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Consolidated Appropriations Act, 2021 (P.L. 116-260)

DEC. 28, 2020

H.R. 133 (as enacted); Consolidated Appropriations Act, 2021

DATED DEC. 28, 2020
DOCUMENT ATTRIBUTES
Citations: H.R. 133 (as enacted); Consolidated Appropriations Act, 2021
[Editor's Note:

Asterisks indicate omitted text.

]

One Hundred Sixteenth Congress
of the
United States of America

AT THE SECOND SESSION

Begun and held at the City of Washington on Friday,
the third day of January, two thousand and twenty

H.R. 133

An Act

Making consolidated appropriations for the fiscal year ending September 30, 2021, providing coronavirus emergency response and relief, and for other purposes.

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

SECTION 1. SHORT TITLE.

This Act may be cited as the "Consolidated Appropriations Act, 2021".

SEC. 2. TABLE OF CONTENTS.

Sec. 1. Short title.

Sec. 2. Table of contents.

Sec. 3. References.

Sec. 4. Explanatory statement.

Sec. 5. Statement of appropriations.

Sec. 6. Availability of funds.

Sec. 7. Adjustments to compensation.

Sec. 8. Definition.

Sec. 9. Office of Management and Budget Reporting Requirement.

DIVISION A — AGRICULTURE, RURAL DEVELOPMENT, FOOD AND DRUG ADMINISTRATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2021

Title I — Agricultural Programs

Title II — Farm Production and Conservation Programs

Title III — Rural Development Programs

Title IV — Domestic Food Programs

Title V — Foreign Assistance and Related Programs

Title VI — Related Agency and Food and Drug Administration

Title VII — General Provisions

DIVISION B — COMMERCE, JUSTICE, SCIENCE, AND RELATED AGENCIES APPROPRIATIONS ACT, 2021

Title I — Department of Commerce

Title II — Department of Justice

Title III — Science

Title IV — Related Agencies

Title V — General Provisions

DIVISION C — DEPARTMENT OF DEFENSE APPROPRIATIONS ACT, 2021

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

Title IX — Overseas Contingency Operations

DIVISION D — ENERGY AND WATER DEVELOPMENT AND RELATED AGENCIES APPROPRIATIONS ACT, 2021

Title I — Corps of Engineers — Civil

Title II — Department of the Interior

Title III — Department of Energy

Title IV — Independent Agencies

Title V — General Provisions

DIVISION E — FINANCIAL SERVICES AND GENERAL GOVERNMENT APPROPRIATIONS ACT, 2021

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

Title VIII — General Provisions — District of Columbia

Title IX — General Provision — Emergency Funding

DIVISION F — DEPARTMENT OF HOMELAND SECURITY APPROPRIATIONS ACT, 2021

Title I — Departmental Management, Operations, Intelligence, and Oversight

Title II — Security, Enforcement, and Investigations

Title III — Protection, Preparedness, Response, and Recovery

Title IV — Research, Development, Training, and Services

Title V — General Provisions

DIVISION G — DEPARTMENT OF THE INTERIOR, ENVIRONMENT, AND RELATED AGENCIES APPROPRIATIONS ACT, 2021

Title I — Department of the Interior

Title II — Environmental Protection Agency

Title III — Related Agencies

Title IV — General Provisions

DIVISION H — DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2021

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 I — LEGISLATIVE BRANCH APPROPRIATIONS ACT, 2021

Title I — Legislative Branch

Title II — General Provisions

DIVISION J — MILITARY CONSTRUCTION, VETERANS AFFAIRS, AND RELATED AGENCIES APPROPRIATIONS ACT, 2021

Title I — Department of Defense

Title II — Department of Veterans Affairs

Title III — Related Agencies

Title IV — Overseas Contingency Operations

Title V — General Provisions

DIVISION K — DEPARTMENT OF STATE, FOREIGN OPERATIONS, AND RELATED PROGRAMS APPROPRIATIONS ACT, 2021

Title I — Department of State and Related Agency

Title II — United States Agency for International Development

Title III — Bilateral Economic Assistance

Title IV — International Security Assistance

Title V — Multilateral Assistance

Title VI — Export and Investment Assistance

Title VII — General Provisions

Title VIII — Nita M. Lowey Middle East Partnership for Peace Act of 2020

Title IX — Emergency Funding and Other Matters

DIVISION L — TRANSPORTATION, HOUSING AND URBAN DEVELOPMENT, AND RELATED AGENCIES APPROPRIATIONS ACT, 2021

Title I — Department of Transportation

Title II — Department of Housing and Urban Development

Title III — Related Agencies

Title IV — General Provisions — This Act

DIVISION M — CORONAVIRUS RESPONSE AND RELIEF SUPPLEMENTAL APPROPRIATIONS ACT, 2021

DIVISION N — ADDITIONAL CORONAVIRUS RESPONSE AND RELIEF

DIVISION O — EXTENSIONS AND TECHNICAL CORRECTIONS

Title I — Immigration Extensions

Title II — Commission on Black Men and Boys Corrections

Title III — U.S. Customs and Border Protection Authority to Accept Donations Extension

Title IV — Livestock Mandatory Reporting Extension

Title V — Soil Health and Income Protection Pilot Program Extension

Title VI — United States-Mexico-Canada Agreement Implementation Act Technical Corrections

Title VII — Deputy Architect of the Capitol Amendments

Title VIII — Pandemic Response Accountability Committee Amendments

Title IX — Adjustment of Status for Liberian Nationals Extension

Title X — Clean Up the Code Act of 2019

Title XI — Amendments to Provisions Relating to Child Care Centers

Title XII — Alaska Natives Extension

Title XIII — Open Technology Fund Opportunity to Contest Proposed Debarment Title XIV — Budgetary Effects

DIVISION P — NATIONAL BIO AND AGRO-DEFENSE FACILITY ACT OF 2020

DIVISION Q — FINANCIAL SERVICES PROVISIONS AND INTELLECTUAL PROPERTY

DIVISION R — PROTECTING OUR INFRASTRUCTURE OF PIPELINES AND ENHANCING SAFETY ACT OF 2020

DIVISION S — INNOVATION FOR THE ENVIRONMENT

DIVISION T — SMITHSONIAN AMERICAN WOMEN'S HISTORY MUSEUM ACT AND NATIONAL MUSEUM OF THE AMERICAN LATINO

DIVISION U — HOMELAND SECURITY AND GOVERNMENTAL AFFAIRS PROVISIONS

DIVISION V — AIRCRAFT CERTIFICATION, SAFETY, AND ACCOUNTABILITY

DIVISION W — INTELLIGENCE AUTHORIZATION ACT FOR FISCAL YEAR 2021

DIVISION X — SUPPORTING FOSTER YOUTH AND FAMILIES THROUGH THE PANDEMIC

DIVISION Y — AMERICAN MINER BENEFITS IMPROVEMENT

DIVISION Z — ENERGY ACT OF 2020

DIVISION AA — WATER RESOURCES DEVELOPMENT ACT OF 2020

DIVISION BB — PRIVATE HEALTH INSURANCE AND PUBLIC HEALTH PROVISIONS

DIVISION CC — HEALTH EXTENDERS

DIVISION DD — MONTANA WATER RIGHTS PROTECTION ACT

DIVISION EE — TAXPAYER CERTAINTY AND DISASTER TAX RELIEF ACT OF 2020

DIVISION FF — OTHER MATTER

Title I — Continuing Education at Affected Foreign Institutions and Modification of Certain Protections for Taxpayer Return Information

Title II — Public Lands

Title III — Foreign Relations and Department of State Provisions

Title IV — Senate Sergeant at Arms Cloud Services

Title V — Repeal of Requirement to Sell Certain Federal Property in Plum Island, New York

Title VI — Preventing Online Sales of E-Cigarettes to Children

Title VII — FAFSA Simplification

Title VIII — Access to Death Information Furnished to or Maintained by the Social Security Administration

Title IX — Telecommunications and Consumer Protection

Title X — Bankruptcy Relief

Title XI — Western Water and Indian Affairs

Title XII — Horseracing Integrity and Safety

Title XIII — Community Development Block Grants

Title XIV — COVID–19 Consumer Protection Act

Title XV — American COMPETE Act

Title XVI — Recording of Obligations

Title XVII — Sudan Claims Resolution

Title XVIII — Theodore Roosevelt Presidential Library Conveyance Act of 2020 Title XIX — United States-Mexico Economic Partnership Act

Title XX — Consumer Product Safety Commission Port Surveillance

Title XXI — COVID–19 Regulatory Relief and Work From Home Safety Act

* * *

DIVISION E — FINANCIAL SERVICES AND GENERAL GOVERNMENT APPROPRIATIONS ACT, 2021

TITLE I

DEPARTMENT OF THE TREASURY

* * *

INTERNAL REVENUE SERVICE

TAXPAYER SERVICES

For necessary expenses of the Internal Revenue Service to provide taxpayer services, including pre-filing assistance and education, filing and account services, taxpayer advocacy services, and other services as authorized by 5 U.S.C. 3109, at such rates as may be determined by the Commissioner, $2,555,606,000, of which not less than $11,000,000 shall be for the Tax Counseling for the Elderly Program, of which not less than $13,000,000 shall be available for low-income taxpayer clinic grants, of which not less than $30,000,000, to remain available until September 30, 2022, shall be available for the Community Volunteer Income Tax Assistance Matching Grants Program for tax return preparation assistance, and of which not less than $211,000,000 shall be available for operating expenses of the Taxpayer Advocate Service: Provided, That of the amounts made available for the Taxpayer Advocate Service, not less than $5,500,000 shall be for identity theft and refund fraud casework.

ENFORCEMENT

For necessary expenses for tax enforcement activities of the Internal Revenue Service to determine and collect owed taxes, to provide legal and litigation support, to conduct criminal investigations, to enforce criminal statutes related to violations of internal revenue laws and other financial crimes, to purchase and hire passenger motor vehicles (31 U.S.C. 1343(b)), and to provide other services as authorized by 5 U.S.C. 3109, at such rates as may be determined by the Commissioner, $5,212,622,000, of which not to exceed $250,000,000 shall remain available until September 30, 2022; of which not less than $60,257,000 shall be for the Interagency Crime and Drug Enforcement program; and of which not to exceed $15,000,000 shall be for investigative technology for the Criminal Investigation Division: Provided, That the amount made available for investigative technology for the Criminal Investigation Division shall be in addition to amounts made available for the Criminal Investigation Division under the "Operations Support" heading.

OPERATIONS SUPPORT

For necessary expenses of the Internal Revenue Service to support taxpayer services and enforcement programs, including rent payments; facilities services; printing; postage; physical security; headquarters and other IRS-wide administration activities; research and statistics of income; telecommunications; information technology development, enhancement, operations, maintenance, and security; the hire of passenger motor vehicles (31 U.S.C. 1343(b)); the operations of the Internal Revenue Service Oversight Board; and other services as authorized by 5 U.S.C. 3109, at such rates as may be determined by the Commissioner; $3,928,102,000, of which not to exceed $275,000,000 shall remain available until September 30, 2022; of which not to exceed $10,000,000 shall remain available until expended for acquisition of equipment and construction, repair and renovation of facilities; of which not to exceed $1,000,000 shall remain available until September 30, 2023, for research; of which not less than $10,000,000, to remain available until expended, shall be available for establishment of an application through which entities registering and renewing registrations in the System for Award Management may request an authenticated electronic certification stating that the entity does or does not have a seriously delinquent tax debt; and of which not to exceed $20,000 shall be for official reception and representation expenses: Provided, That not later than 30 days after the end of each quarter, the Internal Revenue Service shall submit a report to the Committees on Appropriations of the House of Representatives and the Senate and the Comptroller General of the United States detailing major information technology investments in the Internal Revenue Service Integrated Modernization Business Plan portfolio, including detailed, plain language summaries on the status of plans, costs, and results; prior results and actual expenditures of the prior quarter; upcoming deliverables and costs for the fiscal year; risks and mitigation strategies associated with ongoing work; reasons for any cost or schedule variances; and total expenditures by fiscal year: Provided further, That the Internal Revenue Service shall include, in its budget justification for fiscal year 2022, a summary of cost and schedule performance information for its major information technology systems.

BUSINESS SYSTEMS MODERNIZATION

For necessary expenses of the Internal Revenue Service's business systems modernization program, $222,724,000, to remain available until September 30, 2023, for the capital asset acquisition of information technology systems, including management and related contractual costs of said acquisitions, including related Internal Revenue Service labor costs, and contractual costs associated with operations authorized by 5 U.S.C. 3109: Provided, That not later than 30 days after the end of each quarter, the Internal Revenue Service shall submit a report to the Committees on Appropriations of the House of Representatives and the Senate and the Comptroller General of the United States detailing major information technology investments in the Internal Revenue Service Integrated Modernization Business Plan portfolio, including detailed, plain language summaries on the status of plans, costs, and results; prior results and actual expenditures of the prior quarter; upcoming deliverables and costs for the fiscal year; risks and mitigation strategies associated with ongoing work; reasons for any cost or schedule variances; and total expenditures by fiscal year.

ADMINISTRATIVE PROVISIONS — INTERNAL REVENUE SERVICE
(INCLUDING TRANSFER OF FUNDS)

SEC. 101. Not to exceed 4 percent of the appropriation made available in this Act to the Internal Revenue Service under the "Enforcement" heading, and not to exceed 5 percent of any other appropriation made available in this Act to the Internal Revenue Service, may be transferred to any other Internal Revenue Service appropriation upon the advance approval of the Committees on Appropriations of the House of Representatives and the Senate.

SEC. 102. The Internal Revenue Service shall maintain an employee training program, which shall include the following topics: taxpayers' rights, dealing courteously with taxpayers, cross-cultural relations, ethics, and the impartial application of tax law.

SEC. 103. The Internal Revenue Service shall institute and enforce policies and procedures that will safeguard the confidentiality of taxpayer information and protect taxpayers against identity theft.

SEC. 104. Funds made available by this or any other Act to the Internal Revenue Service shall be available for improved facilities and increased staffing to provide sufficient and effective 1– 800 help line service for taxpayers. The Commissioner shall continue to make improvements to the Internal Revenue Service 1– 800 help line service a priority and allocate resources necessary to enhance the response time to taxpayer communications, particularly with regard to victims of tax-related crimes.

SEC. 105. The Internal Revenue Service shall issue a notice of confirmation of any address change relating to an employer making employment tax payments, and such notice shall be sent to both the employer's former and new address and an officer or employee of the Internal Revenue Service shall give special consideration to an offer-in-compromise from a taxpayer who has been the victim of fraud by a third party payroll tax preparer.

SEC. 106. None of the funds made available under this Act may be used by the Internal Revenue Service to target citizens of the United States for exercising any right guaranteed under the First Amendment to the Constitution of the United States.

SEC. 107. None of the funds made available in this Act may be used by the Internal Revenue Service to target groups for regulatory scrutiny based on their ideological beliefs.

SEC. 108. None of funds made available by this Act to the Internal Revenue Service shall be obligated or expended on conferences that do not adhere to the procedures, verification processes, documentation requirements, and policies issued by the Chief Financial Officer, Human Capital Office, and Agency-Wide Shared Services as a result of the recommendations in the report published on May 31, 2013, by the Treasury Inspector General for Tax Administration entitled "Review of the August 2010 Small Business/Self-Employed Division's Conference in Anaheim, California" (Reference Number 2013–10–037).

SEC. 109. None of the funds made available in this Act to the Internal Revenue Service may be obligated or expended —

(1) to make a payment to any employee under a bonus, award, or recognition program; or

(2) under any hiring or personnel selection process with respect to re-hiring a former employee; unless such program or process takes into account the conduct and Federal tax compliance of such employee or former employee.

SEC. 110. None of the funds made available by this Act may be used in contravention of section 6103 of the Internal Revenue Code of 1986 (relating to confidentiality and disclosure of returns and return information).

* * *

DIVISION N — ADDITIONAL CORONAVIRUS RESPONSE AND RELIEF

* * *

Subtitle B — COVID-related Tax Relief Act of 2020

SEC. 271. SHORT TITLE; TABLE OF CONTENTS.

(a) SHORT TITLE. — This subtitle may be cited as the "COVID-related Tax Relief Act of 2020".

(b) AMENDMENT OF 1986 CODE. — Except as otherwise expressly provided, whenever in this Act an amendment or repeal is expressed in terms of an amendment to, or repeal of, a section or other provision, the reference shall be considered to be made to a section or other provision of the Internal Revenue Code of 1986.

(c) TABLE OF CONTENTS. — The table of contents of this Act is as follows:

Sec. 271. Short title; table of contents.

Sec. 272. Additional 2020 recovery rebates for individuals.

Sec. 273. Amendments to recovery rebates under the CARES Act.

Sec. 274. Extension of certain deferred payroll taxes.

Sec. 275. Regulations or guidance clarifying application of educator expense tax de-duction.

Sec. 276. Clarification of tax treatment of forgiveness of covered loans.

Sec. 277. Emergency financial aid grants.

Sec. 278. Clarification of tax treatment of certain loan forgiveness and other business financial assistance under the CARES Act.

Sec. 279. Authority to waive certain information reporting requirements.

Sec. 280. Application of special rules to money purchase pension plans.

Sec. 281. Election to waive application of certain modifications to farming losses.

Sec. 282. Oversight and audit reporting.

Sec. 283. Disclosures to identify tax receivables not eligible for collection pursuant to qualified tax collection contracts.

Sec. 284. Modification of certain protections for taxpayer return information.

Sec. 285. 2020 election to terminate transfer period for qualified transfers from pension plan for covering future retiree costs.

Sec. 286. Extension of credits for paid sick and family leave.

Sec. 287. Election to use prior year net earnings from self-employment in deter-mining average daily self-employment income for purposes of credits for paid sick and family leave.

Sec. 288. Certain technical improvements to credits for paid sick and family leave.

SEC. 272. ADDITIONAL 2020 RECOVERY REBATES FOR INDIVIDUALS.

(a) IN GENERAL. — Subchapter B of chapter 65 of subtitle F is amended by inserting after section 6428 the following new section:

"SEC. 6428A. ADDITIONAL 2020 RECOVERY REBATES FOR INDIVIDUALS.

"(a) IN GENERAL. — In addition to the credit allowed under section 6428, in the case of an eligible individual, there shall be allowed as a credit against the tax imposed by subtitle A for the first taxable year beginning in 2020 an amount equal to the sum of —

"(1) $600 ($1,200 in the case of eligible individuals filing a joint return), plus

"(2) an amount equal to the product of $600 multiplied by the number of qualifying children (within the meaning of section 24(c)) of the taxpayer.

"(b) TREATMENT OF CREDIT. — The credit allowed by subsection (a) shall be treated as allowed by subpart C of part IV of subchapter A of chapter 1.

"(c) LIMITATION BASED ON ADJUSTED GROSS INCOME. — The amount of the credit allowed by subsection (a) (determined without regard to this subsection and subsection (e)) shall be reduced (but not below zero) by 5 percent of so much of the taxpayer's adjusted gross income as exceeds —

"(1) $150,000 in the case of a joint return or a surviving spouse (as defined in section 2(a)),

"(2) $112,500 in the case of a head of household (as defined in section 2(b)), and

"(3) $75,000 in the case of a taxpayer not described in paragraph (1) or (2).

