. 50414. Strengthening rules in case of competition for diabetic
testing strips.

TITLE V–OTHER HEALTH EXTENDERS

Sec. 50501. Extension for family-to-family health information centers.
Sec. 50502. Extension for sexual risk avoidance education.

[[Page 132 STAT. 170]]

Sec. 50503. Extension for personal responsibility education.

TITLE VI–CHILD AND FAMILY SERVICES AND SUPPORTS EXTENDERS

Subtitle A–Continuing the Maternal, Infant, and Early Childhood Home
Visiting Program

Sec. 50601. Continuing evidence-based home visiting program.
Sec. 50602. Continuing to demonstrate results to help families.
Sec. 50603. Reviewing statewide needs to target resources.
Sec. 50604. Improving the likelihood of success in high-risk
communities.
Sec. 50605. Option to fund evidence-based home visiting on a pay for
outcome basis.
Sec. 50606. Data exchange standards for improved interoperability.
Sec. 50607. Allocation of funds.

Subtitle B–Extension of Health Professions Workforce Demonstration
Projects

Sec. 50611. Extension of health workforce demonstration projects for
low-income individuals.

TITLE VII–FAMILY FIRST PREVENTION SERVICES ACT

Subtitle A–Investing in Prevention and Supporting Families

Sec. 50701. Short title.
Sec. 50702. Purpose.

PART I–Prevention Activities Under Title IV-E

Sec. 50711. Foster care prevention services and programs.
Sec. 50712. Foster care maintenance payments for children with parents
in a licensed residential family-based treatment facility for
substance abuse.
Sec. 50713. Title IV-E payments for evidence-based kinship navigator
programs.

PART II–Enhanced Support Under Title IV-B

Sec. 50721. Elimination of time limit for family reunification services
while in foster care and permitting time-limited family
reunification services when a child returns home from foster
care.
Sec. 50722. Reducing bureaucracy and unnecessary delays when placing
children in homes across State lines.
Sec. 50723. Enhancements to grants to improve well-being of families
affected by substance abuse.

PART III–Miscellaneous

Sec. 50731. Reviewing and improving licensing standards for placement in
a relative foster family home.
Sec. 50732. Development of a statewide plan to prevent child abuse and
neglect fatalities.
Sec. 50733. Modernizing the title and purpose of title IV-E.
Sec. 50734. Effective dates.

PART IV–Ensuring the Necessity of a Placement That Is Not in a Foster
Family Home

Sec. 50741. Limitation on Federal financial participation for placements
that are not in foster family homes.
Sec. 50742. Assessment and documentation of the need for placement in a
qualified residential treatment program.
Sec. 50743. Protocols to prevent inappropriate diagnoses.
Sec. 50744. Additional data and reports regarding children placed in a
setting that is not a foster family home.
Sec. 50745. Criminal records checks and checks of child abuse and
neglect registries for adults working in child-care
institutions and other group care settings.
Sec. 50746. Effective dates; application to waivers.

PART V–Continuing Support for Child and Family Services

Sec. 50751. Supporting and retaining foster families for children.
Sec. 50752. Extension of child and family services programs.
Sec. 50753. Improvements to the John H. Chafee foster care independence
program and related provisions.

PART VI–Continuing Incentives to States to Promote Adoption and Legal
Guardianship

Sec. 50761. Reauthorizing adoption and legal guardianship incentive
programs.

[[Page 132 STAT. 171]]

PART VII–Technical Corrections

Sec. 50771. Technical corrections to data exchange standards to improve
program coordination.
Sec. 50772. Technical corrections to State requirement to address the
developmental needs of young children.

PART VIII–Ensuring States Reinvest Savings Resulting From Increase in
Adoption Assistance

Sec. 50781. Delay of adoption assistance phase-in.
Sec. 50782. GAO study and report on State reinvestment of savings
resulting from increase in adoption assistance.

TITLE VIII–SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RESULTS

Sec. 50801. Short title.
Sec. 50802. Social impact partnerships to pay for results.

TITLE IX–PUBLIC HEALTH PROGRAMS

Sec. 50901. Extension for community health centers, the National Health
Service Corps, and teaching health centers that operate GME
programs.
Sec. 50902. Extension for special diabetes programs.

TITLE X–MISCELLANEOUS HEALTH CARE POLICIES

Sec. 51001. Home health payment reform.
Sec. 51002. Information to satisfy documentation of Medicare eligibility
for home health services.
Sec. 51003. Technical amendments to Public Law 114-10.
Sec. 51004. Expanded access to Medicare intensive cardiac rehabilitation
programs.
Sec. 51005. Extension of blended site neutral payment rate for certain
long-term care hospital discharges; temporary adjustment to
site neutral payment rates.
Sec. 51006. Recognition of attending physician assistants as attending
physicians to serve hospice patients.
Sec. 51007. Extension of enforcement instruction on supervision
requirements for outpatient therapeutic services in critical
access and small rural hospitals through 2017.
Sec. 51008. Allowing physician assistants, nurse practitioners, and
clinical nurse specialists to supervise cardiac, intensive
cardiac, and pulmonary rehabilitation programs.
Sec. 51009. Transitional payment rules for certain radiation therapy
services under the physician fee schedule.

TITLE XI–PROTECTING SENIORS’ ACCESS TO MEDICARE ACT

Sec. 52001. Repeal of the Independent Payment Advisory Board.

TITLE XII–OFFSETS

Sec. 53101. Modifying reductions in Medicaid DSH allotments.
Sec. 53102. Third party liability in Medicaid and CHIP.
Sec. 53103. Treatment of lottery winnings and other lump-sum income for
purposes of income eligibility under Medicaid.
Sec. 53104. Rebate obligation with respect to line extension drugs.
Sec. 53105. Medicaid Improvement Fund.
Sec. 53106. Physician fee schedule update.
Sec. 53107. Payment for outpatient physical therapy services and
outpatient occupational therapy services furnished by a
therapy assistant.
Sec. 53108. Reduction for non-emergency ESRD ambulance transports.
Sec. 53109. Hospital transfer policy for early discharges to hospice
care.
Sec. 53110. Medicare payment update for home health services.
Sec. 53111. Medicare payment update for skilled nursing facilities.
Sec. 53112. Preventing the artificial inflation of star ratings after
the consolidation of Medicare Advantage plans offered by the
same organization.
Sec. 53113. Sunsetting exclusion of biosimilars from Medicare part D
coverage gap discount program.
Sec. 53114. Adjustments to Medicare part B and part D premium subsidies
for higher income individuals.
Sec. 53115. Medicare Improvement Fund.
Sec. 53116. Closing the Donut Hole for Seniors.
Sec. 53117. Modernizing child support enforcement fees.
Sec. 53118. Increasing efficiency of prison data reporting.
Sec. 53119. Prevention and Public Health Fund.

[[Page 132 STAT. 172]]

TITLE I–CHIP

SEC. 50101. FUNDING EXTENSION OF THE CHILDREN’S HEALTH INSURANCE
PROGRAM THROUGH FISCAL YEAR 2027.

(a) In General.–Section 2104(a) of the Social Security Act (42
U.S.C. 1397dd(a)), as amended by section 3002(a) of the HEALTHY KIDS Act
(division C of Public Law 115-120), is amended–
(1) in paragraph (25), by striking “; and” and inserting a
semicolon;
(2) in paragraph (26), by striking the period at the end and
inserting a semicolon; and
(3) by adding at the end the following new paragraphs:
“(27) for each of fiscal years 2024 through 2026, such sums
as are necessary to fund allotments to States under subsections
(c) and (m); and
“(28) for fiscal year 2027, for purposes of making two
semi-annual allotments–
“(A) $7,650,000,000 for the period beginning on
October 1, 2026, and ending on March 31, 2027; and
“(B) $7,650,000,000 for the period beginning on
April 1, 2027, and ending on September 30, 2027.”.

(b) Allotments.–
(1) In general.–Section 2104(m) of the Social Security Act
(42 U.S.C. 1397dd(m)), as amended by section 3002(b) of the
HEALTHY KIDS Act (division C of Public Law 115-120), is
amended–
(A) in paragraph (2)(B)–
(i) in the matter preceding clause (i), by
striking “(25)” and inserting “(27)”;
(ii) in clause (i), by striking “and 2023”
and inserting “, 2023, and 2027”; and
(iii) in clause (ii)(I), by striking “(or, in
the case of fiscal year 2018, under paragraph
(4))” and inserting “(or, in the case of fiscal
year 2018 or 2024, under paragraph (4) or (10),
respectively)”;
(B) in paragraph (5)–
(i) by striking “or (10)” and inserting
“(10), or (11)”; and
(ii) by striking “or 2023,” and inserting
“2023, or 2027,”;
(C) in paragraph (7)–
(i) in subparagraph (A), by striking “2023”
and inserting “2027,”; and
(ii) in the matter following subparagraph (B),
by striking “or fiscal year 2022” and inserting
“fiscal year 2022, fiscal year 2024, or fiscal
year 2026”;
(D) in paragraph (9)–
(i) by striking “or (10)” and inserting
“(10), or (11)”; and
(ii) by striking “or 2023,” and inserting
“2023, or 2027,”; and
(E) by adding at the end the following:
“(11) <<NOTE: Computations. States.>> For fiscal year
2027.–
“(A) First half.–Subject to paragraphs (5) and
(7), from the amount made available under subparagraph
(A)

[[Page 132 STAT. 173]]

of paragraph (28) of subsection (a) for the semi-annual
period described in such subparagraph, increased by the
amount of the appropriation for such period under
section 50101(b)(2) of the Advancing Chronic Care,
Extenders, and Social Services Act, the Secretary shall
compute a State allotment for each State (including the
District of Columbia and each commonwealth and
territory) for such semi-annual period in an amount
equal to the first half ratio (described in subparagraph
(D)) of the amount described in subparagraph (C).
“(B) Second half.–Subject to paragraphs (5) and
(7), from the amount made available under subparagraph
(B) of paragraph (28) of subsection (a) for the semi-
annual period described in such subparagraph, the
Secretary shall compute a State allotment for each State
(including the District of Columbia and each
commonwealth and territory) for such semi-annual period
in an amount equal to the amount made available under
such subparagraph, multiplied by the ratio of–
“(i) the amount of the allotment to such
State under subparagraph (A); to
“(ii) the total of the amount of all of the
allotments made available under such subparagraph.
“(C) Full year amount based on rebased amount.–The
amount described in this subparagraph for a State is
equal to the Federal payments to the State that are
attributable to (and countable towards) the total amount
of allotments available under this section to the State
in fiscal year 2026 (including payments made to the
State under subsection (n) for fiscal year 2026 as well
as amounts redistributed to the State in fiscal year
2026), multiplied by the allotment increase factor under
paragraph (6) for fiscal year 2027.
“(D) First half ratio.–The first half ratio
described in this subparagraph is the ratio of–
“(i) the sum of–
“(I) the amount made available
under subsection (a)(28)(A); and
“(II) the amount of the
appropriation for such period under
section 50101(b)(2) of the Advancing
Chronic Care, Extenders, and Social
Services Act; to
“(ii) the sum of–
“(I) the amount described in clause
(i); and
“(II) the amount made available
under subsection (a)(28)(B).”.
(2) One-time appropriation for fiscal year 2027.–There is
appropriated to the Secretary of Health and Human Services, out
of any money in the Treasury not otherwise appropriated, such
sums as are necessary to fund allotments to States under
subsections (c) and (m) of section 2104 of the Social Security
Act (42 U.S.C. 1397dd) for fiscal year 2027, taking into account
the full year amounts calculated for States under paragraph
(11)(C) of subsection (m) of such section (as added by paragraph
(1)) and the amounts appropriated under subparagraphs (A) and
(B) of subsection (a)(28) of such section (as added by
subsection (a)). Such amount shall accompany the allotment

[[Page 132 STAT. 174]]

made for the period beginning on October 1, 2026, and ending on
March 31, 2027, under paragraph (28)(A) of section 2104(a) of
such Act (42 U.S.C. 1397dd(a)), to remain available until
expended. Such amount shall be used to provide allotments to
States under paragraph (11) of section 2104(m) of such Act for
the first 6 months of fiscal year 2027 in the same manner as
allotments are provided under subsection (a)(28)(A) of such
section 2104 and subject to the same terms and conditions as
apply to the allotments provided from such subsection
(a)(28)(A).

(c) Extension of the Child Enrollment Contingency Fund.–Section
2104(n) of the Social Security Act (42 U.S.C. 1397dd(n)), as amended by
section 3002(c) of the HEALTHY KIDS Act (division C of Public Law 115-
120), is amended–
(1) in paragraph (2)–
(A) in subparagraph (A)(ii)–
(i) by striking “and 2018 through 2022” and
inserting “2018 through 2022, and 2024 through
2026”; and
(ii) by striking “and 2023” and inserting
“2023, and 2027”; and
(B) in subparagraph (B)–
(i) by striking “and 2018 through 2022” and
inserting “2018 through 2022, and 2024 through
2026”; and
(ii) by striking “and 2023” and inserting
“2023, and 2027”; and
(2) in paragraph (3)(A), in the matter preceding clause
(i)–
(A) by striking “or in any of fiscal years 2018
through 2022” and inserting “fiscal years 2018 through
2022, or fiscal years 2024 through 2026”; and
(B) by striking “or 2023” and inserting “2023, or
2027”.

(d) Extension of Qualifying States Option.–Section 2105(g)(4) of
the Social Security Act (42 U.S.C. 1397ee(g)(4)), as amended by section
3002(d) of the HEALTHY KIDS Act (division C of Public Law 115-120), is
amended–
(1) in the paragraph heading, by striking “through 2023”
and inserting “through 2027”; and
(2) in subparagraph (A), by striking “2023” and inserting
“2027”.

(e) Extension of Express Lane Eligibility Option.–Section
1902(e)(13)(I) of the Social Security Act (42 U.S.C. 1396a(e)(13)(I)),
as amended by section 3002(e) of the HEALTHY KIDS Act (division C of
Public Law 115-120), is amended by striking “2023” and inserting
“2027”.
(f) Assurance of Eligibility Standard for Children and Families.–
(1) In general.–Section 2105(d)(3) of the Social Security
Act (42 U.S.C. 1397ee(d)(3)), as amended by section 3002(f)(1)
of the HEALTHY KIDS Act (division C of Public Law 115-120), is
amended–
(A) in the paragraph heading, by striking “through
september 30, 2023” and inserting “through september
30, 2027”; and

[[Page 132 STAT. 175]]

(B) in subparagraph (A), in the matter preceding
clause (i), by striking “2023” each place it appears
and inserting “2027”.
(2) Conforming amendments.–Section 1902(gg)(2) of the
Social Security Act (42 U.S.C. 1396a(gg)(2)), as amended by
section 3002(f)(2) of the HEALTHY KIDS Act (division C of Public
Law 115-120), is amended–
(A) in the paragraph heading, by striking “through
september 30, 2023” and inserting “through september
30, 2027”; and
(B) by striking “2023,” each place it appears and
inserting “2027”.
SEC. 50102. EXTENSION OF PEDIATRIC QUALITY MEASURES PROGRAM.

(a) In General.–Section 1139A(i)(1) of the Social Security Act (42
U.S.C. 1320b-9a(i)(1)), as amended by section 3003(b) of the HEALTHY
KIDS Act (division C of Public Law 115-120), is amended–
(1) in subparagraph (B), by striking “; and” and inserting
a semicolon;
(2) in subparagraph (C), by striking the period at the end
and inserting “; and”; and
(3) by adding at the end the following new subparagraph:
“(D) <<NOTE: Time period.>> for the period of
fiscal years 2024 through 2027, $60,000,000 for the
purpose of carrying out this section (other than
subsections (e), (f), and (g)).”.

(b) Making Reporting Mandatory.–Section 1139A of the Social
Security Act (42 U.S.C. 1320b-9a) is amended–
(1) in subsection (a)–
(A) in the heading for paragraph (4), by inserting
“and mandatory reporting” after “reporting”;
(B) in paragraph (4)–
(i) by striking “Not later than” and
inserting the following:
“(A) Voluntary reporting.–Not later than”; and
(ii) by adding at the end the following:
“(B) <<NOTE: Effective dates.>> Mandatory
reporting.–Beginning with the annual State report on
fiscal year 2024 required under subsection (c)(1), the
Secretary shall require States to use the initial core
measurement set and any updates or changes to that set
to report information regarding the quality of pediatric
health care under titles XIX and XXI using the
standardized format for reporting information and
procedures developed under subparagraph (A).”; and
(C) in paragraph (6)(B), by inserting “and,
beginning with the report required on January 1, 2025,
and for each annual report thereafter, the status of
mandatory reporting by States under titles XIX and XXI,
utilizing the initial core quality measurement set and
any updates or changes to that set” before the
semicolon; and
(2) <<NOTE: Effective date.>> in subsection (c)(1)(A), by
inserting “and, beginning with the annual report on fiscal year
2024, all of the core measures described in subsection (a) and
any updates or changes to those measures” before the semicolon.

[[Page 132 STAT. 176]]

SEC. 50103. <<NOTE: Time periods.>> EXTENSION OF OUTREACH AND
ENROLLMENT PROGRAM.

(a) In General.–Section 2113 of the Social Security Act (42 U.S.C.
1397mm), as amended by section 3004(a) of the HEALTHY KIDS Act (division
C of Public Law 115-120), is amended–
(1) in subsection (a)(1), by striking “2023” and inserting
“2027”; and
(2) in subsection (g)–
(A) by striking “and $120,000,000” and inserting
“, $120,000,000”; and
(B) by inserting “, and $48,000,000 for the period
of fiscal years 2024 through 2027” after “2023”.

(b) Additional Reserved Funds.–Section 2113(a) of the Social
Security Act (42 U.S.C. 1397mm(a)) is amended–
(1) in paragraph (1), by striking “paragraph (2)” and
inserting “paragraphs (2) and (3)”; and
(2) by adding at the end the following new paragraph:
“(3) Ten percent set aside for evaluating and providing
technical assistance to grantees.–For the period of fiscal
years 2024 through 2027, an amount equal to 10 percent of such
amounts shall be used by the Secretary for the purpose of
evaluating and providing technical assistance to eligible
entities awarded grants under this section.”.

(c) Use of Reserved Funds for National Enrollment and Retention
Strategies.–Section 2113(h) of the Social Security Act (42 U.S.C.
1397mm(h)) is amended–
(1) in paragraph (5), by striking “; and” and inserting a
semicolon;
(2) by redesignating paragraph (6) as paragraph (7); and
(3) by inserting after paragraph (5) the following new
paragraph:
“(6) the development of materials and toolkits and the
provision of technical assistance to States regarding enrollment
and retention strategies for eligible children under this title
and title XIX; and”.

TITLE II–MEDICARE EXTENDERS

SEC. 50201. EXTENSION OF WORK GPCI FLOOR.

Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w-
4(e)(1)(E)) is amended by striking “January 1, 2018” and inserting
“January 1, 2020”.
SEC. 50202. REPEAL OF MEDICARE PAYMENT CAP FOR THERAPY SERVICES;
LIMITATION TO ENSURE APPROPRIATE
THERAPY.

Section 1833(g) of the Social Security Act (42 U.S.C. 1395l(g)) is
amended–
(1) in paragraph (1)–
(A) by striking “Subject to paragraphs (4) and
(5)” and inserting “(A) Subject to paragraphs (4) and
(5)”;
(B) in the subparagraph (A), as inserted and
designated by subparagraph (A) of this paragraph, by
adding at the end the following new sentence: “The
preceding sentence shall not apply to expenses incurred
with respect to services furnished after December 31,
2017.”; and
(C) by adding at the end the following new
subparagraph:

[[Page 132 STAT. 177]]

“(B) With respect to services furnished during 2018 or a subsequent
year, in the case of physical therapy services of the type described in
section 1861(p), speech-language pathology services of the type
described in such section through the application of section
1861(ll)(2), and physical therapy services and speech-language pathology
services of such type which are furnished by a physician or as incident
to physicians’ services, with respect to expenses incurred in any
calendar year, any amount that is more than the amount specified in
paragraph (2) for the year shall not be considered as incurred expenses
for purposes of subsections (a) and (b) unless the applicable
requirements of paragraph (7) are met.”;
(2) in paragraph (3)–
(A) by striking “Subject to paragraphs (4) and
(5)” and inserting “(A) Subject to paragraphs (4) and
(5)”;
(B) in the subparagraph (A), as inserted and
designated by subparagraph (A) of this paragraph, by
adding at the end the following new sentence: “The
preceding sentence shall not apply to expenses incurred
with respect to services furnished after December 31,
2017.”; and
(C) by adding at the end the following new
subparagraph:.

“(B) With respect to services furnished during 2018 or a subsequent
year, in the case of occupational therapy services (of the type that are
described in section 1861(p) through the operation of section 1861(g)
and of such type which are furnished by a physician or as incident to
physicians’ services), with respect to expenses incurred in any calendar
year, any amount that is more than the amount specified in paragraph (2)
for the year shall not be considered as incurred expenses for purposes
of subsections (a) and (b) unless the applicable requirements of
paragraph (7) are met.”;
(3) in paragraph (5)–
(A) by redesignating subparagraph (D) as paragraph
(8) and moving such paragraph to immediately follow
paragraph (7), as added by paragraph (4) of this
section; and
(B) in subparagraph (E)(iv), by inserting “, except
as such process is applied under paragraph (7)(B)”
before the period at the end; and
(4) by adding at the end the following new paragraph:

“(7) For purposes of paragraphs (1)(B) and (3)(B), with respect to
services described in such paragraphs, the requirements described in
this paragraph are as follows:
“(A) Inclusion of appropriate modifier.–The claim for such
services contains an appropriate modifier (such as the KX
modifier described in paragraph (5)(B)) indicating that such
services are medically necessary as justified by appropriate
documentation in the medical record involved.
“(B) Targeted medical review for certain services above
threshold.–
“(i) In general.–In the case where expenses that
would be incurred for such services would exceed the
threshold described in clause (ii) for the year, such
services shall be subject to the process for medical
review implemented under paragraph (5)(E).
“(ii) Threshold.–The threshold under this clause
for–

[[Page 132 STAT. 178]]

“(I) a year before 2028, is $3,000;
“(II) 2028, is the amount specified in
subclause (I) increased by the percentage increase
in the MEI (as defined in section 1842(i)(3)) for
2028; and
“(III) a subsequent year, is the amount
specified in this clause for the preceding year
increased by the percentage increase in the MEI
(as defined in section 1842(i)(3)) for such
subsequent year;
except that if an increase under subclause (II) or (III)
for a year is not a multiple of $10, it shall be rounded
to the nearest multiple of $10.
“(iii) Application.–The threshold under clause
(ii) shall be applied separately–
“(I) for physical therapy services and
speech-language pathology services; and
“(II) for occupational therapy services.
“(iv) <<NOTE: Time period.>> Funding.–For
purposes of carrying out this subparagraph, the
Secretary shall provide for the transfer, from the
Federal Supplementary Medical Insurance Trust Fund under
section 1841 to the Centers for Medicare & Medicaid
Services Program Management Account, of $5,000,000 for
each fiscal year beginning with fiscal year 2018, to
remain available until expended. Such funds may not be
used by a contractor under section 1893(h) for medical
reviews under this subparagraph.”.
SEC. 50203. MEDICARE AMBULANCE SERVICES.

(a) Extension of Certain Ground Ambulance Add-on Payments.–
(1) Ground ambulance.–Section 1834(l)(13)(A) of the Social
Security Act (42 U.S.C. 1395m(l)(13)(A)) is amended by striking
“2018” and inserting “2023” each place it appears.
(2) Super rural ambulance.–Section 1834(l)(12)(A) of the
Social Security Act (42 U.S.C. 1395m(l)(12)(A)) is amended, in
the first sentence, by striking “2018” and inserting “2023”.

(b) Requiring Ground Ambulance Providers of Services and Suppliers
to Submit Cost and Other Information.–Section 1834(l) of the Social
Security Act (42 U.S.C. 1395m(l)) is amended by adding at the end the
following new paragraph:
“(17) Submission of cost and other information.–
“(A) Development of data collection system.–The
Secretary shall develop a data collection system (which
may include use of a cost survey) to collect cost,
revenue, utilization, and other information determined
appropriate by the Secretary with respect to providers
of services (in this paragraph referred to as
`providers’) and suppliers of ground ambulance services.
Such system shall be designed to collect information–
“(i) <<NOTE: Evaluation.>> needed to
evaluate the extent to which reported costs relate
to payment rates under this subsection;
“(ii) on the utilization of capital equipment
and ambulance capacity, including information
consistent with the type of information described
in section 1121(a); and
“(iii) on different types of ground ambulance
services furnished in different geographic
locations,

[[Page 132 STAT. 179]]

including rural areas and low population density
areas described in paragraph (12).
“(B) Specification of data collection system.–
“(i) In general.–The Secretary shall–
“(I) <<NOTE: Deadline.>> not later
than December 31, 2019, specify the data
collection system under subparagraph
(A); and
“(II) identify the providers and
suppliers of ground ambulance services
that would be required to submit
information under such data collection
system, including the representative
sample described in clause (ii).
“(ii) Determination of representative
sample.–
“(I) <<NOTE: Deadlines.>> In
general.–Not later than December 31,
2019, with respect to the data
collection for the first year under such
system, and for each subsequent year
through 2024, the Secretary shall
determine a representative sample to
submit information under the data
collection system.
“(II) Requirements.–The sample
under subclause (I) shall be
representative of the different types of
providers and suppliers of ground
ambulance services (such as those
providers and suppliers that are part of
an emergency service or part of a
government organization) and the
geographic locations in which ground
ambulance services are furnished (such
as urban, rural, and low population
density areas).
“(III) Limitation.–The Secretary
shall not include an individual provider
or supplier of ground ambulance services
in the sample under subclause (I) in 2
consecutive years, to the extent
practicable.
“(C) Reporting of cost information.–For each year,
a provider or supplier of ground ambulance services
identified by the Secretary under subparagraph
(B)(i)(II) as being required to submit information under
the data collection system with respect to a period for
the year shall submit to the Secretary information
specified under the system. Such information shall be
submitted in a form and manner, and at a time, specified
by the Secretary for purposes of this subparagraph.
“(D) Payment reduction for failure to report.–
“(i) <<NOTE: Effective date.>> In general.–
Beginning January 1, 2022, subject to clause (ii),
a 10 percent reduction to payments under this
subsection shall be made for the applicable period
(as defined in clause (ii)) to a provider or
supplier of ground ambulance services that–
“(I) is required to submit
information under the data collection
system with respect to a period under
subparagraph (C); and
“(II) does not sufficiently submit
such information, as determined by the
Secretary.
“(ii) Applicable period defined.–For
purposes of clause (i), the term `applicable
period’ means, with respect to a provider or
supplier of ground ambulance

[[Page 132 STAT. 180]]

services, a year specified by the Secretary not
more than 2 years after the end of the period with
respect to which the Secretary has made a
determination under clause (i)(II) that the
provider or supplier of ground ambulance services
failed to sufficiently submit information under
the data collection system.
“(iii) Hardship exemption.–The Secretary may
exempt a provider or supplier from the payment
reduction under clause (i) with respect to an
applicable period in the event of significant
hardship, such as a natural disaster, bankruptcy,
or other similar situation that the Secretary
determines interfered with the ability of the
provider or supplier of ground ambulance services
to submit such information in a timely manner for
the specified period.
“(iv) Informal review.–The Secretary shall
establish a process under which a provider or
supplier of ground ambulance services may seek an
informal review of a determination that the
provider or supplier is subject to the payment
reduction under clause (i).
“(E) Ongoing data collection.–
“(i) Revision of data collection system.–The
Secretary may, as the Secretary determines
appropriate and, if available, taking into
consideration the report (or reports) under
subparagraph (F), revise the data collection
system under subparagraph (A).
“(ii) <<NOTE: Time period.>> Subsequent data
collection.–In order to continue to evaluate the
extent to which reported costs relate to payment
rates under this subsection and for other purposes
the Secretary deems appropriate, the Secretary
shall require providers and suppliers of ground
ambulance services to submit information for years
after 2024 as the Secretary determines
appropriate, but in no case less often than once
every 3 years.
“(F) Ground ambulance data collection system
study.–

“(i) <<NOTE: Deadline. Assessment. Reports.>> In
general.–Not later than March 15, 2023, and as
determined necessary by the Medicare Payment
Advisory Commission thereafter, such Commission
shall assess, and submit to Congress a report on,
information submitted by providers and suppliers
of ground ambulance services through the data
collection system under subparagraph (A), the
adequacy of payments for ground ambulance services
under this subsection, and geographic variations
in the cost of furnishing such services.
“(ii) <<NOTE: Analysis.>> Contents.–A
report under clause (i) shall contain the
following:
“(I) An analysis of information
submitted through the data collection
system.
“(II) An analysis of any burden on
providers and suppliers of ground
ambulance services associated with the
data collection system.
“(III) <<NOTE: Recommenda-tion.>>
A recommendation as to whether
information should continue to be
submitted through such data collection
system or if such

[[Page 132 STAT. 181]]

system should be revised under
subparagraph (E)(i).
“(IV) Other information determined
appropriate by the Commission.
“(G) <<NOTE: Web posting.>> Public availability.–
The Secretary shall post information on the results of
the data collection under this paragraph on the Internet
website of the Centers for Medicare & Medicaid Services,
as determined appropriate by the Secretary.
“(H) <<NOTE: Notice.>> Implementation.–The
Secretary shall implement this paragraph through notice
and comment rulemaking.
“(I) Administration.–Chapter 35 of title 44,
United States Code, shall not apply to the collection of
information required under this subsection.
“(J) Limitations on review.–There shall be no
administrative or judicial review under section 1869,
section 1878, or otherwise of the data collection system
or identification of respondents under this paragraph.
“(K) Funding for implementation.–For purposes of
carrying out subparagraph (A), the Secretary shall
provide for the transfer, from the Federal Supplementary
Medical Insurance Trust Fund under section 1841, of
$15,000,000 to the Centers for Medicare & Medicaid
Services Program Management Account for fiscal year
2018. Amounts transferred under this subparagraph shall
remain available until expended.”.
SEC. 50204. 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), in the matter preceding clause (i),
by striking “fiscal year 2018” and inserting “fiscal year
2023”;
(2) in subparagraph (C)–
(A) in clause (i)–
(i) by striking “through 2017” the first
place it appears and inserting “through 2022”;
and
(ii) by striking “ and has less than 800
discharges” and all that follows through the
period at the end and inserting the following
“and has–
“(I) with respect to each of fiscal
years 2005 through 2010, less than 800
discharges during the fiscal year;
“(II) with respect to each of
fiscal years 2011 through 2018, less
than 1,600 discharges of individuals
entitled to, or enrolled for, benefits
under part A during the fiscal year or
portion of fiscal year;
“(III) with respect to each of
fiscal years 2019 through 2022, less
than 3,800 discharges during the fiscal
year; and
“(IV) with respect to fiscal year
2023 and each subsequent fiscal year,
less than 800 discharges during the
fiscal year.”; and
(B) in clause (ii)–

[[Page 132 STAT. 182]]

(i) by striking “subparagraph (B)” and
inserting “subparagraphs (B) and (D)”; and
(ii) by inserting “(except as provided in
clause (i)(II) and subparagraph (D)(i))” after
“regardless”; and
(3) in subparagraph (D)–
(A) by striking “through 2017” and inserting
“through 2022”;
(B) by striking “hospitals with 200 or fewer” and
inserting the following: “hospitals–
“(i) with respect to each of fiscal years
2011 through 2018, with 200 or fewer”;
(C) by striking the period at the end and inserting
“or portion of fiscal year; and”; and
(D) by adding at the end the following new clause:
“(ii) <<NOTE: Time period.>> with respect to
each of fiscal years 2019 through 2022, with 500
or fewer discharges in the fiscal year to 0
percent for low-volume hospitals with greater than
3,800 discharges in the fiscal year.”.

(b) MedPAC Report on Extension of Increased Inpatient Hospital
Payment Adjustment for Certain Low-volume Hospitals.–
(1) In general.–Not later than March 15, 2022, the Medicare
Payment Advisory Commission shall submit to Congress a report on
the extension of the increased inpatient hospital payment
adjustment for certain low-volume hospitals under section
1886(d)(12) of the Social Security Act (42 U.S.C. 1395ww(d)(12))
under the provisions of, and amendments made by, this section.
(2) Contents.–The report under paragraph (1) shall include
an evaluation of the effects of such extension on the following:
(A) Beneficiary utilization of inpatient hospital
services under title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.).
(B) The financial status of hospitals with a low
volume of Medicare or total inpatient admissions.
(C) Program spending under such title XVIII.
(D) Other matters relevant to evaluating the effects
of such extension.
SEC. 50205. 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, 2017” and
inserting “October 1, 2022”;
(2) in clause (ii)(II), by striking “October 1, 2017” and
inserting “October 1, 2022”; and
(3) in clause (iv), by striking subclause (I) and inserting
the following new subclause:
“(I) that is located in–
“(aa) a rural area; or
“(bb) a State with no rural area (as defined in
paragraph (2)(D)) and satisfies any of the criteria in
subclause (I), (II), or (III) of paragraph
(8)(E)(ii),”; and
(4) by inserting after subclause (IV) the following new
flush sentences:

[[Page 132 STAT. 183]]

“Subclause <<NOTE: Applicability.>> (I)(bb) shall apply for purposes
of payment under clause (ii) only for discharges of a hospital occurring
on or after the effective date of a determination of medicare-dependent
small rural hospital status made by the Secretary with respect to the
hospital after the date of the enactment of this sentence. For purposes
of applying subclause (II) of paragraph (8)(E)(ii) under subclause
(I)(bb), such subclause (II) shall be applied by inserting `as of
January 1, 2018,’ after `such State’ each place it appears.”.

(b) Conforming Amendments.–
(1) Extension of target amount.–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, 2017” and inserting “October 1, 2022”;
and
(B) in clause (iv), by striking “through fiscal
year 2017” and inserting “through fiscal year 2022”.
(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 striking “through
fiscal year 2017” and inserting “through fiscal year 2022”.

(c) GAO Study and Report.–
(1) Study.–The Comptroller General of the United States (in
this subsection referred to as the “Comptroller General”)
shall conduct a study on the medicare-dependent, small rural
hospital program under section 1886(d) of the Social Security
Act (42 U.S.C. 1395x(d)). <<NOTE: Analysis.>> Such study shall
include an analysis of the following:
(A) The payor mix of medicare-dependent, small rural
hospitals (as defined in paragraph (5)(G)(iv) of such
section 1886(d)), how such mix will trend in future
years (based on current trends and projections), and
whether or not the requirement under subclause (IV) of
such paragraph should be revised.
(B) The characteristics of medicare-dependent, small
rural hospitals that meet the requirement of such
subclause (IV) through the application of paragraph
(a)(iii)(A) or (a)(iii)(B) of section 412.108 of title
42, Code of Federal Regulations, including Medicare
inpatient and outpatient utilization, payor mix, and
financial status (including Medicare and total margins),
and whether or not Medicare payments for such hospitals
should be revised.
(C) Such other items related to medicare-dependent,
small rural hospitals as the Comptroller General
determines appropriate.
(2) <<NOTE: Recommenda- tions.>> Report.–Not later than 2
years after the date of the enactment of this Act, the
Comptroller General shall submit to Congress a report containing
the results of the study conducted under paragraph (1), together
with recommendations for such legislation and administrative
action as the Comptroller General determines appropriate.
SEC. 50206. EXTENSION OF FUNDING FOR QUALITY MEASURE ENDORSEMENT,
INPUT, AND SELECTION; REPORTING
REQUIREMENTS.

(a) Extension of Funding.–Section 1890(d)(2) of the Social Security
Act (42 U.S.C. 1395aaa(d)(2)) is amended–

[[Page 132 STAT. 184]]

(1) in the first sentence–
(A) by striking “2014 and” and inserting
“2014,”; and
(B) by inserting the following before the period:
“, and $7,500,000 for each of fiscal years 2018 and
2019”; and
(2) by adding at the end the following new sentence:
“Amounts transferred for each of fiscal years 2018 and 2019
shall be in addition to any unobligated funds transferred for a
preceding fiscal year that are available under the preceding
sentence.”

(b) Annual Report by Secretary to Congress.–Section 1890 of the
Social Security Act (42 U.S.C. 1395aaa) is amended by adding at the end
the following new subsection:
“(e) <<NOTE: Effective date.>> Annual Report by Secretary to
Congress.–By not later than March 1 of each year (beginning with 2019),
the Secretary shall submit to Congress a report containing the
following:
“(1) <<NOTE: Plan. Contracts.>> A comprehensive plan that
identifies the quality measurement needs of programs and
initiatives of the Secretary and provides a strategy for using
the entity with a contract under subsection (a) and any other
entity the Secretary has contracted with or may contract with to
perform work associated with section 1890A to help meet those
needs, specifically with respect to the programs under this
title and title XIX. In <<NOTE: Updates.>> years after the
first plan under this paragraph is submitted, the requirements
of this paragraph may be met by providing an update to the plan.
“(2) The amount of funding provided under subsection (d)
for purposes of carrying out this section and section 1890A that
has been obligated by the Secretary, the amount of funding
provided that has been expended, and the amount of funding
provided that remains unobligated.
“(3) With respect to the activities described under this
section or section 1890A, a description of how the funds
described in paragraph (2) have been obligated or expended,
including how much of that funding has been obligated or
expended for work performed by the Secretary, the entity with a
contract under subsection (a), and any other entity the
Secretary has contracted with to perform work.
“(4) A description of the activities for which the funds
described in paragraph (2) were used, including task orders and
activities assigned to the entity with a contract under
subsection (a), activities performed by the Secretary, and task
orders and activities assigned to any other entity the Secretary
has contracted with to perform work related to carrying out
section 1890A.
“(5) The amount of funding described in paragraph (2) that
has been obligated or expended for each of the activities
described in paragraph (4).
“(6) <<NOTE: Estimate. Time period.>> Estimates for, and
descriptions of, obligations and expenditures that the Secretary
anticipates will be needed in the succeeding two year period to
carry out each of the quality measurement activities required
under this section and section 1890A, including any obligations
that will require funds to be expended in a future year.”.

[[Page 132 STAT. 185]]

(1) In general.–Section 1890(b)(5)(A) of the Social
Security Act (42 U.S.C. 1395aaa(b)(5)(A)) is amended–
(A) by redesignating clauses (i) through (vi) as
subclauses (I) through (VI), respectively, and moving
the margins accordingly;
(B) in the matter preceding subclause (I), as
redesignated by subparagraph (A), by striking
“containing a description of–” and inserting
“containing the following:
“(i) A description of–”; and
(C) by adding at the end the following new clauses:
“(ii) An itemization of financial information
for the fiscal year ending September 30 of the
preceding year, including–
“(I) annual revenues of the entity
(including any government funding,
private sector contributions, grants,
membership revenues, and investment
revenue);
“(II) annual expenses of the entity
(including grants paid, benefits paid,
salaries or other compensation,
fundraising expenses, and overhead
costs); and
“(III) a breakdown of the amount
awarded per contracted task order and
the specific projects funded in each
task order assigned to the entity.
“(iii) Any updates or modifications of
internal policies and procedures of the entity as
they relate to the duties of the entity under this
section, including–
“(I) specifically identifying any
modifications to the disclosure of
interests and conflicts of interests for
committees, work groups, task forces,
and advisory panels of the entity; and
“(II) information on external
stakeholder participation in the duties
of the entity under this section
(including complete rosters for all
committees, work groups, task forces,
and advisory panels funded through
government contracts, descriptions of
relevant interests and any conflicts of
interest for members of all committees,
work groups, task forces, and advisory
panels, and the total percentage by
health care sector of all convened
committees, work groups, task forces,
and advisory panels.”.
(2) <<NOTE: Applicability. 42 USC 1395aaa note.>> Effective
date.–The amendments made by this subsection shall apply to
reports submitted for years beginning with 2019.

(d) GAO Study and Report.–
(1) <<NOTE: Contracts.>> Study.–The Comptroller General of
the United States shall conduct a study on health care quality
measurement efforts funded under sections 1890 and 1890A of the
Social Security Act (42 U.S.C. 1395aaa; 1395aaa-1). Such study
shall include an examination of the following:
(A) The extent to which the Secretary of Health and
Human Services (in this subsection referred to as the
“Secretary”) has set and prioritized objectives to be
achieved for each of the quality measurement activities
required under such sections 1890 and 1890A.

[[Page 132 STAT. 186]]

(B) The efforts that the Secretary has undertaken to
meet quality measurement objectives associated with such
sections 1890 and 1890A, including division of
responsibilities for those efforts within the Department
of Health and Human Services and through contracts with
a consensus-based entity under subsection (a) of such
section 1890 (in this subsection referred to as the
“consensus-based entity”) and other entities, and the
extent of any overlap among the work performed by the
Secretary, the consensus-based entity, the Measure
Applications Partnership (MAP) convened by such entity
to provide input to the Secretary on the selection of
quality and efficiency measures, and any other entities
the Secretary has contracted with to perform work
related to carrying out such sections 1890 and 1890A.
(C) The total amount of funding provided to the
Secretary for purposes of carrying out such sections
1890 and 1890A, the amount of such funding that has been
obligated or expended by the Secretary, and the amount
of such funding that remains unobligated.
(D) How the funds described in subparagraph (C) have
been allocated, including how much of the funding has
been allocated for work performed by the Secretary, the
consensus-based entity, and any other entity the
Secretary has contracted with to perform work related to
carrying out such sections 1890 and 1890A, respectively,
and descriptions of such work.
(E) The extent to which the Secretary has developed
a comprehensive and long-term plan to ensure that it can
achieve quality measurement objectives related to
carrying out such sections 1890 and 1890A in a timely
manner and with efficient use of available resources,
including the roles of the consensus-based entity, the
Measure Applications Partnership (MAP), and any other
entity the Secretary has contracted with to perform work
related to such sections 1890 and 1890A in helping the
Secretary achieve those objectives.
(2) <<NOTE: Recommenda- tions.>> Report.–Not later than 18
months after the date of enactment of this Act, the Comptroller
General of the United States shall submit to Congress a report
containing the results of the study conducted under paragraph
(1), together with recommendations for such legislation and
administrative action as the Comptroller General determines
appropriate.
SEC. 50207. EXTENSION OF FUNDING OUTREACH AND ASSISTANCE FOR LOW-
INCOME PROGRAMS; STATE HEALTH
INSURANCE ASSISTANCE PROGRAM REPORTING
REQUIREMENTS.

(a) Funding Extensions.–
(1) Additional funding for state health insurance
programs.–Subsection (a)(1)(B) of section 119 of the Medicare
Improvements for Patients and Providers Act of 2008 (42 U.S.C.
1395b-3 note), as amended by section 3306 of the Patient
Protection and Affordable Care Act (Public Law 111-148), section
610 of the American Taxpayer Relief Act of 2012 (Public Law 112-
240), section 1110 of the Pathway for SGR Reform Act of 2013
(Public Law 113-67), section 110 of the Protecting Access to
Medicare Act of 2014 (Public Law 113-93), and section

[[Page 132 STAT. 187]]

208 of the Medicare Access and CHIP Reauthorization Act of 2015
(Public Law 114-10) is amended–
(A) in clause (vi), by striking “and” at the end;
(B) in clause (vii), by striking the period at the
end and inserting “; and”; and
(C) by adding at the end the following new clauses:
“(viii) for fiscal year 2018, of $13,000,000;
and
“(ix) for fiscal year 2019, of
$13,000,000.”.
(2) Additional funding for area agencies on aging.–
Subsection (b)(1)(B) of such section 119, as so amended, is
amended–
(A) in clause (vi), by striking “and” at the end;
(B) in clause (vii), by striking the period at the
end and inserting “; and”; and
(C) by inserting after clause (vii) the following
new clauses:
“(viii) for fiscal year 2018, of $7,500,000;
and
“(ix) for fiscal year 2019, of $7,500,000.”.
(3) Additional funding for aging and disability resource
centers.–Subsection (c)(1)(B) of such section 119, as so
amended, is amended–
(A) in clause (vi), by striking “and” at the end;
(B) in clause (vii), by striking the period at the
end and inserting “; and”; and
(C) by inserting after clause (vii) the following
new clauses:
“(viii) for fiscal year 2018, of $5,000,000;
and
“(ix) for fiscal year 2019, of $5,000,000.”.
(4) Additional funding for contract with the national center
for benefits and outreach enrollment.–Subsection (d)(2) of such
section 119, as so amended, is amended–
(A) in clause (vi), by striking “and” at the end;
(B) in clause (vii), by striking the period at the
end and inserting “; and”; and
(C) by inserting after clause (vii) the following
new clauses:
“(viii) for fiscal year 2018, of $12,000,000;
and
“(ix) for fiscal year 2019, of
$12,000,000.”.

