119-hr5371

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5371 Engrossed in House

    (EH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 5371

_______________________________________________________________________

 AN ACT

 Making continuing appropriations and extensions for fiscal year 2026, 
 and for other purposes.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Continuing Appropriations and 
Extensions Act, 2026''.

SEC. 2. TABLE OF CONTENTS.

 The table of contents for this Act is as follows:

Sec. 1. SHORT TITLE.

Sec. 2. TABLE OF CONTENTS.

Sec. 3. REFERENCES.
 DIVISION A--CONTINUING APPROPRIATIONS ACT, 2026

 DIVISION B--MISCELLANEOUS EXTENSIONS

 DIVISION C--HEALTH EXTENDERS

Title I--Public Health Extenders
Title II--Medicare
Title III--Human Services
Title IV--Medicaid
Title V--Food and Drug Administration
Title VI--No Surprises Act Implementation
 DIVISION D--DEPARTMENT OF VETERANS AFFAIRS EXTENDERS

Title I--Health Care Matters
Title II--Benefits
Title III--Housing
Title IV--Other Matters
 DIVISION E--MISCELLANEOUS

SEC. 3. REFERENCES.

 Except as expressly provided otherwise, any reference to ``this 
Act'' contained in any division of this Act shall be treated as 
referring only to the provisions of that division.

 DIVISION A--CONTINUING APPROPRIATIONS ACT, 2026

 The following sums are hereby appropriated, out of any money in 
the Treasury not otherwise appropriated, and out of applicable 
corporate or other revenues, receipts, and funds, for the several 
departments, agencies, corporations, and other organizational units of 
Government for fiscal year 2026, and for other purposes, namely:
 

Sec. 101. Such amounts as may be necessary, at a rate for 
operations as provided in the applicable appropriations Acts for fiscal 
year 2025 and under the authority and conditions provided in such Acts, 
for continuing projects or activities (including the costs of direct 
loans and loan guarantees) that are not otherwise specifically provided 
for in this Act, that were conducted in fiscal year 2025, and for which 
appropriations, funds, or other authority were made available in the 
Full-Year Continuing Appropriations Act, 2025 (division A of Public Law 
119-4), except sections 1110, 1113, 1114, and 1207; the proviso in 
paragraph

    (4) of 

section 1602; and sections 1708 and 1808; and except 

section 11104 shall be applied by substituting ``2020, and 2021'' for 
``and 2020''; and except sections 774 and 778 of division B, 

section 540 of division C, and sections 110 and 112 of division D of Public Law 
118-42 as continued in effect by 

section 1101 of division A of Public 
Law 119-4; and except 

section 7069

    (b) of division F of Public Law 118-
47, as continued in effect by 

section 1101 of division A of Public Law 
119-4.
 

Sec. 102.

    (a) No appropriation or funds made available or authority 
granted pursuant to 

section 101 for the Department of Defense shall be 
used for:

    (1) the new production of items not funded for production 
 in fiscal year 2025 or prior years;

    (2) the increase in production rates above those sustained 
 with fiscal year 2025 funds; or

    (3) the initiation, resumption, or continuation of any 
 project, activity, operation, or organization (defined as any 
 project, subproject, activity, budget activity, program 
 element, and subprogram within a program element, and for any 
 investment items defined as a P-1 line item in a budget 
 activity within an appropriation account and an R-1 line item 
 that includes a program element and subprogram element within 
 an appropriation account) for which appropriations, funds, or 
 other authority were not available during fiscal year 2025.

    (b) No appropriation or funds made available or authority granted 
pursuant to 

section 101 for the Department of Defense shall be used to 
initiate multi-year procurements utilizing advance procurement funding 
for economic order quantity procurement unless specifically 
appropriated later.
 

Sec. 103. Appropriations made by 

section 101 shall be available to 
the extent and in the manner that would be provided by the pertinent 
appropriations Act.
 

Sec. 104. Except as otherwise provided in 

section 102, no 
appropriation or funds made available or authority granted pursuant to 

section 101 shall be used to initiate or resume any project or activity 
for which appropriations, funds, or other authority were not available 
during fiscal year 2025.
 

Sec. 105. Appropriations made and authority granted pursuant to 
this Act shall cover all obligations or expenditures incurred for any 
project or activity during the period for which funds or authority for 
such project or activity are available under this Act.
 

Sec. 106. Unless otherwise provided for in this Act or in the 
applicable appropriations Act for fiscal year 2026, appropriations and 
funds made available and authority granted pursuant to this Act shall 
be available until whichever of the following first occurs:

    (1) The enactment into law of an appropriation for any 
 project or activity provided for in this Act.

    (2) The enactment into law of the applicable appropriations 
 Act for fiscal year 2026 without any provision for such project 
 or activity.

    (3) November 21, 2025.
 

Sec. 107. Expenditures made pursuant to this Act shall be charged 
to the applicable appropriation, fund, or authorization whenever a bill 
in which such applicable appropriation, fund, or authorization is 
contained is enacted into law.
 

Sec. 108. Appropriations made and funds made available by or 
authority granted pursuant to this Act may be used without regard to 
the time limitations for submission and approval of apportionments set 
forth in 

section 1513 of title 31, United States Code, but nothing in 
this Act may be construed to waive any other provision of law governing 
the apportionment of funds.
 

Sec. 109. Notwithstanding any other provision of this Act, except 

section 106, for those programs that would otherwise have high initial 
rates of operation or complete distribution of appropriations at the 
beginning of fiscal year 2026 because of distributions of funding to 
States, foreign countries, grantees, or others, such high initial rates 
of operation or complete distribution shall not be made, and no grants 
shall be awarded for such programs funded by this Act that would 
impinge on final funding prerogatives.
 

Sec. 110. This Act shall be implemented so that only the most 
limited funding action of that permitted in the Act shall be taken in 
order to provide for continuation of projects and activities.
 

Sec. 111.

    (a) For entitlements and other mandatory payments whose 
budget authority was provided in an appropriations Act specified in 

section 101, for expenses authorized under 

section 324 of title 38, 
United States Code, and for activities under the Food and Nutrition Act 
of 2008, activities shall be continued at the rate to maintain program 
levels under current law, under the authority and conditions provided 
in the applicable appropriations Act, to be continued through the date 
specified in 

section 106

    (3) of this Act.

    (b) Notwithstanding 

section 106, obligations for mandatory payments 
due on or about the first day of any month that begins after October 
2025 but not later than 30 days after the date specified in 

section 106

    (3) may continue to be made, and funds shall be available for such 
payments.
 

Sec. 112. Amounts made available under 

section 101 for civilian 
personnel compensation and benefits in each department and agency may 
be apportioned up to the rate for operations necessary to avoid 
furloughs within such department or agency, consistent with the 
applicable appropriations Act for fiscal year 2025, except that such 
authority provided under this section shall not be used until after the 
department or agency has taken all necessary actions to reduce or defer 
non-personnel-related administrative expenses.
 

Sec. 113. Funds appropriated by this Act may be obligated and 
expended notwithstanding 

section 10 of Public Law 91-672 (22 U.S.C. 
2412), 

section 15 of the State Department Basic Authorities Act of 1956 
(22 U.S.C. 2680), 

section 313 of the Foreign Relations Authorization 
Act, Fiscal Years 1994 and 1995 (22 U.S.C. 6212), and 

section 504

    (a)

    (1) of the National Security Act of 1947 (50 U.S.C. 3094

    (a)

    (1) ).
 

Sec. 114.

    (a)

    (1) For each amount incorporated by reference in this 
Act that was previously designated by the Congress as an emergency 
requirement pursuant to 

section 251

    (b)

    (2)
        (A)
            (i) of the Balanced Budget 
and Emergency Deficit Control Act of 1985, each provision of law 
designating each such amount as an emergency requirement pursuant to 
such section shall not apply.

    (2) Each amount incorporated by reference in this Act that 
 was designated by the Congress as an emergency requirement 
 pursuant to 

section 251

    (b)

    (2)
        (A)
            (i) of the Balanced Budget and 
 Emergency Deficit Control Act of 1985 in the following 
 provisions of law are designated by the Congress as an 
 emergency requirement pursuant to 

section 4001

    (a)

    (1) of S. Con. 
 Res. 14 (117th Congress), the concurrent resolution on the 
 budget for fiscal year 2022, and to legislation establishing 
 fiscal year 2026 budget enforcement in the House of 
 Representatives: 

section 11206

    (4) of division A of Public Law 
 119-4 and 7068

    (b) of division F of Public Law 118-47, as 
 continued in effect by 

section 1101 of division A of Public Law 
 119-4.

    (b) Each amount incorporated by reference in this Act that was 
previously designated by the Congress as being for disaster relief 
pursuant to 

section 251

    (b)

    (2)
            (D) of the Balanced Budget and Emergency 
Deficit Control Act of 1985 is designated by the Congress as being for 
disaster relief pursuant to a concurrent resolution on the budget.
            (c) Each amount incorporated by reference in this Act that was 
previously designated in division B of Public Law 117-159, division J 
of Public Law 117-58, or in 

section 443

    (b) of division G of Public Law 
117-328 by the Congress as an emergency requirement pursuant to a 
concurrent resolution on the budget shall continue to be treated as an 
amount specified in 

section 103

    (b) of division A of Public Law 118-5.
 

Sec. 115.

    (a) Rescissions or cancellations of discretionary budget 
authority that continue pursuant to 

section 101 in Treasury 
Appropriations Fund Symbols

    (TAFS) --

    (1) to which other appropriations are not provided by this 
 Act, but for which there is a current applicable TAFS that does 
 receive an appropriation in this Act; or

    (2) which are no-year TAFS and receive other appropriations 
 in this Act,
may be continued instead by reducing the rate for operations otherwise 
provided by 

section 101 for such current applicable TAFS, as long as 
doing so does not impinge on the final funding prerogatives of the 
Congress.

    (b) Rescissions or cancellations described in subsection

    (a) shall 
continue in an amount equal to the lesser of--

    (1) the amount specified for rescission or cancellation in 
 the applicable appropriations Act referenced in 

section 101 of 
 this Act; or

    (2) the amount of balances available, as of October 1, 
 2025, from the funds specified for rescission or cancellation 
 in the applicable appropriations Act referenced in 

section 101 
 of this Act.
            (c) No later than November 7, 2025, the Director of the Office of 
Management and Budget shall provide to the Committees on Appropriations 
of the House of Representatives and the Senate a comprehensive list of 
the rescissions or cancellations that will continue pursuant to 

section 101: Provided, That the information in such comprehensive list shall be 
periodically updated to reflect any subsequent changes in the amount of 
balances available, as of October 1, 2025, from the funds specified for 
rescission or cancellation in the applicable appropriations Act 
referenced in 

section 101, and such updates shall be transmitted to the 
Committees on Appropriations of the House of Representatives and the 
Senate upon request.
 

Sec. 116. Amounts made available by 

section 101 for ``Domestic 
Food Programs--Food and Nutrition Service--Special Supplemental 
Nutrition Program for Women, Infants, and Children

    (WIC) '' may be 
apportioned at the rate for operations necessary to maintain 
participation.
 

Sec. 117. 

Section 260 of the Agricultural Marketing Act of 1946 (7 
U.S.C. 1636i) and 

section 942 of the Livestock Mandatory Reporting Act 
of 1999 (7 U.S.C. 1635 note; Public Law 106-78) shall be applied by 
substituting the date specified in 

section 106 of this Act for 
``September 30, 2025''.
 

Sec. 118. 

Section 8302

    (b) of the Agricultural Act of 2014 (16 
U.S.C. 3851a

    (b) ) shall be applied by substituting the date specified in 

section 106 of this Act for ``October 1, 2023''.
 

Sec. 119.

    (a) Amounts made available by 

section 101 for 
``Department of Justice--United States Marshals Service--Salaries and 
Expenses'' may be apportioned up to the rate for operations necessary 
to maintain program operations.

    (b) In addition to amounts provided by 

section 101, for 
``Department of Justice--United States Marshals Service--Salaries and 
Expenses'', there is appropriated $30,000,000, for an additional amount 
for fiscal year 2026, to remain available until September 30, 2027, to 
carry out protective operations.
 

Sec. 120.

    (a) For the closeout of all Space Shuttle contracts and 
associated programs, amounts that have expired but have not been 
cancelled in the Exploration, Space Operations, Human Space Flight, 
Space Flight Capabilities, and Exploration Capabilities appropriations 
accounts shall remain available through fiscal year 2030 for the 
liquidation of valid obligations incurred during the period of fiscal 
year 2001 through fiscal year 2013.

    (b)

    (1) Subject to paragraph

    (2) , this section shall become 
effective immediately upon enactment of this Act.