"(d) ELIGIBLE INDIVIDUAL. — For purposes of this section, the term 'eligible individual' means any individual other than —

"(1) any nonresident alien individual,

"(2) any individual with respect to whom a deduction under section 151 is allowable to another taxpayer for a taxable year beginning in the calendar year in which the individual's taxable year begins, and

"(3) an estate or trust.

"(e) COORDINATION WITH ADVANCE REFUNDS OF CREDIT. —

"(1) IN GENERAL. — The amount of the credit which would (but for this paragraph) be allowable under this section shall be reduced (but not below zero) by the aggregate refunds and credits made or allowed to the taxpayer under subsection (f). Any failure to so reduce the credit shall be treated as arising out of a mathematical or clerical error and assessed according to section 6213(b)(1).

"(2) JOINT RETURNS. — Except as otherwise provided by the Secretary, in the case of a refund or credit made or allowed under subsection (f) with respect to a joint return, half of such refund or credit shall be treated as having been made or allowed to each individual filing such return. "(f) ADVANCE REFUNDS AND CREDITS. —

"(1) IN GENERAL. — Each individual who was an eligible individual for such individual's first taxable year beginning in 2019 shall be treated as having made a payment against the tax imposed by chapter 1 for such taxable year in an amount equal to the advance refund amount for such taxable year.

"(2) ADVANCE REFUND AMOUNT. — For purposes of paragraph (1), the advance refund amount is the amount that would have been allowed as a credit under this section for such taxable year if this section (other than subsection (e) and this subsection) had applied to such taxable year. For purposes of determining the advance refund amount with respect to such taxable year —

"(A) any individual who was deceased before January 1, 2020, shall be treated for purposes of applying subsection (g) in the same manner as if the valid identification number of such person was not included on the return of tax for such taxable year, and

"(B) no amount shall be determined under this sub-section with respect to any qualifying child of the taxpayer if —

"(i) the taxpayer was deceased before January 1, 2020, or

"(ii) in the case of a joint return, both taxpayers were deceased before January 1, 2020.

"(3) TIMING AND MANNER OF PAYMENTS. —

"(A) TIMING. —

"(i) IN GENERAL. — The Secretary shall, subject to the provisions of this title, refund or credit any over-payment attributable to this subsection as rapidly as possible.

"(ii) DEADLINE. —

"(I) IN GENERAL. — Except as provided in subclause (II), no refund or credit shall be made or allowed under this subsection after January 15, 2021.

"(II) EXCEPTION FOR MIRROR CODE POSSESSIONS. — In the case of a possession of the United States which has a mirror code tax system (as such terms are defined in section 272(c) of the COVID-related Tax Relief Act of 2020), no refund or credit shall be made or allowed under this subsection after the earlier of —

"(aa) such date as is determined appropriate by the Secretary, or

"(bb) September 30, 2021.

"(B) DELIVERY OF PAYMENTS. — Notwithstanding any other provision of law, the Secretary may certify and disburse refunds payable under this subsection electronically to —

"(i) any account to which the payee authorized, on or after January 1, 2019, the delivery of a refund of taxes under this title or of a Federal payment (as defined in section 3332 of title 31, United States Code),

"(ii) any account belonging to a payee from which that individual, on or after January 1, 2019, made a payment of taxes under this title, or

"(iii) any Treasury-sponsored account (as defined in section 208.2 of title 31, Code of Federal Regulations).

"(C) WAIVER OF CERTAIN RULES. — Notwithstanding section 3325 of title 31, United States Code, or any other provision of law, with respect to any payment of a refund under this subsection, a disbursing official in the executive branch of the United States Government may modify payment information received from an officer or employee described in section 3325(a)(1)(B) of such title for the purpose of facilitating the accurate and efficient delivery of such payment. Except in cases of fraud or reckless neglect, no liability under sections 3325, 3527, 3528, or 3529 of title 31, United States Code, shall be imposed with respect to payments made under this subparagraph.

"(4) NO INTEREST. — No interest shall be allowed on any overpayment attributable to this subsection.

"(5) APPLICATION TO CERTAIN INDIVIDUALS WHO DO NOT FILE A RETURN OF TAX FOR 2019. —

"(A) IN GENERAL. — In the case of a specified individual who, at the time of any determination made pursuant to paragraph (3), has not filed a tax return for the year described in paragraph (1), the Secretary may use information with respect to such individual which is provided by —

"(i) in the case of a specified social security beneficiary or a specified supplemental security income recipient, the Commissioner of Social Security,

"(ii) in the case of a specified railroad retirement beneficiary, the Railroad Retirement Board, and

"(iii) in the case of a specified veterans beneficiary, the Secretary of Veterans Affairs (in coordination with, and with the assistance of, the Commissioner of Social Security if appropriate).

"(B) SPECIFIED INDIVIDUAL. — For purposes of this paragraph, the term 'specified individual' means any individual who is —

"(i) a specified social security beneficiary,

"(ii)a specified supplemental security income recipient,

"(iii) a specified railroad retirement beneficiary, or

"(iv) a specified veterans beneficiary.

"(C) SPECIFIED SOCIAL SECURITY BENEFICIARY. —

"(i) IN GENERAL. — For purposes of this paragraph, the term 'specified social security beneficiary' means any individual who, for the last month for which the Secretary has available information as of the date of enactment of this section, is entitled to any monthly insurance benefit payable under title II of the Social Security Act (42 U.S.C. 401 et seq.), including payments made pursuant to sections 202(d), 223(g), and 223(i)(7) of such Act.

"(ii) EXCEPTION. — For purposes of this paragraph, the term 'specified social security beneficiary' shall not include any individual if such benefit is not payable for such month by reason of section 202(x)(1)(A) of the Social Security Act (42 U.S.C. 402(x)(1)(A)) or section 1129A of such Act (42 U.S.C. 1320a–8a).

"(D) SPECIFIED SUPPLEMENTAL SECURITY INCOME RECIPIENT. —

"(i) IN GENERAL. — For purposes of this paragraph, the term 'specified supplemental security income recipient' means any individual who, for the last month for which the Secretary has available information as of the date of enactment of this section, is eligible for a monthly benefit payable under title XVI of the Social Security Act (42 U.S.C. 1381 et seq.), including —

"(I) payments made pursuant to section 1614(a)(3)(C) of such Act (42 U.S.C. 1382c(a)(3)(C)),

"(II) payments made pursuant to section 1619(a) (42 U.S.C. 1382h(a)) or subsections (a)(4), (a)(7), or (p)(7) of section 1631 (42 U.S.C. 1383) of such Act, and

"(III) State supplementary payments of the type referred to in section 1616(a) of such Act (42 U.S.C. 1382e(a)) (or payments of the type described in section 212(a) of Public Law 93–66) which are paid by the Commissioner under an agreement referred to in such section 1616(a) (or section 212(a) of Public Law 93–66).

"(ii) EXCEPTION. — For purposes of this paragraph, the term 'specified supplemental security income recipient' shall not include any individual if such monthly benefit is not payable for such month by reason of section 1611(e)(1)(A) of the Social Security Act (42 U.S.C. 1382(e)(1)(A)) or section 1129A of such Act (42 U.S.C. 1320a–8a).

"(E) SPECIFIED RAILROAD RETIREMENT BENEFICIARY. — For purposes of this paragraph, the term 'specified railroad retirement beneficiary' means any individual who, for the last month for which the Secretary has available information as of the date of enactment of this section, is entitled to a monthly annuity or pension payment payable (without regard to section 5(a)(ii) of the Railroad Retirement Act of 1974 (45 U.S.C. 231d(a)(ii))) under —

"(i) section 2(a)(1) of such Act (45 U.S.C. 231a(a)(1)),

"(ii) section 2(c) of such Act (45 U.S.C. 231a(c)),

"(iii) section 2(d)(1) of such Act (45 U.S.C. 231a(d)(1)), or

"(iv) section 7(b)(2) of such Act (45 U.S.C. 231f(b)(2)) with respect to any of the benefit payments described in subparagraph (C)(i).

"(F) SPECIFIED VETERANS BENEFICIARY. —

"(i) IN GENERAL. — For purposes of this paragraph, the term 'specified veterans beneficiary' means any individual who, for the last month for which the Secretary has available information as of the date of enactment of this section, is entitled to a compensation or pension payment payable under —

"(I) section 1110, 1117, 1121, 1131, 1141, or 1151 of title 38, United States Code,

"(II) section 1310, 1312, 1313, 1315, 1316, or 1318 of title 38, United States Code,

"(III) section 1513, 1521, 1533, 1536, 1537, 1541, 1542, or 1562 of title 38, United States Code, or

"(IV) section 1805, 1815, or 1821 of title 38, United States Code, to a veteran, surviving spouse, child, or parent as described in paragraph (2), (3), (4)(A)(ii), or (5) of section 101, title 38, United States Code.

"(ii) EXCEPTION. — For purposes of this paragraph, the term 'specified veterans beneficiary' shall not include any individual if such compensation or pension payment is not payable, or was reduced, for such month by reason of section 1505 or 5313 of title 38, United States Code.

"(G) SUBSEQUENT DETERMINATIONS AND REDETERMINATIONS NOT TAKEN INTO ACCOUNT. — For purposes of this section, any individual's status as a specified social security beneficiary, a specified supplemental security income recipient, a specified railroad retirement beneficiary, or a specified veterans beneficiary shall be unaffected by any determination or redetermination of any entitlement to, or eligibility for, any benefit, payment, or compensation, if such determination or redetermination occurs after the last month for which the Secretary has available information as of the date of enactment of this section.

"(H) PAYMENT TO REPRESENTATIVE PAYEES AND FIDUCIARIES. —

"(i) IN GENERAL. — If the benefit, payment, or compensation referred to in subparagraph (C)(i), (D)(i), (E), or (F)(i) with respect to any specified individual is paid to a representative payee or fiduciary, payment by the Secretary under paragraph (3) with respect to such specified individual shall be made to such individual's representative payee or fiduciary and the entire payment shall be used only for the benefit of the individual who is entitled to the payment.

"(ii) APPLICATION OF ENFORCEMENT PROVISIONS. —

"(I) In the case of a payment described in clause (i) which is made with respect to a specified social security beneficiary or a specified supplemental security income recipient, section 1129(a)(3) of the Social Security Act (42 U.S.C. 1320a–8(a)(3)) shall apply to such payment in the same manner as such section applies to a payment under title II or XVI of such Act.

"(II) In the case of a payment described in clause (i) which is made with respect to a specified railroad retirement beneficiary, section 13 of the Railroad Retirement Act (45 U.S.C. 231l) shall apply to such payment in the same manner as such section applies to a payment under such Act.

"(III) In the case of a payment described in clause (i) which is made with respect to a specified veterans beneficiary, sections 5502, 6106, and 6108 of title 38, United States Code, shall apply to such payment in the same manner as such sections apply to a payment under such title.

"(I) INELIGIBILITY FOR SPECIAL RULE NOT TO BE INTERPRETED AS GENERAL INELIGIBILITY. — An individual shall not fail to be treated as an eligible individual for purposes of this subsection or subsection (a) merely because such individual is not a specified individual (including by reason of subparagraph (C)(ii), (D)(ii), or (F)(ii)).

"(6) NOTICE TO TAXPAYER. — As soon as practicable after the date on which the Secretary distributed any payment to an eligible taxpayer pursuant to this subsection, the Secretary shall send notice by mail to such taxpayer's last known address. Such notice shall indicate the method by which such payment was made, the amount of such payment, and a phone number for the appropriate point of contact at the Internal Revenue Service to report any failure to receive such payment. "(g) IDENTIFICATION NUMBER REQUIREMENT. —

"(1) IN GENERAL. — In the case of a return other than a joint return, the $600 amount in subsection (a)(1) shall be treated as being zero unless the taxpayer includes the valid identification number of the taxpayer on the return of tax for the taxable year.

"(2) JOINT RETURNS. — In the case of a joint return, the $1,200 amount in subsection (a)(1) shall be treated as being —

"(A) $600 if the valid identification number of only 1 spouse is included on the return of tax for the taxable year, and

"(B) zero if the valid identification number of neither spouse is so included.

"(3) QUALIFYING CHILD. — A qualifying child of a taxpayer shall not be taken into account under subsection (a)(2) unless — "(A) the taxpayer includes the valid identification number of such taxpayer (or, in the case of a joint return, the valid identification number of at least 1 spouse) on the return of tax for the taxable year, and

"(B) the valid identification number of such qualifying child is included on the return of tax for the taxable year.

"(4) VALID IDENTIFICATION NUMBER. —

"(A) IN GENERAL. — For purposes of this subsection, the term 'valid identification number' means a social security number (as such term is defined in section 24(h)(7)).

"(B) ADOPTION TAXPAYER IDENTIFICATION NUMBER. — For purposes of paragraph (3)(B), in the case of a qualifying child who is adopted or placed for adoption, the term 'valid identification number' shall include the adoption taxpayer identification number of such child.

"(5) SPECIAL RULE FOR MEMBERS OF THE ARMED FORCES. — Paragraph (2) shall not apply in the case where at least 1 spouse was a member of the Armed Forces of the United States at any time during the taxable year and the valid identification number of at least 1 spouse is included on the return of tax for the taxable year.

"(6) COORDINATION WITH CERTAIN ADVANCE PAYMENTS. — In the case of any payment under subsection (f) which is based on information provided under paragraph (5) of such subsection, a valid identification number shall be treated for purposes of this subsection as included on the taxpayer's return of tax if such valid identification number is provided pursuant to subsection (f)(5).

"(7) MATHEMATICAL OR CLERICAL ERROR AUTHORITY. — Any omission of a correct valid identification number required under this subsection shall be treated as a mathematical or clerical error for purposes of applying section 6213(g)(2) to such omission.

"(h) REGULATIONS. — The Secretary shall prescribe such regulations or other guidance as may be necessary to carry out the purposes of this section, including any such measures as are deemed appropriate to avoid allowing multiple credits or rebates to a tax-payer.".

(b) ADMINISTRATIVE AMENDMENTS. —

(1) DEFINITION OF DEFICIENCY. — Section 6211(b)(4)(A) is amended by striking "and 6428" and inserting "6428, and 6428A".

(2) MATHEMATICAL OR CLERICAL ERROR AUTHORITY. — Section 6213(g)(2)(L) is amended by striking "or 6428" and inserting "6428, or 6428A".

(c) TREATMENT OF POSSESSIONS. —

(3) PAYMENTS TO POSSESSIONS. —

(A) MIRROR CODE POSSESSION. — The Secretary of the Treasury shall pay to each possession of the United States which has a mirror code tax system amounts equal to the loss (if any) to that possession by reason of the amendments made by this section. Such amounts shall be deter-mined by the Secretary of the Treasury based on information provided by the government of the respective possession.

(B) OTHER POSSESSIONS. — The Secretary of the Treasury shall pay to each possession of the United States which does not have a mirror code tax system amounts estimated by the Secretary of the Treasury as being equal to the aggregate benefits (if any) that would have been provided to residents of such possession by reason of the amendments made by this section if a mirror code tax system had been in effect in such possession. The preceding sentence shall not apply unless the respective possession has a plan, which has been approved by the Secretary of the Treasury, under which such possession will promptly distribute such payments to its residents.

(2) COORDINATION WITH CREDIT ALLOWED AGAINST UNITED STATES INCOME TAXES. — No credit shall be allowed against United States income taxes under section 6428A of the Internal Revenue Code of 1986 (as added by this section) to any person —

(A) to whom a credit is allowed against taxes imposed by the possession by reason of the amendments made by this section, or

(B) who is eligible for a payment under a plan described in paragraph (1)(B).

(A) POSSESSION OF THE UNITED STATES — For purposes of this subsection, the term "possession of the United States" includes the Commonwealth of Puerto Rico and the Commonwealth of the Northern Mariana Islands.

(B) MIRROR CODE TAX SYSTEM. — For purposes of this subsection, the term "mirror code tax system" means, with respect to any possession of the United States, the income tax system of such possession if the income tax liability of the residents of such possession under such system is determined by reference to the income tax laws of the United States as if such possession were the United States.

(C) TREATMENT OF PAYMENTS. — For purposes of section 1324 of title 31, United States Code, the payments under this subsection shall be treated in the same manner as a refund due from a credit provision referred to in sub-section (b)(2) of such section.

(d) ADMINISTRATIVE PROVISIONS. —

(1) EXCEPTION FROM REDUCTION OR OFFSET. — Any refund payable by reason of section 6428A(f) of the Internal Revenue Code of 1986 (as added by this section), or any such refund payable by reason of subsection (c) of this section, shall not be —

(A) subject to reduction or offset pursuant to section 3716 or 3720A of title 31, United States Code,

(B) subject to reduction or offset pursuant to subsection (c), (d), (e), or (f) of section 6402 of the Internal Revenue Code of 1986, or

(C) reduced or offset by other assessed Federal taxes that would otherwise be subject to levy or collection.

(2) ASSIGNMENT OF BENEFITS. —

(A) IN GENERAL. — The right of any person to any applicable payment shall not be transferable or assignable, at law or in equity, and no applicable payment shall be subject to, execution, levy, attachment, garnishment, or other legal process, or the operation of any bankruptcy or insolvency law.

(B) ENCODING OF PAYMENTS. — In the case of an applicable payment described in subparagraph (E)(iii)(I) that is paid electronically by direct deposit through the Automated Clearing House (ACH) network, the Secretary of the Treasury (or the Secretary's delegate) shall —

(i) issue the payment using a unique identifier that is reasonably sufficient to allow a financial institution to identify the payment as an applicable payment, and

(ii) further encode the payment pursuant to the same specifications as required for a benefit payment defined in section 212.3 of title 31, Code of Federal Regulations.

(C) GARNISHMENT. —

(i) ENCODED PAYMENTS. — In the case of a garnishment order that applies to an account that has received an applicable payment that is encoded as provided in subparagraph (B), a financial institution shall follow the requirements and procedures set forth in part 212 of title 31, Code of Federal Regulations, except —

(I) notwithstanding section 212.4 of title 31, Code of Federal Regulations (and except as pro-vided in subclause (II)), a financial institution shall not fail to follow the procedures of sections 212.5 and 212.6 of such title with respect to a garnishment order merely because such order has attached, or includes, a notice of right to garnish federal benefits issued by a State child support enforcement agency, and

(II) a financial institution shall not, with regard to any applicable payment, be required to provide the notice referenced in sections 212.6 and 212.7 of title 31, Code of Federal Regulations.

(ii) OTHER PAYMENTS. — In the case of a garnishment order (other than an order that has been served by the United States) that has been received by a financial institution and that applies to an account into which an applicable payment that has not been encoded as provided in subparagraph (B) has been deposited electronically on any date during the lookback period or into which an applicable payment that has been deposited by check on any date in the lookback period, the financial institution, upon the request of the account holder, shall treat the amount of the funds in the account at the time of the request, up to the amount of the applicable payment (in addition to any amounts otherwise protected under part 212 of title 31, Code of Federal Regulations), as exempt from a garnishment order without requiring the con-sent of the party serving the garnishment order or the judgment creditor.

(iii) LIABILITY. — A financial institution that acts in good faith in reliance on clauses (i) or (ii) shall not be subject to liability or regulatory action under any Federal or State law, regulation, court or other order, or regulatory interpretation for actions concerning any applicable payments.

(D) NO RECLAMATION RIGHTS. — This paragraph shall not alter the status of applicable payments as tax refunds or other nonbenefit payments for purpose of any reclamation rights of the Department of the Treasury or the Internal Revenue Service as per part 210 of title 31, Code of Federal Regulations.