(b) State Health Insurance Assistance Program Reporting
Requirements.– <<NOTE: Effective date. Web posting. Grants. 42 USC
1395b-3 note.>> Beginning not later than April 1, 2019, and biennially
thereafter, the Agency for Community Living shall electronically post on
its website the following information, with respect to grants to States
for State health insurance assistance programs, (such information to be
presented by State and by entity receiving funds from the State to carry
out such a program funded by such grant):
(1) The amount of Federal funding provided to each such
State for such program for the period involved and the amount of
Federal funding provided by each such State for such program to
each such entity for the period involved.
(2) Information as the Secretary may specify, with respect
to such programs carried out through such grants, consistent
with the terms and conditions for receipt of such grants.
SEC. 50208. EXTENSION OF HOME HEALTH RURAL ADD-ON.

(a) Extension.–

[[Page 132 STAT. 188]]

(1) In general.–Section 421 of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law
108-173; 117 Stat. 2283; 42 U.S.C. 1395fff note), as amended by
section 5201(b) of the Deficit Reduction Act of 2005 (Public Law
109-171; 120 Stat. 46), section 3131(c) of the Patient
Protection and Affordable Care Act (Public Law 111-148; 124
Stat. 428), and section 210 of the Medicare Access and CHIP
Reauthorization Act of 2015 (Public Law 114-10; 129 Stat. 151)
is amended–
(A) in subsection (a), by striking “January 1,
2018” and inserting “January 1, 2019” each place it
appears;
(B) by redesignating subsections (b) and (c) as
subsections (c) and (d), respectively;
(C) in each of subsections (c) and (d), as so
redesignated, by striking “subsection (a)” and
inserting “subsection (a) or (b)”; and
(D) by inserting after subsection (a) the following
new subsection:

“(b) Subsequent Temporary Increase.–
“(1) <<NOTE: Determination.>> In general.–The Secretary
shall increase the payment amount otherwise made under such
section 1895 for home health services furnished in a county (or
equivalent area) in a rural area (as defined in such section
1886(d)(2)(D)) that, as determined by the Secretary–
“(A) is in the highest quartile of all counties (or
equivalent areas) based on the number of Medicare home
health episodes furnished per 100 individuals who are
entitled to, or enrolled for, benefits under part A of
title XVIII of the Social Security Act or enrolled for
benefits under part B of such title (but not enrolled in
a plan under part C of such title)–
“(i) in the case of episodes and visits
ending during 2019, by 1.5 percent; and
“(ii) in the case of episodes and visits
ending during 2020, by 0.5 percent;
“(B) has a population density of 6 individuals or
fewer per square mile of land area and is not described
in subparagraph (A)–
“(i) in the case of episodes and visits
ending during 2019, by 4 percent;
“(ii) in the case of episodes and visits
ending during 2020, by 3 percent;
“(iii) in the case of episodes and visits
ending during 2021, by 2 percent; and
“(iv) in the case of episodes and visits
ending during 2022, by 1 percent; and
“(C) is not described in either subparagraph (A) or
(B)–
“(i) in the case of episodes and visits
ending during 2019, by 3 percent;
“(ii) in the case of episodes and visits
ending during 2020, by 2 percent; and
“(iii) in the case of episodes and visits
ending during 2021, by 1 percent.
“(2) <<NOTE: Applicability.>> Rules for determinations.–

[[Page 132 STAT. 189]]

“(A) No switching.–For purposes of this
subsection, the determination by the Secretary as to
which subparagraph of paragraph (1) applies to a county
(or equivalent area) shall be made a single time and
shall apply for the duration of the period to which this
subsection applies.
“(B) Utilization.–In determining which counties
(or equivalent areas) are in the highest quartile under
paragraph (1)(A), the following rules shall apply:
“(i) The Secretary shall use data from 2015.
“(ii) The Secretary shall exclude data from
the territories (and the territories shall not be
described in such paragraph).
“(iii) The Secretary may exclude data from
counties (or equivalent areas) in rural areas with
a low volume of home health episodes (and if data
is so excluded with respect to a county (or
equivalent area), such county (or equivalent area)
shall not be described in such paragraph).
“(C) Population density.–In determining population
density under paragraph (1)(B), the Secretary shall use
data from the 2010 decennial Census.
“(3) Limitations on review.–There shall be no
administrative or judicial review under section 1869, section
1878, or otherwise of determinations under paragraph (1).”.
(2) Requirement to submit county data on claim form.–
Section 1895(c) of the Social Security Act (42 U.S.C.
1395fff(c)) is amended–
(A) in paragraph (1), by striking “and” at the
end;
(B) in paragraph (2), by striking the period at the
end and inserting “; and”; and
(C) by adding at the end the following new
paragraph:
“(3) in the case of home health services furnished on or
after January 1, 2019, the claim contains the code for the
county (or equivalent area) in which the home health service was
furnished.”.

(b) HHS OIG Analysis.– <<NOTE: Deadline.>> Not later than January
1, 2023, the Inspector General of the Department of Health and Human
Services shall submit to Congress–
(1) an analysis of the home health claims and utilization of
home health services by county (or equivalent area) under the
Medicare program; and
(2) <<NOTE: Recommenda- tions.>> recommendations the
Inspector General determines appropriate based on such analysis.

[[Page 132 STAT. 190]]

TITLE III–CREATING HIGH-QUALITY RESULTS AND OUTCOMES NECESSARY TO
IMPROVE CHRONIC (CHRONIC) CARE

Subtitle A–Receiving High Quality Care in the Home

SEC. 50301. EXTENDING THE INDEPENDENCE AT HOME DEMONSTRATION
PROGRAM.

(a) In General.–Section 1866E of the Social Security Act (42 U.S.C.
1395cc-5) is amended–
(1) in subsection (e)–
(A) in paragraph (1)–
(i) by striking “An agreement” and inserting
“Agreements”; and
(ii) by striking “5-year” and inserting “7-
year”; and
(B) in paragraph (5)–
(i) by striking “10,000” and inserting
“15,000”; and
(ii) by adding at the end the following new
sentence: “An applicable beneficiary that
participates in the demonstration program by
reason of the increase from 10,000 to 15,000 in
the preceding sentence pursuant to the amendment
made by section 50301(a)(1)(B)(i) of the Advancing
Chronic Care, Extenders, and Social Services Act
shall be considered in the spending target
estimates under paragraph (1) of subsection (c)
and the incentive payment calculations under
paragraph (2) of such subsection for the sixth and
seventh years of such program.”;
(2) in subsection (g), in the first sentence, by inserting
“, including, to the extent practicable, with respect to the
use of electronic health information systems, as described in
subsection (b)(1)(A)(vi)” after “under the demonstration
program”; and
(3) in subsection (i)(1)(A), by striking “will not receive
an incentive payment for the second of 2” and inserting “did
not achieve savings for the third of 3”.

(b) <<NOTE: 42 USC 1395cc-5 note.>> Effective Date.–The amendment
made by subsection (a)(3) shall take effect as if included in the
enactment of Public Law 111-148.
SEC. 50302. EXPANDING ACCESS TO HOME DIALYSIS THERAPY.

(a) In General.–Section 1881(b)(3) of the Social Security Act (42
U.S.C. 1395rr(b)(3)) is amended–
(1) by redesignating subparagraphs (A) and (B) as clauses
(i) and (ii), respectively;
(2) in clause (ii), as redesignated by paragraph (1), by
striking “on a comprehensive” and insert “subject to
subparagraph (B), on a comprehensive”;
(3) by striking “With respect to” and inserting “(A) With
respect to”; and
(4) by adding at the end the following new subparagraph:

[[Page 132 STAT. 191]]

“(B)(i) For purposes of subparagraph (A)(ii), subject to clause
(ii), an individual determined to have end stage renal disease receiving
home dialysis may choose to receive monthly end stage renal disease-
related clinical assessments furnished on or after January 1, 2019, via
telehealth.
“(ii) <<NOTE: Applicability. Time periods.>> Clause (i) shall
apply to an individual only if the individual receives a face-to-face
clinical assessment, without the use of telehealth–
“(I) in the case of the initial 3 months of home dialysis
of such individual, at least monthly; and
“(II) after such initial 3 months, at least once every 3
consecutive months.”.

(b) Originating Site Requirements.–
(1) In general.–Section 1834(m) of the Social Security Act
(42 U.S.C. 1395m(m)) is amended–
(A) in paragraph (4)(C)(ii), by adding at the end
the following new subclauses:
“(IX) A renal dialysis facility,
but only for purposes of section
1881(b)(3)(B).
“(X) The home of an individual, but
only for purposes of section
1881(b)(3)(B).”; and
(B) by adding at the end the following new
paragraph:
“(5) Treatment of home dialysis monthly esrd-related
visit.–The geographic requirements described in paragraph
(4)(C)(i) shall not apply with respect to telehealth services
furnished on or after January 1, 2019, for purposes of section
1881(b)(3)(B), at an originating site described in subclause
(VI), (IX), or (X) of paragraph (4)(C)(ii).”.
(2) No facility fee if originating site for home dialysis
therapy is the home.–Section 1834(m)(2)(B) of the Social
Security (42 U.S.C. 1395m(m)(2)(B)) is amended–
(A) by redesignating clauses (i) and (ii) as
subclauses (I) and (II), and indenting appropriately;
(B) in subclause (II), as redesignated by
subparagraph (A), by striking “clause (i) or this
clause” and inserting “subclause (I) or this
subclause”;
(C) by striking “site.–With respect to” and
inserting “site.–
“(i) In general.–Subject to clause (ii),
with respect to”; and
(D) by adding at the end the following new clause:
“(ii) No facility fee if originating site for
home dialysis therapy is the home.–No facility
fee shall be paid under this subparagraph to an
originating site described in paragraph
(4)(C)(ii)(X).”.

(c) Clarification Regarding Telehealth Provided to Beneficiaries.–
Section 1128A(i)(6) of the Social Security Act (42 U.S.C. 1320a-
7a(i)(6)) is amended–
(1) in subparagraph (H), by striking “or” at the end;
(2) in subparagraph (I), by striking the period at the end
and inserting “; or”; and
(3) by adding at the end the following new subparagraph:
“(J) the provision of telehealth technologies (as
defined by the Secretary) on or after January 1, 2019,
by a provider of services or a renal dialysis facility
(as such terms are defined for purposes of title XVIII)
to an individual with end stage renal disease who is
receiving home dialysis

[[Page 132 STAT. 192]]

for which payment is being made under part B of such
title, if–
“(i) the telehealth technologies are not
offered as part of any advertisement or
solicitation;
“(ii) the telehealth technologies are
provided for the purpose of furnishing telehealth
services related to the individual’s end stage
renal disease; and
“(iii) the provision of the telehealth
technologies meets any other requirements set
forth in regulations promulgated by the
Secretary.”.

(d) Conforming Amendment.–Section 1881(b)(1) of the Social Security
Act (42 U.S.C. 1395rr(b)(1)) is amended by striking “paragraph (3)(A)”
and inserting “paragraph (3)(A)(i)”.

Subtitle B–Advancing Team-Based Care

SEC. 50311. PROVIDING CONTINUED ACCESS TO MEDICARE ADVANTAGE
SPECIAL NEEDS PLANS FOR VULNERABLE
POPULATIONS.

(a) Extension.–Section 1859(f)(1) of the Social Security Act (42
U.S.C. 1395w-28(f)(1)) is amended by striking “and for periods before
January 1, 2019”.
(b) Increased Integration of Dual SNPs.–
(1) In general.–Section 1859(f) of the Social Security Act
(42 U.S.C. 1395w-28(f)) is amended–
(A) in paragraph (3), by adding at the end the
following new subparagraph:
“(F) The plan meets the requirements applicable
under paragraph (8).”; and
(B) by adding at the end the following new
paragraph:
“(8) Increased integration of dual snps.–
“(A) Designated contact.–The Secretary, acting
through the Federal Coordinated Health Care Office
established under section 2602 of Public Law 111-148,
shall serve as a dedicated point of contact for States
to address misalignments that arise with the integration
of specialized MA plans for special needs individuals
described in subsection (b)(6)(B)(ii) under this
paragraph and, consistent with such role, shall
establish–
“(i) a uniform process for disseminating to
State Medicaid agencies information under this
title impacting contracts between such agencies
and such plans under this subsection; and
“(ii) basic resources for States interested
in exploring such plans as a platform for
integration, such as a model contract or other
tools to achieve those goals.
“(B) Unified grievances and appeals process.–
“(i) <<NOTE: Deadline. Procedures.>> In
general.–Not later than April 1, 2020, the
Secretary shall establish procedures, to the
extent feasible as determined by the Secretary,
unifying grievances and appeals procedures under
sections 1852(f), 1852(g), 1902(a)(3), 1902(a)(5),
and 1932(b)(4) for items and services provided by
specialized MA plans for special needs individuals
described in subsection (b)(6)(B)(ii) under this
title and title XIX. <<NOTE: Applicability.>>
With respect

[[Page 132 STAT. 193]]

to items and services described in the preceding
sentence, procedures established under this clause
shall apply in place of otherwise applicable
grievances and appeals procedures. The Secretary
shall solicit comment in developing such
procedures from States, plans, beneficiaries and
their representatives, and other relevant
stakeholders.
“(ii) Procedures.–The procedures established
under clause (i) shall be included in the plan
contract under paragraph (3)(D) and shall–
“(I) adopt the provisions for the
enrollee that are most protective for
the enrollee and, to the extent feasible
as determined by the Secretary, are
compatible with unified timeframes and
consolidated access to external review
under an integrated process;
“(II) take into account differences
in State plans under title XIX to the
extent necessary;
“(III) be easily navigable by an
enrollee; and
“(IV) include the elements
described in clause (iii), as
applicable.
“(iii) Elements described.–Both unified
appeals and unified grievance procedures shall
include, as applicable, the following elements
described in this clause:
“(I) <<NOTE: Notification.>>
Single written notification of all
applicable grievances and appeal rights
under this title and title
XIX. <<NOTE: Waiver authority.>> For
purposes of this subparagraph, the
Secretary may waive the requirements
under section 1852(g)(1)(B) when the
specialized MA plan covers items or
services under this part or under title
XIX.
“(II) Single pathways for
resolution of any grievance or appeal
related to a particular item or service
provided by specialized MA plans for
special needs individuals described in
subsection (b)(6)(B)(ii) under this
title and title XIX.
“(III) <<NOTE: Notices.>> Notices
written in plain language and available
in a language and format that is
accessible to the enrollee, including in
non-English languages that are prevalent
in the service area of the specialized
MA plan.
“(IV) Unified timeframes for
grievances and appeals processes, such
as an individual’s filing of a grievance
or appeal, a plan’s acknowledgment and
resolution of a grievance or appeal, and
notification of decisions with respect
to a grievance or appeal.
“(V) Requirements for how the plan
must process, track, and resolve
grievances and appeals, to ensure
beneficiaries are notified on a timely
basis of decisions that are made
throughout the grievance or appeals
process and are able to easily determine
the status of a grievance or appeal.
“(iv) Continuation of benefits pending
appeal.–The unified procedures under clause (i)
shall, with respect to all benefits under parts A
and B and

[[Page 132 STAT. 194]]

title XIX subject to appeal under such procedures,
incorporate provisions under current law and
implementing regulations that provide continuation
of benefits pending appeal under this title and
title XIX.
“(C) Requirement for unified grievances and
appeals.–For 2021 and subsequent years, the contract of
a specialized MA plan for special needs individuals
described in subsection (b)(6)(B)(ii) with a State
Medicaid agency under paragraph (3)(D) shall require the
use of unified grievances and appeals procedures as
described in subparagraph (B).
“(D) <<NOTE: Contracts. Determinations.>>
Requirements for integration.–
“(i) In general.–For 2021 and subsequent
years, a specialized MA plan for special needs
individuals described in subsection (b)(6)(B)(ii)
shall meet one or more of the following
requirements, to the extent permitted under State
law, for integration of benefits under this title
and title XIX:
“(I) The specialized MA plan must
meet the requirements of contracting
with the State Medicaid agency described
in paragraph (3)(D) in addition to
coordinating long-term services and
supports or behavioral health services,
or both, by meeting an additional
minimum set of requirements determined
by the Secretary through the Federal
Coordinated Health Care Office
established under section 2602 of the
Patient Protection and Affordable Care
Act based on input from stakeholders,
such as notifying the State in a timely
manner of hospitalizations, emergency
room visits, and hospital or nursing
home discharges of enrollees, assigning
one primary care provider for each
enrollee, or sharing data that would
benefit the coordination of items and
services under this title and the State
plan under title XIX. Such minimum set
of requirements must be included in the
contract of the specialized MA plan with
the State Medicaid agency under such
paragraph.
“(II) The specialized MA plan must
meet the requirements of a fully
integrated plan described in section
1853(a)(1)(B)(iv)(II) (other than the
requirement that the plan have similar
average levels of frailty, as determined
by the Secretary, as the PACE program),
or enter into a capitated contract with
the State Medicaid agency to provide
long-term services and supports or
behavioral health services, or both.
“(III) In the case of a specialized
MA plan that is offered by a parent
organization that is also the parent
organization of a Medicaid managed care
organization providing long term
services and supports or behavioral
services under a contract under section
1903(m), the parent organization must
assume clinical and financial
responsibility for benefits provided
under this title and title XIX with
respect to any individual who

[[Page 132 STAT. 195]]

is enrolled in both the specialized MA
plan and the Medicaid managed care
organization.
“(ii) Suspension of enrollment for failure to
meet requirements during initial period.–
<<NOTE: Determination.>> During the period of plan
years 2021 through 2025, if the Secretary
determines that a specialized MA plan for special
needs individuals described in subsection
(b)(6)(B)(ii) has failed to comply with clause
(i), the Secretary may provide for the application
against the Medicare Advantage organization
offering the plan of the remedy described in
section 1857(g)(2)(B) in the same manner as the
Secretary may apply such remedy, and in accordance
with the same procedures as would apply, in the
case of an MA organization determined by the
Secretary to have engaged in conduct described in
section 1857(g)(1). <<NOTE: Compliance.>> If the
Secretary applies such remedy to a Medicare
Advantage organization under the preceding
sentence, the organization shall submit to the
Secretary (at a time, and in a form and manner,
specified by the Secretary) information describing
how the plan will come into compliance with clause
(i).
“(E) Study and report to congress.–
“(i) <<NOTE: Time
period. Consultation. Determination. Evaluation.>>
In general.–Not later than March 15, 2022, and,
subject to clause (iii), biennially thereafter
through 2032, the Medicare Payment Advisory
Commission established under section 1805, in
consultation with the Medicaid and CHIP Payment
and Access Commission established under section
1900, shall conduct (and submit to the Secretary
and the Committees on Ways and Means and Energy
and Commerce of the House of Representatives and
the Committee on Finance of the Senate a report
on) a study to determine how specialized MA plans
for special needs individuals described in
subsection (b)(6)(B)(ii) perform among each other
based on data from Healthcare Effectiveness Data
and Information Set (HEDIS) quality measures,
reported on the plan level, as required under
section 1852(e)(3) (or such other measures or data
sources that are available and appropriate, such
as encounter data and Consumer Assessment of
Healthcare Providers and Systems data, as
specified by such Commissions as enabling an
accurate evaluation under this subparagraph). Such
study shall include, as feasible, the following
comparison groups of specialized MA plans for
special needs individuals described in subsection
(b)(6)(B)(ii):
“(I) A comparison group of such
plans that are described in subparagraph
(D)(i)(I).
“(II) A comparison group of such
plans that are described in subparagraph
(D)(i)(II).
“(III) A comparison group of such
plans operating within the Financial
Alignment Initiative demonstration for
the period for which such plan is so
operating and the demonstration is in
effect, and, in the case that an
integration option that is not with
respect to specialized MA plans for

[[Page 132 STAT. 196]]

special needs individuals is established
after the conclusion of the
demonstration involved.
“(IV) A comparison group of such
plans that are described in subparagraph
(D)(i)(III).
“(V) A comparison group of MA
plans, as feasible, not described in a
previous subclause of this clause, with
respect to the performance of such plans
for enrollees who are special needs
individuals described in subsection
(b)(6)(B)(ii).
“(ii) <<NOTE: Effective
dates. Consultation.>> Additional reports.–
Beginning with 2033 and every five years
thereafter, the Medicare Payment Advisory
Commission, in consultation with the Medicaid and
CHIP Payment and Access Commission, shall conduct
a study described in clause (i).”.
(2) Conforming amendment to responsibilities of federal
coordinated health care office.–Section 2602(d) of Public Law
111-148 (42 U.S.C. 1315b(d)) is amended by adding at the end the
following new paragraphs:
“(6) To act as a designated contact for States under
subsection (f)(8)(A) of section 1859 of the Social Security Act
(42 U.S.C. 1395w-28) with respect to the integration of
specialized MA plans for special needs individuals described in
subsection (b)(6)(B)(ii) of such section.
“(7) To be responsible, subject to the final approval of
the Secretary, for developing regulations and guidance related
to the implementation of a unified grievance and appeals process
as described in subparagraphs (B) and (C) of section 1859(f)(8)
of the Social Security Act (42 U.S.C. 1395w-28(f)(8)).
“(8) To be responsible, subject to the final approval of
the Secretary, for developing regulations and guidance related
to the integration or alignment of policy and oversight under
the Medicare program under title XVIII of such Act and the
Medicaid program under title XIX of such Act regarding
specialized MA plans for special needs individuals described in
subsection (b)(6)(B)(ii) of such section 1859.”.

(c) Improvements to Severe or Disabling Chronic Condition SNPs.–
(1) Care management requirements.–Section 1859(f)(5) of the
Social Security Act (42 U.S.C. 1395w-28(f)(5)) is amended–
(A) by striking “all snps.–The requirements” and
inserting “all snps.–
“(A) In general.–Subject to subparagraph (B), the
requirements”;
(B) by redesignating subparagraphs (A) and (B) as
clauses (i) and (ii), respectively, and indenting
appropriately; and
(C) in clause (ii), as redesignated by subparagraph
(B), by redesignating clauses (i) through (iii) as
subclauses (I) through (III), respectively, and
indenting appropriately; and
(D) by adding at the end the following new
subparagraph:
“(B) Improvements to care management requirements
for severe or disabling chronic condition snps.–For
2020 and subsequent years, in the case of a specialized
MA plan for special needs individuals described

[[Page 132 STAT. 197]]

in subsection (b)(6)(B)(iii), the requirements described
in this paragraph include the following:
“(i) The interdisciplinary team under
subparagraph (A)(ii)(III) includes a team of
providers with demonstrated expertise, including
training in an applicable specialty, in treating
individuals similar to the targeted population of
the plan.
“(ii) Requirements developed by the Secretary
to provide face-to-face encounters with
individuals enrolled in the plan not less
frequently than on an annual basis.
“(iii) As part of the model of care under
clause (i) of subparagraph (A), the results of the
initial assessment and annual reassessment under
clause (ii)(I) of such subparagraph of each
individual enrolled in the plan are addressed in
the individual’s individualized care plan under
clause (ii)(II) of such subparagraph.
“(iv) As part of the annual evaluation and
approval of such model of care, the Secretary
shall take into account whether the plan fulfilled
the previous year’s goals (as required under the
model of care).
“(v) The Secretary shall establish a minimum
benchmark for each element of the model of care of
a plan. The Secretary shall only approve a plan’s
model of care under this paragraph if each element
of the model of care meets the minimum benchmark
applicable under the preceding sentence.”.
(2) Revisions to the definition of a severe or disabling
chronic conditions specialized needs individual.–
(A) In general.–Section 1859(b)(6)(B)(iii) of the
Social Security Act (42 U.S.C. 1395w-28(b)(6)(B)(iii))
is amended–
(i) by striking “who have” and inserting
“who–
“(I) before January 1, 2022,
have”;
(ii) in subclause (I), as added by clause (i),
by striking the period at the end and inserting
“; and”; and
(iii) by adding at the end the following new
subclause:
“(II) on or after January 1, 2022,
have one or more comorbid and medically
complex chronic conditions that is life
threatening or significantly limits
overall health or function, have a high
risk of hospitalization or other adverse
health outcomes, and require intensive
care coordination and that is listed
under subsection (f)(9)(A).”.
(B) Panel of clinical advisors.–Section 1859(f) of
the Social Security Act (42 U.S.C. 1395w-28(f)), as
amended by subsection (b), is amended by adding at the
end the following new paragraph:
“(9) List of conditions for clarification of the definition
of a severe or disabling chronic conditions specialized needs
individual.–
“(A) <<NOTE: Deadlines.>> In general.–Not later
than December 31, 2020, and every 5 years thereafter,
subject to subparagraphs (B) and (C), the Secretary
shall convene a panel of clinical

[[Page 132 STAT. 198]]

advisors to establish and update a list of conditions
that meet each of the following criteria:
“(i) Conditions that meet the definition of a
severe or disabling chronic condition under
subsection (b)(6)(B)(iii) on or after January 1,
2022.
“(ii) Conditions that require prescription
drugs, providers, and models of care that are
unique to the specific population of enrollees in
a specialized MA plan for special needs
individuals described in such subsection on or
after such date and–
“(I) as a result of access to, and
enrollment in, such a specialized MA
plan for special needs individuals,
individuals with such condition would
have a reasonable expectation of slowing
or halting the progression of the
disease, improving health outcomes and
decreasing overall costs for individuals
diagnosed with such condition compared
to available options of care other than
through such a specialized MA plan for
special needs individuals; or
“(II) have a low prevalence in the
general population of beneficiaries
under this title or a disproportionally
high per-beneficiary cost under this
title.
“(B) Inclusion of certain conditions.–The
conditions listed under subparagraph (A) shall include
HIV/AIDS, end stage renal disease, and chronic and
disabling mental illness.
“(C) Requirement.–In establishing and updating the
list under subparagraph (A), the panel shall take into
account the availability of varied benefits, cost-
sharing, and supplemental benefits under the model
described in paragraph (2) of section 1859(h), including
the expansion under paragraph (1) of such section.”.

(d) Quality Measurement at the Plan Level for SNPs and Determination
of Feasability of Quality Measurement at the Plan Level for All MA
Plans.–Section 1853(o) of the Social Security Act (42 U.S.C. 1395w-
23(o)) is amended by adding at the end the following new paragraphs:
“(6) Quality measurement at the plan level for snps.–
“(A) In general.–Subject to subparagraph (B), the
Secretary may require reporting of data under section
1852(e) for, and apply under this subsection, quality
measures at the plan level for specialized MA plans for
special needs individuals instead of at the contract
level.
“(B) Considerations.–Prior to applying quality
measurement at the plan level under this paragraph, the
Secretary shall–
“(i) take into consideration the minimum
number of enrollees in a specialized MA plan for
special needs individuals in order to determine if
a statistically significant or valid measurement
of quality at the plan level is possible under
this paragraph;
“(ii) take into consideration the impact of
such application on plans that serve a
disproportionate number of individuals dually
eligible for benefits under this title and under
title XIX;

[[Page 132 STAT. 199]]

“(iii) if quality measures are reported at
the plan level, ensure that MA plans are not
required to provide duplicative information; and
“(iv) ensure that such reporting does not
interfere with the collection of encounter data
submitted by MA organizations or the
administration of any changes to the program under
this part as a result of the collection of such
data.
“(C) Application.–If the Secretary applies quality
measurement at the plan level under this paragraph–
“(i) such quality measurement may include
Medicare Health Outcomes Survey (HOS), Healthcare
Effectiveness Data and Information Set (HEDIS),
Consumer Assessment of Healthcare Providers and
Systems (CAHPS) measures and quality measures
under part D; and
“(ii) the Secretary shall consider applying
administrative actions, such as remedies described
in section 1857(g)(2), at the plan level.
“(7) Determination of feasibility of quality measurement at
the plan level for all ma plans.–
“(A) Determination of feasibility.–The Secretary
shall determine the feasibility of requiring reporting
of data under section 1852(e) for, and applying under
this subsection, quality measures at the plan level for
all MA plans under this part.
“(B) Consideration of change.–After making a
determination under subparagraph (A), the Secretary
shall consider requiring such reporting and applying
such quality measures at the plan level as described in
such subparagraph”.

(e) GAO Study and Report on State-Level Integration Between Dual
SNPs and Medicaid.–
(1) Study.–The Comptroller General of the United States (in
this subsection referred to as the “Comptroller General”)
shall conduct a study on State-level integration between
specialized MA plans for special needs individuals described in
subsection (b)(6) (B)(ii) of section 1859 of the Social Security
Act (42 U.S.C. 1395w-28) and the Medicaid program under title
XIX of such Act (42 U.S.C. 1396 et seq.). <<NOTE: Analysis.>>
Such study shall include an analysis of the following:
(A) The characteristics of States in which the State
agency responsible for administering the State plan
under such title XIX has a contract with such a
specialized MA plan and that delivers long-term services
and supports under the State plan under such title XIX
through a managed care program, including the
requirements under such State plan with respect to long-
term services and supports.
(B) The types of such specialized MA plans, which
may include the following:
(i) A plan described in section
1853(a)(1)(B)(iv)(II) of such Act (42 U.S.C.
1395w-23(a)(1)(B)(iv)(II)).
(ii) A plan that meets the requirements
described in subsection (f)(3)(D) of such section
1859.
(iii) A plan described in clause (ii) that
also meets additional requirements established by
the State.

[[Page 132 STAT. 200]]

(C) The characteristics of individuals enrolled in
such specialized MA plans.
(D) As practicable, the following with respect to
State programs for the delivery of long-term services
and supports under such title XIX through a managed care
program:
(i) Which populations of individuals are
eligible to receive such services and supports.
(ii) Whether all such services and supports
are provided on a capitated basis or if any of
such services and supports are carved out and
provided through fee-for service.
(E) As practicable, how the availability and
variation of integration arrangements of such
specialized MA plans offered in States affects spending,
service delivery options, access to community-based
care, and utilization of care.
(F) The efforts of State Medicaid programs to
transition dually-eligible beneficiaries receiving long-
term services and supports (LTSS) from institutional
settings to home and community-based settings and
related financial impacts of such transitions.
(G) <<NOTE: Recommenda- tions.>> Barriers and
opportunities for making further progress on dual
integration, as well as recommendations for legislation
or administrative action to expedite or refine pathways
toward fully integrated care.
(2) Report.– <<NOTE: Recommenda- tions.>> Not later than 2
years after the date of the enactment of this Act, the
Comptroller General shall submit to Congress a report containing
the results of the study conducted under paragraph (1), together
with recommendations for such legislation and administrative
action as the Comptroller General determines appropriate.

Subtitle C–Expanding Innovation and Technology

SEC. 50321. ADAPTING BENEFITS TO MEET THE NEEDS OF CHRONICALLY ILL
MEDICARE ADVANTAGE ENROLLEES.

Section 1859 of the Social Security Act (42 U.S.C. 1395w-28) is
amended by adding at the end the following new subsection:
“(h) National Testing of Medicare Advantage Value-Based Insurance
Design Model.–
“(1) <<NOTE: Revision. Deadline.>> In general.–In
implementing the Medicare Advantage Value-Based Insurance Design
model that is being tested under section 1115A(b), the Secretary
shall revise the testing of the model under such section to
cover, effective not later than January 1, 2020, all States.
“(2) Termination and modification provision not applicable
until january 1, 2022.–The provisions of section 1115A(b)(3)(B)
shall apply to the Medicare Advantage Value-Based Insurance
Design model, including such model as revised under paragraph
(1), beginning January 1, 2022, but shall not apply to such
model, as so revised, prior to such date.
“(3) Funding.–The Secretary shall allocate funds made
available under section 1115A(f)(1) to design, implement, and
evaluate the Medicare Advantage Value-Based Insurance Design
model, as revised under paragraph (1).”.

[[Page 132 STAT. 201]]

SEC. 50322. EXPANDING SUPPLEMENTAL BENEFITS TO MEET THE NEEDS OF
CHRONICALLY ILL MEDICARE ADVANTAGE
ENROLLEES.

(a) In General.–Section 1852(a)(3) of the Social Security Act (42
U.S.C. 1395w-22(a)(3)) is amended–
(1) in subparagraph (A), by striking “Each” and inserting
“Subject to subparagraph (D), each”; and
(2) by adding at the end the following new subparagraph:
“(D) Expanding supplemental benefits to meet the
needs of chronically ill enrollees.–
“(i) In general.–For plan year 2020 and
subsequent plan years, in addition to any
supplemental health care benefits otherwise
provided under this paragraph, an MA plan,
including a specialized MA plan for special needs
individuals (as defined in section 1859(b)(6)),
may provide supplemental benefits described in
clause (ii) to a chronically ill enrollee (as
defined in clause (iii)).
“(ii) Supplemental benefits described.–
“(I) In general.–Supplemental
benefits described in this clause are
supplemental benefits that, with respect
to a chronically ill enrollee, have a
reasonable expectation of improving or
maintaining the health or overall
function of the chronically ill enrollee
and may not be limited to being
primarily health related benefits.
“(II) <<NOTE: Determination.>>
Authority to waive uniformity
requirements.–The Secretary may, only
with respect to supplemental benefits
provided to a chronically ill enrollee
under this subparagraph, waive the
uniformity requirements under this part,
as determined appropriate by the
Secretary.
“(iii) Chronically ill enrollee defined.–In
this subparagraph, the term `chronically ill
enrollee’ means an enrollee in an MA plan that the
Secretary determines–
“(I) has one or more comorbid and
medically complex chronic conditions
that is life threatening or
significantly limits the overall health
or function of the enrollee;
“(II) has a high risk of
hospitalization or other adverse health
outcomes; and
“(III) requires intensive care
coordination.”.

(b) GAO Study and Report.–
(1) Study.–The Comptroller General of the United States (in
this subsection referred to as the “Comptroller General”)
shall conduct a study on supplemental benefits provided to
enrollees in Medicare Advantage plans under part C of title
XVIII of the Social Security Act, including specialized MA plans
for special needs individuals (as defined in section 1859(b)(6)
of such Act (42 U.S.C. 1395w-28(b)(6))). <<NOTE: Analysis.>> To
the extend data are available, such study shall include an
analysis of the following:
(A) The type of supplemental benefits provided to
such enrollees, the total number of enrollees receiving
each

[[Page 132 STAT. 202]]

supplemental benefit, and whether the supplemental
benefit is covered by the standard benchmark cost of the
benefit or with an additional premium.
(B) The frequency in which supplemental benefits are
utilized by such enrollees.
(C) The impact supplemental benefits have on–
(i) indicators of the quality of care received
by such enrollees, including overall health and
function of the enrollees;
(ii) the utilization of items and services for
which benefits are available under the original
Medicare fee-for-service program option under
parts A and B of such title XVIII by such
enrollees; and
(iii) the amount of the bids submitted by
Medicare Advantage Organizations for Medicare
Advantage plans under such part C.
(2) Consultation.–In conducting the study under paragraph
(1), the Comptroller General shall, as necessary, consult with
the Centers for Medicare & Medicaid Services and Medicare
Advantage organizations offering Medicare Advantage plans.
(3) <<NOTE: Recommenda- tions.>> Report.–Not later than 5
years after the date of the enactment of this Act, the
Comptroller General shall submit to Congress a report containing
the results of the study conducted under paragraph (1), together
with recommendations for such legislation and administrative
action as the Comptroller General determines appropriate.
SEC. 50323. INCREASING CONVENIENCE FOR MEDICARE ADVANTAGE
ENROLLEES THROUGH TELEHEALTH.

(a) In General.–Section 1852 of the Social Security Act (42 U.S.C.
1395w-22) is amended–
(1) in subsection (a)(1)(B)(i), by inserting “, subject to
subsection (m),” after “means”; and
(2) by adding at the end the following new subsection:

“(m) Provision of Additional Telehealth Benefits.–
“(1) MA plan option.–For plan year 2020 and subsequent
plan years, subject to the requirements of paragraph (3), an MA
plan may provide additional telehealth benefits (as defined in
paragraph (2)) to individuals enrolled under this part.
“(2) Additional telehealth benefits defined.–
“(A) In general.–For purposes of this subsection
and section 1854:
“(i) Definition.–The term `additional
telehealth benefits’ means services–
“(I) for which benefits are
available under part B, including
services for which payment is not made
under section 1834(m) due to the
conditions for payment under such
section; and
“(II) that are identified for such
year as clinically appropriate to
furnish using electronic information and
telecommunications technology when a
physician (as defined in section
1861(r)) or practitioner (described in
section 1842(b)(18)(C)) providing the
service is not at the same location as
the plan enrollee.

[[Page 132 STAT. 203]]

“(ii) Exclusion of capital and infrastructure
costs and investments.–The term `additional
telehealth benefits’ does not include capital and
infrastructure costs and investments relating to
such benefits.
“(B) <<NOTE: Deadline.>> Public comment.–Not
later than November 30, 2018, the Secretary shall
solicit comments on–
“(i) what types of items and services
(including those provided through supplemental
health care benefits, such as remote patient
monitoring, secure messaging, store and forward
technologies, and other non-face-to-face
communication) should be considered to be
additional telehealth benefits; and
“(ii) the requirements for the provision or
furnishing of such benefits (such as training and
coordination requirements).
“(3) Requirements for additional telehealth benefits.–The
Secretary shall specify requirements for the provision or
furnishing of additional telehealth benefits, including with
respect to the following:
“(A) Physician or practitioner qualifications
(other than licensure) and other requirements such as
specific training.
“(B) Factors necessary for the coordination of such
benefits with other items and services including those
furnished in-person.
“(C) <<NOTE: Determination.>> Such other areas as
determined by the Secretary.
“(4) Enrollee choice.–If an MA plan provides a service as
an additional telehealth benefit (as defined in paragraph (2))–
“(A) the MA plan shall also provide access to such
benefit through an in-person visit (and not only as an
additional telehealth benefit); and
“(B) an individual enrollee shall have discretion
as to whether to receive such service through the in-
person visit or as an additional telehealth benefit.
“(5) Treatment under ma.–For purposes of this subsection
and section 1854, if a plan provides additional telehealth
benefits, such additional telehealth benefits shall be treated
as if they were benefits under the original Medicare fee-for-
service program option.
“(6) Construction.–Nothing in this subsection shall be
construed as affecting the requirement under subsection (a)(1)
that MA plans provide enrollees with items and services (other
than hospice care) for which benefits are available under parts
A and B, including benefits available under section 1834(m).”.

(b) Clarification Regarding Inclusion in Bid Amount.–Section
1854(a)(6)(A)(ii)(I) of the Social Security Act (42 U.S.C. 1395w-
24(a)(6)(A)(ii)(I)) is amended by inserting “, including, for plan year
2020 and subsequent plan years, the provision of additional telehealth
benefits as described in section 1852(m)” before the semicolon at the
end.
SEC. 50324. PROVIDING ACCOUNTABLE CARE ORGANIZATIONS THE ABILITY
TO EXPAND THE USE OF TELEHEALTH.

(a) In General.–Section 1899 of the Social Security Act (42 U.S.C.
1395jjj) is amended by adding at the end the following new subsection:

[[Page 132 STAT. 204]]

“(l) Providing ACOs the Ability To Expand the Use of Telehealth
Services.–
“(1) In general.–In the case of telehealth services for
which payment would otherwise be made under this title furnished
on or after January 1, 2020, for purposes of this subsection
only, the following shall apply with respect to such services
furnished by a physician or practitioner participating in an
applicable ACO (as defined in paragraph (2)) to a Medicare fee-
for-service beneficiary assigned to the applicable ACO:
“(A) Inclusion of home as originating site.–
Subject to paragraph (3), the home of a beneficiary
shall be treated as an originating site described in
section 1834(m)(4)(C)(ii).
“(B) No application of geographic limitation.–The
geographic limitation under section 1834(m)(4)(C)(i)
shall not apply with respect to an originating site
described in section 1834(m)(4)(C)(ii) (including the
home of a beneficiary under subparagraph (A)), subject
to State licensing requirements.
“(2) Definitions.–In this subsection:
“(A) Applicable aco.–The term `applicable ACO’
means an ACO participating in a model tested or expanded
under section 1115A or under this section–
“(i) that operates under a two-sided model–
“(I) described in section
425.600(a) of title 42, Code of Federal
Regulations; or
“(II) tested or expanded under
section 1115A; and
“(ii) for which Medicare fee-for-service
beneficiaries are assigned to the ACO using a
prospective assignment method, as determined
appropriate by the Secretary.
“(B) Home.–The term `home’ means, with respect to
a Medicare fee-for-service beneficiary, the place of
residence used as the home of the beneficiary.
“(3) <<NOTE: Applicability.>> Telehealth services received
in the home.–In the case of telehealth services described in
paragraph (1) where the home of a Medicare fee-for-service
beneficiary is the originating site, the following shall apply:
“(A) No facility fee.–There shall be no facility
fee paid to the originating site under section
1834(m)(2)(B).
“(B) Exclusion of certain services.–No payment may
be made for such services that are inappropriate to
furnish in the home setting such as services that are
typically furnished in inpatient settings such as a
hospital.”.

(b) Study and Report.–
(1) Study.–
(A) In general.– <<NOTE: 42 USC 1395jjj note.>> The
Secretary of Health and Human Services (in this
subsection referred to as the “Secretary”) shall
conduct a study on the implementation of section 1899(l)
of the Social Security Act, as added by subsection
(a). <<NOTE: Analysis.>> Such study shall include an
analysis of the utilization of, and expenditures for,
telehealth services under such section.
(B) Collection of data.–The Secretary may collect
such data as the Secretary determines necessary to carry
out the study under this paragraph.

[[Page 132 STAT. 205]]

(2) <<NOTE: Recommenda- tions. 42 USC 1395jjj note.>>
Report.–Not later than January 1, 2026, the Secretary shall
submit to Congress a report containing the results of the study
conducted under paragraph (1), together with recommendations for
such legislation and administrative action as the Secretary
determines appropriate.
SEC. 50325. EXPANDING THE USE OF TELEHEALTH FOR INDIVIDUALS WITH
STROKE.

Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)), as
amended by section 50302(b)(1), is amended–
(1) in paragraph (4)(C)(i), in the matter preceding
subclause (I), by striking “The term” and inserting “Except
as provided in paragraph (6), the term”; and
(2) by adding at the end the following new paragraph:
“(6) Treatment of stroke telehealth services.–
“(A) Non-application of originating site
requirements.– <<NOTE: Determination.>> The
requirements described in paragraph (4)(C) shall not
apply with respect to telehealth services furnished on
or after January 1, 2019, for purposes of diagnosis,
evaluation, or treatment of symptoms of an acute stroke,
as determined by the Secretary.
“(B) <<NOTE: Definition.>> Inclusion of certain
sites.–With respect to telehealth services described in
subparagraph (A), the term `originating site’ shall
include any hospital (as defined in section 1861(e)) or
critical access hospital (as defined in section
1861(mm)(1)), any mobile stroke unit (as defined by the
Secretary), or any other site determined appropriate by
the Secretary, at which the eligible telehealth
individual is located at the time the service is
furnished via a telecommunications system.
“(C) No originating site facility fee for new
sites.–No facility fee shall be paid under paragraph
(2)(B) to an originating site with respect to a
telehealth service described in subparagraph (A) if the
originating site does not otherwise meet the
requirements for an originating site under paragraph
(4)(C).”.