    (2) If this Act is enacted after September 30, 2025, this 
 section shall be applied as if it were in effect on September 
 30, 2025.
 

Sec. 121. 

Section 3014

    (a) of title 18, United States Code, shall 
be applied by substituting the date specified in 

section 106 of this 
Act for ``September 30, 2025''.
 

Sec. 122. Notwithstanding 

section 101, the first proviso in each 
of sections 8092 and 8096 of title VIII of division A of Public Law 
118-47 shall be applied by substituting ``advances'' for 
``reimbursements''.
 

Sec. 123. Notwithstanding sections 102 and 104, amounts made 
available by 

section 101 to the Department of Defense for ``Research, 
Development, Test and Evaluation, Air Force'' shall be apportioned up 
to the rate for operations necessary for the E-7 Wedgetail program, in 
an amount not to exceed $199,676,000, only for the purpose of continued 
rapid prototyping activities to maintain program schedule and 
transition to production for the E-7 Wedgetail program.
 

Sec. 124. Of the unobligated balance of funds available to the 
Department of Defense for the E-7 program under the heading ``Aircraft 
Procurement, Air Force'' in Public Law 119-4, $200,000,000 is hereby 
transferred to and merged with amounts available for the E-7 program 
under the heading ``Research, Development, Test and Evaluation, Air 
Force'' only for the purpose of continued rapid prototyping activities 
to maintain program schedule and transition to production for the E-7 
Wedgetail program.
 

Sec. 125. 

Section 717

    (a) of the Defense Production Act of 1950 (50 
U.S.C. 4564

    (a) ) shall be applied by substituting the date specified in 

section 106 of this Act for ``September 30, 2025''.
 

Sec. 126. Notwithstanding sections 102 and 104, amounts made 
available by 

section 101 of this Act to the Department of Defense for 
``Shipbuilding and Conversion, Navy'' may be apportioned up to the rate 
for operations necessary to fund completion of prior year shipbuilding 
programs for the fiscal year 2016 and fiscal year 2018 Virginia Class 
Submarine Programs, in an amount not to exceed $154,000,000.
 

Sec. 127. During the period covered by this Act, 

section 103

    (f)

    (4)
        (A) of Public Law 108-361 (the Calfed Bay-Delta Authorization 
Act) shall be applied by substituting ``$32,600,000'' for 
``$30,000,000''.
 

Sec. 128.

    (a) Amounts made available by 

section 101 in the first 
proviso under the heading ``Department of Energy--Atomic Energy Defense 
Activities--National Nuclear Security Administration--Weapons 
Activities'' may be apportioned up to the rate for operations necessary 
to maintain current operations for the safe, secure transport of 
nuclear weapons.

    (b) The Director of the Office of Management and Budget and the 
Secretary of Energy shall notify the Committees on Appropriations of 
the House of Representatives and the Senate not later than 3 days after 
each use of the authority provided in subsection

    (a) .
 

Sec. 129. Notwithstanding 

section 101, the matter preceding the 
first proviso under the heading ``Office of Personnel Management--
Salaries and Expenses'' in title V of division B of Public Law 118-47 
shall be applied by substituting ``$197,446,000'' for ``$219,076,000'', 
and the second proviso under such heading in such title of such 
division of such Act shall be applied by substituting ``$214,605,000'' 
for ``$192,975,000''.
 

Sec. 130. Notwithstanding any other provision of this Act, except 

section 106, the District of Columbia may expend local funds made 
available under the heading ``District of Columbia--District of 
Columbia Funds'' for such programs and activities under the District of 
Columbia Appropriations Act, 2024 (title IV of division B of Public Law 
118-47) at the rate set forth in the Fiscal Year 2026 Local Budget Act 
of 2025 (D.C. Bill No. 26-260) as modified as of the date of enactment 
of this Act.
 

Sec. 131. Notwithstanding 

section 101, paragraph

    (1) under the 
heading ``Department of the Treasury--Departmental Offices--Salaries 
and Expenses'' in title I of division B of Public Law 118-47 shall be 
applied by substituting ``$1,350,000'' for ``$350,000'': Provided, 
That such amounts may be obligated in the account and budget structure 
set forth in the fiscal year 2026 President's Budget, submitted 
pursuant to 

section 1105

    (a) of title 31, United States Code, and 
accompanying justification materials.
 

Sec. 132. Amounts made available by 

section 101 for ``Small 
Business Administration--Business Loans Program Account'' may be 
apportioned up to the rate for operations necessary to accommodate 
increased demand for commitments for general business loans authorized 
under paragraphs

    (1) through

    (35) of 

section 7

    (a) of the Small Business 
Act (15 U.S.C. 636

    (a) ), for commitments to guarantee trust certificates 
authorized by 

section 5

    (g) of the Small Business Act (15 U.S.C. 
634

    (g) ), for commitments to guarantee loans under 

section 503 of the 
Small Business Investment Act of 1958 (15 U.S.C. 697), and for 
commitments to guarantee debentures under 

section 303

    (b) of the Small 
Business Investment Act of 1958 (15 U.S.C. 683

    (b) ).
 

Sec. 133. Notwithstanding 

section 101, amounts are provided for 
``Department of the Treasury--Office of Terrorism and Financial 
Intelligence--Salaries and Expenses'' at a rate for operations of 
$237,662,000.
 

Sec. 134. Notwithstanding 

section 101, 

section 1605 of Public Law 
119-4 shall be applied by substituting ``through the end of the last 
applicable pay period that commences on or before the date specified in 

section 106

    (3) of the Continuing Appropriations Act, 2026'' for 
``through the date specified in 

section 1106 of this Act''.
 

Sec. 135. 

Section 1

    (b) of Public Law 117-25 (135 Stat. 297; 136 
Stat. 2133; 136 Stat. 5984; 138 Stat. 1771; 139 Stat. 46) shall be 
applied in each of paragraphs

    (3) and

    (4) by substituting the date 
specified in 

section 106 of this Act for ``September 30, 2025''.
 

Sec. 136. In addition to amounts otherwise provided by 

section 101 
for ``The Judiciary--Supreme Court of the United States--Salaries and 
Expenses'', there is appropriated $28,000,000, for an additional amount 
for fiscal year 2026, to remain available until expended, for the 
protection of the Supreme Court Justices, including the purchase and 
hire of passenger motor vehicles as authorized by 31 U.S.C. 1343 and 
1344, to be expended as the Chief Justice may approve.
 

Sec. 137. 

Section 210G
            (i) of the Homeland Security Act of 2002 (6 
U.S.C. 124n
            (i) ) shall be applied by substituting the date specified in 

section 106 of this Act for ``September 30, 2025''.
 

Sec. 138. 

Section 225

    (e) of division A of Public Law 116-6 (49 
U.S.C. 44901 note) shall be applied by substituting ``fiscal year 2019 
through the date specified in 

section 106 of the Continuing 
Appropriations Act, 2026'' for ``fiscal years 2019 through 2025''.
 

Sec. 139. Amounts made available by 

section 101 to the Department 
of Homeland Security under the heading ``Federal Emergency Management 
Agency--Disaster Relief Fund'' may be apportioned up to the rate for 
operations necessary to carry out response and recovery activities 
under the Robert T. Stafford Disaster Relief and Emergency Assistance 
Act (42 U.S.C. 5121 et seq.).
 

Sec. 140. 

Section 227

    (a) of the Federal Cybersecurity Enhancement 
Act of 2015 (6 U.S.C. 1525

    (a) ) shall be applied by substituting the 
date specified in 

section 106 of this Act for ``September 30, 2025''.
 

Sec. 141. 

Section 111

    (a) of the Cybersecurity Information Sharing 
Act of 2015 (6 U.S.C. 1510

    (a) ) shall be applied by substituting the 
date specified in 

section 106 of this Act for ``September 30, 2025''.
 

Sec. 142. 

Section 2220A

    (s)

    (1) of the Homeland Security Act of 2002 
(6 U.S.C. 665g

    (s)

    (1) ) shall be applied by substituting the date 
specified in 

section 106 of this Act for ``September 30, 2025''.
 

Sec. 143. During the period covered by this Act, 

section 3

    (b)

    (2)
            (C) of the Pittman-Robertson Wildlife Restoration Act (16 U.S.C. 
669b

    (b)

    (2)
            (C) ) shall be applied by substituting ``2027'' for ``2026''.
 

Sec. 144. During the period covered by this Act, 

section 1701 of 
title VII of division B of Public Law 117-43, as amended, shall be 
applied by substituting ``calendar years 2021 through 2026'' for ``2021 
or 2022 or 2023 or 2024'' each place it appears.
 

Sec. 145. Amounts made available by 

section 101 for ``Department 
of the Interior--Department-Wide Programs--Wildland Fire Management'' 
and ``Department of Agriculture--Forest Service--Wildland Fire 
Management'' may be apportioned up to the rate for operations necessary 
for wildfire suppression activities.
 

Sec. 146.

    (a) In addition to amounts otherwise provided by 

section 101, amounts are provided for ``Department of Health and Human 
Services--Indian Health Service--Indian Health Services'' at a rate for 
operations of $72,265,000, for an additional amount for costs of 
staffing and operating facilities that were opened, renovated, or 
expanded in fiscal years 2025 and 2026, and such amounts may be 
apportioned up to the rate for operations necessary to staff and 
operate such facilities.

    (b) In addition to amounts otherwise provided by 

section 101, 
amounts are provided for ``Department of Health and Human Services--
Indian Health Service--Indian Health Facilities'' at a rate for 
operations of $8,050,000, for an additional amount for costs of 
staffing and operating facilities that were opened, renovated, or 
expanded in fiscal years 2025 and 2026, and such amounts may be 
apportioned up to the rate for operations necessary to staff and 
operate such facilities.
 

Sec. 147. Of the amounts made available in the third paragraph 
under the heading ``Environmental Protection Agency--State and Tribal 
Assistance Grants'' in the Disaster Relief Supplemental Appropriations 
Act, 2023 (division N of Public Law 117-328), up to $54,000,000 shall 
be available for technical assistance and grants under 

section 1442

    (b) of the Safe Drinking Water Act (42 U.S.C. 300j-1

    (b) ) in areas where the 
President declared an emergency in August of fiscal year 2022 pursuant 
to the Robert T. Stafford Disaster Relief and Emergency Assistance Act 
(42 U.S.C. 5121 et seq.): Provided, That amounts repurposed pursuant 
to this section that were previously designated by the Congress as 
being for an emergency requirement pursuant to 

section 4001

    (a)

    (1) of S. 
Con. Res 14 (117th Congress), the concurrent resolution on the budget 
for fiscal year 2022, and 

section 1

    (e) of H. Res. 1151 (117th 
Congress), as engrossed in the House of Representatives on June 8, 
2022, are designated as being for an emergency requirement pursuant to 

section 4001

    (a)

    (1) of S. Con. Res. 14 (117th Congress), the concurrent 
resolution on the budget for fiscal year 2022, and to legislation 
establishing fiscal year 2026 budget enforcement in the House of 
Representatives.
 

Sec. 148. Notwithstanding 

section 101, the matter under the 
heading ``Department of Health and Human Services--Administration for 
Children and Families--Children and Families Services Programs'' in 
title II of division D of Public Law 118-47 shall be applied by adding 
the following after the second proviso: ``Provided further, That for 
purposes of 

section 640

    (a)

    (2)
        (B)
            (v) of such Act, the base grant for 
each of the Federated States of Micronesia and the Republic of the 
Marshall Islands shall be $8,000,000, and shall be considered equal to 
the amount provided for base grants for such jurisdictions under such 
Act for the prior fiscal year:''.
 

Sec. 149. Notwithstanding any other provision of this Act, there 
is appropriated--

    (1) For payment to Ashley Paige Turner, heir of Sylvester 
 Turner, late a Representative from the State of Texas, 
 $174,000.

    (2) For payment to Ramona Grijalva, widow of Raul M. 
 Grijalva, late a Representative from the State of Arizona, 
 $174,000.

    (3) For payment to Catherine M. Smith, widow of Gerald E. 
 Connolly, late a Representative from the Commonwealth of 
 Virginia, $174,000.
 

Sec. 150. Notwithstanding any other provision of law, no 
adjustment shall be made under 

section 601

    (a) of the Legislative 
Reorganization Act of 1946 (2 U.S.C. 4501) (relating to cost of living 
adjustments for Members of Congress) during the period covered by this 
Act.
 

Sec. 151. In addition to amounts otherwise provided by 

section 101, for ``Capitol Police--United States Capitol Police Mutual Aid 
Reimbursements'', there is appropriated $30,000,000, for an additional 
amount for fiscal year 2026, to remain available until expended, for 
reimbursements for mutual aid and related training provided under the 
agreements described in 

section 7302 of Public Law 108-458: 
Provided,That obligation of the funds made available in this section in 
this Act shall be subject to notification to the Chairmen and Ranking 
Members of the Committees on Appropriations of both Houses of Congress, 
the Senate Committee on Rules and Administration, and the Committee on 
House Administration of the amount and purpose of the expense within 15 
days of obligation.
 

