PL-119-75 Consolidated Appropriations Act, 2026 US

This Act may be cited as the ``Consolidated Appropriations Act, 2026''.

Sec. 1. Short title. Sec. 2. Table of contents. Sec. 3. References. Sec. 4. Explanatory statement. Sec. 5. Statement of appropriations. Sec. 6. Payment to Widows and Heirs of Deceased Members of Congress.

DIVISION A--DEPARTMENT OF DEFENSE APPROPRIATIONS ACT, 2026

Title I--Military Personnel Title II--Operation and Maintenance Title III--Procurement Title IV--Research, Development, Test and Evaluation Title V--Revolving and Management Funds Title VI--Other Department of Defense Programs Title VII--Related Agencies Title VIII--General Provisions

DIVISION B--DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2026

Title I--Department of Labor Title II--Department of Health and Human Services Title III--Department of Education Title IV--Related Agencies Title V--General Provisions

DIVISION D--TRANSPORTATION, HOUSING AND URBAN DEVELOPMENT, AND RELATED AGENCIES APPROPRIATIONS ACT, 2026

Title I--Department of Transportation Title II--Department of Housing and Urban Development Title III--Related Agencies Title IV--General Provisions--This Act

DIVISION E--FINANCIAL SERVICES AND GENERAL GOVERNMENT APPROPRIATIONS ACT, 2026

Title I--Department of the Treasury Title II--Executive Office of the President and Funds Appropriated to the President Title III--The Judiciary Title IV--District of Columbia Title V--Independent Agencies Title VI--General Provisions--This Act Title VII--General Provisions--Government-wide

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* Editorial note: This law contains text pages that are shorter than other pages, which reflects the printed page in the signed law.

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Title VIII--General Provisions--District of Columbia

DIVISION F--NATIONAL SECURITY, DEPARTMENT OF STATE, AND RELATED PROGRAMS APPROPRIATIONS ACT, 2026

Title I--Department of State and Related Programs Title II--Administration of Assistance Title III--Bilateral Economic Assistance Title IV--International Security Assistance Title V--Multilateral Assistance Title VI--Export and Investment Assistance Title VII--General Provisions

DIVISION G--OTHER MATTERS

DIVISION H--FURTHER CONTINUING APPROPRIATIONS ACT, 2026

DIVISION I--AUTHORIZING EXTENDERS AND TECHNICAL CORRECTIONS

DIVISION J--HEALTH CARE EXTENDERS

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.

The explanatory statement regarding this Act, printed in the House section of the Congressional Record on or about January 21, 2026, and submitted by the chair of the Committee on Appropriations of the House, shall have the same effect with respect to the allocation of funds and implementation of divisions A through D of this Act as if it were a joint explanatory statement of a committee of conference. The explanatory statement regarding division A of H.R. 7006 of the 119th Congress, the explanatory statement regarding division B of H.R. 7006 of the 119th Congress, and the explanatory statement regarding division C of H.R. 7006 of the 119th Congress, printed in the House section of the Congressional Record on January 14, 2026, and submitted by the chair of the Committee on Appropriations of the House, shall each have the same effect with respect to the allocation of funds and implementation of divisions E, F, and G, respectively, of this Act as if they were each a joint explanatory statement of a committee of conference.

The following sums in this Act are appropriated, out of any money in the Treasury not otherwise appropriated, for the fiscal year ending September 30, 2026.

OF DECEASED MEMBERS OF CONGRESS.

For payment to Jill Marie LaMalfa, widow of Douglas L. LaMalfa, late a Representative from the State of California, $174,000.

DIVISION A -- DEPARTMENT OF DEFENSE APPROPRIATIONS ACT, 2026

TITLE I

MILITARY PERSONNEL

Military Personnel, Army

For pay, allowances, individual clothing, subsistence, interest on deposits, gratuities, permanent change of station travel (including all expenses thereof for organizational movements), and expenses of temporary duty travel between permanent duty stations, for members of the Army on active duty (except members of reserve components provided for elsewhere), cadets, and aviation cadets; for members of the Reserve Officers' Training Corps; and for payments pursuant to section 156 of Public Law 97-377, as amended (42 U.S.C. 402 note), and to the Department of Defense Military Retirement Fund, $54,538,366,000.

Military Personnel, Navy

For pay, allowances, individual clothing, subsistence, interest on deposits, gratuities, permanent change of station travel (including all expenses thereof for organizational movements), and expenses of temporary duty travel between permanent duty stations, for members of the Navy on active duty (except members of the Reserve provided for elsewhere), midshipmen, and aviation cadets; for members of the Reserve Officers' Training Corps; and for payments pursuant to section 156 of Public Law 97-377, as amended (42 U.S.C. 402 note), and to the Department of Defense Military Retirement Fund, $40,544,559,000.

Military Personnel, Marine Corps

For pay, allowances, individual clothing, subsistence, interest on deposits, gratuities, permanent change of station travel (including all expenses thereof for organizational movements), and expenses of temporary duty travel between permanent duty stations, for members of the Marine Corps on active duty (except members of the Reserve provided for elsewhere); and for payments pursuant to section 156 of Public Law 97-377, as amended (42 U.S.C. 402 note), and to the Department of Defense Military Retirement Fund, $16,990,389,000.

Military Personnel, Air Force

For pay, allowances, individual clothing, subsistence, interest on deposits, gratuities, permanent change of station travel (including all expenses thereof for organizational movements), and expenses of temporary duty travel between permanent duty stations, for members of the Air Force on active duty (except members of reserve components provided for elsewhere), cadets, and aviation cadets; for members of the Reserve Officers' Training Corps; and for payments pursuant to section 156 of Public Law 97-377, as amended (42 U.S.C. 402 note), and to the Department of Defense Military Retirement Fund, $38,768,392,000.

Military Personnel, Space Force

For pay, allowances, individual clothing, subsistence, interest on deposits, gratuities, permanent change of station travel (including all expenses thereof for organizational movements), and expenses of temporary duty travel between permanent duty stations, for members of the Space Force on duty as described in section 20108 of title 10, United States Code and cadets; for members of the Reserve Officers' Training Corps; for expenses authorized by section 16131 of title 10, United States Code; and for payments pursuant to section 156 of Public Law 97-377, as amended (42 U.S.C. 402 note), and to the Department of Defense Military Retirement Fund, $1,494,342,000.

Reserve Personnel, Army

For pay, allowances, clothing, subsistence, gratuities, travel, and related expenses for personnel of the Army Reserve on active duty under sections 10211, 10302, and 7038 of title 10, United States Code, or while serving on active duty under section 12301(d) of title 10, United States Code, in connection with performing duty specified in section 12310(a) of title 10, United States Code, or while undergoing reserve training, or while performing drills or equivalent duty or other duty, and expenses authorized by section 16131 of title 10, United States Code; and for payments to the Department of Defense Military Retirement Fund, $5,733,696,000.

Reserve Personnel, Navy

For pay, allowances, clothing, subsistence, gratuities, travel, and related expenses for personnel of the Navy Reserve on active duty under section 10211 of title 10, United States Code, or while serving on active duty under section 12301(d) of title 10, United States Code, in connection with performing duty specified in section 12310(a) of title 10, United States Code, or while undergoing reserve training, or while performing drills or equivalent duty, and expenses authorized by section 16131 of title 10, United States Code; and for payments to the Department of Defense Military Retirement Fund, $2,712,359,000.

Reserve Personnel, Marine Corps

For pay, allowances, clothing, subsistence, gratuities, travel, and related expenses for personnel of the Marine Corps Reserve on active duty under section 10211 of title 10, United States Code, or while serving on active duty under section 12301(d) of title 10, United States Code, in connection with performing duty specified in section 12310(a) of title 10, United States Code, or while undergoing reserve training, or while performing drills or equivalent duty, and for members of the Marine Corps platoon leaders class, and expenses authorized by section 16131 of title 10, United States Code; and for payments to the Department of Defense Military Retirement Fund, $1,002,925,000.

Reserve Personnel, Air Force

For pay, allowances, clothing, subsistence, gratuities, travel, and related expenses for personnel of the Air Force Reserve on

active duty under sections 10211, 10305, and 9038 of title 10, United States Code, or while serving on active duty under section 12301(d) of title 10, United States Code, in connection with performing duty specified in section 12310(a) of title 10, United States Code, or while undergoing reserve training, or while performing drills or equivalent duty or other duty, and expenses authorized by section 16131 of title 10, United States Code; and for payments to the Department of Defense Military Retirement Fund, $2,701,115,000.

National Guard Personnel, Army

For pay, allowances, clothing, subsistence, gratuities, travel, and related expenses for personnel of the Army National Guard while on duty under sections 10211, 10302, or 12402 of title 10 or section 708 of title 32, United States Code, or while serving on duty under section 12301(d) of title 10 or section 502(f) of title 32, United States Code, in connection with performing duty specified in section 12310(a) of title 10, United States Code, or while undergoing training, or while performing drills or equivalent duty or other duty, and expenses authorized by section 16131 of title 10, United States Code; and for payments to the Department of Defense Military Retirement Fund, $10,476,992,000.

National Guard Personnel, Air Force

For pay, allowances, clothing, subsistence, gratuities, travel, and related expenses for personnel of the Air National Guard on duty under sections 10211, 10305, or 12402 of title 10 or section 708 of title 32, United States Code, or while serving on duty under section 12301(d) of title 10 or section 502(f) of title 32, United States Code, in connection with performing duty specified in section 12310(a) of title 10, United States Code, or while undergoing training, or while performing drills or equivalent duty or other duty, and expenses authorized by section 16131 of title 10, United States Code; and for payments to the Department of Defense Military Retirement Fund, $5,467,187,000.

TITLE II

OPERATION AND MAINTENANCE

Operation and Maintenance, Army

For expenses, not otherwise provided for, necessary for the operation and maintenance of the Army, as authorized by law, $58,249,178,000: Provided, That not to exceed $12,478,000 may be used for emergencies and extraordinary expenses, to be expended upon the approval or authority of the Secretary of the Army, and payments may be made upon the Secretary's certificate of necessity for confidential military purposes.

Operation and Maintenance, Navy

For expenses, not otherwise provided for, necessary for the operation and maintenance of the Navy and the Marine Corps, as authorized by law, $74,723,177,000: Provided, That not to exceed $15,055,000 may be used for emergencies and extraordinary expenses, to be expended upon the approval or authority of the Secretary of the Navy, and payments may be made upon the Secretary's certificate of necessity for confidential military purposes.

Operation and Maintenance, Marine Corps

For expenses, not otherwise provided for, necessary for the operation and maintenance of the Marine Corps, as authorized by law, $10,983,917,000.

Operation and Maintenance, Air Force

For expenses, not otherwise provided for, necessary for the operation and maintenance of the Air Force, as authorized by law, $61,542,591,000: Provided, That not to exceed $8,238,000 may be used for emergencies and extraordinary expenses, to be expended upon the approval or authority of the Secretary of the Air Force, and payments may be made upon the Secretary's certificate of necessity for confidential military purposes.

Operation and Maintenance, Space Force

For expenses, not otherwise provided for, necessary for the operation and maintenance of the Space Force, as authorized by law, $5,687,748,000.

Operation and Maintenance, Defense-Wide

(including transfer of funds)

For expenses, not otherwise provided for, necessary for the operation and maintenance of activities and agencies of the Department of Defense (other than the military departments), as authorized by law, $56,089,818,000: Provided, That not more than $2,981,000 may be used for the Combatant Commander Initiative Fund authorized under section 166a of title 10, United States Code: Provided further, That not to exceed $36,000,000 may be used for emergencies and extraordinary expenses, to be expended upon the approval or authority of the Secretary of Defense, and

payments may be made upon the Secretary's certificate of necessity for confidential military purposes: Provided further, That of the funds provided under this heading, not less than $60,000,000 shall be made available for the APEX Accelerators, of which not less than $5,000,000 shall be available for centers with eligible entities defined in 10 U.S.C. 4951(1)(D): Provided further, That none of the funds appropriated or otherwise made available by this Act may be used to plan or implement the consolidation or elimination of a budget or appropriations liaison office of the Office of the Secretary of Defense, the office of the Secretary of a military department, or the service headquarters of one of the Armed Forces into a legislative affairs or legislative liaison office: Provided further, That of the funds provided under this heading, not less than $86,500,000 shall be made available to the Defense Information Systems Agency for Defense Agencies and Field Activities network optimization and transition costs: Provided further, That of the funds provided under this heading, $3,121,000, to remain available until September 30, 2027, shall be available only for expenses relating to certain classified activities: Provided further, That of the funds provided under this heading, $27,693,000, to remain available until expended, shall be available only for expenses relating to certain classified activities, and may be transferred as necessary by the Secretary of Defense to operation and maintenance appropriations or research, development, test and evaluation appropriations, to be merged with and to be available for the same time period as the appropriations to which transferred: Provided further, That any ceiling on the investment item unit cost of items that may be purchased with operation and maintenance funds shall not apply to the funds described in the preceding proviso: Provided further, That of the funds provided under this heading, $3,673,457,000, of which $1,499,808,000, to remain available until September 30, 2027, shall be available to provide support and assistance to foreign security forces or other groups or individuals to conduct, support or facilitate counterterrorism, crisis response, or other Department of Defense security cooperation programs: Provided further, That the Secretary of Defense shall provide quarterly reports to the Committees on Appropriations of the House of Representatives and the Senate on the use and status of funds made available in this paragraph: Provided further, That the transfer authority provided under this heading is in addition to any other transfer authority provided elsewhere in this Act.

Counter-ISIS Train and Equip Fund

For the ``Counter-Islamic State of Iraq and Syria Train and Equip Fund'', $342,516,000, to remain available until September 30, 2027: Provided, That such funds shall be available to the Secretary of Defense in coordination with the Secretary of State, to provide assistance, including training; equipment; logistics support, supplies, and services; stipends; infrastructure repair and renovation; construction for facility fortification and humane treatment; and sustainment, to foreign security forces, irregular forces, groups, or individuals participating, or preparing to participate in activities to counter the Islamic State of Iraq and Syria, and their affiliated or associated groups: Provided further, That amounts made available under this heading shall be available to provide assistance only for activities in a country designated by the Secretary of

Defense, in coordination with the Secretary of State, as having a security mission to counter the Islamic State of Iraq and Syria, and following written notification to the congressional defense committees of such designation: Provided further, That the Secretary of Defense shall ensure that prior to providing assistance to elements of any forces or individuals, such elements or individuals are appropriately vetted, including at a minimum, assessing such elements for associations with terrorist groups or groups associated with the Government of Iran; and receiving commitments from such elements to promote respect for human rights and the rule of law: Provided further, That the Secretary of Defense shall, not fewer than 15 days prior to obligating from this appropriation account, notify the congressional defense committees in writing of the details of any such obligation: Provided further, That the Secretary of Defense may accept and retain contributions, including assistance in-kind, from foreign governments, including the Government of Iraq and other entities, to carry out assistance authorized under this heading: Provided further, That contributions of funds for the purposes provided herein from any foreign government or other entity may be credited to this Fund, to remain available until expended, and used for such purposes: Provided further, That the Secretary of Defense shall prioritize such contributions when providing any assistance for construction for facility fortification: Provided further, <<NOTE: Waiver authority. Determination. Notice.>> That the Secretary of Defense may waive a provision of law relating to the acquisition of items and support services or sections 40 and 40A of the Arms Export Control Act (22 U.S.C. 2780 and 2785) if the Secretary determines that such provision of law would prohibit, restrict, delay or otherwise limit the provision of such assistance and a notice of and justification for such waiver is submitted to the congressional defense committees, the Committees on Appropriations and Foreign Relations of the Senate and the Committees on Appropriations and Foreign Affairs of the House of Representatives: Provided further, That the United States may accept equipment procured using funds provided under this heading, or under the heading, ``Iraq Train and Equip Fund'' in prior Acts, that was transferred to security forces, irregular forces, or groups participating, or preparing to participate in activities to counter the Islamic State of Iraq and Syria and returned by such forces or groups to the United States, and such equipment may be treated as stocks of the Department of Defense upon written notification to the congressional defense committees: Provided further, That equipment procured using funds provided under this heading, or under the heading, ``Iraq Train and Equip Fund'' in prior Acts, and not yet transferred to security forces, irregular forces, or groups participating, or preparing to participate in activities to counter the Islamic State of Iraq and Syria may be treated as stocks of the Department of Defense when determined by the Secretary to no longer be required for transfer to such forces or groups and upon written notification to the congressional defense committees: Provided further, That none of the funds made available under this heading may be used to procure or transfer man- portable air defense systems: Provided further, <<NOTE: Time period. Reports.>> That the Secretary of Defense shall provide quarterly reports to the congressional defense committees on the use of funds provided under this heading, including, but not limited to, the number of individuals trained, the nature and scope of support and sustainment provided to each group or

individual, the area of operations for each group, and the contributions of other countries, groups, or individuals.

Operation and Maintenance, Army Reserve

For expenses, not otherwise provided for, necessary for the operation and maintenance, including training, organization, and administration, of the Army Reserve; repair of facilities and equipment; hire of passenger motor vehicles; travel and transportation; care of the dead; recruiting; procurement of services, supplies, and equipment; and communications, $3,258,861,000.

Operation and Maintenance, Navy Reserve

For expenses, not otherwise provided for, necessary for the operation and maintenance, including training, organization, and administration, of the Navy Reserve; repair of facilities and equipment; hire of passenger motor vehicles; travel and transportation; care of the dead; recruiting; procurement of services, supplies, and equipment; and communications, $1,421,774,000.

Operation and Maintenance, Marine Corps Reserve

For expenses, not otherwise provided for, necessary for the operation and maintenance, including training, organization, and administration, of the Marine Corps Reserve; repair of facilities and equipment; hire of passenger motor vehicles; travel and transportation; care of the dead; recruiting; procurement of services, supplies, and equipment; and communications, $319,941,000.

Operation and Maintenance, Air Force Reserve

For expenses, not otherwise provided for, necessary for the operation and maintenance, including training, organization, and administration, of the Air Force Reserve; repair of facilities and equipment; hire of passenger motor vehicles; travel and transportation; care of the dead; recruiting; procurement of services, supplies, and equipment; and communications, $4,246,342,000.

Operation and Maintenance, Army National Guard

For expenses of training, organizing, and administering the Army National Guard, including medical and hospital treatment and related expenses in non-Federal hospitals; maintenance, operation, and repairs to structures and facilities; hire of passenger motor vehicles; personnel services in the National Guard Bureau; travel expenses (other than mileage), as authorized by law for Army personnel on active duty, for Army National Guard division, regimental, and battalion commanders while inspecting units in compliance with National Guard Bureau regulations when specifically authorized by the Chief, National Guard Bureau; supplying and equipping the Army National Guard as authorized by law; and expenses of repair, modification, maintenance, and issue of supplies and equipment (including aircraft), $8,578,238,000.

Operation and Maintenance, Air National Guard

For expenses of training, organizing, and administering the Air National Guard, including medical and hospital treatment and

related expenses in non-Federal hospitals; maintenance, operation, and repairs to structures and facilities; transportation of things, hire of passenger motor vehicles; supplying and equipping the Air National Guard, as authorized by law; expenses for repair, modification, maintenance, and issue of supplies and equipment, including those furnished from stocks under the control of agencies of the Department of Defense; travel expenses (other than mileage) on the same basis as authorized by law for Air National Guard personnel on active Federal duty, for Air National Guard commanders while inspecting units in compliance with National Guard Bureau regulations when specifically authorized by the Chief, National Guard Bureau, $7,267,399,000.

United States Court of Appeals for the Armed Forces

For salaries and expenses necessary for the United States Court of Appeals for the Armed Forces, $21,243,000, of which not to exceed $10,000 may be used for official representation purposes.

Environmental Restoration, Army

(including transfer of funds)

For the Department of the Army, $190,870,000, to remain available until transferred: Provided, That the Secretary of the Army shall, upon determining that such funds are required for environmental restoration, reduction and recycling of hazardous waste, removal of unsafe buildings and debris of the Department of the Army, or for similar purposes, transfer the funds made available by this appropriation to other appropriations made available to the Department of the Army, to be merged with and to be available for the same purposes and for the same time period as the appropriations to which transferred: Provided further, That upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein, such amounts may be transferred back to this appropriation: Provided further, That the transfer authority provided under this heading is in addition to any other transfer authority provided elsewhere in this Act.

Environmental Restoration, Navy

(including transfer of funds)

For the Department of the Navy, $368,949,000, to remain available until transferred: Provided, That the Secretary of the Navy shall, upon determining that such funds are required for environmental restoration, reduction and recycling of hazardous waste, removal of unsafe buildings and debris of the Department of the Navy, or for similar purposes, transfer the funds made available by this appropriation to other appropriations made available to the Department of the Navy, to be merged with and to be available for the same purposes and for the same time period as the appropriations to which transferred: Provided further, That upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein, such amounts may be transferred back to this appropriation: Provided further, That the transfer authority provided under this heading

is in addition to any other transfer authority provided elsewhere in this Act.

Environmental Restoration, Air Force

(including transfer of funds)

For the Department of the Air Force, $396,149,000, to remain available until transferred: Provided, That the Secretary of the Air Force shall, upon determining that such funds are required for environmental restoration, reduction and recycling of hazardous waste, removal of unsafe buildings and debris of the Department of the Air Force, or for similar purposes, transfer the funds made available by this appropriation to other appropriations made available to the Department of the Air Force, to be merged with and to be available for the same purposes and for the same time period as the appropriations to which transferred: Provided further, That upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein, such amounts may be transferred back to this appropriation: Provided further, That the transfer authority provided under this heading is in addition to any other transfer authority provided elsewhere in this Act.

Environmental Restoration, Defense-Wide

(including transfer of funds)

For the Department of Defense, $8,885,000, to remain available until transferred: Provided, That the Secretary of Defense shall, upon determining that such funds are required for environmental restoration, reduction and recycling of hazardous waste, removal of unsafe buildings and debris of the Department of Defense, or for similar purposes, transfer the funds made available by this appropriation to other appropriations made available to the Department of Defense, to be merged with and to be available for the same purposes and for the same time period as the appropriations to which transferred: Provided further, That upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein, such amounts may be transferred back to this appropriation: Provided further, That the transfer authority provided under this heading is in addition to any other transfer authority provided elsewhere in this Act.

Environmental Restoration, Formerly Used Defense Sites

(including transfer of funds)

For the Department of the Army, $235,156,000, to remain available until transferred: Provided, That the Secretary of the Army shall, upon determining that such funds are required for environmental restoration, reduction and recycling of hazardous waste, removal of unsafe buildings and debris at sites formerly used by the Department of Defense, transfer the funds made available by this appropriation to other appropriations made available to the Department of the Army, to be merged with and to be available for the same purposes and for the same time period

as the appropriations to which transferred: Provided further, That upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein, such amounts may be transferred back to this appropriation: Provided further, That the transfer authority provided under this heading is in addition to any other transfer authority provided elsewhere in this Act.

Overseas Humanitarian, Disaster, and Civic Aid

For expenses relating to the Overseas Humanitarian, Disaster, and Civic Aid programs of the Department of Defense (consisting of the programs provided under sections 401, 402, 404, 407, 2557, and 2561 of title 10, United States Code), $100,793,000, to remain available until September 30, 2027.

Cooperative Threat Reduction Account

For assistance, including assistance provided by contract or by grants, under programs and activities of the Department of Defense Cooperative Threat Reduction Program authorized under the Department of Defense Cooperative Threat Reduction Act, $282,830,000, to remain available until September 30, 2028.

Department of Defense Acquisition Workforce Development Account

For the Department of Defense Acquisition Workforce Development Account, $50,846,000: Provided, That no other amounts may be otherwise credited or transferred to the Account, or deposited into the Account, in fiscal year 2026 pursuant to section 1705(d) of title 10, United States Code.

TITLE III

PROCUREMENT

Aircraft Procurement, Army

For construction, procurement, production, modification, and modernization of aircraft, equipment, including ordnance, ground handling equipment, spare parts, and accessories therefor; specialized equipment and training devices; expansion of public and private plants, including the land necessary therefor, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes, $3,625,324,000, to remain available for obligation until September 30, 2028.

Missile Procurement, Army

For construction, procurement, production, modification, and modernization of missiles, equipment, including ordnance, ground handling equipment, spare parts, and accessories therefor; specialized equipment and training devices; expansion of public and private plants, including the land necessary therefor, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes, $7,287,263,000, to remain available for obligation until September 30, 2028.

Procurement of Weapons and Tracked Combat Vehicles, Army

For construction, procurement, production, and modification of weapons and tracked combat vehicles, equipment, including ordnance, spare parts, and accessories therefor; specialized equipment and training devices; expansion of public and private plants, including the land necessary therefor, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes, $3,005,021,000, to remain available for obligation until September 30, 2028.

Procurement of Ammunition, Army

For construction, procurement, production, and modification of ammunition, and accessories therefor; specialized equipment and training devices; expansion of public and private plants, including ammunition facilities, authorized by section 2854 of title 10, United States Code, and the land necessary therefor, for the foregoing purposes, and such lands and interests therein, may be acquired,

and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes, $4,576,705,000, to remain available for obligation until September 30, 2028.

Other Procurement, Army

For construction, procurement, production, and modification of vehicles, including tactical, support, and non-tracked combat vehicles; the purchase of passenger motor vehicles for replacement only; communications and electronic equipment; other support equipment; spare parts, ordnance, and accessories therefor; specialized equipment and training devices; expansion of public and private plants, including the land necessary therefor, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes, $9,412,655,000, to remain available for obligation until September 30, 2028.

Aircraft Procurement, Navy

For construction, procurement, production, modification, and modernization of aircraft, equipment, including ordnance, spare parts, and accessories therefor; specialized equipment; expansion of public and private plants, including the land necessary therefor, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway, $17,239,853,000, to remain available for obligation until September 30, 2028.

Weapons Procurement, Navy

For construction, procurement, production, modification, and modernization of missiles, torpedoes, other weapons, and related support equipment including spare parts, and accessories therefor; expansion of public and private plants, including the land necessary therefor, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway, $6,086,954,000, to remain available for obligation until September 30, 2028.

Procurement of Ammunition, Navy and Marine Corps

For construction, procurement, production, and modification of ammunition, and accessories therefor; specialized equipment and training devices; expansion of public and private plants, including ammunition facilities, authorized by section 2854 of title 10, United

States Code, and the land necessary therefor, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes, $1,098,630,000, to remain available for obligation until September 30, 2028.

Shipbuilding and Conversion, Navy

For expenses necessary for the construction, acquisition, or conversion of vessels as authorized by law, including armor and armament thereof, plant equipment, appliances, and machine tools and installation thereof in public and private plants; reserve plant and Government and contractor-owned equipment layaway; procurement of critical, long lead time components and designs for vessels to be constructed or converted in the future; and expansion of public and private plants, including land necessary therefor, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title, as follows: Columbia Class Submarine, $3,928,828,000; Columbia Class Submarine (AP), $5,350,766,000; Carrier Replacement Program (CVN-80), $1,046,700,000; Carrier Replacement Program (AP), $612,038,000; Carrier Replacement Program (CVN-81), $1,622,935,000; Virginia Class Submarine, $2,740,305,000; Virginia Class Submarine (AP), $3,126,816,000; CVN Refueling Overhauls, $1,579,011,000; DDG-1000 Program, $52,358,000; DDG-51 Destroyer, $10,773,000; DDG-51 Destroyer (AP), $1,750,000,000; FFG-Frigate, $100,000,000; FF(X)-Frigate, $242,000,000; Medium Landing Ship, $800,000,000; TAO Fleet Oiler, $8,346,000; TAGOS Surtass Ships, $612,205,000; Towing, Salvage, and Rescue Ship, $141,500,000; Ship to Shore Connector, $320,000,000; Service Craft, $174,602,000; Auxiliary Personnel Lighter, $79,000,000; Auxiliary Vessels, $290,000,000; For outfitting, post delivery, conversions, and first destination transportation, $886,846,000; and Completion of Prior Year Shipbuilding Programs, $1,676,587,000.

In all: $27,151,616,000, to remain available for obligation until September 30, 2030: Provided, That additional obligations may be incurred after September 30, 2030, for engineering services, tests, evaluations, and other such budgeted work that must be performed in the final stage of ship construction: Provided further, That none of the funds provided under this heading for the construction or conversion of any naval vessel to be constructed in shipyards in the United States shall be expended in foreign facilities for the construction of major components of such vessel: Provided further, That none of the funds provided under this heading shall be used for the construction of any naval vessel in foreign shipyards:

Provided further, That funds appropriated or otherwise made available by this Act for Columbia Class Submarine (AP) may be available for the purposes authorized by subsections (f), (g), (h) or (i) of section 2218a of title 10, United States Code, only in accordance with the provisions of the applicable subsection.

Other Procurement, Navy

For procurement, production, and modernization of support equipment and materials not otherwise provided for, Navy ordnance (except ordnance for new aircraft, new ships, and ships authorized for conversion); the purchase of passenger motor vehicles for replacement only; expansion of public and private plants, including the land necessary therefor, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway, $14,693,978,000, to remain available for obligation until September 30, 2028: Provided, That such funds are also available for the maintenance, repair, and modernization of ships under a pilot program established for such purposes.

Procurement, Marine Corps

For expenses necessary for the procurement, manufacture, and modification of missiles, armament, military equipment, spare parts, and accessories therefor; plant equipment, appliances, and machine tools, and installation thereof in public and private plants; reserve plant and Government and contractor-owned equipment layaway; vehicles for the Marine Corps, including the purchase of passenger motor vehicles for replacement only; and expansion of public and private plants, including land necessary therefor, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title, $3,682,643,000, to remain available for obligation until September 30, 2028.

Aircraft Procurement, Air Force

For construction, procurement, and modification of aircraft and equipment, including armor and armament, specialized ground handling equipment, and training devices, spare parts, and accessories therefor; specialized equipment; expansion of public and private plants, Government-owned equipment and installation thereof in such plants, erection of structures, and acquisition of land, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes including rents and transportation of things, $19,964,954,000, to remain available for obligation until September 30, 2028.

Missile Procurement, Air Force

For construction, procurement, and modification of missiles, rockets, and related equipment, including spare parts and accessories therefor; ground handling equipment, and training devices;

expansion of public and private plants, Government-owned equipment and installation thereof in such plants, erection of structures, and acquisition of land, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; reserve plant and Government and contractor- owned equipment layaway; and other expenses necessary for the foregoing purposes including rents and transportation of things, $3,963,961,000, to remain available for obligation until September 30, 2028.

Procurement of Ammunition, Air Force

For construction, procurement, production, and modification of ammunition, and accessories therefor; specialized equipment and training devices; expansion of public and private plants, including ammunition facilities, authorized by section 2854 of title 10, United States Code, and the land necessary therefor, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; and procurement and installation of equipment, appliances, and machine tools in public and private plants; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes, $773,327,000, to remain available for obligation until September 30, 2028.

Other Procurement, Air Force

For procurement and modification of equipment (including ground guidance and electronic control equipment, and ground electronic and communication equipment), and supplies, materials, and spare parts therefor, not otherwise provided for; the purchase of passenger motor vehicles for replacement only; lease of passenger motor vehicles; and expansion of public and private plants, Government-owned equipment and installation thereof in such plants, erection of structures, and acquisition of land, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon, prior to approval of title; reserve plant and Government and contractor- owned equipment layaway, $32,605,147,000, to remain available for obligation until September 30, 2028.

Procurement, Space Force

For construction, procurement, and modification of spacecraft, rockets, and related equipment, including spare parts and accessories therefor; ground handling equipment, and training devices; expansion of public and private plants, Government-owned equipment and installation thereof in such plants, erection of structures, and acquisition of land, for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; reserve plant and Government and contractor-owned equipment layaway; and other expenses necessary for the foregoing purposes including rents and transportation of things, $4,036,035,000, to remain available for obligation until September 30, 2028.

Procurement, Defense-Wide

For expenses of activities and agencies of the Department of Defense (other than the military departments) necessary for procurement, production, and modification of equipment, supplies, materials, and spare parts therefor, not otherwise provided for; the purchase of passenger motor vehicles for replacement only; expansion of public and private plants, equipment, and installation thereof in such plants, erection of structures, and acquisition of land for the foregoing purposes, and such lands and interests therein, may be acquired, and construction prosecuted thereon prior to approval of title; reserve plant and Government and contractor-owned equipment layaway, $7,142,723,000, to remain available for obligation until September 30, 2028.

Defense Production Act Purchases

For activities by the Department of Defense pursuant to sections 108, 301, 302, and 303 of the Defense Production Act of 1950 (50 U.S.C. 4518, 4531, 4532, and 4533), $321,923,000, to remain available for obligation until expended, which shall be obligated and expended by the Secretary of Defense as if delegated the necessary authorities conferred by the Defense Production Act of 1950.

National Guard and Reserve Equipment Account

For procurement of rotary-wing aircraft; combat, tactical and support vehicles; other weapons; and other procurement items for the reserve components of the Armed Forces, $800,000,000, to remain available for obligation until September 30, 2028: Provided, That the Chiefs of National Guard and Reserve components shall, not later than 30 days after enactment of this Act, individually submit to the congressional defense committees the modernization priority assessment for their respective National Guard or Reserve component: Provided further, That none of the funds made available by this paragraph may be used to procure manned fixed wing aircraft, or procure or modify missiles, munitions, or ammunition.

TITLE IV

RESEARCH, DEVELOPMENT, TEST AND EVALUATION

Research, Development, Test and Evaluation, Army

For expenses necessary for basic and applied scientific research, development, test and evaluation, including maintenance, rehabilitation, lease, and operation of facilities and equipment, $16,705,760,000, to remain available for obligation until September 30, 2027.

Research, Development, Test and Evaluation, Navy

For expenses necessary for basic and applied scientific research, development, test and evaluation, including maintenance, rehabilitation, lease, and operation of facilities and equipment, $28,099,776,000, to remain available for obligation until September 30, 2027: Provided, That funds appropriated in this paragraph which are available for the V-22 may be used to meet unique operational requirements of the Special Operations Forces.

Research, Development, Test and Evaluation, Air Force

For expenses necessary for basic and applied scientific research, development, test and evaluation, including maintenance, rehabilitation, lease, and operation of facilities and equipment, $50,614,595,000, to remain available for obligation until September 30, 2027.

Research, Development, Test and Evaluation, Space Force

For expenses necessary for basic and applied scientific research, development, test and evaluation, including maintenance, rehabilitation, lease, and operation of facilities and equipment, $14,917,160,000, to remain available until September 30, 2027.

Research, Development, Test and Evaluation, Defense-Wide

For expenses of activities and agencies of the Department of Defense (other than the military departments), necessary for basic and applied scientific research, development, test and evaluation; advanced research projects as may be designated and determined by the Secretary of Defense, pursuant to law; maintenance, rehabilitation, lease, and operation of facilities and equipment, $35,248,875,000, to remain available for obligation until September 30, 2027.

Operational Test and Evaluation, Defense

For expenses, not otherwise provided for, necessary for the independent activities of the Director, Operational Test and Evaluation, in the direction and supervision of operational test and evaluation, including initial operational test and evaluation which is conducted prior to, and in support of, production decisions; joint operational testing and evaluation; and administrative expenses in connection therewith, $336,143,000, to remain available for obligation until September 30, 2027.

TITLE V

REVOLVING AND MANAGEMENT FUNDS

Defense Working Capital Funds

For the Defense Working Capital Funds, $2,126,540,000.

National Defense Stockpile Transaction Fund

For the National Defense Stockpile Transaction Fund, $5,700,000, for activities pursuant to the Strategic and Critical Materials Stock Piling Act (50 U.S.C. 98 et seq.).

TITLE VI

OTHER DEPARTMENT OF DEFENSE PROGRAMS

Defense Health Program

For expenses, not otherwise provided for, for medical and health care programs of the Department of Defense as authorized by law, $41,770,246,000; of which $38,942,713,000 shall be for operation and maintenance, of which not to exceed one percent shall remain available for obligation until September 30, 2027, and of which up to $21,023,765,000 may be available for contracts entered into under the TRICARE program; of which $354,821,000, to remain available for obligation until September 30, 2028, shall be for procurement; and of which $2,472,712,000, to remain available for obligation until September 30, 2027, shall be for research, development, test and evaluation: Provided, That of the funds provided under this heading for research, development, test and evaluation, not less than $1,270,000,000 shall be made available to the Defense Health Agency to carry out the congressionally directed medical research programs: Provided further, That, notwithstanding any other provision of law, of the amount made available under this heading for research, development, test and evaluation, not less than $15,000,000 shall be available for HIV prevention educational activities undertaken in connection with United States military training, exercises, and humanitarian assistance activities conducted primarily in African nations: Provided further, That the Secretary of Defense shall submit to the congressional defense committees quarterly reports on the current status of the electronic health record program: Provided further, That the Comptroller General of the United States shall perform quarterly performance reviews of the electronic health record program.

Chemical Agents and Munitions Destruction, Defense

For expenses, not otherwise provided for, necessary for the destruction of the United States stockpile of lethal chemical agents and munitions in accordance with the provisions of section 1412 of the Department of Defense Authorization Act, 1986 (50 U.S.C. 1521), $213,282,000, of which $3,243,000 shall be for operation and maintenance, of which not less than $3,243,000 shall be for the Chemical Stockpile Emergency Preparedness Program, consisting of $2,340,000 for activities on military installations and $903,000, to remain available until September 30, 2027, to assist State and local governments; and $210,039,000, to remain available until September 30, 2027, shall be for research, development, test and evaluation, of which $210,039,000 shall only be for the Assembled Chemical Weapons Alternatives program.

Drug Interdiction and Counter-Drug Activities, Defense

(including transfer of funds)

For drug interdiction and counter-drug activities of the Department of Defense, for transfer to appropriations available to the Department of Defense for military personnel of the reserve components serving under the provisions of title 10 and title 32, United States Code; for operation and maintenance; for procurement; and

for research, development, test and evaluation, $1,148,675,000, of which $678,737,000 shall be for counter-narcotics support; $134,938,000 shall be for the drug demand reduction program; $305,000,000 shall be for the National Guard counter-drug program; and $30,000,000 shall be for the National Guard counter-drug schools program: Provided, That the funds appropriated under this heading shall be available for obligation for the same time period and for the same purpose as the appropriation to which transferred: Provided further, That upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein, such amounts may be transferred back to this appropriation: Provided further, That the transfer authority provided under this heading is in addition to any other transfer authority contained elsewhere in this Act.

Office of the Inspector General

For expenses and activities of the Office of the Inspector General in carrying out the provisions of the Inspector General Act of 1978, as amended, $517,599,000, of which $511,895,000 shall be for operation and maintenance, of which not to exceed $700,000 is available for emergencies and extraordinary expenses to be expended upon the approval or authority of the Inspector General, and payments may be made upon the Inspector General's certificate of necessity for confidential military purposes; of which $1,079,000, to remain available for obligation until September 30, 2028, shall be for procurement; and of which $4,625,000, to remain available until September 30, 2027, shall be for research, development, test and evaluation.

TITLE VII

RELATED AGENCIES

Central Intelligence Agency Retirement and Disability System Fund

For payment to the Central Intelligence Agency Retirement and Disability System Fund, to maintain the proper funding level for continuing the operation of the Central Intelligence Agency Retirement and Disability System, $514,000,000.

Intelligence Community Management Account

For necessary expenses of the Intelligence Community Management Account, $629,128,000.

TITLE VIII

GENERAL PROVISIONS

Sec. 8001. No part of any appropriation contained in this Act shall be used for publicity or propaganda purposes not authorized by the Congress.

Sec. 8002. During the current fiscal year, provisions of law prohibiting the payment of compensation to, or employment of, any person not a citizen of the United States shall not apply to personnel of the Department of Defense: Provided, That salary increases granted to direct and indirect hire foreign national employees of the Department of Defense funded by this Act shall not be at a rate in excess of the percentage increase authorized by law for civilian employees of the Department of Defense whose pay is computed under the provisions of section 5332 of title 5, United States Code, or at a rate in excess of the percentage increase provided by the appropriate host nation to its own employees, whichever is higher: Provided further, That this section shall not apply to Department of Defense foreign service national employees serving at United States diplomatic missions whose pay is set by the Department of State under the Foreign Service Act of 1980: Provided further, That the limitations of this provision shall not apply to foreign national employees of the Department of Defense in the Republic of Turkey.

Sec. 8003. No part of any appropriation contained in this Act shall remain available for obligation beyond the current fiscal year, unless expressly so provided herein. Sec. 8004. No more than 20 percent of the appropriations in this Act which are limited for obligation during the current fiscal year shall be obligated during the last 2 months of the fiscal year: Provided, That this section shall not apply to obligations for support of active duty training of reserve components or summer camp training of the Reserve Officers' Training Corps.

(transfer of funds)

Sec. 8005. Upon determination by the Secretary of Defense that such action is necessary in the national interest, the Secretary may, with the approval of the Director of the Office of Management and Budget, transfer not to exceed $6,000,000,000 of working capital funds of the Department of Defense or funds made available in this Act to the Department of Defense for military functions (except military construction) between such appropriations or funds or any subdivision thereof, to be merged with and to be available for the same purposes, and for the same time period, as the appropriation or fund to which transferred: Provided, That such authority to transfer may not be used unless for higher priority items, based on unforeseen military requirements, than those for which originally appropriated and in no case where the item for which funds are requested has been denied by the Congress: Provided further, That the Secretary of Defense shall notify the Congress promptly of all transfers made pursuant to this authority or any other authority in this Act: Provided further, That no part of the funds in this Act shall be available to prepare or present a request to the Committees on Appropriations of the House of Representatives and the Senate for reprogramming of funds, unless for higher priority items, based on unforeseen military requirements, than those for which

originally appropriated and in no case where the item for which reprogramming is requested has been denied by the Congress: Provided further, That a request for multiple reprogrammings of funds using authority provided in this section shall be made prior to June 30, 2026: Provided further, That transfers among military personnel appropriations shall not be taken into account for purposes of the limitation on the amount of funds that may be transferred under this section.

Sec. 8006. (a) With regard to the list of specific programs, projects, and activities (and the dollar amounts and adjustments to budget activities corresponding to such programs, projects, and activities) contained in the tables titled Explanation of Project Level Adjustments in the explanatory statement regarding this Act and the tables contained in the classified annex accompanying this Act, the obligation and expenditure of amounts appropriated or otherwise made available by this Act for those programs, projects, and activities are hereby required by law to be carried out in the manner provided by such tables to the same extent as if the tables were included in the text of this Act. (b) Amounts specified in the referenced tables described in subsection (a) shall not be treated as subdivisions of appropriations for purposes of section 8005 of this Act: Provided, That section 8005 of this Act shall apply when transfers of the amounts described in subsection (a) occur between appropriation accounts, subject to the limitation in subsection (c): Provided further, That the transfer amount limitation provided in section 8005 of this Act shall not apply to transfers of amounts described in subsection (a) if such transfers are necessary for the proper execution of such funds.

(c) During the current fiscal year, amounts specified in the referenced tables in titles III and IV of this Act described in subsection (a) may not be transferred pursuant to section 8005 of this Act other than for proper execution of such amounts, as provided in subsection (b). Sec. 8007. (a) Not later than 60 days after the date of the enactment of this Act, the Department of Defense shall submit a report to the congressional defense committees to establish the baseline for application of reprogramming and transfer authorities for fiscal year 2026: Provided, That the report shall include-- (1) a table for each appropriation with a separate column to display the President's budget request, adjustments made by Congress, adjustments due to enacted rescissions, if appropriate, and the fiscal year enacted level; (2) a delineation in the table for each appropriation both by budget activity and program, project, and activity as detailed in the Budget Appendix; and (3) an identification of items of special congressional interest.

(b) Notwithstanding section 8005 of this Act, none of the funds provided in this Act shall be available for reprogramming or transfer until the report identified in subsection (a) is submitted to the congressional defense committees, unless the Secretary of Defense certifies in writing to the congressional defense committees that such reprogramming or transfer is necessary as an emergency requirement: Provided, That this subsection shall not apply to transfers from the following appropriations accounts: (1) ``Environmental Restoration, Army'';

(2) ``Environmental Restoration, Navy''; (3) ``Environmental Restoration, Air Force''; (4) ``Environmental Restoration, Defense-Wide''; (5) ``Environmental Restoration, Formerly Used Defense Sites''; and (6) ``Drug Interdiction and Counter-drug Activities, Defense''.

(transfer of funds)

Sec. 8008. During the current fiscal year, cash balances in working capital funds of the Department of Defense established pursuant to section 2208 of title 10, United States Code, may be maintained in only such amounts as are necessary at any time for cash disbursements to be made from such funds: Provided, That transfers may be made between such funds: Provided further, That transfers may be made between working capital funds and the ``Foreign Currency Fluctuations, Defense'' appropriation and the ``Operation and Maintenance'' appropriation accounts in such amounts as may be determined by the Secretary of Defense, with the approval of the Director of the Office of Management and Budget, except that such transfers may not be made unless the Secretary of Defense has notified the Congress of the proposed transfer: Provided further, That except in amounts equal to the amounts appropriated to working capital funds in this Act, no obligations may be made against a working capital fund to procure or increase the value of war reserve material inventory, unless the Secretary of Defense has notified the Congress prior to any such obligation.

Sec. 8009. Funds appropriated by this Act may not be used to initiate, or materially modify the scope of, a special access program without prior notification 30 calendar days in advance to the congressional defense committees.

Sec. 8010. <<NOTE: Contracts. Notifications. Time periods. 10 USC 3501 note.>> (a) None of the funds made available to the Department of Defense for this fiscal year or any prior fiscal year shall be available to initiate: (1) a multiyear contract that employs economic order quantity procurement in excess of $20,000,000 in any one year of the contract or that includes an unfunded contingent liability in excess of $20,000,000; or (2) a contract for advance procurement leading to a multiyear contract that employs economic order quantity procurement in excess of $20,000,000 in any one year, unless the congressional defense committees have been notified at least 30 days in advance of the proposed contract award: Provided, That no part of any appropriation made available to the Department of Defense for this fiscal year or any prior fiscal year shall be available to initiate a multiyear contract for which the economic order quantity advance procurement is not funded at least to the limits of the Government's liability: Provided further, That no part of any appropriation made available to the Department of Defense for this fiscal year or any prior fiscal year shall be available to initiate multiyear procurement contracts for any systems or component thereof if the value of the multiyear contract would exceed $500,000,000 unless specifically provided in this Act: Provided further, That no multiyear procurement contract can be terminated without 30-day prior notification to the congressional defense committees: Provided further, That the execution of

multiyear authority shall require the use of a present value analysis to determine lowest cost compared to an annual procurement.

(b) None of the funds made available to the Department of Defense for this fiscal year or any prior fiscal year may be used for a multiyear contract executed after the date of the enactment of this Act unless in the case of any such contract-- (1) the Secretary of Defense has submitted to Congress a budget request for full funding of units to be procured through the contract and, in the case of a contract for procurement of aircraft, that includes, for any aircraft unit to be procured through the contract for which procurement funds are requested in that budget request for production beyond advance procurement activities in the fiscal year covered by the budget, full funding of procurement of such unit in that fiscal year; (2) cancellation provisions in the contract do not include consideration of recurring manufacturing costs of the contractor associated with the production of unfunded units to be delivered under the contract; (3) the contract provides that payments to the contractor under the contract shall not be made in advance of incurred costs on funded units; and (4) the contract does not provide for a price adjustment based on a failure.

(c) Concurrent with the annual budget submission of the President for fiscal year 2027 pursuant to section 1105(a) of title 31, United States Code, that is in compliance with subsection (b)(1), and notwithstanding subsection (b)(4)(B) of section 804 of the National Defense Authorization Act for Fiscal Year 2026 (Public Law 119-60), funds appropriated to the Department of Defense in title III of this Act or in any other provision of law may be used for multiyear procurement contracts, for a period of not more than five years, as follows: Standard Missile-6; Long Range Anti-Ship Missile; Joint Air-to-Surface Standoff Missile Extended Range; Advanced Medium-Range Air-to-Air Missile; and Standard Missile-3 Block 1B; and for a period of not more than seven years, as follows: PATRIOT Advanced Capability-3 Missile Segment Enhancement; Terminal High Altitude Area Defense; and Tomahawk Cruise Missile Systems: Provided, That until such submission is provided to the congressional defense committees, to include P-1 and R-1 budget justification documents, which shall identify the allocation of funds by program, project, and activity, none of the funds made available to the Department of Defense for this fiscal year or any prior fiscal year may be obligated or expended to enter into any multiyear procurement contracts: Provided further, That before entering into a multiyear procurement contract for Tomahawk Cruise Missile Systems, Joint Air-to-Surface Standoff Missile Extended Range, or Standard Missile-6, the Secretary of Defense shall certify in writing to the congressional defense committees that such action is in the national security interests of the United States.

Sec. 8011. Within the funds appropriated for the operation and maintenance of the Armed Forces, funds are hereby appropriated pursuant to section 401 of title 10, United States Code, for humanitarian and civic assistance costs under chapter 20 of title 10, United States Code: Provided, That such funds may also be obligated for humanitarian and civic assistance costs incidental

to authorized operations and pursuant to authority granted in section 401 of title 10, United States Code, and these obligations shall be reported as required by section 401(d) of title 10, United States Code: Provided further, That funds available for operation and maintenance shall be available for providing humanitarian and similar assistance by using Civic Action Teams in the Trust Territories of the Pacific Islands and freely associated states of Micronesia, pursuant to the Compact of Free Association as authorized by Public Law 99-239: Provided further, That upon a determination by the Secretary of Defense that such action is beneficial for graduate medical education programs conducted at Defense Health Agency medical facilities located in Hawaii, the Secretary of Defense may authorize the provision of medical services at such facilities and transportation to such facilities, on a nonreimbursable basis, for civilian patients from American Samoa, the Commonwealth of the Northern Mariana Islands, the Marshall Islands, the Federated States of Micronesia, Palau, and Guam.

Sec. 8012. None of the funds appropriated by this or any other Act, including prior year Acts, may be used to obligate and expend funds in the Defense Modernization Account made available in accordance with subsection (c) of section 3136 of title 10, United States Code, except for the purposes described in paragraphs (d)(1) through (d)(4): Provided, That any program increases, as detailed in the tables titled Explanation of Project Level Adjustments in the explanatory statement regarding this Act, may not be transferred to the Defense Modernization Account pursuant to subsection (c) of section 3136 of title 10, United States Code. Sec. 8013. None of the funds made available by this Act shall be used in any way, directly or indirectly, to influence congressional action on any legislation or appropriation matters pending before the Congress.

Sec. 8014. None of the funds available in this Act to the Department of Defense, other than appropriations made for necessary or routine refurbishments, upgrades, or maintenance activities, shall be used to reduce or to prepare to reduce the number of deployed and non-deployed strategic delivery vehicles and launchers below the levels set forth in the report submitted to Congress in accordance with section 1042 of the National Defense Authorization Act for Fiscal Year 2012.

(transfer of funds)

Sec. 8015. (a) Funds appropriated in title III of this Act for the Department of Defense Pilot Mentor-Protege Program may be transferred to any other appropriation contained in this Act solely for the purpose of implementing a Mentor-Protege Program developmental assistance agreement pursuant to section 4902 of title 10, United States Code, under the authority of this provision or any other transfer authority contained in this Act. (b) The Secretary of Defense shall include with the budget justification documents in support of the budget for fiscal year 2027 (as submitted to Congress pursuant to section 1105 of title 31, United States Code) a description of each transfer under this section that occurred during the last fiscal year before the fiscal year in which such budget is submitted. Sec. 8016. None of the funds in this Act may be available for the purchase by the Department of Defense (and its departments

and agencies) of welded shipboard anchor and mooring chain unless the anchor and mooring chain are manufactured in the United States from components which are substantially manufactured in the United States: Provided, That for the purpose of this section, the term ``manufactured'' shall include cutting, heat treating, quality control, testing of chain and welding (including the forging and shot blasting process): Provided further, That for the purpose of this section substantially all of the components of anchor and mooring chain shall be considered to be produced or manufactured in the United States if the aggregate cost of the components produced or manufactured in the United States exceeds the aggregate cost of the components produced or manufactured outside the United States: Provided further, <<NOTE: Waiver authority. Certification.>> That when adequate domestic supplies are not available to meet Department of Defense requirements on a timely basis, the Secretary of the Service responsible for the procurement may waive this restriction on a case-by-case basis by certifying in writing to the Committees on Appropriations of the House of Representatives and the Senate that such an acquisition must be made in order to acquire capability for national security purposes.