Subtitle D–Identifying the Chronically Ill Population

SEC. 50331. PROVIDING FLEXIBILITY FOR BENEFICIARIES TO BE PART OF
AN ACCOUNTABLE CARE ORGANIZATION.

Section 1899(c) of the Social Security Act (42 U.S.C. 1395jjj(c)) is
amended–
(1) by redesignating paragraphs (1) and (2) as subparagraphs
(A) and (B), respectively, and indenting appropriately;
(2) by striking “ACOs.–The Secretary” and inserting
“ACOs.–
“(1) In general.–Subject to paragraph (2), the
Secretary”; and
(3) by adding at the end the following new paragraph:
“(2) Providing flexibility.–
“(A) <<NOTE: Contracts.>> Choice of prospective
assignment.–For each agreement period (effective for
agreements entered into or renewed on or after January
1, 2020), in the case where an ACO established under the
program is in a Track that

[[Page 132 STAT. 206]]

provides for the retrospective assignment of Medicare
fee-for-service beneficiaries to the ACO, the Secretary
shall permit the ACO to choose to have Medicare fee-for-
service beneficiaries assigned prospectively, rather
than retrospectively, to the ACO for an agreement
period.
“(B) Assignment based on voluntary identification
by medicare fee-for-service beneficiaries.–
“(i) <<NOTE: Determination.>> In general.–
For performance year 2018 and each subsequent
performance year, if a system is available for
electronic designation, the Secretary shall permit
a Medicare fee-for-service beneficiary to
voluntarily identify an ACO professional as the
primary care provider of the beneficiary for
purposes of assigning such beneficiary to an ACO,
as determined by the Secretary.
“(ii) Notification process.–The Secretary
shall establish a process under which a Medicare
fee-for-service beneficiary is–
“(I) notified of their ability to
make an identification described in
clause (i); and
“(II) informed of the process by
which they may make and change such
identification.
“(iii) <<NOTE: Determination.>> Superseding
claims-based assignment.–A voluntary
identification by a Medicare fee-for-service
beneficiary under this subparagraph shall
supersede any claims-based assignment otherwise
determined by the Secretary.”.

Subtitle E–Empowering Individuals and Caregivers in Care Delivery

SEC. 50341. ELIMINATING BARRIERS TO CARE COORDINATION UNDER
ACCOUNTABLE CARE ORGANIZATIONS.

(a) In General.–Section 1899 of the Social Security Act (42 U.S.C.
1395jjj), as amended by section 50324(a), is amended–
(1) in subsection (b)(2), by adding at the end the following
new subparagraph:
“(I) <<NOTE: Application.>> An ACO that seeks to
operate an ACO Beneficiary Incentive Program pursuant to
subsection (m) shall apply to the Secretary at such
time, in such manner, and with such information as the
Secretary may require.”;
(2) by adding at the end the following new subsection:

“(m) Authority To Provide Incentive Payments to Beneficiaries With
Respect to Qualifying Primary Care Services.–
“(1) Program.–
“(A) In general.–In order to encourage Medicare
fee-for-service beneficiaries to obtain medically
necessary primary care services, an ACO participating
under this section under a payment model described in
clause (i) or (ii) of paragraph (2)(B) may apply to
establish an ACO Beneficiary Incentive Program to
provide incentive payments to such beneficiaries who are
furnished qualifying services in accordance with this
subsection. The Secretary shall permit such an ACO to
establish such a program at the Secretary’s discretion
and subject to such requirements,

[[Page 132 STAT. 207]]

including program integrity requirements, as the
Secretary determines necessary.
“(B) <<NOTE: Determination.>> Implementation.–The
Secretary shall implement this subsection on a date
determined appropriate by the Secretary. <<NOTE: Time
period.>> Such date shall be no earlier than January 1,
2019, and no later than January 1, 2020.
“(2) Conduct of program.–
“(A) Duration.–Subject to subparagraph (H), an ACO
Beneficiary Incentive Program established under this
subsection shall be conducted for such period (of not
less than 1 year) as the Secretary may approve.
“(B) <<NOTE: Determinations.>> Scope.–An ACO
Beneficiary Incentive Program established under this
subsection shall provide incentive payments to all of
the following Medicare fee-for-service beneficiaries who
are furnished qualifying services by the ACO:
“(i) With respect to the Track 2 and Track 3
payment models described in section 425.600(a) of
title 42, Code of Federal Regulations (or in any
successor regulation), Medicare fee-for-service
beneficiaries who are preliminarily prospectively
or prospectively assigned (or otherwise assigned,
as determined by the Secretary) to the ACO.
“(ii) With respect to any future payment
models involving two-sided risk, Medicare fee-for-
service beneficiaries who are assigned to the ACO,
as determined by the Secretary.
“(C) Qualifying service.–For purposes of this
subsection, a qualifying service is a primary care
service, as defined in section 425.20 of title 42, Code
of Federal Regulations (or in any successor regulation),
with respect to which coinsurance applies under part B,
furnished through an ACO by–
“(i) an ACO professional described in
subsection (h)(1)(A) who has a primary care
specialty designation included in the definition
of primary care physician under section 425.20 of
title 42, Code of Federal Regulations (or any
successor regulation);
“(ii) an ACO professional described in
subsection (h)(1)(B); or
“(iii) a Federally qualified health center or
rural health clinic (as such terms are defined in
section 1861(aa)).
“(D) Incentive payments.–An incentive payment made
by an ACO pursuant to an ACO Beneficiary Incentive
Program established under this subsection shall be–
“(i) <<NOTE: Time period.>> in an amount up
to $20, with such maximum amount updated annually
by the percentage increase in the consumer price
index for all urban consumers (United States city
average) for the 12-month period ending with June
of the previous year;
“(ii) in the same amount for each Medicare
fee-for-service beneficiary described in clause
(i) or (ii) of subparagraph (B) without regard to
enrollment of such a beneficiary in a medicare
supplemental policy (described in section
1882(g)(1)), in a State Medicaid plan under title
XIX or a waiver of such a plan, or

[[Page 132 STAT. 208]]

in any other health insurance policy or health
benefit plan;
“(iii) made for each qualifying service
furnished to such a beneficiary described in
clause (i) or (ii) of subparagraph (B) during a
period specified by the Secretary; and
“(iv) <<NOTE: Deadline.>> made no later than
30 days after a qualifying service is furnished to
such a beneficiary described in clause (i) or (ii)
of subparagraph (B).
“(E) No separate payments from the secretary.–The
Secretary shall not make any separate payment to an ACO
for the costs, including incentive payments, of carrying
out an ACO Beneficiary Incentive Program established
under this subsection. Nothing in this subparagraph
shall be construed as prohibiting an ACO from using
shared savings received under this section to carry out
an ACO Beneficiary Incentive Program.
“(F) No application to shared savings
calculation.–Incentive payments made by an ACO under
this subsection shall be disregarded for purposes of
calculating benchmarks, estimated average per capita
Medicare expenditures, and shared savings under this
section.
“(G) Reporting requirements.–An ACO conducting an
ACO Beneficiary Incentive Program under this subsection
shall, at such times and in such format as the Secretary
may require, report to the Secretary such information
and retain such documentation as the Secretary may
require, including the amount and frequency of incentive
payments made and the number of Medicare fee-for-service
beneficiaries receiving such payments.
“(H) Termination.–The Secretary may terminate an
ACO Beneficiary Incentive Program established under this
subsection at any time for reasons determined
appropriate by the Secretary.
“(3) Exclusion of incentive payments.–Any payment made
under an ACO Beneficiary Incentive Program established under
this subsection shall not be considered income or resources or
otherwise taken into account for purposes of–
“(A) determining eligibility for benefits or
assistance (or the amount or extent of benefits or
assistance) under any Federal program or under any State
or local program financed in whole or in part with
Federal funds; or
“(B) any Federal or State laws relating to
taxation.”;
(3) in subsection (e), by inserting “, including an ACO
Beneficiary Incentive Program under subsections (b)(2)(I) and
(m)” after “the program”; and
(4) in subsection (g)(6), by inserting “or of an ACO
Beneficiary Incentive Program under subsections (b)(2)(I) and
(m)” after “under subsection (d)(4)”.

(b) Amendment to Section 1128B.–Section 1128B(b)(3) of the Social
Security Act (42 U.S.C. 1320a-7b(b)(3)) is amended–
(1) by striking “and” at the end of subparagraph (I);
(2) by striking the period at the end of subparagraph (J)
and inserting “; and”; and
(3) by adding at the end the following new subparagraph:

[[Page 132 STAT. 209]]

“(K) an incentive payment made to a Medicare fee-
for-service beneficiary by an ACO under an ACO
Beneficiary Incentive Program established under
subsection (m) of section 1899, if the payment is made
in accordance with the requirements of such subsection
and meets such other conditions as the Secretary may
establish.”.

(c) Evaluation and Report.–
(1) Evaluation.–The Secretary of Health and Human Services
(in this subsection referred to as the “Secretary”) shall
conduct an evaluation of the ACO Beneficiary Incentive Program
established under subsections (b)(2)(I) and (m) of section 1899
of the Social Security Act (42 U.S.C. 1395jjj), as added by
subsection (a). <<NOTE: Analysis.>> The evaluation shall
include an analysis of the impact of the implementation of the
Program on expenditures and beneficiary health outcomes under
title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
(2) Report.– <<NOTE: Recommenda- tions.>> Not later than
October 1, 2023, the Secretary shall submit to Congress a report
containing the results of the evaluation under paragraph (1),
together with recommendations for such legislation and
administrative action as the Secretary determines appropriate.
SEC. 50342. GAO STUDY AND REPORT ON LONGITUDINAL COMPREHENSIVE
CARE PLANNING SERVICES UNDER MEDICARE
PART B.

(a) Study.–The Comptroller General shall conduct a study on the
establishment under part B of the Medicare program under title XVIII of
the Social Security Act of a payment code for a visit for longitudinal
comprehensive care planning services. <<NOTE: Analysis.>> Such study
shall include an analysis of the following to the extent such
information is available:
(1) The frequency with which services similar to
longitudinal comprehensive care planning services are furnished
to Medicare beneficiaries, which providers of services and
suppliers are furnishing those services, whether Medicare
reimbursement is being received for those services, and, if so,
through which codes those services are being reimbursed.
(2) Whether, and the extent to which, longitudinal
comprehensive care planning services would overlap, and could
therefore result in duplicative payment, with services covered
under the hospice benefit as well as the chronic care management
code, evaluation and management codes, or other codes that
already exist under part B of the Medicare program.
(3) Any barriers to hospitals, skilled nursing facilities,
hospice programs, home health agencies, and other applicable
providers working with a Medicare beneficiary to engage in the
care planning process and complete the necessary documentation
to support the treatment and care plan of the beneficiary and
provide such documentation to other providers and the
beneficiary or the beneficiary’s representative.
(4) Any barriers to providers, other than the provider
furnishing longitudinal comprehensive care planning services,
accessing the care plan and associated documentation for use
related to the care of the Medicare beneficiary.
(5) Potential options for ensuring that applicable providers
are notified of a patient’s existing longitudinal care plan and
that applicable providers consider that plan in making their

[[Page 132 STAT. 210]]

treatment decisions, and what the challenges might be in
implementing such options.
(6) Stakeholder’s views on the need for the development of
quality metrics with respect to longitudinal comprehensive care
planning services, such as measures related to–
(A) the process of eliciting input from the Medicare
beneficiary or from a legally authorized representative
and documenting in the medical record the patient-
directed care plan;
(B) the effectiveness and patient-centeredness of
the care plan in organizing delivery of services
consistent with the plan;
(C) the availability of the care plan and associated
documentation to other providers that care for the
beneficiary; and
(D) the extent to which the beneficiary received
services and support that is free from discrimination
based on advanced age, disability status, or advanced
illness.
(7) Stakeholder’s views on how such quality metrics would
provide information on–
(A) the goals, values, and preferences of the
beneficiary;
(B) the documentation of the care plan;
(C) services furnished to the beneficiary; and
(D) outcomes of treatment.
(8) Stakeholder’s views on–
(A) the type of training and education needed for
applicable providers, individuals, and caregivers in
order to facilitate longitudinal comprehensive care
planning services;
(B) the types of providers of services and suppliers
that should be included in the interdisciplinary team of
an applicable provider; and
(C) the characteristics of Medicare beneficiaries
that would be most appropriate to receive longitudinal
comprehensive care planning services, such as
individuals with advanced disease and individuals who
need assistance with multiple activities of daily
living.
(9) Stakeholder’s views on the frequency with which
longitudinal comprehensive care planning services should be
furnished.

(b) Report.– <<NOTE: Recommenda- tions.>> Not later than 18 months
after the date of the enactment of this Act, the Comptroller General
shall submit to Congress a report containing the results of the study
conducted under subsection (a), together with recommendations for such
legislation and administrative action as the Comptroller General
determines appropriate.

(c) Definitions.–In this section:
(1) Applicable provider.–The term “applicable provider”
means a hospice program (as defined in subsection (dd)(2) of
section 1861 of the Social Security Act (42 U.S.C. 1395ww)) or
other provider of services (as defined in subsection (u) of such
section) or supplier (as defined in subsection (d) of such
section) that–
(A) furnishes longitudinal comprehensive care
planning services through an interdisciplinary team; and
(B) meets such other requirements as the Secretary
may determine to be appropriate.

[[Page 132 STAT. 211]]

(2) Comptroller general.–The term “Comptroller General”
means the Comptroller General of the United States.
(3) Interdisciplinary team.–The term “interdisciplinary
team” means a group that–
(A) includes the personnel described in subsection
(dd)(2)(B)(i) of such section 1861;
(B) may include a chaplain, minister, or other
clergy; and
(C) may include other direct care personnel.
(4) Longitudinal comprehensive care planning services.–The
term “longitudinal comprehensive care planning services” means
a voluntary shared decisionmaking process that is furnished by
an applicable provider through an interdisciplinary team and
includes a conversation with Medicare beneficiaries who have
received a diagnosis of a serious or life-threatening illness.
The purpose of such services is to discuss a longitudinal care
plan that addresses the progression of the disease, treatment
options, the goals, values, and preferences of the beneficiary,
and the availability of other resources and social supports that
may reduce the beneficiary’s health risks and promote self-
management and shared decisionmaking.
(5) Secretary.–The term “Secretary” means the Secretary
of Health and Human Services.

Subtitle F–Other Policies to Improve Care for the Chronically Ill

SEC. 50351. GAO STUDY AND REPORT ON IMPROVING MEDICATION
SYNCHRONIZATION.

(a) Study.–The Comptroller General of the United States (in this
section referred to as the “Comptroller General”) shall conduct a
study on the extent to which Medicare prescription drug plans (MA-PD
plans and stand alone prescription drug plans) under part D of title
XVIII of the Social Security Act and private payors use programs that
synchronize pharmacy dispensing so that individuals may receive multiple
prescriptions on the same day to facilitate comprehensive counseling and
promote medication adherence. <<NOTE: Analysis.>> The study shall
include a analysis of the following:
(1) The extent to which pharmacies have adopted such
programs.
(2) The common characteristics of such programs, including
how pharmacies structure counseling sessions under such programs
and the types of payment and other arrangements that Medicare
prescription drug plans and private payors employ under such
programs to support the efforts of pharmacies.
(3) How such programs compare for Medicare prescription drug
plans and private payors.
(4) What is known about how such programs affect patient
medication adherence and overall patient health outcomes,
including if adherence and outcomes vary by patient
subpopulations, such as disease state and socioeconomic status.
(5) What is known about overall patient satisfaction with
such programs and satisfaction with such programs, including
within patient subpopulations, such as disease state and
socioeconomic status.

[[Page 132 STAT. 212]]

(6) The extent to which laws and regulations of the Medicare
program support such programs.
(7) Barriers to the use of medication synchronization
programs by Medicare prescription drug plans.

(b) Report.– <<NOTE: Recommenda- tions.>> Not later than 18 months
after the date of the enactment of this Act, the Comptroller General
shall submit to Congress a report containing the results of the study
under subsection (a), together with recommendations for such legislation
and administrative action as the Comptroller General determines
appropriate.
SEC. 50352. GAO STUDY AND REPORT ON IMPACT OF OBESITY DRUGS ON
PATIENT HEALTH AND SPENDING.

(a) Study.–The Comptroller General of the United States (in this
section referred to as the “Comptroller General”) shall, to the extent
data are available, conduct a study on the use of prescription drugs to
manage the weight of obese patients and the impact of coverage of such
drugs on patient health and on health care spending. Such study shall
examine the use and impact of these obesity drugs in the non-Medicare
population and for Medicare beneficiaries who have such drugs covered
through an MA-PD plan (as defined in section 1860D-1(a)(3)(C) of the
Social Security Act (42 U.S.C. 1395w-101(a)(3)(C))) as a supplemental
health care benefit. <<NOTE: Analysis.>> The study shall include an
analysis of the following:
(1) The prevalence of obesity in the Medicare and non-
Medicare population.
(2) The utilization of obesity drugs.
(3) The distribution of Body Mass Index by individuals
taking obesity drugs, to the extent practicable.
(4) What is known about the use of obesity drugs in
conjunction with the receipt of other items or services, such as
behavioral counseling, and how these compare to items and
services received by obese individuals who do not take obesity
drugs.
(5) Physician considerations and attitudes related to
prescribing obesity drugs.
(6) The extent to which coverage policies cease or limit
coverage for individuals who fail to receive clinical benefit.
(7) What is known about the extent to which individuals who
take obesity drugs adhere to the prescribed regimen.
(8) What is known about the extent to which individuals who
take obesity drugs maintain weight loss over time.
(9) What is known about the subsequent impact such drugs
have on medical services that are directly related to obesity,
including with respect to subpopulations determined based on the
extent of obesity.
(10) What is known about the spending associated with the
care of individuals who take obesity drugs, compared to the
spending associated with the care of individuals who do not take
such drugs.

(b) Report.– <<NOTE: Recommenda- tions.>> Not later than 18 months
after the date of the enactment of this Act, the Comptroller General
shall submit to Congress a report containing the results of the study
under subsection (a), together with recommendations for such legislation
and administrative action as the Comptroller General determines
appropriate.

[[Page 132 STAT. 213]]

SEC. 50353. HHS STUDY AND REPORT ON LONG-TERM RISK FACTORS FOR
CHRONIC CONDITIONS AMONG MEDICARE
BENEFICIARIES.

(a) Study.–The Secretary of Health and Human Services (in this
section referred to as the “Secretary”) shall conduct a study on long-
term cost drivers to the Medicare program, including obesity, tobacco
use, mental health conditions, and other factors that may contribute to
the deterioration of health conditions among individuals with chronic
conditions in the Medicare population. The <<NOTE: Analysis.>> study
shall include an analysis of any barriers to collecting and analyzing
such information and how to remove any such barriers (including through
legislation and administrative actions).

(b) Report.– <<NOTE: Recommenda- tions.>> Not later than 18 months
after the date of the enactment of this Act, the Secretary shall submit
to Congress a report containing the results of the study under
subsection (a), together with recommendations for such legislation and
administrative action as the Secretary determines
appropriate. <<NOTE: Web posting.>> The Secretary shall also post such
report on the Internet website of the Department of Health and Human
Services.
SEC. 50354. PROVIDING PRESCRIPTION DRUG PLANS WITH PARTS A AND B
CLAIMS DATA TO PROMOTE THE APPROPRIATE
USE OF MEDICATIONS AND IMPROVE HEALTH
OUTCOMES.

Section 1860D-4(c) of the Social Security Act (42 U.S.C. 1395w-
104(c)) is amended by adding at the end the following new paragraph:
“(6) Providing prescription drug plans with parts a and b
claims data to promote the appropriate use of medications and
improve health outcomes.–
“(A) Process.–Subject to subparagraph (B), the
Secretary shall establish a process under which a PDP
sponsor of a prescription drug plan may submit a request
for the Secretary to provide the sponsor, on a periodic
basis and in an electronic format, beginning in plan
year 2020, data described in subparagraph (D) with
respect to enrollees in such plan. Such data shall be
provided without regard to whether such enrollees are
described in clause (ii) of paragraph (2)(A).
“(B) Purposes.–A PDP sponsor may use the data
provided to the sponsor pursuant to subparagraph (A) for
any of the following purposes:
“(i) To optimize therapeutic outcomes through
improved medication use, as such phrase is used in
clause (i) of paragraph (2)(A).
“(ii) To improving care coordination so as to
prevent adverse health outcomes, such as
preventable emergency department visits and
hospital readmissions.
“(iii) <<NOTE: Determination.>> For any
other purpose determined appropriate by the
Secretary.
“(C) Limitations on data use.–A PDP sponsor shall
not use data provided to the sponsor pursuant to
subparagraph (A) for any of the following purposes:
“(i) To inform coverage determinations under
this part.

[[Page 132 STAT. 214]]

“(ii) To conduct retroactive reviews of
medically accepted indications determinations.
“(iii) To facilitate enrollment changes to a
different prescription drug plan or an MA-PD plan
offered by the same parent organization.
“(iv) To inform marketing of benefits.
“(v) <<NOTE: Determination.>> For any other
purpose that the Secretary determines is necessary
to include in order to protect the identity of
individuals entitled to, or enrolled for, benefits
under this title and to protect the security of
personal health information.
“(D) <<NOTE: Determination.>> Data described.–The
data described in this clause are standardized extracts
(as determined by the Secretary) of claims data under
parts A and B for items and services furnished under
such parts for time periods specified by the Secretary.
Such data shall include data as current as
practicable.”.

TITLE IV–PART B IMPROVEMENT ACT AND OTHER PART B ENHANCEMENTS

Subtitle A–Medicare Part B Improvement Act

SEC. 50401. HOME INFUSION THERAPY SERVICES TEMPORARY TRANSITIONAL
PAYMENT.

(a) In General.–Section 1834(u) of the Social Security Act (42
U.S.C. 1395m(u)) is amended, by adding at the end the following new
paragraph:
“(7) Home infusion therapy services temporary transitional
payment.–
“(A) Temporary transitional payment.–
“(i) In general.–The Secretary shall, in
accordance with the payment methodology described
in subparagraph (B) and subject to the provisions
of this paragraph, provide a home infusion therapy
services temporary transitional payment under this
part to an eligible home infusion supplier (as
defined in subparagraph (F)) for items and
services described in subparagraphs (A) and (B) of
section 1861(iii)(2)) furnished during the period
specified in clause (ii) by such supplier in
coordination with the furnishing of transitional
home infusion drugs (as defined in clause (iii)).
“(ii) Period specified.–For purposes of
clause (i), the period specified in this clause is
the period beginning on January 1, 2019, and
ending on the day before the date of the
implementation of the payment system under
paragraph (1)(A).
“(iii) Transitional home infusion drug
defined.–For purposes of this paragraph, the term
`transitional home infusion drug’ has the meaning
given to the term `home infusion drug’ under
section 1861(iii)(3)(C)), except that clause (ii)
of such section shall not apply if a drug
described in such clause

[[Page 132 STAT. 215]]

is identified in clauses (i), (ii), (iii) or (iv)
of subparagraph (C) as of the date of the
enactment of this paragraph.
“(B) Payment methodology.–For purposes of this
paragraph, the Secretary shall establish a payment
methodology, with respect to items and services
described in subparagraph (A)(i). Under such payment
methodology the Secretary shall–
“(i) create the three payment categories
described in clauses (i), (ii), and (iii) of
subparagraph (C);
“(ii) assign drugs to such categories, in
accordance with such clauses;
“(iii) assign appropriate Healthcare Common
Procedure Coding System (HCPCS) codes to each
payment category; and
“(iv) establish a single payment amount for
each such payment category, in accordance with
subparagraph (D), for each infusion drug
administration calendar day in the individual’s
home for drugs assigned to such category.
“(C) Payment categories.–
“(i) Payment category 1.–The Secretary shall
create a payment category 1 and assign to such
category drugs which are covered under the Local
Coverage Determination on External Infusion Pumps
(LCD number L33794) and billed with the following
HCPCS codes (as identified as of January 1, 2018,
and as subsequently modified by the Secretary):
J0133, J0285, J0287, J0288, J0289, J0895, J1170,
J1250, J1265, J1325, J1455, J1457, J1570, J2175,
J2260, J2270, J2274, J2278, J3010, or J3285.
“(ii) Payment category 2.–The Secretary
shall create a payment category 2 and assign to
such category drugs which are covered under such
local coverage determination and billed with the
following HCPCS codes (as identified as of January
1, 2018, and as subsequently modified by the
Secretary): J1555 JB, J1559 JB, J1561 JB, J1562
JB, J1569 JB, or J1575 JB.
“(iii) Payment category 3.–The Secretary
shall create a payment category 3 and assign to
such category drugs which are covered under such
local coverage determination and billed with the
following HCPCS codes (as identified as of January
1, 2018, and as subsequently modified by the
Secretary): J9000, J9039, J9040, J9065, J9100,
J9190, J9200, J9360, or J9370.
“(iv) Infusion drugs not otherwise
included.–With <<NOTE: Determination.>> respect
to drugs that are not included in payment category
1, 2, or 3 under clause (i), (ii), or (iii),
respectively, the Secretary shall assign to the
most appropriate of such categories, as determined
by the Secretary, drugs which are–
“(I) covered under such local
coverage determination and billed under
HCPCS codes J7799 or J7999 (as
identified as of July 1, 2017, and as
subsequently modified by the Secretary);
or

[[Page 132 STAT. 216]]

“(II) billed under any code that is
implemented after the date of the
enactment of this paragraph and included
in such local coverage determination or
included in subregulatory guidance as a
home infusion drug described in
subparagraph (A)(i).
“(D) Payment amounts.–
“(i) In general.–Under the payment
methodology, the Secretary shall pay eligible home
infusion suppliers, with respect to items and
services described in subparagraph (A)(i)
furnished during the period described in
subparagraph (A)(ii) by such supplier to an
individual, at amounts equal to the amounts
determined under the physician fee schedule
established under section 1848 for services
furnished during the year for codes and units of
such codes described in clauses (ii), (iii), and
(iv) with respect to drugs included in the payment
category under subparagraph (C) specified in the
respective clause, determined without application
of the geographic adjustment under subsection (e)
of such section.
“(ii) Payment amount for category 1.–For
purposes of clause (i), the codes and units
described in this clause, with respect to drugs
included in payment category 1 described in
subparagraph (C)(i), are one unit of HCPCS code
96365 plus three units of HCPCS code 96366 (as
identified as of January 1, 2018, and as
subsequently modified by the Secretary).
“(iii) Payment amount for category 2.–For
purposes of clause (i), the codes and units
described in this clause, with respect to drugs
included in payment category 2 described in
subparagraph (C)(i), are one unit of HCPCS code
96369 plus three units of HCPCS code 96370 (as
identified as of January 1, 2018, and as
subsequently modified by the Secretary).
“(iv) Payment amount for category 3.–For
purposes of clause (i), the codes and units
described in this clause, with respect to drugs
included in payment category 3 described in
subparagraph (C)(i), are one unit of HCPCS code
96413 plus three units of HCPCS code 96415 (as
identified as of January 1, 2018, and as
subsequently modified by the Secretary).
“(E) Clarifications.–
“(i) Infusion drug administration day.–For
purposes of this subsection, with respect to the
furnishing of transitional home infusion drugs or
home infusion drugs to an individual by an
eligible home infusion supplier or a qualified
home infusion therapy supplier, a reference to
payment to such supplier for an infusion drug
administration calendar day in the individual’s
home shall refer to payment only for the date on
which professional services (as described in
section 1861(iii)(2)(A)) were furnished to
administer such drugs to such individual. For
purposes of the previous sentence, an infusion
drug administration calendar day shall include all
such drugs administered to such individual on such
day.

[[Page 132 STAT. 217]]

“(ii) Treatment of multiple drugs
administered on same infusion drug administration
day.–In the case that an eligible home infusion
supplier, with respect to an infusion drug
administration calendar day in an individual’s
home, furnishes to such individual transitional
home infusion drugs which are not all assigned to
the same payment category under subparagraph (C),
payment to such supplier for such infusion drug
administration calendar day in the individual’s
home shall be a single payment equal to the amount
of payment under this paragraph for the drug,
among all such drugs so furnished to such
individual during such calendar day, for which the
highest payment would be made under this
paragraph.
“(F) <<NOTE: Definition.>> Eligible home infusion
suppliers.–In this paragraph, the term `eligible home
infusion supplier’ means a supplier that is enrolled
under this part as a pharmacy that provides external
infusion pumps and external infusion pump supplies and
that maintains all pharmacy licensure requirements in
the State in which the applicable infusion drugs are
administered.
“(G) Implementation.–Notwithstanding any other
provision of law, the Secretary may implement this
paragraph by program instruction or otherwise.”.

(b) Conforming Amendments.–(1) Section 1842(b)(6)(I) of the Social
Security Act (42 U.S.C. 1395u(b)(6)(I)) is amended by inserting “or, in
the case of items and services described in clause (i) of section
1834(u)(7)(A) furnished to an individual during the period described in
clause (ii) of such section, payment shall be made to the eligible home
infusion therapy supplier” after “payment shall be made to the
qualified home infusion therapy supplier”.
(2) <<NOTE: Applicability. 42 USC 1395l note.>> Section 5012(d) of
the 21st Century Cures Act is amended by inserting the following before
the period at the end: “, except that the amendments made by paragraphs
(1) and (2) of subsection (c) shall apply to items and services
furnished on or after January 1, 2019”.
SEC. 50402. ORTHOTIST’S AND PROSTHETIST’S CLINICAL NOTES AS PART
OF THE PATIENT’S MEDICAL RECORD.

Section 1834(h) of the Social Security Act (42 U.S.C. 1395m(h)) is
amended by adding at the end the following new paragraph:
“(5) Documentation created by orthotists and
prosthetists.– <<NOTE: Determination.>> For purposes of
determining the reasonableness and medical necessity of
orthotics and prosthetics, documentation created by an orthotist
or prosthetist shall be considered part of the individual’s
medical record to support documentation created by eligible
professionals described in section 1848(k)(3)(B).”
SEC. 50403. INDEPENDENT ACCREDITATION FOR DIALYSIS FACILITIES AND
ASSURANCE OF HIGH QUALITY SURVEYS.

(a) Accreditation and Surveys.–
(1) In general.–Section 1865 of the Social Security Act (42
U.S.C. 1395bb) is amended–
(A) in subsection (a)–
(i) in paragraph (1), in the matter preceding
subparagraph (A), by striking “or the conditions
and requirements under section 1881(b)”; and

[[Page 132 STAT. 218]]

(ii) in paragraph (4), by inserting
“(including a renal dialysis facility)” after
“facility”; and
(B) by adding at the end the following new
subsection:

“(e) With respect to an accreditation body that has received
approval from the Secretary under subsection (a)(3)(A) for accreditation
of provider entities that are required to meet the conditions and
requirements under section 1881(b), in addition to review and oversight
authorities otherwise applicable under this title, the Secretary shall
(as the Secretary determines appropriate) conduct, with respect to such
accreditation body and provider entities, any or all of the following as
frequently as is otherwise required to be conducted under this title
with respect to other accreditation bodies or other provider entities:
“(1) Validation surveys referred to in subsection (d).
“(2) Accreditation program reviews (as defined in section
488.8(c) of title 42 of the Code of Federal Regulations, or a
successor regulation).
“(3) Performance reviews (as defined in section 488.8(a) of
title 42 of the Code of Federal Regulations, or a successor
regulation).”.
(2) <<NOTE: 42 USC 1395bb note.>> Timing for acceptance of
requests from accreditation organizations.–
<<NOTE: Deadline.>> Not later than 90 days after the date of
enactment of this Act, the Secretary of Health and Human
Services shall begin accepting requests from national
accreditation bodies for a finding described in section
1865(a)(3)(A) of the Social Security Act (42 U.S.C.
1395bb(a)(3)(A)) for purposes of accrediting provider entities
that are required to meet the conditions and requirements under
section 1881(b) of such Act (42 U.S.C. 1395rr(b)).

(b) Requirement for Timing of Surveys of New Dialysis Facilities.–
Section 1881(b)(1) of the Social Security Act (42 U.S.C. 1395rr(b)(1))
is amended by adding at the end the following new
sentence: <<NOTE: Effective
date. Survey. Determination. Deadline.>> “Beginning 180 days after the
date of the enactment of this sentence, an initial survey of a provider
of services or a renal dialysis facility to determine if the conditions
and requirements under this paragraph are met shall be initiated not
later than 90 days after such date on which both the provider enrollment
form (without regard to whether such form is submitted prior to or after
such date of enactment) has been determined by the Secretary to be
complete and the provider’s enrollment status indicates approval is
pending the results of such survey.”.
SEC. 50404. MODERNIZING THE APPLICATION OF THE STARK RULE UNDER
MEDICARE.

(a) Clarification of the Writing Requirement and Signature
Requirement for Arrangements Pursuant to the Stark Rule.–
(1) Writing requirement.–Section 1877(h)(1) of the Social
Security Act (42 U.S.C. 1395nn(h)(1)) is amended by adding at
the end the following new subparagraph:
“(D) <<NOTE: Determination.>> Written requirement
clarified.–In the case of any requirement pursuant to this
section for a compensation arrangement to be in writing, such
requirement shall be satisfied by such means as determined by
the Secretary, including by a collection of documents, including
contemporaneous documents evidencing the course of conduct
between the parties involved.”.

[[Page 132 STAT. 219]]

(2) Signature requirement.–Section 1877(h)(1) of the Social
Security Act (42 U.S.C. 1395nn(h)(1)), as amended by paragraph
(1), is further amended by adding at the end the following new
subparagraph:
“(E) Special rule for signature requirements.–In
the case of any requirement pursuant to this section for
a compensation arrangement to be in writing and signed
by the parties, such signature requirement shall be met
if–
“(i) <<NOTE: Time period.>> not later than
90 consecutive calendar days immediately following
the date on which the compensation arrangement
became noncompliant, the parties obtain the
required signatures; and
“(ii) the compensation arrangement otherwise
complies with all criteria of the applicable
exception.”.

(b) Indefinite Holdover for Lease Arrangements and Personal Services
Arrangements Pursuant to the Stark Rule.–Section 1877(e) of the Social
Security Act (42 U.S.C. 1395nn(e)) is amended–
(1) in paragraph (1), by adding at the end the following new
subparagraph:
“(C) Holdover lease arrangements.– <<NOTE: Time
period.>> In the case of a holdover lease arrangement
for the lease of office space or equipment, which
immediately follows a lease arrangement described in
subparagraph (A) for the use of such office space or
subparagraph (B) for the use of such equipment and that
expired after a term of at least 1 year, payments made
by the lessee to the lessor pursuant to such holdover
lease arrangement, if–
“(i) the lease arrangement met the conditions
of subparagraph (A) for the lease of office space
or subparagraph (B) for the use of equipment when
the arrangement expired;
“(ii) the holdover lease arrangement is on
the same terms and conditions as the immediately
preceding arrangement; and
“(iii) the holdover arrangement continues to
satisfy the conditions of subparagraph (A) for the
lease of office space or subparagraph (B) for the
use of equipment.”; and
(2) in paragraph (3), by adding at the end the following new
subparagraph:
“(C) <<NOTE: Time period.>> Holdover personal
service arrangement.–In the case of a holdover personal
service arrangement, which immediately follows an
arrangement described in subparagraph (A) that expired
after a term of at least 1 year, remuneration from an
entity pursuant to such holdover personal service
arrangement, if–
“(i) the personal service arrangement met the
conditions of subparagraph (A) when the
arrangement expired;
“(ii) the holdover personal service
arrangement is on the same terms and conditions as
the immediately preceding arrangement; and
“(iii) the holdover arrangement continues to
satisfy the conditions of subparagraph (A).”.

[[Page 132 STAT. 220]]

Subtitle B–Additional Medicare Provisions

SEC. 50411. MAKING PERMANENT THE REMOVAL OF THE RENTAL CAP FOR
DURABLE MEDICAL EQUIPMENT UNDER
MEDICARE WITH RESPECT TO SPEECH
GENERATING DEVICES.

Section 1834(a)(2)(A)(iv) of the Social Security Act (42 U.S.C.
1395m(a)(2)(A)(iv)) is amended by striking “and before October 1,
2018,”.
SEC. 50412. INCREASED CIVIL AND CRIMINAL PENALTIES AND INCREASED
SENTENCES FOR FEDERAL HEALTH CARE
PROGRAM FRAUD AND ABUSE.

(a) Increased Civil Money Penalties and Criminal Fines.–
(1) Increased civil money penalties.–Section 1128A of the
Social Security Act (42 U.S.C. 1320a-7a) is amended–
(A) in subsection (a), in the matter following
paragraph (10)–
(i) by striking “$10,000” and inserting
“$20,000” each place it appears;
(ii) by striking “$15,000” and inserting
“$30,000”; and
(iii) by striking “$50,000” and inserting
“$100,000” each place it appears; and
(B) in subsection (b)–
(i) in paragraph (1), in the flush text
following subparagraph (B), by striking “$2,000”
and inserting “$5,000”;
(ii) in paragraph (2), by striking “$2,000”
and inserting “$5,000”; and
(iii) in paragraph (3)(A)(i), by striking
“$5,000” and inserting “$10,000”.
(2) Increased criminal fines.–Section 1128B of such Act (42
U.S.C. 1320a-7b) is amended–
(A) in subsection (a), in the matter following
paragraph (6)–
(i) by striking “$25,000” and inserting
“$100,000”; and
(ii) by striking “$10,000” and inserting
“$20,000”;
(B) in subsection (b)–
(i) in paragraph (1), in the flush text
following subparagraph (B), by striking
“$25,000” and inserting “$100,000”; and
(ii) in paragraph (2), in the flush text
following subparagraph (B), by striking
“$25,000” and inserting “$100,000”;
(C) in subsection (c), by striking “$25,000” and
inserting “$100,000”;
(D) in subsection (d), in the flush text following
paragraph (2), by striking “$25,000” and inserting
“$100,000”; and
(E) in subsection (e), by striking “$2,000” and
inserting “$4,000”.

(b) Increased Sentences for Felonies Involving Federal Health Care
Program Fraud and Abuse.–

[[Page 132 STAT. 221]]

(1) False statements and representations.–Section 1128B(a)
of the Social Security Act (42 U.S.C. 1320a-7b(a)) is amended,
in the matter following paragraph (6), by striking “not more
than five years or both, or (ii)” and inserting “not more than
10 years or both, or (ii)”.
(2) Antikickback.–Section 1128B(b) of such Act (42 U.S.C.
1320a-7b(b)) is amended–
(A) in paragraph (1), in the flush text following
subparagraph (B), by striking “not more than five
years” and inserting “not more than 10 years”; and
(B) in paragraph (2), in the flush text following
subparagraph (B), by striking “not more than five
years” and inserting “not more than 10 years”.
(3) False statement or representation with respect to
conditions or operations of facilities.–Section 1128B(c) of
such Act (42 U.S.C. 1320a-7b(c)) is amended by striking “not
more than five years” and inserting “not more than 10 years”.
(4) Excess charges.–Section 1128B(d) of such Act (42 U.S.C.
1320a-7b(d)) is amended, in the flush text following paragraph
(2), by striking “not more than five years” and inserting
“not more than 10 years”.

(c) <<NOTE: Applicability. 42 USC 1320a-7a note.>> Effective
Date.–The amendments made by this section shall apply to acts committed
after the date of the enactment of this Act.
SEC. 50413. REDUCING THE VOLUME OF FUTURE EHR-RELATED SIGNIFICANT
HARDSHIP REQUESTS.

Section 1848(o)(2)(A) of the Social Security Act (42 U.S.C. 1395w-
4(o)(2)(A)) and section 1886(n)(3)(A) of such Act (42 U.S.C.
1395ww(n)(3)(A)) are each amended in the last sentence by striking “by
requiring” and all that follows through “this paragraph”.
SEC. 50414. STRENGTHENING RULES IN CASE OF COMPETITION FOR
DIABETIC TESTING STRIPS.

(a) Special Rule in Case of Competition for Diabetic Testing
Strips.–
(1) In general.–Paragraph (10) of section 1847(b) of the
Social Security Act (42 U.S.C. 1395w-3(b)) is amended–
(A) in subparagraph (A), by striking the second
sentence and inserting the following new
sentence: <<NOTE: Determination.>> “With respect to
bids to furnish such types of products on or after
January 1, 2019, the volume for such types of products
shall be determined by the Secretary through the use of
multiple sources of data (from mail order and non-mail
order Medicare markets), including market-based data
measuring sales of diabetic testing strip products that
are not exclusively sold by a single retailer from such
markets.”; and
(B) by adding at the end the following new
subparagraphs:
“(C) Demonstration of ability to furnish types of
diabetic testing strip products.–With respect to bids
to furnish diabetic testing strip products on or after
January 1, 2019, an entity shall attest to the Secretary
that the entity has the ability to obtain an inventory
of the types and quantities of diabetic testing strip
products

[[Page 132 STAT. 222]]

that will allow the entity to furnish such products in a
manner consistent with its bid and–
“(i) demonstrate to the Secretary, through
letters of intent with manufacturers, wholesalers,
or other suppliers, or other evidence as the
Secretary may specify, such ability; or
“(ii) demonstrate to the Secretary that it
made a good faith attempt to obtain such a letter
of intent or such other evidence.
“(D) Use of unlisted types in calculation of
percentage.–With respect to bids to furnish diabetic
testing strip products on or after January 1, 2019, in
determining under subparagraph (A) whether a bid
submitted by an entity under such subparagraph covers 50
percent (or such higher percentage as the Secretary may
specify) of all types of diabetic testing strip
products, the Secretary may not attribute a percentage
to types of diabetic testing strip products that the
Secretary does not identify by brand, model, and market
share volume.
“(E) Adherence to demonstration.–
“(i) In general.–In the case of an entity
that is furnishing diabetic testing strip products
on or after January 1, 2019, under a contract
entered into under the competition conducted
pursuant to paragraph (1), the Secretary shall
establish a process to monitor, on an ongoing
basis, the extent to which such entity continues
to cover the product types included in the
entity’s bid.
“(ii) <<NOTE: Determination.>>
Termination.–If the Secretary determines that an
entity described in clause (i) fails to maintain
in inventory, or otherwise maintain ready access
to (through requirements, contracts, or otherwise)
a type of product included in the entity’s bid,
the Secretary may terminate such contract unless
the Secretary finds that the failure of the entity
to maintain inventory of, or ready access to, the
product is the result of the discontinuation of
the product by the product manufacturer, a market-
wide shortage of the product, or the introduction
of a newer model or version of the product in the
market involved.”.

(b) Codifying and Expanding Anti-switching Rule.–Section 1847(b) of
the Social Security Act (42 U.S.C. 1395w-3(b)), as amended by subsection
(a)(1), is further amended–
(1) by redesignating paragraph (11) as paragraph (12); and
(2) by inserting after paragraph (10) the following new
paragraph:
“(11) Additional special rules in case of competition for
diabetic testing strips.–
“(A) In general.–With respect to an entity that is
furnishing diabetic testing strip products to
individuals under a contract entered into under the
competitive acquisition program established under this
section, the entity shall furnish to each individual a
brand of such products that is compatible with the home
blood glucose monitor selected by the individual.