Sec. 152. Notwithstanding 

section 101, the matter under the 
heading ``Native American Veteran Housing Loan Program Account'' in 
title II of division A of Public Law 118-42 shall be applied by adding 
the following new paragraph:In addition, for the cost of direct loans, 
$6,865,235, as authorized by subchapter V of chapter 37 of title 38, 
United States Code: Provided, That such costs, including the cost of 
modifying such loans, shall be as defined in 

section 502 of the 
Congressional Budget Act of 1974: Provided further, That funds made 
available under this heading are available to subsidize gross 
obligations for the principal amount of direct loans not to exceed 
$75,000,000.''.
 

Sec. 153. 

Section 1424

    (a) of the Better Utilization of Investments 
Leading to Development Act of 2018 (22 U.S.C. 9624

    (a) ) shall be applied 
by substituting the date specified in 

section 106 of this Act for ``the 
date that is 7 years after the date of the enactment of this Act''.
 

Sec. 154. Notwithstanding sections 101 and 106, and sections 1101, 
1106, and 11201 of Public Law 119-4, the fifth and sixth provisos under 
the heading ``Millennium Challenge Corporation'' in title III of 
division F of Public Law 118-47 shall be amended by substituting 
``December 31, 2026'' for ``December 31, 2024'' each place it appears.
 

Sec. 155. Notwithstanding 

section 106, during fiscal year 2026, 
the Secretary of Housing and Urban Development may use the unobligated 
balances of amounts made available in prior fiscal years in paragraphs

    (2) ,

    (3) , and

    (8) under the heading ``Public and Indian Housing--
Tenant-Based Rental Assistance'' to support additional allocations 
under subparagraph
            (D) of paragraph

    (1) and subparagraph
        (B) of 
paragraph

    (4) of such heading to prevent the termination of rental 
assistance for families as the result of insufficient funding in the 
calendar year 2025 funding cycle: Provided,That amounts repurposed 
pursuant to this section that were previously designated by the 
Congress as an emergency requirement pursuant to a concurrent 
resolution on the budget or the Balanced Budget and Emergency Deficit 
Control Act of 1985 are designated by the Congress as being for an 
emergency requirement pursuant to 

section 4001

    (a)

    (1) of S. Con. Res. 14 
(117th Congress), the concurrent resolution on the budget for fiscal 
year 2022, and to legislation establishing fiscal year 2026 budget 
enforcement in the House of Representatives.
 

Sec. 156. Amounts made available by 

section 101 for ``Department 
of Transportation--Office of the Secretary--Payments to Air Carriers'' 
may be apportioned up to the rate for operations necessary to maintain 
Essential Air Service program operations.
 

Sec. 157. 

Section 4144
            (d) of the Motor Carrier Safety 
Reauthorization Act of 2005 (49 U.S.C. 31100 note) shall be applied by 
substituting the date specified in 

section 106 of this Act for 
``September 30, 2025''.
 This division may be cited as the ``Continuing Appropriations Act, 
2026''.

 DIVISION B--MISCELLANEOUS EXTENSIONS

SEC. 101. UNITED STATES GRAIN STANDARDS.

 The authorities (including any limitations on the authorities) 
provided by each provision of the United States Grain Standards Act 
(Public Law 90-487; 7 U.S.C. 74 et seq.) and each provision of law 
amended by that Act, as in effect on September 30, 2025, shall 
continue, and the authorities (and any such limitations) shall be 
carried out, until the later of--

    (1) November 21, 2025; and

    (2) the date specified in the provision of that Act or the 
 provision of law amended by that Act.

 DIVISION C--HEALTH EXTENDERS

 TITLE I--PUBLIC HEALTH EXTENDERS

SEC. 101. EXTENSION FOR COMMUNITY HEALTH CENTERS, NATIONAL HEALTH 
 SERVICE CORPS, AND TEACHING HEALTH CENTERS THAT OPERATE 
 GME PROGRAMS.

    (a) Extension for Community Health Centers.--

Section 10503

    (b)

    (1) of 
the Patient Protection and Affordable Care Act (42 U.S.C. 254b-2

    (b)

    (1) ) 
is amended--

    (1) in subparagraph
            (I) , by striking ``and'' at the end; 
 and

    (2) by adding at the end the following:
 ``
        (K) $606,904,110 for the period beginning on 
 October 1, 2025, and ending on November 21, 2025; 
 and''.

    (b) Extension for the National Health Service Corps.--

Section 10503

    (b)

    (2) of the Patient Protection and Affordable Care Act (42 
U.S.C. 254b-2

    (b)

    (2) ) is amended--

    (1) in subparagraph
        (J) , by striking ``and'' at the end;

    (2) in subparagraph
        (K) , by striking the period at the end 
 and inserting ``; and''; and

    (3) by adding at the end the following:
 ``
            (L) $49,150,685 for the period beginning on 
 October 1, 2025, and ending on November 21, 2025.''.
            (c) Teaching Health Centers That Operate Graduate Medical Education 
Programs.--

Section 340H

    (g)

    (1) of the Public Health Service Act (42 
U.S.C. 256h

    (g)

    (1) ) is amended--

    (1) in subparagraph
        (E) , by striking ``and'' at the end;

    (2) in subparagraph
        (F) , by striking the period at the end 
 and inserting ``; and''; and

    (3) by adding at the end the following:
 ``
        (G) $24,931,507 for the period beginning on 
 October 1, 2025, and ending on November 21, 2025.''.
            (d) Application of Provisions.--Amounts appropriated pursuant to 
the amendments made by this section shall be subject to the 
requirements contained in Public Law 117-328 for funds for programs 
authorized under sections 330 through 340 of the Public Health Service 
Act (42 U.S.C. 254b et seq.).

    (e) Conforming Amendment.--

Section 3014

    (h)

    (4) of title 18, United 
States Code, is amended by striking ``and 

section 2101
            (d) of division B 
of the Full-Year Continuing Appropriations and Extensions Act, 2025'' 
and inserting ``

section 2101
            (d) of division B of the Full-Year 
Continuing Appropriations and Extensions Act, 2025, and 

section 101
            (d) of title I of division C of the Continuing Appropriations and 
Extensions Act, 2026''.

SEC. 102. EXTENSION OF SPECIAL DIABETES PROGRAMS.

    (a) Extension of Special Diabetes Programs for Type I Diabetes.--

Section 330B

    (b)

    (2) of the Public Health Service Act (42 U.S.C. 254c-
2

    (b)

    (2) ) is amended--

    (1) in subparagraph
        (F) , by striking ``and'' at the end;

    (2) in subparagraph
        (G) , by striking the period at the end 
 and inserting ``; and''; and

    (3) by adding at the end the following:
 ``
        (H) $22,652,055 for the period beginning on 
 October 1, 2025, and ending on November 21, 2025, to 
 remain available until expended.''.

    (b) Extending Funding for Special Diabetes Programs for Indians.--

Section 330C
            (c) (2) of the Public Health Service Act (42 U.S.C. 254c-
3
            (c) (2) ) is amended--

    (1) in subparagraph
        (F) , by striking ``and'' at the end;

    (2) in subparagraph
        (G) , by striking the period at the end 
 and inserting ``; and''; and

    (3) by adding at the end the following:
 ``
        (H) $22,652,055 for the period beginning on 
 October 1, 2025, and ending on November 21, 2025, to 
 remain available until expended.''.

SEC. 103. NATIONAL HEALTH SECURITY EXTENSIONS.

    (a) Section 319

    (e)

    (8) of the Public Health Service Act (42 U.S.C. 
247d

    (e)

    (8) ) is amended by striking ``September 30, 2025'' and inserting 
``November 21, 2025''.

    (b) Section 319L

    (e)

    (1)
            (D) of the Public Health Service Act (42 
U.S.C. 247d-7e

    (e)

    (1)
            (D) ) is amended by striking ``September 30, 2025'' 
and inserting ``November 21, 2025''.
            (c) Section 319L-1

    (b) of the Public Health Service Act (42 U.S.C. 
247d-7f

    (b) ) is amended by striking ``September 30, 2025'' and inserting 
``November 21, 2025''.
            (d) (1) Section 2811A

    (g) of the Public Health Service Act (42 U.S.C. 
300hh-10b

    (g) ) is amended by striking ``September 30, 2025'' and 
inserting ``November 21, 2025''.

    (2) Section 2811B

    (g)

    (1) of the Public Health Service Act (42 U.S.C. 
300hh-10c

    (g)

    (1) ) is amended by striking ``September 30, 2025'' and 
inserting ``November 21, 2025''.

    (3) Section 2811C

    (g)

    (1) of the Public Health Service Act (42 U.S.C. 
300hh-10d

    (g)

    (1) ) is amended by striking ``September 30, 2025'' and 
inserting ``November 21, 2025''.

    (e) Section 2812
            (c) (4)
        (B) of the Public Health Service Act (42 
U.S.C. 300hh-11
            (c) (4)
        (B) ) is amended by striking ``September 30, 2025'' 
and inserting ``November 21, 2025''.

 TITLE II--MEDICARE

SEC. 201. EXTENSION OF INCREASED INPATIENT HOSPITAL PAYMENT ADJUSTMENT 
 FOR CERTAIN LOW-VOLUME HOSPITALS.

    (a) In General.--

Section 1886
            (d) (12) of the Social Security Act (42 
U.S.C. 1395ww
            (d) (12) ) is amended--

    (1) in subparagraph
        (B) , by striking ``in fiscal year 
 2026'' and inserting ``during the portion of fiscal year 2026 
 beginning on November 22, 2025, and ending on September 30, 
 2026, and in fiscal year 2027'';

    (2) in subparagraph
            (C) 
            (i) --
        (A) in the matter preceding subclause
            (I) --
            (i) by inserting ``or portion of a fiscal 
 year'' after ``for a fiscal year''; and
            (ii) by inserting ``and the portion of 
 fiscal year 2026 beginning on October 1, 2025, 
 and ending on November 21, 2025'' after 
 ``through 2025'';
        (B) in subclause
            (III) , by inserting ``and the 
 portion of fiscal year 2026 beginning on October 1, 
 2025, and ending on November 21, 2025'' after ``through 
 2025''; and
            (C) in subclause
            (IV) , by striking ``fiscal year 
 2026'' and inserting ``the portion of fiscal year 2026 
 beginning on November 22, 2025, and ending on September 
 30, 2026, and fiscal year 2027''; and

    (3) in subparagraph
            (D) --
        (A) in the matter preceding clause
            (i) , by 
 inserting ``or during the portion of fiscal year 2026 
 beginning on October 1, 2025, and ending on November 
 21, 2025'' after ``through 2025''; and
        (B) in clause
            (ii) , by inserting ``and the portion 
 of fiscal year 2026 beginning on October 1, 2025, and 
 ending on November 21, 2025'' after ``through 2025''.

    (b) Implementation.--Notwithstanding any other provision of law, 
the Secretary of Health and Human Services may implement the amendments 
made by this section by program instruction or otherwise.

SEC. 202. EXTENSION OF THE MEDICARE-DEPENDENT HOSPITAL

    (MDH) PROGRAM.

    (a) In General.--

Section 1886
            (d) (5)
        (G) of the Social Security Act 
(42 U.S.C. 1395ww
            (d) (5)
        (G) ) is amended--

    (1) in clause
            (i) , by striking ``October 1, 2025'' and 
 inserting ``November 22, 2025''; and

    (2) in clause
            (ii) 
            (II) , by striking ``October 1, 2025'' and 
 inserting ``November 22, 2025''.

    (b) Conforming Amendments.--

    (1) In general.--

Section 1886

    (b)

    (3)
            (D) of the Social 
 Security Act (42 U.S.C. 1395ww

    (b)

    (3)
            (D) ) is amended--
        (A) in the matter preceding clause
            (i) , by striking 
 ``October 1, 2025'' and inserting ``November 22, 
 2025''; and
        (B) in clause
            (iv) , by inserting ``and the portion 
 of fiscal year 2026 beginning on October 1, 2025, and 
 ending on November 21, 2025'' after ``through fiscal 
 year 2025''.

    (2) Permitting hospitals to decline reclassification.--
 

Section 13501

    (e)

    (2) of the Omnibus Budget Reconciliation Act of 
 1993 (42 U.S.C. 1395ww note) is amended by inserting ``, or the 
 portion of fiscal year 2026 beginning on October 1, 2025, and 
 ending on November 21, 2025'' after ``through fiscal year 
 2025''.