Sec. 8017. None of the funds appropriated by this Act shall be used for the support of any nonappropriated funds activity of the Department of Defense that procures malt beverages and wine with nonappropriated funds for resale (including such alcoholic beverages sold by the drink) on a military installation located in the United States unless such malt beverages and wine are procured within that State, or in the case of the District of Columbia, within the District of Columbia, in which the military installation is located: Provided, That, in a case in which the military installation is located in more than one State, purchases may be made in any State in which the installation is located: Provided further, That such local procurement requirements for malt beverages and wine shall apply to all alcoholic beverages only for military installations in States which are not contiguous with another State: Provided further, That alcoholic beverages other than wine and malt beverages, in contiguous States and the District of Columbia shall be procured from the most competitive source, price and other factors considered.

Sec. 8018. None of the funds available to the Department of Defense may be used to demilitarize or dispose of M-1 Carbines, M-1 Garand rifles, M-14 rifles,.22 caliber rifles,.30 caliber rifles, or M-1911 pistols, or to demilitarize or destroy small arms ammunition or ammunition components that are not otherwise prohibited from commercial sale under Federal law, unless the small arms ammunition or ammunition components are certified by the Secretary of the Army or designee as unserviceable or unsafe for further use.

Sec. 8019. No more than $500,000 of the funds appropriated or made available in this Act shall be used during a single fiscal year for any single relocation of an organization, unit, activity or function of the Department of Defense into or within the National Capital Region: Provided, That the Secretary of Defense may waive this restriction on a case-by-case basis by certifying in writing to the congressional defense committees that such a relocation is required in the best interest of the Government.

Sec. 8020. Of the funds made available in this Act under the heading ``Procurement, Defense-Wide'', $24,613,000 shall be

available only for incentive payments authorized by section 504 of the Indian Financing Act of 1974 (25 U.S.C. 1544): Provided, That a prime contractor or a subcontractor at any tier that makes a subcontract award to any subcontractor or supplier as defined in section 1544 of title 25, United States Code, or a small business owned and controlled by an individual or individuals defined under section 4221(9) of title 25, United States Code, shall be considered a contractor for the purposes of being allowed additional compensation under section 504 of the Indian Financing Act of 1974 (25 U.S.C. 1544) whenever the prime contract or subcontract amount is over $500,000 and involves the expenditure of funds appropriated by an Act making appropriations for the Department of Defense with respect to any fiscal year: Provided further, That notwithstanding section 1906 of title 41, United States Code, this section shall be applicable to any Department of Defense acquisition of supplies or services, including any contract and any subcontract at any tier for acquisition of commercial items produced or manufactured, in whole or in part, by any subcontractor or supplier defined in section 1544 of title 25, United States Code, or a small business owned and controlled by an individual or individuals defined under section 4221(9) of title 25, United States Code.

Sec. 8021. (a) Notwithstanding any other provision of law, the Secretary of the Air Force may convey at no cost to the Air Force, without consideration, to Indian tribes located in the States of Nevada, Idaho, North Dakota, South Dakota, Montana, Oregon, Minnesota, and Washington relocatable military housing units located at Grand Forks Air Force Base, Malmstrom Air Force Base, Mountain Home Air Force Base, Ellsworth Air Force Base, and Minot Air Force Base that are excess to the needs of the Air Force.

(b) The Secretary of the Air Force shall convey, at no cost to the Air Force, military housing units under subsection (a) in accordance with the request for such units that are submitted to the Secretary by the Operation Walking Shield Program on behalf of Indian tribes located in the States of Nevada, Idaho, North Dakota, South Dakota, Montana, Oregon, Minnesota, and Washington. Any such conveyance shall be subject to the condition that the housing units shall be removed within a reasonable period of time, as determined by the Secretary.

(c) The Operation Walking Shield Program shall resolve any conflicts among requests of Indian tribes for housing units under subsection (a) before submitting requests to the Secretary of the Air Force under subsection (b). (d) In this section, the term ``Indian tribe'' means any recognized Indian tribe included on the current list published by the Secretary of the Interior under section 104 of the Federally Recognized Indian Tribe Act of 1994 (Public Law 103-454; 108 Stat. 4792; 25 U.S.C. 5131).

Sec. 8022. Of the funds appropriated to the Department of Defense under the heading ``Operation and Maintenance, Defense-Wide'', not less than $12,000,000 may be made available only for the mitigation of environmental impacts, including training and technical assistance to tribes, related administrative support, the gathering of information, documenting of environmental damage, and developing a system for prioritization of mitigation and cost to complete estimates for mitigation, on Indian lands resulting from Department of Defense activities.

Sec. 8023. Funds appropriated by this Act for the Defense Media Activity shall not be used for any national or international political or psychological activities. Sec. 8024. Of the amounts appropriated for ``Working Capital Fund, Army'', $100,000,000 shall be available to maintain competitive rates at the arsenals. Sec. 8025. (a) Of the funds made available in this Act, not less than $79,000,000 shall be available for the Civil Air Patrol Corporation, of which-- (1) $57,900,000 shall be available from ``Operation and Maintenance, Air Force'' to support Civil Air Patrol Corporation operation and maintenance, readiness, counter-drug activities, and drug demand reduction activities involving youth programs; (2) $17,800,000 shall be available from ``Aircraft Procurement, Air Force''; and (3) $3,300,000 shall be available from ``Other Procurement, Air Force'' for vehicle procurement.

(b) The Secretary of the Air Force should waive reimbursement for any funds used by the Civil Air Patrol for counter- drug activities in support of Federal, State, and local government agencies.

Sec. 8026. (a) None of the funds appropriated in this Act are available to establish a new Department of Defense (department) federally funded research and development center (FFRDC), either as a new entity, or as a separate entity administrated by an organization managing another FFRDC, or as a nonprofit membership corporation consisting of a consortium of other FFRDCs and other nonprofit entities. (b) Except when acting in a technical advisory capacity, no member of a Board of Directors, Trustees, Overseers, Advisory Group, Special Issues Panel, Visiting Committee, or any similar entity of a defense FFRDC, or any entity that contracts with the Federal government to manage or operate one or more FFRDCs, or any paid consultant to a defense FFRDC shall receive funds appropriated by this Act as compensation for services as a member of such entity: Provided, That a member of any such entity shall be allowed travel expenses and per diem as authorized under the Federal Joint Travel Regulations, when engaged in the performance of membership duties: Provided further, That except when acting in a technical advisory capacity, no paid consultant shall receive funds appropriated by this Act as compensation by more than one FFRDC in a calendar year. (c) Notwithstanding any other provision of law, none of the funds available to the department from any source during the current fiscal year may be used by a defense FFRDC, through a fee or other payment mechanism, for construction of new buildings not located on a military installation, for payment of cost sharing for projects funded by Government grants, for absorption of contract overruns, or for certain charitable contributions, not to include employee participation in community service and/or development. (d) Notwithstanding any other provision of law, of the funds appropriated in this Act, not more than $2,886,300,000 may be funded for professional technical staff-related costs of the defense FFRDCs: Provided, That within such funds, not more than $461,300,000 shall be available for the defense studies and analysis FFRDCs: Provided further, That this subsection shall not apply to staff years funded in the National Intelligence Program and

the Military Intelligence Program: Provided further, That the Secretary of Defense shall, with the submission of the department's fiscal year 2027 budget request, submit a report presenting the specific amounts of staff years of technical effort to be allocated for each defense FFRDC by program during that fiscal year and the associated budget estimates, by appropriation account and program.

Sec. 8027. For the purposes of this Act, the term ``congressional defense committees'' means the Armed Services Committee of the House of Representatives, the Armed Services Committee of the Senate, the Subcommittee on Defense of the Committee on Appropriations of the House of Representatives, and the Subcommittee on Defense of the Committee on Appropriations of the Senate.

Sec. 8028. For the purposes of this Act, the term ``congressional intelligence committees'' means the Permanent Select Committee on Intelligence of the House of Representatives, the Select Committee on Intelligence of the Senate, the Subcommittee on Defense of the Committee on Appropriations of the House of Representatives, and the Subcommittee on Defense of the Committee on Appropriations of the Senate.

Sec. 8029. During the current fiscal year, the Department of Defense may acquire the modification, depot maintenance and repair of aircraft, vehicles and vessels as well as the production of components and other Defense-related articles, through competition between Department of Defense depot maintenance activities and private firms: Provided, That the Senior Acquisition Executive of the military department or Defense Agency concerned, with power of delegation, shall certify that successful bids include comparable estimates of all direct and indirect costs for both public and private bids: Provided further, That Office of Management and Budget Circular A-76 shall not apply to competitions conducted under this section.

Sec. 8030. (a) None of the funds appropriated in this Act may be expended by an entity of the Department of Defense unless the entity, in expending the funds, complies with the Buy American Act. For purposes of this subsection, the term ``Buy American Act'' means chapter 83 of title 41, United States Code.

(b) If the Secretary of Defense determines that a person has been convicted of intentionally affixing a label bearing a ``Made in America'' inscription to any product sold in or shipped to the United States that is not made in America, the Secretary shall determine, in accordance with section 4658 of title 10, United States Code, whether the person should be debarred from contracting with the Department of Defense.

(c) In the case of any equipment or products purchased with appropriations provided under this Act, it is the sense of the Congress that any entity of the Department of Defense, in expending the appropriation, purchase only American-made equipment and products, provided that American-made equipment and products are cost-competitive, quality competitive, and available in a timely fashion. Sec. 8031. None of the funds appropriated or made available in this Act shall be used to procure carbon, alloy, or armor steel plate for use in any Government-owned facility or property under the control of the Department of Defense which were not melted and rolled in the United States or Canada: Provided, That these procurement restrictions shall apply to any and all Federal Supply

Class 9515, American Society of Testing and Materials (ASTM) or American Iron and Steel Institute (AISI) specifications of carbon, alloy or armor steel plate: Provided further, <<NOTE: Waiver authority. Certification.>> That the Secretary of the military department responsible for the procurement may waive this restriction on a case-by-case basis by certifying in writing to the Committees on Appropriations of the House of Representatives and the Senate that adequate domestic supplies are not available to meet Department of Defense requirements on a timely basis and that such an acquisition must be made in order to acquire capability for national security purposes: Provided further, That these restrictions shall not apply to contracts which are in being as of the date of the enactment of this Act.

Sec. 8032. <<NOTE: Determination. Contracts. Rescission. 41 USC 8304 note.>> (a)(1) If the Secretary of Defense, after consultation with the United States Trade Representative, determines that a foreign country which is party to an agreement described in paragraph (2) has violated the terms of the agreement by discriminating against certain types of products produced in the United States that are covered by the agreement, the Secretary of Defense shall rescind the Secretary's blanket waiver of the Buy American Act with respect to such types of products produced in that foreign country.

(2) An agreement referred to in paragraph (1) is any reciprocal defense procurement memorandum of understanding, between the United States and a foreign country pursuant to which the Secretary of Defense has prospectively waived the Buy American Act for certain products in that country.

(b) The Secretary of Defense shall submit to the Congress a report on the amount of Department of Defense purchases from foreign entities in fiscal year 2026. Such report shall separately indicate the dollar value of items for which the Buy American Act was waived pursuant to any agreement described in subsection (a)(2), the Trade Agreements Act of 1979 (19 U.S.C. 2501 et seq.), or any international agreement to which the United States is a party.

(c) For purposes of this section, the term ``Buy American Act'' means chapter 83 of title 41, United States Code. Sec. 8033. None of the funds appropriated by this Act may be used for the procurement of ball and roller bearings other than those produced by a domestic source and of domestic origin: Provided, That <<NOTE: Waiver authority. Certification.>> the Secretary of the military department responsible for such procurement may waive this restriction on a case- by-case basis by certifying in writing to the Committees on Appropriations of the House of Representatives and the Senate, that adequate domestic supplies are not available to meet Department of Defense requirements on a timely basis and that such an acquisition must be made in order to acquire capability for national security purposes: Provided further, That this restriction shall not apply to the purchase of ``commercial products'', as defined by section 103 of title 41, United States Code, except that the restriction shall apply to ball or roller bearings purchased as end items.

Sec. 8034. Of the amounts appropriated in this Act under the heading ``Operation and Maintenance, Defense-Wide'', for the Defense Security Cooperation Agency, $50,000,000, to remain available until September 30, 2027, shall be available to the Secretary of Defense, in coordination with the Secretary of State, to provide

assistance to the Lebanese Armed Forces, including training, equipment, logistics support, supplies and services, stipends, infrastructure repair and renovation, and sustainment: Provided, <<NOTE: Lebanese Armed Forces.>> That the Secretary of Defense shall ensure that the Lebanese Armed Forces are vetted prior to providing assistance, including at a minimum, assessing for associations with terrorist groups and receiving a commitment to promote respect for human rights and the rule of law: Provided further, That the Secretary of Defense shall, not fewer than 15 days prior to obligating the funds provided in this section, notify the congressional defense committees in writing of the details of any such obligation: Provided further, That the Secretary of Defense may waive a provision of law relating to the acquisition of items and support services or sections 40 and 40A of the Arms Export Control Act (22 U.S.C. 2780 and 2785) if the Secretary determines that such provision of law would prohibit, restrict, delay or otherwise limit the provision of such assistance and a notice of and justification for such waiver is submitted to the congressional defense committees, the Committees on Appropriations and Foreign Relations of the Senate and the Committees on Appropriations and Foreign Affairs of the House of Representatives: Provided further, <<NOTE: Time period. Reports.>> That the Secretary of Defense shall provide quarterly reports to the congressional defense committees on the use of funds provided in this section, including, but not limited to, the number of individuals trained within the Lebanese Armed Forces, the nature and scope of support and sustainment provided to the Lebanese Armed Forces, the area of operations for the Lebanese Armed Forces, and the contributions of other countries, groups, or individuals.

Sec. 8035. None of the funds in this Act may be used to purchase any supercomputer which is not manufactured in the United States, unless the Secretary of Defense certifies to the congressional defense committees that such an acquisition must be made in order to acquire capability for national security purposes that is not available from United States manufacturers.

Sec. 8036. (a) The Secretary of Defense may, on a case-by-case basis, waive with respect to a foreign country each limitation on the procurement of defense items from foreign sources provided in law if the Secretary determines that the application of the limitation with respect to that country would invalidate cooperative programs entered into between the Department of Defense and the foreign country, or would invalidate reciprocal trade agreements for the procurement of defense items entered into under section 4851 of title 10, United States Code, and the country does not discriminate against the same or similar defense items produced in the United States for that country.

(b) Subsection (a) applies with respect to-- (1) contracts and subcontracts entered into on or after the date of the enactment of this Act; and (2) options for the procurement of items that are exercised after such date under contracts that are entered into before such date if the option prices are adjusted for any reason other than the application of a waiver granted under subsection (a).

(c) Subsection (a) does not apply to a limitation regarding construction of public vessels, ball and roller bearings, food, and clothing or textile materials as defined by section XI (chapters 50-65) of the Harmonized Tariff Schedule of the United States

and products classified under headings 4010, 4202, 4203, 6401 through 6406, 6505, 7019, 7218 through 7229, 7304.41 through 7304.49, 7306.40, 7502 through 7508, 8105, 8108, 8109, 8211, 8215, and 9404. Sec. 8037. None of the funds made available in this Act, or any subsequent Act making appropriations for the Department of Defense, may be used for the purchase or manufacture of a flag of the United States unless such flags are treated as covered items under section 4862(b) of title 10, United States Code.

Sec. 8038. During the current fiscal year, amounts contained in the Department of Defense Overseas Military Facility Investment Recovery Account shall be available until expended for the payments specified by section 2687a(b)(2) of title 10, United States Code. Sec. 8039. During the current fiscal year, appropriations which are available to the Department of Defense for operation and maintenance may be used to purchase items having an investment item unit cost of not more than $350,000: Provided, That upon determination by the Secretary of Defense that such action is necessary to meet the operational requirements of a Commander of a Combatant Command engaged in a named contingency operation overseas, such funds may be used to purchase items having an investment item unit cost of not more than $500,000.

Sec. 8040. Up to $16,809,000 of the funds appropriated under the heading ``Operation and Maintenance, Navy'' may be made available for the Asia Pacific Regional Initiative Program for the purpose of enabling the United States Indo-Pacific Command to execute Theater Security Cooperation activities such as humanitarian assistance, and payment of incremental and personnel costs of training and exercising with foreign security forces: Provided, That funds made available for this purpose may be used, notwithstanding any other funding authorities for humanitarian assistance, security assistance or combined exercise expenses: Provided further, That funds may not be obligated to provide assistance to any foreign country that is otherwise prohibited from receiving such type of assistance under any other provision of law.

Sec. 8041. <<NOTE: Regulations. Tobacco and tobacco products. 10 USC 2484 note.>> The Secretary of Defense shall issue regulations to prohibit the sale of any tobacco or tobacco-related products in military resale outlets in the United States, its territories and possessions at a price below the most competitive price in the local community: Provided, That such regulations shall direct that the prices of tobacco or tobacco-related products in overseas military retail outlets shall be within the range of prices established for military retail system stores located in the United States.

Sec. 8042. (a) During the current fiscal year, none of the appropriations or funds available to the Department of Defense Working Capital Funds shall be used for the purchase of an investment item for the purpose of acquiring a new inventory item for sale or anticipated sale during the current fiscal year or a subsequent fiscal year to customers of the Department of Defense Working Capital Funds if such an item would not have been chargeable to the Department of Defense Business Operations Fund during fiscal year 1994 and if the purchase of such an investment item would be chargeable during the current fiscal year to appropriations made to the Department of Defense for procurement. (b) The fiscal year 2027 budget request for the Department of Defense as well as all justification material and other documentation supporting the fiscal year 2027 Department of Defense budget

shall be prepared and submitted to the Congress on the basis that any equipment which was classified as an end item and funded in a procurement appropriation contained in this Act shall be budgeted for in a proposed fiscal year 2027 procurement appropriation and not in the supply management business area or any other area or category of the Department of Defense Working Capital Funds.

Sec. 8043. None of the funds appropriated by this Act for programs of the Central Intelligence Agency shall remain available for obligation beyond the current fiscal year, except for funds appropriated for the Reserve for Contingencies, which shall remain available until September 30, 2027: Provided, That funds appropriated, transferred, or otherwise credited to the Central Intelligence Agency Central Services Working Capital Fund during this or any prior fiscal year shall remain available until expended: Provided further, That any funds appropriated or transferred to the Central Intelligence Agency for advanced research and development acquisition, for agent operations, and for covert action programs authorized by the President under section 503 of the National Security Act of 1947 (50 U.S.C. 3093) shall remain available until September 30, 2027: Provided further, That any funds appropriated or transferred to the Central Intelligence Agency for the construction, improvement, or alteration of facilities, including leased facilities, to be used primarily by personnel of the intelligence community, shall remain available until September 30, 2028.

Sec. 8044. (a) Except as provided in subsections (b) and (c), none of the funds made available by this Act may be used-- (1) to establish a field operating agency; or (2) to pay the basic pay of a member of the Armed Forces or civilian employee of the Department of Defense who is transferred or reassigned from a headquarters activity if the member or employee's place of duty remains at the location of that headquarters.

(b) The Secretary of Defense or Secretary of a military department may waive the limitations in subsection (a), on a case-by-case basis, if the Secretary determines, and certifies to the Committees on Appropriations of the House of Representatives and the Senate that the granting of the waiver will reduce the personnel requirements or the financial requirements of the department.

(c) This section does not apply to-- (1) field operating agencies funded within the National Intelligence Program; (2) an Army field operating agency established to eliminate, mitigate, or counter the effects of improvised explosive devices, and, as determined by the Secretary of the Army, other similar threats; (3) an Army field operating agency established to improve the effectiveness and efficiencies of biometric activities and to integrate common biometric technologies throughout the Department of Defense; or (4) an Air Force field operating agency established to administer the Air Force Mortuary Affairs Program and Mortuary Operations for the Department of Defense and authorized Federal entities.

Sec. 8045. (a) None of the funds appropriated by this Act shall be available to convert to contractor performance an activity or function of the Department of Defense that, on or after the

date of the enactment of this Act, is performed by Department of Defense civilian employees unless-- (1) the conversion is based on the result of a public-private competition that includes a most efficient and cost effective organization plan developed by such activity or function; (2) the Competitive Sourcing Official determines that, over all performance periods stated in the solicitation of offers for performance of the activity or function, the cost of performance of the activity or function by a contractor would be less costly to the Department of Defense by an amount that equals or exceeds the lesser of-- (A) 10 percent of the most efficient organization's personnel-related costs for performance of that activity or function by Federal employees; or (B) $10,000,000; and (3) the contractor does not receive an advantage for a proposal that would reduce costs for the Department of Defense by-- (A) not making an employer-sponsored health insurance plan available to the workers who are to be employed in the performance of that activity or function under the contract; or (B) offering to such workers an employer-sponsored health benefits plan that requires the employer to contribute less towards the premium or subscription share than the amount that is paid by the Department of Defense for health benefits for civilian employees under chapter 89 of title 5, United States Code.

(b)(1) The Department of Defense, without regard to subsection (a) of this section or subsection (a), (b), or (c) of section 2461 of title 10, United States Code, and notwithstanding any administrative regulation, requirement, or policy to the contrary shall have full authority to enter into a contract for the performance of any commercial or industrial type function of the Department of Defense that-- (A) is included on the procurement list established pursuant to section 2 of the Javits-Wagner-O'Day Act (section 8503 of title 41, United States Code); (B) is planned to be converted to performance by a qualified nonprofit agency for the blind or by a qualified nonprofit agency for other severely handicapped individuals in accordance with that Act; or (C) is planned to be converted to performance by a qualified firm under at least 51 percent ownership by an Indian tribe, as defined in section 4(e) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b(e)), or a Native Hawaiian Organization, as defined in section 8(a)(15) of the Small Business Act (15 U.S.C. 637(a)(15)).

(2) This section shall not apply to depot contracts or contracts for depot maintenance as provided in sections 2469 and 2474 of title 10, United States Code. (c) The conversion of any activity or function of the Department of Defense under the authority provided by this section shall be credited toward any competitive or outsourcing goal, target, or measurement that may be established by statute, regulation, or policy and is deemed to be awarded under the authority of, and in compliance with, subsection (h) of section 2304 of title 10, United

States Code, for the competition or outsourcing of commercial activities.

(rescissions)

Sec. 8046. Of the funds appropriated in Department of Defense Appropriations Acts, the following funds are hereby rescinded from the following accounts and programs in the specified amounts: Provided, That no amounts may be rescinded from amounts that were 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: ``Shipbuilding and Conversion, Navy: FFG-Frigate'', 2020/ 2031, $240,245,000; ``Shipbuilding and Conversion, Navy: FFG-Frigate'', 2022/ 2026, $418,624,000; ``Shipbuilding and Conversion, Navy: FFG-Frigate'', 2023/ 2027, $483,391,000; ``Cooperative Threat Reduction Account'', 2024/2026, $33,936,000; ``Other Procurement, Army'', 2024/2026, $15,000,000; ``Weapons Procurement, Navy'', 2024/2026, $2,943,000; ``Shipbuilding and Conversion, Navy: FFG-Frigate'', 2024/ 2028, $1,271,572,000; ``Aircraft Procurement, Air Force'', 2024/2026, $25,397,000; ``Missile Procurement, Air Force'', 2024/2026, $41,189,000; ``Procurement, Space Force'', 2024/2026, $107,100,000; ``Defense Health Program'', 2024/2026, $10,473,000; ``Counter-Islamic State of Iraq and Syria Train and Equip Fund'', 2025/2026, $50,000,000; ``Procurement of Weapons and Tracked Combat Vehicles, Army'', 2025/2027, $452,647,000; ``Other Procurement, Army'', 2025/2027, $119,887,000; ``Aircraft Procurement, Navy'', 2025/2027, $155,711,000; ``Weapons Procurement, Navy'', 2025/2027, $200,272,000; ``Shipbuilding and Conversion, Navy: FFG-Frigate'', 2025/ 2029, $151,230,000; ``Aircraft Procurement, Air Force'', 2025/2027, $193,555,000; ``Missile Procurement, Air Force'', 2025/2027, $209,045,000; ``Other Procurement, Air Force'', 2025/2027, $186,638,000; ``Procurement, Space Force'', 2025/2027, $339,196,000; ``Procurement, Defense-Wide'', 2025/2027, $11,807,000; ``Research, Development, Test and Evaluation, Army'', 2025/ 2026, $178,735,000; ``Research, Development, Test and Evaluation, Navy'', 2025/ 2026, $82,461,000; ``Research, Development, Test and Evaluation, Air Force'', 2025/2026, $329,435,000; ``Research, Development, Test and Evaluation, Space Force'', 2025/2026, $370,149,000; and ``Defense Modernization Account, Defense-Wide'', 2025/2028, $28,249,000.

Sec. 8047. None of the funds available in this Act may be used to reduce the authorized positions for military technicians (dual status) of the Army National Guard, Air National Guard, Army Reserve and Air Force Reserve for the purpose of applying

any administratively imposed civilian personnel ceiling, freeze, or reduction on military technicians (dual status), unless such reductions are a direct result of a reduction in military force structure. Sec. 8048. None of the funds appropriated or otherwise made available in this Act may be obligated or expended for assistance to the Democratic People's Republic of Korea unless specifically appropriated for that purpose: Provided, <<NOTE: Armed Forces remains.>> That this restriction shall not apply to any activities incidental to the Defense POW/MIA Accounting Agency mission to recover and identify the remains of United States Armed Forces personnel from the Democratic People's Republic of Korea.

Sec. 8049. (a) None of the funds available to the Department of Defense for any fiscal year for drug interdiction or counter-drug activities may be transferred to any other department or agency of the United States except as specifically provided in an appropriations law.

(b) None of the funds available to the Central Intelligence Agency for any fiscal year for drug interdiction or counter-drug activities may be transferred to any other department or agency of the United States except as specifically provided in an appropriations law.

Sec. 8050. In addition to the amounts appropriated or otherwise made available elsewhere in this Act, $49,000,000 is hereby appropriated to the Department of Defense: Provided, That upon the determination of the Secretary of Defense that it shall serve the national interest, the Secretary shall make grants in the amounts specified as follows: $24,000,000 to the United Service Organizations and $25,000,000 to the Red Cross.

Sec. 8051. Notwithstanding any other provision in this Act, the Small Business Innovation Research program and the Small Business Technology Transfer program set-asides shall be taken proportionally from all programs, projects, or activities to the extent they contribute to the extramural budget. The Secretary of each military department, the Director of each Defense Agency, and the head of each other relevant component of the Department of Defense shall submit to the congressional defense committees, concurrent with submission of the budget justification documents to Congress pursuant to section 1105 of title 31, United States Code, a report with a detailed accounting of the Small Business Innovation Research program and the Small Business Technology Transfer program set-asides taken from programs, projects, or activities within such department, agency, or component during the most recently completed fiscal year.

Sec. 8052. None of the funds available to the Department of Defense under this Act shall be obligated or expended to pay a contractor under a contract with the Department of Defense for costs of any amount paid by the contractor to an employee when-- (1) such costs are for a bonus or otherwise in excess of the normal salary paid by the contractor to the employee; and (2) such bonus is part of restructuring costs associated with a business combination.

(including transfer of funds)

Sec. 8053. During the current fiscal year, no more than $30,000,000 of appropriations made in this Act under the heading ``Operation and Maintenance, Defense-Wide'' may be transferred to appropriations available for the pay of military personnel, to be merged with, and to be available for the same time period as the appropriations to which transferred, to be used in support of such personnel in connection with support and services for eligible organizations and activities outside the Department of Defense pursuant to section 2012 of title 10, United States Code. Sec. 8054. (a) Notwithstanding any other provision of law, the Chief of the National Guard Bureau may permit the use of equipment of the National Guard Distance Learning Project by any person or entity on a space-available, reimbursable basis. The Chief of the National Guard Bureau shall establish the amount of reimbursement for such use on a case-by-case basis.

(b) Amounts collected under subsection (a) shall be credited to funds available for the National Guard Distance Learning Project and be available to defray the costs associated with the use of equipment of the project under that subsection. Such funds shall be available for such purposes without fiscal year limitation. Sec. 8055. (a) None of the funds appropriated or otherwise made available by this or prior Acts may be obligated or expended to retire, prepare to retire, or place in storage or on backup aircraft inventory status any C-40 aircraft. (b) The limitation under subsection (a) shall not apply to an individual C-40 aircraft that the Secretary of the Air Force determines, on a case-by-case basis, to be no longer mission capable due to a Class A mishap.

(c) If the Secretary determines under subsection (b) that an aircraft is no longer mission capable, the Secretary shall submit to the congressional defense committees a certification in writing that the status of such aircraft is due to a Class A mishap and not due to lack of maintenance, repairs, or other reasons.

(d) Not later than 90 days after the date of the enactment of this Act, the Secretary of Defense shall submit to the congressional defense committees a report on the necessary steps taken by the Department of Defense to meet the travel requirements for official or representational duties of members of Congress and the Cabinet in fiscal years 2026 and 2027.

Sec. 8056. (a) None of the funds appropriated in title IV of this Act may be used to procure end-items for delivery to military forces for operational training, operational use, or inventory requirements: Provided, That this restriction does not apply to end-items used in development, prototyping in accordance with an approved test strategy, and test activities preceding and leading to acceptance for operational use.

(b) If the number of end-items budgeted with funds appropriated in title IV of this Act exceeds the number required in an approved test strategy, the Under Secretary of Defense (Research and Engineering) and the Under Secretary of Defense (Acquisition and Sustainment), in coordination with the responsible Service Acquisition Executive, shall certify in writing to the congressional defense committees that there is a bonafide need for the additional end-items at the time of submittal to Congress of the budget of the President for fiscal year 2027 pursuant to section 1105 of

title 31, United States Code: Provided, That this restriction does not apply to programs funded within the National Intelligence Program. (c) The Secretary of Defense shall, at the time of the submittal to Congress of the budget of the President for fiscal year 2027 pursuant to section 1105 of title 31, United States Code, submit to the congressional defense committees a report detailing the use of funds requested in research, development, test and evaluation accounts for end-items used in development, prototyping and test activities preceding and leading to acceptance for operational use: Provided, That the report shall set forth, for each end item covered by the preceding proviso, a detailed list of the statutory authorities under which amounts in the accounts described in that proviso were used for such item: Provided further, That the Secretary of Defense shall, at the time of the submittal to Congress of the budget of the President for fiscal year 2027 pursuant to section 1105 of title 31, United States Code, submit to the congressional defense committees a certification that funds requested for fiscal year 2027 in research, development, test and evaluation accounts are in compliance with this section: Provided further, That the Secretary of Defense may waive this restriction on a case-by-case basis by certifying in writing to the Subcommittees on Defense of the Committees on Appropriations of the House of Representatives and the Senate that it is in the national security interest to do so.

Sec. 8057. None of the funds appropriated or otherwise made available by this or other Department of Defense Appropriations Acts may be obligated or expended for the purpose of performing repairs or maintenance to military family housing units of the Department of Defense, including areas in such military family housing units that may be used for the purpose of conducting official Department of Defense business. Sec. 8058. <<NOTE: Time period. Reports. Strategies. Cost estimates.>> Notwithstanding any other provision of law, funds appropriated in this Act under the heading ``Research, Development, Test and Evaluation, Defense-Wide'' for any new start Defense Innovation Acceleration (PE 0603838D8Z) or Rapid Prototyping Program (PE 0604331D8Z) demonstration project with a value of more than $5,000,000 may only be obligated 15 days after a report, including a description of the project, the planned acquisition and transition strategy and its estimated annual and total cost, has been provided in writing to the congressional defense committees: Provided, That <<NOTE: Waiver authority. Certification.>> the Secretary of Defense may waive this restriction on a case-by-case basis by certifying to the congressional defense committees that it is in the national interest to do so.

Sec. 8059. The Secretary of Defense shall continue to provide a classified quarterly report to the Committees on Appropriations of the House of Representatives and the Senate, Subcommittees on Defense on certain matters as directed in the classified annex accompanying this Act.

Sec. 8060. Notwithstanding section 12310(b) of title 10, United States Code, a servicemember who is a member of the National Guard serving on full-time National Guard duty under section 502(f) of title 32, United States Code, may perform duties in support of the ground- based elements of the National Ballistic Missile Defense System. Sec. 8061. None of the funds provided in this Act may be used to transfer to any nongovernmental entity ammunition held

by the Department of Defense that has a center-fire cartridge and a United States military nomenclature designation of ``armor penetrator'', ``armor piercing (AP)'', ``armor piercing incendiary (API)'', ``armor- piercing incendiary tracer (API-T)'', ``general purpose (GP)'', ``special purpose (SP)'' except 9mm, or ``enhanced performance round (EPR)'', except to an entity performing demilitarization services for the Department of Defense under a contract that requires the entity to demonstrate to the satisfaction of the Department of Defense that the above listed projectiles are either: (1) rendered incapable of reuse by the demilitarization process; or (2) used to manufacture ammunition pursuant to a contract with the Department of Defense or the manufacture of ammunition for export pursuant to a License for Permanent Export of Unclassified Military Articles issued by the Department of State.

Sec. 8062. Notwithstanding any other provision of law, the Chief of the National Guard Bureau, or their designee, may waive payment of all or part of the consideration that otherwise would be required under section 2667 of title 10, United States Code, in the case of a lease of personal property for a period not in excess of 1 year to any organization specified in section 508(d) of title 32, United States Code, or any other youth, social, or fraternal nonprofit organization as may be approved by the Chief of the National Guard Bureau, or their designee, on a case-by-case basis.

(including transfer of funds)

Sec. 8063. Of the amounts appropriated in this Act under the heading ``Operation and Maintenance, Army'', $218,015,597 shall remain available until expended: Provided, That, notwithstanding any other provision of law, the Secretary of Defense is authorized to transfer such funds to other activities of the Federal Government: Provided further, That the Secretary of Defense is authorized to enter into and carry out contracts for the acquisition of real property, construction, personal services, and operations related to projects carrying out the purposes of this section: Provided further, That contracts entered into under the authority of this section may provide for such indemnification as the Secretary determines to be necessary: Provided further, That projects authorized by this section shall comply with applicable Federal, State, and local law to the maximum extent consistent with the national security, as determined by the Secretary of Defense.

Sec. 8064. (a) None of the funds appropriated in this or any other Act, including prior year Acts, may be used to implement a change to-- (1) the appropriations account structure for the National Intelligence Program budget, including through the creation of a new appropriation or new appropriation account; (2) how the National Intelligence Program budget request is presented in the unclassified P-1, R-1, and O-1 documents supporting the Department of Defense budget request; (3) the process by which the National Intelligence Program appropriations are apportioned to the executing agencies; or (4) the process by which the National Intelligence Program appropriations are allotted, obligated and disbursed.

(b) Nothing in subsection (a) shall be construed to prohibit the merger of programs or changes to the National Intelligence

Program budget at or below the Expenditure Center level, provided such change is otherwise in accordance with subsection (a). (c) The Director of National Intelligence and the Secretary of Defense may jointly study and develop detailed proposals for alternative budget presentation and appropriation accounts. Such study shall include a comprehensive counterintelligence risk assessment to ensure that none of the alternative processes will adversely affect counterintelligence.

(d) Upon development of the detailed proposals defined under subsection (c), the Director of National Intelligence and the Secretary of Defense shall-- (1) provide the proposed alternatives to all affected agencies; (2) receive certification from all affected agencies attesting that the proposed alternatives will not adversely affect counterintelligence; and (3) not later than 30 days after receiving all necessary certifications under paragraph (2), present the proposed alternatives and certifications to the congressional defense and intelligence committees.

(including transfer of funds)

Sec. 8065. In addition to amounts made available elsewhere in this Act, $25,000,000 is hereby appropriated to the Department of Defense and made available for transfer to operation and maintenance accounts, procurement accounts, and research, development, test and evaluation accounts only for those efforts by the Commander, United States Africa Command to expand cooperation, share operational information, advance interoperability, or improve the capabilities of our allies and partners in their area of operation: Provided, <<NOTE: Time period. Execution plan.>> That none of the funds provided under this section may be obligated or expended until 30 days after the Secretary of Defense provides to the congressional defense committees an execution plan: Provided further, That not less than 15 days prior to any transfer of funds, the Secretary of Defense shall notify the congressional defense committees of the details of any such transfer: Provided further, That upon transfer, the funds shall be merged with and available for the same purposes, and for the same time period, as the appropriation to which transferred: Provided further, That the transfer authority provided under this section is in addition to any other transfer authority provided elsewhere in this Act.

(including transfer of funds)

Sec. 8066. During the current fiscal year, not to exceed $11,000,000 from each of the appropriations made in title II of this Act for ``Operation and Maintenance, Army'', ``Operation and Maintenance, Navy'', and ``Operation and Maintenance, Air Force'' may be transferred by the military department concerned to its central fund established for Fisher Houses and Suites pursuant to section 2493(d) of title 10, United States Code.

(including transfer of funds)

Sec. 8067. In addition to amounts provided elsewhere in this Act, $5,000,000 is hereby appropriated to the Department of Defense, to remain available for obligation until expended: Provided,

That <<NOTE: Determination. Grants. Fisher House Foundation, Inc.>> notwithstanding any other provision of law, that upon the determination of the Secretary of Defense that it shall serve the national interest, these funds shall be available only for a grant to the Fisher House Foundation, Inc., only for the construction and furnishing of additional Fisher Houses to meet the needs of military family members when confronted with the illness or hospitalization of an eligible military beneficiary.

(including transfer of funds)

Sec. 8068. Of the amounts appropriated for ``Operation and Maintenance, Navy'', up to $1,000,000 shall be available for transfer to the John C. Stennis Center for Public Service Development Trust Fund established under section 116 of the John C. Stennis Center for Public Service Training and Development Act (2 U.S.C. 1105). Sec. 8069. None of the funds available to the Department of Defense may be obligated to modify command and control relationships to give Fleet Forces Command operational and administrative control of United States Navy forces assigned to the Pacific fleet: Provided, That the command and control relationships which existed on October 1, 2004, shall remain in force until a written modification has been proposed to the Committees on Appropriations of the House of Representatives and the Senate: Provided further, That the proposed modification may be implemented 30 days after the notification unless an objection is received from either the House or Senate Appropriations Committees: Provided further, That any proposed modification shall not preclude the ability of the commander of United States Indo-Pacific Command to meet operational requirements.

Sec. 8070. Any notice that is required to be submitted to the Committees on Appropriations of the House of Representatives and the Senate under section 3601 of title 10, United States Code, as added by section 804(a) of the James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 shall be submitted pursuant to that requirement concurrently to the Subcommittees on Defense of the Committees on Appropriations of the House of Representatives and the Senate.

Sec. 8071. Of the amounts appropriated in this Act under the headings ``Procurement, Defense-Wide'' and ``Research, Development, Test and Evaluation, Defense-Wide'', $500,000,000 shall be for the Israeli Cooperative Programs: Provided, That of this amount, $60,000,000 shall be for the Secretary of Defense to provide to the Government of Israel for the procurement of the Iron Dome defense system to counter short- range rocket threats, subject to the U.S.-Israel Iron Dome Procurement Agreement, as amended; $127,000,000 shall be for the Short Range Ballistic Missile Defense (SRBMD) program, including cruise missile defense research and development under the SRBMD program; $40,000,000 shall be for co-production activities of SRBMD systems in the United States and in Israel to meet Israel's defense requirements consistent with each nation's laws, regulations, and procedures, subject to the U.S.-Israeli co-production agreement for SRBMD, as amended; $100,000,000 shall be for an upper-tier component to the Israeli Missile Defense Architecture, of which $100,000,000 shall be for co-production activities of Arrow 3 Upper Tier systems in the United States and in Israel to meet Israel's defense requirements consistent

with each nation's laws, regulations, and procedures, subject to the U.S.-Israeli co-production agreement for Arrow 3 Upper Tier, as amended; and $173,000,000 shall be for the Arrow System Improvement Program including development of a long range, ground and airborne, detection suite. Sec. 8072. Of the amounts appropriated in this Act under the heading ``Shipbuilding and Conversion, Navy'', $1,676,587,000 shall be available until September 30, 2026, to fund prior year shipbuilding cost increases for the following programs: (1) Under the heading ``Shipbuilding and Conversion, Navy'', 2013/2026: Carrier Replacement Program, $150,000,000; (2) Under the heading ``Shipbuilding and Conversion, Navy'', 2016/2026: Virginia Class Submarine Program, $121,538,000; (3) Under the heading ``Shipbuilding and Conversion, Navy'', 2016/2026: DDG 51 Program, $14,892,000; (4) Under the heading ``Shipbuilding and Conversion, Navy'', 2017/2026: Virginia Class Submarine Program, $99,116,000; (5) Under the heading ``Shipbuilding and Conversion, Navy'', 2017/2026: DDG 51 Program, $62,365,000; (6) Under the heading ``Shipbuilding and Conversion, Navy'', 2017/2026: LHA Replacement Program, $93,603,000; (7) Under the heading ``Shipbuilding and Conversion, Navy'', 2018/2026: Virginia Class Submarine Program, $289,761,000; (8) Under the heading ``Shipbuilding and Conversion, Navy'', 2018/2026: DDG 51 Program, $104,238,000; (9) Under the heading ``Shipbuilding and Conversion, Navy'', 2018/2026: LPD Flight II Program, $93,442,000; (10) Under the heading ``Shipbuilding and Conversion, Navy'', 2018/2026: Oceanographic Ships Program, $6,015,000; (11) Under the heading ``Shipbuilding and Conversion, Navy'', 2019/2026: Littoral Combat Ship Program, $5,766,000; (12) Under the heading ``Shipbuilding and Conversion, Navy'', 2019/2026: T-AO Fleet Oiler Program, $15,400,000; (13) Under the heading ``Shipbuilding and Conversion, Navy'', 2019/2026: Ship to Shore Connector Program, $15,480,000; (14) Under the heading ``Shipbuilding and Conversion, Navy'', 2020/2026: CVN Refueling Overhauls, $483,100,000; (15) Under the heading ``Shipbuilding and Conversion, Navy'', 2020/2026: T-AO Fleet Oiler Program, $48,260,000; (16) Under the heading ``Shipbuilding and Conversion, Navy'', 2022/2026: T-AO Fleet Oiler Program, $19,650,000; (17) Under the heading ``Shipbuilding and Conversion, Navy'', 2022/2026: Expeditionary Sea Base Program, $30,000,000; (18) Under the heading ``Shipbuilding and Conversion, Navy'', 2022/2026: Expeditionary Fast Transport Program, $11,231,000; (19) Under the heading ``Shipbuilding and Conversion, Navy'', 2023/2026: T-AO Fleet Oiler Program, $6,530,000; and (20) Under the heading ``Shipbuilding and Conversion, Navy'', 2024/2026: T-AO Fleet Oiler Program, $6,200,000.

Sec. 8073. Funds appropriated by this Act, or made available by the transfer of funds in this Act, for intelligence activities and

intelligence-related activities not otherwise authorized in the Intelligence Authorization Act for Fiscal Year 2026 are deemed to be specifically authorized by the Congress for purposes of section 504 of the National Security Act of 1947 (50 U.S.C. 3094). Sec. 8074. None of the funds provided in this Act shall be available for obligation or expenditure through a reprogramming of funds that creates or initiates a new program, project, or activity unless such program, project, or activity must be undertaken immediately in the interest of national security and only after written prior notification to the congressional defense committees.

Sec. 8075. None of the funds in this Act may be used for research, development, test, evaluation, procurement or deployment of nuclear armed interceptors of a missile defense system.

Sec. 8076. None of the funds made available by this Act may be obligated or expended for the purpose of decommissioning more than one Littoral Combat Ship.

(including transfer of funds)

Sec. 8077. The Secretary of Defense may transfer funds from any available Department of the Navy appropriation (except military construction) to any available Navy ship construction appropriation for the purpose of liquidating necessary changes resulting from inflation, market fluctuations, or rate adjustments for any ship construction program appropriated in law: Provided, That the Secretary may transfer not to exceed $40,000,000 under the authority provided by this section: Provided further, That the Secretary may not transfer any funds until 30 days after the proposed transfer has been reported to the Committees on Appropriations of the House of Representatives and the Senate, unless a response from the Committees is received sooner: Provided further, That any funds transferred pursuant to this section shall retain the same period of availability as when originally appropriated: Provided further, That the transfer authority provided under this section is in addition to any other transfer authority contained elsewhere in this Act: Provided further, That the transfer authority provided by this section expires on September 30, 2030.

Sec. 8078. None of the funds appropriated or made available in this Act shall be used to reduce or disestablish the operation of the 53rd Weather Reconnaissance Squadron of the Air Force Reserve, if such action would reduce the WC- 130 Weather Reconnaissance mission below the levels funded in this Act: Provided, That the Air Force shall allow the 53rd Weather Reconnaissance Squadron to perform other missions in support of national defense requirements during the non-hurricane season.

Sec. 8079. None of the funds provided in this Act shall be available for integration of foreign intelligence information unless the information has been lawfully collected and processed during the conduct of authorized foreign intelligence activities: Provided, That information pertaining to United States persons shall only be handled in accordance with protections provided in the Fourth Amendment of the United States Constitution as implemented through Executive Order No. 12333.

Sec. 8080. <<NOTE: Research and development. Science and technology.>> None of the funds appropriated by this Act for programs of the Office of the Director of National Intelligence shall remain available for obligation beyond the current fiscal year,

except for funds appropriated for research and technology, which shall remain available until September 30, 2027.

Sec. 8081. For purposes of section 1553(b) of title 31, United States Code, any subdivision of appropriations made in this Act under the heading ``Shipbuilding and Conversion, Navy'' shall be considered to be for the same purpose as any subdivision under the heading ``Shipbuilding and Conversion, Navy'' appropriations in any prior fiscal year, and the 1 percent limitation shall apply to the total amount of the appropriation.

Sec. 8082. (a) Not later than 60 days after the date of enactment of this Act, the Director of National Intelligence shall submit a report to the congressional intelligence committees to establish the baseline for application of reprogramming and transfer authorities for fiscal year 2026: Provided, That the report shall include-- (1) a table for each appropriation with a separate column to display the President's budget request, adjustments made by Congress, adjustments due to enacted rescissions, if appropriate, and the fiscal year enacted level; (2) a delineation in the table for each appropriation by Expenditure Center and project; and (3) an identification of items of special congressional interest.

(b) None of the funds provided for the National Intelligence Program in this Act shall be available for reprogramming or transfer until the report identified in subsection (a) is submitted to the congressional intelligence committees, unless the Director of National Intelligence certifies in writing to the congressional intelligence committees that such reprogramming or transfer is necessary as an emergency requirement.

Sec. 8083. Any transfer of amounts appropriated to the Department of Defense Acquisition Workforce Development Account in or for fiscal year 2026 to a military department or Defense Agency pursuant to section 1705(e)(1) of title 10, United States Code, shall be covered by and subject to section 8005 of this Act. Sec. 8084. (a) None of the funds provided for the National Intelligence Program in this or any prior appropriations Act shall be available for obligation or expenditure through a reprogramming or transfer of funds in accordance with section 102A(d) of the National Security Act of 1947 (50 U.S.C. 3024(d)) that-- (1) creates a new start effort; (2) terminates a program with appropriated funding of $10,000,000 or more; (3) transfers funding into or out of the National Intelligence Program; or (4) transfers funding between appropriations, unless the congressional intelligence committees are notified 30 days in advance of such reprogramming of funds; this notification period may be reduced for urgent national security requirements.

(b) None of the funds provided for the National Intelligence Program in this or any prior appropriations Act shall be available for obligation or expenditure through a reprogramming or transfer of funds in accordance with section 102A(d) of the National Security Act of 1947 (50 U.S.C. 3024(d)) that results in a cumulative increase or decrease of the levels specified in the classified annex accompanying the Act unless the congressional intelligence committees are notified 30 days in advance of such reprogramming of funds;

this notification period may be reduced for urgent national security requirements. Sec. 8085. <<NOTE: Web posting. Public information. Reports. Determination.>> (a) Any agency receiving funds made available in this Act, shall, subject to subsections (b) and (c), post on the public website of that agency any report required to be submitted by the Congress in this or any other Act, upon the determination by the head of the agency that it shall serve the national interest.

(b) Subsection (a) shall not apply to a report if-- (1) the public posting of the report compromises national security; or (2) the report contains proprietary information.

(c) The head of the agency posting such report shall do so only after such report has been made available to the requesting Committee or Committees of Congress for no less than 45 days.

Sec. 8086. (a) None of the funds appropriated or otherwise made available by this Act may be expended for any Federal contract for an amount in excess of $1,000,000, unless the contractor agrees not to-- (1) enter into any agreement with any of its employees or independent contractors that requires, as a condition of employment, that the employee or independent contractor agree to resolve through arbitration any claim under title VII of the Civil Rights Act of 1964 or any tort related to or arising out of sexual assault or harassment, including assault and battery, intentional infliction of emotional distress, false imprisonment, or negligent hiring, supervision, or retention; or (2) take any action to enforce any provision of an existing agreement with an employee or independent contractor that mandates that the employee or independent contractor resolve through arbitration any claim under title VII of the Civil Rights Act of 1964 or any tort related to or arising out of sexual assault or harassment, including assault and battery, intentional infliction of emotional distress, false imprisonment, or negligent hiring, supervision, or retention.

(b) None of the funds appropriated or otherwise made available by this Act may be expended for any Federal contract unless the contractor certifies that it requires each covered subcontractor to agree not to enter into, and not to take any action to enforce any provision of, any agreement as described in paragraphs (1) and (2) of subsection (a), with respect to any employee or independent contractor performing work related to such subcontract. For purposes of this subsection, a ``covered subcontractor'' is an entity that has a subcontract in excess of $1,000,000 on a contract subject to subsection (a).

(c) The prohibitions in this section do not apply with respect to a contractor's or subcontractor's agreements with employees or independent contractors that may not be enforced in a court of the United States. (d) The Secretary of Defense may waive the application of subsection (a) or (b) to a particular contractor or subcontractor for the purposes of a particular contract or subcontract if the Secretary or the Deputy Secretary personally determines that the waiver is necessary to avoid harm to national security interests of the United States, and that the term of the contract or subcontract is not longer than necessary to avoid such harm. The determination shall set forth with specificity the grounds for the waiver and for the contract or subcontract term selected, and shall

state any alternatives considered in lieu of a waiver and the reasons each such alternative would not avoid harm to national security interests of the United States. <<NOTE: Public information. Time period.>> The Secretary of Defense shall transmit to Congress, and simultaneously make public, any determination under this subsection not less than 15 business days before the contract or subcontract addressed in the determination may be awarded.

(including transfer of funds)

Sec. 8087. From within the funds appropriated for operation and maintenance for the Defense Health Program in this Act, up to $165,000,000, shall be available for transfer to the Joint Department of Defense--Department of Veterans Affairs Medical Facility Demonstration Fund in accordance with the provisions of section 1704 of the National Defense Authorization Act for Fiscal Year 2010, Public Law 111-84: Provided, That for purposes of section 1704(b), the facility operations funded are operations of the integrated Captain James A. Lovell Federal Health Care Center, consisting of the North Chicago Veterans Affairs Medical Center, the Navy Ambulatory Care Center, and supporting facilities designated as a combined Federal medical facility as described by section 706 of Public Law 110-417: Provided further, That additional funds may be transferred from funds appropriated for operation and maintenance for the Defense Health Program to the Joint Department of Defense-- Department of Veterans Affairs Medical Facility Demonstration Fund upon written notification by the Secretary of Defense to the Committees on Appropriations of the House of Representatives and the Senate.