(E) DEFINITIONS. — For purposes of this paragraph —

(i) ACCOUNT HOLDER. — The term "account holder" means a natural person whose name appears in a financial institution's records as the direct or beneficial owner of an account.

(ii) ACCOUNT REVIEW. — The term "account review" means the process of examining deposits in an account to determine if an applicable payment has been deposited into the account during the lookback period. The financial institution shall perform the account review following the procedures outlined in section 212.5 of title 31, Code of Federal Regulations and in accordance with the requirements of section 212.6 of title 31, Code of Federal Regulations.

(iii) APPLICABLE PAYMENT. — The term "applicable payment" means —

(I) any advance refund amount paid pursuant to section 6428A(f) of Internal Revenue Code of 1986 (as added by this section),

(II) any payment made by a possession of the United States with a mirror code tax system (as defined in subsection (c) of this section) pursuant to such subsection which corresponds to a payment described in subclause (I), and

(III) any payment made by a possession of the United States without a mirror code tax system (as so defined) pursuant to subsection (c) of this section.

(iv) GARNISHMENT. — The term "garnishment" means execution, levy, attachment, garnishment, or other legal process.

(v) GARNISHMENT ORDER. — The term "garnishment order" means a writ, order, notice, summons, judgment, levy, or similar written instruction issued by a court, a State or State agency, a municipality or municipal corporation, or a State child support enforcement agency, including a lien arising by operation of law for overdue child support or an order to freeze the assets in an account, to effect a garnishment against a debtor.

(vi) LOOKBACK PERIOD. — The term "lookback period" means the two month period that begins on the date preceding the date of account review and ends on the corresponding date of the month two months earlier, or on the last date of the month two months earlier if the corresponding date does not exist.

(3) AGENCY INFORMATION SHARING AND ASSISTANCE. —

(A) IN GENERAL. — The Commissioner of Social Security, the Railroad Retirement Board, and the Secretary of Veterans Affairs shall each provide the Secretary of the Treasury (or the Secretary's delegate) such information and assistance as the Secretary of the Treasury (or the Secretary's delegate) may require for purposes of —

(i) making payments under section 6428A(f) of the Internal Revenue Code of 1986 to individuals described in paragraph (5)(A) thereof, or

(ii) providing administrative assistance to a possession of the United States (as defined in subsection (c)(3)(A)) to allow such possession to promptly dis-tribute payments under subsection (c) to its residents.

(B) EXCHANGE OF INFORMATION WITH POSSESSIONS. —

Any information provided to the Secretary of the Treasury (or the Secretary's delegate) pursuant to subparagraph (A)(ii) may be exchanged with a possession of the United States in accordance with the applicable tax coordination agreement for information exchange and administrative assistance that the Internal Revenue Service has agreed to with such possession.

(e) PUBLIC AWARENESS CAMPAIGN. — The Secretary of the Treasury (or the Secretary's delegate) shall conduct a public aware-ness campaign, in coordination with the Commissioner of Social Security and the heads of other relevant Federal agencies, to provide information regarding the availability of the credit and rebate allowed under section 6428A of the Internal Revenue Code of 1986 (as added by this section), including information with respect to individuals who may not have filed a tax return for taxable year 2019.

(f) APPROPRIATIONS TO CARRY OUT REBATES AND ADDRESS

(1) IN GENERAL. — Immediately upon the enactment of this Act, the following sums are appropriated, out of any money in the Treasury not otherwise appropriated, for the fiscal year ending September 30, 2021:

(A) DEPARTMENT OF THE TREASURY. —

(i) For an additional amount for "Department of the Treasury — Internal Revenue Service — Taxpayer Services", $178,335,000, to remain available until September 30, 2021.

(ii) For an additional amount for "Department of the Treasury — Internal Revenue Service — Operations Support", $273,237,000, to remain available until September 30, 2021.

(iii) For an additional amount for "Department of Treasury — Internal Revenue Service — Enforcement", $57,428,000, to remain available until September 30, 2021.

Amounts made available in appropriations under this subparagraph may be transferred between such appropriations upon the advance notification of the Committees on Appropriations of the House of Representatives and the Senate. Such transfer authority is in addition to any other transfer authority provided by law.

(B) SOCIAL SECURITY ADMINISTRATION. — For an additional amount for "Social Security Administration — Limitation on Administrative Expenses", $38,000,000, to remain available until September 30, 2021.

(C) RAILROAD RETIREMENT BOARD. — For an additional amount for "Railroad Retirement Board — Limitation on Administration", $8,300, to remain available until September 30, 2021.

(2) REPORTS. — No later than 15 days after enactment of this Act, the Secretary of the Treasury shall submit a plan to the Committees on Appropriations of the House of Representatives and the Senate detailing the expected use of the funds provided by paragraph (1)(A). Beginning 90 days after enactment of this Act, the Secretary of the Treasury shall submit a quarterly report to the Committees on Appropriations of the House of Representatives and the Senate detailing the actual expenditure of funds provided by paragraph (1)(A) and the expected expenditure of such funds in the subsequent quarter.

(g) CONFORMING AMENDMENTS. —

(1) Paragraph (2) of section 1324(b) of title 31, United States Code, is amended by inserting "6428A," after "6428,".

(2) The table of sections for subchapter B of chapter 65 of subtitle F is amended by inserting after the item relating to section 6428 the following:

"Sec. 6428A. Additional 2020 recovery rebates for individuals.".

SEC. 273. AMENDMENTS TO RECOVERY REBATES UNDER THE CARES ACT.

(a) AMENDMENTS TO SECTION 6428 OF THE INTERNAL REVENUE

(1) in subsection (c)(1), by inserting "or a surviving spouse (as defined in section 2(a))" after "joint return",

(2) in subsection (f) —

(A) in paragraph (3)(A), by striking "section" and inserting "subsection",

(B) in paragraph (4), by striking "section" and inserting "subsection", and

(C) by redesignating paragraph (6) as paragraph (7) and by inserting after paragraph (5) the following new paragraph:

"(6) PAYMENT TO REPRESENTATIVE PAYEES AND FIDUCIARIES. —

"(A) IN GENERAL. — In the case of any individual for which payment information is provided to the Secretary by the Commissioner of Social Security, the Railroad Retirement Board, or the Secretary of Veterans Affairs, the payment by the Secretary under paragraph (3) with respect to such individual may be made to such individual's representative payee or fiduciary and the entire payment shall be —

"(i) provided to the individual who is entitled to the payment, or

"(ii) used only for the benefit of the individual who is entitled to the payment.

"(B) APPLICATION OF ENFORCEMENT PROVISIONS. —

"(i) In the case of a payment described in subparagraph (A) which is made with respect to a social security beneficiary or a supplemental security income recipient, section 1129(a)(3) of the Social Security Act (42 U.S.C. 1320a–8(a)(3)) shall apply to such payment in the same manner as such section applies to a payment under title II or XVI of such Act.

"(ii) In the case of a payment described in subparagraph (A) which is made with respect to a railroad retirement beneficiary, section 13 of the Railroad Retirement Act (45 U.S.C. 231l) shall apply to such payment in the same manner as such section applies to a payment under such Act.

"(iii) In the case of a payment described in subparagraph (A) which is made with respect to a veterans beneficiary, sections 5502, 6106, and 6108 of title 38, United States Code, shall apply to such payment in the same manner as such sections apply to a payment under such title.", and

(3) by striking subsection (g) and inserting the following:

"(g) IDENTIFICATION NUMBER REQUIREMENT. —

"(1) REQUIREMENTS FOR CREDIT. — Subject to paragraph (2), with respect to the credit allowed under subsection (a), the following provisions shall apply:

"(A) IN GENERAL. — In the case of a return other than a joint return, the $1,200 amount in subsection (a)(1) shall be treated as being zero unless the taxpayer includes the valid identification number of the taxpayer on the return of tax for the taxable year.

"(B) JOINT RETURNS. — In the case of a joint return, the $2,400 amount in subsection (a)(1) shall be treated as being —

"(i) $1,200 if the valid identification number of only 1 spouse is included on the return of tax for the taxable year, and

"(ii) zero if the valid identification number of neither spouse is so included.

"(C) QUALIFYING CHILD. — A qualifying child of a taxpayer shall not be taken into account under subsection (a)(2) unless —

"(i) the taxpayer includes the valid identification number of such taxpayer (or, in the case of a joint return, the valid identification number of at least 1 spouse) on the return of tax for the taxable year, and

"(ii) the valid identification number of such qualifying child is included on the return of tax for the taxable year.

"(2) REQUIREMENTS FOR ADVANCE REFUNDS. — No refund shall be payable under subsection (f) to an eligible individual who does not include on the return of tax for the taxable year —

"(A) such individual's valid identification number,

"(B) in the case of a joint return, the valid identification number of such individual's spouse, and

"(C) in the case of any qualifying child taken into account under subsection (a)(2), the valid identification number of such qualifying child.

"(3) VALID IDENTIFICATION NUMBER. —

"(A) IN GENERAL. — For purposes of this subsection, the term 'valid identification number' means a social security number (as such term is defined in section 24(h)(7)).

"(B) ADOPTION TAXPAYER IDENTIFICATION NUMBER. — For purposes of paragraphs (1)(C) and (2)(C), in the case of a qualifying child who is adopted or placed for adoption, the term 'valid identification number' shall include the adoption taxpayer identification number of such child.

"(4) SPECIAL RULE FOR MEMBERS OF THE ARMED FORCES. — Paragraphs (1)(B) and (2)(B) shall not apply in the case where at least 1 spouse was a member of the Armed Forces of the United States at any time during the taxable year and the valid identification number of at least 1 spouse is included on the return of tax for the taxable year.

"(5) MATHEMATICAL OR CLERICAL ERROR AUTHORITY. — Any omission of a correct valid identification number required under this subsection shall be treated as a mathematical or clerical error for purposes of applying section 6213(g)(2) to such omission.".

(b) AMENDMENTS TO SECTION 2201 OF THE CARES ACT. — Section 2201 of the CARES Act is amended —

(1) in subsection (d), by striking "Any credit or refund allowed or made to any individual by reason of section 6428 of the Internal Revenue Code of 1986 (as added by this section) or by reason of subsection (c) of this section" and inserting "Any refund payable by reason of section 6428(f) of the Internal Revenue Code of 1986 (as added by this section), or any such refund payable by reason of subsection (c) of this section,", and

(2) in subsection (f)(1)(A)(i), by inserting after "September 30, 2021" the following: ", of which up to $63,000,000 may be transferred to the "Department of the Treasury — Bureau of the Fiscal Service — Debt Collection" for necessary expenses related to the implementation and operation of Government-wide debt collection activities pursuant to sections 3711(g), 3716, and 3720A of title 31, United States Code, and sub-sections (c) through (f) of section 6402 of the Internal Revenue Code of 1986 to offset the loss resulting from the coronavirus pandemic of debt collection receipts collected pursuant to such sections: Provided, That amounts transferred pursuant to this clause shall be in addition to any other funds made available for this purpose".

(c) EFFECTIVE DATE. — The amendments made by this section shall take effect as if included in section 2201 of the CARES Act.

SEC. 274. EXTENSION OF CERTAIN DEFERRED PAYROLL TAXES.

The Secretary of the Treasury (or the Secretary's delegate) shall ensure that Internal Revenue Service Notice 2020–65 (entitled "Relief with Respect to Employment Tax Deadlines Applicable to Employers Affected by the Ongoing Coronavirus (COVID–19) Dis-ease 2019 Pandemic") and any successor or related regulation, notice, or guidance is applied —

(1) by substituting "December 31, 2021" for "April 30, 2021" each place it appears therein, and

(2) by substituting "January 1, 2022" for "May 1, 2021" each place it appears therein.

SEC. 275. REGULATIONS OR GUIDANCE CLARIFYING APPLICATION OF EDUCATOR EXPENSE TAX DEDUCTION.

Not later than February 28, 2021, the Secretary of the Treasury (or the Secretary's delegate) shall by regulation or other guidance clarify that personal protective equipment, disinfectant, and other supplies used for the prevention of the spread of COVID–19 are treated as described in section 62(a)(2)(D)(ii) of the Internal Revenue Code of 1986. Such regulations or other guidance shall apply to expenses paid or incurred after March 12, 2020.

SEC. 276. CLARIFICATION OF TAX TREATMENT OF FORGIVENESS OF COVERED LOANS.

(a) ORIGINAL PAYCHECK PROTECTION PROGRAM LOANS. —

(1) IN GENERAL. — Subsection (i) of section 7A of the Small Business Act, as redesignated, transferred, and amended by the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, is amended to read as follows:

"(i) TAX TREATMENT. — For purposes of the Internal Revenue Code of 1986 —

"(1) no amount shall be included in the gross income of the eligible recipient by reason of forgiveness of indebtedness described in subsection (b),

"(2) no deduction shall be denied, no tax attribute shall be reduced, and no basis increase shall be denied, by reason of the exclusion from gross income provided by paragraph (1), and

"(3) in the case of an eligible recipient that is a partnership or S corporation —

"(A) any amount excluded from income by reason of paragraph (1) shall be treated as tax exempt income for purposes of sections 705 and 1366 of the Internal Revenue Code of 1986, and

"(B) except as provided by the Secretary of the Treasury (or the Secretary's delegate), any increase in the adjusted basis of a partner's interest in a partnership under section 705 of the Internal Revenue Code of 1986 with respect to any amount described in subparagraph (A) shall equal the partner's distributive share of deductions resulting from costs giving rise to forgiveness described in subsection (b).".

(2) EFFECTIVE DATE. — The amendment made by this sub-section shall apply to taxable years ending after the date of the enactment of the CARES Act.

(b) SUBSEQUENT PAYCHECK PROTECTION PROGRAM LOANS. — For purposes of the Internal Revenue Code of 1986, in the case of any taxable year ending after the date of the enactment of this Act —

(1) no amount shall be included in the gross income of an eligible entity (within the meaning of subparagraph (J) of section 7(a)(37) of the Small Business Act) by reason of forgiveness of indebtedness described in clause (ii) of such subparagraph,

(2) no deduction shall be denied, no tax attribute shall be reduced, and no basis increase shall be denied, by reason of the exclusion from gross income provided by paragraph (1), and

(3) in the case of an eligible entity that is a partnership or S corporation —

(A) any amount excluded from income by reason of paragraph (1) shall be treated as tax exempt income for purposes of sections 705 and 1366 of the Internal Revenue Code of 1986, and

(B) except as provided by the Secretary of the Treasury (or the Secretary's delegate), any increase in the adjusted basis of a partner's interest in a partnership under section 705 of the Internal Revenue Code of 1986 with respect to any amount described in subparagraph (A) shall equal the partner's distributive share of deductions resulting from costs giving rise to the forgiveness of indebtedness referred to in paragraph (1).

SEC. 277. EMERGENCY FINANCIAL AID GRANTS.

(a) IN GENERAL. — In the case of a student receiving a qualified emergency financial aid grant —

(1) such grant shall not be included in the gross income of such individual for purposes of the Internal Revenue Code of 1986, and

(2) such grant shall not be treated as described in subparagraph (A), (B), or (C) of section 25A(g)(2) of such Code.

(b) DEFINITIONS. — For purposes of this subsection, the term "qualified emergency financial aid grant" means —

(1) any emergency financial aid grant awarded by an institution of higher education under section 3504 of the CARES Act,

(2) any emergency financial aid grant from an institution of higher education made with funds made available under section 18004 of the CARES Act, and

(3) any other emergency financial aid grant made to a student from a Federal agency, a State, an Indian tribe, an institution of higher education, or a scholarship-granting organization (including a tribal organization, as defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C.5304)) for the purpose of providing financial relief to students enrolled at institutions of higher education in response to a qualifying emergency (as defined in section 3502(a)(4) of the CARES Act).

(c) LIMITATION. — This section shall not apply to that portion of any amount received which represents payment for teaching, research, or other services required as a condition for receiving the qualified emergency financial aid grant.

(d) EFFECTIVE DATE. — This section shall apply to qualified emergency financial aid grants made after March 26, 2020.

SEC. 278. CLARIFICATION OF TAX TREATMENT OF CERTAIN LOAN FORGIVENESS AND OTHER BUSINESS FINANCIAL ASSIST-ANCE.

(a) UNITED STATES TREASURY PROGRAM MANAGEMENT AUTHORITY. — For purposes of the Internal Revenue Code of 1986 —

(1) no amount shall be included in the gross income of a borrower by reason of forgiveness of indebtedness described in section 1109(d)(2)(D) of the CARES Act,

(2) no deduction shall be denied, no tax attribute shall be reduced, and no basis increase shall be denied, by reason of the exclusion from gross income provided by paragraph (1), and

(3) in the case of a borrower that is a partnership or S. corporation —

(A) any amount excluded from income by reason of paragraph (1) shall be treated as tax exempt income for purposes of sections 705 and 1366 of the Internal Revenue Code of 1986, and

(B) except as provided by the Secretary of the Treasury (or the Secretary's delegate), any increase in the adjusted basis of a partner's interest in a partnership under section 705 of the Internal Revenue Code of 1986 with respect to any amount described in subparagraph (A) shall equal the partner's distributive share of deductions resulting from costs giving rise to forgiveness described in section 1109(d)(2)(D) of the CARES Act.

(b) EMERGENCY EIDL GRANTS AND TARGETED EIDL ADVANCES. — For purposes of the Internal Revenue Code of 1986 —

(1) any advance described in section 1110(e) of the CARES Act or any funding under section 331 of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act shall not be included in the gross income of the person that receives such advance or funding,

(2) no deduction shall be denied, no tax attribute shall be reduced, and no basis increase shall be denied, by reason of the exclusion from gross income provided by paragraph (1), and

(3) in the case of a partnership or S corporation that receives such advance or funding —

(A) any amount excluded from income by reason of paragraph (1) shall be treated as tax exempt income for purposes of sections 705 and 1366 of the Internal Revenue Code of 1986, and

(B) the Secretary of the Treasury (or the Secretary's delegate) shall prescribe rules for determining a partner's distributive share of any amount described in subparagraph (A) for purposes of section 705 of the Internal Revenue Code of 1986.

(c) SUBSIDY FOR CERTAIN LOAN PAYMENTS. — For purposes of the Internal Revenue Code of 1986 —

(1) any payment described in section 1112(c) of the CARES Act shall not be included in the gross income of the person on whose behalf such payment is made,

(2) no deduction shall be denied, no tax attribute shall be reduced, and no basis increase shall be denied, by reason of the exclusion from gross income provided by paragraph (1), and

(3) in the case of a partnership or S corporation on whose behalf of a payment described in section 1112(c) of the CARES Act is made —

(A) any amount excluded from income by reason of paragraph (1) shall be treated as tax exempt income for purposes of sections 705 and 1366 of the Internal Revenue Code of 1986, and

(B) except as provided by the Secretary of the Treasury (or the Secretary's delegate), any increase in the adjusted basis of a partner's interest in a partnership under section 705 of the Internal Revenue Code of 1986 with respect to any amount described in subparagraph (A) shall equal the sum of the partner's distributive share of deductions resulting from interest and fees described in section 1112(c) of the CARES Act and the partner's share, as determined under section 752 of the Internal Revenue Code of 1986, of principal described in section 1112(c) of the CARES Act.