SEC. 203. EXTENSION OF ADD-ON PAYMENTS FOR AMBULANCE SERVICES.

 

Section 1834
            (l) of the Social Security Act (42 U.S.C. 1395m
            (l) ) is 
amended--

    (1) in paragraph

    (12)
        (A) , by striking ``October 1, 2025'' 
 and inserting ``November 22, 2025''; and

    (2) in paragraph

    (13) , by striking ``October 1, 2025'' each 
 place it appears and inserting ``November 22, 2025'' in each 
 such place.

SEC. 204. EXTENSION OF FUNDING FOR QUALITY MEASURE ENDORSEMENT, INPUT, 
 AND SELECTION.

 

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

    (1) in the first sentence, by striking ``September 30, 
 2025'' and inserting ``November 21, 2025''; and

    (2) in the third sentence, by striking ``September 30, 
 2025'' and inserting ``November 21, 2025''.

SEC. 205. EXTENSION OF FUNDING OUTREACH AND ASSISTANCE FOR LOW-INCOME 
 PROGRAMS.

    (a) State Health Insurance Assistance Programs.--Subsection

    (a)

    (1)
        (B)
            (xiv) of 

section 119 of the Medicare Improvements for Patients 
and Providers Act of 2008 (42 U.S.C. 1395b-3 note) is amended by 
striking ``September 30, 2025, $30,000,000'' and inserting ``November 
21, 2025, $32,136,986''.

    (b) Area Agencies on Aging.--Subsection

    (b)

    (1)
        (B)
            (xiv) of such 

section 119 is amended by striking ``September 30, 2025, $30,000,000'' 
and inserting ``November 21, 2025, $32,136,986''.
            (c) Aging and Disability Resource Centers.--Subsection
            (c) (1)
        (B)
            (xiv) of such 

section 119 is amended by striking ``September 
30, 2025, $10,000,000'' and inserting ``November 21, 2025, 
$10,712,329''.
            (d) Coordination of Efforts To Inform Older Americans About 
Benefits Available Under Federal and State Programs.--Subsection
            (d) (2)
            (xiv) of such 

section 119 is amended by striking ``September 30, 
2025, $30,000,000'' and inserting ``November 21, 2025, $32,136,986''.

SEC. 206. EXTENSION OF THE WORK GEOGRAPHIC INDEX FLOOR.

 

Section 1848

    (e)

    (1)
        (E) of the Social Security Act (42 U.S.C. 1395w-
4

    (e)

    (1)
        (E) ) is amended by striking ``October 1, 2025'' and inserting 
``November 22, 2025''.

SEC. 207. EXTENSION OF CERTAIN TELEHEALTH FLEXIBILITIES.

    (a) Removing Geographic Requirements and Expanding Originating 
Sites for Telehealth Services.--

Section 1834
            (m) of the Social Security 
Act (42 U.S.C. 1395m
            (m) ) is amended--

    (1) in paragraph

    (2)
        (B)
            (iii) , by striking ``ending 
 September 30, 2025'' and inserting ``ending November 21, 
 2025''; and

    (2) in paragraph

    (4)
            (C) 
            (iii) , by striking ``ending on 
 September 30, 2025'' and inserting ``ending on November 21, 
 2025''.

    (b) Expanding Practitioners Eligible To Furnish Telehealth 
Services.--

Section 1834
            (m) (4)
        (E) of the Social Security Act (42 U.S.C. 
1395m
            (m) (4)
        (E) ) is amended by striking ``ending on September 30, 2025'' 
and inserting ``ending on November 21, 2025''.
            (c) Extending Telehealth Services for Federally Qualified Health 
Centers and Rural Health Clinics.--

Section 1834
            (m) (8)
        (A) of the Social 
Security Act (42 U.S.C. 1395m
            (m) (8)
        (A) ) is amended by striking ``ending 
on September 30, 2025'' and inserting ``ending on November 21, 2025''.
            (d) Delaying the In-Person Requirements Under Medicare for Mental 
Health Services Furnished Through Telehealth and Telecommunications 
Technology.--

    (1) Delay in requirements for mental health services 
 furnished through telehealth.--

Section 1834
            (m) (7)
        (B)
            (i) of the 
 Social Security Act (42 U.S.C. 1395m
            (m) (7)
        (B)
            (i) ) is amended, 
 in the matter preceding subclause
            (I) , by striking ``on or 
 after October 1, 2025'' and inserting ``on or after November 
 22, 2025''.

    (2) Mental health visits furnished by rural health 
 clinics.--

Section 1834

    (y)

    (2) of the Social Security Act (42 
 U.S.C. 1395m

    (y)

    (2) ) is amended by striking ``October 1, 2025'' 
 and inserting ``November 22, 2025''.

    (3) Mental health visits furnished by federally qualified 
 health centers.--

Section 1834

    (o)

    (4)
        (B) of the Social Security 
 Act (42 U.S.C. 1395m

    (o)

    (4)
        (B) ) is amended by striking ``October 
 1, 2025'' and inserting ``November 22, 2025''.

    (e) Allowing for the Furnishing of Audio-Only Telehealth 
Services.--

Section 1834
            (m) (9) of the Social Security Act (42 U.S.C. 
1395m
            (m) (9) ) is amended by striking ``ending on September 30, 2025'' 
and inserting ``ending on November 21, 2025''.

    (f) Extending Use of Telehealth To Conduct Face-to-Face Encounter 
Prior to Recertification of Eligibility for Hospice Care.--

Section 1814

    (a)

    (7)
            (D) 
            (i) 
            (II) of the Social Security Act (42 U.S.C. 
1395f

    (a)

    (7)
            (D) 
            (i) 
            (II) ) is amended by striking ``ending on September 30, 
2025'' and inserting ``ending on November 21, 2025''.

    (g) Program Instruction Authority.--The Secretary of Health and 
Human Services may implement the amendments made by this section 
through program instruction or otherwise.

SEC. 208. EXTENDING ACUTE HOSPITAL CARE AT HOME WAIVER AUTHORITIES.

 

Section 1866G

    (a)

    (1) of the Social Security Act (42 U.S.C. 1395cc-
7

    (a)

    (1) ) is amended by striking ``September 30, 2025'' and inserting 
``November 21, 2025''.

SEC. 209. EXTENSION OF TEMPORARY INCLUSION OF AUTHORIZED ORAL ANTIVIRAL 
 DRUGS AS COVERED PART D DRUGS.

 

Section 1860D-2

    (e)

    (1)
            (C) of the Social Security Act (42 U.S.C. 
1395w-102

    (e)

    (1)
            (C) ) is amended by striking ``September 30, 2025'' and 
inserting ``November 21, 2025''.

SEC. 210. EXTENSION OF FUNDING FOR MEDICARE HOSPICE SURVEYS.

 

Section 3

    (a)

    (2) of the IMPACT Act of 2014 (Public Law 113-185) is 
amended--

    (1) in subparagraph
        (A) , by striking ``and'' at the end;

    (2) in subparagraph
        (B) , by striking the period at the end 
 and inserting ``; and''; and

    (3) by adding at the end the following new subparagraph:
 ``
            (C) $6,000,000 for the period beginning on 
 October 1, 2025, and ending on November 21, 2025.''.

SEC. 211. MEDICARE IMPROVEMENT FUND.

 

Section 1898

    (b)

    (1) of the Social Security Act (42 U.S.C. 
1395iii

    (b)

    (1) ) is amended--

    (1) by striking ``fiscal year 2026'' and inserting ``fiscal 
 year 2027''; and

    (2) by striking ``$1,804,000,000'' and inserting 
 ``$664,000,000''.

 TITLE III--HUMAN SERVICES

SEC. 301. SEXUAL RISK AVOIDANCE EDUCATION EXTENSION.

 

Section 510 of the Social Security Act (42 U.S.C. 710) is amended--

    (1) in subsection

    (a) --
        (A) in paragraph

    (1) --
            (i) by striking ``2023, for the period 
 beginning on October 1, 2023, and ending on 
 November 17, 2023, for the period beginning on 
 November 18, 2023, and ending on January 19, 
 2024, for the period beginning on January 20, 
 2024, and ending on March 8, 2024, for the 
 period beginning on March 9, 2024, and ending 
 on September 30, 2024, and for fiscal year 
 2025'' and inserting ``2025, and for the period 
 beginning on October 1, 2025, and ending on 
 November 21, 2025''; and
            (ii) by striking ``fiscal year 2024'' and 
 inserting ``fiscal year 2026''; and
        (B) in paragraph

    (2) --
            (i) in subparagraph
        (A) --
            (I) by striking ``through 2023'' 
 and inserting ``through 2025'';
            (II) by striking ``fiscal year 2024 
 or 2025'' and inserting ``fiscal year 
 2026''; and
            (III) by inserting ``(or, with 
 respect to the applicable period, for 
 fiscal year 2026)'' after ``an 
 application for the fiscal year''; and
            (ii) in subparagraph
        (B)
            (i) , by striking 
 ``2024 or 2025'' and inserting ``2026''; and

    (2) in subsection

    (f)

    (1) by striking ``2023, for the period 
 beginning on October 1, 2023, and ending on November 17, 2023, 
 an amount equal to the pro rata portion of the amount 
 appropriated for the corresponding period for fiscal year 2023, 
 for the period beginning on November 18, 2023, and ending on 
 January 19, 2024, an amount equal to the pro rata portion of 
 the amount appropriated for the corresponding period for fiscal 
 year 2023, for the period beginning on January 20, 2024, and 
 ending on March 8, 2024, an amount equal to the pro rata 
 portion of the amount appropriated for the period at the end of 
 the corresponding sentence for fiscal year 2023, for the period 
 beginning on March 9, 2024, and ending on September 30, 2024, 
 an amount equal to the pro rata portion of the amount 
 appropriated for the corresponding period for fiscal year 2023, 
 and for fiscal year 2025, an amount equal to the amount 
 appropriated for fiscal year 2024'' and inserting ``2025, and 
 for the period beginning on October 1, 2025, and ending on 
 November 21, 2025, an amount equal to the pro rata portion of 
 the amount appropriated for the corresponding period for fiscal 
 year 2025''.

SEC. 302. PERSONAL RESPONSIBILITY EDUCATION EXTENSION.

 

Section 513 of the Social Security Act (42 U.S.C. 713) is amended--

    (1) in subsection

    (a)

    (1) --
        (A) in subparagraph
        (A) , in the matter preceding 
 clause
            (i) , by striking ``2023, for the period 
 beginning on October 1, 2023, and ending on November 
 17, 2023, for the period beginning on November 18, 
 2023, and ending on January 19, 2024, for the period 
 beginning on January 20, 2024, and ending on March 8, 
 2024, for the period beginning on March 9, 2024, and 
 ending on September 30, 2024, and for fiscal year 
 2025'' and inserting ``2025, and for the period 
 beginning on October 1, 2025, and ending on November 
 21, 2025''; and
        (B) in subparagraph
        (B)
            (i) , by striking ``the 
 period beginning on October 1, 2023, and ending on 
 November 17, 2023, for the period beginning on November 
 18, 2023, and ending on January 19, 2024, for the 
 period beginning on January 20, 2024, and ending on 
 March 8, 2024, for the period beginning on March 9, 
 2024, and ending on September 30, 2024, and for fiscal 
 year 2025'' and inserting ``fiscal years 2024 and 2025, 
 and for the period beginning on October 1, 2025, and 
 ending on November 21, 2025'';

    (2) in subsection
            (c) (3) , by striking ``2024 or 2025'' and 
 inserting ``2026''; and

    (3) in subsection

    (f) , by striking ``2023, for the period 
 beginning on October 1, 2023, and ending on November 17, 2023, 
 an amount equal to the pro rata portion of the amount 
 appropriated for the corresponding period for fiscal year 2023, 
 for the period beginning on November 18, 2023, and ending on 
 January 19, 2024, an amount equal to the pro rata portion of 
 the amount appropriated for the corresponding period for fiscal 
 year 2023, for the period beginning on January 20, 2024, and 
 ending on March 8, 2024, an amount equal to the pro rata 
 portion of the amount appropriated for the corresponding period 
 for fiscal year 2023, for the period beginning on March 9, 
 2024, and ending on September 30, 2024, an amount equal to the 
 pro rata portion of the amount appropriated for the 
 corresponding period for fiscal year 2023, and for fiscal year 
 2025, an amount equal to the amount appropriated for fiscal 
 year 2024 for fiscal year 2024'' and inserting ``2025, and for 
 the period beginning on October 1, 2025, and ending on November 
 21, 2025, an amount equal to the pro rata portion of the amount 
 appropriated for the corresponding period for fiscal year 
 2025''.