Sec. 8088. Notwithstanding price or other limitations applicable to the purchase of passenger carrying vehicles, appropriations available to the Department of Defense may be used for the purchase of: (1) heavy and light armored vehicles for the physical security of personnel or for force protection purposes up to a limit of $450,000 per vehicle; and (2) passenger motor vehicles up to a limit of $75,000 per vehicle for use by military and civilian employees of the Department of Defense in the United States Central Command area of responsibility.

(including transfer of funds)

Sec. 8089. Upon a determination by the Director of National Intelligence that such action is necessary and in the national interest, the Director may, with the approval of the Director of the Office of Management and Budget, transfer not to exceed $1,500,000,000 of the funds made available in this Act for the National Intelligence Program: Provided, That such authority to transfer may not be used unless for higher priority items, based on unforeseen intelligence requirements, than those for which originally appropriated and in no case where the item for which funds are requested has been denied by the Congress: Provided further, That a <<NOTE: Reprogramming requests. Deadline.>> request for multiple reprogrammings of funds using authority provided in this section shall be made prior to June 30, 2026.

Sec. 8090. Of the amounts appropriated in this Act for ``Shipbuilding and Conversion, Navy'', $290,000,000, to remain available for obligation until September 30, 2030, may be used for the purchase of two used sealift vessels for the National Defense Reserve

Fleet, established under section 11 of the Merchant Ship Sales Act of 1946 (46 U.S.C. 57100): Provided, That such amounts are available for reimbursements to the Ready Reserve Force, Maritime Administration account of the United States Department of Transportation for programs, projects, activities, and expenses related to the National Defense Reserve Fleet: Provided further, That notwithstanding section 2218 of title 10, United States Code, none of these funds shall be transferred to the National Defense Sealift Fund for execution.

Sec. 8091. The Secretary of Defense shall post grant awards on a public website in a searchable format.

Sec. 8092. None of the funds made available by this Act may be used by the National Security Agency to-- (1) conduct an acquisition pursuant to section 702 of the Foreign Intelligence Surveillance Act of 1978 for the purpose of targeting a United States person; or (2) acquire, monitor, or store the contents (as such term is defined in section 2510(8) of title 18, United States Code) of any electronic communication of a United States person from a provider of electronic communication services to the public pursuant to section 501 of the Foreign Intelligence Surveillance Act of 1978.

Sec. 8093. None of the funds made available in this or any other Act may be used to pay the salary of any officer or employee of any agency funded by this Act who approves or implements the transfer of administrative responsibilities or budgetary resources of any program, project, or activity financed by this Act to the jurisdiction of another Federal agency not financed by this Act without the express authorization of Congress: Provided, That this limitation shall not apply to transfers of funds expressly provided for in Department of Defense Appropriations Acts, or provisions of Acts providing supplemental appropriations for the Department of Defense.

Sec. 8094. Of the amounts appropriated in this Act for ``Operation and Maintenance, Navy'', $785,052,000, to remain available until expended, may be used for any purposes related to the National Defense Reserve Fleet established under section 11 of the Merchant Ship Sales Act of 1946 (46 U.S.C. 57100): Provided, That such amounts are available for reimbursements to the Ready Reserve Force, Maritime Administration account of the United States Department of Transportation for programs, projects, activities, and expenses related to the National Defense Reserve Fleet.

Sec. 8095. (a) None of the funds provided in this Act for the TAO Fleet Oiler program shall be used to award a new contract that provides for the acquisition of the following components unless those components are manufactured in the United States: Auxiliary equipment (including pumps) for shipboard services; propulsion equipment (including engines, reduction gears, and propellers); shipboard cranes; spreaders for shipboard cranes; and anchor chains, specifically for the seventh and subsequent ships of the fleet.

(b) None of the funds provided in this Act for any Frigate program shall be used to award a new contract that provides for the acquisition of the following components unless those components are manufactured in the United States: Air circuit breakers; gyrocompasses; electronic navigation chart systems; steering controls; pumps; propulsion and machinery control systems; totally enclosed lifeboats; auxiliary equipment pumps; shipboard cranes;

auxiliary chill water systems; and propulsion propellers: Provided, That the Secretary of the Navy shall incorporate United States manufactured propulsion engines and propulsion reduction gears into any Frigate program beginning not later than with the eleventh ship of the program.

Sec. 8096. None of the funds provided in this Act for requirements development, performance specification development, concept design and development, ship configuration development, systems engineering, naval architecture, marine engineering, operations research analysis, industry studies, preliminary design, development of the Detailed Design and Construction Request for Proposals solicitation package, or related activities for the T-ARC(X) Cable Laying and Repair Ship or the T-AGOS(X) Oceanographic Surveillance Ship may be used to award a new contract for such activities unless these contracts include specifications that all auxiliary equipment, including pumps and propulsion shafts, are manufactured in the United States.

Sec. 8097. No amounts credited or otherwise made available in this or any other Act to the Department of Defense Acquisition Workforce Development Account may be transferred to: (1) the Rapid Prototyping Fund established under section 804(d) of the National Defense Authorization Act for Fiscal Year 2016 (10 U.S.C. 2302 note); or (2) credited to a military-department specific fund established under section 804(d)(2) of the National Defense Authorization Act for Fiscal Year 2016.

Sec. 8098. None of the funds made available by this Act may be used for Government Travel Charge Card expenses by military or civilian personnel of the Department of Defense for gaming, or for entertainment that includes topless or nude entertainers or participants, as prohibited by Department of Defense FMR, Volume 9, Chapter 3 and Department of Defense Instruction 1015.10 (enclosure 3, 14a and 14b).

Sec. 8099. (a) None of the funds made available in this Act may be used to maintain or establish a computer network unless such network is designed to block access to pornography websites.

(b) Nothing in subsection (a) shall limit the use of funds necessary for any Federal, State, tribal, or local law enforcement agency or any other entity carrying out criminal investigations, prosecution, or adjudication activities, or for any activity necessary for the national defense, including intelligence activities. Sec. 8100. None of the funds provided for, or otherwise made available, in this or any other Act, may be obligated or expended by the Secretary of Defense to provide motorized vehicles, aviation platforms, munitions other than small arms and munitions appropriate for customary ceremonial honors, operational military units, or operational military platforms if the Secretary determines that providing such units, platforms, or equipment would undermine the readiness of such units, platforms, or equipment.

Sec. 8101. <<NOTE: Contracts. Memorandums. Grants. Loans. Corporations. Taxes. >> (a) None of the funds made available by this or any other Act may be used to enter into a contract, memorandum of understanding, or cooperative agreement with, make a grant to, or provide a loan or loan guarantee to any corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner

pursuant to an agreement with the authority responsible for collecting such tax liability, provided that the applicable Federal agency is aware of the unpaid Federal tax liability.

(b) Subsection (a) shall not apply if the applicable Federal agency has considered suspension or debarment of the corporation described in such subsection and has made a determination that such suspension or debarment is not necessary to protect the interests of the Federal Government.

Sec. 8102. (a) Amounts appropriated under title IV of this Act, as detailed in budget activity eight in the tables titled Explanation of Project Level Adjustments in the explanatory statement regarding this Act, may be used for expenses for the agile research, development, test and evaluation, procurement, production, modification, and operation and maintenance, only for the following Software and Digital Technology Pilot programs-- (1) Defensive CYBER--Software Prototype Development (PE 0608041A); (2) Risk Management Information (PE 0608013N); (3) Maritime Tactical Command and Control (PE 0608231N); (4) Space Domain Awareness/Planning/Tasking SW (PE 1208248SF); (5) Global Command and Control System (PE 0303150K); (6) Acquisition Visibility (PE 0608648D8Z); (7) Enterprise Platforms and Capabilities--Software Pilot Program (PE 0608140D8Z); and (8) Accelerate the Procurement and Fielding of Innovative Technologies (APFIT) (PE 0000000D8Z).

(b) None of the funds appropriated by this or prior Department of Defense Appropriations Acts may be obligated or expended to initiate additional Software and Digital Technology Pilot Programs in fiscal year 2026. Sec. 8103. None of the funds appropriated or otherwise made available by this Act may be used to transfer the National Reconnaissance Office to the Space Force: Provided, That nothing in this Act shall be construed to limit or prohibit cooperation, collaboration, and coordination between the National Reconnaissance Office and the Space Force or any other elements of the Department of Defense. Sec. 8104. None of the funds made available in this Act may be used in contravention of the following laws enacted or regulations promulgated to implement the United Nations Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (done at New York on December 10, 1984): (1) Section 2340A of title 18, United States Code. (2) Section 2242 of the Foreign Affairs Reform and Restructuring Act of 1998 (division G of Public Law 105-277; 112 Stat. 2681-822; 8 U.S.C. 1231 note) and regulations prescribed thereto, including regulations under part 208 of title 8, Code of Federal Regulations, and part 95 of title 22, Code of Federal Regulations. (3) Sections 1002 and 1003 of the Department of Defense, Emergency Supplemental Appropriations to Address Hurricanes in the Gulf of Mexico, and Pandemic Influenza Act, 2006 (Public Law 109-148).

Sec. 8105. None of the funds made available by this Act may be used to provide arms, training, or other assistance to the Azov Battalion.

Sec. 8106. The Secretary of Defense may, in this fiscal year and each fiscal year thereafter, accept and retain contributions, including money, personal property, and services, from foreign governments and other entities, to carry out assistance authorized by section 1250 of the National Defense Authorization Act for Fiscal Year 2016 (Public Law 114-92): Provided, That such contributions received shall be available to the Secretary of Defense, with the concurrence of the Secretary of State, to provide assistance authorized by such section, for replacement of any weapons or articles provided to entities described in subparagraphs (A) and (B) of subsection (a)(1) of such section from the inventory of the United States, and to recover or dispose of equipment previously provided to such entities: Provided further, That the Secretary of Defense shall consult with the congressional defense committees in advance of the provision of support provided to forces or groups described in subparagraph (B) of such subsection: Provided further, That the Secretary of Defense shall notify the congressional defense committees in writing upon the receipt and upon the obligation of any contribution, delineating the sources and amounts of the funds received and the specific use of such contributions: Provided further, That any notification of obligation of funds received in this section shall specify an estimated timeline for the delivery of defense articles and defense services provided and shall identify if any equipment provided requires enhanced end-use monitoring: Provided further, That contributions of money for the purposes provided herein from any foreign government or other entity may be credited to the Operation and Maintenance, Defense-Wide account, to remain available for the following two fiscal years, and used for such purposes: Provided further, That the Secretary of Defense shall provide quarterly reports to the congressional defense committees on the use and status of funds received pursuant to this section.

Sec. 8107. During the current fiscal year, the Department of Defense is authorized to incur obligations of not to exceed $350,000,000 for purposes specified in section 2350j(c) of title 10, United States Code, in anticipation of receipt of contributions, only from the Government of Kuwait, under that section: Provided, That, such contributions shall, upon receipt, be credited to the appropriations or fund which incurred such obligations.

Sec. 8108. Of the amounts appropriated in this Act under the heading ``Operation and Maintenance, Defense-Wide'', for the Defense Security Cooperation Agency, $1,499,808,000, to remain available until September 30, 2027, shall be available for International Security Cooperation Programs and other programs to provide support and assistance to foreign security forces or other groups or individuals to conduct, support or facilitate counterterrorism, crisis response, or building partner capacity programs: Provided, That the <<NOTE: Time period. Notification.>> Secretary of Defense shall, not less than 15 days prior to obligating funds made available in this section, notify the congressional defense committees in writing of the details of any planned obligation: Provided further, That the Secretary of Defense shall provide quarterly reports to the Committees on Appropriations of the House of Representatives and the Senate on the use and status of funds made available in this section.

Sec. 8109. Of the amounts appropriated in this Act under the heading ``Operation and Maintenance, Defense-Wide'', for the Defense Security Cooperation Agency, $267,298,000, to remain available until September 30, 2027, shall be available for support authorized by subparagraphs (A) through (E) and (G) through (I) of section 1226(a)(1) of the National Defense Authorization Act for Fiscal Year 2016 (22 U.S.C. 2151 note), of which not less than $150,000,000 shall be for Jordan: Provided, That the Secretary of Defense shall, not less than 15 days prior to obligating funds made available under this section, notify the congressional defense committees in writing of the details of any planned obligation and the nature of the expenses incurred: Provided further, That the Secretary of Defense shall provide quarterly reports to the Committees on Appropriations of the House of Representatives and the Senate on the use and status of funds made available in this section.

Sec. 8110. None of the funds made available by this Act may be used in contravention of the War Powers Resolution (50 U.S.C. 1541 et seq.). Sec. 8111. None of the funds made available by this Act for excess defense articles, assistance under section 333 of title 10, United States Code, or peacekeeping operations for the countries designated annually to be in violation of the standards of the Child Soldiers Prevention Act of 2008 (Public Law 110- 457; 22 U.S.C. 2370c-1) may be used to support any military training or operation that includes child soldiers, as defined by the Child Soldiers Prevention Act of 2008, unless such assistance is otherwise permitted under section 404 of the Child Soldiers Prevention Act of 2008.

Sec. 8112. None of the funds made available by this Act may be made available for any member of the Taliban.

Sec. 8113. Notwithstanding any other provision of law, any transfer of funds, appropriated or otherwise made available by this Act, for support to friendly foreign countries in connection with the conduct of operations in which the United States is not participating, pursuant to section 331(d) of title 10, United States Code, shall be made in accordance with section 8005 of this Act. Sec. 8114. ( a) None of the funds appropriated or otherwise made available by this or any other Act may be used by the Secretary of Defense, or any other official or officer of the Department of Defense, to enter into a contract, memorandum of understanding, or cooperative agreement with, or make a grant to, or provide a loan or loan guarantee to Rosoboronexport or any subsidiary of Rosoboronexport.

(b) <<NOTE: Waiver authority. Determination. Certification. Russia.>> The Secretary of Defense may waive the limitation in subsection (a) if the Secretary, in consultation with the Secretary of State and the Director of National Intelligence, determines that it is in the vital national security interest of the United States to do so, and certifies in writing to the congressional defense committees that-- (1) Rosoboronexport has ceased the transfer of lethal military equipment to, and the maintenance of existing lethal military equipment for, the Government of the Syrian Arab Republic; (2) the armed forces of the Russian Federation have withdrawn from Ukraine; and

(3) agents of the Russian Federation have ceased taking active measures to destabilize the control of the Government of Ukraine over eastern Ukraine.

(c) The Inspector General of the Department of Defense shall conduct a review of any action involving Rosoboronexport with respect to a waiver issued by the Secretary of Defense pursuant to subsection (b), and not later than 90 days after the date on which such a waiver is issued by the Secretary of Defense, the Inspector General shall submit to the congressional defense committees a report containing the results of the review conducted with respect to such waiver.

Sec. 8115. The Secretary of Defense shall notify the congressional defense committees in writing not more than 30 days after the receipt of any contribution of funds received from the government of a foreign country for any purpose relating to the stationing or operations of the United States Armed Forces: Provided, That such notification shall include the amount of the contribution; the purpose for which such contribution was made; and the authority under which such contribution was accepted by the Secretary of Defense: Provided further, That not fewer than 15 days prior to obligating such funds, the Secretary of Defense shall submit to the congressional defense committees in writing a notification of the planned use of such contributions, including whether such contributions would support existing or new stationing or operations of the United States Armed Forces.

Sec. 8116. (a) The Chairman of the Joint Chiefs, in coordination with the Secretaries of the military departments and the Chiefs of the Armed Forces, shall submit to the congressional defense committees, not later than 30 days after the last day of each quarter of the fiscal year, a report on the use of operation and maintenance funds for activities or exercises in excess of $5,000,000 that have been designated by the Secretary of Defense as unplanned activities for fiscal year 2026.

(b) Each report required by subsection (a) shall also include-- (1) the title, date, and location, of each activity and exercise covered by the report; (2) an identification of the military department and units that participated in each such activity or exercise (including an estimate of the number of participants); (3) the total cost of the activity or exercise, by budget line item (with a breakdown by cost element such as transportation); and (4) a short explanation of the objective of the activity or exercise.

(c) The report required by subsection (a) shall be submitted in unclassified form, but may include a classified annex. Sec. 8117. (a) Within 45 days of enactment of this Act, the Secretary of Defense shall allocate amounts made available from the Creating Helpful Incentives to Produce Semiconductors (CHIPS) for America Defense Fund for fiscal year 2026 pursuant to the transfer authority in section 102(b)(1) of the CHIPS Act of 2022 (division A of Public Law 117-167), to the account specified, in the amounts specified, and for the projects and activities specified, in the table titled ``Department of Defense Allocation of Funds: CHIPS and Science Act Fiscal Year 2026'' in the report accompanying this Act.

(b) Neither the President nor his designee may allocate any amounts that are made available for any fiscal year under section 102(b)(2) of the CHIPS Act of 2022 if there is in effect an Act making or continuing appropriations for part of a fiscal year for the Department of Defense: Provided, That in any fiscal year, the matter preceding this proviso shall not apply to the allocation, apportionment, or allotment of amounts for continuing administration of programs allocated using funds transferred from the CHIPS for America Defense Fund, which may be allocated pursuant to the transfer authority in section 102(b)(1) of the CHIPS Act of 2022 only in amounts that are no more than the allocation for such purposes in subsection (a) of this section. (c) The Secretary of Defense may reallocate funds allocated by subsection (a) of this section, subject to the terms and conditions contained in the provisos in section 8005 of this Act: Provided, That amounts may be reallocated pursuant to this subsection only for those requirements necessary to carry out section 9903(b) of the William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021 (Public Law 116-283). (d) Concurrent with the annual budget submission of the President for fiscal year 2027, the Secretary of Defense shall submit to the Committees on Appropriations of the House of Representatives and the Senate proposed allocations by account and by program, project, or activity, with detailed justifications, for amounts made available under section 102(b)(2) of the CHIPS Act of 2022 for fiscal year 2027. (e) The Department of Defense shall provide the Committees on Appropriations of the House of Representatives and Senate quarterly reports on the status of balances of projects and activities funded by the CHIPS for America Defense Fund for amounts allocated pursuant to subsection (a) of this section, including all uncommitted, committed, and unobligated funds.

Sec. 8118. Not later than 15 days after the date on which any foreign base that involves the stationing or operations of the United States Armed Forces, including a temporary base, permanent base, or base owned and operated by a foreign country, is opened or closed, the Secretary of Defense shall notify the congressional defense committees in writing of the opening or closing of such base: Provided, That such notification shall also include information on any personnel changes, costs, and savings associated with the opening or closing of such base.

Sec. 8119. None of the funds appropriated or otherwise made available by this or any other Act shall be obligated or expended by the United States Government for any of the following purposes: (1) To establish any military installation or base for the purpose of providing for the permanent stationing of United States Armed Forces in Iraq. (2) To exercise United States control over any oil resource of Iraq or Syria.

Sec. 8120. Up to $500,000,000 of the funds appropriated by this Act under the heading ``Operation and Maintenance, Defense-Wide'' for the Defense Security Cooperation Agency may be used to support the armed forces of Jordan. Sec. 8121. The amounts appropriated in title II of this Act are hereby reduced by $1,050,000,000 to reflect excess cash balances in Department of Defense Working Capital Funds, as follows:

(1) From ``Operation and Maintenance, Army'', $100,000,000; (2) From ``Operation and Maintenance, Navy'', $450,000,000; and (3) From ``Operation and Maintenance, Air Force'', $500,000,000.

Sec. 8122. Of the funds appropriated in this Act under the heading ``Operation and Maintenance, Defense- Wide'', $47,000,000 shall be for continued implementation and expansion of the Sexual Assault Special Victims' Counsel Program: Provided, That the funds are made available for transfer to the Department of the Army, the Department of the Navy, and the Department of the Air Force: Provided further, That funds transferred shall be merged with and available for the same purposes and for the same time period as the appropriations to which the funds are transferred: Provided further, That this transfer authority is in addition to any other transfer authority provided in this Act.

Sec. 8123. In carrying out the program described in the memorandum on the subject of ``Policy for Assisted Reproductive Services for the Benefit of Seriously or Severely Ill/ Injured (Category II or III) Active Duty Service Members'' issued by the Assistant Secretary of Defense for Health Affairs on April 3, 2012, and the guidance issued to implement such memorandum, the Secretary of Defense shall apply such policy and guidance, except that-- (1) the limitation on periods regarding embryo cryopreservation and storage set forth in part III(G) and in part IV(H) of such memorandum shall not apply; and (2) the term ``assisted reproductive technology'' shall include embryo cryopreservation and storage without limitation on the duration of such cryopreservation and storage.

Sec. 8124. The Secretary of Defense may obligate funds made available by this Act for procurement or for research, development, test and evaluation for the F-35 Joint Strike Fighter to modify not fewer than nine F-35 aircraft, including at least three F-35 aircraft of each variant, for any test configuration: Provided, That the Secretary of Defense shall, with the concurrence of the Secretary of the Air Force and the Secretary of the Navy, notify the congressional defense committees not fewer than 30 days prior to obligating funds under this section: Provided further, That any transfer of funds pursuant to the authority provided in this section shall be made in accordance with section 8005 of this Act.

Sec. 8125. None of the funds appropriated or otherwise made available by this or any other Act may be obligated to integrate an alternative engine on any F-35 aircraft. Sec. 8126. The Secretary of Defense may use up to $650,000,000 of the amounts appropriated or otherwise made available in this Act to the Department of Defense for the rapid acquisition and deployment of supplies and associated support services pursuant to section 3601 of title 10, United States Code, but only for the purposes specified in clauses (i), (ii), (iii), and (iv) of subsection (c)(3)(B) of such section and subject to the applicable limits specified in clauses (i), (ii), and (iii) of such subsection and, in the case of clause (iv) of such subsection, subject to a limit of $50,000,000, or for the purposes specified in section 229 of the National Defense Authorization Act for Fiscal Year 2024 (Public Law 118-31) and subject to a limit of $100,000,000: Provided, That the Secretary

of Defense shall notify the congressional defense committees promptly of all uses of this authority.

Sec. 8127. Notwithstanding section 8056 of this Act, amounts appropriated under the heading ``Research, Development, Test and Evaluation, Defense-Wide'' of this Act, as detailed in budget activity eight in the tables titled Explanation of Project Level Adjustments in the explanatory statement accompanying this Act for ``Defense Innovation Unit (DIU) Fielding'' line 301, may be used for expenses for agile research, development, test and evaluation, procurement, production, modification, and operation and maintenance requirements, including the initial acquisition of end-items for operational use: Provided, <<NOTE: Time period. Execution plan.>> That none of these funds may be obligated or expended until 15 days after the Secretary of Defense provides the congressional defense committees a detailed execution plan for such funds.

Sec. 8128. None of the funds made available by this Act may be used to support any activity conducted by, or associated with, the Wuhan Institute of Virology.

Sec. 8129. <<NOTE: EcoHealth Alliance, Inc. China. Determination. Waiver authority. Deadline. Submission.>> None of the funds made available by this Act may be used to fund any work to be performed by EcoHealth Alliance, Inc. in China on research supported by the government of China unless the Secretary of Defense determines that a waiver to such prohibition is in the national security interests of the United States and, not later than 14 days after granting such a waiver, submits to the congressional defense committees a detailed justification for the waiver, including-- (1) an identification of the Department of Defense entity obligating or expending the funds; (2) an identification of the amount of such funds; (3) an identification of the intended purpose of such funds; (4) an identification of the recipient or prospective recipient of such funds (including any third-party entity recipient, as applicable); (5) an explanation for how the waiver is in the national security interests of the United States; and (6) any other information the Secretary determines appropriate.

Sec. 8130. None of the funds appropriated or otherwise made available in this or any other Act may be used to transfer, release, or assist in the transfer or release to or within the United States, its territories, or possessions Khalid Sheikh Mohammed or any other detainee who-- (1) is not a United States citizen or a member of the Armed Forces of the United States; and (2) is or was held on or after June 24, 2009, at United States Naval Station, Guantanamo Bay, Cuba, by the Department of Defense.

Sec. 8131. None of the funds appropriated or otherwise made available in this Act may be used to transfer any individual detained at United States Naval Station Guantanamo Bay, Cuba, to the custody or control of the individual's country of origin, any other foreign country, or any other foreign entity except in accordance with section 1034 of the National Defense Authorization Act for Fiscal Year 2016 (Public Law 114-92) and section 1035 of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Public Law 115-232).

Sec. 8132. (a) None of the funds appropriated or otherwise made available in this or any other Act may be used to construct, acquire, or modify any facility in the United States, its territories, or possessions to house any individual described in subsection (c) for the purposes of detention or imprisonment in the custody or under the effective control of the Department of Defense.

(b) The prohibition in subsection (a) shall not apply to any modification of facilities at United States Naval Station, Guantanamo Bay, Cuba. (c) An individual described in this subsection is any individual who, as of June 24, 2009, is located at United States Naval Station, Guantanamo Bay, Cuba, and who-- (1) is not a citizen of the United States or a member of the Armed Forces of the United States; and (2) is-- (A) in the custody or under the effective control of the Department of Defense; or (B) otherwise under detention at United States Naval Station, Guantanamo Bay, Cuba.

Sec. 8133. None of the funds made available by this Act may be used to carry out the closure or realignment of the United States Naval Station, Guantanamo Bay, Cuba.

Sec. 8134. There is appropriated to the ``Department of Defense Credit Program Account'' established pursuant to section 149(e)(5) of title 10, United States Code, $97,770,000, to remain available until expended, to carry out a pilot program on capital assistance to support defense investment in the industrial base as authorized by section 149(e) of such title, of which up to $2,500,000 may be used for administrative expenses and project-specific transaction costs: Provided, That costs of loans and loan guarantees, including the cost of modifying such loans and loan guarantees, shall be as defined in section 502 of the Congressional Budget Act of 1974: Provided further, That such amounts are available to subsidize gross obligations for the principal amount of loans, and total loan principal, any part of which is to be guaranteed, not to exceed $4,390,000,000: Provided further, That, for the purposes of carrying out the Congressional Budget Act of 1974, the Director of the Congressional Budget Office may request, and the Secretary shall promptly provide documentation and information relating to a project receiving capital assistance as authorized under section 149(e) of such title.

Sec. 8135. None of the funds appropriated or otherwise made available by this Act may be used to divest or prepare to divest more than eight U-2 aircraft. Sec. 8136. The amounts appropriated in title II of this Act are hereby reduced by $1,204,617,000 to reflect savings attributable to efficiencies, streamlining of functions, and management improvements in the Department of Defense, as follows: (1) From ``Operation and Maintenance, Army'', $563,288,000; (2) From ``Operation and Maintenance, Navy'', $109,159,000; (3) From ``Operation and Maintenance, Marine Corps'', $9,467,000; (4) From ``Operation and Maintenance, Air Force'', $319,765,000;

(5) From ``Operation and Maintenance, Space Force'', $6,493,000; and (6) From ``Operation and Maintenance, Defense-Wide'', $196,445,000:

Provided, That such reduction may not be derived from amounts appropriated by this Act for the National Intelligence Program or the Military Intelligence Program. Sec. 8137. (a) Concurrent with the annual budget submission of the President for fiscal year 2027, and each fiscal year thereafter, pursuant to section 1105(a) of title 31, United States Code, the Secretary of Defense shall submit to the Committees on Appropriations of the House of Representatives and the Senate the following with respect to amounts made available by Public Law 119-21 until all such amounts have been expended: (1) proposed allocations by account, by fiscal year, and by program, project, or activity, with detailed justifications; (2) P-1 and R-1 budget justification documents, which shall identify the allocation of funds by program, project, and activity; and (3) budget justification documents, to be known as M-1 and O-1, which shall identify the allocation of funds by budget activity, activity group, and sub-activity group.

(b) Subsequent to the submission required in subsection (a), the Secretary of Defense shall submit to the Committees on Appropriations of the House of Representatives and Senate quarterly reports on the status of balances of projects and activities funded using amounts described in subsection (a), including all uncommitted, committed, and unobligated funds, until all such amounts have been expended.

Sec. 8138. The Secretary of Defense shall obligate funds made available by this or any other Act, including prior year Acts, under the heading ``Research, Development, Test and Evaluation, Navy'' for the Next Generation Fighter program for the purpose of executing the engineering and manufacturing development contract for the Next Generation Fighter aircraft in a manner that achieves accelerated Initial Operational Capability: Provided, That none of the funds made available to the Department of Defense for this fiscal year or any prior fiscal year may be used to pause, cancel, or terminate the Next Generation Fighter program.

Sec. 8139. Of the funds provided under the heading ``Operation and Maintenance, Navy'', not less than $80,000,000 shall be made available for the establishment of a Platform Supply Vessel Pilot Program (in this section referred to as the ``Program'') for the purpose of validating Service requirements necessary to meet at-sea and in-shore logistics operations: Provided, That the Program shall evaluate options to time charter no less than six, and enter into a contractual agreement for no less than two time charters: Provided further, That the condition of the time charter should consider existing United States-built platform supply vessels that are documented under the laws of the United States, owned by a citizen of the United States under 46 U.S.C. 50501, configured for logistics support in the Indo- Pacific region that can meet the regulatory and physical requirements to transport nearly 500,000 gallons of various standard fuels, and provide up to 10,000 square feet of combined deck space for transport of military equipment and personnel for delivery in and out of shallow draft ports in the Indo-Pacific region: Provided further, That the Secretary of

the Navy shall provide a briefing within 180 days after the enactment of this Act to the House and Senate Appropriations Committees on the status of the Program and the effectiveness of using PSVs to fill this critical need.

Sec. 8140. Funds made available for the UH-60 Blackhawk aircraft program under this or any other Act, including prior year Acts, under the headings ``Aircraft Procurement, Army'' and ``Research, Development, Test and Evaluation, Army'' shall be obligated only for the purposes for which such funds were appropriated and such funds may not be reprogrammed or transferred for other purposes: Provided, That none of the funds made available to the Department of Defense for this fiscal year or any prior fiscal year may be used to pause, cancel, or terminate the UH-60 Blackhawk aircraft program or to prepare to pause, cancel, or terminate such program. Sec. 8141. Funds made available for the E-7 Wedgetail aircraft program under this or any other Act, including prior year Acts, under the headings ``Aircraft Procurement, Air Force'' and ``Research, Development, Test and Evaluation, Air Force'' shall be obligated only for the purposes for which such funds were appropriated and such funds may not be reprogrammed or transferred for other purposes: Provided, That none of the funds made available to the Department of Defense for this fiscal year or any prior fiscal year may be used to pause, cancel, or terminate the E-7 Wedgetail aircraft program or to prepare to pause, cancel, or terminate such program. Sec. 8142. None of the funds made available by this Act may be used to close-- (1) the Rock Island Arsenal Museum located in Rock Island Arsenal, Illinois; (2) the Fort Sill National Historic Landmark and Museum located in Lawton, Oklahoma; (3) the United States Army Transportation Museum located at Fort Eustis, Virginia; or (4) the General George Patton Museum of Leadership located at Fort Knox, Kentucky.

Sec. 8143. Of the amounts appropriated in this Act under the heading ``Operation and Maintenance, Defense-Wide'', for the Defense Security Cooperation Agency, $1,000,000,000, to remain available until September 30, 2027, shall be for the Taiwan Security Cooperation Initiative: Provided, That such funds shall be available to the Secretary of Defense, with the concurrence of the Secretary of State, to provide assistance, including new procurement of defense articles, services, and military education and training to Taiwan: Provided further, That equipment procured using funds made available in this section, and not yet transferred to Taiwan, or returned by Taiwan to the United States, may be treated as stocks of the Department of Defense upon written notification to the congressional defense committees: Provided further, That the Secretary of Defense shall, not less than 15 days prior to obligating funds made available in this section, notify the congressional defense committees in writing of the details of any such obligation: Provided further, That the Secretary of Defense shall provide quarterly reports to the congressional defense committees on the use and status of funds made available in this section.

Sec. 8144. Of the amounts appropriated or otherwise made available by title II of this Act under the heading ``Operation

and Maintenance, Air Force'', the Secretary of Defense may reimburse the Federated States of Micronesia in an amount not to exceed $34,000,000 for land acquisition costs for defense sites in Yap. Sec. 8145. The total amount appropriated in title II of this Act is hereby reduced by $550,000,000 to reflect savings due to favorable bulk fuel rates: Provided, That such reduction may not be derived from amounts appropriated by this Act for the National Intelligence Program or the Military Intelligence Program.

Sec. 8146. In making Federal financial assistance, the Department of Defense shall continue to apply the negotiated indirect cost rates in section 200.414 of title 2, Code of Federal Regulations, including with respect to the approval of deviations from negotiated indirect cost rates, to the same extent and in the same manner as such negotiated indirect cost rates were applied in fiscal year 2024: Provided, That none of the funds appropriated in this or prior Department of Defense Appropriations Acts, or otherwise made available to the Department of Defense may be used to develop, modify, or implement changes to such fiscal year 2024 negotiated indirect cost rates.

(including transfer of funds)

Sec. 8147. Of the amounts appropriated in this Act under the heading ``Operation and Maintenance, Defense-Wide'', $150,000,000, to remain available until September 30, 2027, may be used for replacement of defense articles and for reimbursement of defense services provided to or identified for provision to Taiwan: Provided, That such funds may be transferred to appropriations made available under titles II, III, IV, and V of this Act for replacement, through new procurement or repair of existing unserviceable equipment, of defense articles from the stocks of the Department of Defense, and for reimbursement for defense services of the Department of Defense and military education and training, provided to the government of Taiwan or to foreign countries that have provided support to Taiwan at the request of the United States: Provided further, That funds transferred pursuant to this section shall be merged with and available for the same purposes and for the same time period as the appropriations to which the funds are transferred: Provided further, That the Secretary of Defense shall notify the congressional defense committees of the details of such transfers not less than 15 days before any such transfer: Provided further, That upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein, such amounts may be transferred back and merged with this appropriation: Provided further, That the transfer authority provided in this section is in addition to any other transfer authority provided in this Act.

Sec. 8148. None of the funds made available to the Department of Defense for this fiscal year or any prior fiscal year may be used by the Department of Defense to award a sole-source or non- competitive contract in excess of $100,000,000 for space-based airborne moving target indication systems.

Sec. 8149. None of the funds made available to the Department of Defense for this fiscal year or any prior fiscal year may be used to pause, cancel, or terminate the Next-Generation Overhead

Persistent Infrared Geosynchronous Earth Orbit and the Next-Generation Overhead Persistent Infrared Polar programs. Sec. 8150. Any transactions or follow-on transactions entered into pursuant to the authority in section 2808a of title 10, United States Code, to carry out repair and construction projects for facilities may only be carried out if, without regard to section 2808a, such projects are otherwise authorized by law and the use of military construction, operation and maintenance, or research, development, test and evaluation funds is otherwise authorized for such projects: Provided, That none of the funds appropriated or otherwise made available by this or prior Acts, by title I of division D of Public Law 119-37 or by any prior Act making appropriations for Military Construction, Veterans Affairs, and Related Agencies, or by funds made available to the Department of Defense in Public Law 119-21 may be transferred pursuant to the authority in section 2808a of title 10, United States Code. Sec. 8151. The amounts appropriated in title IV of this Act are hereby reduced by $1,000,000,000 due to the expiration of authorizations contained in 15 U.S.C. 638, as follows: ``Research, Development, Test and Evaluation, Army'', $140,000,000; ``Research, Development, Test and Evaluation, Navy'', $157,000,000; ``Research, Development, Test and Evaluation, Air Force'', $325,000,000; ``Research, Development, Test and Evaluation, Space Force'', $140,000,000; and ``Research, Development, Test and Evaluation, Defense- Wide'', $238,000,000:

Provided, That this section shall not apply to appropriations for the National Intelligence Program: Provided further, <<NOTE: Time period. Prorated funds.>> That if a law reauthorizing 15 U.S.C. 638 for fiscal year 2026 is enacted after the date of the enactment of this section and before September 30, 2026, the required expenditure amount in 15 U.S.C. 638 for the Department of Defense for such program for such fiscal year shall be prorated on an annual basis for the remainder of such fiscal year based on the extramural budget (as defined in 15 U.S.C. 638(e)(1)) of the Department on the date of the enactment of such law.

Sec. 8152. Of the amounts appropriated in this Act under the heading ``Operation and Maintenance, Defense-Wide'', for the Defense Security Cooperation Agency, $200,000,000, to remain available until September 30, 2027, shall be available for the International Security Cooperation Program - Baltic Security Initiative to provide support and assistance to the foreign security forces of Estonia, Latvia, and Lithuania in accordance with the objectives identified by section 1247 of the National Defense Authorization Act for Fiscal Year 2026 (Public Law 119-60): Provided, That the Secretary of Defense shall, not less than 15 days prior to obligating funds made available in this section, notify the congressional defense committees in writing of the details of any planned obligation: Provided further, That the Secretary of Defense shall provide quarterly reports to the Committees on Appropriations of the House of Representatives and the Senate on the use and status of funds made available in this section.

(including transfer of funds)

Sec. 8153. (a) In addition to amounts made available elsewhere in this Act, $500,000,000, of which not less than $150,000,000 shall be available only for the qualification and testing of second source providers, is hereby appropriated to the Department of Defense and may be transferred to the procurement accounts of the Army, Navy, Air Force, and Department of Defense and the ``Research, Development, Test and Evaluation, Defense-Wide'' account, only for the following purposes-- (1) investment in modernization, expansion, or facilitization of the solid rocket motor industrial base, including capital equipment, tooling, and facility upgrades; (2) workforce development, training, and retention; (3) supplier base expansion and qualification, including second- and third-tier vendors and non-traditional manufacturers; (4) process improvements, automation, and digital manufacturing; and (5) risk reduction and surge capacity initiatives necessary to ensure reliable, affordable, and timely production of solid rocket motors and related energetics:

(b) Not later than 60 days after the date of the enactment of this Act, the Secretary of Defense shall provide a briefing to the congressional defense committees on planned activities under this section, including an explanation of how competition considerations and industry input were incorporated into acquisition and execution decisions: Provided <<NOTE: Time period. Execution plan.>>, That none of the funds provided under this section may be obligated or expended until 30 days after the Secretary of Defense provides to the congressional defense committees a detailed execution plan for the use of such funds: Provided further, <<NOTE: Time period. Notification.>> That the Secretary of Defense shall, not fewer than 15 days prior to any transfer of funds, notify the Committees on Appropriations of the House of Representatives and the Senate in writing of the details of any such transfer: Provided further, That upon transfer, the funds shall be merged with and available for the same purposes, and for the same time period, as the appropriation to which transferred: Provided further, That upon a determination that all or part of the funds transferred from this appropriation are not necessary for the purposes provided herein, such amounts may be transferred back and merged with this appropriation: Provided further, That the transfer authority provided under this section is in addition to any other transfer authority provided elsewhere in this Act.

This division may be cited as the ``Department of Defense Appropriations Act, 2026''.

DIVISION B-- <<NOTE: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026.>> DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2026

TITLE I

DEPARTMENT OF LABOR

Employment and Training Administration

training and employment services

For necessary expenses of the Workforce Innovation and Opportunity Act (referred to in this Act as ``WIOA'') and the National Apprenticeship Act, $3,981,588,000 plus reimbursements, shall be available. Of the amounts provided: (1) for grants to States for adult employment and training activities, youth activities, and dislocated worker employment and training activities, $2,919,332,000 as follows: (A) $875,649,000 for adult employment and training activities, of which $163,649,000 shall be available for the period July 1, 2026 through June 30, 2027, and of which $712,000,000 shall be available for the period October 1, 2026 through June 30, 2027; (B) $948,130,000 for youth activities, which shall be available for the period April 1, 2026 through June 30, 2027; and (C) $1,095,553,000 for dislocated worker employment and training activities, of which $235,553,000 shall be available for the period July 1, 2026 through June 30, 2027, and of which $860,000,000 shall be available for the period October 1, 2026 through June 30, 2027: Provided, That the funds available for allotment to outlying areas to carry out subtitle B of title I of the WIOA shall not be subject to the requirements of section 127(b)(1)(B)(ii) of such Act: Provided further, That notwithstanding the requirements of WIOA, outlying areas may submit a single application for a consolidated grant that awards funds that would otherwise be available to such areas to carry out the activities described in subtitle B of title I of the WIOA: Provided further, That such application shall be submitted to the Secretary of Labor (referred to in this title as ``Secretary''), at such time, in such manner, and containing such information as the Secretary may require: Provided further, That outlying areas awarded a consolidated grant described in the preceding provisos may use the funds for any of the programs and activities authorized under such subtitle B of title I of the WIOA subject to approval of the application and such reporting requirements issued by the Secretary; and (2) for national programs, $1,062,256,000 as follows: (A) $300,859,000 for the dislocated workers assistance national reserve, of which $100,859,000 shall be available for the period July 1, 2026 through September 30, 2027, and of which $200,000,000 shall be available for the period October 1, 2026 through September 30, 2027: Provided, That funds provided to carry out section 132(a)(2)(A) of the WIOA may be used to provide assistance to a State for statewide or local use in order to address cases where

there have been worker dislocations across multiple sectors or across multiple local areas and such workers remain dislocated; coordinate the State workforce development plan with emerging economic development needs; and train such eligible dislocated workers: Provided further, That funds provided to carry out sections 168(b) and 169(c) of the WIOA may be used for technical assistance and demonstration projects, respectively, that provide assistance to new entrants in the workforce and incumbent workers: Provided further, That notwithstanding section 168(b) of the WIOA, of the funds provided under this subparagraph, the Secretary may reserve not more than 10 percent of such funds to provide technical assistance and carry out additional activities related to the transition to the WIOA: Provided further, That of the funds provided under this subparagraph, $120,000,000 shall be for training and employment assistance under sections 168(b), 169(c) (notwithstanding the 10 percent limitation in such section) and 170 of the WIOA as follows: (i) $55,000,000 shall be for workers in the Appalachian region, as defined by 40 U.S.C. 14102(a)(1), workers in the Lower Mississippi, as defined in section 4(2) of the Delta Development Act (Public Law 100-460, 102 Stat. 2246; 7 U.S.C. 2009aa(2)), and workers in the region served by the Northern Border Regional Commission, as defined by 40 U.S.C. 15733; and (ii) $65,000,000 shall be for the purpose of developing, offering, or improving educational or career training programs at community colleges, defined as public institutions of higher education, as described in section 101(a) of the Higher Education Act of 1965 and at which the associate's degree is primarily the highest degree awarded, with other eligible institutions of higher education, as defined in section 101(a) of the Higher Education Act of 1965, eligible to participate through consortia, with community colleges as the lead grantee: Provided, That the Secretary shall follow the requirements for the program in House Report 116-62: Provided further, That any grant funds used for apprenticeships shall be used to support only apprenticeship programs registered under the National Apprenticeship Act and as referred to in section 3(7)(B) of the WIOA; (B) $62,500,000 for Native American programs under section 166 of the WIOA, which shall be available for the period July 1, 2026 through June 30, 2027; (C) $97,396,000 for migrant and seasonal farmworker programs under section 167 of the WIOA, including $90,134,000 for formula grants (of which not less than 70 percent shall be for employment and training services), $6,591,000 for migrant and seasonal housing (of which not less than 70 percent shall be for permanent housing), and $671,000 for other discretionary purposes, which shall be available for the period April 1, 2026 through June 30, 2027: Provided, That notwithstanding any other provision of law or related regulation, the Department of Labor shall take no action limiting the number or proportion

of eligible participants receiving related assistance services or discouraging grantees from providing such services: Provided further, That notwithstanding the definition of ``eligible seasonal farmworker'' in section 167(i)(3)(A) of the WIOA relating to an individual being ``low-income'', an individual is eligible for migrant and seasonal farmworker programs under section 167 of the WIOA under that definition if, in addition to meeting the requirements of clauses (i) and (ii) of section 167(i)(3)(A), such individual is a member of a family with a total family income equal to or less than 150 percent of the poverty line; (D) $105,000,000 for YouthBuild activities as described in section 171 of the WIOA, which shall be available for the period April 1, 2026 through June 30, 2027; (E) $110,000,000 for ex-offender activities, under the authority of section 169 of the WIOA, which shall be available for the period April 1, 2026 through June 30, 2027: Provided, That of this amount, $30,000,000 shall be for competitive grants to national and regional intermediaries for activities that prepare for employment young adults with criminal legal histories, young adults who have been justice system-involved, or young adults who have dropped out of school or other educational programs, with a priority for projects serving high-crime, high-poverty areas; (F) $6,000,000 for the Workforce Data Quality Initiative, under the authority of section 169 of the WIOA, which shall be available for the period July 1, 2026 through June 30, 2027; (G) $285,000,000 to expand opportunities through apprenticeships only registered under the National Apprenticeship Act and as referred to in section 3(7)(B) of the WIOA, to be available to the Secretary to carry out activities through grants, cooperative agreements, contracts and other arrangements, with States and other appropriate entities, including equity intermediaries and business and labor industry partner intermediaries, which shall be available for the period July 1, 2026 through June 30, 2027; and (H) $95,501,000 for carrying out Demonstration and Pilot projects under section 169(c) of the WIOA, which shall be available for the period April 1, 2026 through June 30, 2027, in addition to funds available for such activities under subparagraph (A) for the projects, and in the amounts, specified in the table titled ``Community Project Funding/Congressionally Directed Spending'' included in the explanatory statement described in section 4 (in the matter preceding division A of this consolidated Act): Provided, That such funds may be used for projects that are related to the employment and training needs of dislocated workers, other adults, or youth: Provided further, That the 10 percent funding limitation under such section of the WIOA shall not apply to such funds: Provided further, That section 169(b)(6)(C) of the WIOA shall not apply to such funds: Provided further, That sections 102 and 107 of this Act shall not apply to such funds.

job corps

(including transfer of funds)

To carry out subtitle C of title I of the WIOA, including Federal administrative expenses, the purchase and hire of passenger motor vehicles, the construction, alteration, and repairs of buildings and other facilities, and the purchase of real property for training centers as authorized by the WIOA, $1,760,155,000, plus reimbursements, as follows: (1) $1,603,325,000 for Job Corps Operations, which shall be available for the period July 1, 2026 through June 30, 2027; (2) $123,000,000 for construction, rehabilitation and acquisition of Job Corps Centers, which shall be available for the period July 1, 2026 through June 30, 2029, and which may include the acquisition, maintenance, and repair of major items of equipment: Provided, That the Secretary may transfer up to 15 percent of such funds to meet the operational needs of such centers or to achieve administrative efficiencies: Provided further, That any funds transferred pursuant to the preceding proviso shall not be available for obligation after June 30, 2027: Provided further, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance of any transfer; and (3) $33,830,000 for necessary expenses of Job Corps, which shall be available for obligation for the period October 1, 2025 through September 30, 2026:

Provided, That no funds from any other appropriation shall be used to provide meal services at or for Job Corps Centers.

community service employment for older americans

To carry out title V of the Older Americans Act of 1965 (referred to in this Act as ``OAA''), $395,000,000, which shall be available for the period April 1, 2026 through June 30, 2027, and may be recaptured and reobligated in accordance with section 517(c) of the OAA.

federal unemployment benefits and allowances

For payments during fiscal year 2026 of trade adjustment benefit payments and allowances under part I of subchapter B of chapter 2 of title II of the Trade Act of 1974, and section 246 of that Act; and for training, employment and case management services, allowances for job search and relocation, and related State administrative expenses under part II of subchapter B of chapter 2 of title II of the Trade Act of 1974, and including benefit payments, allowances, training, employment and case management services, and related State administration provided pursuant to section 231(a) of the Trade Adjustment Assistance Extension Act of 2011, sections 405(a) and 406 of the Trade Preferences Extension Act of 2015, and section 285(a) of the Trade Act of 1974, as amended, $50,300,000 together with such amounts as may be necessary to be charged to the subsequent appropriation for payments for any period subsequent to September 15, 2026: Provided, That notwithstanding section 502 of this Act, any part of the appropriation provided under this heading may remain available for obligation

beyond the current fiscal year pursuant to the authorities of section 245(c) of the Trade Act of 1974 (19 U.S.C. 2317(c)).

state unemployment insurance and employment service operations

(including transfer of funds)

For authorized administrative expenses, $74,306,000, together with not to exceed $4,000,584,000 which may be expended from the Employment Security Administration Account in the Unemployment Trust Fund (``the Trust Fund''), of which-- (1) $3,226,635,000 from the Trust Fund is for grants to States for the administration of State unemployment insurance laws as authorized under title III of the Social Security Act (including not less than $467,000,000 to carry out reemployment services and eligibility assessments under section 306 of such Act, any claimants of regular compensation, as defined in such section, including those who are profiled as most likely to exhaust their benefits, may be eligible for such services and assessments: Provided, That of such amount, $117,000,000 is specified for grants under section 306 of the Social Security Act and is provided to meet the terms of a concurrent resolution on the budget and $350,000,000 is additional new budget authority specified for purposes of a concurrent resolution on the budget; and $9,000,000 for continued support of the Unemployment Insurance Integrity Center of Excellence), the administration of unemployment insurance for Federal employees and for ex-service members as authorized under 5 U.S.C. 8501- 8523, and the administration of trade readjustment allowances, reemployment trade adjustment assistance, and alternative trade adjustment assistance under the Trade Act of 1974 and under section 231(a) of the Trade Adjustment Assistance Extension Act of 2011, sections 405(a) and 406 of the Trade Preferences Extension Act of 2015, and section 285(a) of the Trade Act of 1974, as amended, and shall be available for Federal obligation through December 31, 2026, except that funds for outcome payments pursuant to section 306(f)(2) of the Social Security Act shall be available for Federal obligation through March 31, 2027: Provided, That notwithstanding any other provision of law, the Secretary may recapture any funds appropriated under this paragraph that remain unexpended by a State after the period of expenditure for a State (but before such funds have been returned to the Trust Fund), and such recaptured funds shall remain available until expended for reobligation by the Secretary to the States to carry out automation activities related to the administration of unemployment compensation laws: Provided further, That funds transferred pursuant to the preceding proviso shall not be available until 60 days after the Secretary has submitted a plan to the Committees on Appropriations of the House of Representatives and the Senate on the planned use of funds; (2) $18,000,000 from the Trust Fund is for national activities necessary to support the administration of the Federal-State unemployment insurance system; (3) $653,639,000 from the Trust Fund, together with $21,413,000 from the General Fund of the Treasury, is for

grants to States in accordance with section 6 of the Wagner- Peyser Act, and shall be available for Federal obligation for the period July 1, 2026 through June 30, 2027; (4) $17,500,000 from the Trust Fund is for national activities of the Employment Service, including administration of the work opportunity tax credit under section 51 of the Internal Revenue Code of 1986 (including assisting States in adopting or modernizing information technology for use in the processing of certification requests), and the provision of technical assistance and staff training under the Wagner-Peyser Act; (5) $84,810,000 from the Trust Fund is for the administration of foreign labor certifications and related activities under the Immigration and Nationality Act and related laws, of which $61,528,000 shall be available for the Federal administration of such activities, and $23,282,000 shall be available for grants to States for the administration of such activities; and (6) $52,893,000 from the General Fund is to provide workforce information, national electronic tools, and one-stop system building under the Wagner-Peyser Act and shall be available for Federal obligation for the period July 1, 2026 through June 30, 2027, of which up to $9,800,000 may be used to carry out research and demonstration projects related to testing effective ways to promote greater labor force participation of people with disabilities: Provided, That the Secretary may transfer amounts made available for research and demonstration projects under this paragraph to the ``Office of Disability Employment Policy'' account for such purposes:

Provided, That to the extent that the Average Weekly Insured Unemployment (``AWIU'') for fiscal year 2026 is projected by the Department of Labor to exceed 3,075,000, an additional $28,600,000 from the Trust Fund shall be available for obligation for every 100,000 increase in the AWIU level (including a pro rata amount for any increment less than 100,000) to carry out title III of the Social Security Act: Provided further, That funds appropriated in this Act that are allotted to a State to carry out activities under title III of the Social Security Act may be used by such State to assist other States in carrying out activities under such title III if the other States include areas that have suffered a major disaster declared by the President under the Robert T. Stafford Disaster Relief and Emergency Assistance Act: Provided further, That the Secretary may use funds appropriated for grants to States under title III of the Social Security Act to make payments on behalf of States for the use of the National Directory of New Hires under section 453(j)(8) of such Act: Provided further, That the Secretary may use funds appropriated for grants to States under title III of the Social Security Act to make payments on behalf of States to the entity operating the State Information Data Exchange System: Provided further, That funds appropriated in this Act which are used to establish a national one-stop career center system, or which are used to support the national activities of the Federal-State unemployment insurance, employment service, or immigration programs, may be obligated in contracts, grants, or agreements with States and non-State entities: Provided further, That States awarded competitive grants for improved operations under title III of the Social Security Act, or awarded grants to support the national activities of the Federal-State unemployment insurance system, may award subgrants to other States and non-

State entities under such grants, subject to the conditions applicable to the grants: Provided further, That funds appropriated under this Act for activities authorized under title III of the Social Security Act and the Wagner-Peyser Act may be used by States to fund integrated Unemployment Insurance and Employment Service automation efforts, notwithstanding cost allocation principles prescribed under the final rule entitled ``Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards'' at part 200 of title 2, Code of Federal Regulations: Provided further, That the Secretary, at the request of a State participating in a consortium with other States, may reallot funds allotted to such State under title III of the Social Security Act to other States participating in the consortium or to the entity operating the Unemployment Insurance Information Technology Support Center in order to carry out activities that benefit the administration of the unemployment compensation law of the State making the request: Provided further, That the Secretary may collect fees for the costs associated with additional data collection, analyses, and reporting services relating to the National Agricultural Workers Survey requested by State and local governments, public and private institutions of higher education, and nonprofit organizations and may utilize such sums, in accordance with the provisions of 29 U.S.C. 9a, for the National Agricultural Workers Survey infrastructure, methodology, and data to meet the information collection and reporting needs of such entities, which shall be credited to this appropriation and shall remain available until September 30, 2027, for such purposes.

advances to the unemployment trust fund and other funds

For repayable advances to the Unemployment Trust Fund as authorized by sections 905(d) and 1203 of the Social Security Act, and to the Black Lung Disability Trust Fund as authorized by section 9501(c)(1) of the Internal Revenue Code of 1986; and for nonrepayable advances to the revolving fund established by section 901(e) of the Social Security Act, to the Unemployment Trust Fund as authorized by 5 U.S.C. 8509, and to the ``Federal Unemployment Benefits and Allowances'' account, such sums as may be necessary, which shall be available for obligation through September 30, 2027.

program administration

For expenses of administering employment and training programs, $104,527,000, together with not to exceed $53,906,000 which shall be available from the Employment Security Administration Account in the Unemployment Trust Fund.