(d) GRANTS FOR SHUTTERED VENUE OPERATORS. — For purposes of the Internal Revenue Code of 1986 —

(1) any grant made under section 324 of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act shall not be included in the gross income of the person that receives such grant,

(2) no deduction shall be denied, no tax attribute shall be reduced, and no basis increase shall be denied, by reason of the exclusion from gross income provided by paragraph (1), and

(3) in the case of a partnership or S corporation that receives such grant —

(A) any amount excluded from income by reason of paragraph (1) shall be treated as tax exempt income for purposes of sections 705 and 1366 of the Internal Revenue Code of 1986, and

(B) the Secretary of the Treasury (or the Secretary's delegate) shall prescribe rules for determining a partner's distributive share of any amount described in subparagraph (A) for purposes of section 705 of the Internal Revenue Code of 1986.

(e) EFFECTIVE DATES. —

(1) IN GENERAL. — Except as otherwise provided in this sub-section, subsections (a), (b), and (c) shall apply to taxable years ending after the date of the enactment of the CARES Act.

(2) GRANTS FOR SHUTTERED VENUE OPERATORS; TARGETED EIDL ADVANCES. — Subsection (d), and so much of subsection (b) as relates to funding under section 331 of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, shall apply to taxable years ending after the date of the enactment of this Act.

SEC. 279. AUTHORITY TO WAIVE CERTAIN INFORMATION REPORTING REQUIREMENTS.

The Secretary of the Treasury (or the Secretary's delegate) may provide an exception from any requirement to file an information return otherwise required by chapter 61 of the Internal Revenue Code of 1986 with respect to any amount excluded from gross income by reason of section 7A(i) of the Small Business Act or section 276(b), 277, or 278 of this subtitle.

SEC. 280. APPLICATION OF SPECIAL RULES TO MONEY PURCHASE PENSION PLANS.

(a) IN GENERAL. — Section 2202(a)(6)(B) of the CARES Act is amended by inserting ", and, in the case of a money purchase pension plan, a coronavirus-related distribution which is an in-service withdrawal shall be treated as meeting the distribution rules of section 401(a) of the Internal Revenue Code of 1986" before the period.

(b) EFFECTIVE DATE. — The amendment made by this section shall apply as if included in the enactment of section 2202 of the CARES Act.

SEC. 281. ELECTION TO WAIVE APPLICATION OF CERTAIN MODIFICATIONS TO FARMING LOSSES.

(a) IN GENERAL. — Section 2303 of the CARES Act is amended by adding at the end the following new subsection:

"(e) SPECIAL RULES WITH RESPECT TO FARMING LOSSES. —

"(1) ELECTION TO DISREGARD APPLICATION OF AMENDMENTS MADE BY SUBSECTIONS (a) AND (b). —

"(A) IN GENERAL. — If a taxpayer who has a farming loss (within the meaning of section 172(b)(1)(B)(ii) of the Internal Revenue Code of 1986) for any taxable year beginning in 2018, 2019, or 2020 makes an election under this paragraph, then —

"(i) the amendments made by subsection (a) shall not apply to any taxable year beginning in 2018, 2019, or 2020, and

"(ii) the amendments made by subsection (b) shall not apply to any net operating loss arising in any taxable year beginning in 2018, 2019, or 2020.

"(B) ELECTION. —

"(i) IN GENERAL. — Except as provided in clause (ii)(II), an election under this paragraph shall be made in such manner as may be prescribed by the Secretary. Such election, once made, shall be irrevocable.

"(ii) TIME FOR MAKING ELECTION. —

"(I) IN GENERAL. — An election under this paragraph shall be made by the due date (including extensions of time) for filing the taxpayer's return for the taxpayer's first taxable year ending after the date of the enactment of the COVID-related Tax Relief Act of 2020.

"(II) PREVIOUSLY FILED RETURNS. — In the case of any taxable year for which the taxpayer has filed a return of Federal income tax before the date of the enactment of the COVID-related Tax Relief Act of 2020 which disregards the amendments made by subsections (a) and (b), such taxpayer shall be treated as having made an election under this paragraph unless the taxpayer amends such return to reflect such amendments by the due date (including extensions of time) for filing the taxpayer's return for the first taxable year ending after the date of the enactment of the COVID-related Tax Relief Act of 2020.

"(C) REGULATIONS. — The Secretary of the Treasury (or the Secretary's delegate) shall issue such regulations and other guidance as may be necessary to carry out the purposes of this paragraph, including regulations and guidance relating to the application of the rules of section 172(a) of the Internal Revenue Code of 1986 (as in effect before the date of the enactment of the CARES Act) to taxpayers making an election under this paragraph.

"(2) REVOCATION OF ELECTION TO WAIVE CARRYBACK. — The last sentence of section 172(b)(3) of the Internal Revenue Code of 1986 and the last sentence of section 172(b)(1)(B) of such Code shall not apply to any election —

"(A) which was made before the date of the enactment of the COVID-related Tax Relief Act of 2020, and

"(B) which relates to the carryback period provided under section 172(b)(1)(B) of such Code with respect to any net operating loss arising in taxable years beginning in 2018 or 2019.".

(b) EFFECTIVE DATE. — The amendment made by this section shall take effect as if included in section 2303 of the CARES Act.

SEC. 282. OVERSIGHT AND AUDIT REPORTING.

Section 19010(a)(1) of the CARES Act is amended by striking "and" at the end of subparagraph (F), by striking "and" at the end of subparagraph (G), and by adding at the end the following new subparagraphs:

"(H) the Committee on Finance of the Senate; and

"(I) the Committee on Ways and Means of the House of Representatives; and".

SEC.283. DISCLOSURES TO IDENTIFY TAX RECEIVABLES NOT ELIGIBLE FOR COLLECTION PURSUANT TO QUALIFIED TAX COLLECTION CONTRACTS.

(a) IN GENERAL. — Section 1106 of the Social Security Act (42 U.S.C. 1306) is amended by adding at the end the following:

"(g) Notwithstanding any other provision of this section, the Commissioner of Social Security shall enter into an agreement with the Secretary of the Treasury under which —

"(1) if the Secretary provides the Commissioner with the information described in section 6103(k)(15) of the Internal Revenue Code of 1986 with respect to any individual, the Commissioner shall indicate to the Secretary as to whether such individual receives disability insurance benefits under section 223 or supplemental security income benefits under title XVI (including State supplementary payments of the type referred to in section 1616(a) or payments of the type described in section 212(a) of Public Law 93–66);

"(2) appropriate safeguards are included to assure that the indication described in paragraph (1) will be used solely for the purpose of determining if tax receivables involving such individual are not eligible for collection pursuant to a qualified tax collection contract by reason of section 6306(d)(3)(E) of the Internal Revenue Code of 1986; and

"(3) the Secretary shall pay the Commissioner of Social Security the full costs (including systems and administrative costs) of providing the indication described in paragraph (1).".

(b) AUTHORIZATION OF DISCLOSURE BY SECRETARY OF THE TREASURY —

(1) IN GENERAL. — Section 6103(k) is amended by adding at the end the following new paragraph:

"(15) DISCLOSURES TO SOCIAL SECURITY ADMINISTRATION TO IDENTIFY TAX RECEIVABLES NOT ELIGIBLE FOR COLLECTION PURSUANT TO QUALIFIED TAX COLLECTION CONTRACTS. — In the case of any individual involved with a tax receivable which the Secretary has identified for possible collection pursuant to a qualified tax collection contract (as defined in section 6306(b)), the Secretary may disclose the taxpayer identity and date of birth of such individual to officers, employees, and contractors of the Social Security Administration to determine if such tax receivable is not eligible for collection pursuant to such a qualified tax collection contract by reason of section 6306(d)(3)(E).".

(2) CONFORMING AMENDMENTS RELATED TO SAFEGUARDS. —

(A) Section 6103(a)(3) is amended by striking "or (14)" and inserting "(14), or (15)".

(B) Section 6103(p)(4) is amended —

(i) by striking "(k)(8), (10) or (11)" both places it appears and inserting "(k)(8), (10), (11), or (15)", and

(ii) by striking "any other person described in sub-section (k)(10)" each place it appears and inserting "any other person described in subsection (k)(10) or (15)".

(C) Section 7213(a)(2) is amended by striking "(k)(10), (13), or (14)" and inserting "(k)(10), (13), (14), or (15)".

(c) EFFECTIVE DATE. — The amendments made by this section shall apply to disclosures made on or after the date of the enactment of this Act.

SEC. 284. MODIFICATION OF CERTAIN PROTECTIONS FOR TAXPAYER RETURN INFORMATION.

(a) AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986. —

(1) IN GENERAL. — Subparagraph (D) of section 6103(l)(13) is amended —

(A) by inserting at the end of clause (iii) the following new sentence: "Under such terms and conditions as may be prescribed by the Secretary, after consultation with the Department of Education, an institution of higher education described in subclause (I) or a State higher education agency described in subclause (II) may designate a con-tractor of such institution or state agency to receive return information on behalf of such institution or state agency to administer aspects of the institution's or state agency's activities for the application, award, and administration of such financial aid.", and

(B) by adding at the end the following:

"(iv) REDISCLOSURE TO OFFICE OF INSPECTOR GENERAL, INDEPENDENT AUDITORS, AND CONTRACTORS. — Any return information which is redisclosed under clause (iii) —

"(I) may be further disclosed by persons described in subclauses (I), (II), or (III) of clause (iii) or persons designated in the last sentence of clause (iii) to the Office of Inspector General of the Department of Education and independent auditors conducting audits of such person's administration of the programs for which the return information was received, and

"(II) may be further disclosed by persons described in subclauses (I), (II), or (III) of clause (iii) to contractors of such entities, but only to the extent necessary in carrying out the purposes described in such clause (iii).

"(v) REDISCLOSURE TO FAMILY MEMBERS. — In addition to the purposes for which information is disclosed and used under subparagraphs (A) and (C), or redisclosed under clause (iii), any return information so disclosed or redisclosed may be further disclosed to any individual certified by the Secretary of Education as having provided approval under paragraph (1) or (2) of section 494(a) of the Higher Education Act of 1965, as the case may be, for disclosure related to the income-contingent or income-based repayment plan under subparagraph (A) or the eligibility for, and amount of, Federal student financial aid described in subparagraph (C).

"(vi) REDISCLOSURE OF FAFSA INFORMATION. — Return information received under subparagraph (C) may be redisclosed in accordance with subsection (c) of section 494 of the Higher Education Act of 1965 (as in effect on the date of enactment of the COVID-related Tax Relief Act of 2020) to carry out the purposes specified in such subsection.".

(2) CONFORMING AMENDMENT. — Subparagraph (F) of section 6103(l)(13) is amended by inserting ", and any redisclosure authorized under clause (iii), (iv) (v), or (vi) of subparagraph (D)," after " or (C)".

(3) CONFIDENTIALITY OF RETURN INFORMATION. —

(A) Section 6103(a)(3), as amended by section 3516(a)(1) of the CARES Act, is amended by striking "(13)(A), (13)(B), (13)(C), (13)(D)(i)," and inserting "(13) (other than subparagraphs (D)(v) and (D)(vi) thereof),".

(B) Section 6103(p)(3)(A), as amended by section 3516(a)(2) of such Act, is amended by striking "(13)(A), (13)(B), (13)(C), (13)(D)(i)," and inserting "(13)(D)(iv), (13)(D)(v), (13)(D)(vi)".

(4) EFFECTIVE DATE. — The amendments made by this sub-section shall apply to disclosures made after the date of the enactment of the FUTURE Act (Public Law 116–91).

(b) AMENDMENTS TO THE HIGHER EDUCATION ACT OF 1965. —

(1) IN GENERAL. — Section 494 of the Higher Education Act of 1965 (20 U.S.C. 1098h(a)) is amended —

(A) in subsection (a)(1) —

(i) in the matter preceding subparagraph (A), by inserting ", including return information," after "financial information";

(ii) in subparagraph (A) —

(I) in clause (i) —

(aa) by striking "subparagraph (B), the" and inserting the following: "subparagraph (B) —

"(I) the"; and

(bb) by adding at the end the following:

"(II) the return information of such individuals may be redisclosed pursuant to clauses (iii), (iv), (v), and (vi) of section 6103(l)(13)(D) of the Internal Revenue Code of 1986, for the relevant purposes described in such section; and"; and

(II) in clause (ii), by striking "such disclosure" and inserting "the disclosures described in sub-clauses (I) and (II) of clause (i)"; and

(iii) in subparagraph (B), by striking "disclosure described in subparagraph (A)(i)" and inserting "disclosures described in subclauses (I) and (II) of subparagraph (A)(i)";

(B) in subsection (a)(2)(A)(ii), by striking "affirmatively approve the disclosure described in paragraph (1)(A)(i) and agree that such approval shall serve as an ongoing approval of such disclosure until the date on which the individual elects to opt out of such disclosure" and inserting "affirmatively approve the disclosures described in subclauses (I) and (II) of paragraph (1)(A)(i), to the extent applicable, and agree that such approval shall serve as an ongoing approval of such disclosures until the date on which the individual elects to opt out of such disclosures"; and

(C) by adding at the end the following:

"(c) ACCESS TO FAFSA INFORMATION. —

"(1) REDISCLOSURE OF INFORMATION. — The information in a complete, unredacted Student Aid Report (including any return information disclosed under section 6103(l)(13) of the Internal Revenue Code of 1986 (26 U.S.C. 6103(l)(13))) with respect to an application described in subsection (a)(1) of an applicant for Federal student financial aid —

"(A)upon request for such information by such applicant, shall be provided to such applicant by —

"(i) the Secretary; or

"(ii) in a case in which the Secretary has requested that institutions of higher education carry out the requirements of this subparagraph, an institution of higher education that has received such information; and

"(B) with the written consent by the applicant to an institution of higher education, may be provided by such institution of higher education as is necessary to a scholarship granting organization (including a tribal organization (defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304))), or to an organization assisting the applicant in applying for and receiving Federal, State, local, or tribal assistance, that is designated by the applicant to assist the applicant in applying for and receiving financial assistance for any component of the applicant's cost of attendance (defined in section 472) at that institution.

"(2) DISCUSSION OF INFORMATION. — A discussion of the information in an application described in subsection (a)(1) (including any return information disclosed under section 6103(l)(13) of the Internal Revenue Code of 1986 (26 U.S.C. 6103(l)(13)) of an applicant between an institution of higher education and the applicant may, with the written consent of the applicant, include an individual selected by the applicant (such as an advisor) to participate in such discussion.

"(3) RESTRICTION ON DISCLOSING INFORMATION. — A person receiving information under paragraph (1)(B) or (2) with respect to an applicant shall not use the information for any purpose other than the express purpose for which consent was granted by the applicant and shall not disclose such information to any other person without the express permission of, or request by, the applicant.

"(4) DEFINITIONS. — In this subsection:

"(A) STUDENT AID REPORT. — The term 'Student Aid Report' has the meaning given the term in section 668.2 of title 34, Code of Federal Regulations (or successor regulations).

"(B) WRITTEN CONSENT. — The term 'written consent' means a separate, written document that is signed and dated (which may include by electronic format) by an applicant, which —

"(i) indicates that the information being disclosed includes return information disclosed under section 6103(l)(13) of the Internal Revenue Code of 1986 (26 U.S.C. 6103(l)(13)) with respect to the applicant;

"(ii) states the purpose for which the information is being disclosed; and

"(iii) states that the information may only be used for the specific purpose and no other purposes.

"(5) RECORD KEEPING REQUIREMENT. — An institution of higher education shall —

"(A) keep a record of each written consent made under this subsection for a period of at least 3 years from the date of the student's last date of attendance at the institution; and

"(B) make each such record readily available for review by the Secretary.".

(2) CONFORMING AMENDMENT. — Section 494(a)(3) of the Higher Education Act of 1965 (20 U.S.C. 1098h(a)(3)) is amended by striking "paragraph (1)(A)(i)" both places the term appears and inserting "paragraph (1)(A)(i)(I)".

SEC. 285. 2020 ELECTION TO TERMINATE TRANSFER PERIOD FOR QUALIFIED TRANSFERS FROM PENSION PLAN FOR COVERING FUTURE RETIREE COSTS.

(a) IN GENERAL. — Section 420(f) is amended by adding at the end the following new paragraph:

"(7) ELECTION TO END TRANSFER PERIOD. —

"(A) IN GENERAL. — In the case of an employer maintaining a plan which has made a qualified future transfer under this subsection, such employer may, not later than December 31, 2021, elect to terminate the transfer period with respect to such transfer effective as of any taxable year specified by the taxpayer that begins after the date of such election.

"(B) AMOUNTS TRANSFERRED TO PLAN ON TERMINATION. — Any assets transferred to a health benefits account, or an applicable life insurance account, in a qualified future transfer (and any income allocable thereto) which are not used as of the effective date of the election to terminate the transfer period with respect to such transfer under subparagraph (A), shall be transferred out of the account to the transferor plan within a reasonable period of time. The transfer required by this subparagraph shall be treated as an employer reversion for purposes of section 4980 (other than subsection (d) thereof), unless before the end of the 5-year period beginning after the original transfer period an equivalent amount is transferred back to such health benefits account, or applicable life insurance account, as the case may be. Any such transfer back pursuant to the preceding sentence may be made without regard to section 401(h)(1).

"(C) MINIMUM COST REQUIREMENTS CONTINUE. — The requirements of subsection (c)(3) and paragraph (2)(D) shall apply with respect to a qualified future transfer without regard to any election under subparagraph (A) with respect to such transfer.

"(D) MODIFIED MAINTENANCE OF FUNDED STATUS DURING ORIGINAL TRANSFER PERIOD. — The requirements of paragraph (2)(B) shall apply without regard to any such election, and clause (i) thereof shall be applied by substituting '100 percent' for '120 percent' during the original transfer period.

"(E) CONTINUED MAINTENANCE OF FUNDING STATUS AFTER ORIGINAL TRANSFER PERIOD. —

"(i) IN GENERAL. — In the case of a plan with respect to which there is an excess described in paragraph (2)(B)(ii) as of the valuation date of the plan year in the last year of the original transfer period, paragraph (2)(B) shall apply for 5 years after the original transfer period in the same manner as during a transfer period by substituting the applicable percentage for '120 percent' in clause (i) thereof.

"(ii) APPLICABLE PERCENTAGE. — For purposes of this subparagraph, the applicable percentage shall be determined under the following table:

"For the valuation date of the plan year in the following year after the original transfer period

The applicable percentage is:

1st

104 percent

2nd

108 percent

3rd

112 percent

4th

116 percent

5th

120 percent

"(iii) EARLY TERMINATION OF CONTINUED MAINTENANCE PERIOD WHEN 120 PERCENT FUNDING REACHED. — If, as of the valuation date of any plan year in the first 4 years after the original transfer period with respect to a qualified future transfer, there would be no excess determined under this subparagraph were the applicable percentage 120 percent, then this subparagraph shall cease to apply with respect to the plan.

"(F) ORIGINAL TRANSFER PERIOD. — For purposes of this paragraph, the term 'original transfer period' means the transfer period under this subsection with respect to a qualified future transfer determined without regard to the election under subparagraph (A).".

(b) EFFECTIVE DATE. — The amendments made by this section shall apply to taxable years beginning after December 31, 2019.

SEC. 286. EXTENSION OF CREDITS FOR PAID SICK AND FAMILY LEAVE.

(a) IN GENERAL. — Sections 7001(g), 7002(e), 7003(g), and 7004(e) of the Families First Coronavirus Response Act are each amended by striking "December 31, 2020" and inserting "March 31, 2021".