SEC. 303. EXTENSION OF FUNDING FOR FAMILY-TO-FAMILY HEALTH INFORMATION 
 CENTERS.

 

Section 501
            (c) (1)
        (A) of the Social Security Act (42 U.S.C. 
701
            (c) (1)
        (A) ) is amended--

    (1) in clause
            (vii) , by striking ``and'' at the end;

    (2) in clause
            (viii) , by adding ``; and'' at the end; and

    (3) by adding at the end the following new clause:
 ``
            (ix) $854,795 for the portion of fiscal year 2026 
 beginning on October 1, 2025, and ending on November 21, 
 2025.''.

 TITLE IV--MEDICAID

SEC. 401. MODIFYING CERTAIN DISPROPORTIONATE SHARE HOSPITAL ALLOTMENTS.

    (a) Extending Tennessee DSH Allotments.--

Section 1923

    (f)

    (6)
        (A)
            (vi) of the Social Security Act (42 U.S.C. 1396r-4

    (f)

    (6)
        (A)
            (vi) ) is 
amended--

    (1) in the heading, by inserting ``and a portion of fiscal 
 year 2026'' after ``2025''; and

    (2) by inserting ``, and the DSH allotment for Tennessee 
 for the portion of fiscal year 2026 beginning October 1, 2025, 
 and ending November 21, 2025, shall be $7,564,932'' before the 
 period.

    (b) Delaying DSH Allotment Reductions.--

Section 1923

    (f) of the 
Social Security Act (42 U.S.C. 1396r-4

    (f) ) is amended--

    (1) in paragraph

    (7)
        (A) --
        (A) in clause
            (i) --
            (i) in the matter preceding subclause
            (I) , 
 by striking ``For each of fiscal years 2026 
 through 2028'' and inserting ``For the period 
 beginning November 22, 2025, and ending 
 September 30, 2026, and for each of fiscal 
 years 2027 and 2028'';
            (ii) in subclause
            (I) , by inserting ``or 
 period'' after ``the fiscal year''; and
            (iii) in subclause
            (II) , by inserting ``or 
 period'' after ``in the fiscal year''; and
        (B) in clause
            (ii) , by striking ``for each of 
 fiscal years 2026 through 2028'' and inserting ``for 
 the period beginning November 22, 2025, and ending 
 September 30, 2026, and for each of fiscal years 2027 
 and 2028''; and

    (2) in paragraph

    (8) , by striking ``2027'' and inserting 
 ``2028''.

 TITLE V--FOOD AND DRUG ADMINISTRATION

SEC. 501. SHORT TITLE.

 This title may be cited as the ``Over-the-Counter Monograph Drug 
User Fee Amendments''.

SEC. 502. FINDING.

 Congress finds that the fees authorized by the amendments made in 
this title will be dedicated to over-the-counter

    (OTC) monograph drug 
activities, as set forth in the goals identified for purposes of part 
10 of subchapter C of chapter VII of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 379j-71 et seq.), in the letters from the 
Secretary of Health and Human Services to the Chairman of the Committee 
on Energy and Commerce of the House of Representatives and the Chairman 
of the Committee on Health, Education, Labor, and Pensions of the 
Senate, as set forth in the Congressional Record.

SEC. 503. DEFINITIONS.

 

Section 744L

    (9)
        (A) of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 379j-71

    (9)
        (A) ) is amended--

    (1) in clause
            (v) , by striking ``; or'' and inserting a 
 semicolon;

    (2) in clause
            (vi) --
        (A) by striking ``addition'' and inserting ``the 
 addition''; and
        (B) by striking the period and inserting ``; or''; 
 and

    (3) by adding at the end the following:
 ``
            (vii) the addition or modification of a testing 
 procedure applicable to one or more OTC monograph 
 drugs, provided that such additional or modified 
 testing procedure reflects a voluntary consensus 
 standard with respect to pharmaceutical quality that 
 is--
 ``
            (I) established by a national or 
 international standards development 
 organization; and
 ``
            (II) recognized by the Secretary through 
 a process described in guidance for industry, 
 initially published in July 2023, or any 
 successor guidance, publicly available on the 
 website of the Food and Drug Administration, 
 which addresses voluntary consensus standards 
 for pharmaceutical quality.''.

SEC. 504. AUTHORITY TO ASSESS AND USE OTC MONOGRAPH FEES.

    (a) Types of Fees.--

Section 744M

    (a)

    (1) of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 379j-72

    (a)

    (1) ) is amended--

    (1) in subparagraph
        (A) --
        (A) by striking ``on December 31 of the fiscal year 
 or at any time during the preceding 12-month period'' 
 and inserting ``at any time during the applicable 
 period specified in clause
            (ii) for a fiscal year'';
        (B) by striking ``Each person'' and inserting the 
 following:
 ``
            (i) Assessment of fees.--Each person''; 
 and
            (C) by adding at the end the following:
 ``
            (ii) Applicable period.--For purposes of 
 clause
            (i) , the applicable period is--
 ``
            (I) for fiscal year 2026, the 12-
 month period ending on December 31, 
 2025;
 ``
            (II) for fiscal year 2027, the 9-
 month period ending on September 30, 
 2026; and
 ``
            (III) for fiscal year 2028 and 
 each subsequent fiscal year, the 12-
 month period ending on September 30 of 
 the preceding fiscal year.'';

    (2) in subparagraph
        (B)
            (i) , by amending subclause
            (I) to 
 read as follows:
 ``
            (I) has ceased all activities 
 related to OTC monograph drugs prior 
 to--
 ``

    (aa) for purposes of 
 fiscal year 2026, January 1, 
 2025;
 ``

    (bb) for purposes of 
 fiscal year 2027, January 1, 
 2026; and
 ``
            (cc) for purposes of 
 fiscal year 2028 and each 
 subsequent fiscal year, October 
 1 of the preceding fiscal year; 
 and''; and

    (3) by amending subparagraph
            (D) to read as follows:
 ``
            (D) Due date.--
 ``
            (i) Fiscal year 2026.--For fiscal year 
 2026, the facility fees required under 
 subparagraph
        (A) shall be due on the later of--
 ``
            (I) the first business day of 
 June of such year; or
 ``
            (II) the first business day after 
 the enactment of an appropriations Act 
 providing for the collection and 
 obligation of fees under this section 
 for such year.
 ``
            (ii) Fiscal year 2027.--For fiscal year 
 2027, the facility fees required under 
 subparagraph
        (A) shall be due--
 ``
            (I) in a first installment 
 representing 50 percent of such fee, on 
 the later of--
 ``

    (aa) October 1, 2026; or
 ``

    (bb) the first business 
 day after the enactment of an 
 appropriations Act providing 
 for the collection and 
 obligation of fees under this 
 section for such year; and
 ``
            (II) in a second installment 
 representing the remaining 50 percent 
 of such fee, on--
 ``

    (aa) February 1, 2027; or
 ``

    (bb) if an appropriations 
 Act described in subclause
            (I) (bb) is not in effect on 
 February 1, 2027, the first 
 business day after enactment of 
 such an appropriations Act.
 ``
            (iii) Subsequent fiscal years.--For 
 fiscal year 2028 and each subsequent fiscal 
 year, the facility fees required under 
 subparagraph
        (A) shall be due on the later of--
 ``
            (I) the first business day on or 
 after October 1 of the fiscal year; or
 ``
            (II) the first business day after 
 the date of enactment of an 
 appropriations Act providing for the 
 collection and obligation of fees under 
 this section for the fiscal year.''.

    (b) Fee Revenue Amounts.--

Section 744M

    (b) of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 379j-72

    (b) ) is amended to read as 
follows:
 ``

    (b) Fee Revenue Amounts.--
 ``

    (1) In general.--For each of the fiscal years 2026 
 through 2030, fees under subsection

    (a)

    (1) shall be established 
 to generate a total facility fee revenue amount equal to the 
 sum of--
 ``
        (A) the annual base revenue for the fiscal year 
 (as determined under paragraph

    (2) );
 ``
        (B) the dollar amount equal to the inflation 
 adjustment for the fiscal year (as determined under 
 subsection
            (c) (1) );
 ``
            (C) the dollar amount equal to the operating 
 reserve adjustment for the fiscal year, if applicable 
 (as determined under subsection
            (c) (2) );
 ``
            (D) additional direct cost adjustments (as 
 determined under subsection
            (c) (3) );
 ``
        (E) an additional dollar amount equal to--
 ``
            (i) $2,373,000 for fiscal year 2026;
 ``
            (ii) $1,233,000 for fiscal year 2027; and
 ``
            (iii) $854,000 for fiscal year 2028; and
 ``
        (F) in the case of a fiscal year for which the 
 Secretary applies the one-time facility fee workload 
 adjustment under subsection
            (c) (4) , the dollar amount 
 equal to such adjustment.
 ``

    (2) Annual base revenue.--For purposes of paragraph

    (1) , 
 the dollar amount of the annual base revenue for a fiscal year 
 shall be--
 ``
        (A) for fiscal year 2026, the dollar amount of 
 the total revenue amount established for fiscal year 
 2025 under this subsection as in effect on the day 
 before the date of enactment of the Over-the-Counter 
 Monograph Drug User Fee Amendments, not including any 
 adjustments made for such fiscal year 2025 under 
 subsection
            (c) (2) , as so in effect; and
 ``
        (B) for fiscal years 2027 through 2030, the 
 dollar amount of the total revenue amount established 
 under this subsection for the previous fiscal year, not 
 including any adjustments made for such previous fiscal 
 year under subsection
            (c) (2) or
            (c) (3) .''.
            (c) Adjustments; Annual Fee Setting.--

Section 744M
            (c) of the 
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-72
            (c) ) is 
amended--

    (1) in paragraph

    (1) --
        (A) in subparagraph
        (A) , in the matter preceding 
 clause
            (i) --
            (i) by striking ``subsection

    (b)

    (2)
        (B) '' 
 and inserting ``subsection

    (b)

    (1)
        (B) ''; and
            (ii) by striking ``fiscal year 2022 and 
 each subsequent fiscal year'' and inserting 
 ``each fiscal year'';
        (B) in subparagraph
        (B) , by striking ``fiscal year 
 2022'' and all that follows through the period at the 
 end and inserting the following: ``a fiscal year shall 
 be equal to the product of--
 ``
            (i) for fiscal year 2026--
 ``
            (I) the fee for fiscal year 2025 
 under subsection

    (a)

    (2) ; and
 ``
            (II) the inflation adjustment 
 percentage under subparagraph
            (C) ; and
 ``
            (ii) for each of fiscal years 2027 
 through 2030--
 ``
            (I) the applicable fee under 
 subsection

    (a)

    (2) for the preceding 
 fiscal year; and
 ``
            (II) the inflation adjustment 
 percentage under subparagraph
            (C) .''; 
 and
            (C) in subparagraph
            (C) --
            (i) in the matter preceding clause
            (i) , by 
 inserting ``the sum of'' after ``is equal to'';
            (ii) by striking clause
            (i) ;
            (iii) by redesignating subclauses
            (I) and
            (II) of clause
            (ii) as clauses
            (i) and
            (ii) , 
 respectively, and adjusting the margins 
 accordingly;
            (iv) by striking ``
            (ii) for each of fiscal 
 years 2024 and 2025, the sum of--''; and
            (v) in clause
            (ii) , as so redesignated, by 
 striking ``Washington-Baltimore, DC-MD-VA-WV'' 
 and inserting ``Washington-Arlington-
 Alexandria-DC-VA-MD-WV'';

    (2) in paragraph

    (2) --
        (A) in subparagraph
        (A) --
            (i) by striking ``fiscal year 2021 and 
 subsequent fiscal years'' and inserting ``each 
 fiscal year'';
            (ii) by striking ``subsections

    (b)

    (1)
        (B) and

    (b)

    (2)
            (C) '' and inserting ``subsection

    (b)

    (1)
            (C) ''; and
            (iii) by striking ``the number of weeks 
 specified in subparagraph
        (B) '' and inserting 
 ``10 weeks'';
        (B) by striking subparagraph
        (B) ;
            (C) by redesignating subparagraphs
            (C) and
            (D) as 
 subparagraphs
        (B) and
            (C) , respectively; and
            (D) in subparagraph
            (C) , as so redesignated, by 
 striking ``paragraph

    (4) establishing'' and inserting 
 ``paragraph

    (5) publishing'';

    (3) in paragraph

    (3) --
        (A) in the matter preceding subparagraph
        (A) , by 
 striking ``subsection

    (b)

    (2)
            (D) '' and inserting 
 ``subsection

    (b)