[[Page 132 STAT. 223]]

“(B) Prohibition on influencing and
incentivizing.–An entity described in subparagraph (A)
may not attempt to influence or incentivize an
individual to switch the brand of glucose monitor or
diabetic testing strip product selected by the
individual, including by–
“(i) persuading, pressuring, or advising the
individual to switch; or
“(ii) furnishing information about
alternative brands to the individual where the
individual has not requested such information.
“(C) Provision of information.–
“(i) <<NOTE: Deadline.>> Standardized
information.–Not later than January 1, 2019, the
Secretary shall develop and make available to
entities described in subparagraph (A)
standardized information that describes the rights
of an individual with respect to such an entity.
The information described in the preceding
sentence shall include information regarding–
“(I) the requirements established
under subparagraphs (A) and (B);
“(II) the right of the individual
to purchase diabetic testing strip
products from another mail order
supplier of such products or a retail
pharmacy if the entity is not able to
furnish the brand of such product that
is compatible with the home blood
glucose monitor selected by the
individual; and
“(III) the right of the individual
to return diabetic testing strip
products furnished to the individual by
the entity.
“(ii) Requirement.–With respect to diabetic
testing strip products furnished on or after the
date on which the Secretary develops the
standardized information under clause (i), an
entity described in subparagraph (A) may not
communicate directly to an individual until the
entity has verbally provided the individual with
such standardized information.
“(D) <<NOTE: Requirement. Time period.>> Order
refills.–With respect to diabetic testing strip
products furnished on or after January 1, 2019, the
Secretary shall require an entity furnishing diabetic
testing strip products to an individual to contact and
receive a request from the individual for such products
not more than 14 days prior to dispensing a refill of
such products to the individual.”.

(c) <<NOTE: 42 USC 1395w-3 note.>> Implementation; Non-application
of the Paperwork Reduction Act.–
(1) Implementation.–Notwithstanding any other provision of
law, the Secretary of Health and Human Services may implement
the provisions of, and amendments made by, this section by
program instruction or otherwise.
(2) Non-application of the paperwork reduction act.–Chapter
35 of title 44, United States Code (commonly referred to as the
“Paperwork Reduction Act of 1995”), shall not apply to this
section or the amendments made by this section.

[[Page 132 STAT. 224]]

TITLE V–OTHER HEALTH EXTENDERS

SEC. 50501. EXTENSION FOR FAMILY-TO-FAMILY HEALTH INFORMATION
CENTERS.

Section 501(c) of the Social Security Act (42 U.S.C. 701(c)) is
amended–
(1) in paragraph (1)(A)–
(A) in clause (v), by striking “and” at the end;
(B) in clause (vi), by striking the period at the
end and inserting “; and”; and
(C) by adding at the end the following new clause:
“(vii) $6,000,000 for each of fiscal years 2018 and
2019.”;
(2) in paragraph (3)(C), by inserting before the period the
following: “, and with respect to fiscal years 2018 and 2019,
such centers shall also be developed in all territories and at
least one such center shall be developed for Indian tribes”;
and
(3) by amending paragraph (5) to read as follows:

“(5) <<NOTE: Definitions.>> For purposes of this subsection–
“(A) the term `Indian tribe’ has the meaning given such
term in section 4 of the Indian Health Care Improvement Act (25
U.S.C. 1603);
“(B) the term `State’ means each of the 50 States and the
District of Columbia; and
“(C) the term `territory’ means Puerto Rico, Guam, American
Samoa, the Virgin Islands, and the Northern Mariana Islands.”.
SEC. 50502. EXTENSION FOR SEXUAL RISK AVOIDANCE EDUCATION.

(a) In General.–Section 510 of the Social Security Act (42 U.S.C.
710) is amended to read as follows:
“SEC. 510. SEXUAL RISK AVOIDANCE EDUCATION.

“(a) In General.–
“(1) Allotments to states.–For the purpose described in
subsection (b), the Secretary shall, for each of fiscal years
2018 and 2019, allot to each State which has transmitted an
application for the fiscal year under section 505(a) an amount
equal to the product of–
“(A) the amount appropriated pursuant to subsection
(e)(1) for the fiscal year, minus the amount reserved
under subsection (e)(2) for the fiscal year; and
“(B) the proportion that the number of low-income
children in the State bears to the total of such numbers
of children for all the States.
“(2) Other allotments.–
“(A) Other entities.–For the purpose described in
subsection (b), the Secretary shall, for each of fiscal
years 2018 and 2019, for any State which has not
transmitted an application for the fiscal year under
section 505(a), allot to one or more entities in the
State the amount that would have been allotted to the
State under paragraph (1) if the State had submitted
such an application.
“(B) <<NOTE: Deadlines.>> Process.–The Secretary
shall select the recipients of allotments under
subparagraph (A) by means of a competitive grant process
under which–

[[Page 132 STAT. 225]]

“(i) <<NOTE: Notice.>> not later than 30
days after the deadline for the State involved to
submit an application for the fiscal year under
section 505(a), the Secretary publishes a notice
soliciting grant applications; and
“(ii) not later than 120 days after such
deadline, all such applications must be submitted.

“(b) Purpose.–
“(1) In general.–Except for research under paragraph (5)
and information collection and reporting under paragraph (6),
the purpose of an allotment under subsection (a) to a State (or
to another entity in the State pursuant to subsection (a)(2)) is
to enable the State or other entity to implement education
exclusively on sexual risk avoidance (meaning voluntarily
refraining from sexual activity).
“(2) Required components.–Education on sexual risk
avoidance pursuant to an allotment under this section shall–
“(A) ensure that the unambiguous and primary
emphasis and context for each topic described in
paragraph (3) is a message to youth that normalizes the
optimal health behavior of avoiding nonmarital sexual
activity;
“(B) be medically accurate and complete;
“(C) be age-appropriate;
“(D) be based on adolescent learning and
developmental theories for the age group receiving the
education; and
“(E) be culturally appropriate, recognizing the
experiences of youth from diverse communities,
backgrounds, and experiences.
“(3) Topics.–Education on sexual risk avoidance pursuant
to an allotment under this section shall address each of the
following topics:
“(A) The holistic individual and societal benefits
associated with personal responsibility, self-
regulation, goal setting, healthy decisionmaking, and a
focus on the future.
“(B) The advantage of refraining from nonmarital
sexual activity in order to improve the future prospects
and physical and emotional health of youth.
“(C) The increased likelihood of avoiding poverty
when youth attain self-sufficiency and emotional
maturity before engaging in sexual activity.
“(D) The foundational components of healthy
relationships and their impact on the formation of
healthy marriages and safe and stable families.
“(E) How other youth risk behaviors, such as drug
and alcohol usage, increase the risk for teen sex.
“(F) How to resist and avoid, and receive help
regarding, sexual coercion and dating violence,
recognizing that even with consent teen sex remains a
youth risk behavior.
“(4) Contraception.–Education on sexual risk avoidance
pursuant to an allotment under this section shall ensure that–
“(A) any information provided on contraception is
medically accurate and complete and ensures that
students understand that contraception offers physical
risk reduction, but not risk elimination; and
“(B) the education does not include demonstrations,
simulations, or distribution of contraceptive devices.

[[Page 132 STAT. 226]]

“(5) Research.–
“(A) In general.–A State or other entity receiving
an allotment pursuant to subsection (a) may use up to 20
percent of such allotment to build the evidence base for
sexual risk avoidance education by conducting or
supporting research.
“(B) Requirements.–Any research conducted or
supported pursuant to subparagraph (A) shall be–
“(i) rigorous;
“(ii) evidence-based; and
“(iii) designed and conducted by independent
researchers who have experience in conducting and
publishing research in peer-reviewed outlets.
“(6) Information collection and reporting.–A State or
other entity receiving an allotment pursuant to subsection (a)
shall, as specified by the Secretary–
“(A) collect information on the programs and
activities funded through the allotment; and
“(B) submit reports to the Secretary on the data
from such programs and activities.

“(c) National Evaluation.–
“(1) In general.–The Secretary shall–
“(A) <<NOTE: Consultation.>> in consultation with
appropriate State and local agencies, conduct one or
more rigorous evaluations of the education funded
through this section and associated data; and
“(B) <<NOTE: Reports.>> submit a report to the
Congress on the results of such evaluations, together
with a summary of the information collected pursuant to
subsection (b)(6).
“(2) Consultation.–In conducting the evaluations required
by paragraph (1), including the establishment of rigorous
evaluation methodologies, the Secretary shall consult with
relevant stakeholders and evaluation experts.

“(d) Applicability of Certain Provisions.–
“(1) Sections 503, 507, and 508 apply to allotments under
subsection (a) to the same extent and in the same manner as such
sections apply to allotments under section 502(c).
“(2) Sections 505 and 506 apply to allotments under
subsection (a) to the extent determined by the Secretary to be
appropriate.

“(e) Definitions.–In this section:
“(1) The term `age-appropriate’ means suitable (in terms of
topics, messages, and teaching methods) to the developmental and
social maturity of the particular age or age group of children
or adolescents, based on developing cognitive, emotional, and
behavioral capacity typical for the age or age group.
“(2) The term `medically accurate and complete’ means
verified or supported by the weight of research conducted in
compliance with accepted scientific methods and–
“(A) published in peer-reviewed journals, where
applicable; or
“(B) comprising information that leading
professional organizations and agencies with relevant
expertise in the field recognize as accurate, objective,
and complete.
“(3) The term `rigorous’, with respect to research or
evaluation, means using–

[[Page 132 STAT. 227]]

“(A) established scientific methods for measuring
the impact of an intervention or program model in
changing behavior (specifically sexual activity or other
sexual risk behaviors), or reducing pregnancy, among
youth; or
“(B) other evidence-based methodologies established
by the Secretary for purposes of this section.
“(4) The term `youth’ refers to one or more individuals who
have attained age 10 but not age 20.

“(f) Funding.–
“(1) In general.–To carry out this section, there is
appropriated, out of any money in the Treasury not otherwise
appropriated, $75,000,000 for each of fiscal years 2018 and
2019.
“(2) Reservation.–The Secretary shall reserve, for each of
fiscal years 2018 and 2019, not more than 20 percent of the
amount appropriated pursuant to paragraph (1) for administering
the program under this section, including the conducting of
national evaluations and the provision of technical assistance
to the recipients of allotments.”.

(b) <<NOTE: 42 USC 710 note.>> Effective Date.–The amendment made
by this section shall take effect as if enacted on October 1, 2017.
SEC. 50503. EXTENSION FOR PERSONAL RESPONSIBILITY EDUCATION.

(a) In General.–Section 513 of the Social Security Act (42 U.S.C.
713) is amended–
(1) in subsection (a)(1)(A), by striking “2017” and
inserting “2019”; and
(2) in subsection (a)(4)–
(A) in subparagraph (A), by striking “2017” each
place it appears and inserting “2019”; and
(B) in subparagraph (B)–
(i) in the subparagraph heading, by striking
“3-year grants” and inserting “Competitive prep
grants”; and
(ii) in clause (i), by striking “solicit
applications to award 3-year grants in each of
fiscal years 2012 through 2017” and inserting
“continue through fiscal year 2019 grants awarded
for any of fiscal years 2015 through 2017”;
(3) in subsection (c)(1), by inserting after “youth with
HIV/AIDS,” the following: “victims of human trafficking,”;
and
(4) in subsection (f), by striking “2017” and inserting
“2019”.

(b) <<NOTE: 42 USC 713 note.>> Effective Date.–The amendments made
by this section shall take effect as if enacted on October 1, 2017.

[[Page 132 STAT. 228]]

TITLE VI–CHILD AND FAMILY SERVICES AND SUPPORTS EXTENDERS

Subtitle A–Continuing the Maternal, Infant, and Early Childhood Home
Visiting Program

SEC. 50601. CONTINUING EVIDENCE-BASED HOME VISITING PROGRAM.

Section 511(j)(1)(H) of the Social Security Act (42 U.S.C.
711(j)(1)(H)) is amended by striking “fiscal year 2017” and inserting
“each of fiscal years 2017 through 2022”.
SEC. 50602. CONTINUING TO DEMONSTRATE RESULTS TO HELP FAMILIES.

(a) Require Service Delivery Models To Demonstrate Improvement in
Applicable Benchmark Areas.–Section 511 of the Social Security Act (42
U.S.C. 711) is amended in each of subsections (d)(1)(A) and (h)(4)(A) by
striking “each of”.
(b) Demonstration of Improvements in Subsequent Years.–Section
511(d)(1) of such Act (42 U.S.C. 711(d)(1)) is amended by adding at the
end the following:
“(D) <<NOTE: Reports.>> Demonstration of
improvements in subsequent years.–
“(i) <<NOTE: Deadline. Time period.>>
Continued measurement of improvement in applicable
benchmark areas.–The eligible entity, after
demonstrating improvements for eligible families
as specified in subparagraphs (A) and (B), shall
continue to track and report, not later than 30
days after the end of fiscal year 2020 and every 3
years thereafter, information demonstrating that
the program results in improvements for the
eligible families participating in the program in
at least 4 of the areas specified in subparagraph
(A) that the service delivery model or models
selected by the entity are intended to improve.
“(ii) Corrective action plan.–If the
eligible entity fails to demonstrate improvement
in at least 4 of the areas specified in
subparagraph (A), as compared to eligible families
who do not receive services under an early
childhood home visitation program, the entity
shall develop and implement a plan to improve
outcomes in each of the areas specified in
subparagraph (A) that the service delivery model
or models selected by the entity are intended to
improve, subject to approval by the Secretary. The
plan shall include provisions for the Secretary to
monitor implementation of the plan and conduct
continued oversight of the program, including
through submission by the entity of regular
reports to the Secretary.
“(iii) Technical assistance.–The Secretary
shall provide an eligible entity required to
develop and implement an improvement plan under
clause (ii) with technical assistance to develop
and implement the

[[Page 132 STAT. 229]]

plan. The Secretary may provide the technical
assistance directly or through grants, contracts,
or cooperative agreements.
“(iv) No improvement or failure to submit
report.– <<NOTE: Determinations.>> If the
Secretary determines after a period of time
specified by the Secretary that an eligible entity
implementing an improvement plan under clause (ii)
has failed to demonstrate any improvement in at
least 4 of the areas specified in subparagraph
(A), or if the Secretary determines that an
eligible entity has failed to submit the report
required by clause (i), the Secretary shall
terminate the grant made to the entity under this
section and may include any unexpended grant funds
in grants made to nonprofit organizations under
subsection (h)(2)(B).”.

(c) Including Information on Applicable Benchmarks in Application.–
Section 511(e)(5) of such Act (42 U.S.C. 711(e)(5)) is amended by
inserting “that the service delivery model or models selected by the
entity are intended to improve” before the period at the end.
SEC. <<NOTE: Updates. Deadline.>> 50603. REVIEWING STATEWIDE NEEDS
TO TARGET RESOURCES.

Section 511(b)(1) of the Social Security Act (42 U.S.C. 711(b)(1))
is amended by striking “Not later than” and all that follows through
“section 505(a))” and inserting “Each State shall, as a condition of
receiving payments from an allotment for the State under section 502,
conduct a statewide needs assessment (which may be separate from but in
coordination with the statewide needs assessment required under section
505(a) and which shall be reviewed and updated by the State not later
than October 1, 2020)”.
SEC. 50604. IMPROVING THE LIKELIHOOD OF SUCCESS IN HIGH-RISK
COMMUNITIES.

Section 511(d)(4)(A) of the Social Security Act (42 U.S.C.
711(d)(4)(A)) is amended by inserting “, taking into account the
staffing, community resource, and other requirements to operate at least
one approved model of home visiting and demonstrate improvements for
eligible families” before the period.
SEC. 50605. OPTION TO FUND EVIDENCE-BASED HOME VISITING ON A PAY
FOR OUTCOME BASIS.

(a) In General.–Section 511(c) of the Social Security Act (42
U.S.C. 711(c)) is amended by redesignating paragraphs (3) and (4) as
paragraphs (4) and (5), respectively, and by inserting after paragraph
(2) the following:
“(3) Authority to use grant for a pay for outcomes
initiative.–An eligible entity to which a grant is made under
paragraph (1) may use up to 25 percent of the grant for outcomes
or success payments related to a pay for outcomes initiative
that will not result in a reduction of funding for services
delivered by the entity under a childhood home visitation
program under this section while the eligible entity develops or
operates such an initiative.”.

(b) Definition of Pay for Outcomes Initiative.–Section 511(k) of
such Act (42 U.S.C. 711(k)) is amended by adding at the end the
following:
“(4) Pay for outcomes initiative.–The term `pay for
outcomes initiative’ means a performance-based grant, contract,

[[Page 132 STAT. 230]]

cooperative agreement, or other agreement awarded by a public
entity in which a commitment is made to pay for improved
outcomes achieved as a result of the intervention that result in
social benefit and direct cost savings or cost avoidance to the
public sector. Such an initiative shall include–
“(A) <<NOTE: Study.>> a feasibility study that
describes how the proposed intervention is based on
evidence of effectiveness;
“(B) <<NOTE: Evaluation. Determination.>> a
rigorous, third-party evaluation that uses experimental
or quasi-experimental design or other research
methodologies that allow for the strongest possible
causal inferences to determine whether the initiative
has met its proposed outcomes as a result of the
intervention;
“(C) <<NOTE: Deadline. Public
information. Reports. Requirement.>> an annual,
publicly available report on the progress of the
initiative; and
“(D) a requirement that payments are made to the
recipient of a grant, contract, or cooperative agreement
only when agreed upon outcomes are achieved, except that
this requirement shall not apply with respect to
payments to a third party conducting the evaluation
described in subparagraph (B).”.

(c) Extended Availability of Funds.–Section 511(j)(3) of such Act
(42 U.S.C. 711(j)(3)) is amended–
(1) by striking “(3) Availability.–Funds” and inserting
the following:
“(3) Availability.–
“(A) In general.–Except as provided in
subparagraph (B), funds”; and
(2) by adding at the end the following:
“(B) <<NOTE: Time period.>> Funds for pay for
outcomes initiatives.–Funds made available to an
eligible entity under this section for a fiscal year (or
portion of a fiscal year) for a pay for outcomes
initiative shall remain available for expenditure by the
eligible entity for not more than 10 years after the
funds are so made available.”.
SEC. 50606. DATA EXCHANGE STANDARDS FOR IMPROVED INTEROPERABILITY.

(a) In General.–Section 511(h) of the Social Security Act (42
U.S.C. 711(h)) is amended by adding at the end the following:
“(5) Data exchange standards for improved
interoperability.–
“(A) Designation and use of data exchange
standards.–
“(i) <<NOTE: Consultation.>> Designation.–
The head of the department or agency responsible
for administering a program funded under this
section shall, in consultation with an interagency
work group established by the Office of Management
and Budget and considering State government
perspectives, designate data exchange standards
for necessary categories of information that a
State agency operating the program is required to
electronically exchange with another State agency
under applicable Federal law.
“(ii) Data exchange standards must be
nonproprietary and interoperable.–The data
exchange standards designated under clause (i)
shall, to the

[[Page 132 STAT. 231]]

extent practicable, be nonproprietary and
interoperable.
“(iii) Other requirements.–In designating
data exchange standards under this paragraph, the
Secretary shall, to the extent practicable,
incorporate–
“(I) interoperable standards
developed and maintained by an
international voluntary consensus
standards body, as defined by the Office
of Management and Budget;
“(II) interoperable standards
developed and maintained by
intergovernmental partnerships, such as
the National Information Exchange Model;
and
“(III) interoperable standards
developed and maintained by Federal
entities with authority over contracting
and financial assistance.
“(B) Data exchange standards for federal
reporting.–
“(i) <<NOTE: Consultation.>> Designation.–
The head of the department or agency responsible
for administering a program referred to in this
section shall, in consultation with an interagency
work group established by the Office of Management
and Budget, and considering State government
perspectives, designate data exchange standards to
govern Federal reporting and exchange requirements
under applicable Federal law.
“(ii) Requirements.–The data exchange
reporting standards required by clause (i) shall,
to the extent practicable–
“(I) incorporate a widely accepted,
nonproprietary, searchable, computer-
readable format;
“(II) be consistent with and
implement applicable accounting
principles;
“(III) be implemented in a manner
that is cost-effective and improves
program efficiency and effectiveness;
and
“(IV) be capable of being
continually upgraded as necessary.
“(iii) Incorporation of nonproprietary
standards.–In designating data exchange standards
under this paragraph, the Secretary shall, to the
extent practicable, incorporate existing
nonproprietary standards, such as the eXtensible
Mark up Language.
“(iv) Rule of construction.–Nothing in this
paragraph shall be construed to require a change
to existing data exchange standards for Federal
reporting about a program referred to in this
section, if the head of the department or agency
responsible for administering the program finds
the standards to be effective and efficient.”.

(b) <<NOTE: 42 USC 711 note.>> Effective Date.–The amendment made
by subsection (a) shall take effect on the date that is 2 years after
the date of enactment of this Act.
SEC. 50607. ALLOCATION OF FUNDS.

Section 511(j) of the Social Security Act (42 U.S.C. 711(j)) is
amended by adding at the end the following:

[[Page 132 STAT. 232]]

“(4) <<NOTE: Determination.>> Allocation of funds.–To the
extent that the grant amount awarded under this section to an
eligible entity is determined on the basis of relative
population or poverty considerations, the Secretary shall make
the determination using the most accurate Federal data available
for the eligible entity.”.

Subtitle B–Extension of Health Professions Workforce Demonstration
Projects

SEC. 50611. EXTENSION OF HEALTH WORKFORCE DEMONSTRATION PROJECTS
FOR LOW-INCOME INDIVIDUALS.

Section 2008(c)(1) of the Social Security Act (42 U.S.C.
1397g(c)(1)) is amended by striking “2017” and inserting “2019”.

TITLE VII–FAMILY FIRST PREVENTION SERVICES ACT

Subtitle A– <<NOTE: Bipartisan Budget Act of 2018.>> Investing in
Prevention and Supporting Families
SEC. 50701. <<NOTE: 42 USC 1305 note.>> SHORT TITLE.

This subtitle may be cited as the “Bipartisan Budget Act of 2018”.
SEC. 50702. <<NOTE: 42 USC 622 note.>> PURPOSE.

The purpose of this subtitle is to enable States to use Federal
funds available under parts B and E of title IV of the Social Security
Act to provide enhanced support to children and families and prevent
foster care placements through the provision of mental health and
substance abuse prevention and treatment services, in-home parent skill-
based programs, and kinship navigator services.

PART I–PREVENTION ACTIVITIES UNDER TITLE IV-E

SEC. 50711. FOSTER CARE PREVENTION SERVICES AND PROGRAMS.

(a) State Option.–Section 471 of the Social Security Act (42 U.S.C.
671) is amended–
(1) in subsection (a)(1), by striking “and” and all that
follows through the semicolon and inserting “, adoption
assistance in accordance with section 473, and, at the option of
the State, services or programs specified in subsection (e)(1)
of this section for children who are candidates for foster care
or who are pregnant or parenting foster youth and the parents or
kin caregivers of the children, in accordance with the
requirements of that subsection;”; and
(2) by adding at the end the following:

“(e) Prevention and Family Services and Programs.–
“(1) <<NOTE: Time period.>> In general.–Subject to the
succeeding provisions of this subsection, the Secretary may make
a payment to a State for providing the following services or
programs for a child

[[Page 132 STAT. 233]]

described in paragraph (2) and the parents or kin caregivers of
the child when the need of the child, such a parent, or such a
caregiver for the services or programs are directly related to
the safety, permanence, or well-being of the child or to
preventing the child from entering foster care:
“(A) Mental health and substance abuse prevention
and treatment services.–Mental health and substance
abuse prevention and treatment services provided by a
qualified clinician for not more than a 12-month period
that begins on any date described in paragraph (3) with
respect to the child.
“(B) In-home parent skill-based programs.–In-home
parent skill-based programs for not more than a 12-month
period that begins on any date described in paragraph
(3) with respect to the child and that include parenting
skills training, parent education, and individual and
family counseling.
“(2) Child described.–For purposes of paragraph (1), a
child described in this paragraph is the following:
“(A) A child who is a candidate for foster care (as
defined in section 475(13)) but can remain safely at
home or in a kinship placement with receipt of services
or programs specified in paragraph (1).
“(B) A child in foster care who is a pregnant or
parenting foster youth.
“(3) Date described.–For purposes of paragraph (1), the
dates described in this paragraph are the following:
“(A) The date on which a child is identified in a
prevention plan maintained under paragraph (4) as a
child who is a candidate for foster care (as defined in
section 475(13)).
“(B) The date on which a child is identified in a
prevention plan maintained under paragraph (4) as a
pregnant or parenting foster youth in need of services
or programs specified in paragraph (1).
“(4) Requirements related to providing services and
programs.–Services and programs specified in paragraph (1) may
be provided under this subsection only if specified in advance
in the child’s prevention plan described in subparagraph (A) and
the requirements in subparagraphs (B) through (E) are met:
“(A) Prevention plan.–The State maintains a
written prevention plan for the child that meets the
following requirements (as applicable):
“(i) Candidates.–In the case of a child who
is a candidate for foster care described in
paragraph (2)(A), the prevention plan shall–
“(I) identify the foster care
prevention strategy for the child so
that the child may remain safely at
home, live temporarily with a kin
caregiver until reunification can be
safely achieved, or live permanently
with a kin caregiver;
“(II) list the services or programs
to be provided to or on behalf of the
child to ensure the success of that
prevention strategy; and
“(III) <<NOTE: Compliance.>> comply
with such other requirements as the
Secretary shall establish.

[[Page 132 STAT. 234]]

“(ii) Pregnant or parenting foster youth.–In
the case of a child who is a pregnant or parenting
foster youth described in paragraph (2)(B), the
prevention plan shall–
“(I) be included in the child’s
case plan required under section 475(1);
“(II) list the services or programs
to be provided to or on behalf of the
youth to ensure that the youth is
prepared (in the case of a pregnant
foster youth) or able (in the case of a
parenting foster youth) to be a parent;
“(III) describe the foster care
prevention strategy for any child born
to the youth; and
“(IV) <<NOTE: Compliance.>> comply
with such other requirements as the
Secretary shall establish.
“(B) Trauma-informed.–The services or programs to
be provided to or on behalf of a child are provided
under an organizational structure and treatment
framework that involves understanding, recognizing, and
responding to the effects of all types of trauma and in
accordance with recognized principles of a trauma-
informed approach and trauma-specific interventions to
address trauma’s consequences and facilitate healing.
“(C) Only services and programs provided in
accordance with promising, supported, or well-supported
practices permitted.–
“(i) In general.–Only State expenditures for
services or programs specified in subparagraph (A)
or (B) of paragraph (1) that are provided in
accordance with practices that meet the
requirements specified in clause (ii) of this
subparagraph and that meet the requirements
specified in clause (iii), (iv), or (v),
respectively, for being a promising, supported, or
well-supported practice, shall be eligible for a
Federal matching payment under section
474(a)(6)(A).
“(ii) General practice requirements.–The
general practice requirements specified in this
clause are the following:
“(I) The practice has a book,
manual, or other available writings that
specify the components of the practice
protocol and describe how to administer
the practice.
“(II) There is no empirical basis
suggesting that, compared to its likely
benefits, the practice constitutes a
risk of harm to those receiving it.
“(III) If multiple outcome studies
have been conducted, the overall weight
of evidence supports the benefits of the
practice.
“(IV) Outcome measures are reliable
and valid, and are administrated
consistently and accurately across all
those receiving the practice.
“(V) There is no case data
suggesting a risk of harm that was
probably caused by the treatment and
that was severe or frequent.
“(iii) <<NOTE: Study.>> Promising
practice.–A practice shall be considered to be a
`promising practice’ if the practice is superior
to an appropriate comparison practice using

[[Page 132 STAT. 235]]

conventional standards of statistical significance
(in terms of demonstrated meaningful improvements
in validated measures of important child and
parent outcomes, such as mental health, substance
abuse, and child safety and well-being), as
established by the results or outcomes of at least
one study that–
“(I) was rated by an independent
systematic review for the quality of the
study design and execution and
determined to be well-designed and well-
executed; and
“(II) utilized some form of control
(such as an untreated group, a placebo
group, or a wait list study).
“(iv) <<NOTE: Study.>> Supported practice.–
A practice shall be considered to be a `supported
practice’ if–
“(I) the practice is superior to an
appropriate comparison practice using
conventional standards of statistical
significance (in terms of demonstrated
meaningful improvements in validated
measures of important child and parent
outcomes, such as mental health,
substance abuse, and child safety and
well-being), as established by the
results or outcomes of at least one
study that–
“(aa) was rated by an
independent systematic review
for the quality of the study
design and execution and
determined to be well-designed
and well-executed;
“(bb) was a rigorous
random-controlled trial (or, if
not available, a study using a
rigorous quasi-experimental
research design); and
“(cc) was carried out in a
usual care or practice setting;
and
“(II) <<NOTE: Time period.>> the
study described in subclause (I)
established that the practice has a
sustained effect (when compared to a
control group) for at least 6 months
beyond the end of the treatment.
“(v) <<NOTE: Studies.>> Well-supported
practice.–A practice shall be considered to be a
`well-supported practice’ if–
“(I) the practice is superior to an
appropriate comparison practice using
conventional standards of statistical
significance (in terms of demonstrated
meaningful improvements in validated
measures of important child and parent
outcomes, such as mental health,
substance abuse, and child safety and
well-being), as established by the
results or outcomes of at least two
studies that–
“(aa) were rated by an
independent systematic review
for the quality of the study
design and execution and
determined to be well-designed
and well-executed;
“(bb) were rigorous random-
controlled trials (or, if not
available, studies using a
rigorous quasi-experimental
research design); and
“(cc) were carried out in a
usual care or practice setting;
and

[[Page 132 STAT. 236]]

“(II) <<NOTE: Time period.>> at
least one of the studies described in
subclause (I) established that the
practice has a sustained effect (when
compared to a control group) for at
least 1 year beyond the end of
treatment.
“(D) Guidance on practices criteria and pre-
approved services and programs.–
“(i) <<NOTE: Deadlines.>> In general.–Not
later than October 1, 2018, the Secretary shall
issue guidance to States regarding the practices
criteria required for services or programs to
satisfy the requirements of subparagraph (C). The
guidance shall include a pre-approved list of
services and programs that satisfy the
requirements.
“(ii) Updates.–The Secretary shall issue
updates to the guidance required by clause (i) as
often as the Secretary determines necessary.
“(E) <<NOTE: Time periods. Determination.>>
Outcome assessment and reporting.–The State shall
collect and report to the Secretary the following
information with respect to each child for whom, or on
whose behalf mental health and substance abuse
prevention and treatment services or in-home parent
skill-based programs are provided during a 12-month
period beginning on the date the child is determined by
the State to be a child described in paragraph (2):
“(i) The specific services or programs
provided and the total expenditures for each of
the services or programs.
“(ii) The duration of the services or
programs provided.
“(iii) <<NOTE: Deadline.>> In the case of a
child described in paragraph (2)(A), the child’s
placement status at the beginning, and at the end,
of the 1-year period, respectively, and whether
the child entered foster care within 2 years after
being determined a candidate for foster care.
“(5) State plan component.–
“(A) <<NOTE: Plan.>> In general.–A State electing
to provide services or programs specified in paragraph
(1) shall submit as part of the State plan required by
subsection (a) a prevention services and programs plan
component that meets the requirements of subparagraph
(B).
“(B) <<NOTE: Time period.>> Prevention services
and programs plan component.–In order to meet the
requirements of this subparagraph, a prevention services
and programs plan component, with respect to each 5-year
period for which the plan component is in operation in
the State, shall include the following:
“(i) How providing services and programs
specified in paragraph (1) is expected to improve
specific outcomes for children and families.
“(ii) <<NOTE: Assessments. Determination.>>
How the State will monitor and oversee the safety
of children who receive services and programs
specified in paragraph (1), including through
periodic risk assessments throughout the period in
which the services and programs are provided on
behalf of a child and reexamination of the
prevention plan maintained for the child under
paragraph (4) for the provision of the services or
programs if the State determines

[[Page 132 STAT. 237]]

the risk of the child entering foster care remains
high despite the provision of the services or
programs.
“(iii) With respect to the services and
programs specified in subparagraphs (A) and (B) of
paragraph (1), information on the specific
promising, supported, or well-supported practices
the State plans to use to provide the services or
programs, including a description of–
“(I) the services or programs and
whether the practices used are
promising, supported, or well-supported;
“(II) how the State plans to
implement the services or programs,
including how implementation of the
services or programs will be
continuously monitored to ensure
fidelity to the practice model and to
determine outcomes achieved and how
information learned from the monitoring
will be used to refine and improve
practices;
“(III) how the State selected the
services or programs;
“(IV) the target population for the
services or programs; and
“(V) <<NOTE: Evaluation.>> how
each service or program provided will be
evaluated through a well-designed and
rigorous process, which may consist of
an ongoing, cross-site evaluation
approved by the Secretary.
“(iv) <<NOTE: Consultation.>> A description
of the consultation that the State agencies
responsible for administering the State plans
under this part and part B engage in with other
State agencies responsible for administering
health programs, including mental health and
substance abuse prevention and treatment services,
and with other public and private agencies with
experience in administering child and family
services, including community-based organizations,
in order to foster a continuum of care for
children described in paragraph (2) and their
parents or kin caregivers.
“(v) <<NOTE: Assessment.>> A description of
how the State shall assess children and their
parents or kin caregivers to determine eligibility
for services or programs specified in paragraph
(1).
“(vi) A description of how the services or
programs specified in paragraph (1) that are
provided for or on behalf of a child and the
parents or kin caregivers of the child will be
coordinated with other child and family services
provided to the child and the parents or kin
caregivers of the child under the State plans in
effect under subparts 1 and 2 of part B.
“(vii) Descriptions of steps the State is
taking to support and enhance a competent,
skilled, and professional child welfare workforce
to deliver trauma-informed and evidence-based
services, including–
“(I) ensuring that staff is
qualified to provide services or
programs that are consistent with the
promising, supported, or well-supported
practice models selected; and

[[Page 132 STAT. 238]]

“(II) developing appropriate
prevention plans, and conducting the
risk assessments required under clause
(iii).
“(viii) <<NOTE: Assessment. Evaluation.>> A
description of how the State will provide training
and support for caseworkers in assessing what
children and their families need, connecting to
the families served, knowing how to access and
deliver the needed trauma-informed and evidence-
based services, and overseeing and evaluating the
continuing appropriateness of the services.
“(ix) A description of how caseload size and
type for prevention caseworkers will be
determined, managed, and overseen.
“(x) An assurance that the State will report
to the Secretary such information and data as the
Secretary may require with respect to the
provision of services and programs specified in
paragraph (1), including information and data
necessary to determine the performance measures
for the State under paragraph (6) and compliance
with paragraph (7).
“(C) Reimbursement for services under the
prevention plan component.–
“(i) <<NOTE: Evaluation.>> Limitation.–
Except as provided in subclause (ii), a State may
not receive a Federal payment under this part for
a given promising, supported, or well-supported
practice unless (in accordance with subparagraph
(B)(iii)(V)) the plan includes a well-designed and
rigorous evaluation strategy for that practice.
“(ii) Waiver of limitation.–The Secretary
may waive the requirement for a well-designed and
rigorous evaluation of any well-supported practice
if the Secretary deems the evidence of the
effectiveness of the practice to be compelling and
the State meets the continuous quality improvement
requirements included in subparagraph (B)(iii)(II)
with regard to the practice.
“(6) Prevention services measures.–
“(A) <<NOTE: Time period.>> Establishment; annual
updates.–Beginning with fiscal year 2021, and annually
thereafter, the Secretary shall establish the following
prevention services measures based on information and
data reported by States that elect to provide services
and programs specified in paragraph (1):
“(i) Percentage of candidates for foster care
who do not enter foster care.– <<NOTE: Time
period.>> The percentage of candidates for foster
care for whom, or on whose behalf, the services or
programs are provided who do not enter foster
care, including those placed with a kin caregiver
outside of foster care, during the 12-month period
in which the services or programs are provided and
through the end of the succeeding 12-month period.
“(ii) Per-child spending.–The total amount
of expenditures made for mental health and
substance abuse prevention and treatment services
or in-home parent skill-based programs,
respectively, for, or on behalf of, each child
described in paragraph (2).
“(B) <<NOTE: Deadline. Updates.>> Data.–The
Secretary shall establish and annually update the
prevention services measures–

[[Page 132 STAT. 239]]

“(i) based on the median State values of the
information reported under each clause of
subparagraph (A) for the 3 then most recent years;
and
“(ii) <<NOTE: Determination.>> taking into
account State differences in the price levels of
consumption goods and services using the most
recent regional price parities published by the
Bureau of Economic Analysis of the Department of
Commerce or such other data as the Secretary
determines appropriate.
“(C) Publication of state prevention services
measures.– <<NOTE: Deadline. Public information.>> The
Secretary shall annually make available to the public
the prevention services measures of each State.
“(7) Maintenance of effort for state foster care prevention
expenditures.–
“(A) In general.–If a State elects to provide
services and programs specified in paragraph (1) for a
fiscal year, the State foster care prevention
expenditures for the fiscal year shall not be less than
the amount of the expenditures for fiscal year 2014 (or,
at the option of a State described in subparagraph (E),
fiscal year 2015 or fiscal year 2016 (whichever the
State elects)).
“(B) <<NOTE: Definition.>> State foster care
prevention expenditures.–The term `State foster care
prevention expenditures’ means the following:
“(i) TANF; iv-b; ssbg.–State expenditures
for foster care prevention services and activities
under the State program funded under part A
(including from amounts made available by the
Federal Government), under the State plan
developed under part B (including any such
amounts), or under the Social Services Block Grant
Programs under subtitle A of title XX (including
any such amounts).
“(ii) Other state programs.–State
expenditures for foster care prevention services
and activities under any State program that is not
described in clause (i) (other than any State
expenditures for foster care prevention services
and activities under the State program under this
part (including under a waiver of the program)).
“(C) <<NOTE: Definition.>> State expenditures.–
The term `State expenditures’ means all State or local
funds that are expended by the State or a local agency
including State or local funds that are matched or
reimbursed by the Federal Government and State or local
funds that are not matched or reimbursed by the Federal
Government.
“(D) <<NOTE: Requirement. Reports.>> Determination
of prevention services and activities.–The Secretary
shall require each State that elects to provide services
and programs specified in paragraph (1) to report the
expenditures specified in subparagraph (B) for fiscal
year 2014 and for such fiscal years thereafter as are
necessary to determine whether the State is complying
with the maintenance of effort requirement in
subparagraph (A). The Secretary shall specify the
specific services and activities under each program
referred to in subparagraph (B) that are `prevention
services and activities’ for purposes of the reports.

[[Page 132 STAT. 240]]

“(E) State described.–For purposes of subparagraph
(A), a State is described in this subparagraph if the
population of children in the State in 2014 was less
than 200,000 (as determined by the United States Census
Bureau).
“(8) Prohibition against use of state foster care
prevention expenditures and federal iv-e prevention funds for
matching or expenditure requirement.–A State that elects to
provide services and programs specified in paragraph (1) shall
not use any State foster care prevention expenditures for a
fiscal year for the State share of expenditures under section
474(a)(6) for a fiscal year.
“(9) Administrative costs.–Expenditures described in
section 474(a)(6)(B)–
“(A) shall not be eligible for payment under
subparagraph (A), (B), or (E) of section 474(a)(3); and
“(B) shall be eligible for payment under section
474(a)(6)(B) without regard to whether the expenditures
are incurred on behalf of a child who is, or is
potentially, eligible for foster care maintenance
payments under this part.
“(10) Application.–
“(A) In general.–The provision of services or
programs under this subsection to or on behalf of a
child described in paragraph (2) shall not be considered
to be receipt of aid or assistance under the State plan
under this part for purposes of eligibility for any
other program established under this Act.
“(B) <<NOTE: Time period.>> Candidates in kinship
care.–A child described in paragraph (2) for whom such
services or programs under this subsection are provided
for more than 6 months while in the home of a kin
caregiver, and who would satisfy the AFDC eligibility
requirement of section 472(a)(3)(A)(ii)(II) but for
residing in the home of the caregiver for more than 6
months, is deemed to satisfy that requirement for
purposes of determining whether the child is eligible
for foster care maintenance payments under section
472.”.

(b) Definition.–Section 475 of such Act (42 U.S.C. 675) is amended
by adding at the end the following:
“(13) The term `child who is a candidate for foster care’
means, a child who is identified in a prevention plan under
section 471(e)(4)(A) as being at imminent risk of entering
foster care (without regard to whether the child would be
eligible for foster care maintenance payments under section 472
or is or would be eligible for adoption assistance or kinship
guardianship assistance payments under section 473) but who can
remain safely in the child’s home or in a kinship placement as
long as services or programs specified in section 471(e)(1) that
are necessary to prevent the entry of the child into foster care
are provided. The term includes a child whose adoption or
guardianship arrangement is at risk of a disruption or
dissolution that would result in a foster care placement.”.

(c) Payments Under Title IV-E.–Section 474(a) of such Act (42
U.S.C. 674(a)) is amended–
(1) in paragraph (5), by striking the period at the end and
inserting “; plus”; and
(2) by adding at the end the following:

[[Page 132 STAT. 241]]

“(6) subject to section 471(e)–
“(A) for each quarter–
“(i) <<NOTE: Time periods.>> subject to
clause (ii)–
“(I) beginning after September 30,
2019, and before October 1, 2026, an
amount equal to 50 percent of the total
amount expended during the quarter for
the provision of services or programs
specified in subparagraph (A) or (B) of
section 471(e)(1) that are provided in
accordance with promising, supported, or
well-supported practices that meet the
applicable criteria specified for the
practices in section 471(e)(4)(C); and
“(II) beginning after September 30,
2026, an amount equal to the Federal
medical assistance percentage (which
shall be as defined in section 1905(b),
in the case of a State other than the
District of Columbia, or 70 percent, in
the case of the District of Columbia) of
the total amount expended during the
quarter for the provision of services or
programs specified in subparagraph (A)
or (B) of section 471(e)(1) that are
provided in accordance with promising,
supported, or well-supported practices
that meet the applicable criteria
specified for the practices in section
471(e)(4)(C) (or, with respect to the
payments made during the quarter under a
cooperative agreement or contract
entered into by the State and an Indian
tribe, tribal organization, or tribal
consortium for the administration or
payment of funds under this part, an
amount equal to the Federal medical
assistance percentage that would apply
under section 479B(d) (in this paragraph
referred to as the `tribal FMAP’) if the
Indian tribe, tribal organization, or
tribal consortium made the payments
under a program operated under that
section, unless the tribal FMAP is less
than the Federal medical assistance
percentage that applies to the State);
except that
“(ii) not less than 50 percent of the total
amount expended by a State under clause (i) for a
fiscal year shall be for the provision of services
or programs specified in subparagraph (A) or (B)
of section 471(e)(1) that are provided in
accordance with well-supported practices; plus
“(B) for each quarter specified in subparagraph
(A), an amount equal to the sum of the following
proportions of the total amount expended during the
quarter–
“(i) 50 percent of so much of the
expenditures as are found necessary by the
Secretary for the proper and efficient
administration of the State plan for the provision
of services or programs specified in section
471(e)(1), including expenditures for activities
approved by the Secretary that promote the
development of necessary processes and procedures
to establish and implement the provision of the
services and

[[Page 132 STAT. 242]]

programs for individuals who are eligible for the
services and programs and expenditures
attributable to data collection and reporting; and
“(ii) 50 percent of so much of the
expenditures with respect to the provision of
services and programs specified in section
471(e)(1) as are for training of personnel
employed or preparing for employment by the State
agency or by the local agency administering the
plan in the political subdivision and of the
members of the staff of State-licensed or State-
approved child welfare agencies providing services
to children described in section 471(e)(2) and
their parents or kin caregivers, including on how
to determine who are individuals eligible for the
services or programs, how to identify and provide
appropriate services and programs, and how to
oversee and evaluate the ongoing appropriateness
of the services and programs.”.