(b) COORDINATION WITH TERMINATION OF MANDATE. —

(1) PAYROLL CREDIT FOR PAID SICK LEAVE. — Section 7001(c) of the Families First Coronavirus Response Act is amended by striking "paid by an employer which" and all that follows and inserting "paid by an employer —

"(1) which are required to be paid by reason of the Emergency Paid Sick Leave Act, or

"(2) both —

"(A) which would be so required to be paid if such Act were applied —

"(i) by substituting 'March 31, 2021' for 'December 31, 2020' in section 5109 thereof, and

"(ii) without regard to section 5102(b)(3) thereof, and

"(B) with respect to which all requirements of such Act (other than subsections (a) and (b) of section 5105 thereof, and determined by substituting 'To be compliant with section 5102, an employer may not' for 'It shall be unlawful for any employer to' in section 5104 thereof) which would apply if so required are satisfied.".

(2) CREDIT FOR SICK LEAVE OF SELF-EMPLOYED INDIVIDUALS. — Section 7002(b)(2) of the Families First Coronavirus Response Act is amended to read as follows:

"(2) either —

"(A) would be entitled to receive paid leave during the taxable year pursuant to the Emergency Paid Sick Leave Act if the individual were an employee of an employer (other than himself or herself), or

"(B) would be so entitled if —

"(i) such Act were applied by substituting 'March 31, 2021' for 'December 31, 2020' in section 5109 thereof, and

"(ii) the individual were an employee of an employer (other than himself or herself).".

(3) PAYROLL CREDIT FOR PAID FAMILY LEAVE. — Section 7003(c) of the Families First Coronavirus Response Act is amended by striking "paid by an employer which" and all that follows and inserting "paid by an employer —

"(1) which are required to be paid by reason of the Emergency Family and Medical Leave Expansion Act (including the amendments made by such Act), or

"(2) both —

"(A) which would be so required to be paid if section 102(a)(1)(F) of the Family and Medical Leave Act of 1993, as amended by the Emergency Family and Medical Leave Expansion Act, were applied by substituting 'March 31, 2021' for 'December 31, 2020', and

"(B) with respect to which all requirements of the Family and Medical Leave Act of 1993 (other than section 107 thereof, and determined by substituting 'To be compliant with section 102(a)(1)(F), an employer may not' for 'It shall be unlawful for any employer to' each place it appears in subsection (a) of section 105 thereof, by substituting 'made unlawful in this title or described in this section' for 'made unlawful by this title' in paragraph (2) of such subsection, and by substituting 'To be compliant with section 102(a)(1)(F), an employer may not' for 'It shall be unlawful for any person to' in subsection (b) of such section) which relate to such section 102(a)(1)(F), and which would apply if so required, are satisfied.".

(4) CREDIT FOR FAMILY LEAVE OF SELF-EMPLOYED INDIVIDUALS. — Section 7004(b)(2) of the Families First Coronavirus Response Act is amended to read as follows:

"(2) either —

"(A) would be entitled to receive paid leave during the taxable year pursuant to the Emergency Family and Medical Leave Expansion Act if the individual were an employee of an employer (other than himself or herself), or

"(B) would be so entitled if —

"(i) section 102(a)(1)(F) of the Family and Medical Leave Act of 1993, as amended by the Emergency Family and Medical Leave Expansion Act, were applied by substituting 'March 31, 2021' for 'December 31, 2020', and

"(ii) the individual were an employee of an employer (other than himself or herself).".

(5) COORDINATION WITH CERTAIN EMPLOYMENT TAXES. — Section 7005(a) of the Families First Coronavirus Response Act is amended by inserting "(or, in the case of wages paid after December 31, 2020, and before April 1, 2021, with respect to which a credit is allowed under section 7001 or 7003)" before "shall not be considered".

(c) EFFECTIVE DATE. — The amendments made by this section shall take effect as if included in the provisions of the Families First Coronavirus Response Act to which they relate.

SEC. 287. ELECTION TO USE PRIOR YEAR NET EARNINGS FROM SELF-EMPLOYMENT IN DETERMINING AVERAGE DAILY SELF-EMPLOYMENT INCOME FOR PURPOSES OF CREDITS FOR PAID SICK AND FAMILY LEAVE.

(a) CREDIT FOR SICK LEAVE. — Section 7002(c) of the Families First Coronavirus Response Act is amended by adding at the end the following new paragraph:

"(4) ELECTION TO USE PRIOR YEAR NET EARNINGS FROM SELF-EMPLOYMENT INCOME. — In the case of an individual who elects (at such time and in such manner as the Secretary, or the Secretary's delegate, may provide) the application of this paragraph, paragraph (2)(A) shall be applied by substituting 'the prior taxable year' for 'the taxable year'.".

(b) CREDIT FOR FAMILY LEAVE. — Section 7004(c) of the Families First Coronavirus Response Act is amended by adding at the end the following new paragraph:

"(4) ELECTION TO USE PRIOR YEAR NET EARNINGS FROM SELF-EMPLOYMENT INCOME. — In the case of an individual who elects (at such time and in such manner as the Secretary, or the Secretary's delegate, may provide) the application of this paragraph, paragraph (2)(A) shall be applied by substituting 'the prior taxable year' for 'the taxable year'.".

(c) EFFECTIVE DATE. — The amendments made by this section shall take effect as if included in the provisions of the Families First Coronavirus Response Act to which they relate.

SEC. 288. CERTAIN TECHNICAL IMPROVEMENTS TO CREDITS FOR PAID SICK AND FAMILY LEAVE.

(a) COORDINATION WITH APPLICATION OF CERTAIN DEFINITIONS. —

(1) IN GENERAL. — Sections 7001(c) and 7003(c) of the Families First Coronavirus Response Act are each amended —

(A) by inserting ", determined without regard to paragraphs (1) through (22) of section 3121(b) of such Code" after "as defined in section 3121(a) of the Internal Revenue Code of 1986", and

(B) by inserting ", determined without regard to the sentence in paragraph (1) thereof which begins 'Such term does not include remuneration' " after "as defined in section 3231(e) of the Internal Revenue Code".

(2) CONFORMING AMENDMENTS. — Sections 7001(e)(3) and 7003(e)(3) of the Families First Coronavirus Response Act are each amended by striking "Any term" and inserting "Except as otherwise provided in this section, any term".

(b) COORDINATION WITH EXCLUSION FROM EMPLOYMENT TAXES. — Sections 7001(c) and 7003(c) of the Families First Coronavirus Response Act, as amended by subsection (a), are each amended —

(1) by inserting "and section 7005(a) of this Act," after "determined without regard to paragraphs (1) through (22) of section 3121(b) of such Code", and

(2) by inserting "and without regard to section 7005(a) of this Act" after "which begins 'Such term does not include remuneration' ".

(c) CLARIFICATION OF APPLICABLE RAILROAD RETIREMENT TAX FOR PAID LEAVE CREDITS. — Sections 7001(e) and 7003(e) of the Families First Coronavirus Response Act, as amended by the pre-ceding provisions of this Act, are each amended by adding at the end the following new paragraph:

"(4) REFERENCES TO RAILROAD RETIREMENT TAX. — Any reference in this section to the tax imposed by section 3221(a) of the Internal Revenue Code of 1986 shall be treated as a reference to so much of such tax as is attributable to the rate in effect under section 3111(a) of such Code.".

(d) CLARIFICATION OF TREATMENT OF PAID LEAVE FOR APPLICABLE RAILROAD RETIREMENT TAX. — Section 7005(a) of the Families First Coronavirus Response Act is amended by adding the following sentence at the end of such subsection: "Any reference in this subsection to the tax imposed by section 3221(a) of such Code shall be treated as a reference to so much of the tax as is attributable to the rate in effect under section 3111(a) of such Code.".

(e) CLARIFICATION OF APPLICABLE RAILROAD RETIREMENT TAX FOR HOSPITAL INSURANCE TAX CREDIT. — Section 7005(b)(1) of the Families First Coronavirus Response Act is amended to read as follows:

"(1) IN GENERAL. — The credit allowed by section 7001 and the credit allowed by section 7003 shall each be increased by the amount of the tax imposed by section 3111(b) of the Internal Revenue Code of 1986 and so much of the taxes imposed under section 3221(a) of such Code as are attributable to the rate in effect under section 3111(b) of such Code on qualified sick leave wages, or qualified family leave wages, for which credit is allowed under such section 7001 or 7003 (respectively).".

(f) EFFECTIVE DATE. — The amendments made by this section shall take effect as if included in the provisions of the Families First Coronavirus Response Act to which they relate.

TITLE III — CONTINUING THE PAYCHECK PROTECTION PROGRAM AND OTHER SMALL BUSINESS SUPPORT

SEC. 301. SHORT TITLE.

This title may be cited as the "Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act".

SEC. 302. DEFINITIONS.

In this Act:

(1) ADMINISTRATION; ADMINISTRATOR. — The terms "Administration" and "Administrator" mean the Small Business Administration and the Administrator thereof, respectively.

(2) SMALL BUSINESS CONCERN. — The term "small business concern" has the meaning given the term in section 3 of the Small Business Act (15 U.S.C. 632).

SEC. 303. EMERGENCY RULEMAKING AUTHORITY.

Not later than 10 days after the date of enactment of this Act, the Administrator shall issue regulations to carry out this Act and the amendments made by this Act without regard to the notice requirements under section 553(b) of title 5, United States Code.

SEC. 304. ADDITIONAL ELIGIBLE EXPENSES.

(a) ALLOWABLE USE OF PPP LOAN. — Section 7(a)(36)(F)(i) of the Small Business Act (15 U.S.C. 636(a)(36)(F)(i)) is amended —

(1) in subclause (VI), by striking "and" at the end;

(2) in subclause (VII), by striking the period at the end and inserting a semicolon; and

(3) by adding at the end the following:

"(VIII) covered operations expenditures, as defined in section 7A(a);

"(IX) covered property damage costs, as defined in section 7A(a);

"(X) covered supplier costs, as defined in section 7A(a); and

"(XI) covered worker protection expenditures, as defined in section 7A(a).".

(b) LOAN FORGIVENESS. —

(1) TRANSFER OF SECTION TO SMALL BUSINESS ACT. —

(A) IN GENERAL. — Section 1106 of the CARES Act (15 U.S.C. 9005) is redesignated as section 7A, transferred to the Small Business Act (15 U.S.C. 631 et seq.), and inserted so as to appear after section 7 of the Small Business Act (15 U.S.C. 636).

(B) CONFORMING AMENDMENTS TO TRANSFERRED SECTION. — Section 7A of the Small Business Act, as redesignated and transferred by subparagraph (A) of this paragraph, is amended —

(i) in subsection (a)(1), by striking "under paragraph (36) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), as added by section 1102" and inserting "under section 7(a)(36)"; and

(ii) in subsection (c), by striking "of the Small Business Act (15 U.S.C. 636(a))" each place it appears.

(C) OTHER CONFORMING AMENDMENTS. —

(i) Section 1109(d)(2)(D) of the CARES Act (15 U.S.C. 9008(d)(2)(D)) is amended by striking "section 1106 of this Act" and inserting "section 7A of the Small Business Act".

(ii) Section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) is amended —

(I) in subparagraph (K), by striking "section 1106 of the CARES Act" and inserting "section 7A"; and

(II) in subparagraph (M) —

(aa) by striking "section 1106 of the CARES Act" each place it appears and inserting "section 7A"; and

(bb) in clause (v), by striking "section 1106(a) of the CARES Act" and inserting "section 7A(a)".

(2) ADDITIONAL ELIGIBLE EXPENSES. — Section 7A of the Small Business Act, as redesignated and transferred by paragraph (1) of this subsection, is amended —

(A) in subsection (a) —

(i) by redesignating paragraphs (6), (7), and (8) as paragraphs (10), (11), and (12), respectively;

(ii) by redesignating paragraph (5) as paragraph (8);

(iii) by redesignating paragraph (4) as paragraph (6);

(iv) by redesignating paragraph (3) as paragraph (4);

(v) by inserting after paragraph (2) the following: "(3) the term 'covered operations expenditure' means a payment for any business software or cloud computing service that facilitates business operations, product or service delivery, the processing, payment, or tracking of payroll expenses, human resources, sales and billing functions, or accounting or tracking of supplies, inventory, records and expenses;";

(vi) by inserting after paragraph (4), as so redesignated, the following:

"(5) the term 'covered property damage cost' means a cost related to property damage and vandalism or looting due to public disturbances that occurred during 2020 that was not covered by insurance or other compensation;";

(vii) by inserting after paragraph (6), as so redesignated, the following:

"(7) the term 'covered supplier cost' means an expenditure made by an entity to a supplier of goods for the supply of goods that —

"(A) are essential to the operations of the entity at the time at which the expenditure is made; and

"(B) is made pursuant to a contract, order, or purchase order —

"(i) in effect at any time before the covered period with respect to the applicable covered loan; or

"(ii) with respect to perishable goods, in effect before or at any time during the covered period with respect to the applicable covered loan;";

(viii) by inserting after paragraph (8), as so redesignated, the following:

"(9) the term 'covered worker protection expenditure' —

"(A) means an operating or a capital expenditure to facilitate the adaptation of the business activities of an entity to comply with requirements established or guidance issued by the Department of Health and Human Services, the Centers for Disease Control, or the Occupational Safety and Health Administration, or any equivalent requirements established or guidance issued by a State or local government, during the period beginning on March 1, 2020 and ending the date on which the national emergency declared by the President under the National Emergencies Act (50 U.S.C. 1601 et seq.) with respect to the Coronavirus Disease 2019 (COVID–19) expires related to the maintenance of standards for sanitation, social distancing, or any other worker or customer safety requirement related to COVID–19;

"(B) may include —

"(i) the purchase, maintenance, or renovation of assets that create or expand —

"(I) a drive-through window facility;

"(II) an indoor, outdoor, or combined air or air pressure ventilation or filtration system;

"(III) a physical barrier such as a sneeze guard;

"(IV) an expansion of additional indoor, outdoor, or combined business space;

"(V) an onsite or offsite health screening capability; or

"(VI) other assets relating to the compliance with the requirements or guidance described in subparagraph (A), as determined by the Administrator in consultation with the Secretary of Health and Human Services and the Secretary of Labor; and

"(ii) the purchase of —

"(I) covered materials described in section 328.103(a) of title 44, Code of Federal Regulations, or any successor regulation;

"(II) particulate filtering facepiece respirators approved by the National Institute for Occupational Safety and Health, including those approved only for emergency use authorization; or

"(III) other kinds of personal protective equipment, as determined by the Administrator in consultation with the Secretary of Health and Human Services and the Secretary of Labor; and

"(C) does not include residential real property or intangible property;"; and

(ix) in paragraph (11), as so redesignated —

(I) in subparagraph (C), by striking "and" at the end;

(II) in subparagraph (D), by striking "and" at the end; and

(III) by adding at the end the following:

"(E) covered operations expenditures;

"(F) covered property damage costs;

"(G) covered supplier costs; and

"(H) covered worker protection expenditures; and";

(B) in subsection (b), by adding at the end the following:

"(5) Any covered operations expenditure.

"(6) Any covered property damage cost.

"(7) Any covered supplier cost.

"(8) Any covered worker protection expenditure.";

(C) in subsection (d)(8), by inserting "any payment on any covered operations expenditure, any payment on any covered property damage cost, any payment on any covered supplier cost, any payment on any covered worker protection expenditure," after "rent obligation,"; and

(D) in subsection (e) —

(i) in paragraph (2) —

(I) by inserting "purchase orders, orders, invoices," before "or other documents"; and

(II) by striking "covered lease obligations," and inserting "covered rent obligations, payments on covered operations expenditures, payments on covered property damage costs, payments on covered supplier costs, payments on covered worker protection expenditures,"; and

(ii) in paragraph (3)(B), by inserting "make payments on covered operations expenditures, make payments on covered property damage costs, make payments on covered supplier costs, make payments on covered worker protection expenditures," after "rent obligation,".

(c) EFFECTIVE DATE; APPLICABILITY. —

(1) IN GENERAL. — Except as provided in paragraph (2), the amendments made by subsections (a) and (b) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgive-ness of such a loan.

(2) EXCLUSION OF LOANS ALREADY FORGIVEN. — The amendments made by subsections (a) and (b) shall not apply to a loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) for which the borrower received forgiveness before the date of enactment of this Act under section 1106 of the CARES Act, as in effect on the day before such date of enactment.

SEC. 305. HOLD HARMLESS.

(a) IN GENERAL. — Subsection (h) of section 7A of the Small Business Act, as redesignated and transferred by section 304 of this Act, is amended to read as follows:

"(h) HOLD HARMLESS. —

"(1) DEFINITION. — In this subsection, the term 'initial or second draw PPP loan' means a covered loan or a loan under paragraph (37) of section 7(a).

"(2) RELIANCE. — A lender may rely on any certification or documentation submitted by an applicant for an initial or second draw PPP loan or an eligible recipient or eligible entity receiving initial or second draw PPP loan that —

"(A) is submitted pursuant to all applicable statutory requirements, regulations, and guidance related to initial or second draw PPP loan, including under paragraph (36) or (37) of section 7(a) and under this section; and

"(B) attests that the applicant, eligible recipient, or eligible entity, as applicable, has accurately provided the certification or documentation to the lender in accordance with the statutory requirements, regulations, and guidance described in subparagraph (A).

"(3) NO ENFORCEMENT ACTION. — With respect to a lender that relies on a certification or documentation described in paragraph (2) related to an initial or second draw PPP loan, an enforcement action may not be taken against the lender, and the lender shall not be subject to any penalties relating to loan origination or forgiveness of the initial or second draw PPP loan, if —

"(A) the lender acts in good faith relating to loan origination or forgiveness of the initial or second draw PPP loan based on that reliance; and

"(B) all other relevant Federal, State, local, and other statutory and regulatory requirements applicable to the lender are satisfied with respect to the initial or second draw PPP loan.".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendment made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 306. SELECTION OF COVERED PERIOD FOR FORGIVENESS.

Section 7A of the Small Business Act, as redesignated and transferred by section 304 of this Act, is amended —

(A) by amending paragraph (4) of subsection (a), as so redesignated by section 304(b) of this Act, to read as follows:

"(4) the term 'covered period' means the period —

"(A) beginning on the date of the origination of a covered loan; and

"(B) ending on a date selected by the eligible recipient of the covered loan that occurs during the period —

"(i) beginning on the date that is 8 weeks after such date of origination; and

"(ii) ending on the date that is 24 weeks after such date of origination;"; and

(1) by striking subsection (l).

SEC. 307. SIMPLIFIED FORGIVENESS APPLICATION.

(a) IN GENERAL. — Section 7A of the Small Business Act, as redesignated and transferred by section 304 of this Act, and as amended by section 306 of this Act, is amended —

(1) in subsection (e), in the matter preceding paragraph (1), by striking "An eligible" and inserting "Except as provided in subsection (l), an eligible";

(2) in subsection (f), by inserting "or the certification required under subsection (l), as applicable" after "subsection (e)"; and

(3) by adding at the end the following:

"(l) SIMPLIFIED APPLICATION. —

"(1) COVERED LOANS UP TO $150,000. —

"(A) IN GENERAL. — With respect to a covered loan made to an eligible recipient that is not more than $150,000, the covered loan amount shall be forgiven under this section if the eligible recipient —

"(i) signs and submits to the lender a certification, to be established by the Administrator not later than 24 days after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, which —

"(I) shall be not more than 1 page in length; and

"(II) shall only require the eligible recipient to provide —

"(aa) a description of the number of employees the eligible recipient was able to retain because of the covered loan;

"(bb) the estimated amount of the covered loan amount spent by the eligible recipient on payroll costs; and

"(cc) the total loan value;

"(ii) attests that the eligible recipient has —

"(I) accurately provided the required certification; and

"(II) complied with the requirements under section 7(a)(36); and

"(iii) retains records relevant to the form that prove compliance with such requirements —

"(I) with respect to employment records, for the 4-year period following submission of the form; and

"(II) with respect to other records, for the 3-year period following submission of the form.