    (1)
            (D) ''; and
        (B) by striking subparagraphs
        (A) through
        (E) and 
 inserting the following:
 ``
        (A) $135,000 for fiscal year 2026;
 ``
        (B) $300,000 for fiscal year 2027;
 ``
            (C) $55,000 for fiscal year 2028;
 ``
            (D) $30,000 for fiscal year 2029; and
 ``
        (E) $0 for fiscal year 2030.''; and

    (4) by striking paragraph

    (4) and inserting the following:
 ``

    (4) One-time facility fee workload adjustment.--
 ``
        (A) In general.--In addition to the adjustments 
 under paragraphs

    (1) ,

    (2) , and

    (3) , the Secretary may 
 further increase the fee revenues and fees through a 
 one-time adjustment made for fiscal year 2028, 2029, or 
 2030, in accordance with this paragraph.
 ``
        (B) Adjustment described.--
 ``
            (i) Conditions for adjustment.--An 
 adjustment under this paragraph may be made for 
 a fiscal year only if--
 ``
            (I) an adjustment under this 
 paragraph had not been made for any 
 prior fiscal year;
 ``
            (II) the average number of OTC 
 monograph drug facilities subject to a 
 facility fee under subsection

    (a)

    (1) over the period of the preceding 3 
 fiscal years exceeds 1,625; and
 ``
            (III) with respect to facilities 
 described in subclause
            (II) , the 
 average number of such facilities 
 (expressed as a percentage) that 
 appeared on the arrears lists pursuant 
 to subsection

    (e)

    (1)
        (A)
            (i) over the 
 period of the preceding 3 fiscal years 
 is less than 30 percent.
 ``
            (ii) Amount of adjustment.--An adjustment 
 under this paragraph for a fiscal year shall 
 equal the product of--
 ``
            (I) the total facility revenue 
 amount determined under subsection

    (b) for the fiscal year, exclusive of the 
 adjustment under this paragraph for 
 such fiscal year; and
 ``
            (II) the excess facility 
 percentage described in clause
            (iii) .
 ``
            (iii) Excess facility percentage.--The 
 excess facility percentage described in this 
 clause is--
 ``
            (I) the amount by which the 
 average number of OTC monograph drug 
 facilities subject to a facility fee 
 under subsection

    (a)

    (1) over the 
 preceding 3 fiscal years exceeds 1,625; 
 divided by
 ``
            (II) 1,625.
 ``

    (5) Annual fee setting.--The Secretary shall, not later 
 than 60 days before the first day of each fiscal year--
 ``
        (A) establish for such fiscal year, based on the 
 revenue amounts under subsection

    (b) and the 
 adjustments provided under this subsection--
 ``
            (i) OTC monograph drug facility fees 
 under subsection

    (a)

    (1) ; and
 ``
            (ii) OTC monograph order request fees 
 under subsection

    (a)

    (2) ; and
 ``
        (B) publish such fee revenue amounts, facility 
 fees, and OTC monograph order request fees in the 
 Federal Register.''.
            (d) Crediting and Availability of Fees.--

Section 744M

    (f) of the 
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-72

    (f) ) is 
amended--

    (1) in paragraph

    (2)
            (D) --
        (A) in the subparagraph heading, by striking ``in 
 subsequent years''; and
        (B) by striking ``(after fiscal year 2021)''; and

    (2) in paragraph

    (3) , by striking ``2021 through 2025'' and 
 inserting ``2026 through 2030''.

SEC. 505. REAUTHORIZATION; REPORTING REQUIREMENTS.

    (a) Performance Report.--

Section 744N of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 379j-73) is amended--

    (1) in subsection

    (a) --
        (A) by striking ``Beginning with fiscal year 2021, 
 and not later than 120 calendar days after the end of 
 each fiscal year thereafter'' and inserting the 
 following:
 ``

    (1) In general.--Not later than 120 calendar days after 
 the end of each fiscal year'';
        (B) by striking ``

section 3861

    (b) of the CARES 
 Act'' and inserting ``

section 2 of the Over-the-Counter 
 Monograph Drug User Fee Amendments''; and
            (C) by adding at the end the following:
 ``

    (2) Additional information.--Beginning with fiscal year 
 2026, the annual report under this subsection shall include--
 ``
        (A) the progress of the Food and Drug 
 Administration in achieving the goals, and future plans 
 for meeting the goals, including--
 ``
            (i) the number of Tier 1 OTC monograph 
 order requests for which a proposed order was 
 issued, and the number of such requests for 
 which a final order was issued, in the previous 
 fiscal year;
 ``
            (ii) the number of Tier 2 OTC monograph 
 order requests for which a proposed order was 
 issued, and the number of such requests for 
 which a final order was issued, in the previous 
 fiscal year;
 ``
            (iii) the number of specified safety OTC 
 monograph order requests for which a proposed 
 order was issued, and the number of such 
 requests for which a final order was issued, in 
 the previous fiscal year;
 ``
            (iv) the number of generally recognized 
 as safe and effective finalization OTC 
 monograph order requests for which a proposed 
 order was issued, and the number of such 
 requests for which a final order was issued, in 
 the previous fiscal year;
 ``
            (v) the average timeline for processing 
 OTC monograph order requests, in the aggregate 
 and by submission type, in the previous fiscal 
 year; and
 ``
            (vi) postmarket safety activities with 
 respect to OTC monograph drugs, including--
 ``
            (I) collecting, developing, and 
 reviewing safety information on OTC 
 monograph drugs, including adverse 
 event reports;
 ``
            (II) developing and using 
 improved analytical tools, adverse 
 event data-collection systems, 
 including information technology 
 systems, to assess potential safety 
 problems, including access to external 
 databases; and
 ``
            (III) activities under 

section 760;
 ``
        (B) information regarding registration of OTC 
 monograph drug facilities and contract manufacturing 
 organization facilities and payment of registration 
 fees by such facilities, including--
 ``
            (i) the OTC monograph drug facilities and 
 contract manufacturing organization facilities 
 that were first registered under 

section 510
            (c) or 510
            (i) in the fiscal year; and
 ``
            (ii) for each OTC monograph drug facility 
 and contract manufacturing organization 
 facility that was assessed a facility fee under 
 

section 744M

    (a) in the fiscal year, whether the 
 facility paid such fee;
 ``
            (C) the status of implementation of evidence and 
 testing standards under 

section 505G

    (r) for 
 nonprescription drugs intended for topical 
 administration, including--
 ``
            (i) the application of evidence or 
 testing standards; and
 ``
            (ii) the number of active ingredient 
 requests for nonprescription drugs intended for 
 topical administration reviewed using the 
 standards under 

section 505G

    (b) ; and
 ``
            (D) the progress of the Food and Drug 
 Administration in allowing nonclinical testing 
 alternatives to animal testing for the consideration of 
 sunscreen active ingredients.
 ``

    (3) Confidentiality.--Nothing in paragraph

    (2) shall be 
 construed to authorize the disclosure of information that is 
 prohibited from disclosure under 

section 301

    (j) of this Act or 
 

section 1905 of title 18, United States Code, or that is 
 subject to withholding under 

section 552

    (b)

    (4) of title 5, 
 United States Code.'';

    (2) in subsection

    (b) , by striking ``fiscal year 2021 and 
 each subsequent fiscal year'' and inserting ``each fiscal 
 year''; and

    (3) in subsection
            (d) --
        (A) by striking ``2025'' each place it appears and 
 inserting ``2030''; and
        (B) by adding at the end the following:
 ``

    (4) Minutes of negotiation meetings.--
 ``
        (A) Public availability.--The Secretary shall 
 make publicly available, on the public website of the 
 Food and Drug Administration, robust written minutes of 
 all negotiation meetings conducted under this 
 subsection between the Food and Drug Administration and 
 the regulated industry, not later than 30 days after 
 each such negotiation meeting.
 ``
        (B) Content.--The robust written minutes 
 described under subparagraph
        (A) shall contain, in 
 detail, any substantive proposal made by any party to 
 the negotiations as well as significant controversies 
 or differences of opinion during the negotiations and 
 their resolution.''.

    (b) GAO Report.--

    (1) In general.--Not later than September 30, 2027, the 
 Comptroller General of the United States shall submit to the 
 Committee on Health, Education, Labor, and Pensions of the 
 Senate and the Committee on Energy and Commerce of the House of 
 Representatives a report assessing the supply chain of over-
 the-counter monograph drugs.

    (2) Contents.--The report required under paragraph

    (1) shall include an assessment of--
        (A) the overall stability of the supply chain of 
 over-the-counter monograph drugs;
        (B) what information is collected by the Food and 
 Drug Administration with respect to the supply chain of 
 over-the-counter monograph drugs;
            (C) how the Food and Drug Administration uses 
 information collected on the supply chain of over-the-
 counter monograph drugs to inform regulatory decisions;
            (D) how the Food and Drug Administration 
 coordinates with other Federal agencies to monitor and 
 mitigate disruptions to the supply chain of over-the-
 counter monograph drugs; and
        (E) the unique characteristics of the over-the-
 counter monograph drug marketplace and what additional 
 authorities or information the Food and Drug 
 Administration may need to ensure the stability of the 
 supply chain of over-the-counter monograph drugs.

SEC. 506. TREATMENT OF ACTIVE INGREDIENTS FOR TOPICAL ADMINISTRATION.

    (a) In General.--

Section 505G of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 355h) is amended by adding at the end the 
following:
 ``

    (r) Evidence and Testing Standards for Active Ingredients for 
Topical Administration.--
 ``

    (1) Evidence and testing standards for active ingredients 
 for topical administration.--The Secretary shall--
 ``
        (A) in evaluating the generally recognized as 
 safe and effective status of active ingredients used in 
 nonprescription drugs intended for topical 
 administration for purposes of subsection

    (a) , utilize 
 standards that allow for the use of real world evidence 
 (as defined in 

section 505F

    (b) ), as appropriate, as 
 part of a comprehensive evaluation of scientific 
 evidence to demonstrate the safety and effectiveness of 
 such active ingredients, to supplement evidence from 
 traditional clinical trials, provided that such 
 standards allow the Secretary to evaluate whether the 
 benefits of such active ingredients outweigh the risks; 
 and
 ``
        (B) apply subsection

    (b)

    (6)
            (C) to the regulation 
 of active ingredients used in drugs intended for 
 topical administration.
 ``

    (2) Non-animal testing methods for topical active 
 ingredients.--
 ``
        (A) In general.--The Secretary shall consider the 
 types of nonclinical tests described in paragraphs

    (1) through

    (4) of the first subsection

    (z) of 

section 505 
 (as inserted by 

section 3209

    (a)

    (2) of the Health 
 Extenders, Improving Access to Medicare, Medicaid, and 
 CHIP, and Strengthening Public Health Act of 2022 
 (division FF of Public Law 117-328)), or any other 
 alternative to animal testing that the Secretary 
 determines appropriate, in the consideration of drugs 
 intended for topical administration under this section.
 ``
        (B) Guidance.--Not later than 1 year after the 
 date of enactment of this subsection, the Secretary 
 shall issue new draft guidance on how sponsors can use 
 nonclinical testing alternatives to animal testing, as 
 appropriate, to meet safety and efficacy standards 
 under this section for drugs intended for topical 
 administration.
 ``

    (3) Clarification.--Nothing in this subsection shall be 
 construed to alter, supersede, or limit the standards for 
 making determinations of whether a drug is generally recognized 
 as safe and effective under 

section 201

    (p) or the standards set 
 forth under 

section 505 for determining the safety and 
 effectiveness of drugs.''.

    (b) Sunscreen Final Administrative Order.--A final administrative 
order on nonprescription sunscreen active ingredients issued under 

section 3854 of the Coronavirus Aid, Relief, and Economic Security Act 
(Public Law 116-136; 21 U.S.C. 360fff-3 note) shall--

    (1) account for historical data regarding the safety of 
 sunscreen active ingredients that have previously been accepted 
 for marketing in the United States;

    (2) account for the role of broad spectrum sunscreens with 
 a Sun Protection Factor of 15 or higher in effective skin 
 cancer prevention; and

    (3) incorporate the evidence and testing standards for 
 sunscreen active ingredients detailed in 

section 505G

    (r) of the 
 Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355h) (as added 
 by subsection

    (a) ).

SEC. 507. INCREASING THE CLARITY AND PREDICTABILITY OF THE PROCESS FOR 
 DEVELOPING APPLICATIONS FOR RX-TO-NONPRESCRIPTION 
 SWITCHES.