(d) Technical Assistance and Best Practices, Clearinghouse, and Data
Collection and Evaluations.–Section 476 of such Act (42 U.S.C. 676) is
amended by adding at the end the following:
“(d) Technical Assistance and Best Practices, Clearinghouse, Data
Collection, and Evaluations Relating to Prevention Services and
Programs.–
“(1) <<NOTE: Native Americans.>> Technical assistance and
best practices.–The Secretary shall provide to States and, as
applicable, to Indian tribes, tribal organizations, and tribal
consortia, technical assistance regarding the provision of
services and programs described in section 471(e)(1) and shall
disseminate best practices with respect to the provision of the
services and programs, including how to plan and implement a
well-designed and rigorous evaluation of a promising, supported,
or well-supported practice.
“(2) Clearinghouse of promising, supported, and well-
supported practices.– <<NOTE: Evaluation.>> The Secretary
shall, directly or through grants, contracts, or interagency
agreements, evaluate research on the practices specified in
clauses (iii), (iv), and (v), respectively, of section
471(e)(4)(C), and programs that meet the requirements described
in section 427(a)(1), including culturally specific, or
location- or population-based adaptations of the practices, to
identify and establish a public clearinghouse of the practices
that satisfy each category described by such clauses. In
addition, the clearinghouse shall include information on the
specific outcomes associated with each practice, including
whether the practice has been shown to prevent child abuse and
neglect and reduce the likelihood of foster care placement by
supporting birth families and kinship families and improving
targeted supports for pregnant and parenting youth and their
children.
“(3) Data collection and evaluations.–The Secretary,
directly or through grants, contracts, or interagency
agreements, may collect data and conduct evaluations with
respect to the provision of services and programs described in
section 471(e)(1) for purposes of assessing the extent to which
the provision of the services and programs–
“(A) reduces the likelihood of foster care
placement;
“(B) increases use of kinship care arrangements; or

[[Page 132 STAT. 243]]

“(C) improves child well-being.
“(4) Reports to congress.–
“(A) In general.–The Secretary shall submit to the
Committee on Finance of the Senate and the Committee on
Ways and Means of the House of Representatives periodic
reports based on the provision of services and programs
described in section 471(e)(1) and the activities
carried out under this subsection.
“(B) Public availability.–The Secretary shall make
the reports to Congress submitted under this paragraph
publicly available.
“(5) Appropriation.–Out of any money in the Treasury of
the United States not otherwise appropriated, there are
appropriated to the Secretary $1,000,000 for fiscal year 2018
and each fiscal year thereafter to carry out this subsection.”.

(e) Application to Programs Operated by Indian Tribal
Organizations.–
(1) In general.–Section 479B of such Act (42 U.S.C. 679c)
is amended–
(A) in subsection (c)(1)–
(i) in subparagraph (C)(i)–
(I) in subclause (II), by striking
“and” after the semicolon;
(II) in subclause (III), by striking
the period at the end and inserting “;
and”; and
(III) by adding at the end the
following:
“(IV) at the option of the tribe,
organization, or consortium, services
and programs specified in section
471(e)(1) to children described in
section 471(e)(2) and their parents or
kin caregivers, in accordance with
section 471(e) and subparagraph (E).”;
and
(ii) by adding at the end the following:
“(E) Prevention services and programs for children
and their parents and kin caregivers.–
“(i) In general.– <<NOTE: Requirements.>> In
the case of a tribe, organization, or consortium
that elects to provide services and programs
specified in section 471(e)(1) to children
described in section 471(e)(2) and their parents
or kin caregivers under the plan, the Secretary
shall specify the requirements applicable to the
provision of the services and programs. The
requirements shall, to the greatest extent
practicable, be consistent with the requirements
applicable to States under section 471(e) and
shall permit the provision of the services and
programs in the form of services and programs that
are adapted to the culture and context of the
tribal communities served.
“(ii) Performance measures.–The Secretary
shall establish specific performance measures for
each tribe, organization, or consortium that
elects to provide services and programs specified
in section 471(e)(1). The performance measures
shall, to the greatest extent practicable, be
consistent with the prevention services measures
required for States under section 471(e)(6) but
shall allow for consideration of factors unique to

[[Page 132 STAT. 244]]

the provision of the services by tribes,
organizations, or consortia.”; and
(B) in subsection (d)(1), by striking “and (5)”
and inserting “(5), and (6)(A)”.
(2) Conforming amendment.–The heading for subsection (d) of
section 479B of such Act (42 U.S.C. 679c) is amended by striking
“for Foster Care Maintenance and Adoption Assistance
Payments”.

(f) Application to Programs Operated by Territories.–Section
1108(a)(2) of the Social Security Act (42 U.S.C. 1308(a)(2)) is amended
by striking “or 413(f)” and inserting “413(f), or 474(a)(6)”.
SEC. 50712. FOSTER CARE MAINTENANCE PAYMENTS FOR CHILDREN WITH
PARENTS IN A LICENSED RESIDENTIAL
FAMILY-BASED TREATMENT FACILITY FOR
SUBSTANCE ABUSE.

(a) In General.–Section 472 of the Social Security Act (42 U.S.C.
672) is amended–
(1) in subsection (a)(2)(C), by striking “or” and
inserting “, with a parent residing in a licensed residential
family-based treatment facility, but only to the extent
permitted under subsection (j), or in a”; and
(2) by adding at the end the following:

“(j) Children Placed With a Parent Residing in a Licensed
Residential Family-Based Treatment Facility for Substance Abuse.–
“(1) <<NOTE: Time period.>> In general.–Notwithstanding
the preceding provisions of this section, a child who is
eligible for foster care maintenance payments under this
section, or who would be eligible for the payments if the
eligibility were determined without regard to paragraphs (1)(B)
and (3) of subsection (a), shall be eligible for the payments
for a period of not more than 12 months during which the child
is placed with a parent who is in a licensed residential family-
based treatment facility for substance abuse, but only if–
“(A) the recommendation for the placement is
specified in the child’s case plan before the placement;
“(B) the treatment facility provides, as part of
the treatment for substance abuse, parenting skills
training, parent education, and individual and family
counseling; and
“(C) the substance abuse treatment, parenting
skills training, parent education, and individual and
family counseling is provided under an organizational
structure and treatment framework that involves
understanding, recognizing, and responding to the
effects of all types of trauma and in accordance with
recognized principles of a trauma-informed approach and
trauma-specific interventions to address the
consequences of trauma and facilitate healing.
“(2) Application.–With respect to children for whom foster
care maintenance payments are made under paragraph (1), only the
children who satisfy the requirements of paragraphs (1)(B) and
(3) of subsection (a) shall be considered to be children with
respect to whom foster care maintenance payments are made under
this section for purposes of subsection (h) or section
473(b)(3)(B).”.

[[Page 132 STAT. 245]]

(b) Conforming Amendment.–Section 474(a)(1) of such Act (42 U.S.C.
674(a)(1)) is amended by inserting “subject to section 472(j),” before
“an amount equal to the Federal” the first place it appears.
SEC. 50713. TITLE IV-E PAYMENTS FOR EVIDENCE-BASED KINSHIP
NAVIGATOR PROGRAMS.

Section 474(a) of the Social Security Act (42 U.S.C. 674(a)), as
amended by section 50711(c), is amended–
(1) in paragraph (6), by striking the period at the end and
inserting “; plus”; and
(2) by adding at the end the following:
“(7) <<NOTE: Determination.>> an amount equal to 50
percent of the amounts expended by the State during the quarter
as the Secretary determines are for kinship navigator programs
that meet the requirements described in section 427(a)(1) and
that the Secretary determines are operated in accordance with
promising, supported, or well-supported practices that meet the
applicable criteria specified for the practices in section
471(e)(4)(C), without regard to whether the expenditures are
incurred on behalf of children who are, or are potentially,
eligible for foster care maintenance payments under this
part.”.

PART II–ENHANCED SUPPORT UNDER TITLE IV-B

SEC. 50721. ELIMINATION OF TIME LIMIT FOR FAMILY REUNIFICATION
SERVICES WHILE IN FOSTER CARE AND
PERMITTING TIME-LIMITED FAMILY
REUNIFICATION SERVICES WHEN A CHILD
RETURNS HOME FROM FOSTER CARE.

(a) In General.–Section 431(a)(7) of the Social Security Act (42
U.S.C. 629a(a)(7)) is amended–
(1) in the paragraph heading, by striking “Time-limited
family” and inserting “Family”; and
(2) in subparagraph (A)–
(A) by striking “time-limited family” and
inserting “family”;
(B) by inserting “or a child who has been returned
home” after “child care institution”; and
(C) by striking “, but only during the 15-month
period that begins on the date that the child, pursuant
to section 475(5)(F), is considered to have entered
foster care” and inserting “and to ensure the strength
and stability of the reunification. <<NOTE: Time
period.>> In the case of a child who has been returned
home, the services and activities shall only be provided
during the 15-month period that begins on the date that
the child returns home”.

(b) Conforming Amendments.–
(1) Section 430 of such Act (42 U.S.C. 629) is amended in
the matter preceding paragraph (1), by striking “time-
limited”.
(2) Subsections (a)(4), (a)(5)(A), and (b)(1) of section 432
of such Act (42 U.S.C. 629b) are amended by striking “time-
limited” each place it appears.

[[Page 132 STAT. 246]]

SEC. 50722. REDUCING BUREAUCRACY AND UNNECESSARY DELAYS WHEN
PLACING CHILDREN IN HOMES ACROSS STATE
LINES.

(a) State Plan Requirement.–Section 471(a)(25) of the Social
Security Act (42 U.S.C. 671(a)(25)) is amended–
(1) by striking “provide” and inserting “provides”; and
(2) <<NOTE: Deadline.>> by inserting “, which, in the case
of a State other than the Commonwealth of Puerto Rico, the
United States Virgin Islands, Guam, or American Samoa, not later
than October 1, 2027, shall include the use of an electronic
interstate case-processing system” before the first semicolon.

(b) Exemption of Indian Tribes.–Section 479B(c) of such Act (42
U.S.C. 679c(c)) is amended by adding at the end the following:
“(4) Inapplicability of state plan requirement to have in
effect procedures providing for the use of an electronic
interstate case-processing system.–The requirement in section
471(a)(25) that a State plan provide that the State shall have
in effect procedures providing for the use of an electronic
interstate case-processing system shall not apply to an Indian
tribe, tribal organization, or tribal consortium that elects to
operate a program under this part.”.

(c) Funding for the Development of an Electronic Interstate Case-
processing System to Expedite the Interstate Placement of Children in
Foster Care or Guardianship, or for Adoption.–Section 437 of such Act
(42 U.S.C. 629g) is amended by adding at the end the following:
“(g) Funding for the Development of an Electronic Interstate Case-
processing System to Expedite the Interstate Placement of Children in
Foster Care or Guardianship, or for Adoption.–
“(1) Purpose.–The purpose of this subsection is to
facilitate the development of an electronic interstate case-
processing system for the exchange of data and documents to
expedite the placements of children in foster, guardianship, or
adoptive homes across State lines.
“(2) Requirements.–A State that seeks funding under this
subsection shall submit to the Secretary the following:
“(A) A description of the goals and outcomes to be
achieved, which goals and outcomes must result in–
“(i) reducing the time it takes for a child
to be provided with a safe and appropriate
permanent living arrangement across State lines;
“(ii) improving administrative processes and
reducing costs in the foster care system; and
“(iii) the secure exchange of relevant case
files and other necessary materials in real time,
and timely communications and placement decisions
regarding interstate placements of children.
“(B) A description of the activities to be funded
in whole or in part with the funds, including the
sequencing of the activities.
“(C) A description of the strategies for
integrating programs and services for children who are
placed across State lines.
“(D) Such other information as the Secretary may
require.

[[Page 132 STAT. 247]]

“(3) Funding authority.–The Secretary may provide funds to
a State that complies with paragraph (2). In providing funds
under this subsection, the Secretary shall prioritize States
that are not yet connected with the electronic interstate case-
processing system referred to in paragraph (1).
“(4) Use of funds.–A State to which funding is provided
under this subsection shall use the funding to support the State
in connecting with, or enhancing or expediting services provided
under, the electronic interstate case-processing system referred
to in paragraph (1).
“(5) <<NOTE: Deadline. Public information. Reports. Web
posting.>> Evaluations.–Not later than 1 year after the final
year in which funds are awarded under this subsection, the
Secretary shall submit to the Congress, and make available to
the general public by posting on a website, a report that
contains the following information:
“(A) How using the electronic interstate case-
processing system developed pursuant to paragraph (4)
has changed the time it takes for children to be placed
across State lines.
“(B) The number of cases subject to the Interstate
Compact on the Placement of Children that were processed
through the electronic interstate case-processing
system, and the number of interstate child placement
cases that were processed outside the electronic
interstate case-processing system, by each State in each
year.
“(C) The progress made by States in implementing
the electronic interstate case-processing system.
“(D) How using the electronic interstate case-
processing system has affected various metrics related
to child safety and well-being, including the time it
takes for children to be placed across State lines.
“(E) How using the electronic interstate case-
processing system has affected administrative costs and
caseworker time spent on placing children across State
lines.
“(6) <<NOTE: Consultation. Assessment.>> Data
integration.–The Secretary, in consultation with the
Secretariat for the Interstate Compact on the Placement of
Children and the States, shall assess how the electronic
interstate case-processing system developed pursuant to
paragraph (4) could be used to better serve and protect children
that come to the attention of the child welfare system, by–
“(A) connecting the system with other data systems
(such as systems operated by State law enforcement and
judicial agencies, systems operated by the Federal
Bureau of Investigation for the purposes of the
Innocence Lost National Initiative, and other systems);
“(B) simplifying and improving reporting related to
paragraphs (34) and (35) of section 471(a) regarding
children or youth who have been identified as being a
sex trafficking victim or children missing from foster
care; and
“(C) improving the ability of States to quickly
comply with background check requirements of section
471(a)(20), including checks of child abuse and neglect
registries as required by section 471(a)(20)(B).”.

(d) Reservation of Funds To Improve the Interstate Placement of
Children.–Section 437(b) of such Act (42 U.S.C. 629g(b)) is amended by
adding at the end the following:

[[Page 132 STAT. 248]]

“(4) Improving the interstate placement of children.–The
Secretary shall reserve $5,000,000 of the amount made available
for fiscal year 2018 for grants under subsection (g), and the
amount so reserved shall remain available through fiscal year
2022.”.
SEC. 50723. ENHANCEMENTS TO GRANTS TO IMPROVE WELL-BEING OF
FAMILIES AFFECTED BY SUBSTANCE ABUSE.

Section 437(f) of the Social Security Act (42 U.S.C. 629g(f)) is
amended–
(1) in the subsection heading, by striking “Increase the
Well-Being of, and To Improve the Permanency Outcomes for,
Children Affected by” and inserting “Implement IV-E Prevention
Services, and Improve the Well-Being of, and Improve Permanency
Outcomes for, Children and Families Affected by Heroin, Opioids,
and Other”;
(2) by striking paragraph (2) and inserting the following:
“(2) Regional partnership defined.–In this subsection, the
term `regional partnership’ means a collaborative agreement
(which may be established on an interstate, State, or intrastate
basis) entered into by the following:
“(A) Mandatory partners for all partnership
grants.–
“(i) The State child welfare agency that is
responsible for the administration of the State
plan under this part and part E.
“(ii) The State agency responsible for
administering the substance abuse prevention and
treatment block grant provided under subpart II of
part B of title XIX of the Public Health Service
Act.
“(B) Mandatory partners for partnership grants
proposing to serve children in out-of-home placements.–
If the partnership proposes to serve children in out-of-
home placements, the Juvenile Court or Administrative
Office of the Court that is most appropriate to oversee
the administration of court programs in the region to
address the population of families who come to the
attention of the court due to child abuse or neglect.
“(C) Optional partners.–At the option of the
partnership, any of the following:
“(i) An Indian tribe or tribal consortium.
“(ii) Nonprofit child welfare service
providers.
“(iii) For-profit child welfare service
providers.
“(iv) Community health service providers,
including substance abuse treatment providers.
“(v) Community mental health providers.
“(vi) Local law enforcement agencies.
“(vii) School personnel.
“(viii) Tribal child welfare agencies (or a
consortia of the agencies).
“(ix) Any other providers, agencies,
personnel, officials, or entities that are related
to the provision of child and family services
under a State plan approved under this subpart.
“(D) Exception for regional partnerships where the
lead applicant is an indian tribe or tribal consortia.–
If an Indian tribe or tribal consortium enters

[[Page 132 STAT. 249]]

into a regional partnership for purposes of this
subsection, the Indian tribe or tribal consortium–
“(i) may (but is not required to) include the
State child welfare agency as a partner in the
collaborative agreement;
“(ii) may not enter into a collaborative
agreement only with tribal child welfare agencies
(or a consortium of the agencies); and
“(iii) if the condition described in
paragraph (2)(B) applies, may include tribal court
organizations in lieu of other judicial
partners.”;
(3) in paragraph (3)–
(A) in subparagraph (A)–
(i) by striking “2012 through 2016” and
inserting “2017 through 2021”; and
(ii) by striking “$500,000 and not more than
$1,000,000” and inserting “$250,000 and not more
than $1,000,000”;
(B) in subparagraph (B)–
(i) in the subparagraph heading, by inserting
“; planning” after “approval”;
(ii) in clause (i), by striking “clause
(ii)” and inserting “clauses (ii) and (iii)”;
and
(iii) by adding at the end the following:
“(iii) <<NOTE: Time period.>> Sufficient
planning.–A grant awarded under this subsection
shall be disbursed in two phases: a planning phase
(not to exceed 2 years) and an implementation
phase. The total disbursement to a grantee for the
planning phase may not exceed $250,000, and may
not exceed the total anticipated funding for the
implementation phase.”; and
(C) by adding at the end the following:
“(D) <<NOTE: Determination.>> Limitation on
payment for a fiscal year.–No payment shall be made
under subparagraph (A) or (C) for a fiscal year until
the Secretary determines that the eligible partnership
has made sufficient progress in meeting the goals of the
grant and that the members of the eligible partnership
are coordinating to a reasonable degree with the other
members of the eligible partnership.”;
(4) in paragraph (4)–
(A) in subparagraph (B)–
(i) in clause (i), by inserting “, parents,
and families” after “children”;
(ii) in clause (ii), by striking “safety and
permanence for such children; and” and inserting
“safe, permanent caregiving relationships for the
children;”;
(iii) in clause (iii), by striking “or” and
inserting “increase reunification rates for
children who have been placed in out-of-home care,
or decrease”; and
(iv) by redesignating clause (iii) as clause
(v) and inserting after clause (ii) the following:
“(iii) improve the substance abuse treatment
outcomes for parents including retention in
treatment and successful completion of treatment;
“(iv) facilitate the implementation,
delivery, and effectiveness of prevention services
and programs under section 471(e); and”;

[[Page 132 STAT. 250]]

(B) in subparagraph (D), by striking “where
appropriate,”; and
(C) by striking subparagraphs (E) and (F) and
inserting the following:
“(E) A description of a plan for sustaining the
services provided by or activities funded under the
grant after the conclusion of the grant period,
including through the use of prevention services and
programs under section 471(e) and other funds provided
to the State for child welfare and substance abuse
prevention and treatment services.
“(F) <<NOTE: Determination.>> Additional
information needed by the Secretary to determine that
the proposed activities and implementation will be
consistent with research or evaluations showing which
practices and approaches are most effective.”;
(5) in paragraph (5)(A), by striking “abuse treatment” and
inserting “use disorder treatment including medication assisted
treatment and in-home substance abuse disorder treatment and
recovery”;
(6) in paragraph (7)–
(A) by striking “and” at the end of subparagraph
(C); and
(B) by redesignating subparagraph (D) as
subparagraph (E) and inserting after subparagraph (C)
the following:
“(D) demonstrate a track record of successful
collaboration among child welfare, substance abuse
disorder treatment and mental health agencies; and”;
(7) in paragraph (8)–
(A) in subparagraph (A)–
(i) by striking “establish indicators that
will be” and inserting “review indicators that
are”; and
(ii) by striking “in using funds made
available under such grants to achieve the purpose
of this subsection” and inserting “and establish
a set of core indicators related to child safety,
parental recovery, parenting capacity, and family
well-being. In developing the core indicators, to
the extent possible, indicators shall be made
consistent with the outcome measures described in
section 471(e)(6)”; and
(B) in subparagraph (B)–
(i) in the matter preceding clause (i), by
inserting “base the performance measures on
lessons learned from prior rounds of regional
partnership grants under this subsection, and”
before “consult”; and
(ii) by striking clauses (iii) and (iv) and
inserting the following:
“(iii) Other stakeholders or constituencies
as determined by the Secretary.”;
(8) in paragraph (9)(A), by striking clause (i) and
inserting the following:
“(i) Semiannual reports.–Not later than
September 30 of each fiscal year in which a
recipient of a grant under this subsection is paid
funds under the grant, and every 6 months
thereafter, the grant recipient shall submit to
the Secretary a report on the services provided
and activities carried out during the reporting
period, progress made in achieving the

[[Page 132 STAT. 251]]

goals of the program, the number of children,
adults, and families receiving services, and such
additional information as the Secretary determines
is necessary. The report due not later than
September 30 of the last such fiscal year shall
include, at a minimum, data on each of the
performance indicators included in the evaluation
of the regional partnership.”; and
(9) in paragraph (10), by striking “2012 through 2016” and
inserting “2017 through 2021”.

PART III–MISCELLANEOUS

SEC. 50731. <<NOTE: Deadlines. 42 USC 671 note.>> REVIEWING AND
IMPROVING LICENSING STANDARDS FOR
PLACEMENT IN A RELATIVE FOSTER FAMILY
HOME.

(a) Identification of Reputable Model Licensing Standards.–Not
later than October 1, 2018, the Secretary of Health and Human Services
shall identify reputable model licensing standards with respect to the
licensing of foster family homes (as defined in section 472(c)(1) of the
Social Security Act).
(b) State Plan Requirement.–Section 471(a) of the Social Security
Act (42 U.S.C. 671(a)) is amended–
(1) in paragraph (34)(B), by striking “and” after the
semicolon;
(2) in paragraph (35)(B), by striking the period at the end
and inserting a semicolon; and
(3) by adding at the end the following:
“(36) provides that, not later than April 1, 2019, the
State shall submit to the Secretary information addressing–
“(A) whether the State licensing standards are in
accord with model standards identified by the Secretary,
and if not, the reason for the specific deviation and a
description as to why having a standard that is
reasonably in accord with the corresponding national
model standards is not appropriate for the State;
“(B) whether the State has elected to waive
standards established in 471(a)(10)(A) for relative
foster family homes (pursuant to waiver authority
provided by 471(a)(10)(D)), a description of which
standards the State most commonly waives, and if the
State has not elected to waive the standards, the reason
for not waiving these standards;
“(C) if the State has elected to waive standards
specified in subparagraph (B), how caseworkers are
trained to use the waiver authority and whether the
State has developed a process or provided tools to
assist caseworkers in waiving nonsafety standards per
the authority provided in 471(a)(10)(D) to quickly place
children with relatives; and
“(D) a description of the steps the State is taking
to improve caseworker training or the process, if any;
and”.
SEC. 50732. DEVELOPMENT OF A STATEWIDE PLAN TO PREVENT CHILD ABUSE
AND NEGLECT FATALITIES.

Section 422(b)(19) of the Social Security Act (42 U.S.C. 622(b)(19))
is amended to read as follows:
“(19) document steps taken to track and prevent child
maltreatment deaths by including–

[[Page 132 STAT. 252]]

“(A) a description of the steps the State is taking
to compile complete and accurate information on the
deaths required by Federal law to be reported by the
State agency referred to in paragraph (1), including
gathering relevant information on the deaths from the
relevant organizations in the State including entities
such as State vital statistics department, child death
review teams, law enforcement agencies, offices of
medical examiners, or coroners; and
“(B) a description of the steps the State is taking
to develop and implement a comprehensive, statewide plan
to prevent the fatalities that involves and engages
relevant public and private agency partners, including
those in public health, law enforcement, and the
courts.”.
SEC. 50733. MODERNIZING THE TITLE AND PURPOSE OF TITLE IV-E.

(a) Part Heading.–The heading for part E of title IV of the Social
Security Act (42 U.S.C. 670 et seq.) is amended to read as follows:

“PART E–FEDERAL PAYMENTS FOR FOSTER CARE, PREVENTION, AND
PERMANENCY”.

(b) Purpose.–The first sentence of section 470 of such Act (42
U.S.C. 670) is amended–
(1) by striking “1995) and” and inserting “1995),”;
(2) by inserting “kinship guardianship assistance, and
prevention services or programs specified in section
471(e)(1),” after “needs,”; and
(3) by striking “(commencing with the fiscal year which
begins October 1, 1980)”.
SEC. 50734. <<NOTE: 42 USC 622 note.>> EFFECTIVE DATES.

(a) Effective Dates.–
(1) In general.–Except as provided in paragraph (2),
subject to subsection (b), the amendments made by parts I
through III of this subtitle shall take effect on October 1,
2018.
(2) Exceptions.–The amendments made by sections 50711(d),
50731, and 50733 shall take effect on the date of enactment of
this Act.

(b) Transition Rule.–
(1) <<NOTE: Determination.>> In general.–In the case of a
State plan under part B or E of title IV of the Social Security
Act which the Secretary of Health and Human Services determines
requires State legislation (other than legislation appropriating
funds) in order for the plan to meet the additional requirements
imposed by the amendments made by parts I through III of this
subtitle, the State plan shall not be regarded as failing to
comply with the requirements of such part solely on the basis of
the failure of the plan to meet such additional requirements
before the first day of the first calendar quarter beginning
after the close of the first regular session of the State
legislature that begins after the date of enactment of this Act.
For purposes of the previous sentence, in the case of a State
that has a 2-year legislative session, each year of the session
shall be deemed to be a separate regular session of the State
legislature.

[[Page 132 STAT. 253]]

(2) Application to programs operated by indian tribal
organizations.– <<NOTE: Determination.>> In the case of an
Indian tribe, tribal organization, or tribal consortium which
the Secretary of Health and Human Services determines requires
time to take action necessary to comply with the additional
requirements imposed by the amendments made by parts I through
III of this subtitle (whether the tribe, organization, or tribal
consortium has a plan under section 479B of the Social Security
Act or a cooperative agreement or contract entered into with a
State), the Secretary shall provide the tribe, organization, or
tribal consortium with such additional time as the Secretary
determines is necessary for the tribe, organization, or tribal
consortium to take the action to comply with the additional
requirements before being regarded as failing to comply with the
requirements.

PART IV–ENSURING THE NECESSITY OF A PLACEMENT THAT IS NOT IN A FOSTER
FAMILY HOME

SEC. 50741. LIMITATION ON FEDERAL FINANCIAL PARTICIPATION FOR
PLACEMENTS THAT ARE NOT IN FOSTER
FAMILY HOMES.

(a) Limitation on Federal Financial Participation.–
(1) In general.–Section 472 of the Social Security Act (42
U.S.C. 672), as amended by section 50712(a), is amended–
(A) in subsection (a)(2)(C), by inserting “, but
only to the extent permitted under subsection (k)”
after “institution”; and
(B) by adding at the end the following:

“(k) Limitation on Federal Financial Participation.–
“(1) <<NOTE: Effective date. Time period.>> In general.–
Beginning with the third week for which foster care maintenance
payments are made under this section on behalf of a child placed
in a child-care institution, no Federal payment shall be made to
the State under section 474(a)(1) for amounts expended for
foster care maintenance payments on behalf of the child unless–
“(A) the child is placed in a child-care
institution that is a setting specified in paragraph (2)
(or is placed in a licensed residential family-based
treatment facility consistent with subsection (j)); and
“(B) in the case of a child placed in a qualified
residential treatment program (as defined in paragraph
(4)), the requirements specified in paragraph (3) and
section 475A(c) are met.
“(2) Specified settings for placement.–The settings for
placement specified in this paragraph are the following:
“(A) A qualified residential treatment program (as
defined in paragraph (4)).
“(B) A setting specializing in providing prenatal,
post-partum, or parenting supports for youth.
“(C) In the case of a child who has attained 18
years of age, a supervised setting in which the child is
living independently.
“(D) A setting providing high-quality residential
care and supportive services to children and youth who
have

[[Page 132 STAT. 254]]

been found to be, or are at risk of becoming, sex
trafficking victims, in accordance with section
471(a)(9)(C).
“(3) Assessment to determine appropriateness of placement
in a qualified residential treatment program.–
“(A) Deadline for assessment.–In the case of a
child who is placed in a qualified residential treatment
program, if the assessment required under section
475A(c)(1) is not completed within 30 days after the
placement is made, no Federal payment shall be made to
the State under section 474(a)(1) for any amounts
expended for foster care maintenance payments on behalf
of the child during the placement.
“(B) Deadline for transition out of placement.–If
the assessment required under section 475A(c)(1)
determines that the placement of a child in a qualified
residential treatment program is not appropriate, a
court disapproves such a placement under section
475A(c)(2), or a child who has been in an approved
placement in a qualified residential treatment program
is going to return home or be placed with a fit and
willing relative, a legal guardian, or an adoptive
parent, or in a foster family home, Federal payments
shall be made to the State under section 474(a)(1) for
amounts expended for foster care maintenance payments on
behalf of the child while the child remains in the
qualified residential treatment program only during the
period necessary for the child to transition home or to
such a placement. In no event shall a State receive
Federal payments under section 474(a)(1) for amounts
expended for foster care maintenance payments on behalf
of a child who remains placed in a qualified residential
treatment program after the end of the 30-day period
that begins on the date a determination is made that the
placement is no longer the recommended or approved
placement for the child.
“(4) <<NOTE: Definition.>> Qualified residential treatment
program.–For purposes of this part, the term `qualified
residential treatment program’ means a program that–
“(A) has a trauma-informed treatment model that is
designed to address the needs, including clinical needs
as appropriate, of children with serious emotional or
behavioral disorders or disturbances and, with respect
to a child, is able to implement the treatment
identified for the child by the assessment of the child
required under section 475A(c);
“(B) subject to paragraphs (5) and (6), has
registered or licensed nursing staff and other licensed
clinical staff who–
“(i) provide care within the scope of their
practice as defined by State law;
“(ii) are on-site according to the treatment
model referred to in subparagraph (A); and
“(iii) are available 24 hours a day and 7
days a week;
“(C) to extent appropriate, and in accordance with
the child’s best interests, facilitates participation of
family members in the child’s treatment program;

[[Page 132 STAT. 255]]

“(D) facilitates outreach to the family members of
the child, including siblings, documents how the
outreach is made (including contact information), and
maintains contact information for any known biological
family and fictive kin of the child;
“(E) documents how family members are integrated
into the treatment process for the child, including
post-discharge, and how sibling connections are
maintained;
“(F) provides discharge planning and family-based
aftercare support for at least 6 months post-discharge;
and
“(G) is licensed in accordance with section
471(a)(10) and is accredited by any of the following
independent, not-for-profit organizations:
“(i) The Commission on Accreditation of
Rehabilitation Facilities (CARF).
“(ii) The Joint Commission on Accreditation
of Healthcare Organizations (JCAHO).
“(iii) The Council on Accreditation (COA).
“(iv) Any other independent, not-for-profit
accrediting organization approved by the
Secretary.
“(5) Administrative costs.–The prohibition in paragraph
(1) on Federal payments under section 474(a)(1) shall not be
construed as prohibiting Federal payments for administrative
expenditures incurred on behalf of a child placed in a child-
care institution and for which payment is available under
section 474(a)(3).
“(6) Rule of construction.–The requirements in paragraph
(4)(B) shall not be construed as requiring a qualified
residential treatment program to acquire nursing and behavioral
health staff solely through means of a direct employer to
employee relationship.”.
(2) Conforming amendment.–Section 474(a)(1) of the Social
Security Act (42 U.S.C. 674(a)(1)), as amended by section
50712(b), is amended by striking “section 472(j)” and
inserting “subsections (j) and (k) of section 472”.

(b) Definition of Foster Family Home, Child-Care Institution.–
Section 472(c) of such Act (42 U.S.C. 672(c)(1)) is amended to read as
follows:
“(c) Definitions.–For purposes of this part:
“(1) Foster family home.–
“(A) In general.–The term `foster family home’
means the home of an individual or family–
“(i) that is licensed or approved by the
State in which it is situated as a foster family
home that meets the standards established for the
licensing or approval; and
“(ii) in which a child in foster care has
been placed in the care of an individual, who
resides with the child and who has been licensed
or approved by the State to be a foster parent–
“(I) that the State deems capable
of adhering to the reasonable and
prudent parent standard;
“(II) that provides 24-hour
substitute care for children placed away
from their parents or other caretakers;
and
“(III) that provides the care for
not more than six children in foster
care.

[[Page 132 STAT. 256]]

“(B) State flexibility.–The number of foster
children that may be cared for in a home under
subparagraph (A) may exceed the numerical limitation in
subparagraph (A)(ii)(III), at the option of the State,
for any of the following reasons:
“(i) To allow a parenting youth in foster
care to remain with the child of the parenting
youth.
“(ii) To allow siblings to remain together.
“(iii) To allow a child with an established
meaningful relationship with the family to remain
with the family.
“(iv) To allow a family with special training
or skills to provide care to a child who has a
severe disability.
“(C) Rule of construction.–Subparagraph (A) shall
not be construed as prohibiting a foster parent from
renting the home in which the parent cares for a foster
child placed in the parent’s care.
“(2) <<NOTE: Definition.>> Child-care institution.–
“(A) In general.–The term `child-care institution’
means a private child-care institution, or a public
child-care institution which accommodates no more than
25 children, which is licensed by the State in which it
is situated or has been approved by the agency of the
State responsible for licensing or approval of
institutions of this type as meeting the standards
established for the licensing.
“(B) Supervised settings.–In the case of a child
who has attained 18 years of age, the term shall include
a supervised setting in which the individual is living
independently, in accordance with such conditions as the
Secretary shall establish in regulations.
“(C) Exclusions.–The term shall not include
detention facilities, forestry camps, training schools,
or any other facility operated primarily for the
detention of children who are determined to be
delinquent.”.

(c) Training for State Judges, Attorneys, and Other Legal Personnel
in Child Welfare Cases.–Section 438(b)(1) of such Act (42 U.S.C.
629h(b)(1)) is amended in the matter preceding subparagraph (A) by
inserting “shall provide for the training of judges, attorneys, and
other legal personnel in child welfare cases on Federal child welfare
policies and payment limitations with respect to children in foster care
who are placed in settings that are not a foster family home,” after
“with respect to the child,”.
(d) Assurance of Nonimpact on Juvenile Justice System.–
(1) State plan requirement.–Section 471(a) of such Act (42
U.S.C. 671(a)), as amended by section 50731, is further amended
by adding at the end the following:
“(37) <<NOTE: Certification.>> includes a certification
that, in response to the limitation imposed under section 472(k)
with respect to foster care maintenance payments made on behalf
of any child who is placed in a setting that is not a foster
family home, the State will not enact or advance policies or
practices that would result in a significant increase in the
population of youth in the State’s juvenile justice system.”.
(2) <<NOTE: Evaluations.>> GAO study and report.–The
Comptroller General of the United States shall evaluate the
impact, if any, on State juvenile justice systems of the
limitation imposed under

[[Page 132 STAT. 257]]

section 472(k) of the Social Security Act (as added by section
50741(a)(1)) on foster care maintenance payments made on behalf
of any child who is placed in a setting that is not a foster
family home, in accordance with the amendments made by
subsections (a) and (b) of this section. In particular, the
Comptroller General shall evaluate the extent to which children
in foster care who also are subject to the juvenile justice
system of the State are placed in a facility under the
jurisdiction of the juvenile justice system and whether the lack
of available congregate care placements under the jurisdiction
of the child welfare systems is a contributing factor to that
result. Not later than December 31, 2025, the Comptroller
General shall submit to Congress a report on the results of the
evaluation.
SEC. 50742. ASSESSMENT AND DOCUMENTATION OF THE NEED FOR PLACEMENT
IN A QUALIFIED RESIDENTIAL TREATMENT
PROGRAM.

Section 475A of the Social Security Act (42 U.S.C. 675a) is amended
by adding at the end the following:
“(c) Assessment, Documentation, and Judicial Determination
Requirements for Placement in a Qualified Residential Treatment
Program.– <<NOTE: Applicability.>> In the case of any child who is
placed in a qualified residential treatment program (as defined in
section 472(k)(4)), the following requirements shall apply for purposes
of approving the case plan for the child and the case system review
procedure for the child:
“(1)(A) <<NOTE: Deadline.>> Within 30 days of the start of
each placement in such a setting, a qualified individual (as
defined in subparagraph (D)) shall–
“(i) assess the strengths and needs of the child
using an age-appropriate, evidence-based, validated,
functional assessment tool approved by the Secretary;
“(ii) <<NOTE: Determination.>> determine whether
the needs of the child can be met with family members or
through placement in a foster family home or, if not,
which setting from among the settings specified in
section 472(k)(2) would provide the most effective and
appropriate level of care for the child in the least
restrictive environment and be consistent with the
short- and long-term goals for the child, as specified
in the permanency plan for the child; and
“(iii) <<NOTE: Lists.>> develop a list of child-
specific short- and long-term mental and behavioral
health goals.
“(B)(i) The State shall assemble a family and permanency
team for the child in accordance with the requirements of
clauses (ii) and (iii). The qualified individual conducting the
assessment required under subparagraph (A) shall work in
conjunction with the family of, and permanency team for, the
child while conducting and making the assessment.
“(ii) The family and permanency team shall consist of all
appropriate biological family members, relative, and fictive kin
of the child, as well as, as appropriate, professionals who are
a resource to the family of the child, such as teachers, medical
or mental health providers who have treated the child, or
clergy. In the case of a child who has attained age 14, the
family and permanency team shall include the members of the
permanency planning team for the child that are selected by the
child in accordance with section 475(5)(C)(iv).

[[Page 132 STAT. 258]]

“(iii) The State shall document in the child’s case plan–
“(I) the reasonable and good faith effort of the
State to identify and include all the individuals
described in clause (ii) on the child’s family and
permanency team;
“(II) all contact information for members of the
family and permanency team, as well as contact
information for other family members and fictive kin who
are not part of the family and permanency team;
“(III) evidence that meetings of the family and
permanency team, including meetings relating to the
assessment required under subparagraph (A), are held at
a time and place convenient for family;
“(IV) if reunification is the goal, evidence
demonstrating that the parent from whom the child was
removed provided input on the members of the family and
permanency team;
“(V) evidence that the assessment required under
subparagraph (A) is determined in conjunction with the
family and permanency team;
“(VI) the placement preferences of the family and
permanency team relative to the assessment that
recognizes children should be placed with their siblings
unless there is a finding by the court that such
placement is contrary to their best interest; and
“(VII) if the placement preferences of the family
and permanency team and child are not the placement
setting recommended by the qualified individual
conducting the assessment under subparagraph (A), the
reasons why the preferences of the team and of the child
were not recommended.
“(C) <<NOTE: Determination.>> In the case of a child who
the qualified individual conducting the assessment under
subparagraph (A) determines should not be placed in a foster
family home, the qualified individual shall specify in writing
the reasons why the needs of the child cannot be met by the
family of the child or in a foster family home. A shortage or
lack of foster family homes shall not be an acceptable reason
for determining that the needs of the child cannot be met in a
foster family home. The qualified individual also shall specify
in writing why the recommended placement in a qualified
residential treatment program is the setting that will provide
the child with the most effective and appropriate level of care
in the least restrictive environment and how that placement is
consistent with the short- and long-term goals for the child, as
specified in the permanency plan for the child.
“(D)(i) <<NOTE: Definition.>> Subject to clause (ii), in
this subsection, the term `qualified individual’ means a trained
professional or licensed clinician who is not an employee of the
State agency and who is not connected to, or affiliated with,
any placement setting in which children are placed by the State.
“(ii) <<NOTE: Certification.>> The Secretary may approve a
request of a State to waive any requirement in clause (i) upon a
submission by the State, in accordance with criteria established
by the Secretary, that certifies that the trained professionals
or licensed clinicians with responsibility for performing the
assessments described in subparagraph (A) shall maintain
objectivity with

[[Page 132 STAT. 259]]

respect to determining the most effective and appropriate
placement for a child.
“(2) <<NOTE: Deadline.>> Within 60 days of the start of
each placement in a qualified residential treatment program, a
family or juvenile court or another court (including a tribal
court) of competent jurisdiction, or an administrative body
appointed or approved by the court, independently, shall–
“(A) consider the assessment, determination, and
documentation made by the qualified individual
conducting the assessment under paragraph (1);
“(B) <<NOTE: Determination.>> determine whether
the needs of the child can be met through placement in a
foster family home or, if not, whether placement of the
child in a qualified residential treatment program
provides the most effective and appropriate level of
care for the child in the least restrictive environment
and whether that placement is consistent with the short-
and long-term goals for the child, as specified in the
permanency plan for the child; and
“(C) approve or disapprove the placement.
“(3) The written documentation made under paragraph (1)(C)
and documentation of the determination and approval or
disapproval of the placement in a qualified residential
treatment program by a court or administrative body under
paragraph (2) shall be included in and made part of the case
plan for the child.
“(4) As long as a child remains placed in a qualified
residential treatment program, the State agency shall submit
evidence at each status review and each permanency hearing held
with respect to the child–
“(A) demonstrating that ongoing assessment of the
strengths and needs of the child continues to support
the determination that the needs of the child cannot be
met through placement in a foster family home, that the
placement in a qualified residential treatment program
provides the most effective and appropriate level of
care for the child in the least restrictive environment,
and that the placement is consistent with the short- and
long-term goals for the child, as specified in the
permanency plan for the child;
“(B) documenting the specific treatment or service
needs that will be met for the child in the placement
and the length of time the child is expected to need the
treatment or services; and
“(C) documenting the efforts made by the State
agency to prepare the child to return home or to be
placed with a fit and willing relative, a legal
guardian, or an adoptive parent, or in a foster family
home.
“(5) <<NOTE: Time periods.>> In the case of any child who
is placed in a qualified residential treatment program for more
than 12 consecutive months or 18 nonconsecutive months (or, in
the case of a child who has not attained age 13, for more than 6
consecutive or nonconsecutive months), the State agency shall
submit to the Secretary–
“(A) the most recent versions of the evidence and
documentation specified in paragraph (4); and
“(B) the signed approval of the head of the State
agency for the continued placement of the child in that
setting.”.

[[Page 132 STAT. 260]]

SEC. 50743. PROTOCOLS TO PREVENT INAPPROPRIATE DIAGNOSES.

(a) State Plan Requirement.–Section 422(b)(15)(A) of the Social
Security Act (42 U.S.C. 622(b)(15)(A)) is amended–
(1) in clause (vi), by striking “and” after the semicolon;
(2) by redesignating clause (vii) as clause (viii); and
(3) by inserting after clause (vi) the following:
“(vii) the procedures and protocols the State
has established to ensure that children in foster
care placements are not inappropriately diagnosed
with mental illness, other emotional or behavioral
disorders, medically fragile conditions, or
developmental disabilities, and placed in settings
that are not foster family homes as a result of
the inappropriate diagnoses; and”.

(b) Evaluation.–Section 476 of such Act (42 U.S.C. 676), as amended
by section 50711(d), is further amended by adding at the end the
following:
“(e) Evaluation of State Procedures and Protocols To Prevent
Inappropriate Diagnoses of Mental Illness or Other Conditions.–The
Secretary shall conduct an evaluation of the procedures and protocols
established by States in accordance with the requirements of section
422(b)(15)(A)(vii). The evaluation shall analyze the extent to which
States comply with and enforce the procedures and protocols and the
effectiveness of various State procedures and protocols and shall
identify best practices. <<NOTE: Deadline. Reports.>> Not later than
January 1, 2020, the Secretary shall submit a report on the results of
the evaluation to Congress.”.
SEC. 50744. ADDITIONAL DATA AND REPORTS REGARDING CHILDREN PLACED
IN A SETTING THAT IS NOT A FOSTER
FAMILY HOME.