"(B) LIMITATION ON REQUIRING ADDITIONAL MATERIALS. — An eligible recipient of a covered loan that is not more than $150,000 shall not, at the time of the application for forgiveness, be required to submit any application or documentation in addition to the certification and information required to substantiate forgiveness.

"(C) RECORDS FOR OTHER REQUIREMENTS. — Nothing in subparagraph (A) or (B) shall be construed to exempt an eligible recipient from having to provide documentation independently to a lender to satisfy relevant Federal, State, local, or other statutory or regulatory requirements, or in connection with an audit as authorized under subparagraph (E).

"(D) DEMOGRAPHIC INFORMATION. — The certification established by the Administrator under subparagraph (A) shall include a means by which an eligible recipient may, at the discretion of the eligible recipient, submit demographic information of the owner of the eligible recipient, including the sex, race, ethnicity, and veteran status of the owner.

"(E) AUDIT AUTHORITY. — The Administrator may —

"(i) review and audit covered loans described in subparagraph (A);

"(ii) access any records described in subparagraph (A)(iii); and

"(iii) in the case of fraud, ineligibility, or other material noncompliance with applicable loan or loan forgiveness requirements, modify —

"(I) the amount of a covered loan described in subparagraph (A); or

"(II) the loan forgiveness amount with respect to a covered loan described in subparagraph (A).

"(2) COVERED LOANS OF MORE THAN $150,000. —

"(A) IN GENERAL. — With respect to a covered loan in an amount that is more than $150,000, the eligible recipient shall submit to the lender that is servicing the covered loan the documentation described in subsection (e).

"(B) DEMOGRAPHIC INFORMATION. — The process for submitting the documentation described in subsection (e) shall include a means by which an eligible recipient may, at the discretion of the eligible recipient, submit demographic information of the owner of the eligible recipient, including the sex, race, ethnicity, and veteran status of the owner.

"(3) FORGIVENESS AUDIT PLAN. —

"(A) IN GENERAL. — Not later than 45 days after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, the Administrator shall submit to the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business of the House of Representatives an audit plan that details —

"(i) the policies and procedures of the Administrator for conducting forgiveness reviews and audits of covered loans; and

"(ii) the metrics that the Administrator shall use to determine which covered loans will be audited.

"(B) REPORTS. — Not later than 30 days after the date on which the Administrator submits the audit plan required under subparagraph (A), and each month thereafter, the Administrator shall submit to the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business of the House of Representatives a report on the forgiveness review and audit activities of the Administrator under this subsection, which shall include —

"(i) the number of active reviews and audits;

"(ii) the number of reviews and audits that have been ongoing for more than 60 days; and

"(iii) any substantial changes made to the audit plan submitted under subparagraph (A).".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendments made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 308. SPECIFIC GROUP INSURANCE PAYMENTS AS PAYROLL COSTS.

(a) IN GENERAL. — Section 7(a)(36)(A)(viii)(I)(aa)(EE) of the Small Business Act (15 U.S.C. 636(a)(36)(A)(viii)(I)(aa)(EE)) is amended by inserting "or group life, disability, vision, or dental insurance" before "benefits".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendment made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 309. DEMOGRAPHIC INFORMATION.

On and after the date of enactment of this Act, any loan origination application for a loan under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), as amended and added by this division, shall include a means by which the applicant for the loan may, at the discretion of the applicant, submit demographic information of the owner of the recipient of the loan, including the sex, race, ethnicity, and veteran status of the owner.

SEC. 310. CLARIFICATION OF AND ADDITIONAL LIMITATIONS ON ELIGIBILITY.

(a) DATE IN OPERATION. —

(1) IN GENERAL. — Section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) is amended by adding at the end the following:

"(T) REQUIREMENT FOR DATE IN OPERATION. — A business or organization that was not in operation on February 15, 2020 shall not be eligible for a loan under this paragraph.".

(2) EFFECTIVE DATE; APPLICABILITY. — The amendment made by paragraph (1) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

(b) EXCLUSION OF ENTITIES RECEIVING SHUTTERED VENUE OPERATOR GRANTS. — Section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)), as amended by subsection (a) of this section, is amended by adding at the end the following:

"(U) EXCLUSION OF ENTITIES RECEIVING SHUTTERED VENUE OPERATOR GRANTS. — An eligible person or entity (as defined under of section 24 of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act) that receives a grant under such section 24 shall not be eligible for a loan under this paragraph.".

SEC. 311. PAYCHECK PROTECTION PROGRAM SECOND DRAW LOANS.

(a) IN GENERAL. — Section 7(a) of the Small Business Act (15 U.S.C. 636(a)) is amended by adding at the end the following:

"(37) PAYCHECK PROTECTION PROGRAM SECOND DRAW LOANS. —

"(A) DEFINITIONS. — In this paragraph —

"(i) the terms 'eligible self-employed individual', 'housing cooperative', 'nonprofit organization', 'payroll costs', 'seasonal employer', and 'veterans organization' have the meanings given those terms in paragraph (36), except that 'eligible entity' shall be substituted for 'eligible recipient' each place it appears in the definitions of those terms;

"(ii) the term 'covered loan' means a loan made under this paragraph;

"(iii) the terms 'covered mortgage obligation', 'covered operating expenditure', 'covered property damage cost', 'covered rent obligation', 'covered supplier cost', 'covered utility payment', and 'covered worker protection expenditure' have the meanings given those terms in section 7A(a);

"(iv) the term 'eligible entity' —

"(I) means any business concern, nonprofit organization , housing cooperative, veterans organization, Tribal business concern, eligible self-employed individual, sole proprietor, independent contractor, or small agricultural cooperative that —

"(aa) employs not more than 300 employees; and

"(bb)(AA) except as provided in subitems (BB), (CC), and (DD), had gross receipts during the first, second, third, or, only with respect to an application submitted on or after January 1, 2021, fourth quarter in 2020 that demonstrate not less than a 25 percent reduction from the gross receipts of the entity during the same quarter in 2019;

"(BB) if the entity was not in business during the first or second quarter of 2019, but was in business during the third and fourth quarter of 2019, had gross receipts during the first, second, third, or, only with respect to an application submitted on or after January 1, 2021, fourth quarter of 2020 that demonstrate not less than a 25 percent reduction from the gross receipts of the entity during the third or fourth quarter of 2019;

"(CC) if the entity was not in business during the first, second, or third quarter of 2019, but was in business during the fourth quarter of 2019, had gross receipts during the first, second, third, or, only with respect to an application submitted on or after January 1, 2021, fourth quarter of 2020 that demonstrate not less than a 25 percent reduction from the gross receipts of the entity during the fourth quarter of 2019; or

"(DD) if the entity was not in business during 2019, but was in operation on February 15, 2020, had gross receipts during the second, third, or, only with respect to an application submitted on or after January 1, 2021, fourth quarter of 2020 that demonstrate not less than a 25 percent reduction from the gross receipts of the entity during the first quarter of 2020;

"(II) includes a business concern or organization made eligible for a loan under paragraph (36) under clause (iii)(II), (iv)(IV), or (vii) of subparagraph (D) of paragraph (36) and that meets the requirements described in items (aa) and (bb) of subclause (I); and

"(III) does not include —

"(aa) any entity that is a type of business concern (or would be, if such entity were a business concern) described in section 120.110 of title 13, Code of Federal Regulations (or in any successor regulation or other related guidance or rule that may be issued by the Administrator) other than a business concern described in subsection (a) or (k) of such section; or

"(bb) any business concern or entity primarily engaged in political or lobbying activities, which shall include any entity that is organized for research or for engaging in advocacy in areas such as public policy or political strategy or otherwise describes itself as a think tank in any public documents;

"(cc) any business concern or entity —

"(AA) for which an entity created in or organized under the laws of the People's Republic of China or the Special Administrative Region of Hong Kong, or that has significant operations in the People's Republic of China or the Special Administrative Region of Hong Kong, owns or holds, directly or indirectly, not less than 20 percent of the economic interest of the business concern or entity, including as equity shares or a capital or profit interest in a limited liability company or partnership; or

"(BB) that retains, as a member of the board of directors of the business concern, a person who is a resident of the People's Republic of China;

"(dd) any person required to submit a registration statement under section 2 of the Foreign Agents Registration Act of 1938 (22 U.S.C. 612); or

"(ee) an eligible person or entity (as defined under section 24 of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act) that receives a grant under such section 24; and

"(v) the term 'Tribal business concern' means a Tribal business concern described in section 31(b)(2)(C).

"(B) LOANS. — Except as otherwise provided in this paragraph, the Administrator may guarantee covered loans to eligible entities under the same terms, conditions, and processes as a loan made under paragraph (36).

"(C) MAXIMUM LOAN AMOUNT. —

"(i) IN GENERAL. — Except as otherwise provided in this subparagraph, the maximum amount of a covered loan made to an eligible entity is the lesser of —

"(I) the product obtained by multiplying —

"(aa) at the election of the eligible entity, the average total monthly payment for payroll costs incurred or paid by the eligible entity during —

"(AA) the 1-year period before the date on which the loan is made; or

"(BB) calendar year 2019; by

"(bb) 2.5; or

"(II) $2,000,000.

"(ii) SEASONAL EMPLOYERS. — The maximum amount of a covered loan made to an eligible entity that is a seasonal employer is the lesser of —

"(I) the product obtained by multiplying —

"(aa) at the election of the eligible entity, the average total monthly payments for payroll costs incurred or paid by the eligible entity for any 12-week period between February 15, 2019 and February 15, 2020; by

"(bb) 2.5; or

"(II) $2,000,000.

"(iii) NEW ENTITIES. — The maximum amount of a covered loan made to an eligible entity that did not exist during the 1-year period preceding February 15, 2020 is the lesser of —

"(I) the product obtained by multiplying —

"(aa) the quotient obtained by dividing —

"(AA) the sum of the total monthly payments by the eligible entity for payroll costs paid or incurred by the eligible entity as of the date on which the eligible entity applies for the covered loan; by

"(BB) the number of months in which those payroll costs were paid or incurred; by

"(bb) 2.5; or

"(II) $2,000,000.

"(iv) NAICS 72 ENTITIES. — The maximum amount of a covered loan made to an eligible entity that is assigned a North American Industry Classification System code beginning with 72 at the time of disbursal is the lesser of —

"(I) the product obtained by multiplying —

"(aa) at the election of the eligible entity, the average total monthly payment for payroll costs incurred or paid by the eligible entity during —

"(AA) the 1-year period before the date on which the loan is made; or

"(BB) calendar year 2019; by

"(bb) 3.5; or

"(II) $2,000,000.

"(D) BUSINESS CONCERNS WITH MORE THAN 1 PHYSICAL LOCATION. —

"(i) IN GENERAL. — For a business concern with more than 1 physical location, the business concern shall be an eligible entity if the business concern would be eligible for a loan under paragraph (36) pursuant to clause (iii) of subparagraph (D) of such paragraph, as applied in accordance with clause (ii) of this subparagraph, and meets the revenue reduction requirements described in item (bb) of subparagraph (A)(iv)(I).

"(ii) SIZE LIMIT. — For purposes of applying clause (i), the Administrator shall substitute 'not more than 300 employees' for 'not more than 500 employees' in paragraph (36)(D)(iii).

"(E) WAIVER OF AFFILIATION RULES. —

"(i) IN GENERAL. — The waiver described in paragraph (36)(D)(iv) shall apply for purposes of determining eligibility under this paragraph.

"(ii) SIZE LIMIT. — For purposes of applying clause (i), the Administrator shall substitute 'not more than 300 employees' for 'not more than 500 employees' in subclause (I) and (IV) of paragraph (36)(D)(iv).

"(F) LOAN NUMBER LIMITATION. — An eligible entity may only receive 1 covered loan.

"(G) EXCEPTION FROM CERTAIN CERTIFICATION REQUIREMENTS. — An eligible entity applying for a covered loan shall not be required to make the certification described in clause (iii) or (iv) of paragraph (36)(G).

"(H) FEE WAIVER. — With respect to a covered loan —

"(i) in lieu of the fee otherwise applicable under paragraph (23)(A), the Administrator shall collect no fee; and

"(ii) in lieu of the fee otherwise applicable under paragraph (18)(A), the Administrator shall collect no fee.

"(I) GROSS RECEIPTS AND SIMPLIFIED CERTIFICATION OF REVENUE TEST. —

"(i) LOANS OF UP TO $150,000. — For a covered loan of not more than $150,000, the eligible entity —

"(I) may submit a certification attesting that the eligible entity meets the applicable revenue loss requirement under subparagraph (A)(iv)(I)(bb); and

"(II) if the eligible entity submits a certification under subclause (I), shall, on or before the date on which the eligible entity submits an application for forgiveness under subparagraph (J), produce adequate documentation that the eligible entity met such revenue loss standard.

"(ii) FOR NON-PROFIT AND VETERANS ORGANIZATIONS. — For purposes of calculating gross receipts under subparagraph (A)(iv)(I)(bb) for an eligible entity that is a non-profit organization, a veterans organization, or an organization described in subparagraph (A)(iv)(II), gross receipts means gross receipts within the meaning of section 6033 of the Internal Revenue Code of 1986.

"(J) LOAN FORGIVENESS. —

"(i) DEFINITION OF COVERED PERIOD. — In this subparagraph, the term 'covered period' has the meaning given that term in section 7A(a).

"(ii) FORGIVENESS GENERALLY. — Except as otherwise provided in this subparagraph, an eligible entity shall be eligible for forgiveness of indebtedness on a covered loan in the same manner as an eligible recipient with respect to a loan made under paragraph (36) of this section, as described in section 7A.

"(iii) FORGIVENESS AMOUNT. — An eligible entity shall be eligible for forgiveness of indebtedness on a covered loan in an amount equal to the sum of the following costs incurred or expenditures made during the covered period:

"(I) Payroll costs, excluding any payroll costs that are —

"(aa) qualified wages, as defined in subsection (c)(3) of section 2301 of the CARES Act (26 U.S.C. 3111 note), taken into account in determining the credit allowed under such section; or

"(bb) qualified wages taken into account in determining the credit allowed under subsection (a) or (d) of section 303 of the Taxpayer Certainty and Disaster Relief Act of 2020.

"(II) Any payment of interest on any covered mortgage obligation (which shall not include any prepayment of or payment of principal on a covered mortgage obligation).

"(III) Any covered operations expenditure.

"(IV) Any covered property damage cost.

"(V) Any payment on any covered rent obligation.

"(VI) Any covered utility payment.

"(VII) Any covered supplier cost.

"(VIII) Any covered worker protection expenditure.

"(iv) LIMITATION ON FORGIVENESS FOR ALL ELIGIBLE ENTITIES. — Subject to any reductions under section 7A(d), the forgiveness amount under this subparagraph shall be equal to the lesser of —

"(I) the amount described in clause (ii); and

"(II) the amount equal to the quotient obtained by dividing —

"(aa) the amount of the covered loan used for payroll costs during the covered period; and

"(bb) 0.60.

"(v) SUBMISSION OF MATERIALS FOR FORGIVENESS. — For purposes of applying subsection (l)(1) of section 7A to a covered loan of not more than $150,000 under this paragraph, an eligible entity may be required to provide, at the time of the application for forgiveness, documentation required to substantiate revenue loss in accordance with subparagraph (I).

"(K) LENDER ELIGIBILITY. — Except as otherwise provided in this paragraph, a lender approved to make loans under paragraph (36) may make covered loans under the same terms and conditions as in paragraph (36).

"(L) REIMBURSEMENT FOR LOAN PROCESSING AND SERVICING. — The Administrator shall reimburse a lender authorized to make a covered loan —

"(i) for a covered loan of not more than $50,000, in an amount equal to the lesser of —

"(I) 50 percent of the balance of the financing outstanding at the time of disbursement of the covered loan; or

"(II) $2,500;

"(ii) at a rate, based on the balance of the financing outstanding at the time of disbursement of the covered loan, of —

"(I) 5 percent for a covered loan of more than $50,000 and not more than $350,000; and

"(II) 3 percent for a covered loan of more than $350,000.

"(M) PUBLICATION OF GUIDANCE. — Not later than 10 days after the date of enactment of this paragraph, the Administrator shall issue guidance addressing barriers to accessing capital for minority, underserved, veteran, and women-owned business concerns for the purpose of ensuring equitable access to covered loans.

"(N) STANDARD OPERATING PROCEDURE. — The Administrator shall, to the maximum extent practicable, allow a lender approved to make covered loans to use existing program guidance and standard operating procedures for loans made under this subsection.

"(O) SUPPLEMENTAL COVERED LOANS. — A covered loan under this paragraph may only be made to an eligible entity that —

"(i) has received a loan under paragraph (36); and

"(ii) on or before the expected date on which the covered loan under this paragraph is disbursed to the eligible entity, has used, or will use, the full amount of the loan received under paragraph (36).".

(b) APPLICATION OF EXEMPTION BASED ON EMPLOYEE AVAILABILITY —

(1) IN GENERAL. — Section 7A(d) of the Small Business Act, as redesignated and transferred by section 304 of this Act, is amended —

(A) in paragraph (5)(B), by inserting "(or, with respect to a covered loan made on or after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, not later than the last day of the covered period with respect to such covered loan)" after "December 31, 2020" each place it appears; and

(B) in paragraph (7) —

(i) by inserting "(or, with respect to a covered loan made on or after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Non-profits, and Venues Act, ending on the last day of the covered period with respect to such covered loan)" after "December 31, 2020" the first and third places it appears; and

(ii) by inserting "(or, with respect to a covered loan made on or after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Non-profits, and Venues Act, on or before the last day of the covered period with respect to such covered loan)" after "December 31, 2020" the second place it appears.

(2) MODIFICATION OF DATES. — The Administrator and the Secretary of the Treasury may jointly, by regulation, modify any date in section 7A(d) of the Small Business Act, as redesignated and transferred by section 304 of this Act, other than a deadline established under an amendment made by paragraph (1), in a manner consistent with the purposes of the Paycheck Protection Program to help businesses retain workers and meet financial obligations.

(c) ELIGIBLE CHURCHES AND RELIGIOUS ORGANIZATIONS. —

(1) SENSE OF CONGRESS. — It is the sense of Congress that the interim final rule of the Administration entitled "Business Loan Program Temporary Changes; Paycheck Protection Program" (85 Fed. Reg. 20817 (April 15, 2020)) properly clarified the eligibility of churches and religious organizations for loans made under paragraph (36) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)).

(2) APPLICABILITY OF PROHIBITION. — The prohibition on eligibility established by section 120.110(k) of title 13, Code of Federal Regulations, or any successor regulation, shall not apply to a loan under paragraph (36) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)).