Veterans' Employment and Training

veterans' employment and training service

Not to exceed $269,841,000 may be derived from the Employment Security Administration account in the Unemployment Trust Fund to carry out the provisions of chapters 41, 42, and 43 of title 38, United States Code, of which-- (1) $185,000,000 is for Jobs for Veterans State grants under 38 U.S.C. 4102A(b)(5) to support disabled veterans' outreach program specialists under section 4103A of such title and local

veterans' employment representatives under section 4104(b) of such title, and for the expenses described in section 4102A(b)(5)(C), which shall be available for expenditure by the States through September 30, 2028, and not to exceed 3 percent for the necessary Federal expenditures for data systems and contract support to allow for the tracking of participant and performance information: Provided, That, in addition, such funds may be used to support such specialists and representatives in the provision of services to transitioning members of the Armed Forces who have participated in the Transition Assistance Program and have been identified as in need of intensive services, to members of the Armed Forces who are wounded, ill, or injured and receiving treatment in military treatment facilities or warrior transition units, to the spouses or other family caregivers of such wounded, ill, or injured members, and to surviving spouses of individuals who died while serving as members of the Armed Forces or as a result of a service- connected disability; (2) $34,379,000 is for carrying out the Transition Assistance Program under 38 U.S.C. 4113 and 10 U.S.C. 1144; (3) $47,048,000 is for Federal administration of chapters 41, 42, and 43 of title 38, and sections 2021, 2021A and 2023 of title 38, United States Code: Provided, That up to $500,000 may be used to carry out the Hire VETS Act (division O of Public Law 115-31); and (4) $3,414,000 is for the National Veterans' Employment and Training Services Institute under 38 U.S.C. 4109:

Provided, That the Secretary may reallocate among the appropriations provided under paragraphs (1) through (4) above an amount not to exceed 3 percent of the appropriation from which such reallocation is made.

In addition, from the General Fund of the Treasury, $65,500,000 is for carrying out programs to assist homeless veterans and veterans at risk of homelessness who are transitioning from certain institutions under sections 2021, 2021A, and 2023 of title 38, United States Code: Provided, That notwithstanding subsections (c)(3) and (d) of section 2023, the Secretary may award grants through September 30, 2026, to provide services under such section: Provided further, That services provided under sections 2021 or under 2021A may include, in addition to services to homeless veterans described in section 2002(a)(1), services to veterans who were homeless at some point within the 60 days prior to program entry or veterans who are at risk of homelessness within the next 60 days, and that services provided under section 2023 may include, in addition to services to the individuals described in subsection (e) of such section, services to veterans recently released from incarceration who are at risk of homelessness: Provided further, That notwithstanding paragraph (3) under this heading, funds appropriated in this paragraph may be used for data systems and contract support to allow for the tracking of participant and performance information: Provided further, That notwithstanding sections 2021(e)(2) and 2021A(f)(2) of title 38, United States Code, such funds shall be available for expenditure pursuant to 31 U.S.C. 1553.

In addition, fees may be assessed and deposited in the HIRE Vets Medallion Award Fund pursuant to section 5(b) of the HIRE Vets Act, and such amounts shall be available to the Secretary

to carry out the HIRE Vets Medallion Award Program, as authorized by such Act, and shall remain available until expended: Provided, That such sums shall be in addition to any other funds available for such purposes, including funds available under paragraph (3) of this heading: Provided further, That section 2(d) of division O of the Consolidated Appropriations Act, 2017 (Public Law 115-31; 38 U.S.C. 4100 note) shall not apply.

Employee Benefits Security Administration

salaries and expenses

For necessary expenses for the Employee Benefits Security Administration, $191,100,000, of which up to $3,000,000 shall be made available through September 30, 2027, for the procurement of expert witnesses for enforcement litigation.

Pension Benefit Guaranty Corporation

pension benefit guaranty corporation fund

The Pension Benefit Guaranty Corporation (``Corporation'') is authorized to make such expenditures, including financial assistance authorized by subtitle E of title IV of the Employee Retirement Income Security Act of 1974, within limits of funds and borrowing authority available to the Corporation, and in accord with law, and to make such contracts and commitments without regard to fiscal year limitations, as provided by 31 U.S.C. 9104, as may be necessary in carrying out the program, including associated administrative expenses, through September 30, 2026, for the Corporation: Provided, That none of the funds available to the Corporation for fiscal year 2026 shall be available for obligations for administrative expenses in excess of $494,264,000: Provided further, That to the extent that the number of new plan participants in plans terminated by the Corporation exceeds 100,000 in fiscal year 2026, an amount not to exceed an additional $9,200,000 shall be available through September 30, 2030, for obligations for administrative expenses for every 20,000 additional terminated participants: Provided further, That obligations in excess of the amounts provided for administrative expenses in this paragraph may be incurred and shall be available through September 30, 2030 for obligation for unforeseen and extraordinary pre-termination or termination expenses or extraordinary multiemployer program related expenses after approval by the Office of Management and Budget and notification of the Committees on Appropriations of the House of Representatives and the Senate: Provided further, That an additional amount shall be available for obligation through September 30, 2030 to the extent the Corporation's costs exceed $250,000 for the provision of credit or identity monitoring to affected individuals upon suffering a security incident or privacy breach, not to exceed an additional $100 per affected individual.

Wage and Hour Division

salaries and expenses

For necessary expenses for the Wage and Hour Division, including reimbursement to State, Federal, and local agencies and their employees for inspection services rendered, $260,000,000.

Office of Labor-Management Standards

salaries and expenses

For necessary expenses for the Office of Labor-Management Standards, $48,515,000.

Office of Federal Contract Compliance Programs

salaries and expenses

For necessary expenses for the Office of Federal Contract Compliance Programs, $100,976,000.

Office of Workers' Compensation Programs

salaries and expenses

For necessary expenses for the Office of Workers' Compensation Programs, $120,500,000, together with $2,205,000 which may be expended from the Special Fund in accordance with sections 39(c), 44(d), and 44(j) of the Longshore and Harbor Workers' Compensation Act.

special benefits

(including transfer of funds)

For the payment of compensation, benefits, and expenses (except administrative expenses not otherwise authorized) accruing during the current or any prior fiscal year authorized by 5 U.S.C. 81; continuation of benefits as provided for under the heading ``Civilian War Benefits'' in the Federal Security Agency Appropriation Act, 1947; the Employees' Compensation Commission Appropriation Act, 1944; section 5(f) of the War Claims Act (50 U.S.C. App. 2012); obligations incurred under the War Hazards Compensation Act (42 U.S.C. 1701 et seq.); and 50 percent of the additional compensation and benefits required by section 10(h) of the Longshore and Harbor Workers' Compensation Act, $1,298,385,000, together with such amounts as may be necessary to be charged to the subsequent year appropriation for the payment of compensation and other benefits for any period subsequent to August 15 of the current year, for deposit into and to assume the attributes of the Employees' Compensation Fund established under 5 U.S.C. 8147(a): Provided, That amounts appropriated may be used under 5 U.S.C. 8104 by the Secretary to reimburse an employer, who is not the employer at the time of injury, for portions of the salary of a re-employed, disabled beneficiary: Provided further, That balances of reimbursements unobligated on September 30, 2025, shall remain available until expended for the payment of compensation, benefits, and expenses: Provided further, That in addition

there shall be transferred to this appropriation from the Postal Service and from any other corporation or instrumentality required under 5 U.S.C. 8147(c) to pay an amount for its fair share of the cost of administration, such sums as the Secretary determines to be the cost of administration for employees of such fair share entities through September 30, 2026: Provided further, That of those funds transferred to this account from the fair share entities to pay the cost of administration of the Federal Employees' Compensation Act, $81,808,000 shall be made available to the Secretary as follows: (1) For enhancement and maintenance of automated data processing systems operations and telecommunications systems, $27,549,000; (2) For automated workload processing operations, including document imaging, centralized mail intake, and medical bill processing, $25,956,000; (3) For periodic roll disability management and medical review, $25,957,000; (4) For program integrity, $2,346,000; and (5) The remaining funds shall be paid into the Treasury as miscellaneous receipts:

Provided further, That the Secretary may require that any person filing a notice of injury or a claim for benefits under 5 U.S.C. 81, or the Longshore and Harbor Workers' Compensation Act, provide as part of such notice and claim, such identifying information (including Social Security account number) as such regulations may prescribe.

special benefits for disabled coal miners

For carrying out title IV of the Federal Mine Safety and Health Act of 1977, as amended by Public Law 107-275, $24,585,000, to remain available until expended. For making after July 31 of the current fiscal year, benefit payments to individuals under title IV of such Act, for costs incurred in the current fiscal year, such amounts as may be necessary. For making benefit payments under title IV for the first quarter of fiscal year 2027, $5,900,000, to remain available until expended.

administrative expenses, energy employees occupational illness compensation fund

For necessary expenses to administer the Energy Employees Occupational Illness Compensation Program Act, $68,148,000, to remain available until expended: Provided, That the Secretary may require that any person filing a claim for benefits under the Act provide as part of such claim such identifying information (including Social Security account number) as may be prescribed.

black lung disability trust fund

(including transfer of funds)

Such sums as may be necessary from the Black Lung Disability Trust Fund (the ``Fund''), to remain available until expended, for payment of all benefits authorized by section 9501(d)(1), (2), (6), and (7) of the Internal Revenue Code of 1986; and repayment of, and payment of interest on advances, as authorized by section

9501(d)(4) of that Act. In addition, the following amounts may be expended from the Fund for fiscal year 2026 for expenses of operation and administration of the Black Lung Benefits program, as authorized by section 9501(d)(5): not to exceed $50,684,000 for transfer to the Office of Workers' Compensation Programs, ``Salaries and Expenses''; not to exceed $39,086,000 for transfer to Departmental Management, ``Salaries and Expenses''; not to exceed $373,000 for transfer to Departmental Management, ``Office of Inspector General''; and not to exceed $356,000 for payments into miscellaneous receipts for the expenses of the Department of the Treasury.

Occupational Safety and Health Administration

salaries and expenses

For necessary expenses for the Occupational Safety and Health Administration, $629,309,000, including not to exceed $120,000,000 which shall be the maximum amount available for grants to States under section 23(g) of the Occupational Safety and Health Act (the ``Act''), which grants shall be no less than 50 percent of the costs of State occupational safety and health programs required to be incurred under plans approved by the Secretary under section 18 of the Act; and, in addition, notwithstanding 31 U.S.C. 3302, the Occupational Safety and Health Administration may retain up to $499,000 per fiscal year of training institute course tuition and fees, otherwise authorized by law to be collected, and may utilize such sums for occupational safety and health training and education: Provided, That notwithstanding 31 U.S.C. 3302, the Secretary is authorized, during the fiscal year ending September 30, 2026, to collect and retain fees for services provided to Nationally Recognized Testing Laboratories, and may utilize such sums, in accordance with the provisions of 29 U.S.C. 9a, to administer national and international laboratory recognition programs that ensure the safety of equipment and products used by workers in the workplace: Provided further, That none of the funds appropriated under this paragraph shall be obligated or expended to prescribe, issue, administer, or enforce any standard, rule, regulation, or order under the Act which is applicable to any person who is engaged in a farming operation which does not maintain a temporary labor camp and employs 10 or fewer employees: Provided further, That no funds appropriated under this paragraph shall be obligated or expended to administer or enforce any standard, rule, regulation, or order under the Act with respect to any employer of 10 or fewer employees who is included within a category having a Days Away, Restricted, or Transferred (``DART'') occupational injury and illness rate, at the most precise industrial classification code for which such data are published, less than the national average rate as such rates are most recently published by the Secretary, acting through the Bureau of Labor Statistics, in accordance with section 24 of the Act, except-- (1) to provide, as authorized by the Act, consultation, technical assistance, educational and training services, and to conduct surveys and studies; (2) to conduct an inspection or investigation in response to an employee complaint, to issue a citation for violations

found during such inspection, and to assess a penalty for violations which are not corrected within a reasonable abatement period and for any willful violations found; (3) to take any action authorized by the Act with respect to imminent dangers; (4) to take any action authorized by the Act with respect to health hazards; (5) to take any action authorized by the Act with respect to a report of an employment accident which is fatal to one or more employees or which results in hospitalization of two or more employees, and to take any action pursuant to such investigation authorized by the Act; and (6) to take any action authorized by the Act with respect to complaints of discrimination against employees for exercising rights under the Act:

Provided further, That the foregoing proviso shall not apply to any person who is engaged in a farming operation which does not maintain a temporary labor camp and employs 10 or fewer employees: Provided further, That $12,787,000 shall be available for Susan Harwood training grants: Provided further, That $243,000,000 shall be for Federal Enforcement: Provided further, That not less than $3,500,000 shall be for Voluntary Protection Programs.

Mine Safety and Health Administration

salaries and expenses

For necessary expenses for the Mine Safety and Health Administration, $387,816,000, including purchase and bestowal of certificates and trophies in connection with mine rescue and first-aid work, and the hire of passenger motor vehicles, including up to $2,000,000 for mine rescue and recovery activities and not less than $10,537,000 for State assistance grants: Provided, That notwithstanding 31 U.S.C. 3302, not to exceed $750,000 may be collected by the National Mine Health and Safety Academy for room, board, tuition, and the sale of training materials, otherwise authorized by law to be collected, to be available for mine safety and health education and training activities: Provided further, That notwithstanding 31 U.S.C. 3302, the Mine Safety and Health Administration is authorized to collect and retain up to $2,499,000 from fees collected for the approval and certification of equipment, materials, and explosives for use in mines, and may utilize such sums for such activities: Provided further, That the Secretary is authorized to accept lands, buildings, equipment, and other contributions from public and private sources and to prosecute projects in cooperation with other agencies, Federal, State, or private: Provided further, <<NOTE: 30 USC 962.>> That the Mine Safety and Health Administration is authorized to promote health and safety education and training in the mining community through cooperative programs with States, industry, and safety associations: Provided further, That the Secretary is authorized to recognize the Joseph A. Holmes Safety Association as a principal safety association and, notwithstanding any other provision of law, may provide funds and, with or without reimbursement, personnel, including service of Mine Safety and Health Administration officials as officers in local chapters or in

the national organization: Provided further, <<NOTE: Approval. 30 USC 962.>> That any funds available to the Department of Labor may be used, with the approval of the Secretary, to provide for the costs of mine rescue and survival operations in the event of a major disaster.

Bureau of Labor Statistics

salaries and expenses

For necessary expenses for the Bureau of Labor Statistics, including advances or reimbursements to State, Federal, and local agencies and their employees for services rendered, $640,500,000, together with not to exceed $68,000,000 which may be expended from the Employment Security Administration account in the Unemployment Trust Fund.

Office of Disability Employment Policy

salaries and expenses

(including transfer of funds)

For necessary expenses for the Office of Disability Employment Policy to provide leadership, develop policy and initiatives, and award grants furthering the objective of eliminating barriers to the training and employment of people with disabilities, $43,000,000, of which not less than $9,000,000 shall be for research and demonstration projects related to testing effective ways to promote greater labor force participation of people with disabilities: Provided, That the Secretary may transfer amounts made available under this heading for research and demonstration projects to the ``State Unemployment Insurance and Employment Service Operations'' account for such purposes.

Departmental Management

salaries and expenses

(including transfer of funds)

For necessary expenses for Departmental Management, including the hire of three passenger motor vehicles, $362,877,000, together with not to exceed $308,000, which may be expended from the Employment Security Administration account in the Unemployment Trust Fund: Provided, That $116,125,000 shall be for the Bureau of International Labor Affairs, of which $81,725,000 shall be available for obligation through December 31, 2026: Provided further, That funds available to the Bureau of International Labor Affairs may be used to administer or operate international labor activities, bilateral and multilateral technical assistance, and microfinance programs, by or through contracts, grants, subgrants and other arrangements: Provided further, That not less than $30,175,000 shall be for programs to combat exploitative child labor internationally and not less than $30,175,000 shall be used to implement model programs that address worker rights issues through technical assistance in countries with which the United States has free trade agreements or trade preference programs:

Provided further, That $4,281,000 shall be used for program evaluation and shall be available for obligation through September 30, 2027: Provided further, That funds available for program evaluation may be used to administer grants for the purpose of evaluation: Provided further, That grants made for the purpose of evaluation shall be awarded through fair and open competition: Provided further, That funds available for program evaluation may be transferred to any other appropriate account in the Department for such purpose: Provided further, That the Committees on Appropriations of the House of Representatives and the Senate are notified at least 15 days in advance of any transfer: Provided further, That $23,000,000 shall be for the Women's Bureau and may be used for grants to serve and promote the interests of women in the workforce: Provided further, That of the amounts made available to the Women's Bureau, not less than $5,000,000 shall be used for grants authorized by the Women in Apprenticeship and Nontraditional Occupations Act: Provided further, That the Department of Labor shall support staffing levels necessary to fulfill its statutory responsibilities including carrying out programs, projects, and activities funded in this title of this Act in a timely manner.

it modernization

For necessary expenses for Department of Labor centralized infrastructure technology investment activities related to support systems and modernization, $6,889,000, which shall be available through September 30, 2027.

office of inspector general

For salaries and expenses of the Office of Inspector General in carrying out the provisions of the Inspector General Act of 1978, $91,187,000, together with not to exceed $5,841,000 which may be expended from the Employment Security Administration account in the Unemployment Trust Fund: Provided, That not more than $2,000,000 of the amount provided under this heading may be available until expended.

General Provisions

Sec. 101. None of the funds appropriated by this Act for the Job Corps shall be used to pay the salary and bonuses of an individual, either as direct costs or any proration as an indirect cost, at a rate in excess of Executive Level II.

(transfer of funds)

Sec. 102. Not to exceed 1 percent of any discretionary funds (pursuant to the Balanced Budget and Emergency Deficit Control Act of 1985) which are appropriated for the current fiscal year for the Department of Labor in this Act may be transferred between a program, project, or activity, but no such program, project, or activity shall be increased by more than 3 percent by any such transfer: Provided, That the transfer authority granted by this section shall not be used to create any new program or to fund any project or activity for which no funds are provided in this Act: Provided further, That the Committees on Appropriations of

the House of Representatives and the Senate are notified at least 15 days in advance of any transfer.

Sec. 103. In accordance with Executive Order 13126, none of the funds appropriated or otherwise made available pursuant to this Act shall be obligated or expended for the procurement of goods mined, produced, manufactured, or harvested or services rendered, in whole or in part, by forced or indentured child labor in industries and host countries already identified by the United States Department of Labor prior to enactment of this Act.

Sec. 104. Except as otherwise provided in this section, none of the funds made available to the Department of Labor for grants under section 414(c) of the American Competitiveness and Workforce Improvement Act of 1998 (29 U.S.C. 2916a) may be used for any purpose other than competitive grants for training individuals who are older than 16 years of age and are not currently enrolled in school within a local educational agency in the occupations and industries for which employers are using H-1B visas to hire foreign workers, and the related activities necessary to support such training. Sec. 105. None of the funds made available by this Act under the heading ``Employment and Training Administration'' shall be used by a recipient or subrecipient of such funds to pay the salary and bonuses of an individual, either as direct costs or indirect costs, at a rate in excess of Executive Level II. This limitation shall not apply to vendors providing goods and services as defined in Office of Management and Budget Circular A-133. Where States are recipients of such funds, States may establish a lower limit for salaries and bonuses of those receiving salaries and bonuses from subrecipients of such funds, taking into account factors including the relative cost-of-living in the State, the compensation levels for comparable State or local government employees, and the size of the organizations that administer Federal programs involved including Employment and Training Administration programs.

(transfer of funds)

Sec. 106. (a) Notwithstanding section 102, the Secretary may transfer funds made available to the Employment and Training Administration by this Act, either directly or through a set-aside, for technical assistance services to grantees to ``Program Administration'' when it is determined that those services will be more efficiently performed by Federal employees: Provided, That this section shall not apply to section 171 of the WIOA. (b) Notwithstanding section 102, the Secretary may transfer not more than 0.5 percent of each discretionary appropriation made available to the Employment and Training Administration by this Act to ``Program Administration'' in order to carry out program integrity activities relating to any of the programs or activities that are funded under any such discretionary appropriations: Provided, That notwithstanding section 102 and the preceding proviso, the Secretary may transfer not more than 0.5 percent of funds made available in paragraphs (1) and (2) of the ``Office of Job Corps'' account to paragraph (3) of such account to carry out program integrity activities related to the Job Corps program: Provided further, That funds transferred under this subsection shall be available to the Secretary to carry out program integrity activities

directly or through grants, cooperative agreements, contracts and other arrangements with States and other appropriate entities: Provided further, That funds transferred under the authority provided by this subsection shall be available for obligation through September 30, 2027.

(transfer of funds)

Sec. 107. (a) The Secretary may reserve not more than 0.75 percent from each appropriation made available in this Act identified in subsection (b) in order to carry out evaluations of any of the programs or activities that are funded under such accounts. Any funds reserved under this section shall be transferred to ``Departmental Management'' for use by the Office of the Chief Evaluation Officer within the Department of Labor, and shall be available for obligation through September 30, 2027: <<NOTE: Plan. Time period.>> Provided, That such funds shall only be available if the Chief Evaluation Officer of the Department of Labor submits a plan to the Committees on Appropriations of the House of Representatives and the Senate describing the evaluations to be carried out 15 days in advance of any transfer.

(b) The accounts referred to in subsection (a) are: ``Training and Employment Services'', ``Job Corps'', ``Community Service Employment for Older Americans'', ``State Unemployment Insurance and Employment Service Operations'', ``Employee Benefits Security Administration'', ``Office of Workers' Compensation Programs'', ``Wage and Hour Division'', ``Office of Federal Contract Compliance Programs'', ``Office of Labor Management Standards'', ``Occupational Safety and Health Administration'', ``Mine Safety and Health Administration'', ``Office of Disability Employment Policy'', funding made available to the ``Bureau of International Labor Affairs'' and ``Women's Bureau'' within the ``Departmental Management, Salaries and Expenses'' account, and ``Veterans' Employment and Training''. Sec. 108. (a) Section 7 of the Fair Labor Standards Act of 1938 (29 U.S.C. 207) shall be applied as if the following text is part of such section:

``(s)(1) The provisions of this section shall not apply for a period of 2 years after the occurrence of a major disaster to any employee-- ``(A) employed to adjust or evaluate claims resulting from or relating to such major disaster, by an employer not engaged, directly or through an affiliate, in underwriting, selling, or marketing property, casualty, or liability insurance policies or contracts; ``(B) who receives from such employer on average weekly compensation of not less than $591.00 per week or any minimum weekly amount established by the Secretary, whichever is greater, for the number of weeks such employee is engaged in any of the activities described in subparagraph (C); and ``(C) whose duties include any of the following: ``(i) interviewing insured individuals, individuals who suffered injuries or other damages or losses arising from or relating to a disaster, witnesses, or physicians; ``(ii) inspecting property damage or reviewing factual information to prepare damage estimates;

``(iii) evaluating and making recommendations regarding coverage or compensability of claims or determining liability or value aspects of claims; ``(iv) negotiating settlements; or ``(v) making recommendations regarding litigation.

``(2) The exemption in this subsection shall not affect the exemption provided by section 13(a)(1). ``(3) For purposes of this subsection-- ``(A) the term `major disaster' means any disaster or catastrophe declared or designated by any State or Federal agency or department; ``(B) the term `employee employed to adjust or evaluate claims resulting from or relating to such major disaster' means an individual who timely secured or secures a license required by applicable law to engage in and perform the activities described in clauses (i) through (v) of paragraph (1)(C) relating to a major disaster, and is employed by an employer that maintains worker compensation insurance coverage or protection for its employees, if required by applicable law, and withholds applicable Federal, State, and local income and payroll taxes from the wages, salaries and any benefits of such employees; and ``(C) the term `affiliate' means a company that, by reason of ownership or control of 25 percent or more of the outstanding shares of any class of voting securities of one or more companies, directly or indirectly, controls, is controlled by, or is under common control with, another company.''.

(b) This section shall be effective on the date of enactment of this Act.

Sec. 109. (a) Flexibility With Respect to the Crossing of H-2B Nonimmigrants Working in the Seafood Industry.-- (1) In general.--Subject to paragraph (2), if a petition for H-2B nonimmigrants filed by an employer in the seafood industry is granted, the employer may bring the nonimmigrants described in the petition into the United States at any time during the 120-day period beginning on the start date for which the employer is seeking the services of the nonimmigrants without filing another petition. (2) Requirements for crossings after 90th day.--An employer in the seafood industry may not bring H-2B nonimmigrants into the United States after the date that is 90 days after the start date for which the employer is seeking the services of the nonimmigrants unless the employer-- (A) completes a new assessment of the local labor market by-- (i) listing job orders in local newspapers on 2 separate Sundays; and (ii) posting the job opportunity on the appropriate Department of Labor Electronic Job Registry and at the employer's place of employment; and (B) offers the job to an equally or better qualified United States worker who-- (i) applies for the job; and (ii) will be available at the time and place of need. (3) Exemption from rules with respect to staggering.--The Secretary of Labor shall not consider an employer in the seafood industry who brings H-2B nonimmigrants into

the United States during the 120-day period specified in paragraph (1) to be staggering the date of need in violation of section 655.20(d) of title 20, Code of Federal Regulations, or any other applicable provision of law.

(b) H-2B Nonimmigrants Defined.--In this section, the term ``H-2B nonimmigrants'' means aliens admitted to the United States pursuant to section 101(a)(15)(H)(ii)(B) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(15)(H)(ii)(B)). Sec. 110. The determination of prevailing wage for the purposes of the H-2B program shall be the greater of--(1) the actual wage level paid by the employer to other employees with similar experience and qualifications for such position in the same location; or (2) the prevailing wage level for the occupational classification of the position in the geographic area in which the H-2B nonimmigrant will be employed, based on the best information available at the time of filing the petition. In the determination of prevailing wage for the purposes of the H-2B program, the Secretary shall accept private wage surveys even in instances where Occupational Employment Statistics survey data are available unless the Secretary determines that the methodology and data in the provided survey are not statistically supported.

Sec. 111. None of the funds in this Act shall be used to enforce the definition of corresponding employment found in 20 CFR 655.5 or the three-fourths guarantee rule definition found in 20 CFR 655.20, or any references thereto. Further, for the purpose of regulating admission of temporary workers under the H-2B program, the definition of temporary need shall be that provided in 8 CFR 214.2(h)(6)(ii)(B). Sec. 112. Notwithstanding any other provision of law, the Secretary may furnish through grants, cooperative agreements, contracts, and other arrangements, up to $450,000 of excess personal property, at a value determined by the Secretary, to apprenticeship programs for the purpose of training apprentices in those programs.

Sec. 113. (a) The Act entitled ``An Act to create a Department of Labor'', approved March 4, 1913 (37 Stat. 736, chapter 141) is amended by adding at the end the following new section: ``(a) In General.--The Secretary of Labor is authorized to employ law enforcement officers or special agents to-- ``(1) provide protection for the Secretary of Labor during the workday of the Secretary and during any activity that is preliminary or postliminary to the performance of official duties by the Secretary; ``(2) provide protection, incidental to the protection provided to the Secretary, to a member of the immediate family of the Secretary who is participating in an activity or event relating to the official duties of the Secretary; ``(3) provide continuous protection to the Secretary (including during periods not described in paragraph (1)) and to the members of the immediate family of the Secretary if there is a unique and articulable threat of physical harm, in accordance with guidelines established by the Secretary; and ``(4) provide protection to the Deputy Secretary of Labor or another senior officer representing the Secretary of Labor at a public event if there is a unique and articulable threat of physical harm, in accordance with guidelines established by the Secretary.

``(b) Authorities.--The Secretary of Labor may authorize a law enforcement officer or special agent employed under subsection (a), for the purpose of performing the duties authorized under subsection (a), to-- ``(1) carry firearms; ``(2) make arrests without a warrant for any offense against the United States committed in the presence of such officer or special agent; ``(3) perform protective intelligence work, including identifying and mitigating potential threats and conducting advance work to review security matters relating to sites and events; ``(4) coordinate with local law enforcement agencies; and ``(5) initiate criminal and other investigations into potential threats to the security of the Secretary, in coordination with the Inspector General of the Department of Labor.

``(c) Compliance With Guidelines.--A law enforcement officer or special agent employed under subsection (a) shall exercise any authority provided under this section in accordance with any-- ``(1) guidelines issued by the Attorney General; and ``(2) guidelines prescribed by the Secretary of Labor.''.

(b) This section shall be effective on the date of enactment of this Act.

Sec. 114. The Secretary is authorized to dispose of or divest, by any means the Secretary determines appropriate, including an agreement or partnership to construct a new Job Corps center, all or a portion of the real property on which the Treasure Island Job Corps Center and the Gary Job Corps Center are situated. Any sale or other disposition, to include any associated construction project, will not be subject to any requirement of any Federal law or regulation relating to the disposition of Federal real property or relating to Federal procurement, including but not limited to subchapter III of chapter 5 of title 40 of the United States Code, subchapter V of chapter 119 of title 42 of the United States Code, and chapter 33 of division C of subtitle I of title 41 of the United States Code. The net proceeds of such a sale shall be transferred to the Secretary, which shall be available until expended for such project to carry out the Job Corps Program on Treasure Island and the Job Corps Program in and around San Marcos, Texas, respectively.

Sec. 115. None of the funds made available by this Act may be used to-- (1) alter or terminate the Interagency Agreement between the United States Department of Labor and the United States Department of Agriculture; (2) close any of the Civilian Conservation Centers, except if such closure is necessary to prevent the endangerment of the health and safety of the students, the capacity of the program is retained, and the requirements of section 159(j) of the WIOA are met; or (3) close any Job Corps Centers, except if such closure meets the criterion entitled ``Long-Term Center Performance'' or the criterion entitled ``Evaluation of Continuing Center Operations'' established by 81 FR 12529, the capacity of the program is retained, and the requirements of section 159(j) of the WIOA are met.

(rescission)

Sec. 116. Of the unobligated funds available under section 286(s)(2) of the Immigration and Nationality Act (8 U.S.C. 1356(s)(2)), $206,000,000 are hereby permanently rescinded not later than September 30, 2026.

This title may be cited as the ``Department of Labor Appropriations Act, 2026''.

Notwithstanding any other provision of any other division of this Act, funds appropriated or otherwise made available by division F of this Act or other Acts making appropriations for the Department of State, foreign operations, and related programs, including provisions of Acts providing supplemental appropriations for the Department of State, foreign operations, and related programs, may not be used for a contribution, grant, or other payment to the United Nations Relief and Works Agency, notwithstanding any other provision of law-- (1) for any amounts provided in prior fiscal years or in fiscal year 2026; or (2) for amounts provided in fiscal year 2027, until March 25, 2027.

DIVISION H-- <<NOTE: Further Continuing Appropriations Act, 2026.>> FURTHER CONTINUING APPROPRIATIONS ACT, 2026

Sec. 101. The Continuing Appropriations Act, 2026 (division A of Public Law 119-37) is amended by striking the date specified in section 106(3) and inserting ``February 13, 2026''.

Sec. 102. For the purposes of the Continuing Appropriations Act, 2026 (division A of Public Law 119-37), the time covered by such division shall be considered to include the period which began on or about January 31, 2026, during which there occurred a lapse in appropriations.

Sec. 103. Amounts made available in the Continuing Appropriations Act, 2026 (division A of Public Law 119-37) and the Consolidated Appropriations Act, 2026 for personnel pay, allowances, and benefits in each department and agency shall be available for payments pursuant to subsection (c) of section 1341 of title 31, United States Code and such payments shall be made. Sec. 104. All obligations incurred and in anticipation of the appropriations made and authority granted by the Continuing Appropriations Act, 2026 (division A of Public Law 119-37) and by the Consolidated Appropriations Act, 2026 for the purposes of maintaining the essential level of activity to protect life and property and bringing about orderly termination of Government function, and for purposes as otherwise authorized by law, are hereby ratified and approved if otherwise in accord with the provisions of such Act. Sec. 105. Section 213 of title II of division C of the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026, and the amendments made by such section, are hereby repealed and shall have no force or effect.

This division may be cited as the ``Further Continuing Appropriations Act, 2026''.

DIVISION I--AUTHORIZING EXTENDERS AND TECHNICAL CORRECTIONS

GRAIN STANDARDS ACT EXTENSION.

Sections 7(j)(5), 7A(l)(4), and 21(e) of the United States Grain Standards Act (7 U.S.C. 79(j)(5), 79a(l)(4), 87j(e)) shall be applied by substituting ``September 30, 2026'' for ``September 30, 2025'' each place it appears.

PROGRAM.

Section 1(b) of Public Law 117-25 (135 Stat. 297; 136 Stat. 2133; 136 Stat. 5984; 139 Stat. 46) is amended in each of paragraphs (3) and (4) by striking ``September 30, 2025'' and inserting ``September 30, 2026''.

SERVICE PARTICIPATION IN ACES PROGRAM.

Section 8302(b) of the Agricultural Act of 2014 (16 U.S.C. 3851a(b)) shall be applied by substituting ``October 1, 2026'' for ``October 1, 2023''.

(a) Financing.--Section 1309(a) of the National Flood Insurance Act of 1968 (42 U.S.C. 4016(a)) is amended, in the first sentence, by striking ``September 30, 2023'' and inserting ``September 30, 2026''.

(b) Program Expiration.--Section 1319 of the National Flood Insurance Act of 1968 (42 U.S.C. 4026) is amended by striking ``September 30, 2023'' and inserting ``September 30, 2026''. (c) Effective Date.-- (1) In general.--Subject to paragraph (2), this section shall take effect immediately upon the date of enactment of this Act. (2) Alternate date.--If this Act is enacted after January 30, 2026, this section shall take effect as if enacted on January 30, 2026.

Section 225(e) of the Department of Homeland Security Appropriations Act, 2019 (division A of Public Law 116-6; 49 U.S.C. 44901 note) is amended by striking ``2025'' and inserting ``2026''.

CARRIER SAFETY ADVISORY COMMITTEE.

Section 4144(d) of the Motor Carrier Safety Reauthorization Act of 2005 (49 U.S.C. 31100 note; Public Law 109-59) shall be applied by substituting ``September 30, 2026'' for ``September 30, 2025''.

Section 227(a) of the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. 1525(a)) is amended by striking ``September 30, 2025'' and inserting ``September 30, 2026''.

Section 111(a) of the Cybersecurity Information Sharing Act of 2015 (6 U.S.C. 1510(a)) is amended by striking ``September 30, 2025'' and inserting ``September 30, 2026''.

Section 2220A(s)(1) of the Homeland Security Act of 2002 (6 U.S.C. 665g(s)(1)) is amended by striking ``September 30, 2025'' and inserting ``September 30, 2026''.

BOARD.

Section 1078(f)(1) of the National Defense Authorization Act for Fiscal Year 2018 (40 U.S.C. 11301 note) is amended by striking ``On and after the date that is 2 years after the date on which the Comptroller General of the United States issues the third report required under subsection (b)(7)(B)'' and inserting ``After September 30, 2026''.

EXISTENCE OF PAROLE COMMISSION.

Any expiration date established by section 235(b) of the Sentencing Reform Act of 1984 (18 U.S.C. 3551 note; Public Law 98-473), as such section relates to chapter 311 of title 18, United States Code, and the United States Parole Commission, shall not apply during the period beginning on October 1, 2025, and ending on January 30, 2031.

Section 3014(a) of title 18, United States Code, is amended by striking ``and ending on September 30, 2025''.

HEALTHCARE WORKERS.

Section 220(c) of the Immigration and Nationality Technical Corrections Act of 1994 (8 U.S.C. 1182 note) shall be applied by substituting ``September 30, 2026'' for ``September 30, 2015''.

Section 401(b) of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (8 U.S.C. 1324a note) shall be applied by substituting ``September 30, 2026'' for ``September 30, 2015''.

RELIGIOUS WORKERS.

Section 101(a)(27)(C)(ii) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(27)(C)(ii)) shall be applied by substituting ``September 30, 2026'' for ``September 30, 2015'' each place such date appears.

SUPPLEMENTAL VISA EXEMPTION.

Notwithstanding the numerical limitation set forth in section 214(g)(1)(B) of the Immigration and Nationality Act (8 U.S.C. 1184(g)(1)(B)), the Secretary of Homeland Security, after consultation with the Secretary of Labor, and upon the determination that the needs of United States businesses cannot be satisfied during fiscal year 2026 with United States workers who are willing, qualified, and able to perform temporary nonagricultural labor, may increase the total number of aliens who may receive a visa under section 101(a)(15)(H)(ii)(b) of such Act (8 U.S.C. 1101(a)(15)(H)(ii)(b)) in such fiscal year by not more than the highest number of H-2B nonimmigrants who participated in the H-2B returning worker program in any fiscal year in which returning workers were exempt from such numerical limitation.

(a) In General.--The United States Sentencing Commission (in this section, referred to as the ``Commission'') shall promulgate the guidelines or amendments provided for under section 8605(e) of the SAFER SKIES Act (title LXXXVI of Public Law 119-60) as soon as possible after the date of enactment of such Act, and in any event not later than December 31, 2026, notwithstanding the deadline under section 994(p) of title 28, United States Code.

(b) Effective Date.--The amendments to the guidelines promulgated under subsection (a) shall take effect 180 days after the date of promulgation by the Commission, except to the extent that the effective date is revised or the amendment is otherwise modified or disapproved by an Act of Congress, and shall supersede any amendment to the contrary contained in the amendments to the sentencing guidelines submitted to Congress by the Commission on or about May 1, 2026. (c) Rule of Construction.--The requirements of this section shall supersede the timeline set forth in section 8605(e)(1) of the SAFER SKIES Act (title LXXXVI of Public Law 119-60).

(a) In General.--Section 126 of the Continuing Appropriations Act, 2026 (division A of the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026 (Public Law 119-37; 139 Stat. 502)) is amended to read as follows:

``Sec. 126. Notwithstanding section 106, during the period ending on the last day of the first calendar quarter of 2026, section 1930(a)(6)(B)(i) of title 28, United States Code, shall be applied as if `During the 5-year period' were struck.''.

(b) Application of Amendments Made by the Bankruptcy Administration Improvement Act of 2025.-- (1) In general.--Section 6(b)(2)(A) of the Bankruptcy Administration Improvement Act of 2025 <<NOTE: 11 USC 330 note.>> is amended by striking ``on the'' and inserting ``on or after the''. (2) Effective date.--The amendment made by paragraph (1) shall take effect as though enacted immediately after the enactment of the Bankruptcy Administration Improvement Act of 2025.

(a) Extension of Preferential Treatment for Certain Countries in Africa Under African Growth and Opportunity Act; Retroactive Application.-- (1) Extension.-- (A) Trade act of 1974.--Section 506B of the Trade Act of 1974 (19 U.S.C. 2466b) is amended by striking ``September 30, 2025'' and inserting ``December 31, 2026''. (B) African growth and opportunity act.-- (i) In general.--Section 112(g) of the African Growth and Opportunity Act (19 U.S.C. 3721(g)) is amended by striking ``September 30, 2025'' and inserting ``December 31, 2026''. (ii) Regional apparel article program.-- Section 112(b)(3)(A) of the African Growth and Opportunity Act (19 U.S.C. 3721(b)(3)(A)) is amended-- (I) in clause (i), by striking ``21 succeeding'' and inserting ``23 succeeding''; and (II) in clause (ii)(II), by striking ``September 30, 2025'' and inserting ``December 31, 2026''. (iii) Third-country fabric program.--Section 112(c)(1) of the African Growth and Opportunity Act (19 U.S.C. 3721(c)(1)) is amended-- (I) in the paragraph heading, by striking ``September 30, 2025'' and inserting ``December 31, 2026''; (II) in subparagraph (A), by striking ``September 30, 2025'' and inserting ``December 31, 2026''; and (III) in subparagraph (B)(ii), by striking ``September 30, 2025'' and inserting ``December 31, 2026''. (2) Retroactive application.-- (A) In general.--Notwithstanding section 514 of the Tariff Act of 1930 (19 U.S.C. 1514) or any other provision of law, and subject to subparagraph (B), any entry of a covered article to which duty-free treatment or other preferential treatment under section 506A of the Trade Act of 1974 (19 U.S.C. 2466a) or section 112 of the African Grown and Opportunity Act (19 U.S.C. 3721) would have applied if the entry had been made on September 30, 2025, that was made-- (i) after September 30, 2025, and

(ii) before the date of the enactment of this Act, shall be liquidated or reliquidated as though such entry occurred on the date of the enactment of this Act. (B) Requests.--A liquidation or reliquidation may be made under subparagraph (A) with respect to an entry only if a request therefor is filed with the Commissioner of U.S. Customs and Border Protection not later than 180 days after the date of the enactment of this Act that contains sufficient information to enable such Commissioner-- (i) to locate the entry; or (ii) to reconstruct the entry if it cannot be located. (C) Payment of amounts owed.--Any amounts owed by the United States pursuant to the liquidation or reliquidation of an entry of a covered article under subparagraph (A) shall be paid, without interest of any kind, not later than 90 days after the date of the liquidation or reliquidation (as the case may be). (D) Definitions.--In this paragraph: (i) Covered article.--The term ``covered article'' means an article from a country that is designated by the President as a beneficiary sub- Saharan African country under section 104 of the African Growth and Opportunity Act (19 U.S.C. 3703) as of the day before the date of the enactment of this Act. (ii) Entry.--The term ``entry'' includes a withdrawal from warehouse for consumption.

(b) Extension of Customs User Fees.-- (1) In general.--Section 13031(j)(3) of the Consolidated Omnibus Budget Reconciliation Act of 1985 (19 U.S.C. 58c(j)(3)) is amended-- (A) in subparagraph (A), by striking ``September 30, 2031'' and inserting ``December 31, 2031''; and (B) in subparagraph (B)(i), by striking ``September 30, 2031'' and inserting ``December 31, 2031''. (2) Rate for merchandise processing fees.--Section 503 of the United States-Korea Free Trade Agreement Implementation Act (Public Law 112-41;19 U.S.C. 3805 note) is amended by striking ``September 30, 2031'' and inserting ``December 31, 2031''.

(a) Extension of Special Rules for Haiti Under Caribbean Basin Economic Recovery Act.--Section 213A of the Caribbean Basin Economic Recovery Act (19 U.S.C. 2703a) is amended-- (1) in subsection (b)-- (A) in paragraph (1)-- (i) by amending subparagraph (B)(v)(I) to read as follows: ``(I) Applicable percentage.--The term `applicable percentage' means 60 percent or more on and after December 20, 2017.''; and (ii) by amending subparagraph (C) to read as follows: ``(C) Quantitative limitations.--The preferential treatment described in subparagraph (A) shall be extended, during each period after the initial applicable 1-year period, to not more than 1.25 percent of the aggregate square

meter equivalents of all apparel articles imported into the United States in the most recent 12-month period for which data are available.''; and (B) in paragraph (2), by striking ``in each of the 16 succeeding 1-year periods'' each place it appears and inserting ``in any of the succeeding 1-year periods''; and (2) by amending subsection (h) to read as follows:

``(h) Termination.--The duty-free treatment provided under this section shall remain in effect until December 31, 2026.''. (b) Restoration of Eligibility of Certain Articles for Preferential Treatment.-- (1) In general.--The President shall proclaim such modifications to the Harmonized Tariff Schedule of the United States as may be necessary to restore the eligibility of articles described in paragraph (2) for preferential treatment under section 213A of the Caribbean Basin Economic Recovery Act (19 U.S.C. 2703a). (2) Articles described.--An article described in this paragraph is an article that-- (A) was eligible for preferential treatment under section 213A of the Caribbean Basin Economic Recovery Act (19 U.S.C. 2703a) on December 20, 2006; and (B) became ineligible for such treatment after that date and before the date of the enactment of this Act as a result of revisions to the Harmonized Tariff Schedule. (3) Effective date of proclamation.--A proclamation under paragraph (1) shall take effect not earlier than 2 business days after the President submits to the Committee on Finance of the Senate and the Committee on Ways and Means of the House of Representatives a report on the proclamation and the reasons for the modifications to the Harmonized Tariff Schedule under the proclamation.

(c) Retroactive Application.-- (1) In general.--Notwithstanding section 514 of the Tariff Act of 1930 (19 U.S.C. 1514) or any other provision of law, and subject to paragraph (2), any entry of a covered article to which duty-free treatment or other preferential treatment under the Caribbean Basin Economic Recovery Act (19 U.S.C. 2701 et seq.) would have applied if the entry had been made before September 30, 2025, that was made-- (A) on or after September 30, 2025, and (B) before the date of the enactment of this Act, shall be liquidated or reliquidated as though such entry occurred on the date of the enactment of this Act. (2) Requests.--A liquidation or reliquidation may be made under paragraph (1) with respect to an entry only if a request therefor is filed with the Commissioner of U.S. Customs and Border Protection not later than 180 days after the date of the enactment of this Act that contains sufficient information to enable such Commissioner-- (A) to locate the entry; or (B) to reconstruct the entry if it cannot be located. (3) Payment of amounts owed.--Any amounts owed by the United States pursuant to the liquidation or reliquidation of an entry of a covered article under paragraph (1) shall be paid, without interest of any kind, not later than 90 days

after the date of the liquidation or reliquidation (as the case may be). (4) Definitions.--In this subsection: (A) Covered article.--The term ``covered article'' means an article from Haiti. (B) Entry.--The term ``entry'' includes a withdrawal from warehouse for consumption.

(a) Statutory PAYGO Scorecards.--The budgetary effects of this division and each succeeding division shall not be entered on either PAYGO scorecard maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010. (b) Senate PAYGO Scorecards.--The budgetary effects of this division and each succeeding division shall not be entered on any PAYGO scorecard maintained for purposes of section 4106 of H. Con. Res. 71 (115th Congress). (c) Classification of Budgetary Effects.--Notwithstanding Rule 3 of the Budget Scorekeeping Guidelines set forth in the joint explanatory statement of the committee of conference accompanying Conference Report 105-217 and section 250(c)(8) of the Balanced Budget and Emergency Deficit Control Act of 1985, the budgetary effects of this division and each succeeding division 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.

DIVISION J--HEALTH CARE EXTENDERS

The table of contents of this division is as follows:

DIVISION J--HEALTH CARE EXTENDERS

Sec. 6001. Table of contents.

STATE PROVIDERS UNDER MEDICAID AND CHIP.

(a) In General.--Section 1902(kk) of the Social Security Act (42 U.S.C. 1396a(kk)) is amended by adding at the end the following new paragraph: ``(10) Streamlined enrollment process for eligible out-of- state providers.-- ``(A) In general.--The State-- ``(i) adopts and implements a process to allow an eligible out-of-State provider to enroll under the State plan (or a waiver of such plan) to furnish items and services to, or order, prescribe, refer, or certify eligibility for items and services for, qualifying individuals without the imposition of screening or enrollment requirements by such State that exceed the minimum necessary for such State to provide payment to an eligible out-of-State provider under such State plan (or a waiver of such plan), such as the provider's name and National Provider Identifier (and such other information specified by the Secretary); and ``(ii) provides that an eligible out-of-State provider that enrolls as a participating provider in the State plan (or a waiver of such plan) through such process shall be so enrolled for a 5-year period, unless the provider is terminated or excluded from participation during such period. ``(B) Definitions.--In this paragraph: ``(i) Eligible out-of-state provider.--The term `eligible out-of-State provider' means, with respect to a State, a provider-- ``(I) that is located in any other State; ``(II) that-- ``(aa) was determined by the Secretary to have a limited risk of fraud, waste, and abuse for purposes of determining the level of screening to be conducted under section 1866(j)(2), has been so screened under such section 1866(j)(2), and is enrolled in the Medicare program under title XVIII; or ``(bb) was determined by the State agency administering or supervising the administration of the State plan (or a waiver of such plan) of such other State to have a limited risk of fraud, waste, and abuse for purposes of determining the level of screening to be conducted under paragraph (1) of this subsection, has been so screened under such paragraph (1), and is enrolled under such State plan (or a waiver of such plan); and ``(III) that has not been--

``(aa) excluded from participation in any Federal health care program pursuant to section 1128 or 1128A; ``(bb) excluded from participation in the State plan (or a waiver of such plan) pursuant to part 1002 of title 42, Code of Federal Regulations (or any successor regulation), or State law; or ``(cc) terminated from participating in a Federal health care program or the State plan (or a waiver of such plan) for a reason described in paragraph (8)(A). ``(ii) Qualifying individual.--The term `qualifying individual' means an individual under 21 years of age who is enrolled under the State plan (or waiver of such plan). ``(iii) State.--The term `State' means 1 of the 50 States or the District of Columbia.''.

(b) Conforming Amendments.-- (1) Section 1902(a)(77) of the Social Security Act (42 U.S.C. 1396a(a)(77)) is amended by inserting ``enrollment,'' after ``screening,''. (2) The subsection heading for section 1902(kk) of such Act (42 U.S.C. 1396a(kk)) is amended by inserting ``enrollment,'' after ``screening,''. (3) Section 2107(e)(1)(G) of such Act (42 U.S.C. 1397gg(e)(1)(G)) is amended by inserting ``enrollment,'' after ``screening,''.