    (a) In General.--

Section 505

    (b) of the Federal Food, Drug, and 
Cosmetic Act (21 U.S.C. 355

    (b) ) is amended by adding at the end the 
following:
 ``

    (7) Rx-to-nonprescription switches.--
 ``
        (A) Meetings.--Any person planning to submit an 
 application for an Rx-to-nonprescription switch may 
 submit to the Secretary a written request for a 
 meeting, for purposes of developing a plan for such 
 application that addresses the potential risks to 
 public health of such switch and the evidence necessary 
 to support such application, including the design of 
 any necessary studies, and the format and content of 
 the planned application. The Secretary may grant such a 
 meeting, as appropriate, consistent with established 
 procedures for granting meetings with, and providing 
 written responses to, applications under this section. 
 Each such meeting shall be documented in meeting 
 minutes.
 ``
        (B) Guidance.--
 ``
            (i) In general.--Not later than 18 months 
 after the date of enactment of this paragraph, 
 the Secretary shall issue guidance to increase 
 the clarity and predictability of the process 
 and standards for approval of applications for 
 nonprescription drugs under this section, 
 including in the case of applications for an 
 Rx-to-nonprescription switch, especially with 
 respect to prescription drugs with well-
 established safety profiles for which an 
 applicant may seek approval for nonprescription 
 use.
 ``
            (ii) Contents.--The guidance under clause
            (i) shall--
 ``
            (I) describe how published 
 reports in medical literature, any 
 previous finding of safety or 
 effectiveness for the drug under this 
 section, the results of significant 
 human experience with the drug, 
 unpublished studies and other data, and 
 other sources of information may be 
 used to support an application for a 
 nonprescription drug, including in the 
 context of an application for an Rx-to-
 nonprescription switch;
 ``
            (II) set forth procedures for 
 sponsors to request meetings described 
 in subparagraph
        (A) and document the 
 recommendations made in such meetings;
 ``
            (III) describe evidentiary 
 expectations to support approval of an 
 application for a nonprescription drug, 
 including in the context of an 
 application for an Rx-to-
 nonprescription switch, including how 
 sponsors can demonstrate that consumers 
 can appropriately self-select and use 
 the drug and comprehend the 
 nonprescription drug label; and
 ``
            (IV) provide recommendations for 
 how mechanisms, in addition to the 
 required Drug Facts Label, such as 
 mobile applications and decisions aids, 
 can be incorporated into the 
 information submitted in support of an 
 application for an Rx-to-
 nonprescription switch.
 ``
            (C) Plan to engage with stakeholders.--Not later 
 than 1 year after the date of enactment of this 
 paragraph, the Secretary shall develop and make 
 publicly available on the website of the Food and Drug 
 Administration a plan to engage stakeholders on steps 
 and factors for application holders and other 
 stakeholders to consider in identifying approved 
 prescription drugs that may be promising candidates for 
 applications for an Rx-to-nonprescription switch.
 ``
            (D) === Definition. ===
-For purposes of this paragraph, 
 the term `Rx-to-nonprescription switch' means the 
 approval of an application, or supplemental 
 application, as applicable, submitted under this 
 section by the holder of an approved application for a 
 prescription drug seeking approval to market such drug 
 as a nonprescription drug, including for--
 ``
            (i) a full Rx-to-nonprescription switch, 
 under which a drug previously approved for 
 prescription use only is--
 ``
            (I) approved for nonprescription 
 use under the same conditions as 
 applied to the drug when approved for 
 prescription use; or
 ``
            (II) approved for nonprescription 
 use subject to one or more additional 
 conditions for nonprescription use; and
 ``
            (ii) a partial Rx-to-nonprescription 
 switch, under which the drug is approved for 
 nonprescription use only under certain 
 conditions described in the approved labeling, 
 while the drug otherwise remains approved for 
 prescription use only.
 ``
        (E) Rule of construction.--Nothing in this 
 paragraph shall be construed to--
 ``
            (i) supersede or modify the authority of 
 the Secretary under 

section 505G with respect 
 to the regulation of OTC monograph drugs; or
 ``
            (ii) authorize the disclosure by the 
 Secretary of confidential commercial 
 information or trade secrets.''.

    (b) GAO Report.--

    (1) In general.--Not later than 1 year after the date of 
 enactment of this Act, the Comptroller General of the United 
 States shall submit to the Committee on Health, Education, 
 Labor, and Pensions of the Senate and the Committee on Energy 
 and Commerce of the House of Representatives a report that 
 evaluates--
        (A) the number of applications for an Rx-to-
 nonprescription switch approved during the period 
 beginning on October 1, 2022, and ending on the date of 
 the report;
        (B) the number of drugs for which an application 
 for an Rx-to-nonprescription switch was approved during 
 such period subject to an additional condition for 
 nonprescription use;
            (C) among the drugs for which an application for a 
 full or partial Rx-to-nonprescription switch was 
 approved during such period, the average length of time 
 from receipt by the Food and Drug Administration of the 
 application to the approval of such application;
            (D) the number of partial Rx-to-nonprescription 
 switch applications approved during such period, and 
 the number of applications for such a partial switch 
 not approved;
        (E) any barriers to timely and predictable review 
 of applications for an Rx-to-nonprescription switch;
        (F) engagement by the Food and Drug Administration 
 with public stakeholders, including public meetings or 
 additional activities to support review of applications 
 for an Rx-to-nonprescription switch; and
        (G) opportunities for collaboration between the 
 Center for Drug Evaluation and Research and the Centers 
 for Medicare & Medicaid Services for the purpose of 
 analyzing health insurance claims data for commonly 
 prescribed drugs that appear to be suitable for an Rx-
 to-nonprescription switch.

    (2) === Definition. ===
-In this subsection, the term ``Rx-to-
 nonprescription switch'' has the meaning given such term in 
 paragraph

    (7) of 

section 505

    (b) of the Federal Food, Drug, and 
 Cosmetic Act (21 U.S.C. 244

    (b) ), as added by subsection

    (a) .

SEC. 508. REGULATION OF CERTAIN NONPRESCRIPTION DRUGS THAT ARE MARKETED 
 WITHOUT AN APPROVED DRUG APPLICATION.

    (a) Development Advice to Sponsors or Requestors.--

Section 505G

    (h) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355h

    (h) ) is 
amended by striking ``sponsors or requestors'' and inserting 
``sponsors, requestors, or organizations nominated by sponsors or 
requestors to represent their interests in a proceeding''.

    (b) Technical Correction.--

Section 505G

    (b)

    (2)
        (A)
            (iv) 
            (III) of the 
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355h

    (b)

    (2)
        (A)
            (iv) 
            (III) ) 
is amended by striking ``requestors'' and inserting ``sponsors or 
requestors''.

SEC. 509. SUNSET DATES.

    (a) Authorization.--Sections 744L and 744M of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 379j-71; 379j-72) shall cease to be 
effective October 1, 2030.

    (b) Reporting Requirements.--

Section 744N of the Federal Food, 
Drug, and Cosmetic Act (21 U.S.C. 379j-73) shall cease to be effective 
January 31, 2031.

SEC. 510. EFFECTIVE DATE.

 The amendments made by this title shall take effect on October 1, 
2025, or the date of the enactment of this Act, whichever is later, 
except that fees under part 10 of subchapter C of chapter VII of the 
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 379j-71 et seq.) shall 
be assessed beginning October 1, 2025, regardless of the date of the 
enactment of this Act.

SEC. 511. SAVINGS CLAUSE.

 Notwithstanding the amendments made by this title, part 10 of 
subchapter C of chapter VII of the Federal Food, Drug, and Cosmetic Act 
(21 U.S.C. 379j-71 et seq.), as in effect on the day before the date of 
enactment of this Act, shall continue to be in effect with respect to 
assessing and collecting any fee required by such part for a fiscal 
year prior to fiscal year 2026.

 TITLE VI--NO SURPRISES ACT IMPLEMENTATION

SEC. 601. EXTENDING AVAILABILITY OF FUNDING FOR NO SURPRISES ACT 
 IMPLEMENTATION.

 

Section 118

    (a) of division BB of the Consolidated Appropriations 
Act, 2021 (Public Law 116-260) is amended--

    (1) by striking ``otherwise appropriated, to the Secretary 
 of Health and Human Services'' and inserting the following: 
 ``otherwise appropriated--
 ``

    (1) to the Secretary of Health and Human Services'';

    (2) in paragraph

    (1) , as so inserted, by striking 
 ``September 30, 2025.'' and inserting ``November 21, 2025; 
 and''; and

    (3) by adding at the end the following new paragraph:
 ``

    (2) to the Secretary of Health and Human Services, in 
 addition to amounts otherwise appropriated under paragraph

    (1) , 
 $15,000,000 for the period beginning on October 1, 2025, and 
 ending on November 21, 2025.''.

 DIVISION D--DEPARTMENT OF VETERANS AFFAIRS EXTENDERS

 TITLE I--HEALTH CARE MATTERS

SEC. 101. EXTENSION OF AUTHORITY FOR COLLECTION OF COPAYMENTS FOR 
 HOSPITAL CARE AND NURSING HOME CARE.

 

Section 1710

    (f)

    (2)
        (B) of title 38, United States Code, is amended 
by striking ``September 30, 2025'' and inserting ``November 21, 2025''.

SEC. 102. EXTENSION OF REQUIREMENT TO PROVIDE NURSING HOME CARE TO 
 CERTAIN VETERANS WITH SERVICE-CONNECTED DISABILITIES.

 

Section 1710A
            (d) of title 38, United States Code, is amended by 
striking ``September 30, 2025'' and inserting ``November 21, 2025''.

SEC. 103. EXTENSION OF STAFF SERGEANT PARKER GORDON FOX SUICIDE 
 PREVENTION GRANT PROGRAM.

 

Section 201

    (j) of the Commander John Scott Hannon Veterans Mental 
Health Care Improvement Act of 2019 (Public Law 116-171; 38 U.S.C. 
1720F note) is amended by striking ``the date that is three years after 
the date on which the first grant is awarded under this section'' and 
inserting ``November 21, 2025''.

SEC. 104. EXTENSION OF FUNDING FOR EXPANSION OF RURAL ACCESS NETWORK 
 FOR GROWTH ENHANCEMENT PROGRAM.

 

Section 2
            (d) of the Sgt. Ketchum Rural Veterans Mental Health Act 
of 2021 (Public Law 117-21; 38 U.S.C. 1712A note) is amended by 
striking ``2025'' and inserting ``2026''.

 TITLE II--BENEFITS

SEC. 201. EXTENSION OF REQUIREMENT FOR QUARTERLY BRIEFINGS ON 
 ADMINISTRATION OF AUTHORITIES RELATING TO DETERMINATIONS 
 REGARDING PRESUMPTIONS OF SERVICE CONNECTION BASED ON 
 TOXIC EXPOSURE.

 

Section 202

    (b)

    (2) of the Sergeant First Class Heath Robinson 
Honoring our Promise to Address Comprehensive Toxics Act of 2022 
(Public Law 117-168) is amended by striking ``On a quarterly basis 
during the two-year period beginning on the date of the enactment of 
this Act,'' and inserting ``On a quarterly basis during the period 
beginning on the date of the enactment of this Act and ending on 
December 31, 2026,''.

SEC. 202. EXTENSION OF REQUIREMENT RELATING TO RESTORATION OF 
 ENTITLEMENT TO EDUCATIONAL ASSISTANCE IN CASES OF CLOSURE 
 OR DISAPPROVAL OF EDUCATIONAL INSTITUTIONS.

 

Section 3699
            (c) (2)
            (C) of title 38, United States Code, is amended 
by striking ``September 30, 2025'' and inserting ``November 21, 2025''.

SEC. 203. EXTENSION OF TEMPORARY CLARIFICATION OF LICENSURE 
 REQUIREMENTS FOR CONTRACTOR MEDICAL PROFESSIONALS TO 
 PERFORM MEDICAL DISABILITY EXAMINATIONS FOR THE 
 DEPARTMENT OF VETERANS AFFAIRS UNDER PILOT PROGRAM FOR 
 USE OF CONTRACT PHYSICIANS FOR DISABILITY EXAMINATIONS.

 

Section 2002

    (a)

    (4) of the Johnny Isakson and David P. Roe, M.D. 
Veterans Health Care and Benefits Improvement Act of 2020 (Public Law 
116-315; 38 U.S.C. 5101 note) is amended by striking ``five years'' and 
inserting ``six years''.

SEC. 204. EXTENSION OF AUTHORITY TO MAINTAIN REGIONAL OFFICE IN 
 REPUBLIC OF PHILIPPINES.

 

Section 315

    (b) of title 38, United States Code, is amended by 
striking ``September 30, 2025'' and inserting ``November 21, 2025''.

 TITLE III--HOUSING

SEC. 301. EXTENSION OF AUTHORIZATION OF APPROPRIATIONS FOR HOMELESS 
 WOMEN VETERANS AND HOMELESS VETERANS WITH CHILDREN 
 REINTEGRATION GRANT PROGRAM.

 

Section 2021A

    (f)

    (1) of title 38, United States Code, is amended by 
striking ``2025'' and inserting ``2026''.