SEC. 312. INCREASED ABILITY FOR PAYCHECK PROTECTION PROGRAM BORROWERS TO REQUEST AN INCREASE IN LOAN AMOUNT DUE TO UPDATED REGULATIONS.

(a) DEFINITIONS. — In this section —

(1) the terms "covered loan" and "eligible recipient" have the meanings given those terms in 7(a)(36)(A) of the Small Business Act (15 U.S.C. 636(a)(36)(A)); and

(2) the term "included covered loan" means a covered loan for which, as of the date of enactment of this Act, the borrower had not received forgiveness under section 1106 of the CARES Act, as in effect on the day before such date of enactment.

(b) RULES OR GUIDANCE. — Not later than 17 days after the date of enactment of this Act, and without regard to the notice requirements under section 553(b) of title 5, United States Code, the Administrator shall issue rules or guidance to ensure that an eligible recipient of an included covered loan that returns amounts disbursed under the included covered loan or does not accept the full amount of the included covered loan for which the eligible recipient was approved —

(1) in the case of an eligible recipient that returned all or part of an included covered loan, the eligible recipient may reapply for a covered loan for an amount equal to the difference between the amount retained and the maximum amount applicable; and

(2) in the case of an eligible recipient that did not accept the full amount of an included covered loan, the eligible recipient may request a modification to increase the amount of the covered loan to the maximum amount applicable, subject to the requirements of section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)).

(c) INTERIM FINAL RULES. — Notwithstanding the interim final rule issued by the Administration entitled "Business Loan Program Temporary Changes; Paycheck Protection Program — Loan Increases" (85 Fed. Reg. 29842 (May 19, 2020)), an eligible recipient of an included covered loan that is eligible for an increased covered loan amount as a result of any interim final rule that allows for covered loan increases may submit a request for an increase in the included covered loan amount even if —

(1) the initial covered loan amount has been fully disbursed; or

(2) the lender of the initial covered loan has submitted to the Administration a Form 1502 report related to the covered loan.

SEC. 313. CALCULATION OF MAXIMUM LOAN AMOUNT FOR FARMERS AND RANCHERS UNDER THE PAYCHECK PROTECTION PROGRAM.

(a) IN GENERAL. — Section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)), as amended by section 310 of this Act, is amended —

(1) in subparagraph (E), in the matter preceding clause (i), by striking "During" and inserting "Except as provided in subparagraph (V), during"; and

(2) by adding at the end the following:

"(V) CALCULATION OF MAXIMUM LOAN AMOUNT FOR FARMERS AND RANCHERS. —

"(i) DEFINITION. — In this subparagraph, the term 'covered recipient' means an eligible recipient that —

"(I) operates as a sole proprietorship or as an independent contractor, or is an eligible self-employed individual;

"(II) reports farm income or expenses on a Schedule F (or any equivalent successor schedule); and

"(III) was in business as of February 15, 2020.

"(ii) NO EMPLOYEES. — With respect to covered recipient without employees, the maximum covered loan amount shall be the lesser of —

"(I) the sum of —

"(aa) the product obtained by multiplying —

"(AA) the gross income of the covered recipient in 2019, as reported on a Schedule F (or any equivalent successor schedule), that is not more than $100,000, divided by 12; and

"(BB) 2.5; and

"(bb) the outstanding amount of a loan under subsection (b)(2) that was made during the period beginning on January 31, 2020 and ending on April 3, 2020 that the borrower intends to refinance under the covered loan, not including any amount of any advance under the loan that is not required to be repaid; or

"(II) $2,000,000.

"(iii) WITH EMPLOYEES. — With respect to a covered recipient with employees, the maximum covered loan amount shall be calculated using the formula described in subparagraph (E), except that the gross income of the covered recipient described in clause (ii)(I)(aa)(AA) of this subparagraph, as divided by 12, shall be added to the sum calculated under subparagraph (E)(i)(I).

"(iv) RECALCULATION. — A lender that made a covered loan to a covered recipient before the date of enactment of this subparagraph may, at the request of the covered recipient —

"(I) recalculate the maximum loan amount applicable to that covered loan based on the formula described in clause (ii) or (iii), as applicable, if doing so would result in a larger covered loan amount; and

"(II) provide the covered recipient with additional covered loan amounts based on that recalculation.".

(b) EFFECTIVE DATE; APPLICABILITY. —

(1) IN GENERAL. — Except as provided in paragraph (2), the amendments made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

(2) EXCLUSION OF LOANS ALREADY FORGIVEN. — The amendments made by subsection (a) shall not apply to a loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) for which the borrower received forgiveness before the date of enactment of this Act under section 1106 of the CARES Act, as in effect on the day before such date of enactment.

SEC. 314. FARM CREDIT SYSTEM INSTITUTIONS.

(a) DEFINITION OF FARM CREDIT SYSTEM INSTITUTION. — In this section, the term "Farm Credit System institution" —

(1) means an institution of the Farm Credit System chartered under the Farm Credit Act of 1971 (12 U.S.C. 2001 et seq.); and

(2) does not include the Federal Agricultural Mortgage Corporation.

(b) FACILITATION OF PARTICIPATION IN PPP AND SECOND DRAW LOANS. —

(1) APPLICABLE RULES. — Solely with respect to loans under paragraphs (36) and (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), Farm Credit Administration regulations and guidance issued as of July 14, 2020, and compliance with such regulations and guidance, shall be deemed functionally equivalent to requirements referenced in section 3(a)(iii)(II) of the interim final rule of the Administration entitled "Business Loan Program Temporary Changes; Paycheck Protection Program" (85 Fed. Reg. 20811 (April 15, 2020)) or any similar requirement referenced in that interim final rule in implementing such paragraph (37).

(2) APPLICABILITY OF CERTAIN LOAN REQUIREMENTS. — For purposes of making loans under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)) or forgiving those loans in accordance with section 7A of the Small Business Act, as redesignated and transferred by section 304 of this Act, and subparagraph (J) of such paragraph (37), sections 4.13, 4.14, and 4.14A of the Farm Credit Act of 1971 (12 U.S.C. 2199, 2202, 2202a) (including regulations issued under those sections) shall not apply.

(3) RISK WEIGHT. —

(A) IN GENERAL. — With respect to the application of Farm Credit Administration capital requirements, a loan described in subparagraph (B) —

(i) shall receive a risk weight of zero percent; and

(ii) shall not be included in the calculation of any applicable leverage ratio or other applicable capital ratio or calculation.

(B) LOANS DESCRIBED. — A loan referred to in subparagraph (A) is —

(iii) a loan made by a Farm Credit Bank described in section 1.2(a) of the Farm Credit Act of 1971 (12 U.S.C. 2002(a)) to a Federal Land Bank Association, a Production Credit Association, or an agricultural credit association described in that section to make loans under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)) or forgive those loans in accordance with section 7A of the Small Business Act, as redesignated and transferred by section 304 of this Act, and subparagraph (J) of such paragraph (37); or

(iv) a loan made by a Federal Land Bank Association, a Production Credit Association, an agricultural credit association, or the bank for cooperatives described in section 1.2(a) of the Farm Credit Act of 1971 (12 U.S.C. 2002(a)) under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)).

(c) EFFECTIVE DATE; APPLICABILITY. — This section shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 315. DEFINITION OF SEASONAL EMPLOYER.

(a) PPP LOANS. — Section 7(a)(36)(A) of the Small Business Act (15 U.S.C. 636(a)(36)(A)) is amended —

(1) in clause (xi), by striking "and" at the end;

(2) in clause (xii), by striking the period at the end and inserting a semicolon; and

(3) by adding at the end the following:

"(xiii) the term 'seasonal employer' means an eligible recipient that —

"(I) does not operate for more than 7 months in any calendar year; or

"(II) during the preceding calendar year, had gross receipts for any 6 months of that year that were not more than 33.33 percent of the gross receipts of the employer for the other 6 months of that year;".

(b) LOAN FORGIVENESS. — Paragraph (12) of section 7A(a) of the Small Business Act, as so redesignated and transferred by section 304 of this Act, is amended to read as follows:

"(12) the terms 'payroll costs' and 'seasonal employer' have the meanings given those terms in section 7(a)(36).".

(c) EFFECTIVE DATE; APPLICABILITY. — The amendments made by subsections (a) and (b) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 316. HOUSING COOPERATIVES.

Section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) is amended —

(1) in subparagraph (A), as amended by section 315(a) of this Act, by adding at the end the following:

"(xiv) the term 'housing cooperative' means a cooperative housing corporation (as defined in section 216(b) of the Internal Revenue Code of 1986) that employs not more than 300 employees;"; and

(2) in subparagraph (D) —

(A) in clause (i), by inserting "housing cooperative," before "veterans organization," each place it appears; and

(B) in clause (vi), by inserting ", a housing cooperative," before "a veterans organization".

SEC. 317. ELIGIBILITY OF NEWS ORGANIZATIONS FOR LOANS UNDER THE PAYCHECK PROTECTION PROGRAM.

(a) ELIGIBILITY OF INDIVIDUAL STATIONS, NEWSPAPERS, AND PUBLIC BROADCASTING ORGANIZATIONS. — Section 7(a)(36)(D)(iii) of the Small Business Act (15 U.S.C. 636(a)(36)(D)(iii)) is amended —

(1) by striking "During the covered period" and inserting the following:

"(I) IN GENERAL. — During the covered period"; and

(2) by adding at the end the following

"(II) ELIGIBILITY OF NEWS ORGANIZATIONS. —

"(aa) DEFINITION. — In this subclause, the term 'included business concern' means a business concern, including any station which broadcasts pursuant to a license granted by the Federal Communications Commission under title III of the Communications Act of 1934 (47 U.S.C. 301 et seq.) without regard for whether such a station is a concern as defined in section 121.105 of title 13, Code of Federal Regulations, or any successor thereto —

"(AA) that employs not more than 500 employees, or the size standard established by the Administrator for the North American Industry Classification System code applicable to the business concern, per physical location of such business concern; or

"(BB) any nonprofit organization or any organization otherwise subject to section 511(a)(2)(B) of the Internal Revenue Code of 1986 that is a public broadcasting entity (as defined in section 397(11) of the Communications Act of 1934 (47 U.S.C. 397(11))).

"(bb) ELIGIBILITY. — During the covered period, an included business concern shall be eligible to receive a covered loan if —

"(AA) the included business concern is majority owned or controlled by a business concern that is assigned a North American Industry Classification System code beginning with 511110 or 5151 or, with respect to a public broadcasting entity (as defined in section 397(11) of the Communications Act of 1934 (47 U.S.C. 397(11))), has a trade or business that falls under such a code; and

"(BB) the included business concern makes a good faith certification that proceeds of the loan will be used to support expenses at the component of the included business concern that produces or distributes locally focused or emergency information.".

(b) ELIGIBILITY OF AFFILIATED ENTITIES. — Section 7(a)(36)(D)(iv) of the Small Business Act (15 U.S.C. 636(a)(36)(D)(iv)) is amended —

(1) in subclause (II), by striking "and" at the end;

(2) in subclause (III), by striking the period at the end and inserting "; and"; and

(3) by adding at the end the following:

"(IV)(aa) any business concern (including any station which broadcasts pursuant to a license granted by the Federal Communications Commission under title III of the Communications Act of 1934 (47 U.S.C. 301 et seq.) without regard for whether such a station is a concern as defined in section 121.105 of title 13, Code of Federal Regulations, or any success or thereto) that employs not more than 500 employees, or the size standard established by the Administrator for the North American Industry Classification System code applicable to the business concern, per physical location of such business concern and is majority owned or controlled by a business concern that is assigned a North American Industry Classification System code beginning with 511110 or 5151; or

"(bb) any nonprofit organization that is assigned a North American Industry Classification System code beginning with 5151.".

(c) APPLICATION OF PROHIBITION ON PUBLICLY TRADED COMPANIES. — Clause (viii) of section 7(a)(36)(D) of the Small Business Act (15 U.S.C. 636(a)(36)(D), as added by section 342 of this Act is amended —

(1) by striking "Notwithstanding" and inserting the following:

"(I) IN GENERAL. — Subject to subclause (II), and notwithstanding"; and

(2) by adding at the end —

"(II) RULE FOR AFFILIATED ENTITIES. — With respect to a business concern made eligible by clause (iii)(II) or clause (iv)(IV) of this subparagraph, the Administrator shall not consider whether any affiliated entity, which for purposes of this subclause shall include any entity that owns or controls such business concern, is an issuer.".

SEC. 318. ELIGIBILITY OF 501(c)(6) AND DESTINATION MARKETING ORGANIZATIONS FOR LOANS UNDER THE PAYCHECK PROTECTION PROGRAM.

Section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) is amended —

(1) in subparagraph (A), as amended by section 316 of this Act, by adding at the end the following:

"(xv) the term 'destination marketing organization' means a nonprofit entity that is —

"(I) an organization described in section 501(c) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code; or

"(II) a State, or a political subdivision of a State (including any instrumentality of such entities) —

"(aa) engaged in marketing and promoting communities and facilities to businesses and leisure travelers through a range of activities, including —

"(AA) assisting with the location of meeting and convention sites;

"(BB) providing travel information on area attractions, lodging accommodations, and restaurants;

"(CC) providing maps; and

"(DD) organizing group tours of local historical, recreational, and cultural attractions; or

"(bb) that is engaged in, and derives the majority of the operating budget of the entity from revenue attributable to, providing live events; and"; and

(2) in subparagraph (D), as amended by section 316 of this Act —

(A) in clause (v), by inserting "or for purposes of determining the number of employees of a housing cooperative or a business concern or organization made eligible for a loan under this paragraph under clause (iii)(II), (iv)(IV), or (vii)," after "clause (i)(I),";

(B) in clause (vi), by inserting "a business concern or organization made eligible for a loan under this paragraph under clause (vii)," after "a nonprofit organization,"; and

(C) by adding at the end the following:

"(vii) ELIGIBILITY FOR CERTAIN 501(c)(6) ORGANIZATIONS. —

"(I) IN GENERAL. — Any organization that is described in section 501(c)(6) of the Internal Revenue Code and that is exempt from taxation under section 501(a) of such Code (excluding professional sports leagues and organizations with the purpose of promoting or participating in a political campaign or other activity) shall be eligible to receive a covered loan if —

"(aa) the organization does not receive more than 15 percent of its receipts from lobbying activities;

"(bb) the lobbying activities of the organization do not comprise more than 15 percent of the total activities of the organization;

"(cc) the cost of the lobbying activities of the organization did not exceed $1,000,000 during the most recent tax year of the organization that ended prior to February 15, 2020; and

"(dd) the organization employs not more than 300 employees.

"(II) DESTINATION MARKETING ORGANIZATIONS. — Any destination marketing organization shall be eligible to receive a covered loan if —

"(aa) the destination marketing organization does not receive more than 15 percent of its receipts from lobbying activities;

"(bb) the lobbying activities of the destination marketing organization do not comprise more than 15 percent of the total activities of the organization;

"(cc) the cost of the lobbying activities of the destination marketing organization did not exceed $1,000,000 during the most recent tax year of the destination marketing organization that ended prior to February 15, 2020; and

"(dd) the destination marketing organization employs not more than 300 employees; and

"(ee) the destination marketing organization —

"(AA) is described in section 501(c) of the Internal Revenue Code and is exempt from taxation under section 501(a) of such Code; or

"(BB) is a quasi-governmental entity or is a political subdivision of a State or local government, including any instrumentality of those entities.".

SEC. 319. PROHIBITION ON USE OF LOAN PROCEEDS FOR LOBBYING ACTIVITIES.

Section 7(a)(36)(F) of the Small Business Act (15 U.S.C. 636(a)(36)(F)) is amended by adding at the end the following:

"(vi) PROHIBITION. — None of the proceeds of a covered loan may be used for —

"(I) lobbying activities, as defined in section 3 of the Lobbying Disclosure Act of 1995 (2 U.S.C. 1602);

"(II) lobbying expenditures related to a State or local election; or

"(III) expenditures designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive order proposed or pending before Congress or any State government, State legislature, or local legislature or legislative body.".

SEC. 320. BANKRUPTCY PROVISIONS.

(a) IN GENERAL. — Section 364 of title 11, United States Code, is amended by adding at the end the following:

"(g)(1) The court, after notice and a hearing, may authorize a debtor in possession or a trustee that is authorized to operate the business of the debtor under section 1183, 1184, 1203, 1204, or 1304 of this title to obtain a loan under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), and such loan shall be treated as a debt to the extent the loan is not forgiven in accordance with section 7A of the Small Business Act or subparagraph (J) of such paragraph (37), as applicable, with priority equal to a claim of the kind specified in subsection (c)(1) of this section.

"(2) The trustee may incur debt described in paragraph (1) notwithstanding any provision in a contract, prior order authorizing the trustee to incur debt under this section, prior order authorizing the trustee to use cash collateral under section 363, or applicable law that prohibits the debtor from incurring additional debt.

"(3) The court shall hold a hearing within 7 days after the filing and service of the motion to obtain a loan described in paragraph (1). Notwithstanding the Federal Rules of Bankruptcy Procedure, at such hearing, the court may grant relief on a final basis.".

(b) ALLOWANCE OF ADMINISTRATIVE EXPENSES. — Section 503(b) of title 11, United States Code, is amended —

(1) in paragraph (8)(B), by striking "and" at the end;

(2) in paragraph (9), by striking the period at the end and inserting "; and"; and

(3) by adding at the end the following:

"(10) any debt incurred under section 364(g)(1) of this title.".

(c) CONFIRMATION OF PLAN FOR REORGANIZATION. — Section 1191 of title 11, United States Code, is amended by adding at the end the following:

"(f) SPECIAL PROVISION RELATED TO COVID–19 PANDEMIC. — Notwithstanding section 1129(a)(9)(A) of this title and subsection (e) of this section, a plan that provides for payment of a claim of a kind specified in section 503(b)(10) of this title may be confirmed under subsection (b) of this section if the plan proposes to make payments on account of such claim when due under the terms of the loan giving rise to such claim.".

(d) CONFIRMATION OF PLAN FOR FAMILY FARMERS AND FISHERMEN. — Section 1225 of title 11, United States Code, is amended by adding at the end the following:

"(d) Notwithstanding section 1222(a)(2) of this title and subsection (b)(1) of this section, a plan that provides for payment of a claim of a kind specified in section 503(b)(10) of this title may be confirmed if the plan proposes to make payments on account of such claim when due under the terms of the loan giving rise to such claim.".

(e) CONFIRMATION OF PLAN FOR INDIVIDUALS. — Section 1325 of title 11, United States Code, is amended by adding at the end the following:

"(d) Notwithstanding section 1322(a)(2) of this title and subsection (b)(1) of this section, a plan that provides for payment of a claim of a kind specified in section 503(b)(10) of this title may be confirmed if the plan proposes to make payments on account of such claim when due under the terms of the loan giving rise to such claim.".

(f) EFFECTIVE DATE; SUNSET. —

(1) EFFECTIVE DATE. — The amendments made by subsections (a) through (e) shall —

(A) take effect on the date on which the Administrator submits to the Director of the Executive Office for United States Trustees a written determination that, subject to satisfying any other eligibility requirements, any debtor in possession or trustee that is authorized to operate the business of the debtor under section 1183, 1184, 1203, 1204, or 1304 of title 11, United States Code, would be eligible for a loan under paragraphs (36) and (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)); and

(B) apply to any case pending on or commenced on or after the date described in subparagraph (A).