(c) Effective Date.--The amendments made by this section shall take effect on the date that is 3 years after the date of enactment of this Act.

ELIGIBILITY FOR WORKING ADULTS WITH DISABILITIES.

(a) Modification of Optional Buy-in Groups.-- (1) In general.--Section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended-- (A) in subclause (XV)-- (i) by striking ``, but less than 65,''; and (ii) by inserting ``, including at least the group described in section 1905(a)(xviii)'' before the semicolon at the end; and (B) in subclause (XVI), by inserting ``including at least the group described in section 1905(a)(xii),'' after ``the State may establish,''. (2) Individuals described.--Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended-- (A) in clause (xvi), by striking ``or'' at the end; (B) in clause (xvii), by adding ``or'' after the comma at the end; and (C) by adding after clause (xvii) the following new clause: ``(xviii) individuals who, but for earnings in excess of the limit established under subsection (q)(2)(B), would be considered to be receiving supplemental security income, and who are at least 16 years of age,''.

(3) Definition modification.--Section 1905(v)(1)(A) of the Social Security Act (42 U.S.C. 1396d(v)(1)(A)) is amended by striking ``, but less than 65,''.

(b) Application to Certain States.--A State that, as of the date of enactment of this Act, provides for making medical assistance available to individuals described in subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) shall not be regarded as failing to comply with the requirements of the amendments made by subsection (a) before January 1, 2028.

RESIDENCY AND COVERAGE FOR MILITARY FAMILIES.

(a) In General.--Section 1902 of the Social Security Act (42 U.S.C. 1396a) is amended-- (1) in subsection (a)-- (A) in paragraph (88), by striking ``and'' at the end; (B) in paragraph (89), by striking the period at the end and inserting ``; and''; and (C) by inserting after paragraph (89), the following new paragraph: ``(90) beginning January 1, 2030, provide, with respect to an active duty relocated individual (as defined in subsection (yy)(1))-- ``(A) that, for purposes of determining eligibility for medical assistance under the State plan (or waiver of such plan), such active duty relocated individual is treated as a resident of the State unless such individual voluntarily elects not to be so treated for such purposes; ``(B) that if, at the time of relocation (as described in subsection (yy)(1)), such active duty relocated individual is on a home and community-based services waiting list (as defined in subsection (yy)(2)), such individual remains on such list until-- ``(i) the State completes an assessment and renders a decision with respect to the eligibility of such individual to receive the relevant home and community-based services at the time a slot for such services becomes available and, in the case such decision is a denial of such eligibility, such individual has exhausted the individual's opportunity for a fair hearing; or ``(ii) such individual elects to be removed from such list; and ``(C) payment for medical assistance furnished under the State plan (or a waiver of the plan) on behalf of such active duty relocated individual in the military service relocation State (as referred to in subsection (yy)(1)(B)(i)), to the extent that such assistance is available in such military service relocation State in accordance with such guidance as the Secretary may issue to ensure access to such assistance.''; and (2) by adding at the end the following new subsection:

``(yy) Active Duty Relocated Individual; Home and Community-based Services Waiting List.--For purposes of subsection (a)(90) and this subsection:

``(1) Active duty relocated individual.--The term `active duty relocated individual' means an individual-- ``(A) who-- ``(i) is enrolled under the State plan (or waiver of such plan); or ``(ii) with respect to an individual described in subparagraph (C)(ii), would be so enrolled pursuant to subsection (a)(10)(A)(ii)(VI) if such individual began receiving home and community- based services; ``(B) who-- ``(i) is a member of the Armed Forces engaged in active duty service and is relocated to another State (in this subsection referred to as the `military service relocation State') by reason of such service; ``(ii) would be described in clause (i) except that the individual stopped being engaged in active duty service (including by reason of retirement from such service) and the last day on which the individual was engaged in active duty service occurred not more than 12 months ago; or ``(iii) is a dependent (as defined by the Secretary) of a member described in clause (i) or (ii) who relocates to the military service relocation State with such member; and ``(C) who-- ``(i) was receiving home and community-based services (as defined in section 9817(a)(2)(B) of the American Rescue Plan Act of 2021) at the time of such relocation; or ``(ii) if the State maintains a home and community-based services waiting list, was on such home and community-based services waiting list at the time of such relocation. ``(2) Home and community-based services waiting list.--The term `home and community-based services waiting list' means, in the case of a State that has a limit on the number of individuals who may receive home and community-based services under section 1115(a) or section 1915(c), a list maintained by such State of individuals who are requesting to receive such services under 1 or more such sections but for whom the State has not yet completed an assessment and rendered a decision with respect to the eligibility of such individuals to receive the relevant home and community-based services at the time a slot for such services becomes available due to such limit.''.

(b) Implementation Funding.--There are appropriated, out of any funds in the Treasury not otherwise obligated, $1,000,000 for each of fiscal years 2026 through 2030, to remain available until expended, to the Secretary of Health and Human Services for purposes of implementing the amendments made by subsection (a).

ON COSTS OF PROVIDING MATERNITY, LABOR, AND DELIVERY SERVICES.

(a) State Study.-- (1) In general.--Not later than 30 months after the date of enactment of this Act, and every 5 years thereafter, each

State (as such term is defined in section 1101(a)(1) of the Social Security Act (42 U.S.C. 1301(a)(1)) for purposes of titles XIX and XXI of such Act) shall conduct a study on the costs of providing maternity, labor, and delivery services in applicable hospitals (as defined in paragraph (3)) and submit the results of such study to the Secretary of Health and Human Services (referred to in this section as the ``Secretary'') in such form and manner as the Secretary requires. (2) Content of study.--A State study required under paragraph (1) shall include the following information (to the extent practicable and as further defined by the Secretary) with respect to maternity, labor, and delivery services furnished by applicable hospitals located in the State: (A) An estimate of the cost of providing maternity, labor, and delivery services at applicable hospitals, based on the expenditures a representative sample of such hospitals incurred for providing such services during the 2 most recent years for which data is available. (B) An estimate of the cost of providing maternity, labor, and delivery services at hospitals that would be applicable hospitals (as defined in paragraph (3)) if not for ceasing to provide labor and delivery services within the past 5 years, based on the expenditures a representative sample of such hospitals incurred for providing such services during the 2 most recent years for which data is available. (C) To the extent data allow, an analysis of the extent to which geographic location, community demographics, and local economic factors (as defined by the Secretary) affect the cost of providing maternity, labor, and delivery services at applicable hospitals described in subparagraphs (A) and (B), including the cost of services that support the provision of maternity, labor, and delivery services. (D) The amounts applicable hospitals are paid for maternity, labor, and delivery services, by geographic location and hospital size, under-- (i) parts A and B of the Medicare program; (ii) the State Medicaid program, including payment amounts for such services under fee-for- service payment arrangements and under managed care (as applicable); (iii) the State CHIP plan, including payment amounts for such services under fee-for-service payment arrangements and under managed care (as applicable); and (iv) private health insurance. (E) A comparative payment rate analysis-- (i) comparing payment rates for maternity, labor, and delivery services (inclusive of all payments received by applicable hospitals for furnishing maternity, labor, and delivery services) under the State Medicaid fee-for-service program to such payment rates for such services under Medicare (including those described in paragraphs (2) and (3) of section 447.203(b) of title 42, Code of Federal Regulations), and, to the extent data is available, such payment rates for such services under Medicaid managed care

and private health insurers within geographic areas of the State; and (ii) analyzing different payment methods for such services, such as the use of bundled payments, quality incentives, and low-volume adjustments. (F) An evaluation, using such methodology and parameters established by the Secretary, of whether each hospital located in the State that furnishes maternity, labor, and delivery services is expected to experience in the next 3 years significant changes in particular expenditures or types of reimbursement for maternity, labor, and delivery services. (3) Applicable hospital defined.--For purposes of this subsection, the term ``applicable hospital'' means any hospital located in a State that meets either of the following criteria: (A) The hospital provides labor and delivery services and more than 50 percent of the hospital's births (in the most recent year for which such data is available) are financed by the Medicaid program or CHIP. (B) The hospital-- (i) is located in a rural area (as defined by the Federal Office of Rural Health Policy for the purpose of rural health grant programs administered by such Office); (ii) based on the most recent 2 years of data available (as determined by the Secretary), furnished services for less than an average of 300 births per year; and (iii) provides labor and delivery services. (4) Assistance to small hospitals in compiling cost information.--There are appropriated to the Secretary for fiscal year 2026, $10,000,000 for the purpose of providing grants and technical assistance to a hospital described in paragraph (3)(B) to enable such hospital to compile detailed information for use in the State studies required under paragraph (1), to remain available until expended. (5) HHS report on state studies.--For each year in which a State is required to conduct a study under paragraph (1), the Secretary shall issue, not later than 18 months after the date on which the State submits to the Secretary the data described in such paragraph, a publicly available report that compiles and details the results of such study and includes the information described in paragraph (2).

(b) HHS Report on National Data Collection Findings.--Not later than 3 years and 6 months after the date of enactment of this Act, the Secretary shall submit to Congress, and make publicly available, a report analyzing the first studies conducted by States under subsection (a)(1), including recommendations for improving data collection on the cost of providing maternity, labor, and delivery services.

(c) Implementation Funding.--In addition to the amount appropriated under subsection (a)(4), there are appropriated, out of any funds in the Treasury not otherwise obligated, $3,000,000 for fiscal year 2026, to remain available until expended, to the Secretary of Health and Human Services for purposes of implementing this section.

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 striking ``2025 and a portion of fiscal year 2026'' and inserting ``2027''; and (2) by inserting ``, and the DSH allotment for Tennessee for the portion of fiscal year 2026 beginning on January 31, 2026, and ending September 30, 2026, shall be $35,351,507, which may be claimed as fiscal year 2026 uncompensated care costs, and the DSH allotment for Tennessee for fiscal year 2027, shall be $53,100,000'' before the period.

(b) Eliminating Certain DSH Allotment Reductions.--Section 1923(f)(7)(A) of the Social Security Act (42 U.S.C. 1396r-4(f)(7)(A)) is amended-- (1) in clause (i)-- (A) in the matter preceding subclause (I), by striking ``the period beginning January 31, 2026, and ending September 30, 2026, and for each of fiscal years 2027 and 2028'' and inserting ``fiscal year 2028''; (B) in subclause (I), by striking ``or period''; and (C) in subclause (II), by striking ``or period'' each place it appears; and (2) in clause (ii), by striking ``the period beginning January 31, 2026, and ending September 30, 2026, and for each of fiscal years 2027 and 2028'' and inserting ``fiscal year 2028''.

HOSPITAL PAYMENT ADJUSTMENTS UNDER THE MEDICAID PROGRAM.

(a) In General.--Section 1923(g) of the Social Security Act (42 U.S.C. 1396r-4(g)) is amended-- (1) in paragraph (1)-- (A) in subparagraph (A)-- (i) in the matter preceding clause (i), by striking ``(other than a hospital described in paragraph (2)(B))''; (ii) in clause (i), by inserting ``with respect to such hospital and year'' after ``described in subparagraph (B)''; and (iii) in clause (ii)-- (I) in subclause (I), by striking ``and'' at the end; (II) in subclause (II), by striking the period and inserting ``; and''; and (III) by adding at the end the following new subclause: ``(III) payments made under title XVIII or by an applicable plan (as defined in section 1862(b)(8)(F)) for such services.''; and (B) in subparagraph (B)-- (i) in the matter preceding clause (i), by striking ``in this clause are'' and inserting ``in this subparagraph are, with respect to a hospital and a year,''; and (ii) by adding at the end the following new clause: ``(iii) Individuals who are eligible for medical assistance under the State plan or under a waiver

of such plan and for whom the State plan or waiver is a payor for such services after application of benefits under title XVIII or under an applicable plan (as defined in section 1862(b)(8)(F)), but only if the hospital has in the aggregate incurred costs exceeding payments under such State plan, waiver, title XVIII, or applicable plan for such services furnished to such individuals during such year.''; (2) by striking paragraph (2); (3) by redesignating paragraph (3) as paragraph (2); and (4) in paragraph (2), as so redesignated, by striking ``Notwithstanding paragraph (2) of this subsection (as in effect on October 1, 2021), paragraph (2)'' and inserting ``Paragraph (2)''.

(b) Effective Date.-- (1) In general.--Except as provided in paragraph (2), the amendments made by this section shall apply to payment adjustments made under section 1923 of the Social Security Act (42 U.S.C. 1396r-4) for Medicaid State plan rate years beginning on or after the date of enactment of this Act. (2) State option to distribute unspent dsh allotments from prior years up to modified cap.-- (A) In general.--If, for any Medicaid State plan rate year that begins on or after October 1, 2022, and before the date of enactment of this Act, a State did not spend the full amount of its Federal fiscal year allotment under section 1923 of the Social Security Act (42 U.S.C. 1396r-4) applicable to that State plan rate year, the State may use the unspent portion of such allotment to increase the amount of any payment adjustment made to a hospital for such rate year, provided that-- (i) such payment adjustment (as so increased) is consistent with subsection (g) of such section (as amended by this section); and (ii) the total amount of all payment adjustments for the State plan rate year (as so increased) does not exceed the disproportionate share hospital allotment for the State and applicable Federal fiscal year under subsection (f) of such section. (B) No recoupment of payments already made to hospitals.--A State shall not recoup any payment adjustment made by the State to a hospital for a Medicaid State plan rate year described in subparagraph (A) if such payment adjustment is consistent with section 1923(g) of such Act (42 U.S.C. 1396r-4(g)) as in effect on October 1, 2021. (C) Authority to permit retroactive modification of state plan amendments to allow for increases.-- (i) In general.--Subject to clause (ii), solely for the purpose of allowing a State to increase the amount of a payment adjustment to a hospital for a Medicaid State plan rate year described in subparagraph (A) pursuant to this paragraph, a State may retroactively modify a provision of the Medicaid State plan, a waiver of such plan, or a State plan amendment that relates to such rate year and the Secretary may approve such modification. (ii) Deadline.--A State may not submit a request for approval of a retroactive modification to a provision

of the Medicaid State plan, a waiver of such plan, or a State plan amendment for a Medicaid State plan rate year after the date by which the State is required to submit the independent certified audit for such State plan rate year as required under section 1923(j)(2) of the Social Security Act (42 U.S.C. 1396r-4(j)(2)). (D) Reporting.--If a State increases a payment adjustment made to a hospital for a Medicaid State plan rate year pursuant to this paragraph, the State shall include information in such form and manner as the Secretary shall specify on such increased payment adjustment as part of the annual report submitted by the State under section 1923(j)(1) of the Social Security Act (42 U.S.C. 1396r-4(j)(1)) for such State plan rate year or, if necessary, as determined by the Secretary, in an amendment to such annual report.

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 ``during the portion of fiscal year 2026 beginning on January 31, 2026, and ending on September 30, 2026, and in fiscal year 2027'' and inserting ``during the portion of fiscal year 2027 beginning on January 1, 2027, and ending on September 30, 2027, and in fiscal year 2028''; (2) in subparagraph (C)(i)-- (A) in the matter preceding subclause (I), by striking ``through 2025 and the portion of fiscal year 2026 beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``through 2026 and the portion of fiscal year 2027 beginning on October 1, 2026, and ending on December 31, 2026''; (B) in subclause (III), by striking ``through 2025 and the portion of fiscal year 2026 beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``through 2026 and the portion of fiscal year 2027 beginning on October 1, 2026, and ending on December 31, 2026''; and (C) in subclause (IV), by striking ``the portion of fiscal year 2026 beginning on January 31, 2026, and ending on September 30, 2026, and fiscal year 2027'' and inserting ``the portion of fiscal year 2027 beginning on January 1, 2027, and ending on September 30, 2027, and fiscal year 2028''; and (3) in subparagraph (D)-- (A) in the matter preceding clause (i), by striking ``through 2025 or during the portion of fiscal year 2026 beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``through 2026 or during the portion of fiscal year 2027 beginning on October 1, 2026, and ending on December 31, 2026''; and

(B) in clause (ii), by striking ``through 2025 and the portion of fiscal year 2026 beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``through 2026 and the portion of fiscal year 2027 beginning on October 1, 2026, and ending on December 31, 2026''.

(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.

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 ``January 31, 2026'' and inserting ``January 1, 2027''; and (2) in clause (ii)(II), by striking ``January 31, 2026'' and inserting ``January 1, 2027''.

(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 ``January 31, 2026'' and inserting ``January 1, 2027''; and (B) in clause (iv), by striking ``through fiscal year 2025 and the portion of fiscal year 2026 beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``through fiscal year 2026 and the portion of fiscal year 2027 beginning on October 1, 2026, and ending on December 31, 2026''. (2) Permitting hospitals to decline reclassification.-- Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 1993 (42 U.S.C. 1395ww note) is amended by striking ``through fiscal year 2025, or the portion of fiscal year 2026 beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``through fiscal year 2026, or the portion of fiscal year 2027 beginning on October 1, 2026, and ending on December 31, 2026''.

Section 1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) is amended-- (1) in paragraph (12)(A), by striking ``January 31, 2026'' and inserting ``January 1, 2028''; and (2) in paragraph (13), by striking ``January 31, 2026'' each place it appears and inserting ``January 1, 2028'' in each such place.

ELIGIBLE ALTERNATIVE PAYMENT MODELS.

(a) In General.--Section 1833(z) of the Social Security Act (42 U.S.C. 1395l(z)) is amended-- (1) in paragraph (1)(A)-- (A) by inserting ``, and during 2028,'' after ``with 2026''; and (B) by inserting ``, or, with respect to 2028, 3.1 percent'' after ``1.88 percent''; (2) in paragraph (2)--

(A) in subparagraph (B)-- (i) in the heading, by inserting ``and 2028'' after ``2026''; and (ii) in the matter preceding clause (i), by inserting ``and 2028'' after ``2026''; (B) in subparagraph (C)-- (i) in the heading, by striking ``Beginning in 2027'' and inserting ``2027 and 2029 and subsequent years''; and (ii) in the matter preceding clause (i), by inserting ``and 2029'' after ``2027''; and (C) in subparagraph (D), by striking ``and 2026'' and inserting ``2026, and 2028''; and (3) in paragraph (4)(B), by inserting ``, or, with respect to 2028, 3.1 percent'' after ``1.88 percent''.

(b) Conforming Amendments.--Section 1848(q)(1)(C)(iii) of the Social Security Act (42 U.S.C. 1395w-4(q)(1)(C)(iii)) is amended-- (1) in subclause (II), by inserting ``and 2028'' after ``2026''; and (2) in subclause (III), by inserting ``and 2029'' after ``2027''.

INPUT, AND SELECTION.

Section 1890(d)(2) of the Social Security Act (42 U.S.C. 1395aaa(d)(2)) is amended-- (1) in the first sentence-- (A) by striking ``and $13,300,000'' and inserting ``$13,300,000''; and (B) by inserting the following before the period at the end: ``, and $15,100,000 for fiscal year 2027''; and (2) in the third sentence, by striking ``and 2026'' and inserting ``2026, and 2027''.

INCOME PROGRAMS.

(a) State Health Insurance Assistance Programs.--Subsection (a)(1)(B) of section 119 of the Medicare Improvements for Patients and Providers Act of 2008 (42 U.S.C. 1395b-3 note) is amended-- (1) in clause (xiv), by striking ``and'' at the end; (2) in clause (xv), by striking the period at the end and inserting ``; and''; and (3) by inserting after clause (xv) the following new clause: ``(xvi) for the period beginning on January 31, 2026, and ending on December 31, 2027, $30,000,000.''.

(b) Area Agencies on Aging.--Subsection (b)(1)(B) of such section 119 is amended-- (1) in clause (xiv), by striking ``and'' at the end; (2) in clause (xv), by striking the period at the end and inserting ``; and''; and (3) by inserting after clause (xv) the following new clause: ``(xvi) for the period beginning on January 31, 2026, and ending on December 31, 2027, $30,000,000.''.

(c) Aging and Disability Resource Centers.--Subsection (c)(1)(B) of such section 119 is amended-- (1) in clause (xiv), by striking ``and'' at the end; (2) in clause (xv), by striking the period at the end and inserting ``; and''; and

(3) by inserting after clause (xv) the following new clause: ``(xvi) for the period beginning on January 31, 2026, and ending on December 31, 2027, $10,000,000.''.

(d) Coordination of Efforts to Inform Older Americans About Benefits Available Under Federal and State Programs.--Subsection (d)(2) of such section 119 is amended-- (1) in clause (xiv), by striking ``and'' at the end; (2) in clause (xv), by striking the period at the end and inserting ``; and''; and (3) by inserting after clause (xv) the following new clause: ``(xvi) for the period beginning on January 31, 2026, and ending on December 31, 2027, $30,000,000.''.

Section 3(a)(2) of the IMPACT Act of 2014 (Public Law 113-185), as amended by section 6205 of division F of the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026 (Public Law 119-37), <<NOTE: 139 Stat. 632.>> is amended-- (1) in subparagraph (B), by striking ``and'' at the end; (2) in subparagraph (C), by striking the period at the end and inserting ``; and''; and (3) by adding at the end the following new subparagraph: ``(D) $4,400,000 for the period beginning on January 31, 2026, and ending on December 31, 2026, to remain available until expended.''.

Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w- 4(e)(1)(E)) is amended by striking ``January 31, 2026'' and inserting ``January 1, 2027''.

(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 January 30, 2026'' and inserting ``ending December 31, 2027''; and (2) in paragraph (4)(C)(iii), by striking ``ending on January 30, 2026'' and inserting ``ending on December 31, 2027''.

(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 January 30, 2026'' and inserting ``ending on December 31, 2027''. (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 January 30, 2026'' and inserting ``ending on December 31, 2027''. (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 January 31, 2026'' and inserting ``on or after January 1, 2028''. (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 ``January 31, 2026'' and inserting ``January 1, 2028''. (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 ``January 31, 2026'' and inserting ``January 1, 2028''.

(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 January 30, 2026'' and inserting ``ending on December 31, 2027''. (f) Extending Use of Telehealth to Conduct Face-to-face Encounter Prior to Recertification of Eligibility for Hospice Care.-- (1) In general.--Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)) is amended-- (A) by striking ``ending on January 30, 2026'' and inserting ``ending on December 31, 2027''; and (B) by inserting ``, except that this subclause shall not apply in the case of such an encounter with an individual occurring on or after January 31, 2026, if such individual is located in an area that is subject to a moratorium on the enrollment of hospice programs under this title pursuant to section 1866(j)(7), if such individual is receiving hospice care from a provider that is subject to enhanced oversight under this title pursuant to section 1866(j)(3), or if such encounter is performed by a hospice physician or nurse practitioner who is not enrolled under section 1866(j) and is not an opt-out physician or practitioner (as defined in section 1802(b)(6)(D))'' before the semicolon. (2) Requiring use of modifier.--Section 1814(a)(7)(D)(i)(II) of the Social Security Act (42 U.S.C. 1395f(a)(7)(D)(i)(II)), as amended by paragraph (1), is further amended by inserting ``, but only if, in the case of such an encounter occurring on or after January 1, 2027, any hospice claim includes 1 or more modifiers or codes (as specified by the Secretary) to indicate that such encounter was conducted via telehealth'' after ``as determined appropriate by the Secretary''.

(g) Requiring Modifiers for Telehealth Services in Certain Instances.--Section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended by adding at the end the following new paragraph: ``(10) Required use of modifiers in certain instances.--Not later than January 1, 2027, the Secretary shall establish requirements to include one or more codes or modifiers, as determined appropriate by the Secretary, in the case of-- ``(A) claims for telehealth services under this subsection that are furnished through a telehealth virtual platform-- ``(i) by a physician or practitioner that contracts with an entity that owns such virtual platform; or

``(ii) for which a physician or practitioner has a payment arrangement with an entity for use of such virtual platform; and ``(B) claims for telehealth services under this subsection that are furnished incident to a physician's or practitioner's professional service.''.

(h) 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.

FLEXIBILITIES.

(a) In General.--Section 1866G(a)(1) of the Social Security Act (42 U.S.C. 1395cc-7(a)(1)) is amended by striking ``January 30, 2026'' and inserting ``September 30, 2030''. (b) Requiring Additional Study and Report.--Section 1866G of the Social Security Act (42 U.S.C. 1395cc-7) is amended-- (1) in subsection (a)(3)(E)-- (A) in clause (ii), by striking ``the study described in subsection (b)'' and inserting ``the studies described in subsections (b) and (c)''; and (B) by adding at the end the following new flush sentence: ``The Secretary may require that such data and information be submitted through a hospital's cost report, through such survey instruments as the Secretary may develop, through medical record information, or through such other means as the Secretary determines appropriate.''; (2) in subsection (b)-- (A) in the subsection heading, by striking ``Study'' and inserting ``Initial Study''; and (B) in paragraph (3), by striking ``subsection'' and inserting ``section''; (3) by redesignating subsections (c) and (d) as subsections (d) and (e), respectively; (4) by inserting after subsection (b) the following new subsection:

``(c) Subsequent Study and Report.-- ``(1) In general.--Not later than September 30, 2029, the Secretary shall conduct a study to-- ``(A) analyze, to the extent practicable, the criteria established by hospitals under the Acute Hospital Care at Home initiative to determine which individuals may be furnished services under such initiative; and ``(B) analyze and compare (both within and between hospitals participating in the initiative, and relative to comparable hospitals that do not participate in the initiative, for relevant parameters such as diagnosis- related groups)-- ``(i) quality of care furnished to individuals with similar conditions and characteristics in the inpatient setting and through the Acute Hospital Care at Home initiative, including health outcomes, hospital readmission rates (including readmissions both within and beyond 30 days post- discharge), hospital mortality rates, length of stay, infection rates, composition of

care team (including the types of labor used, such as contracted labor), the ratio of nursing staff, transfers from the hospital to the home, transfers from the home to the hospital (including the timing, frequency, and causes of such transfers), transfers and discharges to post-acute care settings (including the timing, frequency, and causes of such transfers and discharges), and patient and caregiver experience of care; ``(ii) clinical conditions treated and diagnosis-related groups of discharges from inpatient settings relative to discharges from the Acute Hospital Care at Home initiative; ``(iii) costs incurred by the hospital for furnishing care in inpatient settings relative to costs incurred by the hospital for furnishing care through the Acute Hospital Care at Home initiative, including costs relating to staffing, equipment, food, prescriptions, and other services, as determined by the Secretary; ``(iv) the quantity, mix, and intensity of services (such as in-person visits and virtual contacts with patients and the intensity of such services) furnished in inpatient settings relative to the Acute Hospital Care at Home initiative, and, to the extent practicable, the nature and extent of family or caregiver involvement; ``(v) socioeconomic information on individuals treated in comparable inpatient settings relative to the initiative, including racial and ethnic data, income, housing, geographic proximity to the brick-and-mortar facility and whether such individuals are dually eligible for benefits under this title and title XIX; and ``(vi) the quality of care, outcomes, costs, quantity and intensity of services, and other relevant metrics between individuals who entered into the Acute Hospital Care at Home initiative directly from an emergency department compared with individuals who entered into the Acute Hospital Care at Home initiative directly from an existing inpatient stay in a hospital. ``(2) Selection bias.--In conducting the study under paragraph (1), the Secretary shall, to the extent practicable, analyze and compare individuals who participate and do not participate in the initiative controlling for selection bias or other factors that may impact the reliability of data. ``(3) Report.--Not later than September 30, 2029, the Secretary of Health and Human Services shall-- ``(A) submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report on the study conducted under paragraph (1); and ``(B) <<NOTE: Public information. Web posting.>> make such report publicly available on a website of the Centers for Medicare & Medicaid Services. ``(4) Funding.--In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account for fiscal year 2026, out of any amounts in the Treasury not otherwise appropriated, $2,500,000, to remain available until expended, for purposes of carrying out this section.''; and

(5) in subsection (e), as redesignated by paragraph (3), by striking ``and (b)(1)'' and inserting ``, (b)(1), and (c)(1)''.

(a) In General.--Section 1861(eee)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1395x(eee)(2)(A)(ii)) is amended by inserting ``(including, with respect to items and services furnished through audio and video real-time communications technology (excluding audio-only) on or after January 31, 2026, and before January 1, 2028, in the home of an individual who is an outpatient of the hospital)'' after ``outpatient basis''. (b) Implementation.--Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendment made by subsection (a) by program instruction or otherwise.

DME UNDER MEDICARE.

(a) Durable Medical Equipment.-- (1) In general.--Section 1834(a) of the Social Security Act (42 U.S.C. 1395m(a)) is amended by adding at the end the following new paragraph: ``(23) Master list inclusion and claim review for certain items.-- ``(A) <<NOTE: Effective date. Determination. Time period.>> Master list inclusion.--Beginning January 1, 2029, for purposes of the Master List described in section 414.234(b) of title 42, Code of Federal Regulations (or any successor regulation), in determining which items have aberrant billing patterns (as such term is used for purposes of such section), the Secretary shall also treat an item for which payment may be made under this subsection as having such an aberrant billing pattern if the Secretary determines that, without explanatory contributing factors (such as furnishing emergent care services), a substantial number of claims for such items under this subsection are for such items ordered by a physician or practitioner who has not previously (during a period of not less than 24 months, as established by the Secretary) furnished to the individual involved any item or service for which payment may be made under this title. ``(B) Claim review.--With respect to items furnished on or after January 1, 2029, that are included on the Master List pursuant to subparagraph (A), if such an item is not subject to a determination of coverage in advance pursuant to paragraph (15)(C), the Secretary may conduct prepayment review of claims for payment for such item.''. (2) Conforming amendment for prosthetic devices, orthotics, and prosthetics.--Section 1834(h)(3) of the Social Security Act (42 U.S.C. 1395m(h)(3)) is amended by inserting ``, and paragraph (23) of subsection (a) shall apply to prosthetic devices, orthotics, and prosthetics in the same manner as such provision applies to items for which payment may be made under such subsection'' before the period at the end.

(b) Report on Identifying Clinical Diagnostic Laboratory Tests at High Risk for Fraud and Effective Mitigation Measures.--Not later than January 1, 2028, the Inspector General of the Department of Health and Human Services shall submit to

Congress a report assessing fraud risks relating to clinical diagnostic laboratory tests for which payment may be made under section 1834A of the Social Security Act (42 U.S.C. 1395m-1) and effective tools for reducing such fraudulent claims. The report may include, at the Inspector General's discretion-- (1) which, if any, clinical diagnostic laboratory tests are identified as being at high risk of fraudulent claims, and an analysis of the factors that contribute to such risk; (2) with respect to a clinical diagnostic laboratory test identified under paragraph (1) as being at high risk of fraudulent claims-- (A) the amount payable under such section 1834A with respect to such test; (B) the number of such tests furnished to individuals enrolled under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.); (C) whether an order for such a test was more likely to come from a provider with whom the individual involved did not have a prior relationship, as determined on the basis of prior payment experience; and (D) the frequency with which a claim for payment under such section 1834A included the payment modifier identified by code 59 or 91; and (3) suggested strategies for reducing the number of fraudulent claims made with respect to tests so identified as being at high risk, including-- (A) an analysis of whether the Centers for Medicare & Medicaid Services can detect aberrant billing patterns with respect to such tests in a timely manner; (B) any strategies for identifying and monitoring the providers who are outliers with respect to the number of such tests that such providers order; and (C) targeted education efforts to mitigate improper billing for such tests; and (4) such other information as the Inspector General determines appropriate.

(c) Funding.--In addition to amounts otherwise available, there is appropriated to the Inspector General of the Department of Health and Human Services, out of any money in the Treasury not otherwise appropriated, $1,200,000 for fiscal year 2026, to remain available until expended, to carry out this section.

SERVICES VIA TELEHEALTH TO INDIVIDUALS WITH LIMITED ENGLISH PROFICIENCY.

(a) In General.--Not later than 1 year after the date of enactment of this section, the Secretary of Health and Human Services, in consultation with 1 or more entities from each of the categories described in paragraphs (1) through (7) of subsection (b), shall issue and disseminate, or update and revise as applicable, guidance for the entities described in such subsection on the following: (1) Best practices on facilitating and integrating use of interpreters during a telemedicine appointment. (2) Best practices on providing accessible instructions on how to access telecommunications systems (as such term is used for purposes of section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) for individuals with limited English proficiency.

(3) Best practices on improving access to digital patient portals for individuals with limited English proficiency. (4) Best practices on integrating the use of video platforms that enable multi-person video calls furnished via a telecommunications system for purposes of providing interpretation during a telemedicine appointment for an individual with limited English proficiency. (5) Best practices for providing patient materials, communications, and instructions in multiple languages, including text message appointment reminders and prescription information.

(b) Entities Described.--For purposes of subsection (a), an entity described in this subsection is an entity in 1 or more of the following categories: (1) Health information technology service providers, including-- (A) electronic medical record companies; (B) remote patient monitoring companies; and (C) telehealth or mobile health vendors and companies. (2) Health care providers, including-- (A) physicians; and (B) hospitals. (3) Health insurers. (4) Language service companies. (5) Interpreter or translator professional associations. (6) Health and language services quality certification organizations. (7) Patient and consumer advocates, including such advocates that work with individuals with limited English proficiency.

DIABETES PREVENTION PROGRAM SUPPLIERS IN MDPP EXPANDED MODEL.

(a) In General.--For the period beginning on January 1, 2026, and ending on December 31, 2029-- (1) an entity may participate in the MDPP by offering only MDPP services via distance learning or online delivery modalities if such entity meets the conditions for enrollment as an MDPP supplier; (2) if an entity participates in the MDPP in the manner described in paragraph (1), in the case of online MDPP services furnished by such entity to an MDPP beneficiary who was not located in the same State as the entity at the time such services were furnished, the entity shall not be prohibited from submitting a claim for payment for such services solely by reason of the location of such beneficiary at such time; and (3) no limit is applied on the number of times an individual may enroll in the MDPP.

(b) Definitions.--In this section: (1) MDPP.--The term ``MDPP'' means the Medicare Diabetes Prevention Program (as such term is defined in section 410.79(b) of title 42, Code of Federal Regulations). (2) Regulatory terms.--The terms ``distance learning'', ``MDPP beneficiary'', ``MDPP services'', ``MDPP supplier'', and ``online'' have the meanings given such terms in section 410.79(b) of title 42, Code of Federal Regulations.

(3) Secretary.--The term ``Secretary'' means the Secretary of Health and Human Services.

(c) Implementation.--Notwithstanding any other provision of law, the Secretary may implement this section by program instruction or otherwise.

INDUCED MOVEMENT DISORDER OUTREACH AND EDUCATION.

Not later than January 1, 2028, the Secretary of Health and Human Services shall use existing communications mechanisms to provide education and outreach to physicians and appropriate non-physician practitioners participating under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) with respect to periodic screening for medication-induced movement disorders that are associated with the treatment of mental health disorders in at-risk patients, as well as resources related to clinical guidelines and best practices for furnishing such screening services through telehealth. Such education and outreach shall include information on how to account for such screening services in evaluation and management code selection. The Secretary shall, to the extent practicable, seek input from relevant stakeholders to inform such education and outreach. Such education and outreach may also address other relevant screening services furnished through telehealth, as the Secretary determines appropriate.

Not later than 18 months after the date of the enactment of this Act, the Comptroller General of the United States shall conduct a technology assessment of, and submit to Congress a report on, the capabilities and limitations of wearable medical devices used to support clinical decision-making. Such report shall include a description of-- (1) the potential for such devices to accurately prescribe treatments; (2) an examination of the benefits and challenges of artificial intelligence to augment such capabilities; and (3) policy options to enhance the benefits and mitigate potential challenges of developing or using such devices.

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 ``January 30, 2026'' and inserting ``December 31, 2026''.

AMOUNT UNDER MEDICARE.

Section 1814(i)(2)(B) of the Social Security Act (42 U.S.C. 1395f(i)(2)(B)) is amended-- (1) in clause (ii), by striking ``2033'' and inserting ``2035''; and (2) in clause (iii), by striking ``2033'' and inserting ``2035''.

FOR LOW-INCOME INDIVIDUALS.

Section 1860D-14(a) of the Social Security Act (42 U.S.C. 1395w- 114(a)) is amended--

(1) in paragraph (1)(D)(ii), by striking ``that does not exceed $1 for'' and all that follows through the period at the end and inserting "that does not exceed-- `` ``(I) for a plan year before 2028-- ``(aa) for a generic drug or a preferred drug that is a multiple source drug (as defined in section 1927(k)(7)(A)(i)), $1 or, if less, the copayment amount applicable to an individual under clause (iii); and ``(bb) for any other drug, $3 or, if less, the copayment amount applicable to an individual under clause (iii); and ``(II) for plan year 2028 and each subsequent plan year-- ``(aa) for a generic drug, $0; ``(bb) for a preferred drug that is a multiple source drug (as defined in section 1927(k)(7)(A)(i)), the dollar amount applied under this clause for such a drug for the preceding plan year, increased by the annual percentage increase in the consumer price index (all items; U.S. city average) as of September of such preceding year, or, if less, the copayment amount applicable to an individual under clause (iii); and ``(cc) for a drug not described in either item (aa) or (bb), the dollar amount applied under this clause for such a drug for the preceding plan year, increased in the manner specified in item (bb), or, if less, the copayment amount applicable to an individual under clause (iii). Any amount established under item (bb) or (cc) of subclause (II), that is based on an increase of $1 or $3, that is not a multiple of 5 cents or 10 cents, respectively, shall be rounded to the nearest multiple of 5 cents or 10 cents, respectively.''; and (2) in paragraph (4)(A)(ii), by inserting ``(before 2028)'' after ``a subsequent year''.

PROVIDERS ACT.

(a) In General.--Section 1852(c) of the Social Security Act (42 U.S.C. 1395w-22(c)) is amended-- (1) in paragraph (1)(C)-- (A) by striking ``plan, and any'' and inserting ``plan, any''; and (B) by inserting the following before the period: ``, and, in the case of a specified MA plan (as defined in paragraph (3)(C)), for plan year 2028 and subsequent plan years, the information described in paragraph (3)(B)''; and (2) by adding at the end the following new paragraph: ``(3) Provider directory accuracy.-- ``(A) In general.--For plan year 2028 and subsequent plan years, each MA organization offering a specified MA plan (as defined in subparagraph (C)) shall, for each such plan offered by the organization--

``(i) <<NOTE: Public information. Website.>> maintain, on a publicly available internet website, an accurate provider directory that includes the information described in subparagraph (B); ``(ii) not less frequently than once every 90 days (or, in the case of a hospital or any other facility determined appropriate by the Secretary, at a lesser frequency specified by the Secretary but in no case less frequently than once every 12 months), verify the provider directory information of each provider listed in such directory and, if applicable, update such information; ``(iii) if the organization is unable to verify such information with respect to a provider, include in such directory an indication that the information of such provider may not be up to date; and ``(iv) remove a provider from such directory within 5 business days if the organization determines that the provider is no longer a provider participating in the network of such plan. ``(B) Provider directory information.--The information described in this subparagraph is information enrollees may need to access covered benefits from a provider with which such organization offering such plan has an agreement for furnishing items and services covered under such plan, such as name, specialty, contact information, primary office or facility addresses where items or services are furnished, whether the provider is accepting new patients, accommodations for people with disabilities, cultural and linguistic capabilities, and telehealth capabilities. ``(C) Specified ma plan.--In this paragraph, the term `specified MA plan' means-- ``(i) a network-based plan (as defined in subsection (d)(5)(C)); or ``(ii) a Medicare Advantage private fee-for- service plan (as defined in section 1859(b)(2)) that meets the access standards under subsection (d)(4), in whole or in part, through entering into contracts or agreements as provided for under subparagraph (B) of such subsection.''.

(b) Accountability for Provider Directory Accuracy.-- (1) Cost sharing for services furnished based on reliance on incorrect provider directory information.--Section 1852(d) of the Social Security Act (42 U.S.C. 1395w-22(d)) is amended-- (A) in paragraph (1)(C)-- (i) in clause (ii), by striking ``or'' at the end; (ii) in clause (iii), by striking the semicolon at the end and inserting ``, or''; and (iii) by adding at the end the following new clause: ``(iv) for plan year 2028 and subsequent plan years, in the case of a specified MA plan (as defined in subsection (c)(3)(C)), the services were furnished by a provider that was not participating in the network of such plan but was listed in the provider directory of such plan on the date on which the appointment was made, as described in paragraph (7)(A);''; and (B) by adding at the end the following new paragraph:

``(7) Cost sharing for services furnished based on reliance on incorrect provider directory information.-- ``(A) In general.--For plan year 2028 and subsequent plan years, if an enrollee in a specified MA plan (as defined in subsection (c)(3)(C)) is furnished an item or service by a provider that is not participating in the network of such plan but is listed in the provider directory of such plan (as required to be provided to an enrollee pursuant to subsection (c)(1)(C)) on the date on which the appointment is made, and if such item or service would otherwise be covered under such plan if furnished by a provider that is participating in the network of such plan, the MA organization offering such plan shall ensure that the enrollee is only responsible for the lesser of-- ``(i) the amount of cost sharing that would apply if such provider had been participating in the network of such plan; or ``(ii) the amount of cost sharing that would otherwise apply (without regard to this subparagraph). ``(B) Notification requirement.--For plan year 2028 and subsequent plan years, each MA organization that offers a specified MA plan shall-- ``(i) notify enrollees of their cost-sharing protections under this paragraph and make such notifications, to the extent practicable, by not later than the first day of an annual, coordinated election period under section 1851(e)(3) with respect to a year; ``(ii) include information regarding such cost-sharing protections in the provider directory of each specified MA plan offered by the MA organization.; and ``(iii) notify enrollees of their cost-sharing protections under this paragraph in the first explanation of benefits issued in a plan year.''. (2) Required provider directory accuracy analysis and reports.-- (A) In general.--Section 1857(e) of the Social Security Act (42 U.S.C. 1395w-27(e)) is amended by adding at the end the following new paragraph: ``(6) Provider directory accuracy analysis and reports.-- ``(A) In general.--Beginning with plan years beginning on or after January 1, 2028, subject to subparagraph (C), a contract under this section with an MA organization shall require the organization, for each specified MA plan (as defined in section 1852(c)(3)(C)) offered by the organization, to annually do the following: ``(i) Conduct an analysis estimating the accuracy of the provider directory information of such plan using a random sample of providers included in such provider directory as follows: ``(I) Such a random sample shall include a random sample of each specialty of providers with a high inaccuracy rate of provider directory information relative to other specialties of providers, as determined by the Secretary.

``(II) For purposes of subclause (I), one type of specialty may be providers specializing in mental health or substance use disorder treatment. ``(ii) Submit to the Secretary a report containing the results of the analysis conducted under clause (i), including an accuracy score for such provider directory information (as determined using a plan verification method specified by the Secretary under subparagraph (B)(i)). ``(B) Determination of accuracy score.-- ``(i) In general.--The Secretary shall specify plan verification methods, such as using telephonic verification or other approaches using data sources maintained by an MA organization or using publicly available data sets, that MA organizations may use for estimating accuracy scores of the provider directory information of specified MA plans offered by such organizations. ``(ii) Accuracy score methodology.--With respect to each such method specified by the Secretary as described in clause (i), the Secretary shall specify a methodology for MA organizations to use in estimating such accuracy scores. Each such methodology shall take into account the administrative burden on plans and providers and the relative importance of certain provider directory information on enrollee ability to access care. ``(C) Exception.--The Secretary may waive the requirements of this paragraph in the case of a specified MA plan with low enrollment (as defined by the Secretary). ``(D) <<NOTE: Effective date. Web posting.>> Transparency.--Beginning with plan years beginning on or after January 1, 2029, the Secretary shall post accuracy scores (as reported under subparagraph (A)(ii)), in a machine readable file, on an internet website maintained by the Centers for Medicare & Medicaid Services.''. (B) Provision of information to beneficiaries.-- Section 1851(d)(4) of the Social Security Act (42 U.S.C. 1395w-21(d)(4)) is amended by adding at the end the following new subparagraph: ``(F) Provider directory.--Beginning with plan years beginning on or after January 1, 2029, in the case of a specified MA plan (as defined in section 1852(c)(3)(C)), the accuracy score of the plan's provider directory (as reported under section 1857(e)(6)(A)(ii)) listed prominently on the plan's provider directory.''. (C) Funding.--In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account, out of any money in the Treasury not otherwise appropriated, $4,000,000 for fiscal year 2026, to remain available until expended, to carry out the amendments made by this paragraph. (3) GAO study and report.-- (A) Analysis.--The Comptroller General of the United States (in this paragraph referred to as the ``Comptroller General'') shall conduct a study of the implementation of the amendments made by paragraphs (1) and (2). To the

extent data are available and reliable, such study shall include an analysis of-- (i) the use of cost-sharing protections required under section 1852(d)(7)(A) of the Social Security Act, as added by paragraph (1); (ii) the trends in provider directory information accuracy scores submitted to the Secretary of Health and Human Services under section 1857(e)(6)(A)(ii) of the Social Security Act (as added by paragraph (2)(A)), both overall and among providers specializing in mental health or substance use disorder treatment; (iii) provider response rates by plan verification methods; (iv) administrative costs to providers and Medicare Advantage organizations; and (v) other items determined appropriate by the Comptroller General. (B) Report.--Not later than January 15, 2033, the Comptroller General shall submit to Congress a report containing the results of the study conducted under subparagraph (A), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate.

(c) Guidance on Maintaining Accurate Provider Directories.-- (1) <<NOTE: Public information. 42 USC 1395w-22 note.>> Stakeholder meeting.-- (A) In general.--Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this subsection as the ``Secretary'') shall hold a public meeting to receive input on approaches for maintaining accurate provider directories for Medicare Advantage plans under part C of title XVIII of the Social Security Act (42 U.S.C. 1395w-21 et seq.), including input on approaches for reducing administrative burden, such as data standardization, and best practices to maintain accurate provider directory information. (B) Participants.--Participants of the meeting under subparagraph (A) shall include representatives from the Centers for Medicare & Medicaid Services and the Assistant Secretary for Technology Policy and Office of the National Coordinator for Health Information Technology. Such meeting shall be open to the public. To the extent practicable, the Secretary shall include health care providers, companies that specialize in relevant technologies, health insurers, and patient advocates. (2) Guidance to medicare advantage organizations.--Not later than 18 months after the date of enactment of this Act, the Secretary shall issue guidance to Medicare Advantage organizations offering Medicare Advantage plans under part C of title XVIII of the Social Security Act (42 U.S.C. 1395w-21 et seq.) on maintaining accurate provider directories for such plans, taking into consideration input received during the stakeholder meeting under paragraph (1). Such guidance may include the following, as determined appropriate by the Secretary:

(A) Best practices for Medicare Advantage organizations on how to work with providers to maintain the accuracy of provider directories and reduce provider and Medicare Advantage organization burden with respect to maintaining the accuracy of provider directories. (B) Information on data sets and data sources with information that could be used by Medicare Advantage organizations to maintain accurate provider directories. (C) Approaches for utilizing data sources maintained by Medicare Advantage organizations and publicly available data sets to maintain accurate provider directories. (D) Information that may be useful to include in provider directories for Medicare beneficiaries to use in assessing plan networks when selecting a plan and accessing providers participating in plan networks during the plan year. (3) Guidance to part b providers.--Not later than 12 months after the date of enactment of this Act, the Secretary shall issue guidance to providers of services and suppliers who furnish items or services for which benefits are available under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.) on when to update the National Plan and Provider Enumeration System (or a successor system) for information changes.

SCREENING TESTS.

(a) Coverage.--Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended-- (1) in subsection (s)(2)-- (A) by striking the semicolon at the end of subparagraph (JJ) and inserting ``; and''; and (B) by adding at the end the following new subparagraph: ``(KK) multi-cancer early detection screening tests (as defined in subsection (nnn));''; and (2) by adding at the end the following new subsection:

``(nnn) Multi-cancer Early Detection Screening Tests.-- ``(1) In general.--The term `multi- cancer early detection screening test' means a test furnished to an individual for the concurrent detection of multiple cancer types across multiple organ sites on or after January 1, 2029, that-- ``(A) is cleared under section 510(k), classified under section 513(f)(2), or approved under section 515 of the Federal Food, Drug, and Cosmetic Act; ``(B) is-- ``(i) a genomic sequencing blood or blood product test that includes the analysis of cell- free nucleic acids; or ``(ii) a test based on samples of biological material that provide results comparable to those obtained with a test described in clause (i), as determined by the Secretary; and ``(C) the Secretary determines is-- ``(i) reasonable and necessary for the prevention or early detection of an illness or disability; and

``(ii) appropriate for individuals entitled to benefits under part A or enrolled under part B. ``(2) NCD process.--In making determinations under paragraph (1)(C) regarding the coverage of a new test, the Secretary shall use the process for making national coverage determinations (as defined in section 1869(f)(1)(B)) under this title.''.

(b) Payment and Standards for Multi-cancer Early Detection Screening Tests.-- (1) In general.--Section 1834 of the Social Security Act (42 U.S.C. 1395m) is amended by adding at the end the following new subsection:

``(aa) Payment and Standards for Multi-cancer Early Detection Screening Tests.-- ``(1) Payment amount.--The payment amount for a multi-cancer early detection screening test (as defined in section 1861(nnn)) is-- ``(A) with respect to such a test furnished before January 1, 2031, equal to the payment amount in effect on the date of the enactment of this subsection for a multi-target stool screening DNA test covered pursuant to section 1861(pp)(1)(D); and ``(B) with respect to such a test furnished on or after January 1, 2031, equal to the lesser of-- ``(i) the amount described in subparagraph (A); or ``(ii) the payment amount determined for such test under section 1834A. ``(2) Limitations.-- ``(A) In general.--No payment may be made under this part for a multi-cancer early detection screening test furnished during a year to an individual if-- ``(i) such individual-- ``(I) is under 50 years of age; or ``(II) as of January 1 of such year, has attained the age specified in subparagraph (B) for such year; or ``(ii) such a test was furnished to the individual during the previous 11 months. ``(B) Age specified.--For purposes of subparagraph (A)(i)(II), the age specified in this subparagraph is-- ``(i) for 2029, 65 years of age; and ``(ii) for a succeeding year, the age specified in this subparagraph for the preceding year, increased by 1 year. ``(C) Standards following uspstf rating of a or b.-- In the case of a multi-cancer early detection screening test that is recommended with a grade of A or B by the United States Preventive Services Task Force, beginning on the date on which coverage for such test is provided pursuant to section 1861(ddd)(1), the preceding provisions of this paragraph shall not apply.''. (2) Conforming amendments.-- (A) Section 1833 of the Social Security Act (42 U.S.C. 1395l) is amended-- (i) in subsection (a)--

(I) in paragraph (1)(D)(i)(I), by striking ``section 1834(d)(1)'' and inserting ``subsection (d)(1) or (aa) of section 1834''; and (II) in paragraph (2)(D)(i)(I), by striking ``section 1834(d)(1)'' and inserting ``subsection (d)(1) or (aa) of section 1834''; and (ii) in subsection (h)(1)(A), by striking ``section 1834(d)(1)'' and inserting ``subsections (d)(1) and (aa) of section 1834''. (B) Section 1862(a)(1)(A) of the Social Security Act (42 U.S.C. 1395y(a)(1)(A)) is amended-- (i) by striking ``or additional preventive services'' and inserting ``, additional preventive services''; and (ii) by inserting ``, or multi-cancer early detection screening tests (as defined in section 1861(nnn))'' after ``(as described in section 1861(ddd)(1))''.

(c) Rule of Construction Relating to Other Cancer Screening Tests.--Nothing in this section, including the amendments made by this section, shall be construed-- (1) in the case of an individual who undergoes a multi- cancer early detection screening test, to affect coverage under part B of title XVIII of the Social Security Act for other cancer screening tests covered under such title, such as screening tests for breast, cervical, colorectal, lung, or prostate cancer; or (2) in the case of an individual who undergoes another cancer screening test, to affect coverage under such part for a multi-cancer early detection screening test or the use of such a test as a diagnostic or confirmatory test for a result of the other cancer screening test.