Section 479A(a)(7)(A) of the Social Security Act (42 U.S.C.
679b(a)(7)(A)) is amended by striking clauses (i) through (vi) and
inserting the following:
“(i) with respect to each such placement–
“(I) the type of the placement
setting, including whether the placement
is shelter care, a group home and if so,
the range of the child population in the
home, a residential treatment facility,
a hospital or institution providing
medical, rehabilitative, or psychiatric
care, a setting specializing in
providing prenatal, post-partum, or
parenting supports, or some other kind
of child-care institution and if so,
what kind;
“(II) the number of children in the
placement setting and the age, race,
ethnicity, and gender of each of the
children;
“(III) for each child in the
placement setting, the length of the
placement of the child in the setting,
whether the placement of the child in
the setting is the first placement of
the child and if not, the number and
type of previous placements of the
child, and whether the child has special
needs or another diagnosed mental or
physical illness or condition; and
“(IV) the extent of any specialized
education, treatment, counseling, or
other services provided in the setting;
and

[[Page 132 STAT. 261]]

“(ii) separately, the number and ages of
children in the placements who have a permanency
plan of another planned permanent living
arrangement; and”.
SEC. 50745. CRIMINAL RECORDS CHECKS AND CHECKS OF CHILD ABUSE AND
NEGLECT REGISTRIES FOR ADULTS WORKING
IN CHILD-CARE INSTITUTIONS AND OTHER
GROUP CARE SETTINGS.

(a) State Plan Requirement.–Section 471(a)(20) of the Social
Security Act (42 U.S.C. 671(a)(20)) is amended–
(1) in subparagraph (A)(ii), by striking “and” after the
semicolon;
(2) in subparagraph (B)(iii), by striking “and”after the
semicolon;
(3) in subparagraph (C), by adding “and” after the
semicolon; and
(4) by inserting after subparagraph (C), the following new
subparagraph:
“(D) provides procedures for any child-care
institution, including a group home, residential
treatment center, shelter, or other congregate care
setting, to conduct criminal records checks, including
fingerprint-based checks of national crime information
databases (as defined in section 534(f)(3)(A) of title
28, United States Code), and checks described in
subparagraph (B) of this paragraph, on any adult working
in a child-care institution, including a group home,
residential treatment center, shelter, or other
congregate care setting, unless the State reports to the
Secretary the alternative criminal records checks and
child abuse registry checks the State conducts on any
adult working in a child-care institution, including a
group home, residential treatment center, shelter, or
other congregate care setting, and why the checks
specified in this subparagraph are not appropriate for
the State;”.

(b) Technical Amendments.–Subparagraphs (A) and (C) of section
471(a)(20) of the Social Security Act (42 U.S.C. 671(a)(20)) are each
amended by striking “section 534(e)(3)(A)” and inserting “section
534(f)(3)(A)”.
SEC. 50746. <<NOTE: 42 USC 622 note.>> EFFECTIVE DATES;
APPLICATION TO WAIVERS.

(a) Effective Dates.–
(1) In general.–Subject to paragraph (2) and subsections
(b), (c), and (d), the amendments made by this part shall take
effect as if enacted on January 1, 2018.
(2) <<NOTE: Determination.>> Transition rule.–In the case
of a State plan under part B or E of title IV of the Social
Security Act which the Secretary of Health and Human Services
determines requires State legislation (other than legislation
appropriating funds) in order for the plan to meet the
additional requirements imposed by the amendments made by this
part, the State plan shall not be regarded as failing to comply
with the requirements of part B or E of title IV of such Act
solely on the basis of the failure of the plan to meet the
additional requirements before the first day of the first
calendar quarter beginning after the close of the first regular
session of the State legislature that begins after the date of
enactment of this Act. For purposes of the previous sentence, in
the case of a State that has a 2-year legislative session, each
year of

[[Page 132 STAT. 262]]

the session shall be deemed to be a separate regular session of
the State legislature.

(b) Limitation on Federal Financial Participation for Placements
That Are Not in Foster Family Homes and Related Provisions.–
(1) <<NOTE: Effective date.>> In general.–The amendments
made by sections 50741(a), 50741(b), 50741(d), and 50742 shall
take effect on October 1, 2019.
(2) State option to delay effective date for not more than 2
years.–If a State requests a delay in the effective date, the
Secretary of Health and Human Services shall delay the effective
date provided for in paragraph (1) with respect to the State for
the amount of time requested by the State, not to exceed 2
years. If the effective date is so delayed for a period with
respect to a State under the preceding sentence, then–
(A) notwithstanding section 50734, the date that the
amendments made by section 50711(c) take effect with
respect to the State shall be delayed for the period;
and
(B) <<NOTE: Applicability.>> in applying section
474(a)(6) of the Social Security Act with respect to the
State, “on or after the date this paragraph takes
effect with respect to the State” is deemed to be
substituted for “after September 30, 2019” in
subparagraph (A)(i)(I) of such section.

(c) Criminal Records Checks and Checks of Child Abuse and Neglect
Registries for Adults Working in Child-care Institutions and Other Group
Care Settings.– <<NOTE: Effective date.>> Subject to subsection (a)(2),
the amendments made by section 50745 shall take effect on October 1,
2018.

(d) Application to States With Waivers.–In the case of a State
that, on the date of enactment of this Act, has in effect a waiver
approved under section 1130 of the Social Security Act (42 U.S.C. 1320a-
9), the amendments made by this part shall not apply with respect to the
State before the expiration (determined without regard to any
extensions) of the waiver to the extent the amendments are inconsistent
with the terms of the waiver.

PART V–CONTINUING SUPPORT FOR CHILD AND FAMILY SERVICES

SEC. 50751. SUPPORTING AND RETAINING FOSTER FAMILIES FOR CHILDREN.

(a) Supporting and Retaining Foster Parents as a Family Support
Service.–Section 431(a)(2)(B) of the Social Security Act (42 U.S.C.
631(a)(2)(B)) is amended by redesignating clauses (iii) through (vi) as
clauses (iv) through (vii), respectively, and inserting after clause
(ii) the following:
“(iii) To support and retain foster families
so they can provide quality family-based settings
for children in foster care.”.

(b) Support for Foster Family Homes.–Section 436 of such Act (42
U.S.C. 629f) is amended by adding at the end the following:
“(c) Support for Foster Family Homes.– <<NOTE: Appropriation
authorization.>> Out of any money in the Treasury of the United States
not otherwise appropriated, there are appropriated to the Secretary for
fiscal year 2018, $8,000,000 for the Secretary to make competitive
grants to States, Indian tribes, or tribal consortia to support the
recruitment and

[[Page 132 STAT. 263]]

retention of high-quality foster families to increase their capacity to
place more children in family settings, focused on States, Indian
tribes, or tribal consortia with the highest percentage of children in
non-family settings. The amount appropriated under this subparagraph
shall remain available through fiscal year 2022.”.
SEC. 50752. EXTENSION OF CHILD AND FAMILY SERVICES PROGRAMS.

(a) Extension of Stephanie Tubbs Jones Child Welfare Services
Program.–Section 425 of the Social Security Act (42 U.S.C. 625) is
amended by striking “2012 through 2016” and inserting “2017 through
2021”.
(b) Extension of Promoting Safe and Stable Families Program
Authorizations.–
(1) In general.–Section 436(a) of such Act (42 U.S.C.
629f(a)) is amended by striking all that follows
“$345,000,000” and inserting “for each of fiscal years 2017
through 2021.”.
(2) Discretionary grants.–Section 437(a) of such Act (42
U.S.C. 629g(a)) is amended by striking “2012 through 2016” and
inserting “2017 through 2021”.

(c) Extension of Funding Reservations for Monthly Caseworker Visits
and Regional Partnership Grants.–Section 436(b) of such Act (42 U.S.C.
629f(b)) is amended–
(1) in paragraph (4)(A), by striking “2012 through 2016”
and inserting “2017 through 2021”; and
(2) in paragraph (5), by striking “2012 through 2016” and
inserting “2017 through 2021”.

(d) Reauthorization of Funding for State Courts.–
(1) Extension of program.–Section 438(c)(1) of such Act (42
U.S.C. 629h(c)(1)) is amended by striking “2012 through 2016”
and inserting “2017 through 2021”.
(2) Extension of federal share.–Section 438(d) of such Act
(42 U.S.C. 629h(d)) is amended by striking “2012 through 2016”
and inserting “2017 through 2021”.

(e) Repeal of Expired Provisions.–Section 438(e) of such Act (42
U.S.C. 629h(e)) is repealed.
SEC. 50753. IMPROVEMENTS TO THE JOHN H. CHAFEE FOSTER CARE
INDEPENDENCE PROGRAM AND RELATED
PROVISIONS.

(a) Authority To Serve Former Foster Youth Up To Age 23.–Section
477 of the Social Security Act (42 U.S.C. 677) is amended–
(1) in subsection (a)(5), by inserting “(or 23 years of
age, in the case of a State with a certification under
subsection (b)(3)(A)(ii) to provide assistance and services to
youths who have aged out of foster care and have not attained
such age, in accordance with such subsection)” after “21 years
of age”;
(2) in subsection (b)(3)(A)–
(A) by inserting “(i)” before “A certification”;
(B) by striking “children who have left foster
care” and all that follows through the period and
inserting “youths who have aged out of foster care and
have not attained 21 years of age.”; and
(C) by adding at the end the following:
“(ii) <<NOTE: Determination.>> If the State has
elected under section 475(8)(B) to extend eligibility
for foster care to all children who have not attained 21
years of age, or if the Secretary determines that the
State agency responsible for administering the State
plans under this part and part B uses

[[Page 132 STAT. 264]]

State funds or any other funds not provided under this
part to provide services and assistance for youths who
have aged out of foster care that are comparable to the
services and assistance the youths would receive if the
State had made such an election, the certification
required under clause (i) may provide that the State
will provide assistance and services to youths who have
aged out of foster care and have not attained 23 years
of age.”; and
(3) in subsection (b)(3)(B), by striking “children who have
left foster care” and all that follows through the period and
inserting “youths who have aged out of foster care and have not
attained 21 years of age (or 23 years of age, in the case of a
State with a certification under subparagraph (A)(i) to provide
assistance and services to youths who have aged out of foster
care and have not attained such age, in accordance with
subparagraph (A)(ii)).”.

(b) Authority To Redistribute Unspent Funds.–Section 477(d) of such
Act (42 U.S.C. 677(d)) is amended–
(1) in paragraph (4), by inserting “or does not expend
allocated funds within the time period specified under section
477(d)(3)” after “provided by the Secretary”; and
(2) by adding at the end the following:
“(5) Redistribution of unexpended amounts.–
“(A) <<NOTE: Applicability.>> Availability of
amounts.–To the extent that amounts paid to States
under this section in a fiscal year remain unexpended by
the States at the end of the succeeding fiscal year, the
Secretary may make the amounts available for
redistribution in the second succeeding fiscal year
among the States that apply for additional funds under
this section for that second succeeding fiscal year.
“(B) Redistribution.–
“(i) In general.–The Secretary shall
redistribute the amounts made available under
subparagraph (A) for a fiscal year among eligible
applicant
States. <<NOTE: Definition. Determination.>> In
this subparagraph, the term `eligible applicant
State’ means a State that has applied for
additional funds for the fiscal year under
subparagraph (A) if the Secretary determines that
the State will use the funds for the purpose for
which originally allotted under this section.
“(ii) Amount to be redistributed.–The amount
to be redistributed to each eligible applicant
State shall be the amount so made available
multiplied by the State foster care ratio, (as
defined in subsection (c)(4), except that, in such
subsection, `all eligible applicant States (as
defined in subsection (d)(5)(B)(i))’ shall be
substituted for `all States’).
“(iii) Treatment of redistributed amount.–
Any amount made available to a State under this
paragraph shall be regarded as part of the
allotment of the State under this section for the
fiscal year in which the redistribution is made.
“(C) <<NOTE: Definition.>> Tribes.–For purposes
of this paragraph, the term `State’ includes an Indian
tribe, tribal organization, or tribal consortium that
receives an allotment under this section.”.

[[Page 132 STAT. 265]]

(c) Expanding and Clarifying the Use of Education and Training
Vouchers.–
(1) In general.–Section 477(i)(3) of such Act (42 U.S.C.
677(i)(3)) is amended–
(A) by striking “on the date” and all that follows
through “23” and inserting “to remain eligible until
they attain 26”; and
(B) by inserting “, but in no event may a youth
participate in the program for more than 5 years
(whether or not consecutive)” before the period.
(2) Conforming amendment.–Section 477(i)(1) of such Act (42
U.S.C. 677(i)(1)) is amended by inserting “who have attained 14
years of age” before the period.

(d) Other Improvements.–Section 477 of such Act (42 U.S.C. 677), as
amended by subsections (a), (b), and (c), is amended–
(1) in the section heading, by striking “independence
program” and inserting “program for successful transition to
adulthood”;
(2) in subsection (a)–
(A) in paragraph (1)–
(i) by striking “identify children who are
likely to remain in foster care until 18 years of
age and to help these children make the transition
to self-sufficiency by providing services” and
inserting “support all youth who have experienced
foster care at age 14 or older in their transition
to adulthood through transitional services”;
(ii) by inserting “and post-secondary
education” after “high school diploma”; and
(iii) by striking “training in daily living
skills, training in budgeting and financial
management skills” and inserting “training and
opportunities to practice daily living skills
(such as financial literacy training and driving
instruction)”;
(B) in paragraph (2), by striking “who are likely
to remain in foster care until 18 years of age receive
the education, training, and services necessary to
obtain employment” and inserting “who have experienced
foster care at age 14 or older achieve meaningful,
permanent connections with a caring adult”;
(C) in paragraph (3), by striking “who are likely
to remain in foster care until 18 years of age prepare
for and enter postsecondary training and education
institutions” and inserting “who have experienced
foster care at age 14 or older engage in age or
developmentally appropriate activities, positive youth
development, and experiential learning that reflects
what their peers in intact families experience”; and
(D) by striking paragraph (4) and redesignating
paragraphs (5) through (8) as paragraphs (4) through
(7);
(3) in subsection (b)–
(A) in paragraph (2)(D), by striking “adolescents”
and inserting “youth”; and
(B) in paragraph (3)–
(i) in subparagraph (D)–
(I) by inserting “including
training on youth development” after
“to provide training”; and

[[Page 132 STAT. 266]]

(II) by striking “adolescents
preparing for independent living” and
all that follows through the period and
inserting “youth preparing for a
successful transition to adulthood and
making a permanent connection with a
caring adult.”;
(ii) in subparagraph (H), by striking
“adolescents” each place it appears and
inserting “youth”; and
(iii) in subparagraph (K)–
(I) by striking “an adolescent”
and inserting “a youth”; and
(II) by striking “the adolescent”
each place it appears and inserting
“the youth”; and
(4) in subsection (f), by striking paragraph (2) and
inserting the following:
“(2) <<NOTE: Analyses.>> Report to congress.–Not later
than October 1, 2019, the Secretary shall submit to the
Committee on Ways and Means of the House of Representatives and
the Committee on Finance of the Senate a report on the National
Youth in Transition Database and any other databases in which
States report outcome measures relating to children in foster
care and children who have aged out of foster care or left
foster care for kinship guardianship or adoption. The report
shall include the following:
“(A) A description of the reasons for entry into
foster care and of the foster care experiences, such as
length of stay, number of placement settings, case goal,
and discharge reason of 17-year-olds who are surveyed by
the National Youth in Transition Database and an
analysis of the comparison of that description with the
reasons for entry and foster care experiences of
children of other ages who exit from foster care before
attaining age 17.
“(B) A description of the characteristics of the
individuals who report poor outcomes at ages 19 and 21
to the National Youth in Transition Database.
“(C) <<NOTE: Determination.>> Benchmarks for
determining what constitutes a poor outcome for youth
who remain in or have exited from foster care and plans
the executive branch will take to incorporate these
benchmarks in efforts to evaluate child welfare agency
performance in providing services to children
transitioning from foster care.
“(D) An analysis of the association between types
of placement, number of overall placements, time spent
in foster care, and other factors, and outcomes at ages
19 and 21.
“(E) An analysis of the differences in outcomes for
children in and formerly in foster care at age 19 and 21
among States.”.

(e) Clarifying Documentation Provided to Foster Youth Leaving Foster
Care.–Section 475(5)(I) of such Act (42 U.S.C. 675(5)(I)) is amended by
inserting after “REAL ID Act of 2005” the following: “, and any
official documentation necessary to prove that the child was previously
in foster care”.

[[Page 132 STAT. 267]]

PART VI–CONTINUING INCENTIVES TO STATES TO PROMOTE ADOPTION AND LEGAL
GUARDIANSHIP

SEC. 50761. <<NOTE: 42 USC 673b note.>> REAUTHORIZING ADOPTION
AND LEGAL GUARDIANSHIP INCENTIVE
PROGRAMS.

(a) In General.–Section 473A of the Social Security Act (42 U.S.C.
673b) is amended–
(1) in subsection (b)(4), by striking “2013 through 2015”
and inserting “2016 through 2020”;
(2) in subsection (h)(1)(D), by striking “2016” and
inserting “2021”; and
(3) in subsection (h)(2), by striking “2016” and inserting
“2021”.

(b) <<NOTE: 42 USC 673b note.>> Effective Date.–The amendments made
by subsection (a) shall take effect as if enacted on October 1, 2017.

PART VII–TECHNICAL CORRECTIONS

SEC. 50771. TECHNICAL CORRECTIONS TO DATA EXCHANGE STANDARDS TO
IMPROVE PROGRAM COORDINATION.

(a) In General.–Section 440 of the Social Security Act (42 U.S.C.
629m) is amended to read as follows:
“SEC. 440. DATA EXCHANGE STANDARDS FOR IMPROVED INTEROPERABILITY.

“(a) <<NOTE: Consultation. Establishment.>> Designation.–The
Secretary shall, in consultation with an interagency work group
established by the Office of Management and Budget and considering State
government perspectives, by rule, designate data exchange standards to
govern, under this part and part E–
“(1) necessary categories of information that State
agencies operating programs under State plans approved under
this part are required under applicable Federal law to
electronically exchange with another State agency; and
“(2) Federal reporting and data exchange required under
applicable Federal law.

“(b) Requirements.–The data exchange standards required by
paragraph (1) shall, to the extent practicable–
“(1) incorporate a widely accepted, non-proprietary,
searchable, computer-readable format, such as the Extensible
Markup Language;
“(2) contain interoperable standards developed and
maintained by intergovernmental partnerships, such as the
National Information Exchange Model;
“(3) incorporate interoperable standards developed and
maintained by Federal entities with authority over contracting
and financial assistance;
“(4) be consistent with and implement applicable accounting
principles;
“(5) be implemented in a manner that is cost-effective and
improves program efficiency and effectiveness; and
“(6) be capable of being continually upgraded as necessary.

“(c) Rule of Construction.–Nothing in this subsection shall be
construed to require a change to existing data exchange standards found
to be effective and efficient.”.

[[Page 132 STAT. 268]]

(b) <<NOTE: Deadline. Regulations. 42 USC 629m note.>> Effective
Date.–Not later than the date that is 24 months after the date of the
enactment of this section, the Secretary of Health and Human Services
shall issue a proposed rule that–
(1) <<NOTE: Determination.>> identifies federally required
data exchanges, include specification and timing of exchanges to
be standardized, and address the factors used in determining
whether and when to standardize data exchanges; and
(2) specifies State implementation options and describes
future milestones.
SEC. 50772. TECHNICAL CORRECTIONS TO STATE REQUIREMENT TO ADDRESS
THE DEVELOPMENTAL NEEDS OF YOUNG
CHILDREN.

Section 422(b)(18) of the Social Security Act (42 U.S.C. 622(b)(18))
is amended by striking “such children” and inserting “all vulnerable
children under 5 years of age”.

PART VIII–ENSURING STATES REINVEST SAVINGS RESULTING FROM INCREASE IN
ADOPTION ASSISTANCE

SEC. 50781. DELAY OF ADOPTION ASSISTANCE PHASE-IN.

(a) In General.–The table in section 473(e)(1)(B) of the Social
Security Act (42 U.S.C. 673(e)(1)(B)) is amended by striking the last 2
rows and inserting the following:

—————————————————————————————————————-
“2017 through 2023…………………….. 2
2024………………………………….. 2 (or, in the case of a child for whom an adoption assistance
agreement is entered into under this section on or after July 1,
2024, any age)
2025 or thereafter……………………… any age.”.
—————————————————————————————————————-

(b) <<NOTE: 42 USC 673 note.>> Effective Date.–The amendment made
by this section shall take effect as if enacted on January 1, 2018.
SEC. 50782. GAO STUDY AND REPORT ON STATE REINVESTMENT OF SAVINGS
RESULTING FROM INCREASE IN ADOPTION
ASSISTANCE.

(a) Study.–The Comptroller General of the United States shall study
the extent to which States are complying with the requirements of
section 473(a)(8) of the Social Security Act (42 U.S.C. 673(a)(8))
relating to the effects of phasing out the AFDC income eligibility
requirements for adoption assistance payments under section 473 of the
Social Security Act, as enacted by section 402 of the Fostering
Connections to Success and Increasing Adoptions Act of 2008 (Public Law
110-351; 122 Stat. 3975) and amended by section 206 of the Preventing
Sex Trafficking and Strengthening Families Act (Public Law 113-183; 128
Stat. 1919). <<NOTE: Analysis.>> In particular, the Comptroller General
shall analyze the extent to which States are complying with the
following requirements under section 473(a)(8)(D) of the Social Security
Act:

[[Page 132 STAT. 269]]

(1) The requirement to spend an amount equal to the amount
of the savings (if any) in State expenditures under part E of
title IV of the Social Security Act resulting from phasing out
the AFDC income eligibility requirements for adoption assistance
payments under section 473 of such Act to provide to children of
families any service that may be provided under part B or E of
title IV of such Act.
(2) The requirement that a State shall spend not less than
30 percent of the amount of any savings described in paragraph
(1) on post-adoption services, post-guardianship services, and
services to support and sustain positive permanent outcomes for
children who otherwise might enter into foster care under the
responsibility of the State, with at least \2/3\ of the spending
by the State to comply with the 30 percent requirement being
spent on post-adoption and post-guardianship services.

(b) <<NOTE: Recommenda- tions.>> Report.–The Comptroller General
of the United States shall submit to the Committee on Finance of the
Senate, the Committee on Ways and Means of the House of Representatives,
and the Secretary of Health and Human Services a report that contains
the results of the study required by subsection (a), including
recommendations to ensure compliance with laws referred to in subsection
(a).

TITLE VIII– <<NOTE: Social Impact Partnerships to Pay for Results
Act.>> SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RESULTS
SEC. 50801. <<NOTE: 42 USC 1305 note.>> SHORT TITLE.

This subtitle may be cited as the “Social Impact Partnerships to
Pay for Results Act”.
SEC. 50802. SOCIAL IMPACT PARTNERSHIPS TO PAY FOR RESULTS.

Title XX of the Social Security Act (42 U.S.C. 1397 et seq.) is
amended–
(1) in the title heading, by striking “TO STATES” and
inserting “AND PROGRAMS”; and
(2) by adding at the end the following:

“Subtitle C–Social Impact Demonstration Projects

“purposes

“Sec. 2051. <<NOTE: 42 USC 1397n note.>> The purposes of this
subtitle are the following:
“(1) To improve the lives of families and individuals in
need in the United States by funding social programs that
achieve real results.
“(2) To redirect funds away from programs that, based on
objective data, are ineffective, and into programs that achieve
demonstrable, measurable results.
“(3) To ensure Federal funds are used effectively on social
services to produce positive outcomes for both service
recipients and taxpayers.
“(4) To establish the use of social impact partnerships to
address some of our Nation’s most pressing problems.

[[Page 132 STAT. 270]]

“(5) To facilitate the creation of public-private
partnerships that bundle philanthropic or other private
resources with existing public spending to scale up effective
social interventions already being implemented by private
organizations, nonprofits, charitable organizations, and State
and local governments across the country.
“(6) To bring pay-for-performance to the social sector,
allowing the United States to improve the impact and
effectiveness of vital social services programs while
redirecting inefficient or duplicative spending.
“(7) To incorporate outcomes measurement and randomized
controlled trials or other rigorous methodologies for assessing
program impact.

“social impact partnership application

“Sec. 2052. <<NOTE: Deadline. Consultation. Federal Register,
publication. 42 USC 1397n-1 note.>> (a) Notice.–Not later than 1 year
after the date of the enactment of this subtitle, the Secretary of the
Treasury, in consultation with the Federal Interagency Council on Social
Impact Partnerships, shall publish in the Federal Register a request for
proposals from States or local governments for social impact partnership
projects in accordance with this section.

“(b) Required Outcomes for Social Impact Partnership Project.–To
qualify as a social impact partnership project under this subtitle, a
project must produce one or more measurable, clearly defined outcomes
that result in social benefit and Federal, State, or local savings
through any of the following:
“(1) Increasing work and earnings by individuals in the
United States who are unemployed for more than 6 consecutive
months.
“(2) Increasing employment and earnings of individuals who
have attained 16 years of age but not 25 years of age.
“(3) Increasing employment among individuals receiving
Federal disability benefits.
“(4) Reducing the dependence of low-income families on
Federal means-tested benefits.
“(5) Improving rates of high school graduation.
“(6) Reducing teen and unplanned pregnancies.
“(7) Improving birth outcomes and early childhood health
and development among low-income families and individuals.
“(8) Reducing rates of asthma, diabetes, or other
preventable diseases among low-income families and individuals
to reduce the utilization of emergency and other high-cost care.
“(9) Increasing the proportion of children living in two-
parent families.
“(10) Reducing incidences and adverse consequences of child
abuse and neglect.
“(11) Reducing the number of youth in foster care by
increasing adoptions, permanent guardianship arrangements,
reunifications, or placements with a fit and willing relative,
or by avoiding placing children in foster care by ensuring they
can be cared for safely in their own homes.
“(12) Reducing the number of children and youth in foster
care residing in group homes, child care institutions, agency-
operated foster homes, or other non-family foster homes, unless
it is determined that it is in the interest of the child’s long-
term health, safety, or psychological well-being to not be
placed in a family foster home.

[[Page 132 STAT. 271]]

“(13) Reducing the number of children returning to foster
care.
“(14) Reducing recidivism among juvenile offenders,
individuals released from prison, or other high-risk
populations.
“(15) Reducing the rate of homelessness among our most
vulnerable populations.
“(16) Improving the health and well-being of those with
mental, emotional, and behavioral health needs.
“(17) Improving the educational outcomes of special-needs
or low-income children.
“(18) Improving the employment and well-being of returning
United States military members.
“(19) Increasing the financial stability of low-income
families.
“(20) Increasing the independence and employability of
individuals who are physically or mentally disabled.
“(21) Other measurable outcomes defined by the State or
local government that result in positive social outcomes and
Federal savings.

“(c) Application Required.–The notice described in subsection (a)
shall require a State or local government to submit an application for
the social impact partnership project that addresses the following:
“(1) The outcome goals of the project.
“(2) A description of each intervention in the project and
anticipated outcomes of the intervention.
“(3) Rigorous evidence demonstrating that the intervention
can be expected to produce the desired outcomes.
“(4) The target population that will be served by the
project.
“(5) The expected social benefits to participants who
receive the intervention and others who may be impacted.
“(6) Projected Federal, State, and local government costs
and other costs to conduct the project.
“(7) Projected Federal, State, and local government savings
and other savings, including an estimate of the savings to the
Federal Government, on a program-by-program basis and in the
aggregate, if the project is implemented and the outcomes are
achieved as a result of the intervention.
“(8) If savings resulting from the successful completion of
the project are estimated to accrue to the State or local
government, the likelihood of the State or local government to
realize those savings.
“(9) A plan for delivering the intervention through a
social impact partnership model.
“(10) A description of the expertise of each service
provider that will administer the intervention, including a
summary of the experience of the service provider in delivering
the proposed intervention or a similar intervention, or
demonstrating that the service provider has the expertise
necessary to deliver the proposed intervention.
“(11) An explanation of the experience of the State or
local government, the intermediary, or the service provider in
raising private and philanthropic capital to fund social service
investments.
“(12) The detailed roles and responsibilities of each
entity involved in the project, including any State or local
government

[[Page 132 STAT. 272]]

entity, intermediary, service provider, independent evaluator,
investor, or other stakeholder.
“(13) A summary of the experience of the service provider
in delivering the proposed intervention or a similar
intervention, or a summary demonstrating the service provider
has the expertise necessary to deliver the proposed
intervention.
“(14) A summary of the unmet need in the area where the
intervention will be delivered or among the target population
who will receive the intervention.
“(15) The proposed payment terms, the methodology used to
calculate outcome payments, the payment schedule, and
performance thresholds.
“(16) The project budget.
“(17) The project timeline.
“(18) The criteria used to determine the eligibility of an
individual for the project, including how selected populations
will be identified, how they will be referred to the project,
and how they will be enrolled in the project.
“(19) The evaluation design.
“(20) The metrics that will be used in the evaluation to
determine whether the outcomes have been achieved as a result of
the intervention and how the metrics will be measured.
“(21) An explanation of how the metrics used in the
evaluation to determine whether the outcomes achieved as a
result of the intervention are independent, objective indicators
of impact and are not subject to manipulation by the service
provider, intermediary, or investor.
“(22) A summary explaining the independence of the
evaluator from the other entities involved in the project and
the evaluator’s experience in conducting rigorous evaluations of
program effectiveness including, where available, well-
implemented randomized controlled trials on the intervention or
similar interventions.
“(23) The capacity of the service provider to deliver the
intervention to the number of participants the State or local
government proposes to serve in the project.
“(24) A description of whether and how the State or local
government and service providers plan to sustain the
intervention, if it is timely and appropriate to do so, to
ensure that successful interventions continue to operate after
the period of the social impact partnership.

“(d) Project Intermediary Information Required.–The application
described in subsection (c) shall also contain the following information
about any intermediary for the social impact partnership project
(whether an intermediary is a service provider or other entity):
“(1) Experience and capacity for providing or facilitating
the provision of the type of intervention proposed.
“(2) The mission and goals.
“(3) Information on whether the intermediary is already
working with service providers that provide this intervention or
an explanation of the capacity of the intermediary to begin
working with service providers to provide the intervention.
“(4) Experience working in a collaborative environment
across government and nongovernmental entities.
“(5) Previous experience collaborating with public or
private entities to implement evidence-based programs.

[[Page 132 STAT. 273]]

“(6) Ability to raise or provide funding to cover operating
costs (if applicable to the project).
“(7) Capacity and infrastructure to track outcomes and
measure results, including–
“(A) capacity to track and analyze program
performance and assess program impact; and
“(B) experience with performance-based awards or
performance-based contracting and achieving project
milestones and targets.
“(8) Role in delivering the intervention.
“(9) How the intermediary would monitor program success,
including a description of the interim benchmarks and outcome
measures.

“(e) Feasibility Studies Funded Through Other Sources.–The notice
described in subsection (a) shall permit a State or local government to
submit an application for social impact partnership funding that
contains information from a feasibility study developed for purposes
other than applying for funding under this subtitle.

“awarding social impact partnership agreements

“Sec. 2053. <<NOTE: Deadline. Consultation. Determination. 42 USC
1397n-2 note.>> (a) Timeline in Awarding Agreement.–Not later than 6
months after receiving an application in accordance with section 2052,
the Secretary, in consultation with the Federal Interagency Council on
Social Impact Partnerships, shall determine whether to enter into an
agreement for a social impact partnership project with a State or local
government.

“(b) Considerations in Awarding Agreement.–In determining whether
to enter into an agreement for a social impact partnership project (the
application for which was submitted under section 2052) the Secretary,
in consultation with the Federal Interagency Council on Social Impact
Partnerships and the head of any Federal agency administering a similar
intervention or serving a population similar to that served by the
project, shall consider each of the following:
“(1) The recommendations made by the Commission on Social
Impact Partnerships.
“(2) The value to the Federal Government of the outcomes
expected to be achieved if the outcomes specified in the
agreement are achieved as a result of the intervention.
“(3) The likelihood, based on evidence provided in the
application and other evidence, that the State or local
government in collaboration with the intermediary and the
service providers will achieve the outcomes.
“(4) The savings to the Federal Government if the outcomes
specified in the agreement are achieved as a result of the
intervention.
“(5) The savings to the State and local governments if the
outcomes specified in the agreement are achieved as a result of
the intervention.
“(6) The expected quality of the evaluation that would be
conducted with respect to the agreement.
“(7) The capacity and commitment of the State or local
government to sustain the intervention, if appropriate and
timely and if the intervention is successful, beyond the period
of the social impact partnership.

“(c) <<NOTE: Determinations.>> Agreement Authority.–

[[Page 132 STAT. 274]]

“(1) Agreement requirements.–In accordance with this
section, the Secretary, in consultation with the Federal
Interagency Council on Social Impact Partnerships and the head
of any Federal agency administering a similar intervention or
serving a population similar to that served by the project, may
enter into an agreement for a social impact partnership project
with a State or local government if the Secretary, in
consultation with the Federal Interagency Council on Social
Impact Partnerships, determines that each of the following
requirements are met:
“(A) The State or local government agrees to
achieve one or more outcomes as a result of the
intervention, as specified in the agreement and
validated by independent evaluation, in order to receive
payment.
“(B) The Federal payment to the State or local
government for each specified outcome achieved as a
result of the intervention is less than or equal to the
value of the outcome to the Federal Government over a
period not to exceed 10 years, as determined by the
Secretary, in consultation with the State or local
government.
“(C) The duration of the project does not exceed 10
years.
“(D) The State or local government has
demonstrated, through the application submitted under
section 2052, that, based on prior rigorous experimental
evaluations or rigorous quasi-experimental studies, the
intervention can be expected to achieve each outcome
specified in the agreement.
“(E) The State, local government, intermediary, or
service provider has experience raising private or
philanthropic capital to fund social service investments
(if applicable to the project).
“(F) The State or local government has shown that
each service provider has experience delivering the
intervention, a similar intervention, or has otherwise
demonstrated the expertise necessary to deliver the
intervention.
“(2) Payment.–The Secretary shall pay the State or local
government only if the independent evaluator described in
section 2055 determines that the social impact partnership
project has met the requirements specified in the agreement and
achieved an outcome as a result of the intervention, as
specified in the agreement and validated by independent
evaluation.

“(d) <<NOTE: Deadline. Federal Register, publication.>> Notice of
Agreement Award.–Not later than 30 days after entering into an
agreement under this section the Secretary shall publish a notice in the
Federal Register that includes, with regard to the agreement, the
following:
“(1) The outcome goals of the social impact partnership
project.
“(2) A description of each intervention in the project.
“(3) The target population that will be served by the
project.
“(4) The expected social benefits to participants who
receive the intervention and others who may be impacted.
“(5) The detailed roles, responsibilities, and purposes of
each Federal, State, or local government entity, intermediary,
service provider, independent evaluator, investor, or other
stakeholder.

[[Page 132 STAT. 275]]

“(6) The payment terms, the methodology used to calculate
outcome payments, the payment schedule, and performance
thresholds.
“(7) The project budget.
“(8) The project timeline.
“(9) <<NOTE: Criteria.>> The project eligibility criteria.
“(10) The evaluation design.
“(11) The metrics that will be used in the evaluation to
determine whether the outcomes have been achieved as a result of
each intervention and how these metrics will be measured.
“(12) <<NOTE: Estimate.>> The estimate of the savings to
the Federal, State, and local government, on a program-by-
program basis and in the aggregate, if the agreement is entered
into and implemented and the outcomes are achieved as a result
of each intervention.

“(e) Authority to Transfer Administration of Agreement.–The
Secretary may transfer to the head of another Federal agency the
authority to administer (including making payments under) an agreement
entered into under subsection (c), and any funds necessary to do so.
“(f) Requirement on Funding Used to Benefit Children.–Not less
than 50 percent of all Federal payments made to carry out agreements
under this section shall be used for initiatives that directly benefit
children.

“feasibility study funding

“Sec. 2054. <<NOTE: 42 USC 1397n-3 note.>> (a) Requests for
Funding for Feasibility Studies.–The Secretary shall reserve a portion
of the amount made available to carry out this subtitle to assist States
or local governments in developing feasibility studies to apply for
social impact partnership funding under section 2052. To be eligible to
receive funding to assist with completing a feasibility study, a State
or local government shall submit an application for feasibility study
funding addressing the following:
“(1) A description of the outcome goals of the social
impact partnership project.
“(2) A description of the intervention, including
anticipated program design, target population, an estimate
regarding the number of individuals to be served, and setting
for the intervention.
“(3) Evidence to support the likelihood that the
intervention will produce the desired outcomes.
“(4) A description of the potential metrics to be used.
“(5) The expected social benefits to participants who
receive the intervention and others who may be impacted.
“(6) <<NOTE: Cost estimate.>> Estimated costs to conduct
the project.
“(7) <<NOTE: Estimates.>> Estimates of Federal, State, and
local government savings and other savings if the project is
implemented and the outcomes are achieved as a result of each
intervention.
“(8) <<NOTE: Time period.>> An estimated timeline for
implementation and completion of the project, which shall not
exceed 10 years.
“(9) With respect to a project for which the State or local
government selects an intermediary to operate the project, any
partnerships needed to successfully execute the project and the
ability of the intermediary to foster the partnerships.
“(10) The expected resources needed to complete the
feasibility study for the State or local government to apply for
social impact partnership funding under section 2052.

[[Page 132 STAT. 276]]

“(b) Federal Selection of Applications for Feasibility Study.–
<<NOTE: Deadline. Consultation.>> Not later than 6 months after
receiving an application for feasibility study funding under subsection
(a), the Secretary, in consultation with the Federal Interagency Council
on Social Impact Partnerships and the head of any Federal agency
administering a similar intervention or serving a population similar to
that served by the project, shall select State or local government
feasibility study proposals for funding based on the following:
“(1) The recommendations made by the Commission on Social
Impact Partnerships.
“(2) The likelihood that the proposal will achieve the
desired outcomes.
“(3) The value of the outcomes expected to be achieved as a
result of each intervention.
“(4) The potential savings to the Federal Government if the
social impact partnership project is successful.
“(5) The potential savings to the State and local
governments if the project is successful.

“(c) <<NOTE: Deadline. Web posting.>> Public Disclosure.–Not
later than 30 days after selecting a State or local government for
feasibility study funding under this section, the Secretary shall cause
to be published on the website of the Federal Interagency Council on
Social Impact Partnerships information explaining why a State or local
government was granted feasibility study funding.

“(d) Funding Restriction.–
“(1) Feasibility study restriction.–The Secretary may not
provide feasibility study funding under this section for more
than 50 percent of the estimated total cost of the feasibility
study reported in the State or local government application
submitted under subsection (a).
“(2) Aggregate restriction.–Of the total amount made
available to carry out this subtitle, the Secretary may not use
more than $10,000,000 to provide feasibility study funding to
States or local governments under this section.
“(3) No guarantee of funding.–The Secretary shall have the
option to award no funding under this section.

“(e) <<NOTE: Deadline.>> Submission of Feasibility Study
Required.–Not later than 9 months after the receipt of feasibility
study funding under this section, a State or local government receiving
the funding shall complete the feasibility study and submit the study to
the Federal Interagency Council on Social Impact Partnerships.

“(f) Delegation of Authority.–The Secretary may transfer to the
head of another Federal agency the authorities provided in this section
and any funds necessary to exercise the authorities.

“evaluations

“Sec. 2055. <<NOTE: Determination. 42 USC 1397n-4 note.>> (a)
Authority to Enter Into Agreements.–For each State or local government
awarded a social impact partnership project approved by the Secretary
under this subtitle, the head of the relevant agency, as recommended by
the Federal Interagency Council on Social Impact Partnerships and
determined by the Secretary, shall enter into an agreement with the
State or local government to pay for all or part of the independent
evaluation to determine whether the State or local government project
has achieved a specific outcome as a result of the intervention in order
for the State or local government to receive outcome payments under this
subtitle.

[[Page 132 STAT. 277]]

“(b) <<NOTE: Determination.>> Evaluator Qualifications.–The head
of the relevant agency may not enter into an agreement with a State or
local government unless the head determines that the evaluator is
independent of the other parties to the agreement and has demonstrated
substantial experience in conducting rigorous evaluations of program
effectiveness including, where available and appropriate, well-
implemented randomized controlled trials on the intervention or similar
interventions.

“(c) <<NOTE: Evaluation. Certification.>> Methodologies to Be
Used.–The evaluation used to determine whether a State or local
government will receive outcome payments under this subtitle shall use
experimental designs using random assignment or other reliable,
evidence-based research methodologies, as certified by the Federal
Interagency Council on Social Impact Partnerships, that allow for the
strongest possible causal inferences when random assignment is not
feasible.

“(d) Progress Report.–
“(1) Submission of report.–The independent evaluator
shall–
“(A) not later than 2 years after a project has
been approved by the Secretary and biannually thereafter
until the project is concluded, submit to the head of
the relevant agency and the Federal Interagency Council
on Social Impact Partnerships a written report
summarizing the progress that has been made in achieving
each outcome specified in the agreement; and
“(B) before the scheduled time of the first outcome
payment and before the scheduled time of each subsequent
payment, submit to the head of the relevant agency and
the Federal Interagency Council on Social Impact
Partnerships a written report that includes the results
of the evaluation conducted to determine whether an
outcome payment should be made along with information on
the unique factors that contributed to achieving or
failing to achieve the outcome, the challenges faced in
attempting to achieve the outcome, and information on
the improved future delivery of this or similar
interventions.
“(2) Submission to the secretary and congress.–Not later
than 30 days after receipt of the written report pursuant to
paragraph (1)(B), the Federal Interagency Council on Social
Impact Partnerships shall submit the report to the Secretary and
each committee of jurisdiction in the House of Representatives
and the Senate.

“(e) Final Report.–
“(1) Submission of report.–Within 6 months after the
social impact partnership project is completed, the independent
evaluator shall–
“(A) <<NOTE: Evaluation.>> evaluate the effects of
the activities undertaken pursuant to the agreement with
regard to each outcome specified in the agreement; and
“(B) submit to the head of the relevant agency and
the Federal Interagency Council on Social Impact
Partnerships a written report that includes the results
of the evaluation and the conclusion of the evaluator as
to whether the State or local government has fulfilled
each obligation of the agreement, along with information
on the unique factors that contributed to the success or
failure of the project, the challenges faced in
attempting to achieve

[[Page 132 STAT. 278]]

the outcome, and information on the improved future
delivery of this or similar interventions.
“(2) Submission to the secretary and congress.–Not later
than 30 days after receipt of the written report pursuant to
paragraph (1)(B), the Federal Interagency Council on Social
Impact Partnerships shall submit the report to the Secretary and
each committee of jurisdiction in the House of Representatives
and the Senate.

“(f) Limitation on Cost of Evaluations.–Of the amount made
available under this subtitle for social impact partnership projects,
the Secretary may not obligate more than 15 percent to evaluate the
implementation and outcomes of the projects.
“(g) Delegation of Authority.–The Secretary may transfer to the
head of another Federal agency the authorities provided in this section
and any funds necessary to exercise the authorities.

“federal interagency council on social impact partnerships

“Sec. 2056. <<NOTE: 42 USC 1397n-5 note.>> (a) Establishment.–
There is established the Federal Interagency Council on Social Impact
Partnerships (in this section referred to as the `Council’) to–
“(1) coordinate with the Secretary on the efforts of social
impact partnership projects funded under this subtitle;
“(2) advise and assist the Secretary in the development and
implementation of the projects;
“(3) advise the Secretary on specific programmatic and
policy matter related to the projects;
“(4) provide subject-matter expertise to the Secretary with
regard to the projects;
“(5) <<NOTE: Certification.>> certify to the Secretary that
each State or local government that has entered into an
agreement with the Secretary for a social impact partnership
project under this subtitle and each evaluator selected by the
head of the relevant agency under section 2055 has access to
Federal administrative data to assist the State or local
government and the evaluator in evaluating the performance and
outcomes of the project;
“(6) address issues that will influence the future of
social impact partnership projects in the United States;
“(7) provide guidance to the executive branch on the future
of social impact partnership projects in the United States;
“(8) <<NOTE: Certification.>> prior to approval by the
Secretary, certify that each State and local government
application for a social impact partnership contains rigorous,
independent data and reliable, evidence-based research
methodologies to support the conclusion that the project will
yield savings to the State or local government or the Federal
Government if the project outcomes are achieved;
“(9) <<NOTE: Certification.>> certify to the Secretary, in
the case of each approved social impact partnership that is
expected to yield savings to the Federal Government, that the
project will yield a projected savings to the Federal Government
if the project outcomes are achieved, and coordinate with the
relevant Federal agency to produce an after-action accounting
once the project is complete to determine the actual Federal
savings realized, and the extent to which actual savings aligned
with projected savings; and

[[Page 132 STAT. 279]]

“(10) <<NOTE: Reports. Public information.>> provide
periodic reports to the Secretary and make available reports
periodically to Congress and the public on the implementation of
this subtitle.