SEC. 302. EXTENSION OF AUTHORITY FOR TREATMENT AND REHABILITATION FOR 
 SERIOUSLY MENTALLY ILL AND HOMELESS VETERANS.

    (a) General Treatment.--

Section 2031

    (b) of title 38, United States 
Code, is amended by striking ``September 30, 2025'' and inserting 
``November 21, 2025''.

    (b) Additional Services at Certain Locations.--

Section 2033
            (d) of 
title 38, United States Code, is amended by striking ``September 30, 
2025'' and inserting ``November 21, 2025''.

SEC. 303. EXTENSION OF FUNDING FOR FINANCIAL ASSISTANCE FOR SUPPORTIVE 
 SERVICES FOR VERY LOW-INCOME VETERAN FAMILIES IN 
 PERMANENT HOUSING.

 Of the amounts appropriated to the Department of Veterans Affairs 
for fiscal year 2026 for ``Medical Services'', $92,000,000 shall be 
available until November 21, 2025, to carry out subsections

    (a) ,

    (b) , 
and
            (c) of 

section 2044 of title 38, United States Code.

SEC. 304. EXTENSION OF FUNDING FOR GRANT PROGRAM FOR HOMELESS VETERANS 
 WITH SPECIAL NEEDS.

 Of the amounts appropriated to the Department of Veterans Affairs 
for fiscal year 2026 for ``Medical Services'', $833,333 shall be 
available until November 21, 2025, for the purposes of the program 
under 

section 2061 of title 38, United States Code.

SEC. 305. EXTENSION OF AUTHORITY TO PROVIDE ASSISTANCE FOR SPECIALLY 
 ADAPTED HOUSING FOR DISABLED VETERANS RESIDING 
 TEMPORARILY IN HOUSING OWNED BY A FAMILY MEMBER.

 

Section 2102A

    (e) of title 38, United States Code, is amended by 
striking ``September 30, 2025'' and inserting ``November 21, 2025''.

SEC. 306. EXTENSION OF AUTHORITY FOR SPECIALLY ADAPTED HOUSING 
 ASSISTIVE TECHNOLOGY GRANT PROGRAM.

 

Section 2108

    (g) of title 38, United States Code, is amended by 
striking ``September 30, 2025'' and inserting ``November 21, 2025''.

SEC. 307. IMPROVEMENTS TO PARTIAL CLAIM PROGRAM OF THE DEPARTMENT OF 
 VETERANS AFFAIRS.

    (a) Clarification of Relationship to Other Powers of Secretary.--

Section 3720

    (h) of title 38, United States Code, is amended by striking 
``of subsection

    (a) '' and all that follows through the period at the 
end and inserting ``of subsection

    (a) in conjunction with the purchase 
of a loan under 

section 3732

    (a)

    (2) of this title unless the Secretary 
determines the purchase would be made consistent with 

section 3732
            (d) of this title.''.

    (b) Administration of Partial Claim Program.--

Section 3737 of such 
title is amended--

    (1) in subsection

    (b)

    (2) , by striking ``first lien 
 guaranteed loan for such property'' and inserting ``amount of 
 indebtedness under the guaranteed loan that the Secretary does 
 not purchase''; and

    (2) in subsection
            (c) --
        (A) in paragraph

    (2)
        (B)
            (ii) , by striking ``120 
 days'' and inserting ``180 days''; and
        (B) by amending paragraph

    (3) to read as follows:
 ``

    (3) An amount paid to the holder of a loan as a partial claim--
 ``
        (A) shall not alter the guaranty calculation specified by 
 

section 3703 of this title;
 ``
        (B) shall be included, for the purpose of a liquidation 
 sale, in the same manner as any other advance allowed by the 
 Secretary; and
 ``
            (C) shall not be claimed under the guaranty or increase 
 the Secretary's cost of acquisition of the property securing 
 the defaulted loan.''.
            (c) Requirements of Loan Holder.--Section
            (d) (1) of such section is 
amending by inserting ``and servicing the loan'' after ``documents''.
            (d) Default and Foreclosure.--Subsection

    (e) of such section is 
amended--

    (1) in paragraph

    (1) --
        (A) in subparagraph
        (A) , by striking ``an 
 individual who'' and all that follows through the 
 period at the end and inserting the following: ``a 
 borrower who defaults on a partial claim shall be 
 liable to the Secretary for any loss suffered by the 
 Secretary with respect to such default, and such loss 
 may be recovered in the same manner as any other debt 
 due the United States. The Secretary shall not restore 
 housing loan entitlement under 

section 3702

    (b) of this 
 title until such loss is repaid in full.''; and
        (B) by amending subparagraph
        (B) to read as 
 follows:
 ``
        (B) The Secretary may charge administrative costs, fees, and 
interest, as appropriate, with respect to any default under a partial 
claim in a manner similar to the interest and administrative costs 
charged under 

section 5315 of this title.''; and

    (2) by amending paragraph

    (2) to read as follows:
 ``

    (2) Notwithstanding 

section 2410 of title 28, a nonjudicial sale 
of real property to satisfy a loan guaranteed under this chapter shall 
discharge the property from a partial claim interest held by the 
Secretary, provided that the holder of the guaranteed loan conducts the 
non-judicial sale and distributes the sale proceeds, if any, in 
accordance with the State or local law where such property is 
situated.''.

    (e) Guidance in Advance of Regulations.--Subsection

    (h) of such 
section is amended to read as follows:
 ``

    (h) Guidance in Advance of Regulations.--Notwithstanding any 
other provision of law, the Secretary may, before prescribing 
regulations, issue administrative guidance with respect to the Partial 
Claim Program under this section and the loss mitigation options 
prescribed under 

section 3732
            (d) of this title, including any 
additional terms, conditions, and requirements the Secretary determines 
necessary.''.

SEC. 308. GOVERNMENT ACCOUNTABILITY OFFICE REPORTS ON PARTIAL CLAIM 
 PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS AND OTHER 
 MATTERS.

    (a) Annual Reports.--

    (1) In general.--Not later than one year after the date of 
 the enactment of this Act, and every year thereafter until the 
 Partial Claim Program terminates, the Comptroller General of 
 the United States shall submit to the Committee on Veterans' 
 Affairs of the Senate and the Committee on Veterans' Affairs of 
 the House of Representatives a report.

    (2) Elements.--Each report required by paragraph

    (1) shall 
 include, for the period covered by the report and disaggregated 
 by quarter, the following:
        (A) Key data on the performance of the Partial 
 Claim Program, including--
            (i) the number of partial claims filed and 
 approved; and
            (ii) the redefault and foreclosure rates of 
 loans for which a partial claim was made.
        (B) A comparison of the data described in 
 subparagraph
        (A) with data on the performance of other 
 loss mitigation options provided by the Department of 
 Veterans Affairs.
            (C) The number of housing loans insured, 
 guaranteed, or made by the Secretary of Veterans 
 Affairs under chapter 37 of title 38, United States 
 Code.
            (D) The number of applications for housing loan 
 benefits under such chapter denied.
        (E) The number of housing loans insured, 
 guaranteed, or made by the Secretary under such chapter 
 refinanced under 

section 3710

    (a)

    (8) or 3712 of title 
 38, United States Code.
        (F) The number of veterans who owe a payment on a 
 mortgage associated with a loan insured, guaranteed, or 
 made by the Secretary under such chapter that is at 
 least--
            (i) 60 days late; and
            (ii) 90 days late.

    (b) Assessment.--

    (1) In general.--Not later than one year before the Partial 
 Claim Program terminates, the Comptroller General shall--
        (A) conduct an assessment of the benefits and 
 challenges of the Partial Claim Program; and
        (B) submit to the Committee on Veterans' Affairs of 
 the Senate and the Committee on Veterans' Affairs of 
 the House of Representatives a report on the findings 
 of the Comptroller General with respect to that 
 assessment.

    (2) Considerations.--In conducting the assessment required 
 by paragraph

    (1) , the Comptroller General shall consider the 
 following:
        (A) The characteristics of borrowers for whom a 
 partial claim was made compared to the characteristics 
 of borrowers provided other loss mitigation options by 
 the Department of Veterans Affairs.
        (B) The performance of loans guaranteed under 
 chapter 37 of title 38, United States Code, following 
 various loss mitigation actions.
            (C) The information the Department considered in 
 determining whether a borrower would benefit from a 
 partial claim compared to other loss mitigation 
 options.
            (D) The costs to taxpayers of the Partial Claim 
 Program compared to the costs of other loss mitigation 
 options provided by the Department.
        (E) Any similarities and differences in the 
 Department's administration and use of the Partial 
 Claim Program compared to the Department's 
 administration and use of the COVID-19 Veterans 
 Assistance Partial Claim Payment program established 
 under subpart F of part 36 of title 38, Code of 
 Regulations.
        (F) The information the Department learned from the 
 COVID-19 Veterans Assistance Partial Claim Payment 
 program and the extent to which those lessons learned 
 were applied to the Partial Claim Program.
        (G) The types of information the Department 
 collected to monitor the performance and effectiveness 
 of the Partial Claim Program and how the Department 
 used that information to make any needed adjustments to 
 the program.
        (H) How the use by the Department of partial claims 
 compares to the use of partial claims by other Federal 
 housing agencies, including, for each partial claim 
 program--
            (i) the volume of loans for which partial 
 claims have been made;
            (ii) the results for borrowers (including 
 redefault and foreclosure rates); and
            (iii) the costs to taxpayers.
            (c) Partial Claim Program Defined.--In this section, the term 
``Partial Claim Program'' means the Partial Claim Program of the 
Department of Veterans Affairs carried out under 

section 3737 of title 
38, United States Code.

 TITLE IV--OTHER MATTERS

SEC. 401. EXTENSION OF SUBPOENA AUTHORITY OF INSPECTOR GENERAL OF 
 DEPARTMENT OF VETERANS AFFAIRS.

 

Section 312
            (d) (7)
        (A) of title 38, United States Code, is amended by 
striking ``September 30, 2025'' and inserting ``November 21, 2025''.

SEC. 402. EXTENSION OF AUTHORITY FOR SECRETARY OF VETERANS AFFAIRS TO 
 TRANSPORT INDIVIDUALS TO AND FROM FACILITIES OF 
 DEPARTMENT OF VETERANS AFFAIRS.

 

Section 111A

    (a)

    (2) of title 38, United States Code, is amended by 
striking ``September 30, 2025'' and inserting ``November 21, 2025''.

SEC. 403. EXTENSION OF AUTHORITY RELATING TO VENDEE LOAN PROGRAM.

 

Section 3733

    (a)

    (8) of title 38, United States Code, is amended--

    (1) in the matter preceding subparagraph
        (A) , by striking 
 ``September 30, 2025'' and inserting ``November 21, 2025''; and

    (2) in subparagraph
            (C) , by striking ``September 30, 2025'' 
 and inserting ``November 21, 2025''.

SEC. 404. EXTENSION OF AUTHORITY FOR TRANSFER OF REAL PROPERTY.

 

Section 8118

    (a)

    (5) of title 38, United States Code, is amended by 
striking ``September 30, 2025'' and inserting ``November 21, 2025''.

 DIVISION E--MISCELLANEOUS

SEC. 101. BUDGETARY EFFECTS.

    (a) Statutory PAYGO Scorecards.--The budgetary effects of divisions 
B through D shall not be entered on either PAYGO scorecard maintained 
pursuant to 

section 4
            (d) of the Statutory Pay-As-You-Go Act of 2010.

    (b) Senate PAYGO Scorecards.--The budgetary effects of divisions B 
through D shall not be entered on any PAYGO scorecard maintained for 
purposes of 

section 4106 of H. Con. Res. 71 (115th Congress).
            (c) Classification of Budgetary Effects.--Notwithstanding Rule 3 of 
the Budget Scorekeeping Guidelines set forth in the joint explanatory 
statement of the committee of conference accompanying Conference Report 
105-217 and 

section 250
            (c) (8) of the Balanced Budget and Emergency 
Deficit Control Act of 1985, the budgetary effects of divisions B 
through D shall not be estimated--

    (1) for purposes of 

section 251 of such Act;

    (2) for purposes of an allocation to the Committee on 
 Appropriations pursuant to 

section 302

    (a) of the Congressional 
 Budget Act of 1974; and

    (3) for purposes of paragraph

    (4)
            (C) of 

section 3 of the 
 Statutory Pay-As-You-Go Act of 2010 as being included in an 
 appropriation Act.

 Passed the House of Representatives September 19, 2025.

 Attest:

 Clerk.
119th CONGRESS

 1st Session

 H. R. 5371

_______________________________________________________________________

 AN ACT

 Making continuing appropriations and extensions for fiscal year 2026, 
 and for other purposes.