(d) Funding.--In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account, out of any money in the Treasury not otherwise appropriated, $2,000,000 for fiscal year 2026, to remain available until expended, to carry out this section.

SELF-ADMINISTRABLE HOME INFUSION DRUGS.

(a) In General.--Section 1861(n) of the Social Security Act (42 U.S.C. 1395x(n)) is amended by adding at the end the following new sentence: `` Beginning with the first calendar quarter beginning on or after the date that is 1 year after the date of the enactment of this sentence, an external infusion pump and associated home infusion drug (as defined in subsection (iii)(3)(C)) or other associated supplies that do not meet the appropriate for use in the home requirement applied to the definition of durable medical equipment under section 414.202 of title 42, Code of Federal Regulations (or any successor to such regulation) shall be treated as meeting such requirement if each of the following criteria is satisfied: ``(1) The prescribing information approved by the Food and Drug Administration for the home infusion drug associated with the pump instructs that the drug should be administered by or under the supervision of a health care professional. ``(2) A qualified home infusion therapy supplier (as defined in subsection (iii)(3)(D)) administers or supervises the administration of the drug or biological in a safe and effective manner in the patient's home (as defined in subsection (iii)(3)(B)).

``(3) The prescribing information described in paragraph (1) instructs that the drug should be infused at least 12 times per year-- ``(A) intravenously or subcutaneously; or ``(B) at infusion rates that the Secretary determines would require the use of an external infusion pump.''.

(b) Cost Sharing Notification.--The Secretary of Health and Human Services shall ensure that patients are notified of the cost sharing for electing home infusion therapy compared to other applicable settings of care for the furnishing of infusion drugs under the Medicare program.

BENEFICIARIES.

(a) In General.--Section 1860D-4(b)(1) of the Social Security Act (42 U.S.C. 1395w-104(b)(1)) is amended by striking subparagraph (A) and inserting the following: ``(A) In general.-- ``(i) Participation of any willing pharmacy.-- A PDP sponsor offering a prescription drug plan shall permit any pharmacy that meets the standard contract terms and conditions under such plan to participate as a network pharmacy of such plan. ``(ii) Contract terms and conditions.-- ``(I) In general.--Notwithstanding any other provision of law, for plan years beginning on or after January 1, 2029, in accordance with clause (i), contract terms and conditions offered by such PDP sponsor shall be reasonable and relevant according to standards established by the Secretary under subclause (II). ``(II) Standards.--Not later than the first Monday in April of 2028, the Secretary shall establish standards for reasonable and relevant contract terms and conditions for purposes of this clause. ``(III) Request for information.-- Not later than April 1, 2027, for purposes of establishing the standards under subclause (II), the Secretary shall issue a request for information to seek input on trends in prescription drug plan and network pharmacy contract terms and conditions, current prescription drug plan and network pharmacy contracting practices, whether pharmacy reimbursement and dispensing fees paid by PDP sponsors to network pharmacies sufficiently cover the ingredient and operational costs of such pharmacies, the use and application of pharmacy quality measures by PDP sponsors for network pharmacies, PDP sponsor restrictions or limitations on the dispensing of covered part D drugs by network pharmacies (or any subsets of such pharmacies), PDP sponsor auditing practices for network pharmacies, areas in current regulations or program guidance related to contracting between prescription drug

plans and network pharmacies requiring clarification or additional specificity, factors for consideration in determining the reasonableness and relevance of contract terms and conditions between prescription drug plans and network pharmacies, and other issues as determined appropriate by the Secretary.''.

(b) Essential Retail Pharmacies.--Section 1860D-42 of the Social Security Act (42 U.S.C. 1395w-152) is amended by adding at the end the following new subsection: ``(e) Essential Retail Pharmacies.-- ``(1) <<NOTE: Effective date. Reports. Time period. Termination date.>> In general.--With respect to plan years beginning on or after January 1, 2028, the Secretary shall publish reports, at least once every 2 years until 2034, and periodically thereafter, that provide information, to the extent feasible, on-- ``(A) trends in ingredient cost reimbursement, dispensing fees, incentive payments and other fees paid by PDP sponsors offering prescription drug plans and MA organizations offering MA-PD plans under this part to essential retail pharmacies (as defined in paragraph (2)) with respect to the dispensing of covered part D drugs, including a comparison of such trends between essential retail pharmacies and pharmacies that are not essential retail pharmacies; ``(B) trends in amounts paid to PDP sponsors offering prescription drug plans and MA organizations offering MA-PD plans under this part by essential retail pharmacies with respect to the dispensing of covered part D drugs, including a comparison of such trends between essential retail pharmacies and pharmacies that are not essential retail pharmacies; ``(C) trends in essential retail pharmacy participation in pharmacy networks and preferred pharmacy networks for prescription drug plans offered by PDP sponsors and MA-PD plans offered by MA organizations under this part, including a comparison of such trends between essential retail pharmacies and pharmacies that are not essential retail pharmacies; ``(D) trends in the number of essential retail pharmacies, including variation in such trends by geographic region or other factors; ``(E) a comparison of cost-sharing for covered part D drugs dispensed by essential retail pharmacies that are network pharmacies for prescription drug plans offered by PDP sponsors and MA-PD plans offered by MA organizations under this part and cost-sharing for covered part D drugs dispensed by other network pharmacies for such plans located in similar geographic areas that are not essential retail pharmacies; ``(F) a comparison of the volume of covered part D drugs dispensed by essential retail pharmacies that are network pharmacies for prescription drug plans offered by PDP sponsors and MA-PD plans offered by MA organizations under this part and such volume of dispensing by network pharmacies for such plans located in similar geographic areas that are not essential retail pharmacies, including information on any patterns or trends

in such comparison specific to certain types of covered part D drugs, such as generic drugs or drugs specified as specialty drugs by a PDP sponsor under a prescription drug plan or an MA organization under an MA-PD plan; and ``(G) a comparison of the information described in subparagraphs (A) through (F) between essential retail pharmacies that are network pharmacies for prescription drug plans offered by PDP sponsors under this part and essential retail pharmacies that are network pharmacies for MA-PD plans offered by MA organizations under this part. ``(2) Definition of essential retail pharmacy.--In this subsection, the term `essential retail pharmacy' means, with respect to a plan year, a retail pharmacy that-- ``(A) is not a pharmacy that is an affiliate as defined in paragraph (4); and ``(B) is located in-- ``(i) a rural area in which there is no other retail pharmacy within 10 miles, as determined by the Secretary; ``(ii) a suburban area in which there is no other retail pharmacy within 2 miles, as determined by the Secretary; or ``(iii) an urban area in which there is no other retail pharmacy within 1 mile, as determined by the Secretary. ``(3) List of essential retail pharmacies.-- ``(A) <<NOTE: Effective date. Public information. Web posting.>> Publication of list of essential retail pharmacies.--For each plan year (beginning with plan year 2028), the Secretary shall publish, on a publicly available internet website of the Centers for Medicare & Medicaid Services, a list of retail pharmacies that meet the criteria described in subparagraphs (A) and (B) of paragraph (2) to be considered an essential retail pharmacy. ``(B) Required submissions from pdp sponsors.--For each plan year (beginning with plan year 2028), each PDP sponsor offering a prescription drug plan and each MA organization offering an MA-PD plan shall submit to the Secretary, for the purposes of determining retail pharmacies that meet the criterion specified in subparagraph (A) of paragraph (2), a list of retail pharmacies that are affiliates of such sponsor or organization, or are affiliates of a pharmacy benefit manager acting on behalf of such sponsor or organization, at a time, and in a form and manner, specified by the Secretary. ``(C) Reporting by pdp sponsors and ma organizations.--For each plan year beginning with plan year 2027, each PDP sponsor offering a prescription drug plan and each MA organization offering an MA-PD plan under this part shall submit to the Secretary information on incentive payments and other fees paid by such sponsor or organization to pharmacies, insofar as any such payments or fees are not otherwise reported, at a time, and in a form and manner, specified by the Secretary. ``(D) Implementation.--Notwithstanding any other provision of law, the Secretary may implement this paragraph by program instruction or otherwise.

``(E) Nonapplication of paperwork reduction act.-- Chapter 35 of title 44, United States Code, shall not apply to the implementation of this paragraph. ``(4) Definition of affiliate; pharmacy benefit manager.--In this subsection, the terms `affiliate' and `pharmacy benefit manager' have the meaning given those terms in section 1860D- 12(h)(7).''.

(c) Enforcement.-- (1) In general.--Section 1860D-4(b)(1) of the Social Security Act (42 U.S.C. 1395w-104(b)(1)) is amended by adding at the end the following new subparagraph: ``(F) Enforcement of standards for reasonable and relevant contract terms and conditions.-- ``(i) Allegation submission process.-- ``(I) In general.--Not later than January 1, 2029, the Secretary shall establish a process through which a pharmacy may submit to the Secretary an allegation of a violation by a PDP sponsor offering a prescription drug plan of the standards for reasonable and relevant contract terms and conditions under subparagraph (A)(ii), or of subclause (VIII) of this clause. ``(II) Frequency of submission.-- ``(aa) In general.--Except as provided in item (bb), the allegation submission process under this clause shall allow pharmacies to submit any allegations of violations described in subclause (I) not more frequently than once per plan year per contract between a pharmacy and a PDP sponsor. ``(bb) Allegations relating to contract modifications.--In the case where a contract between a pharmacy and a PDP sponsor is modified following the submission of allegations by a pharmacy with respect to such contract and plan year, the allegation submission process under this clause shall allow such pharmacy to submit an additional allegation related to those modifications with respect to such contract and plan year. ``(III) Access to relevant documents and materials.--A PDP sponsor subject to an allegation under this clause-- ``(aa) shall provide documents or materials, as specified by the Secretary, including contract offers made by such sponsor to such pharmacy or correspondence related to such offers, to the Secretary at a time, and in a form and manner, specified by the Secretary; and ``(bb) shall not prohibit or otherwise limit the ability of a pharmacy to submit such documents or materials to the Secretary for the purpose of submitting an allegation or providing evidence for such an allegation under this clause.

``(IV) Standardized template.--The Secretary shall establish a standardized template for pharmacies to use for the submission of allegations described in subclause (I). Such template shall require that the submission include a certification by the pharmacy that the information included is accurate, complete, and true to the best of the knowledge, information, and belief of such pharmacy. ``(V) Preventing frivolous allegations.--In the case where the Secretary determines that a pharmacy has submitted frivolous allegations under this clause on a routine basis, the Secretary may temporarily prohibit such pharmacy from using the allegation submission process under this clause, as determined appropriate by the Secretary. ``(VI) Exemption from freedom of information act.--Allegations submitted under this clause shall be exempt from disclosure under section 552 of title 5, United States Code. ``(VII) Rule of construction.-- Nothing in this clause shall be construed as limiting the ability of a pharmacy to pursue other legal actions or remedies, consistent with applicable Federal or State law, with respect to a potential violation of a requirement described in this subparagraph. ``(VIII) Anti-retaliation and anti- coercion.--Consistent with applicable Federal or State law, a PDP sponsor shall not-- ``(aa) retaliate against a pharmacy for submitting any allegations under this clause; or ``(bb) coerce, intimidate, threaten, or interfere with the ability of a pharmacy to submit any such allegations. ``(ii) Investigation.--The Secretary shall investigate, as determined appropriate by the Secretary, allegations submitted pursuant to clause (i). ``(iii) Enforcement.-- ``(I) In general.--In the case where the Secretary determines that a PDP sponsor offering a prescription drug plan has violated the standards for reasonable and relevant contract terms and conditions under subparagraph (A)(ii) or the provisions of clause (i)(VIII) of this subparagraph, the Secretary may use authorities under sections 1857(g) and 1860D-12(b)(3)(E) to impose civil monetary penalties or other intermediate sanctions. ``(II) Application of civil monetary penalties.--The provisions of section 1128A (other than subsections (a) and (b)) shall apply to a civil monetary penalty under this clause in the same manner as such provisions apply to a penalty or proceeding under section 1128A(a).''.

(2) Conforming amendment.--Section 1857(g)(1) of the Social Security Act (42 U.S.C. 1395w-27(g)(1)) is amended-- (A) in subparagraph (J), by striking ``or'' after the semicolon; (B) by redesignating subparagraph (K) as subparagraph (L); (C) by inserting after subparagraph (J), the following new subparagraph: ``(K) fails to comply with the standards for reasonable and relevant contract terms and conditions under subparagraph (A)(ii) of section 1860D-4(b)(1) or violates the provisions of subparagraph (F)(i)(VIII) of such section; or''; (D) in subparagraph (L), as redesignated by subparagraph (B), by striking ``through (J)'' and inserting ``through (K)''; and (E) in the flush matter following subparagraph (L), as so redesignated, by striking ``subparagraphs (A) through (K)'' and inserting ``subparagraphs (A) through (L)''.

(d) Accountability of Pharmacy Benefit Managers for Violations of Reasonable and Relevant Contract Terms and Conditions.-- (1) In general.--Section 1860D-12(b) of the Social Security Act (42 U.S.C. 1395w-112) is amended by adding at the end the following new paragraph: ``(9) Accountability of pharmacy benefit managers for violations of reasonable and relevant contract terms and conditions.-- For plan years beginning on or after January 1, 2029, each contract entered into with a PDP sponsor under this part with respect to a prescription drug plan offered by such sponsor shall provide that any pharmacy benefit manager acting on behalf of such sponsor has a written agreement with the PDP sponsor under which the pharmacy benefit manager agrees to reimburse the PDP sponsor for any amounts paid by such sponsor under section 1860D-4(b)(1)(F)(iii)(I) to the Secretary as a result of a violation described in such section if such violation is related to a responsibility delegated to the pharmacy benefit manager by such PDP sponsor.''. (2) Ma-pd plans.--Section 1857(f)(3) of the Social Security Act (42 U.S.C. 1395w-27(f)(3)) is amended by adding at the end the following new subparagraph: ``(F) Accountability of pharmacy benefit managers for violations of reasonable and relevant contract terms.-- For plan years beginning on or after January 1, 2029, section 1860D- 12(b)(9).''.

(e) Biennial Report on Enforcement and Oversight of Pharmacy Access Requirements.--Section 1860D-42 of the Social Security Act (42 U.S.C. 1395w-152), as amended by subsection (b), is amended by adding at the end the following new subsection: ``(f) Biennial Report on Enforcement and Oversight of Pharmacy Access Requirements.-- ``(1) In general.--Not later than 2 years after the date of enactment of this subsection, and at least once every 2 years thereafter, the Secretary shall publish a report on enforcement and oversight actions and activities undertaken by the Secretary with respect to the requirements under section 1860D-4(b)(1).

``(2) Limitation.--A report under paragraph (1) shall not disclose-- ``(A) identifiable information about individuals or entities unless such information is otherwise publicly available; or ``(B) trade secrets with respect to any entities.''.

(f) Funding.--In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account, out of any money in the Treasury not otherwise appropriated, $188,000,000 for fiscal year 2026, to remain available until expended, to carry out this section.

(a) In General.-- (1) Prescription drug plans.--Section 1860D-12 of the Social Security Act (42 U.S.C. 1395w-112) is amended by adding at the end the following new subsection:

``(h) Requirements Relating to Pharmacy Benefit Managers.-- For plan years beginning on or after January 1, 2028: ``(1) Agreements with pharmacy benefit managers.--Each contract entered into with a PDP sponsor under this part with respect to a prescription drug plan offered by such sponsor shall provide that any pharmacy benefit manager acting on behalf of such sponsor has a written agreement with the PDP sponsor under which the pharmacy benefit manager, and any affiliates of such pharmacy benefit manager, as applicable, agree to meet the following requirements: ``(A) No income other than bona fide service fees.-- ``(i) In general.--The pharmacy benefit manager and any affiliate of such pharmacy benefit manager shall not derive any remuneration with respect to any services provided on behalf of any entity or individual, in connection with the utilization of covered part D drugs, from any such entity or individual other than bona fide service fees, subject to clauses (ii) and (iii). ``(ii) Incentive payments.--For the purposes of this subsection, an incentive payment (as determined by the Secretary) paid by a PDP sponsor to a pharmacy benefit manager or an affiliate of a pharmacy benefit manager that is performing services on behalf of such sponsor shall be deemed a `bona fide service fee' (even if such payment does not otherwise meet the definition of such term under paragraph (7)(B)) if such payment is a flat dollar amount, is consistent with fair market value (as specified by the Secretary), is related to services actually performed by the pharmacy benefit manager or affiliate of such pharmacy benefit manager, on behalf of the PDP sponsor making such payment, in connection with the utilization of covered part D drugs, and meets additional requirements, if any, as determined appropriate by the Secretary. ``(iii) Clarification on rebates and discounts used to lower costs for covered part d drugs.-- Rebates, discounts, and other price concessions received by a pharmacy benefit manager or an affiliate of a pharmacy benefit manager from manufacturers,

even if such price concessions are calculated as a percentage of a drug's price, shall not be considered a violation of the requirements of clause (i) if they are fully passed through to a PDP sponsor and are compliant with all regulatory and subregulatory requirements related to direct and indirect remuneration for manufacturer rebates, discounts, and other price concessions under this part, including in cases where a PDP sponsor is acting as a pharmacy benefit manager on behalf of a prescription drug plan offered by such PDP sponsor. ``(iv) Evaluation of remuneration arrangements.-- Components of subsets of remuneration arrangements (such as fees or other forms of compensation paid to or retained by the pharmacy benefit manager or affiliate of such pharmacy benefit manager), as determined appropriate by the Secretary, between pharmacy benefit managers or affiliates of such pharmacy benefit managers, as applicable, and other entities involved in the dispensing or utilization of covered part D drugs (including PDP sponsors, manufacturers, pharmacies, and other entities as determined appropriate by the Secretary) shall be subject to review by the Secretary, in consultation with the Office of the Inspector General of the Department of Health and Human Services, as determined appropriate by the Secretary. The Secretary, in consultation with the Office of the Inspector General, shall review whether remuneration under such arrangements is consistent with fair market value (as specified by the Secretary) through reviews and assessments of such remuneration, as determined appropriate. ``(v) Disgorgement.--The pharmacy benefit manager shall disgorge any remuneration paid to such pharmacy benefit manager or an affiliate of such pharmacy benefit manager in violation of this subparagraph to the PDP sponsor. ``(vi) Additional requirements.--The pharmacy benefit manager shall-- ``(I) enter into a written agreement with any affiliate of such pharmacy benefit manager, under which the affiliate shall identify and disgorge any remuneration described in clause (v) to the pharmacy benefit manager; and ``(II) attest, subject to any requirements determined appropriate by the Secretary, that the pharmacy benefit manager has entered into a written agreement described in subclause (I) with any affiliate of the pharmacy benefit manager. ``(B) Transparency regarding guarantees and cost performance evaluations.--The pharmacy benefit manager shall-- ``(i) define, interpret, and apply, in a fully transparent and consistent manner for purposes of calculating or otherwise evaluating pharmacy benefit manager performance against pricing guarantees or similar

cost performance measurements related to rebates, discounts, price concessions, or net costs, terms such as-- ``(I) `generic drug', in a manner consistent with the definition of the term under section 423.4 of title 42, Code of Federal Regulations, or a successor regulation; ``(II) `brand name drug', in a manner consistent with the definition of the term under section 423.4 of title 42, Code of Federal Regulations, or a successor regulation; ``(III) `specialty drug'; ``(IV) `rebate'; and ``(V) `discount'; ``(ii) identify any drugs, claims, or price concessions excluded from any pricing guarantee or other cost performance measure in a clear and consistent manner; and ``(iii) where a pricing guarantee or other cost performance measure is based on a pricing benchmark other than the wholesale acquisition cost (as defined in section 1847A(c)(6)(B)) of a drug, calculate and provide a wholesale acquisition cost-based equivalent to the pricing guarantee or other cost performance measure. ``(C) Provision of information.-- ``(i) In general.--Not later than July 1 of each year, beginning in 2028, the pharmacy benefit manager shall submit to the PDP sponsor, and to the Secretary, a report, in accordance with this subparagraph, and shall make such report available to such sponsor at no cost to such sponsor in a format specified by the Secretary under paragraph (5). Each such report shall include, with respect to such PDP sponsor and each plan offered by such sponsor, the following information with respect to the previous plan year: ``(I) A list of all drugs covered by the plan that were dispensed including, with respect to each such drug-- ``(aa) the brand name, generic or non-proprietary name, and National Drug Code; ``(bb) the number of plan enrollees for whom the drug was dispensed, the total number of prescription claims for the drug (including original prescriptions and refills, counted as separate claims), and the total number of dosage units of the drug dispensed; ``(cc) the number of prescription claims described in item (bb) by each type of dispensing channel through which the drug was dispensed, including retail, mail order, specialty pharmacy, long term care pharmacy, home infusion pharmacy, or other types of pharmacies or dispensers; ``(dd) the average wholesale acquisition cost, listed as cost per day's supply, cost per dosage unit, and cost per typical course of treatment (as applicable);

``(ee) the average wholesale price for the drug, listed as price per day's supply, price per dosage unit, and price per typical course of treatment (as applicable); ``(ff) the total out-of- pocket spending by plan enrollees on such drug after application of any benefits under the plan, including plan enrollee spending through copayments, coinsurance, and deductibles; ``(gg) total rebates paid by the manufacturer on the drug as reported under the Detailed DIR Report (or any successor report) submitted by such sponsor to the Centers for Medicare & Medicaid Services; ``(hh) all other direct or indirect remuneration on the drug as reported under the Detailed DIR Report (or any successor report) submitted by such sponsor to the Centers for Medicare & Medicaid Services; ``(ii) the average pharmacy reimbursement amount paid by the plan for the drug in the aggregate and disaggregated by dispensing channel identified in item (cc); ``(jj) the average National Average Drug Acquisition Cost (NADAC); and ``(kk) total manufacturer- derived revenue, inclusive of bona fide service fees, attributable to the drug and retained by the pharmacy benefit manager and any affiliate of such pharmacy benefit manager. ``(II) In the case of a pharmacy benefit manager that has an affiliate that is a retail, mail order, or specialty pharmacy, with respect to drugs covered by such plan that were dispensed, the following information: ``(aa) The percentage of total prescriptions that were dispensed by pharmacies that are an affiliate of the pharmacy benefit manager for each drug. ``(bb) The interquartile range of the total combined costs paid by the plan and plan enrollees, per dosage unit, per course of treatment, per 30-day supply, and per 90-day supply for each drug dispensed by pharmacies that are not an affiliate of the pharmacy benefit manager and that are included in the pharmacy network of such plan. ``(cc) The interquartile range of the total combined costs paid by the plan and plan enrollees, per dosage unit, per course of treatment, per 30-day supply, and per 90-day supply for each drug dispensed by pharmacies that are an affiliate of the pharmacy benefit manager and that are included in the pharmacy network of such plan. ``(dd) The lowest total combined cost paid by the plan and plan enrollees, per dosage

unit, per course of treatment, per 30-day supply, and per 90- day supply, for each drug that is available from any pharmacy included in the pharmacy network of such plan. ``(ee) The difference between the average acquisition cost of the affiliate, such as a pharmacy or other entity that acquires prescription drugs, that initially acquires the drug and the amount reported under subclause (I)(jj) for each drug. ``(ff) A list inclusive of the brand name, generic or non- proprietary name, and National Drug Code of covered part D drugs subject to an agreement with a covered entity under section 340B of the Public Health Service Act for which the pharmacy benefit manager or an affiliate of the pharmacy benefit manager had a contract or other arrangement with such a covered entity in the service area of such plan. ``(III) Where a drug approved under section 505(c) of the Federal Food, Drug, and Cosmetic Act (referred to in this subclause as the `listed drug') is covered by the plan, the following information: ``(aa) A list of currently marketed generic drugs approved under section 505(j) of the Federal Food, Drug, and Cosmetic Act pursuant to an application that references such listed drug that are not covered by the plan, are covered on the same formulary tier or a formulary tier typically associated with higher cost-sharing than the listed drug, or are subject to utilization management that the listed drug is not subject to. ``(bb) The estimated average beneficiary cost-sharing under the plan for a 30-day supply of the listed drug. ``(cc) Where a generic drug listed under item (aa) is on a formulary tier typically associated with higher cost- sharing than the listed drug, the estimated average cost- sharing that a beneficiary would have paid for a 30-day supply of each of the generic drugs described in item (aa), had the plan provided coverage for such drugs on the same formulary tier as the listed drug. ``(dd) A written justification for providing more favorable coverage of the listed drug than the generic drugs described in item (aa). ``(ee) The number of currently marketed generic drugs approved under section 505(j) of the Federal Food, Drug, and Cosmetic Act pursuant to an application that references such listed drug.

``(IV) Where a reference product (as defined in section 351(i) of the Public Health Service Act) is covered by the plan, the following information: ``(aa) A list of currently marketed biosimilar biological products licensed under section 351(k) of the Public Health Service Act pursuant to an application that refers to such reference product that are not covered by the plan, are covered on the same formulary tier or a formulary tier typically associated with higher cost- sharing than the reference product, or are subject to utilization management that the reference product is not subject to. ``(bb) The estimated average beneficiary cost-sharing under the plan for a 30-day supply of the reference product. ``(cc) Where a biosimilar biological product listed under item (aa) is on a formulary tier typically associated with higher cost-sharing than the reference product, the estimated average cost-sharing that a beneficiary would have paid for a 30-day supply of each of the biosimilar biological products described in item (aa), had the plan provided coverage for such products on the same formulary tier as the reference product. ``(dd) A written justification for providing more favorable coverage of the reference product than the biosimilar biological products described in item (aa). ``(ee) The number of currently marketed biosimilar biological products licensed under section 351(k) of the Public Health Service Act, pursuant to an application that refers to such reference product. ``(V) Total gross spending on covered part D drugs by the plan, not net of rebates, fees, discounts, or other direct or indirect remuneration. ``(VI) The total amount retained by the pharmacy benefit manager or an affiliate of such pharmacy benefit manager in revenue related to utilization of covered part D drugs under that plan, inclusive of bona fide service fees. ``(VII) The total spending on covered part D drugs net of rebates, fees, discounts, or other direct and indirect remuneration by the plan. ``(VIII) An explanation of any benefit design parameters under such plan that encourage plan enrollees to fill prescriptions at pharmacies that are an affiliate of such pharmacy benefit manager, such as mail and specialty home delivery programs, and retail and mail auto-refill programs. ``(IX) The following information: ``(aa) A list of all brokers, consultants, advisors, and auditors that receive compensation from the pharmacy benefit manager or

an affiliate of such pharmacy benefit manager for referrals, consulting, auditing, or other services offered to PDP sponsors related to pharmacy benefit management services. ``(bb) The amount of compensation provided by such pharmacy benefit manager or affiliate to each such broker, consultant, advisor, and auditor. ``(cc) The methodology for calculating the amount of compensation provided by such pharmacy benefit manager or affiliate, for each such broker, consultant, advisor, and auditor. ``(X) A list of all affiliates of the pharmacy benefit manager. ``(XI) A summary document submitted in a standardized template developed by the Secretary that includes such information described in subclauses (I) through (X). ``(ii) Written explanation of contracts or agreements with manufacturers.-- ``(I) In general.--The pharmacy benefit manager shall, not later than 30 days after the finalization of any contract or agreement between such pharmacy benefit manager or an affiliate of such pharmacy benefit manager and a manufacturer (or subsidiary, agent, or entity affiliated with such manufacturer) that makes rebates, discounts, payments, or other financial incentives related to one or more covered part D drugs or other prescription drugs, as applicable, of the manufacturer directly or indirectly contingent upon coverage, formulary placement, or utilization management conditions on any other covered part D drugs or other prescription drugs, as applicable, submit to the PDP sponsor a written explanation of such contract or agreement. ``(II) Requirements.--A written explanation under subclause (I) shall-- ``(aa) include the manufacturer subject to the contract or agreement, all covered part D drugs and other prescription drugs, as applicable, subject to the contract or agreement and the manufacturers of such drugs, and a high-level description of the terms of such contract or agreement and how such terms apply to such drugs; and

``(bb) b e certified by the Chief Executive Officer, Chief Financial Officer, or General Counsel of such pharmacy benefit manager, or affiliate of such pharmacy benefit manager, as applicable, or an individual delegated with the authority to sign on behalf of one of these officers, who reports directly to the officer. ``(III) Definition of other prescription drugs.--For purposes of this clause, the term `other prescription drugs' means prescription drugs

covered as supplemental benefits under this part or prescription drugs paid outside of this part. ``(D) Audit rights.-- ``(i) In general.--Not less than once a year, at the request of the PDP sponsor, the pharmacy benefit manager shall allow for an audit of the pharmacy benefit manager to ensure compliance with all terms and conditions under the written agreement described in this paragraph and the accuracy of information reported under subparagraph (C). ``(ii) Auditor.--The PDP sponsor shall have the right to select an auditor. The pharmacy benefit manager shall not impose any limitations on the selection of such auditor. ``(iii) Provision of information.--The pharmacy benefit manager shall make available to such auditor all records, data, contracts, and other information necessary to confirm the accuracy of information reported under subparagraph (C), subject to reasonable restrictions on how such information must be reported to prevent redisclosure of such information. ``(iv) Timing.--The pharmacy benefit manager must provide information under clause (iii) and other information, data, and records relevant to the audit to such auditor within 6 months of the initiation of the audit and respond to requests for additional information from such auditor within 30 days after the request for additional information. ``(v) Information from affiliates.--The pharmacy benefit manager shall be responsible for providing to such auditor information required to be reported under subparagraph (C) or under clause (iii) of this subparagraph that is owned or held by an affiliate of such pharmacy benefit manager. ``(2) Enforcement.-- ``(A) In general.--Each PDP sponsor shall-- ``(i) disgorge to the Secretary any amounts disgorged to the PDP sponsor by a pharmacy benefit manager under paragraph (1)(A)(v); ``(ii) require, in a written agreement with any pharmacy benefit manager acting on behalf of such sponsor or affiliate of such pharmacy benefit manager, that such pharmacy benefit manager or affiliate reimburse the PDP sponsor for any civil money penalty imposed on the PDP sponsor as a result of the failure of the pharmacy benefit manager or affiliate to meet the requirements of paragraph (1) that are applicable to the pharmacy benefit manager or affiliate under the agreement; and ``(iii) require, in a written agreement with any such pharmacy benefit manager acting on behalf of such sponsor or affiliate of such pharmacy benefit manager, that such pharmacy benefit manager or affiliate be subject to punitive remedies for breach of contract for failure to comply with the requirements applicable under paragraph (1).

``(B) Reporting of alleged violations.--The Secretary shall make available and maintain a mechanism for manufacturers, PDP sponsors, pharmacies, and other entities that have contractual relationships with pharmacy benefit managers or affiliates of such pharmacy benefit managers to report, on a confidential basis, alleged violations of paragraph (1)(A) or subparagraph (C). ``(C) Anti-retaliation and anti-coercion.-- Consistent with applicable Federal or State law, a PDP sponsor shall not-- ``(i) retaliate against an individual or entity for reporting an alleged violation under subparagraph (B); or ``(ii) coerce, intimidate, threaten, or interfere with the ability of an individual or entity to report any such alleged violations. ``(3) Certification of compliance.-- ``(A) In general.--Each PDP sponsor shall furnish to the Secretary (at a time and in a manner specified by the Secretary) an annual certification of compliance with this subsection, as well as such information as the Secretary determines necessary to carry out this subsection. ``(B) Implementation.--Notwithstanding any other provision of law, the Secretary may implement this paragraph by program instruction or otherwise. ``(4) Rule of construction.--Nothing in this subsection shall be construed as-- ``(A) prohibiting flat dispensing fees or reimbursement or payment for ingredient costs (including customary, industry-standard discounts directly related to drug acquisition that are retained by pharmacies or wholesalers) to entities that acquire or dispense prescription drugs; or ``(B) modifying regulatory requirements or sub- regulatory program instruction or guidance related to pharmacy payment, reimbursement, or dispensing fees. ``(5) Standard formats.-- ``(A) In general.--Not later than June 1, 2027, the Secretary shall specify standard, machine-readable formats for pharmacy benefit managers to submit annual reports required under paragraph (1)(C)(i). ``(B) Implementation.--Notwithstanding any other provision of law, the Secretary may implement this paragraph by program instruction or otherwise. ``(6) Confidentiality.-- ``(A) In general.--Information disclosed by a pharmacy benefit manager, an affiliate of a pharmacy benefit manager, a PDP sponsor, or a pharmacy under this subsection that is not otherwise publicly available or available for purchase shall not be disclosed by the Secretary or a PDP sponsor receiving the information, except that the Secretary may disclose the information for the following purposes: ``(i) As the Secretary determines necessary to carry out this part. ``(ii) To permit the Comptroller General to review the information provided.

``(iii) To permit the Director of the Congressional Budget Office to review the information provided. ``(iv) To permit the Executive Director of the Medicare Payment Advisory Commission to review the information provided. ``(v) To the Attorney General for the purposes of conducting oversight and enforcement under this title. ``(vi) To the Inspector General of the Department of Health and Human Services in accordance with its authorities under the Inspector General Act of 1978 (section 406 of title 5, United States Code), and other applicable statutes. ``(B) Restriction on use of information.--The Secretary, the Comptroller General, the Director of the Congressional Budget Office, and the Executive Director of the Medicare Payment Advisory Commission shall not report on or disclose information disclosed pursuant to subparagraph (A) to the public in a manner that would identify-- ``(i) a specific pharmacy benefit manager, affiliate, pharmacy, manufacturer, wholesaler, PDP sponsor, or plan; or ``(ii) contract prices, rebates, discounts, or other remuneration for specific drugs in a manner that may allow the identification of specific contracting parties or of such specific drugs. ``(7) Definitions.--For purposes of this subsection: ``(A) Affiliate.--The term `affiliate' means, with respect to any pharmacy benefit manager or PDP sponsor, any entity that, directly or indirectly-- ``(i) owns or is owned by, controls or is controlled by, or is otherwise related in any ownership structure to such pharmacy benefit manager or PDP sponsor; or ``(ii) acts as a contractor, principal, or agent to such pharmacy benefit manager or PDP sponsor, insofar as such contractor, principal, or agent performs any of the functions described under subparagraph (C). ``(B) Bona fide service fee.--The term `bona fide service fee' means a fee that is reflective of the fair market value (as specified by the Secretary, through notice and comment rulemaking) for a bona fide, itemized service actually performed on behalf of an entity, that the entity would otherwise perform (or contract for) in the absence of the service arrangement and that is not passed on in whole or in part to a client or customer, whether or not the entity takes title to the drug. Such fee must be a flat dollar amount and shall not be directly or indirectly based on, or contingent upon-- ``(i) drug price, such as wholesale acquisition cost or drug benchmark price (such as average wholesale price); ``(ii) the amount of discounts, rebates, fees, or other direct or indirect remuneration with respect to covered part D drugs dispensed to enrollees in a prescription

drug plan, except as permitted pursuant to paragraph (1)(A)(ii); ``(iii) coverage or formulary placement decisions or the volume or value of any referrals or business generated between the parties to the arrangement; or ``(iv) any other amounts or methodologies prohibited by the Secretary. ``(C) Pharmacy benefit manager.--The term `pharmacy benefit manager' means any person or entity that, either directly or through an intermediary, acts as a price negotiator or group purchaser on behalf of a PDP sponsor or prescription drug plan, or manages the prescription drug benefits provided by such sponsor or plan, including the processing and payment of claims for prescription drugs, the performance of drug utilization review, the processing of drug prior authorization requests, the adjudication of appeals or grievances related to the prescription drug benefit, contracting with network pharmacies, controlling the cost of covered part D drugs, or the provision of related services. Such term includes any person or entity that carries out one or more of the activities described in the preceding sentence, irrespective of whether such person or entity calls itself a `pharmacy benefit manager'.''. (2) MA-PD plans.--Section 1857(f)(3) of the Social Security Act (42 U.S.C. 1395w-27(f)(3)), as amended by section 6223(d)(2), is amended by adding at the end the following new subparagraph: ``(G) Requirements relating to pharmacy benefit managers.--For plan years beginning on or after January 1, 2028, section 1860D-12(h).''. (3) Nonapplication of paperwork reduction act.--Chapter 35 of title 44, United States Code, shall not apply to the implementation of this subsection. (4) Funding.-- (A) Secretary.--In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account, out of any money in the Treasury not otherwise appropriated, $113,000,000 for fiscal year 2026, to remain available until expended, to carry out this subsection. (B) OIG.--In addition to amounts otherwise available, there is appropriated to the Inspector General of the Department of Health and Human Services, out of any money in the Treasury not otherwise appropriated, $20,000,000 for fiscal year 2026, to remain available until expended, to carry out this subsection.

(b) GAO Study and Report on Price-related Compensation Across the Supply Chain.-- (1) Study.--The Comptroller General of the United States (in this subsection referred to as the ``Comptroller General'') shall conduct a study describing the use of compensation and payment structures related to a prescription drug's price within the retail prescription drug supply chain in part D of title XVIII of the Social Security Act (42 U.S.C. 1395w-101 et seq.). Such study shall summarize information from Federal agencies

and industry experts, to the extent available, with respect to the following: (A) The type, magnitude, other features (such as the pricing benchmarks used), and prevalence of compensation and payment structures related to a prescription drug's price, such as calculating fee amounts as a percentage of a prescription drug's price, between intermediaries in the prescription drug supply chain, including-- (i) pharmacy benefit managers; (ii) PDP sponsors offering prescription drug plans and Medicare Advantage organizations offering MA-PD plans; (iii) drug wholesalers; (iv) pharmacies; (v) manufacturers; (vi) pharmacy services administrative organizations; (vii) brokers, auditors, consultants, and other entities that-- (I) advise PDP sponsors offering prescription drug plans and Medicare Advantage organizations offering MA-PD plans regarding pharmacy benefits; or (II) review PDP sponsor and Medicare Advantage organization contracts with pharmacy benefit managers; and (viii) other service providers that contract with any of the entities described in clauses (i) through (vii) that may use price-related compensation and payment structures, such as rebate aggregators (or other entities that negotiate or process price concessions on behalf of pharmacy benefit managers, plan sponsors, or pharmacies). (B) The primary business models and compensation structures for each category of intermediary described in subparagraph (A). (C) Variation in price-related compensation structures between affiliated entities (such as entities with common ownership, either full or partial, and subsidiary relationships) and unaffiliated entities. (D) Potential conflicts of interest among contracting entities related to the use of prescription drug price-related compensation structures, such as the potential for fees or other payments set as a percentage of a prescription drug's price to advantage formulary selection, distribution, or purchasing of prescription drugs with higher prices. (E) Notable differences, if any, in the use and level of price-based compensation structures over time and between different market segments, such as under part D of title XVIII of the Social Security Act (42 U.S.C. 1395w-101 et seq.) and the Medicaid program under title XIX of such Act (42 U.S.C. 1396 et seq.). (F) The effects of drug price-related compensation structures and alternative compensation structures on Federal health care programs and program beneficiaries, including with respect to cost-sharing, premiums, Federal

outlays, biosimilar and generic drug adoption and utilization, drug shortage risks, and the potential for fees set as a percentage of a drug's price to advantage the formulary selection, distribution, or purchasing of drugs with higher prices. (G) Other issues determined to be relevant and appropriate by the Comptroller General. (2) Report.--Not later than 2 years after the date of enactment of this section, the Comptroller General shall submit to Congress a report containing the results of the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Comptroller General determines appropriate.

(c) Medpac Reports on Agreements With Pharmacy Benefit Managers With Respect to Prescription Drug Plans and Ma-pd Plans.-- (1) In general.--The Medicare Payment Advisory Commission shall submit to Congress the following reports: (A) Initial report.--Not later than the first March 15 occurring after the date that is 2 years after the date on which the Secretary makes the data available to the Commission, a report regarding agreements with pharmacy benefit managers with respect to prescription drug plans and MA-PD plans. Such report shall include, to the extent practicable-- (i) a description of trends and patterns, including relevant averages, totals, and other figures for the types of information submitted; (ii) an analysis of any differences in agreements and their effects on plan enrollee out- of-pocket spending and average pharmacy reimbursement, and other impacts; and (iii) any recommendations the Commission determines appropriate. (B) Final report.--Not later than 2 years after the date on which the Commission submits the initial report under subparagraph (A), a report describing any changes with respect to the information described in subparagraph (A) over time, together with any recommendations the Commission determines appropriate. (2) Funding.--In addition to amounts otherwise available, there is appropriated to the Medicare Payment Advisory Commission, out of any money in the Treasury not otherwise appropriated, $1,000,000 for fiscal year 2026, to remain available until expended, to carry out this subsection.

ATTESTATION FOR EACH OFF-CAMPUS OUTPATIENT DEPARTMENT OF A PROVIDER.

(a) In General.--Section 1833(t) of the Social Security Act (42 U.S.C. 1395l(t)) is amended by adding at the end the following new paragraph: ``(23) Use of unique health identifiers; attestation.-- ``(A) In general.--No payment may be made under this subsection (or under an applicable payment system

pursuant to paragraph (21)) for items and services furnished on or after January 1, 2028, by an off-campus outpatient department of a provider (as defined in subparagraph (C)) unless-- ``(i) such department has obtained, and such items and services are billed under, a National Provider Identifier that is separate from such identifier for such provider; ``(ii) such provider has submitted to the Secretary, during the 2-year period ending on the date such items and services are so furnished, an initial provider-based status attestation that such department is compliant with the requirements described in section 413.65 of title 42, Code of Federal Regulations (or a successor regulation), which, until the Secretary establishes the process described in subparagraph (B), may include an attestation submitted in accordance with paragraph (b)(3) of such section (as in effect on the date of enactment of this paragraph); and ``(iii) after such provider has submitted an attestation under clause (ii), such provider has submitted a subsequent attestation within the timeframe specified by the Secretary. ``(B) Process for submission and review.--

``(i) <<NOTE: Notice. Regulations. Determination. A udits.>> In general.--The Secretary shall, through notice and comment rulemaking, establish a process for each provider with an off-campus outpatient department of a provider to submit an initial and subsequent attestation pursuant to clauses (ii) and (iii), respectively, of subparagraph (A), and for the Secretary to review each such attestation and determine, through site visits, remote audits, or other means (as determined appropriate by the Secretary), whether such department is compliant with the requirements described in such subparagraph. ``(ii) Funding.--In addition to amounts otherwise available, there is appropriated to the Centers for Medicare & Medicaid Services Program Management Account for fiscal year 2026, out of any amounts in the Treasury not otherwise appropriated, $20,000,000, to remain available until expended, for purposes of carrying out this subparagraph. ``(C) Off-campus outpatient department of a provider defined.--For purposes of this paragraph, the term `off- campus outpatient department of a provider' means a department of a provider (as defined in section 413.65 of title 42, Code of Federal Regulations, or any successor regulation) that is not located-- ``(i) on the campus (as defined in such section) of such provider; or ``(ii) within the distance (described in such definition of campus) from a remote location of a hospital facility (as defined in such section).''.

(b) HHS OIG Analysis.--Not later than January 1, 2030, the Inspector General of the Department of Health and Human Services shall submit to Congress--

(1) an analysis of the process established by the Secretary of Health and Human Services to conduct the reviews and determinations described in section 1833(t)(23)(B) of the Social Security Act, as added by subsection (a) of this section; and (2) recommendations based on such analysis, as the Inspector General determines appropriate.

PAYMENT CHANGES.

(a) Revised Phase-in of Reductions From Private Payor Rate Implementation.--Section 1834A(b)(3) of the Social Security Act (42 U.S.C. 1395m-1(b)(3)) is amended-- (1) in subparagraph (A), by striking ``2028'' and inserting ``2029''; and (2) in subparagraph (B)-- (A) in clause (ii), by striking ``2025 and for the period beginning on January 1, 2026, and ending on January 30, 2026'' and inserting ``2026''; and (B) in clause (iii), by striking ``the period beginning on January 31, 2026, and ending on December 31, 2026, and for each of 2027 and 2028'' and inserting ``each of 2027 through 2029''.

(b) Revised Data Collection Period for Reporting of Private Sector Payment Rates for Establishment of Medicare Payment Rates.--Section 1834A(a)(4)(B) of the Social Security Act (42 U.S.C. 1395m-1(a)(4)(B)) is amended by striking ``2019'' each place it appears and inserting ``2025'' in each such place. (c) Revised Reporting Period for Reporting of Private Sector Payment Rates for Establishment of Medicare Payment Rates.--Section 1834A(a)(1)(B) of the Social Security Act (42 U.S.C. 1395m-1(a)(1)(B)) is amended-- (1) in clause (i), by striking ``January 31'' and inserting ``April 30''; and (2) in clause (ii), by striking ``February 1, 2026, and ending April 30, 2026'' and inserting ``May 1, 2026, and ending July 31, 2026''.

(d) 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.

Section 251A(6) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901a(6)) is amended-- (1) in subparagraph (D), by striking ``such that,'' and all that follows and inserting ``such that the payment reduction shall be 2.0 percent for such fiscal year.''; and (2) by adding at the end the following: ``(F) On the date on which the President submits the budget under section 1105 of title 31, United States Code, for fiscal year 2033, the President shall order a sequestration of payments for the Medicare programs specified in section 256(d), effective upon issuance, such that, notwithstanding the 2 percent limit specified in subparagraph (A) for such payments-- ``(i) with respect to the first 5 months in which such order is effective for such fiscal year, the payment reduction shall be 2.0 percent; and

``(ii) with respect to the last 7 months in which such order is effective for such fiscal year, the payment reduction shall be 0 percent.''.

Section 1898(b)(1) of the Social Security Act (42 U.S.C. 1395iii(b)(1)) is amended by striking ``$1,403,000,000'' and inserting ``$2,062,000,000''.

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 ``2025, and for the period beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026''; and (ii) by striking ``fiscal year 2026'' and inserting ``fiscal year 2027''; and (B) in paragraph (2)-- (i) in subparagraph (A)-- (I) by striking ``through 2025'' and inserting ``through 2026''; and (II) by striking ``fiscal year 2026'' each place it appears and inserting ``fiscal year 2027''; and (ii) in subparagraph (B)(i), by striking ``2026'' and inserting ``2027''; and (2) in subsection (f)(1) by striking ``2025, and for the period beginning on October 1, 2025, and ending on January 30, 2026, an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year 2025'' and inserting ``2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026, an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year 2026''.

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 ``2025, and for the period beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026''; and (B) in subparagraph (B)(i), by striking ``fiscal years 2024 and 2025, and for the period beginning on October 1, 2025, and ending on January 30, 2026'' and inserting ``fiscal years 2025 and 2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026''; (2) in subsection (c)(3), by striking ``2026'' and inserting ``2027''; and

(3) in subsection (f), by striking ``2025, and for the period beginning on October 1, 2025, and ending on January 30, 2026, an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year 2025'' and inserting ``2026, and for the period beginning on October 1, 2026, and ending on December 31, 2026, an amount equal to the pro rata portion of the amount appropriated for the corresponding period for fiscal year 2026''.

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 (viii), by striking ``for fiscal year 2025'' and inserting ``for each of fiscal years 2025 and 2026''; and (2) in clause (ix), by striking ``October 1, 2025, and ending on January 30, 2026, an amount equal to the pro rata portion of the amount appropriated for fiscal year 2025'' and inserting ``October 1, 2026, and ending on December 31, 2026, an amount equal to the pro rata portion of the amount appropriated for fiscal year 2026''.

ASSISTANCE FOR NEEDY FAMILIES PROGRAM.

Activities authorized by part A of title IV of the Social Security Act (other than under section 403(c) or 418 of such Act) and section 1108(b) of the Social Security Act shall continue through December 31, 2026, in the manner authorized for fiscal year 2025, and out of any money in the Treasury of the United States not otherwise appropriated, there are hereby appropriated such sums as may be necessary for such purpose.

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 by striking subparagraphs (H), (I), (J), and (K) and inserting the following: ``(H) $4,236,712,328 for fiscal year 2024; ``(I) $4,295,287,671 for fiscal year 2025; ``(J) $4,600,000,000 for fiscal year 2026; and ``(K) $1,159,452,055 for the period beginning on October 1, 2026, and ending on December 31, 2026; 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 by striking subparagraphs (I), (J), (K), and (L) and inserting the following: ``(I) $341,208,605 for fiscal year 2024; ``(J) $349,736,600 for fiscal year 2025; ``(K) $350,000,000 for fiscal year 2026; and

``(L) $88,219,178 for the period beginning on October 1, 2026, and ending on December 31, 2026.''.

(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 by striking subparagraphs (D), (E), (F), and (G) and inserting the following: `` ``(D) $168,915,878 for fiscal year 2024; ``(E) $181,563,574 for fiscal year 2025; ``(F) $225,000,000 for fiscal year 2026; ``(G) $250,000,000 for fiscal year 2027; ``(H) $275,000,000 for fiscal year 2028; and ``(I) $300,000,000 for fiscal year 2029.''.

(d) Application of Provisions.--Amounts appropriated pursuant to the amendments made by this section shall be subject to the requirements contained in Public Law 118-47 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 Amendments.--Section 3014(h)(4) of title 18, United States Code, is amended by striking ``and section 6101(d) of the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026'' and inserting ``section 6101(d) of the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026, and section 6401(d) of the Consolidated Appropriations Act, 2026''.

(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 by striking subparagraphs (E), (F), (G), and (H) and inserting the following: ``(E) $155,619,196 for fiscal year 2024, to remain available until expended; ``(F) $159,228,188 for fiscal year 2025, to remain available until expended; ``(G) $200,000,000 for fiscal year 2026, to remain available until expended; and ``(H) $50,410,959 for the period beginning on October 1, 2026, and ending on December 31, 2026, 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 by striking subparagraphs (E), (F), (G), and (H) and inserting the following: ``(E) $155,619,196 for fiscal year 2024, to remain available until expended; ``(F) $159,228,188 for fiscal year 2025, to remain available until expended; ``(G) $200,000,000 for fiscal year 2026, to remain available until expended; and ``(H) $50,410,959 for the period beginning on October 1, 2026, and ending on December 31, 2026, to remain available until expended.''.

(a) Section 319(e)(8) of the Public Health Service Act (42 U.S.C. 247d(e)(8)) is amended by striking ``January 30, 2026'' and inserting ``December 31, 2026''. (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 ``January 30, 2026'' and inserting ``December 31, 2026''. (c) Section 319L-1(b) of the Public Health Service Act (42 U.S.C. 247d-7f(b)) is amended by striking ``January 30, 2026'' and inserting ``December 31, 2026''. (d) Section 2811A(g) of the Public Health Service Act (42 U.S.C. 300hh-10b(g)) is amended by striking ``January 30, 2026'' and inserting ``December 31, 2026''. (e) Section 2811B(g)(1) of the Public Health Service Act (42 U.S.C. 300hh-10c(g)(1)) is amended by striking ``January 30, 2026'' and inserting ``December 31, 2026''. (f) Section 2811C(g)(1) of the Public Health Service Act (42 U.S.C. 300hh-10d(g)(1)) is amended by striking ``January 30, 2026'' and inserting ``December 31, 2026''. (g) Section 2812(c)(4)(B) of the Public Health Service Act (42 U.S.C. 300hh-11(c)(4)(B)) is amended by striking ``January 30, 2026'' and inserting ``December 31, 2026''.

Section 118(a) of division BB of the Consolidated Appropriations Act, 2021 <<NOTE: 134 Stat. 2889; 138 Stat. 1538; 139 Stat. 649.>> (Public Law 116-260) is amended-- (1) in paragraph (1), by striking ``January 30, 2026'' and inserting ``December 31, 2026''; and (2) in paragraph (2)-- (A) by striking ``$14,000,000'' and inserting ``$42,100,000''; and (B) by striking ``January 30, 2026'' and inserting ``December 31, 2026''.

Subtitle B--World Trade Center Health Program

9/11 RESPONDER AND SURVIVOR HEALTH FUNDING CORRECTIONS.