“(b) Composition of Council.–The Council shall have 11 members, as
follows:
“(1) Chair.–The Chair of the Council shall be the Director
of the Office of Management and Budget.
“(2) Other members.–The head of each of the following
entities shall designate one officer or employee of the entity
to be a Council member:
“(A) The Department of Labor.
“(B) The Department of Health and Human Services.
“(C) The Social Security Administration.
“(D) The Department of Agriculture.
“(E) The Department of Justice.
“(F) The Department of Housing and Urban
Development.
“(G) The Department of Education.
“(H) The Department of Veterans Affairs.
“(I) The Department of the Treasury.
“(J) The Corporation for National and Community
Service.

“commission on social impact partnerships

“Sec. 2057. <<NOTE: 42 USC 1397n-6 note.>> (a) Establishment.–
There is established the Commission on Social Impact Partnerships (in
this section referred to as the `Commission’).

“(b) Duties.–The duties of the Commission shall be to–
“(1) assist the Secretary and the Federal Interagency
Council on Social Impact Partnerships in reviewing applications
for funding under this subtitle;
“(2) <<NOTE: Recommenda- tions.>> make recommendations to
the Secretary and the Federal Interagency Council on Social
Impact Partnerships regarding the funding of social impact
partnership agreements and feasibility studies; and
“(3) provide other assistance and information as requested
by the Secretary or the Federal Interagency Council on Social
Impact Partnerships.

“(c) Composition.–The Commission shall be composed of nine
members, of whom–
“(1) one shall be appointed by the President, who will
serve as the Chair of the Commission;
“(2) one shall be appointed by the Majority Leader of the
Senate;
“(3) one shall be appointed by the Minority Leader of the
Senate;
“(4) one shall be appointed by the Speaker of the House of
Representatives;
“(5) one shall be appointed by the Minority Leader of the
House of Representatives;
“(6) one shall be appointed by the Chairman of the
Committee on Finance of the Senate;
“(7) one shall be appointed by the ranking member of the
Committee on Finance of the Senate;
“(8) one member shall be appointed by the Chairman of the
Committee on Ways and Means of the House of Representatives; and

[[Page 132 STAT. 280]]

“(9) one shall be appointed by the ranking member of the
Committee on Ways and Means of the House of Representatives.

“(d) Qualifications of Commission Members.–The members of the
Commission shall–
“(1) be experienced in finance, economics, pay for
performance, or program evaluation;
“(2) have relevant professional or personal experience in a
field related to one or more of the outcomes listed in this
subtitle; or
“(3) be qualified to review applications for social impact
partnership projects to determine whether the proposed metrics
and evaluation methodologies are appropriately rigorous and
reliant upon independent data and evidence-based research.

“(e) <<NOTE: Deadlines.>> Timing of Appointments.–The appointments
of the members of the Commission shall be made not later than 120 days
after the date of the enactment of this subtitle, or, in the event of a
vacancy, not later than 90 days after the date the vacancy
arises. <<NOTE: President.>> If a member of Congress fails to appoint a
member by that date, the President may select a member of the
President’s choice on behalf of the member of Congress. Notwithstanding
the preceding sentence, if not all appointments have been made to the
Commission as of that date, the Commission may operate with no fewer
than five members until all appointments have been made.

“(f) Term of Appointments.–
“(1) In general.–The members appointed under subsection
(c) shall serve as follows:
“(A) Three members shall serve for 2 years.
“(B) Three members shall serve for 3 years.
“(C) <<NOTE: President.>> Three members (one of
which shall be Chair of the Commission appointed by the
President) shall serve for 4 years.
“(2) Assignment of terms.–The Commission shall designate
the term length that each member appointed under subsection (c)
shall serve by unanimous agreement. In the event that unanimous
agreement cannot be reached, term lengths shall be assigned to
the members by a random process.

“(g) Vacancies.–Subject to subsection (e), in the event of a
vacancy in the Commission, whether due to the resignation of a member,
the expiration of a member’s term, or any other reason, the vacancy
shall be filled in the manner in which the original appointment was made
and shall not affect the powers of the Commission.
“(h) Appointment Power.–Members of the Commission appointed under
subsection (c) shall not be subject to confirmation by the Senate.

“limitation on use of funds

“Sec. 2058. <<NOTE: 42 USC 1397n-7 note.>> Of the amounts made
available to carry out this subtitle, the Secretary may not use more
than $2,000,000 in any fiscal year to support the review, approval, and
oversight of social impact partnership projects, including activities
conducted by–
“(1) the Federal Interagency Council on Social Impact
Partnerships; and

[[Page 132 STAT. 281]]

“(2) any other agency consulted by the Secretary before
approving a social impact partnership project or a feasibility
study under section 2054.

“no federal funding for credit enhancements

“Sec. 2059. <<NOTE: 42 USC 1397n-8 note.>> No amount made available
to carry out this subtitle may be used to provide any insurance,
guarantee, or other credit enhancement to a State or local government
under which a Federal payment would be made to a State or local
government as the result of a State or local government failing to
achieve an outcome specified in an agreement.

“availability of funds

“Sec. 2060. <<NOTE: Termination date. 42 USC 1397n-9
note.>> Amounts made available to carry out this subtitle shall remain
available until 10 years after the date of the enactment of this
subtitle.

“website

“Sec. 2061. The Federal <<NOTE: 42 USC 1397n-10 note.>>
Interagency Council on Social Impact Partnerships shall establish and
maintain a public website that shall display the following:
“(1) <<NOTE: Records.>> A copy of, or method of accessing,
each notice published regarding a social impact partnership
project pursuant to this subtitle.
“(2) A copy of each feasibility study funded under this
subtitle.
“(3) For each State or local government that has entered
into an agreement with the Secretary for a social impact
partnership project, the website shall contain the following
information:
“(A) The outcome goals of the project.
“(B) A description of each intervention in the
project.
“(C) The target population that will be served by
the project.
“(D) The expected social benefits to participants
who receive the intervention and others who may be
impacted.
“(E) The detailed roles, responsibilities, and
purposes of each Federal, State, or local government
entity, intermediary, service provider, independent
evaluator, investor, or other stakeholder.
“(F) The payment terms, methodology used to
calculate outcome payments, the payment schedule, and
performance thresholds.
“(G) The project budget.
“(H) The project timeline.
“(I) The project eligibility criteria.
“(J) The evaluation design.
“(K) The metrics used to determine whether the
proposed outcomes have been achieved and how these
metrics are measured.
“(4) A copy of the progress reports and the final reports
relating to each social impact partnership project.
“(5) <<NOTE: Estimate.>> An estimate of the savings to the
Federal, State, and local government, on a program-by-program
basis and in the

[[Page 132 STAT. 282]]

aggregate, resulting from the successful completion of the
social impact partnership project.

“regulations

“Sec. 2062. <<NOTE: Consultation. 42 USC 1397n-11 note.>> The
Secretary, in consultation with the Federal Interagency Council on
Social Impact Partnerships, may issue regulations as necessary to carry
out this subtitle.

“definitions

“Sec. 2063. <<NOTE: 42 USC 1397n-12 note.>> In this subtitle:
“(1) Agency.–The term `agency’ has the meaning given that
term in section 551 of title 5, United States Code.
“(2) Intervention.–The term `intervention’ means a
specific service delivered to achieve an impact through a social
impact partnership project.
“(3) Secretary.–The term `Secretary’ means the Secretary
of the Treasury.
“(4) Social impact partnership project.–The term `social
impact partnership project’ means a project that finances social
services using a social impact partnership model.
“(5) Social impact partnership model.–The term `social
impact partnership model’ means a method of financing social
services in which–
“(A) Federal funds are awarded to a State or local
government only if a State or local government achieves
certain outcomes agreed on by the State or local
government and the Secretary; and
“(B) the State or local government coordinates with
service providers, investors (if applicable to the
project), and (if necessary) an intermediary to
identify–
“(i) an intervention expected to produce the
outcome;
“(ii) a service provider to deliver the
intervention to the target population; and
“(iii) investors to fund the delivery of the
intervention.
“(6) State.–The term `State’ means each State of the
United States, the District of Columbia, each commonwealth,
territory or possession of the United States, and each federally
recognized Indian tribe.

“funding

“Sec. 2064. <<NOTE: 42 USC 1397n-13 note.>> Out of any money in the
Treasury of the United States not otherwise appropriated, there is
hereby appropriated $100,000,000 for fiscal year 2018 to carry out this
subtitle.”.

TITLE IX–PUBLIC HEALTH PROGRAMS

SEC. 50901. EXTENSION FOR COMMUNITY HEALTH CENTERS, THE NATIONAL
HEALTH SERVICE CORPS, AND TEACHING
HEALTH CENTERS THAT OPERATE GME
PROGRAMS.

(a) Community Health Centers Funding.–Section 10503(b)(1)(F) of the
Patient Protection and Affordable Care Act (42 U.S.C. 254b-2(b)(1)(F)),
as amended by section 3101 of Public Law 115-96, is amended to read as
follows:

[[Page 132 STAT. 283]]

“(F) $3,800,000,000 for fiscal year 2018 and
$4,000,000,000 for fiscal year 2019.”.

(b) Other Community Health Centers Provisions.–Section 330 of the
Public Health Service Act (42 U.S.C. 254b) is amended–
(1) in subsection (b)(1)(A)(ii), by striking “abuse” and
inserting “use disorder”;
(2) in subsection (b)(2)(A), by striking “abuse” and
inserting “use disorder”;
(3) in subsection (c)–
(A) in paragraph (1), by striking subparagraphs (B)
through (D);
(B) by striking “(1) In general” and all that
follows through “The Secretary” and inserting the
following:
“(1) Centers.–The Secretary”; and
(C) in paragraph (1), as amended, by redesignating
clauses (i) through (v) as subparagraphs (A) through (E)
and moving the margin of each of such redesignated
subparagraph 2 ems to the left;
(4) by striking subsection (d) and inserting the following:

“(d) Improving Quality of Care.–
“(1) Supplemental awards.–The Secretary may award
supplemental grant funds to health centers funded under this
section to implement evidence-based models for increasing access
to high-quality primary care services, which may include models
related to–
“(A) improving the delivery of care for individuals
with multiple chronic conditions;
“(B) workforce configuration;
“(C) reducing the cost of care;
“(D) enhancing care coordination;
“(E) expanding the use of telehealth and
technology-enabled collaborative learning and capacity
building models;
“(F) care integration, including integration of
behavioral health, mental health, or substance use
disorder services; and
“(G) addressing emerging public health or substance
use disorder issues to meet the health needs of the
population served by the health center.
“(2) Sustainability.–In making supplemental awards under
this subsection, the Secretary may consider whether the health
center involved has submitted a plan for continuing the
activities funded under this subsection after supplemental
funding is expended.
“(3) Special consideration.–The Secretary may give special
consideration to applications for supplemental funding under
this subsection that seek to address significant barriers to
access to care in areas with a greater shortage of health care
providers and health services relative to the national
average.”;
(5) in subsection (e)(1)–
(A) in subparagraph (B)–
(i) by striking “2 years” and inserting “1
year”; and
(ii) <<NOTE: Grants. Deadline. Implementation
plan.>> by adding at the end the following: “The
Secretary shall not make a grant under this
paragraph

[[Page 132 STAT. 284]]

unless the applicant provides assurances to the
Secretary that within 120 days of receiving grant
funding for the operation of the health center,
the applicant will submit, for approval by the
Secretary, an implementation plan to meet the
requirements of subsection (k)(3) <<NOTE: Time
period.>> . The Secretary may extend such 120-day
period for achieving compliance upon a
demonstration of good cause by the health
center.”; and
(B) in subparagraph (C)–
(i) in the subparagraph heading, by striking
“and plans”;
(ii) by striking “or plan (as described in
subparagraphs (B) and (C) of subsection (c)(1))”;
(iii) by striking “or plan, including the
purchase” and inserting the following:
“including–
“(i) the purchase”;
(iv) by inserting “, which may include data
and information systems” after “of equipment”;
(v) by striking the period at the end and
inserting a semicolon; and
(vi) by adding at the end the following:
“(ii) the provision of training and technical
assistance; and
“(iii) other activities that–
“(I) reduce costs associated with
the provision of health services;
“(II) improve access to, and
availability of, health services
provided to individuals served by the
centers;
“(III) enhance the quality and
coordination of health services; or
“(IV) improve the health status of
communities.”;
(6) in subsection (e)(5)(B)–
(A) in the heading of subparagraph (B), by striking
“and plans”; and
(B) by striking “and subparagraphs (B) and (C) of
subsection (c)(1) to a health center or to a network or
plan” and inserting “to a health center or to a
network”;
(7) in subsection (e), by adding at the end the following:
“(6) New access points and expanded services.–
“(A) Approval of new access points.–
“(i) In general.–The Secretary may approve
applications for grants under subparagraph (A) or
(B) of paragraph (1) to establish new delivery
sites.
“(ii) Special consideration.–In carrying out
clause (i), the Secretary may give special
consideration to applicants that have demonstrated
the new delivery site will be located within a
sparsely populated area, or an area which has a
level of unmet need that is higher relative to
other applicants.
“(iii) Consideration of applications.–In
carrying out clause (i), the Secretary shall
approve applications for grants in such a manner
that the ratio of the medically underserved
populations in rural areas which may be expected
to use the services provided by the applicants
involved to the medically

[[Page 132 STAT. 285]]

underserved populations in urban areas which may
be expected to use the services provided by the
applicants is not less than two to three or
greater than three to two.
“(iv) Service area overlap.–If in carrying
out clause (i) the applicant proposes to serve an
area that is currently served by another health
center funded under this section, the Secretary
may consider whether the award of funding to an
additional health center in the area can be
justified based on the unmet need for additional
services within the catchment area.
“(B) Approval of expanded service applications.–
“(i) In general.–The Secretary may approve
applications for grants under subparagraph (A) or
(B) of paragraph (1) to expand the capacity of the
applicant to provide required primary health
services described in subsection (b)(1) or
additional health services described in subsection
(b)(2).
“(ii) Priority expansion projects.–In
carrying out clause (i), the Secretary may give
special consideration to expanded service
applications that seek to address emerging public
health or behavioral health, mental health, or
substance abuse issues through increasing the
availability of additional health services
described in subsection (b)(2) in an area in which
there are significant barriers to accessing care.
“(iii) Consideration of applications.–In
carrying out clause (i), the Secretary shall
approve applications for grants in such a manner
that the ratio of the medically underserved
populations in rural areas which may be expected
to use the services provided by the applicants
involved to the medically underserved populations
in urban areas which may be expected to use the
services provided by such applicants is not less
than two to three or greater than three to two.”;
(8) in subsection (h)–
(A) in paragraph (1), by striking “and children and
youth at risk of homelessness” and inserting “,
children and youth at risk of homelessness, homeless
veterans, and veterans at risk of homelessness”; and
(B) in paragraph (5)–
(i) by striking subparagraph (B);
(ii) by redesignating subparagraph (C) as
subparagraph (B); and
(iii) in subparagraph (B) (as so
redesignated)–
(I) in the subparagraph heading, by
striking “abuse” and inserting “use
disorder”; and
(II) by striking “abuse” and
inserting “use disorder”;
(9) in subsection (k)–
(A) in paragraph (2)–
(i) in the paragraph heading, by inserting
“unmet” before “need”;
(ii) in the matter preceding subparagraph (A),
by inserting “or subsection (e)(6)” after
“subsection (e)(1)”;

[[Page 132 STAT. 286]]

(iii) in subparagraph (A), by inserting
“unmet” before “need for health services”;
(iv) in subparagraph (B), by striking “and”
at the end;
(v) in subparagraph (C), by striking the
period at the end and inserting “; and”; and
(vi) by adding after subparagraph (C) the
following:
“(D) in the case of an application for a grant
pursuant to subsection (e)(6), a demonstration that the
applicant has consulted with appropriate State and local
government agencies, and health care providers regarding
the need for the health services to be provided at the
proposed delivery site.”;
(B) in paragraph (3)–
(i) in the matter preceding subparagraph (A),
by inserting “or subsection (e)(6)” after
“subsection (e)(1)(B)”;
(ii) in subparagraph (B), by striking “in the
catchment area of the center” and inserting “,
including other health care providers that provide
care within the catchment area, local hospitals,
and specialty providers in the catchment area of
the center, to provide access to services not
available through the health center and to reduce
the non-urgent use of hospital emergency
departments”;
(iii) in subparagraph (H)(ii), by inserting
“who shall be directly employed by the center”
after “approves the selection of a director for
the center”;
(iv) in subparagraph (L), by striking “and”
at the end;
(v) in subparagraph (M), by striking the
period and inserting “; and”; and
(vi) by inserting after subparagraph (M), the
following:
“(N) the center has written policies and procedures
in place to ensure the appropriate use of Federal funds
in compliance with applicable Federal statutes,
regulations, and the terms and conditions of the Federal
award.”; and
(C) by striking paragraph (4);
(10) in subsection (l), by adding at the end the following:
“Funds expended to carry out activities under this subsection
and operational support activities under subsection (m) shall
not exceed 3 percent of the amount appropriated for this section
for the fiscal year involved.”;
(11) in subsection (q)(4), by adding at the end the
following: “A <<NOTE: Waiver. Time period.>> waiver provided
by the Secretary under this paragraph may not remain in effect
for more than 1 year and may not be extended after such period.
An entity may not receive more than one waiver under this
paragraph in consecutive years.”;
(12) in subsection (r)(3)–
(A) by striking “appropriate committees of Congress
a report concerning the distribution of funds under this
section” and inserting the following: “Committee on
Health, Education, Labor, and Pensions of the Senate,
and the Committee on Energy and Commerce of the House of
Representatives, a report including, at a minimum–

[[Page 132 STAT. 287]]

“(A) the distribution of funds for carrying out
this section”;
(B) by striking “populations. Such report shall
include an assessment” and inserting the following:
“populations;
“(B) an assessment”;
(C) by striking “and the rationale for any
substantial changes in the distribution of funds.” and
inserting a semicolon; and
(D) by adding at the end the following:
“(C) the distribution of awards and funding for new
or expanded services in each of rural areas and urban
areas;
“(D) the distribution of awards and funding for
establishing new access points, and the number of new
access points created;
“(E) the amount of unexpended funding for loan
guarantees and loan guarantee authority under title XVI;
“(F) the rationale for any substantial changes in
the distribution of funds;
“(G) the rate of closures for health centers and
access points;
“(H) the number and reason for any grants awarded
pursuant to subsection (e)(1)(B); and
“(I) the number and reason for any waivers provided
pursuant to subsection (q)(4).”;
(13) in subsection (r), by adding at the end the following
new paragraph:
“(5) Funding for participation of health centers in all of
us research program.– <<NOTE: Appropriation authorization.>> In
addition to any amounts made available pursuant to paragraph (1)
of this subsection, section 402A of this Act, or section 10503
of the Patient Protection and Affordable Care Act, there is
authorized to be appropriated, and there is appropriated, out of
any monies in the Treasury not otherwise appropriated, to the
Secretary $25,000,000 for fiscal year 2018 to support the
participation of health centers in the All of Us Research
Program under the Precision Medicine Initiative under section
498E of this Act.”; and
(14) by striking subsection (s).

(c) National Health Service Corps.–Section 10503(b)(2)(F) of the
Patient Protection and Affordable Care Act (42 U.S.C. 254b-2(b)(2)(F)),
as amended by section 3101 of Public Law 115-96, is amended to read as
follows:
“(F) $310,000,000 for each of fiscal years 2018 and
2019.”.

(d) Teaching Health Centers That Operate Graduate Medical Education
Programs.–
(1) Payments.–Subsection (a) of section 340H of the Public
Health Service Act (42 U.S.C. 256h) is amended to read as
follows:

“(a) Payments.–
“(1) In general.–Subject to subsection (h)(2), the
Secretary shall make payments under this section for direct
expenses and indirect expenses to qualified teaching health
centers that are listed as sponsoring institutions by the
relevant accrediting body for, as appropriate–

[[Page 132 STAT. 288]]

“(A) maintenance of filled positions at existing
approved graduate medical residency training programs;
“(B) expansion of existing approved graduate
medical residency training programs; and
“(C) establishment of new approved graduate medical
residency training programs.
“(2) Per resident amount.–In making payments under
paragraph (1), the Secretary shall consider the cost of training
residents at teaching health centers and the implications of the
per resident amount on approved graduate medical residency
training programs at teaching health centers.
“(3) Priority.–In making payments under paragraph (1)(C),
the Secretary shall give priority to qualified teaching health
centers that–
“(A) serve a health professional shortage area with
a designation in effect under section 332 or a medically
underserved community (as defined in section 799B); or
“(B) are located in a rural area (as defined in
section 1886(d)(2)(D) of the Social Security Act).”.
(2) Funding.–Paragraph (1) of section 340H(g) of the Public
Health Service Act (42 U.S.C. 256h(g)), as amended by section
3101 of Public Law 115-96, is amended by striking “and
$30,000,000 for the period of the first and second quarters of
fiscal year 2018,” and inserting “and $126,500,000 for each of
fiscal years 2018 and 2019,”.
(3) Annual reporting.–Subsection (h)(1) of section 340H of
the Public Health Service Act (42 U.S.C. 256h) is amended–
(A) by redesignating subparagraph (D) as
subparagraph (H); and
(B) by inserting after subparagraph (C) the
following:
“(D) The number of patients treated by residents
described in paragraph (4).
“(E) The number of visits by patients treated by
residents described in paragraph (4).
“(F) Of the number of residents described in
paragraph (4) who completed their residency training at
the end of such residency academic year, the number and
percentage of such residents entering primary care
practice (meaning any of the areas of practice listed in
the definition of a primary care residency program in
section 749A).
“(G) Of the number of residents described in
paragraph (4) who completed their residency training at
the end of such residency academic year, the number and
percentage of such residents who entered practice at a
health care facility–
“(i) primarily serving a health professional
shortage area with a designation in effect under
section 332 or a medically underserved community
(as defined in section 799B); or
“(ii) located in a rural area (as defined in
section 1886(d)(2)(D) of the Social Security
Act).”.
(4) Report on training costs.–Not later than March 31,
2019, the Secretary of Health and Human Services shall submit to
the Congress a report on the direct graduate expenses of
approved graduate medical residency training programs, and the
indirect expenses associated with the additional costs of
teaching residents, of qualified teaching health centers (as
such

[[Page 132 STAT. 289]]

terms are used or defined in section 340H of the Public Health
Service Act (42 U.S.C. 256h)).
(5) Definition.–Subsection (j) of section 340H of the
Public Health Service Act (42 U.S.C. 256h) is amended–
(A) by redesignating paragraphs (2) and (3) as
paragraphs (3) and (4), respectively; and
(B) by inserting after paragraph (1) the following:
“(2) New approved graduate medical residency training
program.–The term `new approved graduate medical residency
training program’ means an approved graduate medical residency
training program for which the sponsoring qualified teaching
health center has not received a payment under this section for
a previous fiscal year (other than pursuant to subsection
(a)(1)(C)).”.
(6) Technical correction.–Subsection (f) of section 340H
(42 U.S.C. 256h) is amended by striking “hospital” each place
it appears and inserting “teaching health center”.
(7) <<NOTE: Applicability. 42 USC 256h note.>> Payments for
previous fiscal years.–The provisions of section 340H of the
Public Health Service Act (42 U.S.C. 256h), as in effect on the
day before the date of enactment of Public Law 115-96, shall
continue to apply with respect to payments under such section
for fiscal years before fiscal year 2018.

(e) Application.–Amounts appropriated pursuant to this section for
fiscal year 2018 or 2019 are subject to the requirements contained in
Public Law 115-31 for funds for programs authorized under sections 330
through 340 of the Public Health Service Act (42 U.S.C. 254b-256).
(f) Conforming Amendments.–Paragraph (4) of section 3014(h) of
title 18, United States Code, as amended by section 3101 of Public Law
115-96, is amended by striking “and section 3101(d) of the CHIP and
Public Health Funding Extension Act” and inserting “and section
50901(e) of the Advancing Chronic Care, Extenders, and Social Services
Act”.
SEC. 50902. EXTENSION FOR SPECIAL DIABETES PROGRAMS.

(a) Special Diabetes Program for Type I Diabetes.–Section
330B(b)(2)(D) of the Public Health Service Act (42 U.S.C. 254c-
2(b)(2)(D)), as amended by section 3102 of Public Law 115-96, is amended
to read as follows:
“(D) $150,000,000 for each of fiscal years 2018 and
2019, to remain available until expended.”.

(b) Special Diabetes Program for Indians.–Subparagraph (D) of
section 330C(c)(2) of the Public Health Service Act (42 U.S.C. 254c-
3(c)(2)), as amended by section 3102 of Public Law 115-96, is amended to
read as follows:
“(D) $150,000,000 for each of fiscal years 2018 and
2019, to remain available until expended.”.

TITLE X–MISCELLANEOUS HEALTH CARE POLICIES

SEC. 51001. <<NOTE: Time periods.>> HOME HEALTH PAYMENT REFORM.

(a) Budget Neutral Transition to a 30-day Unit of Payment for Home
Health Services.–Section 1895(b) of the Social Security Act (42 U.S.C.
1395fff(b)) is amended–

[[Page 132 STAT. 290]]

(1) in paragraph (2)–
(A) by striking “payment.–In defining” and
inserting “payment.–
“(A) In general.–In defining”; and
(B) by adding at the end the following new
subparagraph:
“(B) 30-day unit of service.–For purposes of
implementing the prospective payment system with respect
to home health units of service furnished during a year
beginning with 2020, the Secretary shall apply a 30-day
unit of service as the unit of service applied under
this paragraph.”;
(2) in paragraph (3)–
(A) in subparagraph (A), by adding at the end the
following new clause:
“(iv) Budget neutrality for 2020.–With
respect to payments for home health units of
service furnished that end during the 12-month
period beginning January 1, 2020, the Secretary
shall calculate a standard prospective payment
amount (or amounts) for 30-day units of service
(as described in paragraph (2)(B)) for the
prospective payment system under this subsection.
Such standard prospective payment amount (or
amounts) shall be calculated in a manner such that
the estimated aggregate amount of expenditures
under the system during such period with
application of paragraph (2)(B) is equal to the
estimated aggregate amount of expenditures that
otherwise would have been made under the system
during such period if paragraph (2)(B) had not
been enacted.
The <<NOTE: Applicability.>> previous sentence
shall be applied before (and not affect the
application of) paragraph (3)(B). In calculating
such amount (or amounts), the Secretary shall make
assumptions about behavior changes that could
occur as a result of the implementation of
paragraph (2)(B) and the case-mix adjustment
factors established under paragraph (4)(B) and
shall provide a description of such assumptions in
the notice and comment rulemaking used to
implement this clause.”; and
(B) by adding at the end the following new
subparagraph:
“(D) <<NOTE: Notice. Regulations.>> Behavior
assumptions and adjustments.–
“(i) <<NOTE: Deadline. Determination.>> In
general.–The Secretary shall annually determine
the impact of differences between assumed behavior
changes (as described in paragraph (3)(A)(iv)) and
actual behavior changes on estimated aggregate
expenditures under this subsection with respect to
years beginning with 2020 and ending with 2026.
“(ii) Permanent adjustments.–The Secretary
shall, at a time and in a manner determined
appropriate, through notice and comment
rulemaking, provide for one or more permanent
increases or decreases to the standard prospective
payment amount (or amounts) for applicable years,
on a prospective basis, to offset for such
increases or decreases in estimated aggregate
expenditures (as determined under clause (i)).

[[Page 132 STAT. 291]]

“(iii) Temporary adjustments for
retrospective behavior.–The Secretary shall, at a
time and in a manner determined appropriate,
through notice and comment rulemaking, provide for
one or more temporary increases or decreases to
the payment amount for a unit of home health
services (as determined under paragraph (4)) for
applicable years, on a prospective basis, to
offset for such increases or decreases in
estimated aggregate expenditures (as determined
under clause (i)). <<NOTE: Applicability.>> Such a
temporary increase or decrease shall apply only
with respect to the year for which such temporary
increase or decrease is made, and the Secretary
shall not take into account such a temporary
increase or decrease in computing such amount
under this subsection for a subsequent year.”;
and
(3) in paragraph (4)(B)–
(A) by striking “Factors.–The Secretary” and
inserting “Factors.–
“(i) In general.–The Secretary”; and
(B) by adding at the end the following new clause:
“(ii) Treatment of therapy thresholds.–For
2020 and subsequent years, the Secretary shall
eliminate the use of therapy thresholds
(established by the Secretary) in case mix
adjustment factors established under clause (i)
for calculating payments under the prospective
payment system under this subsection.”.

(b) Technical Expert Panel.–
(1) <<NOTE: Recommenda- tions.>> In general.–During the
period beginning on January 1, 2018, and ending on December 31,
2018, the Secretary of Health and Human Services shall hold at
least one session of a technical expert panel, the participants
of which shall include home health providers, patient
representatives, and other relevant stakeholders. The technical
expert panel shall identify and prioritize recommendations with
respect to the prospective payment system for home health
services under section 1895(b) of the Social Security Act (42
U.S.C. 1395fff(b)), on the following:
(A) The Home Health Groupings Model, as described in
the proposed rule “Medicare and Medicaid Programs; CY
2018 Home Health Prospective Payment System Rate Update
and Proposed CY 2019 Case-Mix Adjustment Methodology
Refinements; Home Health Value-Based Purchasing Model;
and Home Health Quality Reporting Requirements” (82
Fed. Reg. 35294 through 35332 (July 28, 2017)).
(B) Alternative case-mix models to the Home Health
Groupings Model that were submitted during 2017 as
comments in response to proposed rule making, including
patient-focused factors that consider the risks of
hospitalization and readmission to a hospital,
improvement or maintenance of functionality of
individuals to increase the capacity for self-care,
quality of care, and resource utilization.
(2) Inapplicability of faca.–The provisions of the Federal
Advisory Committee Act (5 U.S.C. App.) shall not apply to the
technical expert panel under paragraph (1).

[[Page 132 STAT. 292]]

(3) Report.–Not later than April 1, 2019, the Secretary of
Health and Human Services shall submit to the Committee on Ways
and Means and the Committee on Energy and Commerce of the House
of Representatives and the Committee on Finance of the Senate a
report on the recommendations of such panel described in such
paragraph.
(4) <<NOTE: Deadline.>> Notice and comment rulemaking.–Not
later than December 31, 2019, the Secretary of Health and Human
Services shall pursue notice and comment rulemaking on a case-
mix system with respect to the prospective payment system for
home health services under section 1895(b) of the Social
Security Act (42 U.S.C. 1395fff(b)).

(c) Reports.–
(1) Interim report.–Not later than March 15, 2022, the
Medicare Payment Advisory Commission shall submit to Congress an
interim report on the application of a 30-day unit of service as
the unit of service applied under section 1895(b)(2) of the
Social Security Act (42 U.S.C. 1395fff(b)(2)), as amended by
subsection (a), including an analysis of the level of payments
provided to home health agencies as compared to the cost of
delivering home health services, and any unintended
consequences, including with respect to behavioral changes and
quality.
(2) Final report.–Not later than March 15, 2026, such
Commission shall submit to Congress a final report on such
application and any such consequences.
SEC. 51002. <<NOTE: Certification.>> INFORMATION TO SATISFY
DOCUMENTATION OF MEDICARE ELIGIBILITY
FOR HOME HEALTH SERVICES.

(a) Part A.–Section 1814(a) of the Social Security Act (42 U.S.C.
1395f(a)) is amended by inserting before “For purposes of paragraph
(2)(C),” the following new sentence: “For purposes of documentation
for physician certification and recertification made under paragraph (2)
on or after January 1, 2019, and made with respect to home health
services furnished by a home health agency, in addition to using
documentation in the medical record of the physician who so certifies or
the medical record of the acute or post-acute care facility (in the case
that home health services were furnished to an individual who was
directly admitted to the home health agency from such a facility), the
Secretary may use documentation in the medical record of the home health
agency as supporting material, as appropriate to the case involved.”.
(b) Part B.–Section 1835(a) of the Social Security Act (42 U.S.C.
1395n(a)) is amended by inserting before “For purposes of paragraph
(2)(A),” the following new sentence: “For purposes of documentation
for physician certification and recertification made under paragraph (2)
on or after January 1, 2019, and made with respect to home health
services furnished by a home health agency, in addition to using
documentation in the medical record of the physician who so certifies or
the medical record of the acute or post-acute care facility (in the case
that home health services were furnished to an individual who was
directly admitted to the home health agency from such a facility), the
Secretary may use documentation in the medical record of the home health
agency as supporting material, as appropriate to the case involved.”.

[[Page 132 STAT. 293]]

SEC. 51003. TECHNICAL AMENDMENTS TO PUBLIC LAW 114-10.

(a) MIPS Transition.–Section 1848 of the Social Security Act (42
U.S.C. 1395w-4) is amended–
(1) in subsection (q)–
(A) in paragraph (1)–
(i) in subparagraph (B), by striking “items
and services” and inserting “covered
professional services (as defined in subsection
(k)(3)(A))”; and
(ii) in subparagraph (C)(iv)–
(I) by amending subclause (I) to
read as follows:
“(I) <<NOTE: Time periods.>> The
minimum number (as determined by the
Secretary) of–
“(aa) for performance
periods beginning before January
1, 2018, individuals enrolled
under this part who are treated
by the eligible professional for
the performance period involved;
and
“(bb) for performance
periods beginning on or after
January 1, 2018, individuals
enrolled under this part who are
furnished covered professional
services (as defined in
subsection (k)(3)(A)) by the
eligible professional for the
performance period involved.”;
(II) in subclause (II), by striking
“items and services” and inserting
“covered professional services (as
defined in subsection (k)(3)(A))”; and
(III) by amending subclause (III) to
read as follows:
“(III) <<NOTE: Time periods.>> The
minimum amount (as determined by the
Secretary) of–
“(aa) for performance
periods beginning before January
1, 2018, allowed charges billed
by such professional under this
part for such performance
period; and
“(bb) for performance
periods beginning on or after
January 1, 2018, allowed charges
for covered professional
services (as defined in
subsection (k)(3)(A)) billed by
such professional for such
performance period.”;
(B) in paragraph (5)(D)–
(i) in clause (i)(I), by inserting “subject
to clause (iii),” after “clauses (i) and (ii) of
paragraph (2)(A),”; and
(ii) by adding at the end the following new
clause:
“(iii) Transition years.–For each of the
second, third, fourth, and fifth years for which
the MIPS applies to payments, the performance
score for the performance category described in
paragraph (2)(A)(ii) shall not take into account
the improvement of the professional involved.”;
(C) in paragraph (5)(E)–
(i) in clause (i)(I)(bb)–
(I) in the heading by striking
“First 2 years” and inserting “First
5 years”; and
(II) by striking “the first and
second years” and inserting “each of
the first through fifth years”;

[[Page 132 STAT. 294]]

(ii) in clause (i)(II)(bb)–
(I) in the heading, by striking “2
years” and inserting “5 years”; and
(II) by striking the second sentence
and inserting the following new
sentences: “For each of the second,
third, fourth, and fifth years for which
the MIPS applies to payments, not less
than 10 percent and not more than 30
percent of such score shall be based on
performance with respect to the category
described in clause (ii) of paragraph
(2)(A) <<NOTE: Determination.>> .
Nothing in the previous sentence shall
be construed, with respect to a
performance period for a year described
in the previous sentence, as preventing
the Secretary from basing 30 percent of
such score for such year with respect to
the category described in such clause
(ii), if the Secretary determines, based
on information posted under subsection
(r)(2)(I) that sufficient resource use
measures are ready for adoption for use
under the performance category under
paragraph (2)(A)(ii) for such
performance period.”;
(D) in paragraph (6)(D)–
(i) in clause (i), in the second sentence, by
striking “Such performance threshold” and
inserting “Subject to clauses (iii) and (iv),
such performance threshold”;
(ii) in clause (ii)–
(I) in the first sentence, by
inserting “(beginning with 2019 and
ending with 2024)” after “for each
year of the MIPS”; and
(II) in the second sentence, by
inserting “subject to clause (iii),”
after “For each such year,”;
(iii) in clause (iii)–
(I) in the heading, by striking
“2” and inserting “5”; and
(II) in the first sentence, by
striking “two years” and inserting
“five years”; and
(iv) by adding at the end the following new
clause:
“(iv) Additional special rule for third,
fourth and fifth years of mips.–
<<NOTE: Determination.>> For purposes of
determining MIPS adjustment factors under
subparagraph (A), in addition to the requirements
specified in clause (iii), the Secretary shall
increase the performance threshold with respect to
each of the third, fourth, and fifth years to
which the MIPS applies to ensure a gradual and
incremental transition to the performance
threshold described in clause (i) (as estimated by
the Secretary) with respect to the sixth year to
which the MIPS applies.”;
(E) in paragraph (6)(E)–
(i) by striking “In the case of items and
services” and inserting “In the case of covered
professional services (as defined in subsection
(k)(3)(A))”; and
(ii) by striking “under this part with
respect to such items and services” and inserting
“under this part with respect to such covered
professional services”; and

[[Page 132 STAT. 295]]

(F) in paragraph (7), in the first sentence, by
striking “items and services” and inserting “covered
professional services (as defined in subsection
(k)(3)(A))”;
(2) in subsection (r)(2), by adding at the end the following
new subparagraph:
“(I) <<NOTE: Deadline. Web
posting.>> Information.–The Secretary shall, not later
than December 31st of each year (beginning with 2018),
post on the Internet website of the Centers for Medicare
& Medicaid Services information on resource use measures
in use under subsection (q), resource use measures under
development and the time-frame for such development,
potential future resource use measure topics, a
description of stakeholder engagement, and the percent
of expenditures under part A and this part that are
covered by resource use measures.”; and
(3) in subsection (s)(5)(B), by striking “section
1833(z)(2)(C)” and inserting “section 1833(z)(3)(D)”.

(b) Physician-focused Payment Model Technical Advisory Committee
Provision of Initial Proposal Feedback.–Section 1868(c)(2)(C) of the
Social Security Act (42 U.S.C. 1395ee(c)(2)(C)) is amended to read as
follows:
“(C) Committee review of models submitted.–The
Committee, on a periodic basis–
“(i) shall review models submitted under
subparagraph (B);
“(ii) may provide individuals and stakeholder
entities who submitted such models with–
“(I) initial feedback on such
models regarding the extent to which
such models meet the criteria described
in subparagraph (A); and
“(II) an explanation of the basis
for the feedback provided under
subclause (I); and
“(iii) <<NOTE: Recommenda- tions.>> shall
prepare comments and recommendations regarding
whether such models meet the criteria described in
subparagraph (A) and submit such comments and
recommendations to the Secretary.”.
SEC. 51004. EXPANDED ACCESS TO MEDICARE INTENSIVE CARDIAC
REHABILITATION PROGRAMS.

Section 1861(eee)(4)(B) of the Social Security Act (42 U.S.C.
1395x(eee)(4)(B)) is amended–
(1) in clause (v), by striking “or” at the end;
(2) in clause (vi), by striking the period at the end and
inserting a semicolon; and
(3) by adding at the end the following new clauses:
“(vii) stable, chronic heart failure (defined as
patients with left ventricular ejection fraction of 35
percent or less and New York Heart Association (NYHA)
class II to IV symptoms despite being on optimal heart
failure therapy for at least 6 weeks); or
“(viii) <<NOTE: Determination.>> any additional
condition for which the Secretary has determined that a
cardiac rehabilitation program shall be covered, unless
the Secretary determines, using the same process used to
determine that the condition is covered for a cardiac
rehabilitation program, that such coverage is not
supported by the clinical evidence.”.

[[Page 132 STAT. 296]]

SEC. 51005. EXTENSION OF BLENDED SITE NEUTRAL PAYMENT RATE FOR
CERTAIN LONG-TERM CARE HOSPITAL
DISCHARGES; TEMPORARY ADJUSTMENT TO
SITE NEUTRAL PAYMENT RATES.

(a) Extension.–Section 1886(m)(6)(B)(i) of the Social Security Act
(42 U.S.C. 1395ww(m)(6)(B)(i)) is amended–
(1) in subclause (I), by striking “fiscal year 2016 or
fiscal year 2017” and inserting “fiscal years 2016 through
2019”; and
(2) in subclause (II), by striking “2018” and inserting
“2020”.

(b) Temporary Adjustment to Site Neutral Payment Rates.–Section
1886(m)(6)(B) of the Social Security Act (42 U.S.C. 1395ww(m)(6)(B)) is
amended–
(1) in clause (ii), in the matter preceding subclause (I),
by striking “In this paragraph” and inserting “Subject to
clause (iv), in this paragraph”; and
(2) by adding at the end the following new clause:
“(iv) Adjustment.–For each of fiscal years
2018 through 2026, the amount that would otherwise
apply under clause (ii)(I) for the year
(determined without regard to this clause) shall
be reduced by 4.6 percent.”.
SEC. 51006. RECOGNITION OF ATTENDING PHYSICIAN ASSISTANTS AS
ATTENDING PHYSICIANS TO SERVE HOSPICE
PATIENTS.

(a) Recognition of Attending Physician Assistants as Attending
Physicians To Serve Hospice Patients.–
(1) In general.–Section 1861(dd)(3)(B) of the Social
Security Act (42 U.S.C. 1395x(dd)(3)(B)) is amended–
(A) by striking “or nurse” and inserting “, the
nurse”; and
(B) by inserting “, or the physician assistant (as
defined in such subsection)” after “subsection
(aa)(5))”.
(2) Clarification of hospice role of physician assistants.–
Section 1814(a)(7)(A)(i)(I) of the Social Security Act (42
U.S.C. 1395f(a)(7)(A)(i)(I)) is amended by inserting “or a
physician assistant” after “a nurse practitioner”.

(b) <<NOTE: Applicability. 42 USC 1395f note.>> Effective Date.–The
amendments made by this section shall apply to items and services
furnished on or after January 1, 2019.
SEC. 51007. EXTENSION OF ENFORCEMENT INSTRUCTION ON SUPERVISION
REQUIREMENTS FOR OUTPATIENT
THERAPEUTIC SERVICES IN CRITICAL
ACCESS AND SMALL RURAL HOSPITALS
THROUGH 2017.

Section 1 of Public Law 113-198, as amended by section 1 of Public
Law 114-112 and section 16004(a) of the 21st Century Cures Act (Public
Law 114-255), <<NOTE: 128 Stat. 2057.>> is amended–
(1) in the section heading, by striking “2016” and
inserting “2017”; and
(2) by striking “and 2016” and inserting “2016, and
2017”.

[[Page 132 STAT. 297]]

SEC. 51008. ALLOWING PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS,
AND CLINICAL NURSE SPECIALISTS TO
SUPERVISE CARDIAC, INTENSIVE CARDIAC,
AND PULMONARY REHABILITATION PROGRAMS.