(a) In General.--Section 3351(a)(2)(A) of the Public Health Service Act (42 U.S.C. 300mm-61(a)(2)(A)) is amended-- (1) in clause (x), by striking ``; and'' and inserting a semicolon; (2) by redesignating clause (xi) as clause (xii); and (3) by inserting after clause (x), the following: ``(xi) for each of fiscal years 2026 through 2040-- ``(I) the amount determined under this subparagraph for the previous fiscal year multiplied by 1.07; multiplied by ``(II) the ratio of-- ``(aa) the total number of individuals enrolled in the WTC Program on July 1 of such previous fiscal year; to ``(bb) the total number of individuals so enrolled on July 1 of the fiscal year prior to such previous fiscal year; and''.

(b) Report to Congress.-- (1) In general.--Not later than 3 years after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this subsection as the ``Secretary'') shall conduct an assessment of anticipated budget authority and outlays of the World Trade Center Health Program (referred to in this subsection as the ``Program'') through the duration of the Program and submit a report summarizing such assessment to-- (A) the Speaker and minority leader of the House of Representatives; (B) the majority and minority leaders of the Senate; (C) the Committee on Health, Education, Labor, and Pensions and the Committee on the Budget of the Senate; and (D) the Committee on Energy and Commerce and the Committee on the Budget of the House of Representatives. (2) Inclusions.--The report required under paragraph (1) shall include-- (A) a projection of Program budgetary needs on a per-fiscal year basis through fiscal year 2090; (B) a review of Program modeling for each of fiscal years 2017 through the fiscal year prior to the fiscal year in which the report is issued to assess how anticipated budgetary needs compared to actual expenditures; (C) an assessment of the projected budget authority and expenditures of the Program through fiscal year 2090 by comparing-- (i) such projected authority and expenditures resulting from application of section 3351(a)(2)(A) of the Public Health Service Act (42 U.S.C. 300mm-61(a)(2)(A)), as amended by subsection (a); and (ii) such projected authority and expenditures that would result if such section were amended so that the formula under clause (xi) of such section, as amended by subsection (a), were to be extended through fiscal year 2090; and (D) any recommendations of the Secretary to make changes to the formula under such section 3351(a)(2)(A), as so amended, to fully offset anticipated Program expenditures through fiscal year 2090.

(c) Technical Amendments.--Title XXXIII of the Public Health Service Act (42 U.S.C. 300mm et seq.) is amended-- (1) in section 3352(d) (42 U.S.C. 300mm-62(d)), by striking ``Any amounts'' and inserting ``Any unobligated amounts''; (2) in section 3353(d) (42 U.S.C. 300mm-63(d)), by striking ``Any amounts'' and inserting ``Any unobligated amounts''; and (3) in section 3354(d) (42 U.S.C. 300mm-64(d)), by striking ``Any amounts'' and inserting ``Any unobligated amounts''.

(a) Maternal Mortality Review Committees.--Section 317K(d) of the Public Health Service Act (42 U.S.C. 247b-12(d)) is amended--

(1) in paragraph (1)(A), by inserting ``(including obstetricians and gynecologists)'' after ``clinical specialties''; and (2) in paragraph (3)(A)(i)-- (A) in subclause (I), by striking ``as applicable'' and inserting ``if available''; and (B) in subclause (III), by striking ``, as appropriate'' and inserting ``and coordinating with individuals responsible for certifying deaths to improve the collection and quality of death record reports, including by amending errors and missing or incomplete information to cause-of-death information on a death certificate, as appropriate''.

(b) Maternal Mortality.--Section 317K of the Public Health Service Act (42 U.S.C. 247b-12) is amended-- (1) by redesignating subsections (e) and (f) as subsections (f) and (g), respectively; and (2) by inserting after subsection (d) the following:

``(e) Best Practices Relating to the Prevention of Maternal Mortality.-- ``(1) In general.--The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall, in consultation with the Administrator of the Health Resources and Services Administration, identify and disseminate to health care providers, relevant professional societies, and perinatal quality collaboratives, best practices related to preventing maternal morbidity and mortality, taking into consideration any relevant findings from other Federal maternal health programs. ``(2) Frequency.--The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall disseminate the best practices referred to in paragraph (1) not less than once per fiscal year.''.

(c) Authorization of Appropriations.--Subsection (g) of section 317K of the Public Health Service Act (42 U.S.C. 247b-12), as redesignated by subsection (b)(1), is amended by striking ``$58,000,000 for each of fiscal years 2019 through 2023'' and inserting ``$100,000,000 for each of fiscal years 2026 through 2030''.

Section 372 of the Public Health Service Act (42 U.S.C. 274) is amended-- (1) in subsection (b)(2)-- (A) by moving the margins of subparagraphs (M) through (O) 2 ems to the left; (B) in subparagraph (A)-- (i) in clause (i), by striking ``, and'' and inserting ``; and''; and (ii) in clause (ii), by striking the comma at the end and inserting a semicolon; (C) in subparagraph (C), by striking ``twenty-four- hour telephone service'' and inserting ``24-hour telephone or information technology service''; (D) in each of subparagraphs (B) through (M), by striking the comma at the end and inserting a semicolon; (E) in subparagraph (N), by striking ``transportation, and'' and inserting ``transportation;''; (F) in subparagraph (O), by striking the period and inserting a semicolon; and

(G) by adding at the end the following: ``(P) encourage the integration of electronic health records systems through application programming interfaces (or successor technologies) among hospitals, organ procurement organizations, and transplant centers, including the use of automated electronic hospital referrals and the grant of remote, electronic access to hospital electronic health records of potential donors by organ procurement organizations, in a manner that complies with the privacy regulations promulgated under the Health Insurance Portability and Accountability Act of 1996, at part 160 of title 45, Code of Federal Regulations, and subparts A, C, and E of part 164 of such title (or any successor regulations); and ``(Q) consider establishing a dashboard to display the number of transplants performed, the types of transplants performed, the number and types of organs that entered the Organ Procurement and Transplantation Network system and failed to be transplanted, and other appropriate statistics, which should be updated more frequently than annually.''; and (2) by adding at the end the following:

``(d) Registration Fees.-- ``(1) In general.--The Secretary may collect registration fees from any member of the Organ Procurement and Transplantation Network for each transplant candidate such member places on the list described in subsection (b)(2)(A)(i). Such registration fees shall be collected and distributed only to support the operation of the Organ Procurement and Transplantation Network. Such registration fees are authorized to remain available until expended. ``(2) Collection.--The Secretary may collect the registration fees under paragraph (1) directly or through awards made under subsection (b)(1)(A). ``(3) Distribution.--Any amounts collected under this subsection shall-- ``(A) be credited to the currently applicable appropriation, account, or fund of the Department of Health and Human Services as discretionary offsetting collections; and ``(B) be available, only to the extent and in the amounts provided in advance in appropriations Acts, to distribute such fees among awardees described in subsection (b)(1)(A). ``(4) Transparency.--The Secretary shall-- ``(A) promptly post on the website of the Organ Procurement and Transplantation Network-- ``(i) the amount of registration fees collected under this subsection from each member of the Organ Procurement and Transplantation Network; and ``(ii) a list of activities such fees are used to support; and ``(B) update the information posted pursuant to subparagraph (A), as applicable for each calendar quarter for which fees are collected under paragraph (1). ``(5) GAO review.--Not later than 2 years after the date of enactment of this subsection, the Comptroller General of the United States shall, to the extent data are available-- ``(A) conduct a review concerning the activities under this subsection; and

``(B) submit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Energy and Commerce of the House of Representatives, a report on such review, including related recommendations, as applicable. ``(6) Sunset.--The authority to collect registration fees under paragraph (1) shall expire on the date that is 3 years after the date of enactment of the Consolidated Appropriations Act, 2026.''.

(a) No Consideration of Income of Organ Recipient.--Section 377 of the Public Health Service Act (42 U.S.C. 274f) is amended-- (1) by redesignating subsections (c) through (f) as subsections (d) through (g), respectively; (2) by inserting after subsection (b) the following:

``(c) No Consideration of Income of Organ Recipient.--The recipient of a grant under this section, in providing reimbursement to a donating individual through such grant, shall not give any consideration to the income of the organ recipient.''; and (3) in subsection (f), as so redesignated-- (A) in paragraph (1), by striking ``subsection (c)(1)'' and inserting ``subsection (d)(1)''; and (B) in paragraph (2), by striking ``subsection (c)(2)'' and inserting ``subsection (d)(2)''.

(b) Removal of Expectation of Payments by Organ Recipients.--Section 377(e) of the Public Health Service Act (42 U.S.C. 274f(e)), as redesignated by subsection (a)(1), is amended-- (1) in paragraph (1), by adding ``or'' at the end; (2) in paragraph (2), by striking ``; or'' and inserting a period; and (3) by striking paragraph (3).

(c) Annual Report.--Section 377 of the Public Health Service Act (42 U.S.C. 274f), as amended by subsections (a) and (b), is amended by adding at the end the following: ``(h) Annual Report.--Not later than December 31 of each year, beginning in fiscal year 2027, the Secretary shall-- ``(1) prepare, submit to the Congress, and make public a report on whether grants under this section provided adequate funding during the preceding fiscal year to reimburse all donating individuals participating in the grant program under this section for all qualifying expenses; and ``(2) include in each such report-- ``(A) the estimated number of all donating individuals participating in the grant program under this section who did not receive reimbursement for all qualifying expenses during the preceding fiscal year; and ``(B) the total amount of funding that is estimated to be necessary to fully reimburse all donating individuals participating in the grant program under this section for all qualifying expenses.''.

Section 409I(d)(1) of the Public Health Service Act (42 U.S.C. 284m(d)(1)) is amended by striking ``section,'' and all that follows through the period at the end and inserting ``section, $25,000,000 for each of fiscal years 2026 through 2028.''.

(a) In General.--Section 1106(b) of the Public Health Service Act (42 U.S.C. 300b-5(b)) is amended-- (1) in paragraph (1)(A)(iii), by striking ``prevention and treatment of sickle cell disease'' and inserting ``treatment of sickle cell disease and the prevention and treatment of complications of sickle cell disease''; (2) in paragraph (2)(D), by striking ``prevention and treatment of sickle cell disease'' and inserting ``treatment of sickle cell disease and the prevention and treatment of complications of sickle cell disease''; (3) in paragraph (3)-- (A) in subparagraph (A), by striking ``enter into a contract with'' and inserting ``make a grant to, or enter into a contract or cooperative agreement with,''; and (B) in subparagraph (B), in each of clauses (ii) and (iii), by striking ``prevention and treatment of sickle cell disease'' and inserting ``treatment of sickle cell disease and the prevention and treatment of complications of sickle cell disease''; and (4) in paragraph (6), by striking ``$4,455,000 for each of fiscal years 2019 through 2023'' and inserting ``$8,205,000 for each of fiscal years 2026 through 2030''.

(b) Sense of Congress.--It is the sense of Congress that further research should be undertaken to expand the understanding of the causes of, and to find cures for, heritable blood disorders, including sickle cell disease.

(a) Definition of Family Caregiver.--Section 2901(5) of the Public Health Service Act (42 U.S.C. 300ii(5)) is amended by striking ``unpaid adult'' and inserting ``unpaid individual''. (b) Funding.--Section 2905 of the Public Health Service Act (42 U.S.C. 300ii-4) is amended by striking ``fiscal years 2020 through fiscal year 2024'' and inserting ``fiscal years 2026 through 2030''.

(a) Research Relating to Preterm Labor and Delivery and the Care, Treatment, and Outcomes of Preterm and Low Birthweight Infants.-- (1) In general.--Section 3(e) of the Prematurity Research Expansion and Education for Mothers who deliver Infants Early Act (42 U.S.C. 247b-4f(e)) is amended by striking ``fiscal years 2019 through 2023'' and inserting ``fiscal years 2026 through 2030''. (2) Technical correction.--Effective as if included in the enactment of the PREEMIE Reauthorization Act of 2018 (Public Law 115-328), section 2 of such Act <<NOTE: 42 USC 247b-4f and note.>> is amended, in the matter preceding paragraph (1), by striking ``Section 2'' and inserting ``Section 3''.

(b) Interagency Working Group.--Section 5(a) of the PREEMIE Reauthorization Act of 2018 <<NOTE: 132 Stat. 4473.>> (Public Law 115-328) is amended by striking ``The Secretary of Health and Human Services, in collaboration with other departments, as appropriate, may establish'' and inserting ``Not later than 18 months after the date of the enactment of the Consolidated Appropriations Act, 2026, the

Secretary of Health and Human Services, in collaboration with other departments, as appropriate, shall establish''.

(c) Study on Preterm Births.-- (1) In general.--The Secretary of Health and Human Services shall enter into appropriate arrangements with the National Academies of Sciences, Engineering, and Medicine under which the National Academies shall-- (A) not later than 30 days after the date of enactment of this Act, convene a committee of experts in maternal health to study premature births in the United States; and (B) upon completion of the study under subparagraph (A)-- (i) approve by consensus a report on the results of such study; (ii) include in such report-- (I) an assessment of each of the topics listed in paragraph (2); (II) the analysis required by paragraph (3); and (III) the raw data used to develop such report; and (iii) not later than 24 months after the date of enactment of this Act, transmit such report to-- (I) the Secretary of Health and Human Services; (II) the Committee on Energy and Commerce of the House of Representatives; and (III) the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate. (2) Assessment topics.--The topics listed in this subsection are each of the following: (A) The financial costs of premature birth to society, including-- (i) an analysis of stays in neonatal intensive care units and the cost of such stays; (ii) long-term costs of stays in such units to society and the family involved post-discharge; and (iii) health care costs for families post- discharge from such units (such as medications, therapeutic services, co-payments for visits, and specialty equipment). (B) The factors that impact preterm birth rates. (C) Opportunities for earlier detection of premature birth risk factors, including-- (i) opportunities to improve maternal and infant health; and (ii) opportunities for public health programs to provide support and resources for parents in- hospital, in non-hospital settings, and post- discharge. (3) Analysis.--The analysis required by this subsection is an analysis of-- (A) targeted research strategies to develop effective drugs, treatments, or interventions to bring at-risk pregnancies to term; (B) State and other programs' best practices with respect to reducing premature birth rates; and

(C) precision medicine and preventative care approaches starting early in the life course (including during pregnancy) with a focus on behavioral and biological influences on premature birth, child health, and the trajectory of such approaches into adulthood.

(a) Dissemination of Best Practices.--Section 2 of the Dr. Lorna Breen Health Care Provider Protection Act (Public Law 117-105) is amended by striking ``2 years'' and inserting ``5 years''.

(b) Education and Awareness Initiative Encouraging Use of Mental Health and Substance Use Disorder Services by Health Care Professionals.--Section 3 of the Dr. Lorna Breen Health Care Provider Protection Act (Public Law 117-105) is amended-- (1) in subsection (b), by inserting ``and annually thereafter,'' after ``of this Act,''; and (2) in subsection (c), by striking ``2022 through 2024'' and inserting ``2026 through 2030''.

(c) Programs to Promote Mental Health Among the Health Professional Workforce.--The second section 764 of the Public Health Service Act (42 U.S.C. 294t), as added by section 4 of the Dr. Lorna Breen Health Care Provider Protection Act (Public Law 117-105), is amended-- (1) by redesignating such section 764 as section 764A; (2) in subsection (a)(3)-- (A) by striking ``to eligible entities in'' and inserting ``to eligible entities that-- ``(A) are in''; (B) by striking the period and inserting ``; or''; and (C) by adding at the end the following: ``(B) have a focus on the reduction of administrative burden on health care workers.''; (3) in subsection (c), by inserting ``not less than'' after ``period of''; and (4) in subsection (f), by striking ``2022 through 2024'' and inserting ``2026 through 2030''.

RESEARCH INTO PEDIATRIC USES OF DRUGS; ADDITIONAL AUTHORITIES OF FOOD AND DRUG ADMINISTRATION REGARDING MOLECULARLY TARGETED CANCER DRUGS.

(a) In General.-- (1) Additional active ingredient for application drug; limitation regarding novel-combination application drug.-- Section 505B(a)(3) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(a)(3)) is amended-- (A) by redesignating subparagraphs (B) and (C) as subparagraphs (C) and (D), respectively; and

(B) by striking subparagraph (A) and inserting the following: ``(A) In general.--For purposes of paragraph (1)(B), the investigation described in this paragraph is a molecularly targeted pediatric cancer investigation of-- ``(i) the drug or biological product for which the application referred to in such paragraph is submitted; or ``(ii) such drug or biological product used in combination with-- ``(I) an active ingredient of a drug or biological product-- ``(aa) for which an approved application under section 505(j) under this Act or under section 351(k) of the Public Health Service Act is in effect; and

``(bb) t hat is determined by the Secretary, after consultation with the applicant, to be part of the standard of care for treating a pediatric cancer; or ``(II) an active ingredient of a drug or biological product-- ``(aa) for which an approved application under section 505(b) of this Act or section 351(a) of the Public Health Service Act to treat an adult cancer is in effect and is held by the same person submitting the application under paragraph (1)(B); and

``(bb) t hat is directed at a molecular target that the Secretary determines to be substantially relevant to the growth or progression of a pediatric cancer. ``(B) Additional requirements.-- ``(i) Design of investigation.--A molecularly targeted pediatric cancer investigation referred to in subparagraph (A) shall be designed to yield clinically meaningful pediatric study data that is gathered using appropriate formulations for each age group for which the study is required, regarding dosing, safety, and preliminary efficacy to inform potential pediatric labeling. ``(ii) Limitation.--An investigation described in subparagraph (A)(ii) may be required only if the drug or biological product for which the application referred to in paragraph (1)(B) contains either-- ``(I) a single new active ingredient; or ``(II) more than one active ingredient, if an application for the combination of active ingredients has not previously been approved but each active ingredient is in a drug product that has been previously approved to treat an adult cancer. ``(iii) Results of already-completed preclinical studies of application drug.--With respect to an investigation required pursuant to paragraph (1)(B), the Secretary may require the results of any completed preclinical studies relevant to the initial pediatric study plan be submitted to the Secretary at the same

time that the initial pediatric study plan required under subsection (e)(1) is submitted. ``(iv) Rule of construction regarding inactive ingredients.--With respect to a combination of active ingredients referred to in subparagraph (A)(ii), such subparagraph shall not be construed as addressing the use of inactive ingredients with such combination.''. (2) Determination of applicable requirements.--Section 505B(e)(1) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(e)(1)) is amended by adding at the end the following: ``The Secretary shall determine whether subparagraph (A) or (B) of subsection (a)(1) applies with respect to an application before the date on which the applicant is required to submit the initial pediatric study plan under paragraph (2)(A).''. (3) Clarifying applicability.--Section 505B(a)(1) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(a)(1)) is amended by adding at the end the following: ``(C) Rule of construction.--No application that is subject to the requirements of subparagraph (B) shall be subject to the requirements of subparagraph (A), and no application (or supplement to an application) that is subject to the requirements of subparagraph (A) shall be subject to the requirements of subparagraph (B).''. (4) Conforming amendments.--Section 505B(a) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(a)) is amended-- (A) in paragraph (3)(C), as redesignated by paragraph (1)(A) of this subsection, by striking ``investigations described in this paragraph'' and inserting ``investigations referred to in subparagraph (A)''; and (B) in paragraph (3)(D), as redesignated by paragraph (1)(A) of this subsection, by striking ``the assessments under paragraph (2)(B)'' and inserting ``the assessments required under paragraph (1)(A)''.

(b) Guidance.--The Secretary of Health and Human Services, acting through the Commissioner of Food and Drugs, shall-- (1) not later than 12 months after the date of enactment of this Act, issue draft guidance on the implementation of the amendments made by subsection (a); and (2) not later than 12 months after closing the comment period on such draft guidance, finalize such guidance.

(c) Applicability.--The amendments made by this section apply with respect to any application under section 505(b) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355(b)) and any application under section 351(a) of the Public Health Service Act (42 U.S.C. 262(a)), that is submitted on or after the date that is 3 years after the date of enactment of this Act.

(d) Reports to Congress.-- (1) Secretary of health and human services.--Not later than 6 years after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report on the Secretary's efforts, in coordination with industry, to ensure implementation of the amendments made by subsection (a).

(2) GAO study and report.-- (A) Study.--Not later than 8 years after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study of the effectiveness of requiring assessments and investigations described in section 505B of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.355c), as amended by subsection (a), in the development of drugs and biological products for pediatric cancer indications, including consideration of any benefits to, or burdens on, pediatric cancer drug development. (B) Findings.--Not later than 10 years after the date of enactment of this Act, the Comptroller General shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report containing the findings of the study conducted under subparagraph (A).

(a) Equal Accountability for Pediatric Study Requirements.--Section 505B(d) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(d)) is amended-- (1) in paragraph (1), by striking ``Beginning 270'' and inserting ``Noncompliance letter.--Beginning 270''; (2) in paragraph (2)-- (A) by striking ``The drug or'' and inserting ``Effect of noncompliance.--The drug or''; and (B) by striking ``(except that the drug or biological product shall not be subject to action under section 303)'' and inserting ``(except that the drug or biological product shall be subject to action under section 303 only if such person demonstrated a lack of due diligence in satisfying the applicable requirement)''; and (3) by adding at the end the following: ``(3) Limitation.--The Secretary shall not issue enforcement actions under section 303 for failures under this subsection in the case of a drug or biological product that is no longer marketed.''.

(b) Due Diligence.--Section 505B(d) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355c(d)), as amended by subsection (a), is further amended by adding at the end the following: ``(4) Due diligence.--Before the Secretary may conclude that a person failed to submit or otherwise meet a requirement as described in the matter preceding paragraph (1), the Secretary shall-- ``(A) issue a noncompliance letter pursuant to paragraph (1); ``(B) provide such person with a 45-day period beginning on the date of receipt of such noncompliance letter to respond in writing as set forth in such paragraph; and ``(C) after reviewing such written response, determine whether the person demonstrated a lack of due diligence in satisfying such requirement.''.

(c) Conforming Amendments.--Section 303(f)(4)(A) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 333(f)(4)(A)) is amended by striking ``or 505-1'' and inserting ``505-1, or 505B''.

(d) Transition Rule.--The Secretary of Health and Human Services may take enforcement action under section 303 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 333) only for failures described in section 505B(d) of such Act (21 U.S.C. 355c(d)) that occur on or after the date that is 180 days after the date of enactment of this Act.

Section 508(b) of the Food and Drug Administration Safety and Innovation Act (21 U.S.C. 355c-1(b)) is amended-- (1) in paragraph (11), by striking the semicolon at the end and inserting ``, including an evaluation of compliance with deadlines provided for in deferrals and deferral extensions;''; (2) in paragraph (15), by striking ``and'' at the end; (3) in paragraph (16), by striking the period at the end and inserting ``; and''; and (4) by adding at the end the following: ``(17) a listing of penalties, settlements, or payments under section 303 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 353) for failure to comply with requirements under such section 505B, including, for each penalty, settlement, or payment, the name of the drug, the sponsor thereof, and the amount of the penalty, settlement, or payment imposed.''.

VOUCHERS TO ENCOURAGE TREATMENTS FOR RARE PEDIATRIC DISEASES.

(a) Extension.--Paragraph (5) of section 529(b) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360ff(b)) is amended by striking ``December 20, 2024, unless'' and all that follows through the period at the end and inserting ``September 30, 2029.''. (b) User Fee Payment.--Section 529(c)(4) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360ff(c)(4)) is amended by striking subparagraph (A) and inserting the following: ``(A) In general.--The priority review user fee required by this subsection shall be due upon the submission of a human drug application under section 505(b)(1) or section 351(a) of the Public Health Service Act for which the priority review voucher is used. All other user fees associated with the human drug application shall be due as required by the Secretary or under applicable law.''.

(c) GAO Report on Effectiveness of Rare Pediatric Disease Priority Voucher Awards in Incentivizing Rare Pediatric Disease Drug Development.-- (1) GAO study.-- (A) Study.--The Comptroller General of the United States shall conduct a study of the effectiveness of awarding rare pediatric disease priority vouchers under section 529 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360ff), as amended by subsection (a), in the development of human drug products that treat or prevent rare pediatric diseases (as defined in such section 529). (B) Contents of study.--In conducting the study under subparagraph (A), the Comptroller General shall examine the following: (i) The indications for each drug or biological product that--

(I) is the subject of a rare pediatric disease product application (as defined in section 529 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360ff)) for which a priority review voucher was awarded; and (II) was approved under section 505 of the Federal Food, Drug, and Cosmetic Act (42 U.S.C. 355) or licensed under section 351 of the Public Health Service Act (42 U.S.C. 262). (ii) Whether, and to what extent, an unmet need related to the treatment or prevention of a rare pediatric disease was met through the approval or licensure of such a drug or biological product. (iii) The size of the company to which a priority review voucher was awarded under section 529 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360ff) for such a drug or biological product. (iv) The value of such priority review voucher if transferred. (v) Identification of each drug for which a priority review voucher awarded under such section 529 was used. (vi) The size of the company using each priority review voucher awarded under such section 529. (vii) The length of the period of time between the date on which a priority review voucher was awarded under such section 529 and the date on which it was used. (viii) Whether, and to what extent, an unmet need related to the treatment or prevention of a rare pediatric disease was met through the approval under section 505 of the Federal Food, Drug, and Cosmetic Act (42 U.S.C. 355) or licensure under section 351 of the Public Health Service Act (42 U.S.C. 262) of a drug for which a priority review voucher was used. (ix) Whether, and to what extent, companies were motivated by the availability of priority review vouchers under section 529 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360ff) to attempt to develop a drug for a rare pediatric disease. (x) Whether, and to what extent, pediatric review vouchers awarded under such section were successful in stimulating development and expedited patient access to drug products for treatment or prevention of a rare pediatric disease that wouldn't otherwise take place without the incentive provided by such vouchers. (xi) The impact of such priority review vouchers on the workload, review process, and public health prioritization efforts of the Food and Drug Administration. (xii) Any other incentives in Federal law that exist for companies developing drugs or biological products described in clause (i). (2) Report on findings.--Not later than 5 years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Energy

and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report containing the findings of the study conducted under paragraph (1).

ORPHAN DRUGS.

(a) In General.--Section 527 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360cc) is amended-- (1) in subsection (a), in the matter following paragraph (2), by striking ``same disease or condition'' and inserting ``same approved use or indication within such rare disease or condition''; (2) in subsection (b)-- (A) in the matter preceding paragraph (1), by striking ``same rare disease or condition'' and inserting ``same approved use or indication for which such 7-year period applies to such already approved or licensed drug''; and (B) in paragraph (1), by inserting ``, relating to the approved use or indication,'' after ``the needs''; (3) in subsection (c)(1), by striking ``same rare disease or condition as the already approved drug'' and inserting ``same use or indication for which the already approved or licensed drug was approved or licensed''; and (4) by adding at the end the following:

``(f) Approved Use or Indication Defined.--In this section, the term `approved use or indication' means the use or indication approved under section 505 of this Act or licensed under section 351 of the Public Health Service Act for a drug designated under section 526 for a rare disease or condition.''. (b) Application of Amendments.--The amendments made by subsection (a) shall apply with respect to any drug designated under section 526 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bb), regardless of the date on which the drug was so designated, and regardless of the date on which the drug was approved under section 505 of such Act (21 U.S.C. 355) or licensed under section 351 of the Public Health Service Act (42 U.S.C. 262).

Subtitle B--United States-Abraham Accords Cooperation and Security

DRUG ADMINISTRATION.

(a) In General.--Chapter X of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 391 et seq.) is amended by adding at the end the following: ``SEC. 1015. ABRAHAM ACCORDS OFFICE.

``(a) In General.--The Secretary, acting through the Commissioner of Food and Drugs, shall establish within the Food and Drug Administration an office, to be known as the Abraham Accords Office, to be headed by a director. ``(b) Office.--Not later than 2 years after the date of enactment of this section, the Secretary shall--

``(1) in consultation with the governments of Abraham Accords countries, as well as appropriate United States Government diplomatic and security personnel-- ``(A) select the location of the Abraham Accords Office in an Abraham Accords country; and ``(B) establish such office; and ``(2) assign to such office such personnel of the Food and Drug Administration as the Secretary determines necessary to carry out the functions of such office.

``(c) Duties.--The Secretary, acting through the Director of the Abraham Accords Office, shall-- ``(1) after the Abraham Accords Office is established-- ``(A) as part of the Food and Drug Administration's work to strengthen the international oversight of regulated commodities, provide technical assistance to regulatory partners in Abraham Accords countries on strengthening regulatory oversight and converging regulatory requirements for the oversight of regulated products, including good manufacturing practices and other issues relevant to manufacturing medical products that are regulated by the Food and Drug Administration; and ``(B) facilitate interactions between the Food and Drug Administration and interested parties in Abraham Accords countries, including by sharing relevant information regarding United States regulatory pathways with such parties, and facilitate feedback on the research, development, and manufacturing of products regulated in accordance with this Act; and ``(2) carry out other functions and activities as the Secretary determines to be necessary to carry out this section.

``(d) Abraham Accords Country Defined.--In this section, the term `Abraham Accords country' means a country identified by the Department of State as having signed the Abraham Accords Declaration. ``(e) National Security.--Nothing in this section shall be construed to require any action inconsistent with a national security recommendation provided by the Federal Government.''. (b) Report to Congress.-- (1) In general.--Not later than 3 years after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to the Congress a report on the Abraham Accords Office, including-- (A) an evaluation of how the Office has advanced progress toward conformance with Food and Drug Administration regulatory requirements by manufacturers in the Abraham Accords countries; (B) a numerical count of parties that the Office has helped facilitate interactions or feedback pursuant to section 1015(c)(1)(B) of the Federal Food, Drug, and Cosmetic Act (as added by subsection (a)); (C) a summary of technical assistance provided to regulatory partners in Abraham Accords countries pursuant to subparagraph (A) of such section 1015(c)(1); and (D) recommendations for increasing and improving coordination between the Food and Drug Administration and entities in Abraham Accords countries.

(2) Abraham accords country defined.--In this subsection, the term ``Abraham Accords country'' has the meaning given such term in section 1015(d) of the Federal Food, Drug, and Cosmetic Act (as added by subsection (a)).

(a) Public Health Service Act.--Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended-- (1) in part D (42 U.S.C. 300gg-111 et seq.), by adding at the end the following new section: ``SEC. 2799A-11. OVERSIGHT OF ENTITIES THAT PROVIDE PHARMACY BENEFIT MANAGEMENT SERVICES.

``(a) In General.--For plan years beginning on or after the date that is 30 months after the date of enactment of this section (referred to in this subsection and subsection (b) as the `effective date'), a group health plan or a health insurance issuer offering group health insurance coverage, or an entity providing pharmacy benefit management services on behalf of such a plan or issuer, shall not enter into a contract, including an extension or renewal of a contract, entered into on or after the effective date, with an applicable entity unless such applicable entity agrees to-- ``(1) not limit or delay the disclosure of information to the group health plan (including such a plan offered through a health insurance issuer) in such a manner that prevents an entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer offering group health insurance coverage from making the reports described in subsection (b); and ``(2) provide the entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer relevant information necessary to make the reports described in subsection (b).

``(b) Reports.-- ``(1) In general.--For plan years beginning on or after the effective date, in the case of any contract between a group health plan or a health insurance issuer offering group health insurance coverage offered in connection with such a plan and an entity providing pharmacy benefit management services on behalf of such plan or issuer, including an extension or renewal of such a contract, entered into on or after the effective date, the entity providing pharmacy benefit management services on behalf of such a group health plan or health insurance issuer, not less frequently than every 6 months (or, at the request of a group health plan, not less frequently than quarterly, and under the same conditions, terms, and cost of the semiannual report under this subsection), shall submit to the group health plan a report in accordance with this section. Each such report shall be made available to such group health plan in plain language, in a machine-readable format, and as the Secretary may determine, other formats. Each such

report shall include the information described in paragraph (2). ``(2) Information described.--For purposes of paragraph (1), the information described in this paragraph is, with respect to drugs covered by a group health plan or group health insurance coverage offered by a health insurance issuer in connection with a group health plan during each reporting period-- ``(A) in the case of a group health plan that is offered by a specified large employer or that is a specified large plan, and is not offered as health insurance coverage, or in the case of health insurance coverage for which the election under paragraph (3) is made for the applicable reporting period-- ``(i) a list of drugs for which a claim was filed and, with respect to each such drug on such list-- ``(I) the contracted compensation paid by the group health plan or health insurance issuer for each covered drug (identified by the National Drug Code) to the entity providing pharmacy benefit management services or other applicable entity on behalf of the group health plan or health insurance issuer; ``(II) the contracted compensation paid to the pharmacy, by any entity providing pharmacy benefit management services or other applicable entity on behalf of the group health plan or health insurance issuer, for each covered drug (identified by the National Drug Code); ``(III) for each such claim, the difference between the amount paid under subclause (I) and the amount paid under subclause (II); ``(IV) the proprietary name, established name or proper name, and the National Drug Code; ``(V) for each claim for the drug (including original prescriptions and refills) and for each dosage unit of the drug for which a claim was filed, the type of dispensing channel used to furnish the drug, including retail, mail order, or specialty pharmacy; ``(VI) with respect to each drug dispensed, for each type of dispensing channel (including retail, mail order, or specialty pharmacy)-- ``(aa) whether such drug is a brand name drug or a generic drug, and-- ``(AA) in the case of a brand name drug, the wholesale acquisition cost, listed as cost per days supply and cost per dosage unit, on the date such drug was dispensed; and ``(BB) in the case of a generic drug, the average wholesale price, listed as cost per days supply and cost per dosage unit, on the date such drug was dispensed; and ``(bb) the total number of-- ``(AA) prescription claims (including original prescriptions and refills);

``(BB) participants and beneficiaries for whom a claim for such drug was filed through the applicable dispensing channel; ``(CC) dosage units and dosage units per fill of such drug; and ``(DD) days supply of such drug per fill; ``(VII) the net price per course of treatment or single fill, such as a 30- day supply or 90-day supply to the plan or coverage after rebates, fees, alternative discounts, or other remuneration received from applicable entities; ``(VIII) the total amount of out-of- pocket spending by participants and beneficiaries on such drug, including spending through copayments, coinsurance, and deductibles, but not including any amounts spent by participants and beneficiaries on drugs not covered under the plan or coverage, or for which no claim is submitted under the plan or coverage; ``(IX) the total net spending on the drug; ``(X) the total amount received, or expected to be received, by the plan or issuer from any applicable entity in rebates, fees, alternative discounts, or other remuneration; ``(XI) the total amount received, or expected to be received, by the entity providing pharmacy benefit management services, from applicable entities, in rebates, fees, alternative discounts, or other remuneration from such entities-- ``(aa) for claims incurred during the reporting period; and ``(bb) that is related to utilization of such drug or spending on such drug; and ``(XII) to the extent feasible, information on the total amount of remuneration for such drug, including copayment assistance dollars paid, copayment cards applied, or other discounts provided by each drug manufacturer (or entity administering copayment assistance on behalf of such drug manufacturer), to the participants and beneficiaries enrolled in such plan or coverage; ``(ii) a list of each therapeutic class (as defined by the Secretary) for which a claim was filed under the group health plan or health insurance coverage during the reporting period, and, with respect to each such therapeutic class-- ``(I) the total gross spending on drugs in such class before rebates, price concessions, alternative discounts, or other remuneration from applicable entities; ``(II) the net spending in such class after such rebates, price concessions, alternative discounts, or other remuneration from applicable entities; ``(III) the total amount received, or expected to be received, by the entity providing pharmacy

benefit management services, from applicable entities, in rebates, fees, alternative discounts, or other remuneration from such entities-- ``(aa) for claims incurred during the reporting period; and ``(bb) that is related to utilization of drugs or drug spending; ``(IV) the average net spending per 30-day supply and per 90-day supply by the plan or by the issuer with respect to such coverage and its participants and beneficiaries, among all drugs within the therapeutic class for which a claim was filed during the reporting period; ``(V) the number of participants and beneficiaries who filled a prescription for a drug in such class, including the National Drug Code for each such drug; ``(VI) if applicable, a description of the formulary tiers and utilization mechanisms (such as prior authorization or step therapy) employed for drugs in that class; and ``(VII) the total out-of-pocket spending under the plan or coverage by participants and beneficiaries, including spending through copayments, coinsurance, and deductibles, but not including any amounts spent by participants and beneficiaries on drugs not covered under the plan or coverage or for which no claim is submitted under the plan or coverage; ``(iii) with respect to any drug for which gross spending under the group health plan or health insurance coverage exceeded $10,000 during the reporting period or, in the case that gross spending under the group health plan or coverage exceeded $10,000 during the reporting period with respect to fewer than 50 drugs, with respect to the 50 prescription drugs with the highest spending during the reporting period-- ``(I) a list of all other drugs in the same therapeutic class as such drug; ``(II) if applicable, the rationale for the formulary placement of such drug in that therapeutic category or class, selected from a list of standard rationales established by the Secretary, in consultation with stakeholders; and ``(III) any change in formulary placement compared to the prior plan year; and ``(iv) in the case that such plan or issuer (or an entity providing pharmacy benefit management services on behalf of such plan or issuer) has an affiliated pharmacy or pharmacy under common ownership, including mandatory mail and specialty home delivery programs, retail and mail auto-refill programs, and cost sharing assistance incentives funded by an entity providing pharmacy benefit services-- ``(I) an explanation of any benefit design parameters that encourage or require participants and beneficiaries in the plan or coverage to fill

prescriptions at mail order, specialty, or retail pharmacies; ``(II) the percentage of total prescriptions dispensed by such pharmacies to participants or beneficiaries in such plan or coverage; and ``(III) a list of all drugs dispensed by such pharmacies to participants or beneficiaries enrolled in such plan or coverage, and, with respect to each drug dispensed-- ``(aa) the amount charged, per dosage unit, per 30-day supply, or per 90-day supply (as applicable) to the plan or issuer, and to participants and beneficiaries; ``(bb) the median amount charged to such plan or issuer, and the interquartile range of the costs, per dosage unit, per 30-day supply, and per 90-day supply, including amounts paid by the participants and beneficiaries, when the same drug is dispensed by other pharmacies that are not affiliated with or under common ownership with the entity and that are included in the pharmacy network of such plan or coverage; ``(cc) the lowest cost per dosage unit, per 30-day supply and per 90-day supply, for each such drug, including amounts charged to the plan or coverage and to participants and beneficiaries, that is available from any pharmacy included in the network of such plan or coverage; and ``(dd) the net acquisition cost per dosage unit, per 30-day supply, and per 90-day supply, if such drug is subject to a maximum price discount; and ``(B) with respect to any group health plan, including group health insurance coverage offered in connection with such a plan, regardless of whether the plan or coverage is offered by a specified large employer or whether it is a specified large plan-- ``(i) a summary document for the group health plan that includes such information described in clauses (i) through (iv) of subparagraph (A), as specified by the Secretary through guidance, program instruction, or otherwise (with no requirement of notice and comment rulemaking), that the Secretary determines useful to group health plans for purposes of selecting pharmacy benefit management services, such as an estimated net price to group health plan and participant or beneficiary, a cost per claim, the fee structure or reimbursement model, and estimated cost per participant or beneficiary; ``(ii) a summary document for plans and issuers to provide to participants and beneficiaries, which shall be made available to participants or beneficiaries upon request to their group health plan (including in the case of group health insurance coverage offered in connection with such a plan), that--

``(I) contains such information described in clauses (iii), (iv), (v), and (vi), as applicable, as specified by the Secretary through guidance, program instruction, or otherwise (with no requirement of notice and comment rulemaking) that the Secretary determines useful to participants or beneficiaries in better understanding the plan or coverage or benefits under such plan or coverage; ``(II) contains only aggregate information; and ``(III) states that participants and beneficiaries may request specific, claims-level information required to be furnished under subsection (c) from the group health plan or health insurance issuer; and ``(iii) with respect to drugs covered by such plan or coverage during such reporting period-- ``(I) the total net spending by the plan or coverage for all such drugs; ``(II) the total amount received, or expected to be received, by the plan or issuer from any applicable entity in rebates, fees, alternative discounts, or other remuneration; and ``(III) to the extent feasible, information on the total amount of remuneration for such drugs, including copayment assistance dollars paid, copayment cards applied, or other discounts provided by each drug manufacturer (or entity administering copayment assistance on behalf of such drug manufacturer) to participants and beneficiaries; ``(iv) amounts paid directly or indirectly in rebates, fees, or any other type of compensation (as defined in section 408(b)(2)(B)(ii)(dd)(AA) of the Employee Retirement Income Security Act) to brokerage firms, brokers, consultants, advisors, or any other individual or firm, for-- ``(I) the referral of the group health plan's or health insurance issuer's business to an entity providing pharmacy benefit management services, including the identity of the recipient of such amounts; ``(II) consideration of the entity providing pharmacy benefit management services by the group health plan or health insurance issuer; or ``(III) the retention of the entity by the group health plan or health insurance issuer; ``(v) an explanation of any benefit design parameters that encourage or require participants and beneficiaries in such plan or coverage to fill prescriptions at mail order, specialty, or retail pharmacies that are affiliated with or under common ownership with the entity providing pharmacy benefit management services under such plan or coverage, including mandatory mail and specialty home delivery programs, retail and mail auto-refill programs, and cost-sharing assistance incentives directly or indirectly funded by such entity; and

``(vi) total gross spending on all drugs under the plan or coverage during the reporting period. ``(3) Opt-in for group health insurance coverage offered by a specified large employer or that is a specified large plan.-- In the case of group health insurance coverage offered in connection with a group health plan that is offered by a specified large employer or is a specified large plan, such group health plan may, on an annual basis, for plan years beginning on or after the date that is 30 months after the date of enactment of this section, elect to require an entity providing pharmacy benefit management services on behalf of the health insurance issuer to submit to such group health plan a report that includes all of the information described in paragraph (2)(A), in addition to the information described in paragraph (2)(B). ``(4) Privacy requirements.-- ``(A) In general.--An entity providing pharmacy benefit management services on behalf of a group health plan or a health insurance issuer offering group health insurance coverage shall report information under paragraph (1) in a manner consistent with the privacy regulations promulgated under section 13402(a) of the Health Information Technology for Economic and Clinical Health Act and consistent with the privacy regulations promulgated under the Health Insurance Portability and Accountability Act of 1996 in part 160 and subparts A and E of part 164 of title 45, Code of Federal Regulations (or successor regulations) (referred to in this paragraph as the `HIPAA privacy regulations') and shall restrict the use and disclosure of such information according to such privacy regulations and such HIPAA privacy regulations. ``(B) Additional requirements.-- ``(i) In general.--An entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer offering group health insurance coverage that submits a report under paragraph (1) shall ensure that such report contains only summary health information, as defined in section 164.504(a) of title 45, Code of Federal Regulations (or successor regulations). ``(ii) Restrictions.--In carrying out this subsection, a group health plan shall comply with section 164.504(f) of title 45, Code of Federal Regulations (or a successor regulation), and a plan sponsor shall act in accordance with the terms of the agreement described in such section. ``(C) Rule of construction.-- ``(i) Nothing in this section shall be construed to modify the requirements for the creation, receipt, maintenance, or transmission of protected health information under the HIPAA privacy regulations. ``(ii) Nothing in this section shall be construed to affect the application of any Federal or State privacy or civil rights law, including the HIPAA privacy regulations, the Genetic Information Nondiscrimination Act

of 2008 (Public Law 110-233) (including the amendments made by such Act), the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), section 1557 of the Patient Protection and Affordable Care Act (42 U.S.C. 18116), title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and title VII of the Civil Rights Act of 1964 (42 U.S.C. 2000e). ``(D) Written notice.--Each plan year, group health plans, including with respect to group health insurance coverage offered in connection with a group health plan, shall provide to each participant or beneficiary written notice informing the participant or beneficiary of the requirement for entities providing pharmacy benefit management services on behalf of the group health plan or health insurance issuer offering group health insurance coverage to submit reports to group health plans under paragraph (1), as applicable, which may include incorporating such notification in plan documents provided to the participant or beneficiary, or providing individual notification. ``(E) Limitation to business associates.--A group health plan receiving a report under paragraph (1) may disclose such information only to the entity from which the report was received or to that entity's business associates as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations) or as permitted by the HIPAA privacy regulations. ``(F) Clarification regarding public disclosure of information.--Nothing in this section shall prevent an entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer offering group health insurance coverage, from placing reasonable restrictions on the public disclosure of the information contained in a report described in paragraph (1), except that such plan, issuer, or entity may not-- ``(i) restrict disclosure of such report to the Department of Health and Human Services, the Department of Labor, or the Department of the Treasury; or ``(ii) prevent disclosure for the purposes of subsection (c), or any other public disclosure requirement under this section. ``(G) Limited form of report.--The Secretary shall define through rulemaking a limited form of the report under paragraph (1) required with respect to any group health plan established by a plan sponsor that is, or is affiliated with, a drug manufacturer, drug wholesaler, or other direct participant in the drug supply chain, in order to prevent anti-competitive behavior. ``(5) Standard format and regulations.-- ``(A) In general.--Not later than 18 months after the date of enactment of this section, the Secretary shall specify through rulemaking a standard format for entities providing pharmacy benefit management services on behalf of group health plans and health insurance issuers offering group health insurance coverage, to submit reports required under paragraph (1).

``(B) Additional regulations.--Not later than 18 months after the date of enactment of this section, the Secretary shall, through rulemaking, promulgate any other final regulations necessary to implement the requirements of this section. In promulgating such regulations, the Secretary shall, to the extent practicable, align the reporting requirements under this section with the reporting requirements under section 2799A-10.

``(c) Requirement To Provide Information to Participants or Beneficiaries.--A group health plan, including with respect to group health insurance coverage offered in connection with a group health plan, upon request of a participant or beneficiary, shall provide to such participant or beneficiary-- ``(1) the summary document described in subsection (b)(2)(B)(ii); and ``(2) the information described in subsection (b)(2)(A)(i)(III) with respect to a claim made by or on behalf of such participant or beneficiary.

``(d) Enforcement.-- ``(1) In general.--The Secretary shall enforce this section. The enforcement authority under this subsection shall apply only with respect to group health plans (including group health insurance coverage offered in connection with such a plan) to which the requirements of subparts I and II of part A and part D apply in accordance with section 2722, and with respect to entities providing pharmacy benefit management services on behalf of such plans and applicable entities providing services on behalf of such plans. ``(2) Failure to provide information.--A group health plan, a health insurance issuer offering group health insurance coverage, an entity providing pharmacy benefit management services on behalf of such a plan or issuer, or an applicable entity providing services on behalf of such a plan or issuer that violates subsection (a); an entity providing pharmacy benefit management services on behalf of such a plan or issuer that fails to provide the information required under subsection (b); or a group health plan that fails to provide the information required under subsection (c), shall be subject to a civil monetary penalty in the amount of $10,000 for each day during which such violation continues or such information is not disclosed or reported. ``(3) False information.--A health insurance issuer, an entity providing pharmacy benefit management services, or a third party administrator providing services on behalf of such issuer offered by a health insurance issuer that knowingly provides false information under this section shall be subject to a civil monetary penalty in an amount not to exceed $100,000 for each item of false information. Such civil monetary penalty shall be in addition to other penalties as may be prescribed by law. ``(4) Procedure.--The provisions of section 1128A of the Social Security Act, other than subsections (a) and (b) and the first sentence of subsection (c)(1) of such section shall apply to civil monetary penalties under this subsection in the same manner as such provisions apply to a penalty or proceeding under such section.

``(5) Waivers.--The Secretary may waive penalties under paragraph (2), or extend the period of time for compliance with a requirement of this section, for an entity in violation of this section that has made a good-faith effort to comply with the requirements in this section.

``(e) Rule of Construction.--Nothing in this section shall be construed to permit a health insurance issuer, group health plan, entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer, or other entity to restrict disclosure to, or otherwise limit the access of, the Secretary to a report described in subsection (b)(1) or information related to compliance with subsections (a), (b), (c), or (d) by such issuer, plan, or entity. ``(f) Definitions.--In this section: ``(1) Applicable entity.--The term `applicable entity' means-- ``(A) an applicable group purchasing organization, drug manufacturer, distributor, wholesaler, rebate aggregator (or other purchasing entity designed to aggregate rebates), or associated third party; ``(B) any subsidiary, parent, affiliate, or subcontractor of a group health plan, health insurance issuer, entity that provides pharmacy benefit management services on behalf of such a plan or issuer, or any entity described in subparagraph (A); or ``(C) such other entity as the Secretary may specify through rulemaking. ``(2) Applicable group purchasing organization.--The term `applicable group purchasing organization' means a group purchasing organization that is affiliated with or under common ownership with an entity providing pharmacy benefit management services. ``(3) Contracted compensation.--The term `contracted compensation' means the sum of any ingredient cost and dispensing fee for a drug (inclusive of the out-of-pocket costs to the participant or beneficiary), or another analogous compensation structure that the Secretary may specify through regulations. ``(4) Gross spending.--The term `gross spending', with respect to prescription drug benefits under a group health plan or health insurance coverage, means the amount spent by a group health plan or health insurance issuer on prescription drug benefits, calculated before the application of rebates, fees, alternative discounts, or other remuneration. ``(5) Net spending.--The term `net spending', with respect to prescription drug benefits under a group health plan or health insurance coverage, means the amount spent by a group health plan or health insurance issuer on prescription drug benefits, calculated after the application of rebates, fees, alternative discounts, or other remuneration. ``(6) Plan sponsor.--The term `plan sponsor' has the meaning given such term in section 3(16)(B) of the Employee Retirement Income Security Act of 1974. ``(7) Remuneration.--The term `remuneration' has the meaning given such term by the Secretary through rulemaking, which shall be reevaluated by the Secretary every 5 years.

``(8) Specified large employer.--The term `specified large employer' means, in connection with a group health plan (including group health insurance coverage offered in connection with such a plan) established or maintained by a single employer, with respect to a calendar year or a plan year, as applicable, an employer who employed an average of at least 100 employees on business days during the preceding calendar year or plan year and who employs at least 1 employee on the first day of the calendar year or plan year. ``(9) Specified large plan.--The term `specified large plan' means a group health plan (including group health insurance coverage offered in connection with such a plan) established or maintained by a plan sponsor described in clause (ii) or (iii) of section 3(16)(B) of the Employee Retirement Income Security Act of 1974 that had an average of at least 100 participants on business days during the preceding calendar year or plan year, as applicable. ``(10) Wholesale acquisition cost.--The term `wholesale acquisition cost' has the meaning given such term in section 1847A(c)(6)(B) of the Social Security Act.''; and (2) in section 2723 (42 U.S.C. 300gg-22)-- (A) in subsection (a)-- (i) in paragraph (1), by inserting ``(other than section 2799A-11)'' after ``part D''; and (ii) in paragraph (2), by inserting ``(other than section 2799A-11)'' after ``part D''; and (B) in subsection (b)-- (i) in paragraph (1), by inserting ``(other than section 2799A-11)'' after ``part D''; (ii) in paragraph (2)(A), by inserting ``(other than section 2799A-11)'' after ``part D''; and (iii) in paragraph (2)(C)(ii), by inserting ``(other than section 2799A-11)'' after ``part D''.

(b) Employee Retirement Income Security Act of 1974.-- (1) In general.--Subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1021 et seq.) is amended-- (A) in subpart B of part 7 (29 U.S.C. 1185 et seq.), by adding at the end the following: ``SEC. 726. OVERSIGHT OF ENTITIES THAT PROVIDE PHARMACY BENEFIT MANAGEMENT SERVICES.

``(a) In General.--For plan years beginning on or after the date that is 30 months after the date of enactment of this section (referred to in this subsection and subsection (b) as the `effective date'), a group health plan or a health insurance issuer offering group health insurance coverage, or an entity providing pharmacy benefit management services on behalf of such a plan or issuer, shall not enter into a contract, including an extension or renewal of a contract, entered into on or after the effective date, with an applicable entity unless such applicable entity agrees to-- ``(1) not limit or delay the disclosure of information to the group health plan (including such a plan offered through a health insurance issuer) in such a manner that prevents an entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer offering

group health insurance coverage from making the reports described in subsection (b); and ``(2) provide the entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer relevant information necessary to make the reports described in subsection (b).