(a) Cardiac and Intensive Cardiac Rehabilitation Programs.–Section
1861(eee) of the Social Security Act (42 U.S.C. 1395x(eee)) is amended–
(1) in paragraph (1)–
(A) by striking “physician-supervised”; and
(B) by inserting “under the supervision of a
physician (as defined in subsection (r)(1)) or a
physician assistant, nurse practitioner, or clinical
nurse specialist (as those terms are defined in
subsection (aa)(5))” before the period at the end;
(2) in paragraph (2)–
(A) in subparagraph (A)(iii), by striking the period
at the end and inserting a semicolon; and
(B) in subparagraph (B), by striking “a physician”
and inserting “a physician (as defined in subsection
(r)(1)) or a physician assistant, nurse practitioner, or
clinical nurse specialist (as those terms are defined in
subsection (aa)(5))”; and
(3) in paragraph (4)(A), in the matter preceding clause
(i)–
(A) by striking “physician-supervised”; and
(B) by inserting “under the supervision of a
physician (as defined in subsection (r)(1)) or a
physician assistant, nurse practitioner, or clinical
nurse specialist (as those terms are defined in
subsection (aa)(5))” after “paragraph (3)”.

(b) Pulmonary Rehabilitation Programs.–Section 1861(fff)(1) of the
Social Security Act (42 U.S.C. 1395x(fff)(1)) is amended–
(1) by striking “physician-supervised”; and
(2) by inserting “under the supervision of a physician (as
defined in subsection (r)(1)) or a physician assistant, nurse
practitioner, or clinical nurse specialist (as those terms are
defined in subsection (aa)(5))” before the period at the end.

(c) <<NOTE: Applicability. 42 USC 1395x note.>> Effective Date.–The
amendments made by this section shall apply to items and services
furnished on or after January 1, 2024.
SEC. 51009. TRANSITIONAL PAYMENT RULES FOR CERTAIN RADIATION
THERAPY SERVICES UNDER THE PHYSICIAN
FEE SCHEDULE.

Section 1848 of the Social Security Act (42 U.S.C. 1395w-4) is
amended–
(1) in subsection (b)(11), by striking “2017 and 2018” and
inserting “2017, 2018, and 2019”; and
(2) in subsection (c)(2)(K)(iv), by striking “2017 and
2018” and inserting “2017, 2018, and 2019”.

[[Page 132 STAT. 298]]

TITLE XI–PROTECTING SENIORS’ ACCESS TO MEDICARE ACT

SEC. 52001. REPEAL OF THE INDEPENDENT PAYMENT ADVISORY BOARD.

(a) Repeal.–Section 1899A of the Social Security Act (42 U.S.C.
1395kkk) is repealed.
(b) Conforming Amendments.–
(1) Lobbying cooling-off period.–Paragraph (3) of section
207(c) of title 18, United States Code, is repealed.
(2) GAO study and report.–Section 3403(b) of the Patient
Protection and Affordable Care Act (42 U.S.C. 1395kkk-1) is
repealed.
(3) MedPAC review and comment.–Section 1805(b) of the
Social Security Act (42 U.S.C. 1395b-6(b)) is amended–
(A) by striking paragraph (4);
(B) by redesignating paragraphs (5) through (8) as
paragraphs (4) through (7), respectively; and
(C) by redesignating the paragraph (9) that was
redesignated by section 3403(c)(1) of the Patient
Protection and Affordable Care Act (Public Law 111-148)
as paragraph (8).
(4) Name change.–Section 10320(b) of the Patient Protection
and Affordable Care Act (Public Law 111-148) <<NOTE: 42 USC
1395kkk note.>> is repealed.
(5) Rule of construction.–Section 10320(c) of the Patient
Protection and Affordable Care Act (Public Law 111-148) is
repealed.

TITLE XII–OFFSETS

SEC. 53101. MODIFYING REDUCTIONS IN MEDICAID DSH ALLOTMENTS.

Section 1923(f)(7)(A) of the Social Security Act (42 U.S.C. 1396r-
4(f)(7)(A)) is amended–
(1) in clause (i), in the matter preceding subclause (I), by
striking “2018” and inserting “2020”; and
(2) in clause (ii), by striking subclauses (I) through
(VIII) and inserting the following:
“(I) $4,000,000,000 for fiscal year
2020; and
“(II) $8,000,000,000 for each of
fiscal years 2021 through 2025.”.
SEC. 53102. THIRD PARTY LIABILITY IN MEDICAID AND CHIP.

(a) Modification of Third Party Liability Rules Related to Special
Treatment of Certain Types of Care and Payments.–
(1) In general.–Section 1902(a)(25)(E) of the Social
Security Act (42 U.S.C. 1396a(a)(25)(E)) is amended, in the
matter preceding clause (i), by striking “prenatal or”.
(2) <<NOTE: 42 USC 1396a note.>> Effective date.–The
amendment made by paragraph (1) shall take effect on the date of
enactment of this Act.

(b) Delay in Effective Date and Repeal of Certain Bipartisan Budget
Act of 2013 Amendments.–
(1) <<NOTE: Applicability.>> Repeal.–Effective as of
September 30, 2017, subsection (b) of section 202 of the
Bipartisan Budget Act of 2013 (Public Law 113-67; 127 Stat.
1177; 42 U.S.C. 1396a note) (including

[[Page 132 STAT. 299]]

any amendments made by such subsection) <<NOTE: 42 USC 1396a and
note, 1396k, 1396p.>> is repealed and the provisions amended by
such subsection shall be applied and administered as if such
amendments had never been enacted.
(2) Delay in effective date.–Subsection (c) of section 202
of the Bipartisan Budget Act of 2013 (Public Law 113-67; 127
Stat. 1177; 42 U.S.C. 1396a note) is amended to read as follows:

“(c) <<NOTE: 42 USC 1396a note.>> Effective Date.–The amendments
made by subsection (a) shall take effect on October 1, 2019.”.
(3) <<NOTE: Applicability.>> Effective date; treatment.–The
repeal and amendment made by this subsection shall take effect
as if enacted on September 30, 2017, and shall apply with
respect to any open claims, including claims pending, generated,
or filed, after such date. The amendments made by subsections
(a) and (b) of section 202 of the Bipartisan Budget Act of 2013
(Public Law 113-67; 127 Stat. 1177; 42 U.S.C. 1396a note) that
took effect on October 1, 2017, are null and void and section
1902(a)(25) of the Social Security Act (42 U.S.C. 1396a(a)(25))
shall be applied and administered as if such amendments had not
taken effect on such date.

(c) GAO Study and Report.–Not later than 18 months after the date
of enactment of this Act, the Comptroller General of the United States
shall submit a report to the Committee on Energy and Commerce of the
House of Representatives and the Committee on Finance of the Senate on
the impacts of the amendments made by subsections (a)(1) and (b)(2),
including–
(1) the impact, or potential effect, of such amendments on
access to prenatal and preventive pediatric care (including
early and periodic screening, diagnostic, and treatment
services) covered under State plans under such title (or waivers
of such plans);
(2) the impact, or potential effect, of such amendments on
access to services covered under such plans or waivers for
individuals on whose behalf child support enforcement is being
carried out by a State agency under part D of title IV of such
Act; and
(3) the impact, or potential effect, on providers of
services under such plans or waivers of delays in payment or
related issues that result from such amendments.

(d) Application to CHIP.–
(1) In general.–Section 2107(e)(1) of the Social Security
Act (42 U.S.C. 1397gg(e)(1)) is amended–
(A) by redesignating subparagraphs (B) through (R)
as subparagraphs (C) through (S), respectively; and
(B) by inserting after subparagraph (A) the
following new subparagraph:
“(B) Section 1902(a)(25) (relating to third party
liability).”.
(2) Mandatory reporting.–Section 1902(a)(25)(I)(i) of the
Social Security Act (42 U.S.C. 1396a(a)(25)(I)(i)) is amended–
(A) by striking “medical assistance under the State
plan” and inserting “medical assistance under a State
plan (or under a waiver of the plan)”;
(B) by striking “(and, at State option, child” and
inserting “and child”; and
(C) by striking “title XXI)” and inserting “title
XXI”.

[[Page 132 STAT. 300]]

SEC. 53103. <<NOTE: 42 USC 1396a note.>> TREATMENT OF LOTTERY
WINNINGS AND OTHER LUMP-SUM INCOME FOR
PURPOSES OF INCOME ELIGIBILITY UNDER
MEDICAID.

(a) In General.–Section 1902 of the Social Security Act (42 U.S.C.
1396a) is amended–
(1) in subsection (a)(17), by striking “(e)(14), (e)(14)”
and inserting “(e)(14), (e)(15)”; and
(2) in subsection (e)(14), by adding at the end the
following new subparagraph:
“(K) Treatment of certain lottery winnings and
income received as a lump sum.–
“(i) <<NOTE: Determination. Time
periods.>> In general.–In the case of an
individual who is the recipient of qualified
lottery winnings (pursuant to lotteries occurring
on or after January 1, 2018) or qualified lump sum
income (received on or after such date) and whose
eligibility for medical assistance is determined
based on the application of modified adjusted
gross income under subparagraph (A), a State
shall, in determining such eligibility, include
such winnings or income (as applicable) as income
received–
“(I) in the month in which such
winnings or income (as applicable) is
received if the amount of such winnings
or income is less than $80,000;
“(II) over a period of 2 months if
the amount of such winnings or income
(as applicable) is greater than or equal
to $80,000 but less than $90,000;
“(III) over a period of 3 months if
the amount of such winnings or income
(as applicable) is greater than or equal
to $90,000 but less than $100,000; and
“(IV) over a period of 3 months
plus 1 additional month for each
increment of $10,000 of such winnings or
income (as applicable) received, not to
exceed a period of 120 months (for
winnings or income of $1,260,000 or
more), if the amount of such winnings or
income is greater than or equal to
$100,000.
“(ii) <<NOTE: Applicability.>> Counting in
equal installments.–For purposes of subclauses
(II), (III), and (IV) of clause (i), winnings or
income to which such subclause applies shall be
counted in equal monthly installments over the
period of months specified under such subclause.
“(iii) <<NOTE: Determination.>> Hardship
exemption.–An individual whose income, by
application of clause (i), exceeds the applicable
eligibility threshold established by the State,
shall continue to be eligible for medical
assistance to the extent that the State
determines, under procedures established by the
State (in accordance with standards specified by
the Secretary), that the denial of eligibility of
the individual would cause an undue medical or
financial hardship as determined on the basis of
criteria established by the Secretary.
“(iv) Notifications and assistance required
in case of loss of eligibility.–A State shall,
with respect to an individual who loses
eligibility for medical

[[Page 132 STAT. 301]]

assistance under the State plan (or a waiver of
such plan) by reason of clause (i)–
“(I) before the date on which the
individual loses such eligibility,
inform the individual–
“(aa) of the individual’s
opportunity to enroll in a
qualified health plan offered
through an Exchange established
under title I of the Patient
Protection and Affordable Care
Act during the special
enrollment period specified in
section 9801(f)(3) of the
Internal Revenue Code of 1986
(relating to loss of Medicaid or
CHIP coverage); and
“(bb) of the date on which
the individual would no longer
be considered ineligible by
reason of clause (i) to receive
medical assistance under the
State plan or under any waiver
of such plan and be eligible to
reapply to receive such medical
assistance; and
“(II) provide technical assistance
to the individual seeking to enroll in
such a qualified health plan.
“(v) Qualified lottery winnings defined.–In
this subparagraph, the term `qualified lottery
winnings’ means winnings from a sweepstakes,
lottery, or pool described in paragraph (3) of
section 4402 of the Internal Revenue Code of 1986
or a lottery operated by a multistate or
multijurisdictional lottery association, including
amounts awarded as a lump sum payment.
“(vi) Qualified lump sum income defined.–In
this subparagraph, the term `qualified lump sum
income’ means income that is received as a lump
sum from monetary winnings from gambling (as
defined by the Secretary and including gambling
activities described in section 1955(b)(4) of
title 18, United States Code).”.

(b) <<NOTE: 42 USC 1396a note.>> Rules of Construction.–
(1) Interception of lottery winnings allowed.–Nothing in
the amendment made by subsection (a)(2) shall be construed as
preventing a State from intercepting the State lottery winnings
awarded to an individual in the State to recover amounts paid by
the State under the State Medicaid plan under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.) for medical
assistance furnished to the individual.
(2) Applicability limited to eligibility of recipient of
lottery winnings or lump sum income.–Nothing in the amendment
made by subsection (a)(2) shall be construed, with respect to a
determination of household income for purposes of a
determination of eligibility for medical assistance under the
State plan under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.) (or a waiver of such plan) made by applying
modified adjusted gross income under subparagraph (A) of section
1902(e)(14) of such Act (42 U.S.C. 1396a(e)(14)), as limiting
the eligibility for such medical assistance of any individual
that is a member of the household other than the individual who
received qualified lottery winnings or qualified lump-sum

[[Page 132 STAT. 302]]

income (as defined in subparagraph (K) of such section
1902(e)(14), as added by subsection (a)(2) of this section).
SEC. 53104. REBATE OBLIGATION WITH RESPECT TO LINE EXTENSION
DRUGS.

(a) In General.–Section 1927(c)(2)(C) of the Social Security Act
(42 U.S.C. 1396r-8(c)(2)(C)) is amended by striking “(C) treatment of
new formulations.–In the case” and all that follows through the period
at the end of the first sentence and inserting the following:
“(C) Treatment of new formulations.–
“(i) In general.–In the case of a drug that
is a line extension of a single source drug or an
innovator multiple source drug that is an oral
solid dosage form, the rebate obligation for a
rebate period with respect to such drug under this
subsection shall be the greater of the amount
described in clause (ii) for such drug or the
amount described in clause (iii) for such drug.
“(ii) Amount 1.–For purposes of clause (i),
the amount described in this clause with respect
to a drug described in clause (i) and rebate
period is the amount computed under paragraph (1)
for such drug, increased by the amount computed
under subparagraph (A) and, as applicable,
subparagraph (B) for such drug and rebate period.
“(iii) Amount 2.–For purposes of clause (i),
the amount described in this clause with respect
to a drug described in clause (i) and rebate
period is the amount computed under paragraph (1)
for such drug, increased by the product of–
“(I) the average manufacturer price
for the rebate period of the line
extension of a single source drug or an
innovator multiple source drug that is
an oral solid dosage form;
“(II) the highest additional rebate
(calculated as a percentage of average
manufacturer price) under this paragraph
for the rebate period for any strength
of the original single source drug or
innovator multiple source drug; and
“(III) the total number of units of
each dosage form and strength of the
line extension product paid for under
the State plan in the rebate period (as
reported by the State).”.

(b) <<NOTE: Applicability. 42 USC 1396r-8 note.>> Effective Date.–
The amendments made subsection (a) shall apply with respect to rebate
periods beginning on or after October 1, 2018.
SEC. 53105. MEDICAID IMPROVEMENT FUND.

Section 1941(b) of the Social Security Act (42 U.S.C. 1396w-1(b)) is
amended–
(1) in paragraph (1), by striking “$5,000,000” and
inserting “$0”; and
(2) in paragraph (3)(A), by striking “$980,000,000” and
inserting “$0”.

[[Page 132 STAT. 303]]

SEC. 53106. PHYSICIAN FEE SCHEDULE UPDATE.

Section 1848(d)(18) of the Social Security Act (42 U.S.C. 1395w-
4(d)(18)) is amended by striking “paragraph (1)(C)” and all that
follows and inserting the following: “paragraph (1)(C)–
“(A) for 2016 and each subsequent year through 2018
shall be 0.5 percent; and
“(B) for 2019 shall be 0.25 percent.”.
SEC. 53107. PAYMENT FOR OUTPATIENT PHYSICAL THERAPY SERVICES AND
OUTPATIENT OCCUPATIONAL THERAPY
SERVICES FURNISHED BY A THERAPY
ASSISTANT.

Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended
by adding at the end the following new subsection:
“(v) Payment for Outpatient Physical Therapy Services and
Outpatient Occupational Therapy Services Furnished by a Therapy
Assistant.–
“(1) <<NOTE: Time period.>> In general.–In the case of an
outpatient physical therapy service or outpatient occupational
therapy service furnished on or after January 1, 2022, for which
payment is made under section 1848 or subsection (k), that is
furnished in whole or in part by a therapy assistant (as defined
by the Secretary), the amount of payment for such service shall
be an amount equal to 85 percent of the amount of payment
otherwise applicable for the service under this part. Nothing in
the preceding sentence shall be construed to change applicable
requirements with respect to such services.
“(2) Use of modifier.–

“(A) <<NOTE: Deadline.>> <<NOTE: Notice. Regulation.>>
Establishment.–Not later than January 1, 2019, the
Secretary shall establish a modifier to indicate (in a
form and manner specified by the Secretary), in the case
of an outpatient physical therapy service or outpatient
occupational therapy service furnished in whole or in
part by a therapy assistant (as so defined), that the
service was furnished by a therapy assistant.
“(B) Required use.–Each request for payment, or
bill submitted, for an outpatient physical therapy
service or outpatient occupational therapy service
furnished in whole or in part by a therapy assistant (as
so defined) on or after January 1, 2020, shall include
the modifier established under subparagraph (A) for each
such service.
“(3) <<NOTE: Notice. Regulation.>> Implementation.–The
Secretary shall implement this subsection through notice and
comment rulemaking.”.
SEC. 53108. REDUCTION FOR NON-EMERGENCY ESRD AMBULANCE TRANSPORTS.

Section 1834(l)(15) of the Social Security Act (42. U.S.C.
1395m(l)(15)) is amended by striking “on or after October 1, 2013” and
inserting “during the period beginning on October 1, 2013, and ending
on September 30, 2018, and by 23 percent for such services furnished on
or after October 1, 2018”.
SEC. 53109. HOSPITAL TRANSFER POLICY FOR EARLY DISCHARGES TO
HOSPICE CARE.

(a) In General.–Section 1886(d)(5)(J) of the Social Security Act
(42 U.S.C. 1395ww(d)(5)(J)) is amended–
(1) in clause (ii)–
(A) in subclause (III), by striking “or” at the
end;

[[Page 132 STAT. 304]]

(B) by redesignating subclause (IV) as subclause
(V); and
(C) by inserting after subclause (III) the following
new subclause:
“(IV) for discharges occurring on or after October 1, 2018,
is provided hospice care by a hospice program; or”; and
(2) in clause (iv)–
(A) by inserting after the first sentence the
following new sentence: “The Secretary shall include in
the proposed rule published for fiscal year 2019, a
description of the effect of clause (ii)(IV).”; and
(B) in subclause (I), by striking “and (III)” and
inserting “(III), and, in the case of proposed and
final rules for fiscal year 2019 and subsequent fiscal
years, (IV)”.

(b) MedPAC Evaluation and Report.–
(1) Evaluation.–The Medicare Payment Advisory Commission
(in this subsection referred to as the “Commission”) shall
conduct an evaluation of the effects of the amendments made by
subsection (a), including the effects on–
(A) the numbers of discharges of patients from an
inpatient hospital setting to a hospice program;
(B) the lengths of stays of patients in an inpatient
hospital setting who are discharged to a hospice
program;
(C) spending under the Medicare program under title
XVIII of the Social Security Act; and
(D) other areas determined appropriate by the
Commission.
(2) Consideration.–In conducting the evaluation under
paragraph (1), the Commission shall consider factors such as
whether the timely access to hospice care by patients admitted
to a hospital has been affected through changes to hospital
policies or behaviors made as a result of such amendments.
(3) <<NOTE: Deadline.>> Preliminary results.–Not later
than March 15, 2020, the Commission shall provide Congress with
preliminary results on the evaluation being conducted under
paragraph (1).
(4) Report.–Not later than March 15, 2021, the Commission
shall submit to Congress a report on the evaluation conducted
under paragraph (1).
SEC. 53110. MEDICARE PAYMENT UPDATE FOR HOME HEALTH SERVICES.

Section 1895(b)(3)(B) of the Social Security Act (42 U.S.C.
1395fff(b)(3)(B)) is amended–
(1) in clause (iii), in the last sentence, by inserting
before the period at the end the following: “and for 2020 shall
be 1.5 percent”; and
(2) in clause (vi), by inserting “and 2020” after “except
2018”.
SEC. 53111. MEDICARE PAYMENT UPDATE FOR SKILLED NURSING
FACILITIES.

Section 1888(e)(5)(B) of the Social Security Act (42 U.S.C.
1395yy(e)(5)(B)) is amended–
(1) in clause (i), by striking “and (iii)” and inserting
“, (iii), and (iv)”;
(2) in clause (ii), by striking “clause (iii)” and
inserting “clauses (iii) and (iv)”; and

[[Page 132 STAT. 305]]

(3) by adding at the end the following new clause:
“(iv) Special rule for fiscal year 2019.–For
fiscal year 2019 (or other similar annual period
specified in clause (i)), the skilled nursing
facility market basket percentage, after
application of clause (ii), is equal to 2.4
percent.”.
SEC. 53112. PREVENTING THE ARTIFICIAL INFLATION OF STAR RATINGS
AFTER THE CONSOLIDATION OF MEDICARE
ADVANTAGE PLANS OFFERED BY THE SAME
ORGANIZATION.

Section 1853(o)(4) of the Social Security Act (42 U.S.C. 1395w-
23(o)(4)) is amended by adding at the end the following new
subparagraph:
“(D) Special rule to prevent the artificial
inflation of star ratings after the consolidation of
medicare advantage plans offered by a single
organization.–
“(i) <<NOTE: Contracts.>> In general.–If–
“(I) a Medicare Advantage
organization has entered into more than
one contract with the Secretary with
respect to the offering of Medicare
Advantage plans; and
“(II) <<NOTE: Effective date.>> on
or after January 1, 2019, the Secretary
approves a request from the organization
to consolidate the plans under one or
more contract (in this subparagraph
referred to as a `closed contract’) with
the plans offered under a separate
contract (in this subparagraph referred
to as the `continuing contract’);
with respect to the continuing contract, the
Secretary shall adjust the quality rating under
the 5-star rating system and any quality increase
under this subsection and rebate amounts under
section 1854 to reflect an enrollment-weighted
average of scores or ratings for the continuing
and closed contracts, as determined appropriate by
the Secretary.
“(ii) Application.–An adjustment under
clause (i) shall apply for any year for which the
quality rating of the continuing contract is based
primarily on a measurement period that is prior to
the first year in which a closed contract is no
longer offered.”.
SEC. 53113. SUNSETTING EXCLUSION OF BIOSIMILARS FROM MEDICARE PART
D COVERAGE GAP DISCOUNT PROGRAM.

Section 1860D-14A(g)(2)(A) of the Social Security Act (42 U.S.C.
1395w-114a(g)(2)(A)) is amended by inserting “, with respect to a plan
year before 2019,” after “other than”.
SEC. 53114. ADJUSTMENTS TO MEDICARE PART B AND PART D PREMIUM
SUBSIDIES FOR HIGHER INCOME
INDIVIDUALS.

(a) In General.–Section 1839(i)(3)(C)(i) of the Social Security Act
(42 U.S.C. 1395r(i)(3)(C)(i)) is amended–
(1) in subclause (II), in the matter preceding the table, by
striking “years beginning with”; and
(2) by adding at the end the following new subclause:
“(III) Subject to paragraph (5),
for years beginning with 2019:

[[Page 132 STAT. 306]]

“If the modified adjusted gross income is:……. The applicable
percentage is:
More than $85,000 but not more than $107,000…… 35 percent
More than $107,000 but not more than $133,500….. 50 percent
More than $133,500 but not more than $160,000….. 65 percent
More than $160,000 but less than $500,000……… 80 percent
At least $500,000…………………………… 85 percent.”.

”. (b) Joint Returns.–Section 1839(i)(3)(C)(ii) of the Social
Security Act (42 U.S.C. 1395r(i)(3)(C)(ii)) is amended by inserting
before the period the following: <<NOTE: Applicability.>> “except,
with respect to the dollar amounts applied in the last row of the table
under subclause (III) of such clause (and the second dollar amount
specified in the second to last row of such table), clause (i) shall be
applied by substituting dollar amounts which are 150 percent of such
dollar amounts for the calendar year”.

(c) Inflation Adjustment.–Section 1839(i)(5) of the Social Security
Act (42 U.S.C. 1395r(i)(5)) is amended–
(1) in subparagraph (A), by striking “In the case” and
inserting “Subject to subparagraph (C), in the case”;
(2) in subparagraph (B), by striking “subparagraph (A)”
and inserting “subparagraph (A) or (C)”; and
(3) by adding at the end the following new subparagraph:
“(C) Treatment of adjustments for certain higher
income individuals.–
“(i) In general.–Subparagraph (A) shall not
apply with respect to each dollar amount in
paragraph (3) of $500,000.
“(ii) <<NOTE: Time periods.>> Adjustment
beginning 2028.–In the case of any calendar year
beginning after 2027, each dollar amount in
paragraph (3) of $500,000 shall be increased by an
amount equal to–
“(I) such dollar amount, multiplied
by
“(II) the percentage (if any) by
which the average of the Consumer Price
Index for all urban consumers (United
States city average) for the 12-month
period ending with August of the
preceding calendar year exceeds such
average for the 12-month period ending
with August 2026.”.
SEC. 53115. MEDICARE IMPROVEMENT FUND.

Section 1898(b)(1) of the Social Security Act (42 U.S.C.
1395iii(b)(1)) is amended by striking “$220,000,000” and inserting
“$0”.
SEC. 53116. CLOSING THE DONUT HOLE FOR SENIORS.

(a) Closing Donut Hole Sooner.–Section 1860D-2(b)(2)(D) of the
Social Security Act (42 U.S.C. 1395w-102(b)(2)(D))–
(1) in clause (i), by amending subclause (I) to read as
follows:
“(I) equal to the difference
between–

[[Page 132 STAT. 307]]

“(aa) the applicable gap
percentage (specified in clause
(ii) for the year); and
“(bb) the discount
percentage specified in section
1860D-14A(g)(4)(A) for such
applicable drugs (or, in the
case of a year after 2018, 50
percent); or”; and
(2) in clause (ii)–
(A) in subclause (IV), by adding “and” at the end;
(B) by striking subclause (V); and
(C) in subclause (VI)–
(i) by striking “2020” and inserting
“2019”; and
(ii) by redesignating such subclause as
subclause (V).

(b) Lowering Discounted Price.–Section 1860D-14A(g)(4)(A) of the
Social Security Act (42 U.S.C. 1395w-114a(g)(4)(A)) is amended by
inserting “(or, with respect to a plan year after plan year 2018, 30
percent)” after “50 percent”.
SEC. 53117. MODERNIZING CHILD SUPPORT ENFORCEMENT FEES.

(a) In General.–Section 454(6)(B)(ii) of the Social Security Act
(42 U.S.C. 654(6)(B)(ii)) is amended–
(1) by striking “$25” and inserting “$35”; and
(2) by striking “$500” each place it appears and inserting
“$550”.

(b) <<NOTE: 42 USC 654 note.>> Effective Date.–
(1) <<NOTE: Applicability.>> In general.–The amendments
made by subsection (a) shall take effect on the 1st day of the
1st fiscal year that begins on or after the date of the
enactment of this Act, and shall apply to payments under part D
of title IV of the Social Security Act (42 U.S.C. 651 et seq.)
for calendar quarters beginning on or after such 1st day.
(2) <<NOTE: Determination.>> Delay permitted if state
legislation required.–If the Secretary of Health and Human
Services determines that State legislation (other than
legislation appropriating funds) is required in order for a
State plan developed pursuant to part D of title IV of the
Social Security Act (42 U.S.C. 651 et seq.) to meet the
requirements imposed by the amendment made by subsection (a),
the plan shall not be regarded as failing to meet such
requirements before the 1st day of the 1st calendar quarter
beginning after the first regular session of the State
legislature that begins after the date of the enactment of this
Act. <<NOTE: Time period.>> For purposes of the preceding
sentence, if the State has a 2-year legislative session, each
year of the session is deemed to be a separate regular session
of the State legislature.
SEC. 53118. INCREASING EFFICIENCY OF PRISON DATA REPORTING.

(a) In General.–Section 1611(e)(1)(I)(i)(II) of the Social Security
Act (42 U.S.C. 1382(e)(1)(I)(i)(II)) is amended by striking “30 days”
each place it appears and inserting “15 days”.
(b) <<NOTE: Applicability. 42 USC 1382 note.>> Effective Date.–The
amendments made by subsection (a) shall apply with respect to any
payment made by the Commissioner of Social Security pursuant to section
1611(e)(1)(I)(i)(II) of the Social Security Act (42 U.S.C.
1382(e)(1)(I)(i)(II)) (as amended by such subsection) on or after the
date that is 6 months after the date of enactment of this Act.

[[Page 132 STAT. 308]]

SEC. 53119. PREVENTION AND PUBLIC HEALTH FUND.

Section 4002(b) of the Patient Protection and Affordable Care Act
(42 U.S.C. 300u-11(b)), as amended by section 3103 of Public Law 115-96,
is amended by striking paragraphs (4) through (9) and inserting the
following:
“(4) for fiscal year 2019, $900,000,000;
“(5) for each of fiscal years 2020 and 2021, $950,000,000;
“(6) for each of fiscal years 2022 and 2023,
$1,000,000,000;
“(7) for each of fiscal years 2024 and 2025,
$1,300,000,000;
“(8) for each of fiscal years 2026 and 2027,
$1,800,000,000; and
“(9) for fiscal year 2028 and each fiscal year thereafter,
$2,000,000,000.”.

DIVISION F– <<NOTE: Improvements to Agriculture Programs Act of 2018. 7
USC 9011 note.>> IMPROVEMENTS TO AGRICULTURE PROGRAMS

Sec. 60101. (a) Treatment of Seed Cotton.–
(1) Designation of seed cotton as a covered commodity.–
Section 1111(6) of the Agricultural Act of 2014 (7 U.S.C.
9011(6)) is amended–
(A) by striking “The term” and inserting the
following:
“(A) In general.–The term”; and
(B) by adding at the end the following:
“(B) <<NOTE: Effective date.>> Inclusion.–
Effective beginning with the 2018 crop year, the term
`covered commodity’ includes seed cotton.”.
(2) Reference price for seed cotton.–Section 1111(18) of
the Agricultural Act of 2014 (7 U.S.C. 9011(18)) is amended by
adding at the end the following:
“(O) For seed cotton, $0.367 per pound.”.
(3) Definition of seed cotton.–Section 1111 of the
Agricultural Act of 2014 (7 U.S.C. 9011) is amended–
(A) by redesignating paragraphs (20) through (24) as
paragraphs (21) through (25), respectively; and
(B) by inserting after paragraph (19) the following:
“(20) Seed cotton.–The term `seed cotton’ means unginned
upland cotton that includes both lint and seed.”.
(4) Payment yield.–Section 1113 of the Agricultural Act of
2014 (7 U.S.C. 9013) is amended by adding at the end the
following:

“(e) Payment Yield for Seed Cotton.–
“(1) Payment yield.–Subject to paragraph (2), the payment
yield for seed cotton for a farm shall be equal to 2.4 times the
payment yield for upland cotton for the farm established under
section 1104(e)(3) of the Food, Conservation, and Energy Act of
2008 (7 U.S.C. 8714(e)(3)) (as in effect on September 30, 2013).
“(2) Update.–At the sole discretion of the owner of a farm
with a yield for upland cotton described in paragraph (1), the
owner of the farm shall have a 1-time opportunity to update the
payment yield for upland cotton for the farm, as provided in
subsection (d), for the purpose of calculating the payment yield
for seed cotton under paragraph (1).”.
(5) Payment acres.–Section 1114(b) of the Agricultural Act
of 2014 (7 U.S.C. 9014(b)) is amended by adding at the end the
following:

[[Page 132 STAT. 309]]

“(4) Seed cotton.–
“(A) <<NOTE: Deadline.>> In general.–Not later
than 90 days after the date of enactment of this
paragraph, the Secretary shall require the owner of a
farm to allocate all generic base acres on the farm
under subparagraph (B) or (C), or both.
“(B) No recent history of covered commodities.–In
the case of a farm on which no covered commodities
(including seed cotton) were planted or were prevented
from being planted at any time during the 2009 through
2016 crop years, the owner of such farm shall allocate
generic base acres on the farm to unassigned crop base
for which no payments may be made under section 1116 or
1117.
“(C) Recent history of covered commodities.–In the
case of a farm not described in subparagraph (B), the
owner of such farm shall allocate generic base acres on
the farm–
“(i) subject to subparagraph (D), to seed
cotton base acres in a quantity equal to the
greater of–
“(I) 80 percent of the generic base
acres on the farm; or
“(II) the average number of seed
cotton acres planted or prevented from
being planted on the farm during the
2009 through 2012 crop years (not to
exceed the total generic base acres on
the farm); or
“(ii) to base acres for covered commodities
(including seed cotton), by applying subparagraphs
(B), (D), (E), and (F) of section 1112(a)(3).
“(D) Treatment of residual generic base acres.–In
the case of a farm on which generic base acres are
allocated under subparagraph (C)(i), the residual
generic base acres shall be allocated to unassigned crop
base for which no payments may be made under section
1116 or 1117.
“(E) Effect of failure to allocate.–In the case of
a farm not described in subparagraph (B) for which the
owner of the farm fails to make an election under
subparagraph (C), the owner of the farm shall be deemed
to have elected to allocate all generic base acres in
accordance with subparagraph (C)(i).”.
(6) Recordkeeping regarding unassigned crop base.–Section
1114 of the Agricultural Act of 2014 (7 U.S.C. 9014) is amended
by adding at the end the following:

“(f) Unassigned Crop Base.–The Secretary shall maintain
information on generic base acres on a farm allocated as unassigned crop
base under subsection (b)(4).”.
(7) Special election period for price loss coverage or
agriculture risk coverage.–Section 1115 of the Agricultural Act
of 2014 (7 U.S.C. 9015) is amended–
(A) in subsection (a), by striking “For” and
inserting “Except as provided in subsection (g), for”;
and
(B) by adding at the end the following:

“(g) Special Election.–
“(1) In general.–In the case of acres allocated to seed
cotton on a farm, all of the producers on the farm shall be
given the opportunity to make a new 1-time election under

[[Page 132 STAT. 310]]

subsection (a) to reflect the designation of seed cotton as a
covered commodity for that crop year under section 1111(6)(B).
“(2) Effect of failure to make unanimous election.–If all
the producers on a farm fail to make a unanimous election under
paragraph (1), the producers on the farm shall be deemed to have
elected price loss coverage under section 1116 for acres
allocated on the farm to seed cotton.”.
(8) Effective price.–Section 1116 of the Agricultural Act
of 2014 (7 U.S.C. 9016) is amended by adding at the end the
following:

“(h) Effective Price for Seed Cotton.–
“(1) In general.–The effective price for seed cotton under
subsection (b) shall be equal to the marketing year average
price for seed cotton, as calculated under paragraph (2).
“(2) Calculation.–The marketing year average price for
seed cotton for a crop year shall be equal to the quotient
obtained by dividing–
“(A) the sum obtained by adding–
“(i) the product obtained by multiplying–
“(I) the upland cotton lint
marketing year average price; and
“(II) the total United States
upland cotton lint production, measured
in pounds; and
“(ii) the product obtained by multiplying–
“(I) the cottonseed marketing year
average price; and
“(II) the total United States
cottonseed production, measured in
pounds; by
“(B) the sum obtained by adding–
“(i) the total United States upland cotton
lint production, measured in pounds; and
“(ii) the total United States cottonseed
production, measured in pounds.”.
(9) Deemed loan rate for seed cotton.–Section 1202 of the
Agricultural Act of 2014 (7 U.S.C. 9032) is amended by adding at
the end the following:

“(c) Seed Cotton.–
“(1) In general.–For purposes of section 1116(b)(2) and
paragraphs (1)(B)(ii) and (2)(A)(ii)(II) of section 1117(b), the
loan rate for seed cotton shall be deemed to be equal to $0.25
per pound.
“(2) Effect.–Nothing in this subsection authorizes any
nonrecourse marketing assistance loan under this subtitle for
seed cotton.”.
(10) Limitation on stacked income protection plan for
producers of upland cotton.–Section 508B of the Federal Crop
Insurance Act (7 U.S.C. 1508b) is amended by adding at the end
the following:

“(f) <<NOTE: Effective date.>> Limitation.–Effective beginning
with the 2019 crop year, a farm shall not be eligible for the Stacked
Income Protection Plan for upland cotton for a crop year for which the
farm is enrolled in coverage for seed cotton under–
“(1) price loss coverage under section 1116 of the
Agricultural Act of 2014 (7 U.S.C. 9016); or
“(2) agriculture risk coverage under section 1117 of that
Act (7 U.S.C. 9017).”.

[[Page 132 STAT. 311]]

(11) Technical correction.–Section 1114(b)(2) of the
Agricultural Act of 2014 (7 U.S.C. 9014(b)(2)) is amended by
striking “paragraphs (1)(B) and (2)(B)” and inserting
“paragraphs (1) and (2)”.
(12) <<NOTE: 7 USC 9011 note.>> Administration.–The
Secretary of Agriculture shall carry out the amendments made by
this subsection in accordance with section 1601 of the
Agricultural Act of 2014 (7 U.S.C. 9091).
(13) <<NOTE: Applicability. Effective date. 7 USC 9011
note.>> Application.–Except as provided in paragraph (10), the
amendments made by this subsection shall apply beginning with
the 2018 crop year.

(b) Margin Protection Program for Dairy Producers.–
(1) Monthly calculation of actual dairy production margin.–
(A) Definitions.–Section 1401 of the Agricultural
Act of 2014 (7 U.S.C. 9051) is amended–
(i) by striking paragraph (4); and
(ii) by redesignating paragraphs (5) through
(11) as paragraphs (4) through (10), respectively.
(B) Calculation of actual dairy production margin.–
Section 1402(b)(1) of the Agricultural Act of 2014 (7
U.S.C. 9052(b)(1)) is amended by striking “consecutive
2-month period” each place it appears and inserting
“month”.
(C) Margin protection payments.–Section 1406 of the
Agricultural Act of 2014 (7 U.S.C. 9056) is amended–
(i) by striking “consecutive 2-month period”
each place it appears and inserting “month”; and
(ii) in subsection (c)(2)(B), by striking
“6” and inserting “12”.
(2) Participation of dairy operations in margin protection
program.–Section 1404 of the Agricultural Act of 2014 (7 U.S.C.
9054) is amended–
(A) in subsection (b)–
(i) in paragraph (1), by inserting “,
including the establishment of a date each
calendar year by which a dairy operation shall
register for the calendar year” before the period
at the end;
(ii) by redesignating paragraphs (2) and (3)
as paragraphs (3) and (4), respectively; and
(iii) by inserting after paragraph (1) the
following:
“(2) Extension of election period for 2018 calendar year.–
<<NOTE: Deadline. Determination.>> The Secretary shall extend
the election period for the 2018 calendar year by not less than
90 days after the date of enactment of the Bipartisan Budget Act
of 2018 or such additional period as the Secretary determines is
necessary for dairy operations to make new elections to
participate for that calendar year, including dairy operations
that elected to so participate before that date of enactment.”;
and
(B) in subsection (c), by adding at the end the
following:
“(4) Exemption.–A limited resource, beginning, veteran, or
socially disadvantaged farmer, as defined by the Secretary,
shall be exempt from the administrative fee under this
subsection.”.
(3) Production history of participating dairy operations.–
Section 1405(a) of the Agricultural Act of 2014 (7 U.S.C.
9055(a)) is amended by adding at the end the following:

[[Page 132 STAT. 312]]

“(3) Continued applicability of base production history.–A
production history established for a dairy operation under
paragraph (1) shall be the base production history for the dairy
operation in subsequent years (as adjusted under paragraph
(2)).”.
(4) Premiums for margin protection program.–Section 1407 of
the Agricultural Act of 2014 (7 U.S.C. 9057) is amended–
(A) in subsection (b)–
(i) by striking the subsection heading and
inserting the following: “Tier I: Premium Per
Hundredweight for First 5,000,000 Pounds of
Production.–”;
(ii) in paragraph (1), by striking
“4,000,000” and inserting “5,000,000”; and
(iii) in paragraph (2)–
(I) by striking “$0.010” and
inserting “None”;
(II) by striking “$0.025” and
inserting “None”;
(III) by striking “$0.040” and
inserting “$0.009”;
(IV) by striking “$0.055” and
inserting “$0.016”;
(V) by striking “$0.090” and
inserting “$0.040”;
(VI) by striking “$0.217” and
inserting “$0.063”;
(VII) by striking “$0.300” and
inserting “$0.087”; and
(VIII) by striking “$0.475” and
inserting “$0.142”; and
(B) in subsection (c)–
(i) by striking the subsection heading and
inserting the following: “Tier II: Premium Per
Hundredweight for Production in Excess of
5,000,000 Pounds.–”; and
(ii) in paragraph (1), by striking
“4,000,000” and inserting “5,000,000”.
(5) <<NOTE: 7 USC 9051 note.>> Application.–The amendments
made by this subsection shall apply beginning with the 2018
calendar year.

(c) Limitation on Crop Insurance Livestock-Related Expenditures.–
(1) In general.–Section 523(b) of the Federal Crop
Insurance Act (7 U.S.C. 1523(b)) is amended by striking
paragraph (10).
(2) Conforming amendments.–Section 516 of the Federal Crop
Insurance Act (7 U.S.C. 1516) is amended in subsections
(a)(2)(C) and (b)(1)(D) by striking “subsections (a)(3)(E)(ii)
and (b)(10) of section 523” each place it appears and inserting
“subsection (a)(3)(E)(ii) of that section”.

Sec. 60102. (a) Section 1240B of the Food Security Act of 1985 (16
U.S.C. 3839aa-2) is amended by striking subsection (a) and inserting the
following:
“(a) <<NOTE: Time period. Payments. Contracts.>> Establishment.–
During each of the 2002 through 2019 fiscal years, the Secretary shall
provide payments to producers that enter into contracts with the
Secretary under the program.”.

(b) Section 1241 of the Food Security Act of 1985 (16 U.S.C. 3841)
is amended–
(1) in subsection (a)–

[[Page 132 STAT. 313]]

(A) in the matter preceding paragraph (1), by
striking “2018” and inserting “2018 (and fiscal year
2019 in the case of the program specified in paragraph
(5))”; and
(B) in paragraph (5)(E), by striking “fiscal year
2018” and inserting “each of fiscal years 2018 through
2019”; and
(2) in subsection (b), by striking “2018” and inserting
“2018 (and fiscal year 2019 in the case of the program
specified in subsection (a)(5))”.

This division may be cited as the “Improvements to Agriculture
Programs Act of 2018”.

DIVISION G–BUDGETARY EFFECTS

SEC. 70101. BUDGETARY EFFECTS.

(a) In General.–The budgetary effects of division A, subdivision 2
of division B, and division C and each succeeding division shall not be
entered on either PAYGO scorecard maintained pursuant to section 4(d) of
the Statutory Pay-As-You-Go Act of 2010.
(b) Senate Paygo Scorecards.–The budgetary effects of division A,
subdivision 2 of division B, and division C and each succeeding division
shall not be entered on any PAYGO scorecard maintained for purposes of
section 4106 of H. Con. Res. 71 (115th Congress).
(c) Classification of Budgetary Effects.–Notwithstanding Rule 3 of
the Budget Scorekeeping Guidelines set forth in the joint explanatory
statement of the committee of conference accompanying Conference Report
105-217 and section 250(c)(8) of the Balanced Budget and Emergency
Deficit Control Act of 1985, the budgetary effects of division A,
subdivision 2 of division B, and division C and each succeeding division
shall not be estimated–
(1) for purposes of section 251 of such Act; and
(2) for purposes of paragraph (4)(C) of section 3 of the
Statutory Pay-As-You-Go Act of 2010 as being included in an
appropriation Act.

Approved February 9, 2018.

LEGISLATIVE HISTORY–H.R. 1892:
—————————————————————————

HOUSE REPORTS: No. 115-119 (Comm. on the Judiciary).
CONGRESSIONAL RECORD:
Vol. 163 (2017):
May 16, 18, considered and passed
House.
Nov. 28, considered and passed
Senate, amended.
Vol. 164 (2018):
Feb. 6, House concurred in Senate
amendment with an amendment.
Feb. 7, Senate considered concurring
in House amendment with an
amendment.
Feb. 8, Senate concurred in House
amendment with an amendment.
House concurred in Senate
amendment.

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