``(b) Reports.-- ``(1) In general.--For plan years beginning on or after the effective date, in the case of any contract between a group health plan or a health insurance issuer offering group health insurance coverage offered in connection with such a plan and an entity providing pharmacy benefit management services on behalf of such plan or issuer, including an extension or renewal of such a contract, entered into on or after the effective date, the entity providing pharmacy benefit management services on behalf of such a group health plan or health insurance issuer, not less frequently than every 6 months (or, at the request of a group health plan, not less frequently than quarterly, and under the same conditions, terms, and cost of the semiannual report under this subsection), shall submit to the group health plan a report in accordance with this section. Each such report shall be made available to such group health plan in plain language, in a machine-readable format, and as the Secretary may determine, other formats. Each such report shall include the information described in paragraph (2). ``(2) Information described.--For purposes of paragraph (1), the information described in this paragraph is, with respect to drugs covered by a group health plan or group health insurance coverage offered by a health insurance issuer in connection with a group health plan during each reporting period-- ``(A) in the case of a group health plan that is offered by a specified large employer or that is a specified large plan, and is not offered as health insurance coverage, or in the case of health insurance coverage for which the election under paragraph (3) is made for the applicable reporting period-- ``(i) a list of drugs for which a claim was filed and, with respect to each such drug on such list-- ``(I) the contracted compensation paid by the group health plan or health insurance issuer for each covered drug (identified by the National Drug Code) to the entity providing pharmacy benefit management services or other applicable entity on behalf of the group health plan or health insurance issuer; ``(II) the contracted compensation paid to the pharmacy, by any entity providing pharmacy benefit management services or other applicable entity on behalf of the group health plan or health insurance issuer, for each covered drug (identified by the National Drug Code); ``(III) for each such claim, the difference between the amount paid under subclause (I) and the amount paid under subclause (II); ``(IV) the proprietary name, established name or proper name, and the National Drug Code;

``(V) for each claim for the drug (including original prescriptions and refills) and for each dosage unit of the drug for which a claim was filed, the type of dispensing channel used to furnish the drug, including retail, mail order, or specialty pharmacy; ``(VI) with respect to each drug dispensed, for each type of dispensing channel (including retail, mail order, or specialty pharmacy)-- ``(aa) whether such drug is a brand name drug or a generic drug, and-- ``(AA) in the case of a brand name drug, the wholesale acquisition cost, listed as cost per days supply and cost per dosage unit, on the date such drug was dispensed; and ``(BB) in the case of a generic drug, the average wholesale price, listed as cost per days supply and cost per dosage unit, on the date such drug was dispensed; and ``(bb) the total number of-- ``(AA) prescription claims (including original prescriptions and refills); ``(BB) participants and beneficiaries for whom a claim for such drug was filed through the applicable dispensing channel; ``(CC) dosage units and dosage units per fill of such drug; and ``(DD) days supply of such drug per fill; ``(VII) the net price per course of treatment or single fill, such as a 30- day supply or 90-day supply to the plan or coverage after rebates, fees, alternative discounts, or other remuneration received from applicable entities; ``(VIII) the total amount of out-of- pocket spending by participants and beneficiaries on such drug, including spending through copayments, coinsurance, and deductibles, but not including any amounts spent by participants and beneficiaries on drugs not covered under the plan or coverage, or for which no claim is submitted under the plan or coverage; ``(IX) the total net spending on the drug; ``(X) the total amount received, or expected to be received, by the plan or issuer from any applicable entity in rebates, fees, alternative discounts, or other remuneration; ``(XI) the total amount received, or expected to be received, by the entity providing pharmacy benefit management services, from applicable entities, in rebates, fees, alternative discounts, or other remuneration from such entities-- ``(aa) for claims incurred during the reporting period; and

``(bb) that is related to utilization of such drug or spending on such drug; and ``(XII) to the extent feasible, information on the total amount of remuneration for such drug, including copayment assistance dollars paid, copayment cards applied, or other discounts provided by each drug manufacturer (or entity administering copayment assistance on behalf of such drug manufacturer), to the participants and beneficiaries enrolled in such plan or coverage; ``(ii) a list of each therapeutic class (as defined by the Secretary) for which a claim was filed under the group health plan or health insurance coverage during the reporting period, and, with respect to each such therapeutic class-- ``(I) the total gross spending on drugs in such class before rebates, price concessions, alternative discounts, or other remuneration from applicable entities; ``(II) the net spending in such class after such rebates, price concessions, alternative discounts, or other remuneration from applicable entities; ``(III) the total amount received, or expected to be received, by the entity providing pharmacy benefit management services, from applicable entities, in rebates, fees, alternative discounts, or other remuneration from such entities-- ``(aa) for claims incurred during the reporting period; and ``(bb) that is related to utilization of drugs or drug spending; ``(IV) the average net spending per 30-day supply and per 90-day supply by the plan or by the issuer with respect to such coverage and its participants and beneficiaries, among all drugs within the therapeutic class for which a claim was filed during the reporting period; ``(V) the number of participants and beneficiaries who filled a prescription for a drug in such class, including the National Drug Code for each such drug; ``(VI) if applicable, a description of the formulary tiers and utilization mechanisms (such as prior authorization or step therapy) employed for drugs in that class; and ``(VII) the total out-of-pocket spending under the plan or coverage by participants and beneficiaries, including spending through copayments, coinsurance, and deductibles, but not including any amounts spent by participants and beneficiaries on drugs not covered under the plan or coverage or for which no claim is submitted under the plan or coverage; ``(iii) with respect to any drug for which gross spending under the group health plan or health insurance coverage exceeded $10,000 during the reporting period or, in the case that gross spending under the

group health plan or coverage exceeded $10,000 during the reporting period with respect to fewer than 50 drugs, with respect to the 50 prescription drugs with the highest spending during the reporting period-- ``(I) a list of all other drugs in the same therapeutic class as such drug; ``(II) if applicable, the rationale for the formulary placement of such drug in that therapeutic category or class, selected from a list of standard rationales established by the Secretary, in consultation with stakeholders; and ``(III) any change in formulary placement compared to the prior plan year; and ``(iv) in the case that such plan or issuer (or an entity providing pharmacy benefit management services on behalf of such plan or issuer) has an affiliated pharmacy or pharmacy under common ownership, including mandatory mail and specialty home delivery programs, retail and mail auto-refill programs, and cost sharing assistance incentives funded by an entity providing pharmacy benefit services-- ``(I) an explanation of any benefit design parameters that encourage or require participants and beneficiaries in the plan or coverage to fill prescriptions at mail order, specialty, or retail pharmacies; ``(II) the percentage of total prescriptions dispensed by such pharmacies to participants or beneficiaries in such plan or coverage; and ``(III) a list of all drugs dispensed by such pharmacies to participants or beneficiaries enrolled in such plan or coverage, and, with respect to each drug dispensed-- ``(aa) the amount charged, per dosage unit, per 30-day supply, or per 90-day supply (as applicable) to the plan or issuer, and to participants and beneficiaries; ``(bb) the median amount charged to such plan or issuer, and the interquartile range of the costs, per dosage unit, per 30-day supply, and per 90-day supply, including amounts paid by the participants and beneficiaries, when the same drug is dispensed by other pharmacies that are not affiliated with or under common ownership with the entity and that are included in the pharmacy network of such plan or coverage; ``(cc) the lowest cost per dosage unit, per 30-day supply and per 90-day supply, for each such drug, including amounts charged to the plan or coverage and to participants and beneficiaries, that is available from any pharmacy included in the network of such plan or coverage; and ``(dd) the net acquisition cost per dosage unit, per 30-day supply, and per 90-day

supply, if such drug is subject to a maximum price discount; and ``(B) with respect to any group health plan, including group health insurance coverage offered in connection with such a plan, regardless of whether the plan or coverage is offered by a specified large employer or whether it is a specified large plan-- ``(i) a summary document for the group health plan that includes such information described in clauses (i) through (iv) of subparagraph (A), as specified by the Secretary through guidance, program instruction, or otherwise (with no requirement of notice and comment rulemaking), that the Secretary determines useful to group health plans for purposes of selecting pharmacy benefit management services, such as an estimated net price to group health plan and participant or beneficiary, a cost per claim, the fee structure or reimbursement model, and estimated cost per participant or beneficiary; ``(ii) a summary document for plans and issuers to provide to participants and beneficiaries, which shall be made available to participants or beneficiaries upon request to their group health plan (including in the case of group health insurance coverage offered in connection with such a plan), that-- ``(I) contains such information described in clauses (iii), (iv), (v), and (vi), as applicable, as specified by the Secretary through guidance, program instruction, or otherwise (with no requirement of notice and comment rulemaking) that the Secretary determines useful to participants or beneficiaries in better understanding the plan or coverage or benefits under such plan or coverage; ``(II) contains only aggregate information; and ``(III) states that participants and beneficiaries may request specific, claims-level information required to be furnished under subsection (c) from the group health plan or health insurance issuer; and ``(iii) with respect to drugs covered by such plan or coverage during such reporting period-- ``(I) the total net spending by the plan or coverage for all such drugs; ``(II) the total amount received, or expected to be received, by the plan or issuer from any applicable entity in rebates, fees, alternative discounts, or other remuneration; and ``(III) to the extent feasible, information on the total amount of remuneration for such drugs, including copayment assistance dollars paid, copayment cards applied, or other discounts provided by each drug manufacturer (or entity administering copayment assistance on behalf of such drug manufacturer) to participants and beneficiaries; ``(iv) amounts paid directly or indirectly in rebates, fees, or any other type of compensation (as defined

in section 408(b)(2)(B)(ii)(dd)(AA)) to brokerage firms, brokers, consultants, advisors, or any other individual or firm, for-- ``(I) the referral of the group health plan's or health insurance issuer's business to an entity providing pharmacy benefit management services, including the identity of the recipient of such amounts; ``(II) consideration of the entity providing pharmacy benefit management services by the group health plan or health insurance issuer; or ``(III) the retention of the entity by the group health plan or health insurance issuer; ``(v) an explanation of any benefit design parameters that encourage or require participants and beneficiaries in such plan or coverage to fill prescriptions at mail order, specialty, or retail pharmacies that are affiliated with or under common ownership with the entity providing pharmacy benefit management services under such plan or coverage, including mandatory mail and specialty home delivery programs, retail and mail auto-refill programs, and cost-sharing assistance incentives directly or indirectly funded by such entity; and ``(vi) total gross spending on all drugs under the plan or coverage during the reporting period. ``(3) Opt-in for group health insurance coverage offered by a specified large employer or that is a specified large plan.--In the case of group health insurance coverage offered in connection with a group health plan that is offered by a specified large employer or is a specified large plan, such group health plan may, on an annual basis, for plan years beginning on or after the date that is 30 months after the date of enactment of this section, elect to require an entity providing pharmacy benefit management services on behalf of the health insurance issuer to submit to such group health plan a report that includes all of the information described in paragraph (2)(A), in addition to the information described in paragraph (2)(B). ``(4) Privacy requirements.-- ``(A) In general.--An entity providing pharmacy benefit management services on behalf of a group health plan or a health insurance issuer offering group health insurance coverage shall report information under paragraph (1) in a manner consistent with the privacy regulations promulgated under section 13402(a) of the Health Information Technology for Economic and Clinical Health Act (42 U.S.C. 17932(a)) and consistent with the privacy regulations promulgated under the Health Insurance Portability and Accountability Act of 1996 in part 160 and subparts A and E of part 164 of title 45, Code of Federal Regulations (or successor regulations) (referred to in this paragraph as the `HIPAA privacy regulations') and shall restrict the use and disclosure of such information according to such privacy regulations and such HIPAA privacy regulations. ``(B) Additional requirements.--

``(i) In general.--An entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer offering group health insurance coverage that submits a report under paragraph (1) shall ensure that such report contains only summary health information, as defined in section 164.504(a) of title 45, Code of Federal Regulations (or successor regulations). ``(ii) Restrictions.--In carrying out this subsection, a group health plan shall comply with section 164.504(f) of title 45, Code of Federal Regulations (or a successor regulation), and a plan sponsor shall act in accordance with the terms of the agreement described in such section. ``(C) Rule of construction.-- ``(i) Nothing in this section shall be construed to modify the requirements for the creation, receipt, maintenance, or transmission of protected health information under the HIPAA privacy regulations. ``(ii) Nothing in this section shall be construed to affect the application of any Federal or State privacy or civil rights law, including the HIPAA privacy regulations, the Genetic Information Nondiscrimination Act of 2008 (Public Law 110-233) (including the amendments made by such Act), the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), section 1557 of the Patient Protection and Affordable Care Act (42 U.S.C. 18116), title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and title VII of the Civil Rights Act of 1964 (42 U.S.C. 2000e). ``(D) Written notice.--Each plan year, group health plans, including with respect to group health insurance coverage offered in connection with a group health plan, shall provide to each participant or beneficiary written notice informing the participant or beneficiary of the requirement for entities providing pharmacy benefit management services on behalf of the group health plan or health insurance issuer offering group health insurance coverage to submit reports to group health plans under paragraph (1), as applicable, which may include incorporating such notification in plan documents provided to the participant or beneficiary, or providing individual notification. ``(E) Limitation to business associates.--A group health plan receiving a report under paragraph (1) may disclose such information only to the entity from which the report was received or to that entity's business associates as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations) or as permitted by the HIPAA privacy regulations. ``(F) Clarification regarding public disclosure of information.--Nothing in this section shall prevent an entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer offering group health insurance coverage, from placing reasonable restrictions on the public disclosure of the

information contained in a report described in paragraph (1), except that such plan, issuer, or entity may not-- ``(i) restrict disclosure of such report to the Department of Health and Human Services, the Department of Labor, or the Department of the Treasury; or ``(ii) prevent disclosure for the purposes of subsection (c), or any other public disclosure requirement under this section. ``(G) Limited form of report.--The Secretary shall define through rulemaking a limited form of the report under paragraph (1) required with respect to any group health plan established by a plan sponsor that is, or is affiliated with, a drug manufacturer, drug wholesaler, or other direct participant in the drug supply chain, in order to prevent anti-competitive behavior. ``(5) Standard format and regulations.-- ``(A) In general.--Not later than 18 months after the date of enactment of this section, the Secretary shall specify through rulemaking a standard format for entities providing pharmacy benefit management services on behalf of group health plans and health insurance issuers offering group health insurance coverage, to submit reports required under paragraph (1). ``(B) Additional regulations.--Not later than 18 months after the date of enactment of this section, the Secretary shall, through rulemaking, promulgate any other final regulations necessary to implement the requirements of this section. In promulgating such regulations, the Secretary shall, to the extent practicable, align the reporting requirements under this section with the reporting requirements under section 725.

``(c) Requirement To Provide Information to Participants or Beneficiaries.--A group health plan, including with respect to group health insurance coverage offered in connection with a group health plan, upon request of a participant or beneficiary, shall provide to such participant or beneficiary-- ``(1) the summary document described in subsection (b)(2)(B)(ii); and ``(2) the information described in subsection (b)(2)(A)(i)(III) with respect to a claim made by or on behalf of such participant or beneficiary.

``(d) Rule of Construction.--Nothing in this section shall be construed to permit a health insurance issuer, group health plan, entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer, or other entity to restrict disclosure to, or otherwise limit the access of, the Secretary to a report described in subsection (b)(1) or information related to compliance with subsections (a), (b), or (c) of this section or section 502(c)(13) by such issuer, plan, or entity. ``(e) Definitions.--In this section: ``(1) Applicable entity.--The term `applicable entity' means-- ``(A) an applicable group purchasing organization, drug manufacturer, distributor, wholesaler, rebate aggregator (or other purchasing entity designed to aggregate rebates), or associated third party;

``(B) any subsidiary, parent, affiliate, or subcontractor of a group health plan, health insurance issuer, entity that provides pharmacy benefit management services on behalf of such a plan or issuer, or any entity described in subparagraph (A); or ``(C) such other entity as the Secretary may specify through rulemaking. ``(2) Applicable group purchasing organization.--The term `applicable group purchasing organization' means a group purchasing organization that is affiliated with or under common ownership with an entity providing pharmacy benefit management services. ``(3) Contracted compensation.--The term `contracted compensation' means the sum of any ingredient cost and dispensing fee for a drug (inclusive of the out-of-pocket costs to the participant or beneficiary), or another analogous compensation structure that the Secretary may specify through regulations. ``(4) Gross spending.--The term `gross spending', with respect to prescription drug benefits under a group health plan or health insurance coverage, means the amount spent by a group health plan or health insurance issuer on prescription drug benefits, calculated before the application of rebates, fees, alternative discounts, or other remuneration. ``(5) Net spending.--The term `net spending', with respect to prescription drug benefits under a group health plan or health insurance coverage, means the amount spent by a group health plan or health insurance issuer on prescription drug benefits, calculated after the application of rebates, fees, alternative discounts, or other remuneration. ``(6) Plan sponsor.--The term `plan sponsor' has the meaning given such term in section 3(16)(B). ``(7) Remuneration.--The term `remuneration' has the meaning given such term by the Secretary through rulemaking, which shall be reevaluated by the Secretary every 5 years. ``(8) Specified large employer.--The term `specified large employer' means, in connection with a group health plan (including group health insurance coverage offered in connection with such a plan) established or maintained by a single employer, with respect to a calendar year or a plan year, as applicable, an employer who employed an average of at least 100 employees on business days during the preceding calendar year or plan year and who employs at least 1 employee on the first day of the calendar year or plan year. ``(9) Specified large plan.--The term `specified large plan' means a group health plan (including group health insurance coverage offered in connection with such a plan) established or maintained by a plan sponsor described in clause (ii) or (iii) of section 3(16)(B) that had an average of at least 100 participants on business days during the preceding calendar year or plan year, as applicable. ``(10) Wholesale acquisition cost.--The term `wholesale acquisition cost' has the meaning given such term in section 1847A(c)(6)(B) of the Social Security Act (42 U.S.C. 1395w- 3a(c)(6)(B)).''; (B) in section 502 (29 U.S.C. 1132)--

(i) in subsection (a)(6), by striking ``or (9)'' and inserting ``(9), or (13)''; (ii) in subsection (b)(3), by striking ``under subsection (c)(9)'' and inserting ``under paragraphs (9) and (13) of subsection (c)''; and (iii) in subsection (c), by adding at the end the following: ``(13) Secretarial enforcement authority relating to oversight of pharmacy benefit management services.-- ``(A) Failure to provide information.--The Secretary may impose a penalty against a plan administrator of a group health plan, a health insurance issuer offering group health insurance coverage, or an entity providing pharmacy benefit management services on behalf of such a plan or issuer, or an applicable entity (as defined in section 726(e)) that violates section 726(a); an entity providing pharmacy benefit management services on behalf of such a plan or issuer that fails to provide the information required under section 726(b); or any person who causes a group health plan to fail to provide the information required under section 726(c), in the amount of $10,000 for each day during which such violation continues or such information is not disclosed or reported. ``(B) False information.--The Secretary may impose a penalty against a plan administrator of a group health plan, a health insurance issuer offering group health insurance coverage, an entity providing pharmacy benefit management services, or an applicable entity (as defined in section 726(e)) that knowingly provides false information under section 726, in an amount not to exceed $100,000 for each item of false information. Such penalty shall be in addition to other penalties as may be prescribed by law. ``(C) Waivers.--The Secretary may waive penalties under subparagraph (A), or extend the period of time for compliance with a requirement of this section, for an entity in violation of section 726 that has made a good- faith effort to comply with the requirements of section 726.''; and (C) in section 732(a) (29 U.S.C. 1191a(a)), by striking ``section 711'' and inserting ``sections 711 and 726''. (2) Clerical amendment.--The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.) is amended by inserting after the item relating to section 725 the following new item:

``Sec. 726. Oversight of entities that provide pharmacy benefit management services.''.

(c) Internal Revenue Code of 1986.-- (1) In general.--Chapter 100 of the Internal Revenue Code of 1986 is amended-- (A) by adding at the end of subchapter B the following: ``SEC. 9826. OVERSIGHT OF ENTITIES THAT PROVIDE PHARMACY BENEFIT MANAGEMENT SERVICES.

``(a) In General.--For plan years beginning on or after the date that is 30 months after the date of enactment of this section (referred to in this subsection and subsection (b) as the `effective

date'), a group health plan, or an entity providing pharmacy benefit management services on behalf of such a plan, shall not enter into a contract, including an extension or renewal of a contract, entered into on or after the effective date, with an applicable entity unless such applicable entity agrees to-- ``(1) not limit or delay the disclosure of information to the group health plan in such a manner that prevents an entity providing pharmacy benefit management services on behalf of a group health plan from making the reports described in subsection (b); and ``(2) provide the entity providing pharmacy benefit management services on behalf of a group health plan relevant information necessary to make the reports described in subsection (b).

``(b) Reports.-- ``(1) In general.--For plan years beginning on or after the effective date, in the case of any contract between a group health plan and an entity providing pharmacy benefit management services on behalf of such plan, including an extension or renewal of such a contract, entered into on or after the effective date, the entity providing pharmacy benefit management services on behalf of such a group health plan, not less frequently than every 6 months (or, at the request of a group health plan, not less frequently than quarterly, and under the same conditions, terms, and cost of the semiannual report under this subsection), shall submit to the group health plan a report in accordance with this section. Each such report shall be made available to such group health plan in plain language, in a machine-readable format, and as the Secretary may determine, other formats. Each such report shall include the information described in paragraph (2). ``(2) Information described.--For purposes of paragraph (1), the information described in this paragraph is, with respect to drugs covered by a group health plan during each reporting period-- ``(A) in the case of a group health plan that is offered by a specified large employer or that is a specified large plan, and is not offered as health insurance coverage, or in the case of health insurance coverage for which the election under paragraph (3) is made for the applicable reporting period-- ``(i) a list of drugs for which a claim was filed and, with respect to each such drug on such list-- ``(I) the contracted compensation paid by the group health plan for each covered drug (identified by the National Drug Code) to the entity providing pharmacy benefit management services or other applicable entity on behalf of the group health plan; ``(II) the contracted compensation paid to the pharmacy, by any entity providing pharmacy benefit management services or other applicable entity on behalf of the group health plan, for each covered drug (identified by the National Drug Code); ``(III) for each such claim, the difference between the amount paid under subclause (I) and the amount paid under subclause (II);

``(IV) the proprietary name, established name or proper name, and the National Drug Code; ``(V) for each claim for the drug (including original prescriptions and refills) and for each dosage unit of the drug for which a claim was filed, the type of dispensing channel used to furnish the drug, including retail, mail order, or specialty pharmacy; ``(VI) with respect to each drug dispensed, for each type of dispensing channel (including retail, mail order, or specialty pharmacy)-- ``(aa) whether such drug is a brand name drug or a generic drug, and-- ``(AA) in the case of a brand name drug, the wholesale acquisition cost, listed as cost per days supply and cost per dosage unit, on the date such drug was dispensed; and ``(BB) in the case of a generic drug, the average wholesale price, listed as cost per days supply and cost per dosage unit, on the date such drug was dispensed; and ``(bb) the total number of-- ``(AA) prescription claims (including original prescriptions and refills); ``(BB) participants and beneficiaries for whom a claim for such drug was filed through the applicable dispensing channel; ``(CC) dosage units and dosage units per fill of such drug; and ``(DD) days supply of such drug per fill; ``(VII) the net price per course of treatment or single fill, such as a 30- day supply or 90-day supply to the plan after rebates, fees, alternative discounts, or other remuneration received from applicable entities; ``(VIII) the total amount of out-of- pocket spending by participants and beneficiaries on such drug, including spending through copayments, coinsurance, and deductibles, but not including any amounts spent by participants and beneficiaries on drugs not covered under the plan, or for which no claim is submitted under the plan; ``(IX) the total net spending on the drug; ``(X) the total amount received, or expected to be received, by the plan from any applicable entity in rebates, fees, alternative discounts, or other remuneration; ``(XI) the total amount received, or expected to be received, by the entity providing pharmacy benefit management services, from applicable entities, in rebates, fees, alternative discounts, or other remuneration from such entities-- ``(aa) for claims incurred during the reporting period; and

``(bb) that is related to utilization of such drug or spending on such drug; and ``(XII) to the extent feasible, information on the total amount of remuneration for such drug, including copayment assistance dollars paid, copayment cards applied, or other discounts provided by each drug manufacturer (or entity administering copayment assistance on behalf of such drug manufacturer), to the participants and beneficiaries enrolled in such plan; ``(ii) a list of each therapeutic class (as defined by the Secretary) for which a claim was filed under the group health plan during the reporting period, and, with respect to each such therapeutic class-- ``(I) the total gross spending on drugs in such class before rebates, price concessions, alternative discounts, or other remuneration from applicable entities; ``(II) the net spending in such class after such rebates, price concessions, alternative discounts, or other remuneration from applicable entities; ``(III) the total amount received, or expected to be received, by the entity providing pharmacy benefit management services, from applicable entities, in rebates, fees, alternative discounts, or other remuneration from such entities-- ``(aa) for claims incurred during the reporting period; and ``(bb) that is related to utilization of drugs or drug spending; ``(IV) the average net spending per 30-day supply and per 90-day supply by the plan and its participants and beneficiaries, among all drugs within the therapeutic class for which a claim was filed during the reporting period; ``(V) the number of participants and beneficiaries who filled a prescription for a drug in such class, including the National Drug Code for each such drug; ``(VI) if applicable, a description of the formulary tiers and utilization mechanisms (such as prior authorization or step therapy) employed for drugs in that class; and ``(VII) the total out-of-pocket spending under the plan by participants and beneficiaries, including spending through copayments, coinsurance, and deductibles, but not including any amounts spent by participants and beneficiaries on drugs not covered under the plan or for which no claim is submitted under the plan; ``(iii) with respect to any drug for which gross spending under the group health plan exceeded $10,000 during the reporting period or, in the case that gross spending under the group health plan exceeded $10,000 during the reporting period with respect to fewer than 50 drugs, with respect to the 50 prescription drugs

with the highest spending during the reporting period-- ``(I) a list of all other drugs in the same therapeutic class as such drug; ``(II) if applicable, the rationale for the formulary placement of such drug in that therapeutic category or class, selected from a list of standard rationales established by the Secretary, in consultation with stakeholders; and ``(III) any change in formulary placement compared to the prior plan year; and ``(iv) in the case that such plan (or an entity providing pharmacy benefit management services on behalf of such plan) has an affiliated pharmacy or pharmacy under common ownership, including mandatory mail and specialty home delivery programs, retail and mail auto-refill programs, and cost sharing assistance incentives funded by an entity providing pharmacy benefit services-- ``(I) an explanation of any benefit design parameters that encourage or require participants and beneficiaries in the plan to fill prescriptions at mail order, specialty, or retail pharmacies; ``(II) the percentage of total prescriptions dispensed by such pharmacies to participants or beneficiaries in such plan; and ``(III) a list of all drugs dispensed by such pharmacies to participants or beneficiaries enrolled in such plan, and, with respect to each drug dispensed-- ``(aa) the amount charged, per dosage unit, per 30-day supply, or per 90-day supply (as applicable) to the plan, and to participants and beneficiaries; ``(bb) the median amount charged to such plan, and the interquartile range of the costs, per dosage unit, per 30- day supply, and per 90-day supply, including amounts paid by the participants and beneficiaries, when the same drug is dispensed by other pharmacies that are not affiliated with or under common ownership with the entity and that are included in the pharmacy network of such plan; ``(cc) the lowest cost per dosage unit, per 30-day supply and per 90-day supply, for each such drug, including amounts charged to the plan and to participants and beneficiaries, that is available from any pharmacy included in the network of such plan; and ``(dd) the net acquisition cost per dosage unit, per 30-day supply, and per 90-day supply, if such drug is subject to a maximum price discount; and ``(B) with respect to any group health plan, regardless of whether the plan is offered by a specified large employer or whether it is a specified large plan--

``(i) a summary document for the group health plan that includes such information described in clauses (i) through (iv) of subparagraph (A), as specified by the Secretary through guidance, program instruction, or otherwise (with no requirement of notice and comment rulemaking), that the Secretary determines useful to group health plans for purposes of selecting pharmacy benefit management services, such as an estimated net price to group health plan and participant or beneficiary, a cost per claim, the fee structure or reimbursement model, and estimated cost per participant or beneficiary; ``(ii) a summary document for plans to provide to participants and beneficiaries, which shall be made available to participants or beneficiaries upon request to their group health plan, that-- ``(I) contains such information described in clauses (iii), (iv), (v), and (vi), as applicable, as specified by the Secretary through guidance, program instruction, or otherwise (with no requirement of notice and comment rulemaking) that the Secretary determines useful to participants or beneficiaries in better understanding the plan or benefits under such plan; ``(II) contains only aggregate information; and ``(III) states that participants and beneficiaries may request specific, claims-level information required to be furnished under subsection (c) from the group health plan; and ``(iii) with respect to drugs covered by such plan during such reporting period-- ``(I) the total net spending by the plan for all such drugs; ``(II) the total amount received, or expected to be received, by the plan from any applicable entity in rebates, fees, alternative discounts, or other remuneration; and ``(III) to the extent feasible, information on the total amount of remuneration for such drugs, including copayment assistance dollars paid, copayment cards applied, or other discounts provided by each drug manufacturer (or entity administering copayment assistance on behalf of such drug manufacturer) to participants and beneficiaries; ``(iv) amounts paid directly or indirectly in rebates, fees, or any other type of compensation (as defined in section 408(b)(2)(B)(ii)(dd)(AA) of the Employee Retirement Income Security Act (29 U.S.C. 1108(b)(2)(B)(ii)(dd)(AA))) to brokerage firms, brokers, consultants, advisors, or any other individual or firm, for-- ``(I) the referral of the group health plan's business to an entity providing pharmacy benefit management services, including the identity of the recipient of such amounts;

``(II) consideration of the entity providing pharmacy benefit management services by the group health plan; or ``(III) the retention of the entity by the group health plan; ``(v) an explanation of any benefit design parameters that encourage or require participants and beneficiaries in such plan to fill prescriptions at mail order, specialty, or retail pharmacies that are affiliated with or under common ownership with the entity providing pharmacy benefit management services under such plan, including mandatory mail and specialty home delivery programs, retail and mail auto-refill programs, and cost-sharing assistance incentives directly or indirectly funded by such entity; and ``(vi) total gross spending on all drugs under the plan during the reporting period. ``(3) Opt-in for group health insurance coverage offered by a specified large employer or that is a specified large plan.-- In the case of group health insurance coverage offered in connection with a group health plan that is offered by a specified large employer or is a specified large plan, such group health plan may, on an annual basis, for plan years beginning on or after the date that is 30 months after the date of enactment of this section, elect to require an entity providing pharmacy benefit management services on behalf of the health insurance issuer to submit to such group health plan a report that includes all of the information described in paragraph (2)(A), in addition to the information described in paragraph (2)(B). ``(4) Privacy requirements.-- ``(A) In general.--An entity providing pharmacy benefit management services on behalf of a group health plan shall report information under paragraph (1) in a manner consistent with the privacy regulations promulgated under section 13402(a) of the Health Information Technology for Economic and Clinical Health Act (42 U.S.C. 17932(a)) and consistent with the privacy regulations promulgated under the Health Insurance Portability and Accountability Act of 1996 in part 160 and subparts A and E of part 164 of title 45, Code of Federal Regulations (or successor regulations) (referred to in this paragraph as the `HIPAA privacy regulations') and shall restrict the use and disclosure of such information according to such privacy regulations and such HIPAA privacy regulations. ``(B) Additional requirements.-- ``(i) In general.--An entity providing pharmacy benefit management services on behalf of a group health plan that submits a report under paragraph (1) shall ensure that such report contains only summary health information, as defined in section 164.504(a) of title 45, Code of Federal Regulations (or successor regulations). ``(ii) Restrictions.--In carrying out this subsection, a group health plan shall comply with section 164.504(f) of title 45, Code of Federal Regulations (or a successor regulation), and a plan sponsor shall act

in accordance with the terms of the agreement described in such section. ``(C) Rule of construction.-- ``(i) Nothing in this section shall be construed to modify the requirements for the creation, receipt, maintenance, or transmission of protected health information under the HIPAA privacy regulations. ``(ii) Nothing in this section shall be construed to affect the application of any Federal or State privacy or civil rights law, including the HIPAA privacy regulations, the Genetic Information Nondiscrimination Act of 2008 (Public Law 110-233) (including the amendments made by such Act), the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), section 1557 of the Patient Protection and Affordable Care Act (42 U.S.C. 18116), title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and title VII of the Civil Rights Act of 1964 (42 U.S.C. 2000e). ``(D) Written notice.--Each plan year, group health plans shall provide to each participant or beneficiary written notice informing the participant or beneficiary of the requirement for entities providing pharmacy benefit management services on behalf of the group health plan to submit reports to group health plans under paragraph (1), as applicable, which may include incorporating such notification in plan documents provided to the participant or beneficiary, or providing individual notification. ``(E) Limitation to business associates.--A group health plan receiving a report under paragraph (1) may disclose such information only to the entity from which the report was received or to that entity's business associates as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations) or as permitted by the HIPAA privacy regulations. ``(F) Clarification regarding public disclosure of information.--Nothing in this section shall prevent an entity providing pharmacy benefit management services on behalf of a group health plan, from placing reasonable restrictions on the public disclosure of the information contained in a report described in paragraph (1), except that such plan or entity may not-- ``(i) restrict disclosure of such report to the Department of Health and Human Services, the Department of Labor, or the Department of the Treasury; or ``(ii) prevent disclosure for the purposes of subsection (c), or any other public disclosure requirement under this section. ``(G) Limited form of report.--The Secretary shall define through rulemaking a limited form of the report under paragraph (1) required with respect to any group health plan established by a plan sponsor that is, or is affiliated with, a drug manufacturer, drug wholesaler, or other direct participant in the drug supply chain, in order to prevent anti-competitive behavior. ``(5) Standard format and regulations.--

``(A) In general.--Not later than 18 months after the date of enactment of this section, the Secretary shall specify through rulemaking a standard format for entities providing pharmacy benefit management services on behalf of group health plans, to submit reports required under paragraph (1). ``(B) Additional regulations.--Not later than 18 months after the date of enactment of this section, the Secretary shall, through rulemaking, promulgate any other final regulations necessary to implement the requirements of this section. In promulgating such regulations, the Secretary shall, to the extent practicable, align the reporting requirements under this section with the reporting requirements under section 9825.

``(c) Requirement To Provide Information to Participants or Beneficiaries.--A group health plan, upon request of a participant or beneficiary, shall provide to such participant or beneficiary-- ``(1) the summary document described in subsection (b)(2)(B)(ii); and ``(2) the information described in subsection (b)(2)(A)(i)(III) with respect to a claim made by or on behalf of such participant or beneficiary.

``(d) Rule of Construction.--Nothing in this section shall be construed to permit a health insurance issuer, group health plan, entity providing pharmacy benefit management services on behalf of a group health plan or health insurance issuer, or other entity to restrict disclosure to, or otherwise limit the access of, the Secretary to a report described in subsection (b)(1) or information related to compliance with subsections (a), (b), or (c) of this section or section 4980D(g) by such issuer, plan, or entity. ``(e) Definitions.--In this section: ``(1) Applicable entity.--The term `applicable entity' means-- ``(A) an applicable group purchasing organization, drug manufacturer, distributor, wholesaler, rebate aggregator (or other purchasing entity designed to aggregate rebates), or associated third party; ``(B) any subsidiary, parent, affiliate, or subcontractor of a group health plan, health insurance issuer, entity that provides pharmacy benefit management services on behalf of such a plan or issuer, or any entity described in subparagraph (A); or ``(C) such other entity as the Secretary may specify through rulemaking. ``(2) Applicable group purchasing organization.--The term `applicable group purchasing organization' means a group purchasing organization that is affiliated with or under common ownership with an entity providing pharmacy benefit management services. ``(3) Contracted compensation.--The term `contracted compensation' means the sum of any ingredient cost and dispensing fee for a drug (inclusive of the out-of-pocket costs to the participant or beneficiary), or another analogous compensation structure that the Secretary may specify through regulations.

``(4) Gross spending.--The term `gross spending', with respect to prescription drug benefits under a group health plan, means the amount spent by a group health plan on prescription drug benefits, calculated before the application of rebates, fees, alternative discounts, or other remuneration. ``(5) Net spending.--The term `net spending', with respect to prescription drug benefits under a group health plan, means the amount spent by a group health plan on prescription drug benefits, calculated after the application of rebates, fees, alternative discounts, or other remuneration. ``(6) Plan sponsor.--The term `plan sponsor' has the meaning given such term in section 3(16)(B) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(16)(B)). ``(7) Remuneration.--The term `remuneration' has the meaning given such term by the Secretary, through rulemaking, which shall be reevaluated by the Secretary every 5 years. ``(8) Specified large employer.--The term `specified large employer' means, in connection with a group health plan established or maintained by a single employer, with respect to a calendar year or a plan year, as applicable, an employer who employed an average of at least 100 employees on business days during the preceding calendar year or plan year and who employs at least 1 employee on the first day of the calendar year or plan year. ``(9) Specified large plan.--The term `specified large plan' means a group health plan established or maintained by a plan sponsor described in clause (ii) or (iii) of section 3(16)(B) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(16)(B)) that had an average of at least 100 participants on business days during the preceding calendar year or plan year, as applicable. ``(10) Wholesale acquisition cost.--The term `wholesale acquisition cost' has the meaning given such term in section 1847A(c)(6)(B) of the Social Security Act (42 U.S.C. 1395w- 3a(c)(6)(B)).''; (2) Exception for certain group health plans.--Section 9831(a)(2) of the Internal Revenue Code of <<NOTE: 26 USC 9831.>> 1986 is amended by inserting ``other than with respect to section 9826,'' before ``any group health plan''. (3) Enforcement.--Section 4980D of the Internal Revenue Code of 1986 is amended by adding at the end the following new subsection:

``(g) Application to Requirements Imposed on Certain Entities Providing Pharmacy Benefit Management Services.--In the case of any requirement under section 9826 that applies with respect to an entity providing pharmacy benefit management services on behalf of a group health plan, any reference in this section to such group health plan (and the reference in subsection (e)(1) to the employer) shall be treated as including a reference to such entity.''.

(4) Clerical amendment.--The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by adding at the end the following new item:

``Sec. 9826. Oversight of entities that provide pharmacy benefit management services.''.

PLAN; EXCEPTION FOR INNOCENT PLAN FIDUCIARIES.

(a) In General.--Section 408(b)(2) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2)) is amended-- (1) in subparagraph (B)(viii)-- (A) by redesignating subclauses (II) through (IV) as subclauses (III) through (V), respectively; (B) in subclause (I)-- (i) by striking ``subclause (II)'' and inserting ``subclause (III)''; and (ii) by striking ``subclauses (II) and (III)'' and inserting ``subclauses (III) and (IV)''; and (C) by inserting after subclause (I) the following: ``(II) Pursuant to subsection (a), subparagraphs (C) and (D) of section 406(a)(1) shall not apply to a responsible plan fiduciary, notwithstanding any failure to remit required amounts under subparagraph (C)(i), if the following conditions are met: ``(aa) The responsible plan fiduciary did not know that the covered service provider failed or would fail to make required remittances and reasonably believed that the covered service provider remitted such required amounts. ``(bb) The responsible plan fiduciary, upon discovering that the covered service provider failed to remit the required amounts, requests in writing that the covered service provider remit such amounts. ``(cc) If the covered service provider fails to comply with a written request described in subclause (III) within 90 days of the request, the responsible plan fiduciary notifies the Secretary of the covered service provider's failure, in accordance with subclauses (III) and (IV).''; and (2) by adding at the end the following: ``(C)(i)(I) For plan years beginning on or after the date that is 30 months after the date of enactment of this subparagraph (referred to in this clause as the `effective date'), no contract or arrangement or renewal or extension of a contract or arrangement, entered into on or after the effective date, for services between a covered plan and a covered service provider (or between a sponsor of a covered plan and a covered service provider), through a health insurance issuer offering group health insurance coverage, a third-party administrator, an entity providing pharmacy benefit management services, or other entity, for pharmacy benefit management services, is reasonable within the meaning of this paragraph unless such entity providing pharmacy benefit management services-- ``(aa) remits 100 percent of rebates, fees, alternative discounts, and other remuneration received from any applicable entity that are related to utilization of drugs or drug spending under such health plan or health insurance coverage, to the group health plan or, in the case of a health insurance issuer offering group health insurance

coverage in connection with a group health plan, to the health insurance issuer offering group health insurance coverage on behalf of the plan; and ``(bb) does not enter into any contract for pharmacy benefit management services on behalf of such a plan or coverage, with an applicable entity unless 100 percent of rebates, fees, alternative discounts, and other remuneration received under such contract that are related to the utilization of drugs or drug spending under such group health plan or health insurance coverage are remitted to the group health plan or, in the case of a health insurance issuer offering group health insurance coverage in connection with a group health plan, to the health insurance issuer on behalf of the plan by the entity providing pharmacy benefit management services. ``(II) Nothing in subclause (I) shall be construed to affect the term of a contract or arrangement, as in effect on the effective date (as described in such subclause), except that such subclause shall apply to any renewal or extension of such a contract or arrangement entered into on or after such effective date, as so described.

``(ii) With respect to such rebates, fees, alternative discounts, and other remuneration-- ``(I) the rebates, fees, alternative discounts, and other remuneration under clause (i)(I) shall be-- ``(aa) remitted-- ``(AA) on a quarterly basis, to the group health plan or, in the case of a health insurance issuer offering group health insurance coverage in connection with a group health plan, to the group health insurance issuer on behalf of the plan, not later than 90 days after the end of each quarter; or ``(BB) in the case of an underpayment in a remittance for a prior quarter, as soon as practicable, but not later than 90 days after notice of the underpayment is first given; ``(bb) fully disclosed and enumerated to the group health plan or health insurance issuer; and ``(cc) returned to the covered service provider for pharmacy benefit management services on behalf of the group health plan if any audit by a plan sponsor, issuer or a third party designated by a plan sponsor, indicates that the amounts received are in excess of correct amounts after such amounts have been paid to the group health plan, in the amount of such excess; ``(II) the Secretary may issue regulations governing-- ``(aa) procedures for the remittance of rebates, fees, alternative discounts, and other remuneration under subclause (I)(aa); ``(bb) any audit pursuant to this subparagraph; and ``(cc) the timing, manner, and content of the disclosure of rebates, fees, alternative discounts, and other remuneration under subclause (I)(bb) as well as any other information the Secretary determines necessary for the responsible plan fiduciary to consider the reasonableness of the contract or arrangement (provided that such information does not

include personally identifiable health information or protected health information subject to established individual privacy and nondiscrimination requirements under law); and ``(III) the records of such rebates, fees, alternative discounts, other remuneration, and disclosures, shall be available for audit by the plan (or the plan sponsor, issuer, or a third party designated by a plan sponsor on behalf of the plan), not less than once per plan year.

``(iii) To ensure that an entity providing pharmacy benefit management services is able to meet the requirements of clause (ii)(I), a rebate aggregator (or other purchasing entity designed to aggregate rebates) and an applicable group purchasing organization shall remit such rebates to the entity providing pharmacy benefit management services not later than 45 days after the end of each quarter.

``(iv) A third-party administrator of a group health plan, a health insurance issuer offering group health insurance coverage, or a covered service provider for pharmacy benefit management services under such health plan or health insurance coverage shall make rebate contracts with rebate aggregators or drug manufacturers available for audit by such plan, subject to reasonable restrictions (as determined by the Secretary) on confidentiality to prevent re-disclosure of such contracts or use of such information in audits for purposes unrelated to this section.

``(v) Audits carried out under clauses (ii)(III) and (iv) shall be performed by an auditor selected by the responsible plan fiduciary. Payment for such auditors shall not be made, whether directly or indirectly, by the entity providing pharmacy benefit management services. ``(vi) Nothing in this subparagraph shall be construed to-- ``(I) prohibit reasonable payments to entities offering pharmacy benefit management services for bona fide services using a fee structure not described in this subparagraph, provided that such fees are transparent and quantifiable to group health plans and health insurance issuers; ``(II) require a third-party administrator of a group health plan or covered service provider for pharmacy benefit management services under such health plan or health insurance coverage to remit bona fide service fees to the group health plan; ``(III) limit the ability of a group health plan or health insurance issuer to pass through rebates, fees, alternative discounts, and other remuneration to the participant or beneficiary; ``(IV) modify the requirements for the creation, receipt, maintenance, or transmission of protected health information under the privacy regulations promulgated under the Health Insurance Portability and Accountability Act of 1996 in part 160 and subparts A and E of part 164 of title 45, Code of Federal Regulations (or successor regulations); or ``(V) limit any requirement under subparagraph (A) or (B).

``(vii) For purposes of this subparagraph-- ``(I) the terms `applicable entity' and `applicable group purchasing organization' have the meanings given such terms in section 726(e);

``(II) the terms `covered plan', `covered service provider', and `responsible plan fiduciary' have the meanings given such terms in subparagraph (B); and ``(III) the terms `group health insurance coverage', `health insurance coverage', and `health insurance issuer' have the meanings given such terms in section 733.''.

(b) Rule of Construction.--Subclause (II)(aa) of section 408(b)(2)(B)(viii) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2)(B)(viii)), as amended by subsection (a), shall not be construed to relieve or limit a responsible plan fiduciary from the duty to monitor the practices of any covered service provider that contracts with the applicable covered plan, including for the purposes of ensuring the reasonableness of compensation. For purposes of this subsection, the terms ``covered plan'', ``covered service provider'', and ``responsible plan fiduciary'' have the meanings given such terms in section 408(b)(2)(B)(ii) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2)(B)(ii)).

(c) Clarification of Covered Service Provider.-- (1) Services.--Section 408(b)(2)(B)(ii)(I)(bb) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2)(B)(ii)(I)(bb)) is amended-- (A) in subitem (AA) by striking ``Brokerage services,'' and inserting ``Services (including brokerage services),''; and (B) in subitem (BB)-- (i) by striking ``Consulting,'' and inserting ``Other services,''; and (ii) by striking ``related to the development or implementation of plan design'' and all that follows through the period at the end and inserting ``including any of the following: plan design, insurance or insurance product selection (including vision and dental), recordkeeping, medical management, benefits administration selection (including vision and dental), stop-loss insurance, pharmacy benefit management services, wellness design and management services, transparency tools, group purchasing organization agreements and services, participation in and services from preferred vendor panels, disease management, compliance services, employee assistance programs, or third-party administration services, or consulting services related to any such services.''. (2) Certain arrangements for pharmacy benefit management services considered as indirect.-- (A) In general.--Section 408(b)(2)(B)(i) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2)(B)(i)) is amended-- (i) by striking ``requirements of this clause'' and inserting ``requirements of this subparagraph''; and (ii) by adding at the end the following: ``For purposes of applying section 406(a)(1)(C) with respect to a transaction described under this subparagraph or subparagraph (C), a contract or arrangement for services between a covered plan and an entity providing services to the plan, including a health insurance issuer providing health insurance coverage in connection with

the covered plan, in which such entity contracts, in connection with such plan, with a service provider for pharmacy benefit management services, shall be considered an indirect furnishing of goods, services, or facilities between the covered plan and the service provider for pharmacy benefit management services acting as the party in interest.''. (B) Exemption.--Section 408(b)(2)(B) (29 U.S.C. 1108(b)(2)(B)) of such Act is amended by adding at the end the following: ``(x) A service provider for pharmacy benefit management services that is considered to indirectly furnish goods, services, or facilities to a covered plan, as described in clause (i)(I), is entitled to relief with respect to a violation of this section provided the conditions for receiving such relief are satisfied.''. (C) Health insurance issuer and health insurance coverage defined.--Section 408(b)(2)(B)(ii)(I)(aa) of such Act (29 U.S.C. 1108(b)(2)(B)(ii)(I)(aa)) is amended by inserting before the period at the end ``and the terms `health insurance coverage' and `health insurance issuer' have the meanings given such terms in section 733(b)''. (D) Technical amendment.--Section 408(b)(2)(B)(ii)(I)(aa) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2)(B)(ii)(I)(aa)) is amended by inserting ``in'' after ``defined''. (E) Regulatory authority.--Section 408(b)(2)(B)(iii) of such Act (29 U.S.C. 1108(b)(2)(B)(iii)) is amended, in the matter preceding subclause (I), by inserting ``(in accordance with regulations issued by the Secretary addressing time, manner, and content of such disclosures)'', after ``following''.

(a) In General.--Section 505(j)(3) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355(j)(3)) is amended by adding at the end the following: ``(H)(i) Upon request (in controlled correspondence or an analogous process) by a person that has submitted or intends to submit an abbreviated application under this subsection for a drug that is required by regulation to contain one or more of the same inactive ingredients in the same concentrations as the listed drug referred to, or for which the Secretary determines there is a scientific justification for an approach that is in vitro, in whole or in part, to be used to demonstrate bioequivalence for a drug if such a drug contains one or more of the same inactive ingredients in the same concentrations as the listed drug referred to, the Secretary shall inform the person whether such drug is qualitatively and quantitatively the same as the listed drug. The Secretary may also provide such information to such a person on the Secretary's own initiative during the review of an abbreviated application under this subsection for such drug.

``(ii) Notwithstanding section 301(j), if the Secretary determines that such drug is not qualitatively or quantitatively the same as the listed drug, the Secretary shall identify and disclose to the person--

``(I) the ingredient or ingredients that cause such drug not to be qualitatively or quantitatively the same as the listed drug; and ``(II) for any ingredient for which there is an identified quantitative deviation, the amount of such deviation. ``(iii) If the Secretary determines that such drug is qualitatively and quantitatively the same as the listed drug, the Secretary shall not change or rescind such determination after the submission of an abbreviated application for such drug under this subsection unless-- ``(I) the formulation of the listed drug has been changed and the Secretary has determined that the prior listed drug formulation was withdrawn for reasons of safety or effectiveness; or ``(II) the Secretary makes a written determination that the prior determination must be changed because an error has been identified. ``(iv) If the Secretary makes a written determination described in clause (iii)(II), the Secretary shall provide notice and a copy of the written determination to the person making the request under clause (i).

``(v) The disclosures authorized under clauses (i) and (ii) are disclosures authorized by law, including for purposes of section 1905 of title 18, United States Code. This subparagraph shall not otherwise be construed to authorize the disclosure of nonpublic qualitative or quantitative information about the ingredients in a listed drug, or to affect the status, if any, of such information as trade secret or confidential commercial information for purposes of section 301(j) of this Act, section 552 of title 5, United States Code, or section 1905 of title 18, United States Code.''. (b) Guidance.-- (1) In general.-- Not later than one year after the date of enactment of this Act, the Secretary of Health and Human Services shall issue draft guidance, or update guidance, describing how the Secretary will determine whether a drug is qualitatively and quantitatively the same as the listed drug (as such terms are used in section 505(j)(3)(H) of the Federal Food, Drug, and Cosmetic Act, as added by subsection (a)), including with respect to assessing pH adjusters. (2) Process.--In issuing guidance under this subsection, the Secretary of Health and Human Services shall-- (A) publish draft guidance; (B) provide a period of at least 60 days for comment on the draft guidance; and (C) after considering any comments received and not later than one year after the close of the comment period on the draft guidance, publish final guidance.

(c) Applicability.--Section 505(j)(3)(H) of the Federal Food, Drug, and Cosmetic Act, as added by subsection (a), applies beginning on the date of enactment of this Act, irrespective of the date on which the guidance required by subsection (b) is finalized.

Approved February 3, 2026.

LEGISLATIVE HISTORY--H.R. 7148: ---------------------------------------------------------------------------

CONGRESSIONAL RECORD, Vol. 172 (2026): Jan. 22, considered and passed House. Jan. 30, considered and passed Senate, amended. Feb. 3, House considered and concurred in Senate amendments. DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2026): Feb. 3, Presidential remarks.

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