(2) SUNSET. —

(C) IN GENERAL. — If the amendments made by subsections (a) through (e) take effect under paragraph (1), effective on the date that is 2 years after the date of enactment of this Act —

(i) section 364 of title 11, United States Code, is amended by striking subsection (g);

(ii) section 503(b) of title 11, United States Code, is amended —

(I) in paragraph (8)(B), by adding "and" at the end;

(II) in paragraph (9), by striking "; and" at the end and inserting a period; and

(III) by striking paragraph (10);

(iii) section 1225 of title 11, United States Code, is amended by striking subsection (d); and

(iv) section 1325 of title 11, United States Code, is amended by striking subsection (d).

(B) APPLICABILITY. — Notwithstanding the amendments made by subparagraph (A) of this paragraph, if the amendments made by subsections (a) through (e) take effect under paragraph (1) of this subsection, such amendments shall apply to any case under title 11, United States Code, commenced before the date that is 2 years after the date of enactment of this Act.

SEC. 321. OVERSIGHT.

(a) COMPLIANCE WITH OVERSIGHT REQUIREMENTS. —

(1) IN GENERAL. — Except as provided in paragraph (2), on and after the date of enactment of this Act, the Administrator shall comply with any data or information requests or inquiries made by the Comptroller General of the United States not later than 15 days (or such later date as the Comptroller General may specify) after receiving the request or inquiry.

(2) EXCEPTION. — If the Administrator is unable to comply with a request or inquiry described in paragraph (1) before the applicable date described in that paragraph, the Administrator shall, before such applicable date, submit to the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business of the House of Representatives a notification that includes a detailed justification for the inability of the Administrator to comply with the request or inquiry.

(b) TESTIMONY. — Not later than the date that is 120 days after the date of enactment of this Act, and not less than twice each year thereafter until the date that is 2 years after the date of enactment of this Act, the Administrator and the Secretary of the Treasury shall testify before the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business of the House of Representatives regarding implementation of this Act and the amendments made by this Act.

SEC. 322. CONFLICTS OF INTEREST.

(a) DEFINITIONS. — In this section:

(1) CONTROLLING INTEREST. — The term "controlling interest" means owning, controlling, or holding not less than 20 percent, by vote or value, of the outstanding amount of any class of equity interest in an entity.

(2) COVERED ENTITY. —

(A) DEFINITION. — The term "covered entity" means an entity in which a covered individual directly or indirectly holds a controlling interest.

(B) TREATMENT OF SECURITIES. — For the purpose of determining whether an entity is a covered entity, the securities owned, controlled, or held by 2 or more individuals who are related as described in paragraph (3)(B) shall be aggregated.

(3) COVERED INDIVIDUAL. — The term "covered individual" means —

(A) the President, the Vice President, the head of an Executive department, or a Member of Congress; and

(B) the spouse, as determined under applicable common law, of an individual described in subparagraph (A).

(4) EXECUTIVE DEPARTMENT. — The term "Executive department" has the meaning given the term in section 101 of title 5, United States Code.

(5) MEMBER OF CONGRESS. — The term "Member of Congress" means a Member of the Senate or House of Representatives, a Delegate to the House of Representatives, and the Resident Commissioner from Puerto Rico.

(6) EQUITY INTEREST. — The term "equity interest" means —

(C) a share in an entity, without regard to whether the share is —

(i) transferable; or

(ii) classified as stock or anything similar;

(D) a warrant or right, other than a right to convert, to purchase, sell, or subscribe to a share or interest described in subparagraph (A) or

(B), respectively.

(b) REQUIREMENT FOR DISCLOSURE REGARDING EXISTING LOANS. — For any loan under paragraph (36) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)) made to a covered entity before the date of enactment of this Act —

(1) if, before the date of enactment of this Act, the covered entity submitted an application for forgiveness under section 1106 of the CARES Act (15 U.S.C. 9005) (as such section was in effect on the day before the date of enactment of this Act) with respect to such loan, not later than 30 days after the date of enactment of this Act, the principal executive officer, or individual performing a similar function, of the covered entity shall disclose to the Administrator that the entity is a covered entity; and

(2) if, on or after the date of enactment of this Act, the covered entity submits an application for forgiveness under section 7A of the Small Business Act, as redesignated and transferred by section 304 of this Act, with respect to such loan, not later than 30 days after submitting the application, the principal executive officer, or individual performing a similar function, of the covered entity shall disclose to the Administrator that the entity is a covered entity.

(c) BAN ON NEW LOANS. — On and after the date of enactment of this Act, a loan under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), as added and amended by this Act, may not be made to a covered entity.

SEC. 323. COMMITMENT AUTHORITY AND APPROPRIATIONS.

(a) COMMITMENT AUTHORITY. — Section 1102(b) of the CARES Act (Public Law 116–136) is amended —

(1) in paragraph (1) —

(A) in the paragraph heading, by inserting "AND SECOND DRAW" after "PPP";

(B) by striking "August 8, 2020" and inserting "March 31, 2021";

(C) by striking "paragraph (36)" and inserting "paragraphs (36) and (37)"; and

(D) by striking " $659,000,000,000" and inserting " $806,450,000,000"; and

(2) by adding at the end the following:

"(3) 2021 7(a) LOAN PROGRAM LEVEL AND FUNDING. — Notwithstanding the amount authorized under the heading 'Small Business Administration — Business Loans Program Account' under the Financial Services and General Government Appropriations Act, 2021 for commitments for general business loans authorized under paragraphs (1) through (35) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), commitments for general business loans authorized under paragraphs (1) through (35) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)) shall not exceed $75,000,000,000 for a combination of amortizing term loans and the aggregated maximum line of credit provided by revolving loans during the period beginning on the date of enactment of this Act and ending on September 30, 2021.".

(b) CLARIFICATION OF SECONDARY MARKET CAP. — Section 1107(b) of the CARES Act (15 U.S.C. 9006(b)) is amended by inserting "with respect to loans under any paragraph of section 7(a) of the Small Business Act (15 U.S.C. 636(a))" before "shall not exceed".

(c) RESCISSION. — With respect to unobligated balances under the heading "Small Business Administration — Business Loans Program Account, CARES Act" as of the day before the date of enactment of this Act, $146,500,000,000 shall be rescinded and deposited into the general fund of the Treasury.

(d) DIRECT APPROPRIATIONS. —

(1) NEW DIRECT APPROPRIATIONS FOR PPP LOANS, SECOND DRAW LOANS, AND THE MBDA. — There is appropriated, out of amounts in the Treasury not otherwise appropriated, for the fiscal year ending September 30, 2021, to remain available until expended, for additional amounts —

(A) $284,450,000,000 under the heading "Small Business Administration — Business Loans Program Account, CARES Act", for the cost of guaranteed loans as authorized under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), as amended and added by this Act, including the cost of any modifications to any loans guaranteed under such paragraph (36) that were approved on or before August 8, 2020, of which —

(i) not less than $15,000,000,000 shall be for guaranteeing loans under such paragraph (36) or (37) made by community financial institutions, as defined in section 7(a)(36)(A) of the Small Business Act (15 U.S.C. 636(a)(36)(A));

(ii) not less than $15,000,000,000 shall be for guaranteeing loans under such paragraph (36) or (37) made by —

(I) insured depository institutions (as defined in section 3 of the Federal Deposit Insurance Act (12 U.S.C. 1813)) with consolidated assets of less than $10,000,000,000;

(II) credit unions (as defined in section 7(a)(36)(A) of the Small Business Act (15 U.S.C. 636(a)(36)(A))) with consolidated assets of less than $10,000,000,000; or

(III) institutions of the Farm Credit System chartered under the Farm Credit Act of 1971 (12 U.S.C. 2001 et seq.) with consolidated assets of less than $10,000,000,000 (not including the Federal Agricultural Mortgage Corporation);

(iv) not less than $25,000,000,000 shall be for guaranteeing loans under paragraph (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), as added by this Act, that are —

(I) made to eligible entities with not more than 10 employees; or

(II) in an amount that is not more than $250,000 and made to an eligible entity that is located in a neighborhood that is a low-income neighborhood or a moderate-income neighborhood, for the purposes of the Community Reinvestment Act of 1977 (12 U.S.C. 2901 et seq.);

(B) $25,000,000 under the heading "Department of Commerce — Minority Business Development Agency" for the Minority Business Development Centers Program, including Specialty Centers, for necessary expenses, including any cost sharing requirements that may exist, for assisting minority business enterprises to prevent, prepare for, and respond to coronavirus, including identifying and accessing local, State, and Federal government assistance related to such virus;

(C) $50,000,000 under the heading "Small Business Administration — Salaries and Expenses" for the cost of carrying out reviews and audits of loans under subsection (l) of section 7A of the Small Business Act, as redesignated, transferred, and amended by this Act;

(D) $20,000,000,000 under the heading "Small Business Administration — Targeted EIDL Advance" to carry out section 331 of this Act, of which $20,000,000 shall be made available to the Inspector General of the Small Business Administration to prevent waste, fraud, and abuse with respect to funding made available under that section;

(E) $57,000,000 for the program established under section 7(m) of the Small Business Act (15 U.S.C. 636(m)) of which —

(i) $50,000,000 shall be to provide technical assistance grants under such section 7(m) under the heading "Small Business Administration — Entrepreneurial Development Programs"; and

(ii) $7,000,000 shall be to provide direct loans under such section 7(m) under the heading "Small Business Administration — Business Loans Program Account";

(F) $1,918,000,000 under the heading "Small Business Administration — Business Loans Program Account" for the cost of guaranteed loans as authorized by paragraphs (1) through (35) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), including the cost of carrying out sections 326, 327, and 328 of this Act;

(G) $3,500,000,000 under the heading "Small Business Administration — Business Loans Program Account, CARES Act" for carrying out section 325 of this Act; and

(H) $15,000,000,000 under the heading "Small Business Administration — Shuttered Venue Operators" to carry out section 324 of this Act.

(2) MODIFICATION OF SET-ASIDES. —

(A) IN GENERAL. — Notwithstanding paragraph (1)(A), if the Administrator makes the determination described in subparagraph (B) of this paragraph, the Administrator may reduce the amount of any allocation under paragraph (1)(A) to be such amount as the Administrator may determine necessary.

(B) REQUIREMENTS FOR DETERMINATION. — The determination described in this subparagraph is a determination by the Administrator that —

(i) is not made earlier than 25 days after the date of enactment of this Act;

(ii) it is not reasonably expected that a type of entity described in paragraph (1)(A) will make, or receive, as applicable, the minimum amount of loans necessary to meet the applicable allocation under paragraph(1)(A); and

(iii) it is reasonably expected that the total amount of loans guaranteed under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), as amended and added by this Act, will equal substantially all of the amount permitted by available funds by March 31, 2021.

(3) APPROPRIATIONS FOR THE OFFICE OF INSPECTOR GENERAL. —

(C) IN GENERAL. — Effective on the date of enactment of this Act, the remaining unobligated balances of funds from amounts made available for "Small Business Administration — Office of Inspector General" undersection 1107(a)(3) of the CARES Act (15 U.S.C. 9006(a)(3)), are hereby rescinded.

(B) FUNDING. —

(i) IN GENERAL. — There is appropriated, for an additional amount, for the fiscal year ending September 30, 2021, out of amounts in the Treasury not otherwise appropriated, an amount equal to the amount rescinded under subparagraph (A), to remain available until expended, under the heading "Small Business Administration — Office of Inspector General".

(ii) USE OF FUNDS. — The amounts made available under clause (i) shall be available for the same purposes, in addition to other funds as may be available for such purposes, and under the same authorities as the amounts made available under section 1107(a)(3) of the CARES Act (15 U.S.C. 9006(a)(3)).

SEC. 324. GRANTS FOR SHUTTERED VENUE OPERATORS.

(a) DEFINITIONS. — In this section:

(1) ELIGIBLE PERSON OR ENTITY. —

(A) IN GENERAL. — The term "eligible person or entity" means a live venue operator or promoter, theatrical producer, or live performing arts organization operator, a relevant museum operator, a motion picture theatre operator, or a talent representative that meets the following requirements:

(i) The live venue operator or promoter, theatrical producer, or live performing arts organization operator, the relevant museum operator, the motion picture theatre operator, or the talent representative —

(I) was fully operational as a live venue operator or promoter, theatrical producer, or live performing arts organization operator, a relevant museum operator, a motion picture theatre operator, or a talent representative on February 29, 2020; and

(II) has gross earned revenue during the first, second, third, or, only with respect to an application submitted on or after January 1, 2021, fourth quarter in 2020 that demonstrates not less than a 25 percent reduction from the gross earned revenue of the live venue operator or promoter, theatrical producer, or live performing arts organization operator, the relevant museum operator, the motion picture theatre operator, or the talent representative during the same quarter in 2019.

(ii) As of the date of the grant under this section —

(I) the live venue operator or promoter, theatrical producer, or live performing arts organization operator is or intends to resume organizing, promoting, producing, managing, or hosting future live events described in paragraph (3)(A)(i);

(II) the motion picture theatre operator is open or intends to reopen for the primary purpose of public exhibition of motion pictures;

(III) the relevant museum operator is open or intends to reopen; or

(IV) the talent representative is representing or managing artists and entertainers.

(iii) The venues at which the live venue operator or promoter, theatrical producer, or live performing arts organization operator promotes, produces, manages, or hosts events described in paragraph (3)(A)(i) or the artists and entertainers represented or managed by the talent representative perform have the following characteristics:

(I) A defined performance and audience space.

(II) Mixing equipment, a public address system, and a lighting rig.

(III) Engages 1 or more individuals to carry out not less than 2 of the following roles:

(aa) A sound engineer.

(ab) A booker.

(ac) A promoter.

(ad) A stage manager.

(ae) Security personnel.

(af) A box office manager.

(IV) There is a paid ticket or cover charge to attend most performances and artists are paid fairly and do not play for free or solely for tips, except for fundraisers or similar charitable events.

(V) For a venue owned or operated by a non-profit entity that produces free events, the events are produced and managed primarily by paid employees, not by volunteers.

(VI) Performances are marketed through listings in printed or electronic publications, on websites, by mass email, or on social media.

(iv) A motion picture theatre or motion picture theatres operated by the motion picture theatre operator have the following characteristics:

(I) At least 1 auditorium that includes a motion picture screen and fixed audience seating.

(II) A projection booth or space containing not less than 1 motion picture projector.

(III) A paid ticket charge to attend exhibition of motion pictures.

(IV) Motion picture exhibitions are marketed through showtime listings in printed or electronic publications, on websites, by mass mail, or on social media.

(v) The relevant museum or relevant museums for which the relevant museum operator is seeking a grant under this section have the following characteristics:

(I) Serving as a relevant museum as its principal business activity.

(II) Indoor exhibition spaces that are a component of the principal business activity and which have been subjected to pandemic-related occupancy restrictions.

(III) At least 1 auditorium, theater, or performance or lecture hall with fixed audience seating and regular programming.

(vi)(I) The live venue operator or promoter, theatrical producer, or live performing arts organization operator, the relevant museum operator, the motion picture theatre operator, or the talent representative does not have, or is not majority owned or controlled by an entity with, any of the following characteristics:

(aa) Being an issuer, the securities of which are listed on a national securities exchange.

(ab) Receiving more than 10 percent of gross revenue from Federal funding during 2019, excluding amounts received by the live venue operator or promoter, theatrical producer, or live performing arts organization operator, the relevant museum operator, the motion picture theatre operator, or the talent representative under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.).

(II) The live venue operator or promoter, theatrical producer, or live performing arts organization operator, the relevant museum operator, the motion picture theatre operator, or the talent representative does not have, or is not majority owned or controlled by an entity with, more than 2 of the following characteristics:

(aa) Owning or operating venues, relevant museums, motion picture theatres, or talent agencies or talent management companies in more than 1 country.

(ab) Owning or operating venues, relevant museums, motion picture theatres, or talent agencies or talent management companies in more than 10 States.

(ac) Employing more than 500 employees as of February 29, 2020, determined on a full-time equivalent basis in accordance with subparagraph (C).

(III) The live venue operator or promoter, theatrical producer, or live performing arts organization operator, the relevant museum operator, the motion picture theatre operator, or the talent representative has not received, on or after the date of enactment of this Act, a loan guaranteed under paragraph (36) or (37) of section 7(a) of the Small Business Act (15 U.S.C. 636(a)), as amended and added by this division.

(IV) For purposes of applying the characteristics described in subclauses (I), (II), and (III) to an entity owned by a State or a political subdivision of a State, the relevant entity —

(aa) shall be the live venue operator or promoter, theatrical producer, or live performing arts organization operator, the relevant museum operator, the motion picture theatre operator, or the talent representative; and

(ab) shall not include entities of the State or political subdivision other than the live venue operator or promoter, theatrical producer, or live performing arts organization operator, the relevant museum operator, the motion picture theatre operator, or the talent representative.

(B) EXCLUSION. — The term "eligible person or entity" shall not include a live venue operator or promoter, theatrical producer, or live performing arts organization operator, a relevant museum operator, a motion picture theatre operator, or a talent representative that —

(i) presents live performances of a prurient sexual nature; or

(ii) derives, directly or indirectly, more than de minimis gross revenue through the sale of products or services, or the presentation of any depictions or displays, of a prurient sexual nature.

(C) CALCULATION OF FULL-TIME EMPLOYEES. — For purposes of determining the number of full-time equivalent employees under subparagraph (A)(vi)(II)(cc) of this paragraph and under paragraph (2)(E) —

(iii) any employee working not fewer than 30 hours per week shall be considered a full-time employee; and

(iv) any employee working not fewer than 10 hours and fewer than 30 hours per week shall be counted as one-half of a full-time employee. entity of an eligible person or entity that also meets the requirements under subparagraph (A) and that is not described in subparagraph (B) shall be treated by the Administrator as an independent, non-affiliated entity for the purposes of this section.

(2) EXCHANGE; ISSUER; SECURITY. — The terms "exchange", "issuer", and "security" have the meanings given those terms in section 3(a) of the Securities Exchange Act of 1934 (15 U.S.C. 78c(a)).

(3) LIVE VENUE OPERATOR OR PROMOTER, THEATRICAL PRODUCER, OR LIVE PERFORMING ARTS ORGANIZATION OPERATOR. — The term "live venue operator or promoter, theatrical producer, or live performing arts organization operator" —

(A) means —

(i) an individual or entity —

(I) that, as a principal business activity, organizes, promotes, produces, manages, or hosts live concerts, comedy shows, theatrical productions, or other events by performing artists for which —

(aa) a cover charge through ticketing or front door entrance fee is applied; and

(ab) performers are paid in an amount that is based on a percentage of sales, a guarantee (in writing or standard contract), or another mutually beneficial formal agreement; and

(II) for which not less than 70 percent of the earned revenue of the individual or entity is generated through, to the extent related to a live event described in subclause (I), cover charges or ticket sales, production fees or production reimbursements, nonprofit educational initiatives, or the sale of event beverages, food, or merchandise; or

(ii) an individual or entity that, as a principal business activity, makes available for purchase by the public an average of not less than 60 days before the date of the event tickets to events —

(I) described in clause (i)(I); and

(II) for which performers are paid in an amount that is based on a percentage of sales, a guarantee (in writing or standard contract), or another mutually beneficial formal agreement; and

(B) includes an individual or entity described in subparagraph (A) that —

(i) operates for profit;

(ii) is a nonprofit organization;

(iii) is government-owned; or

(iv) is a corporation, limited liability company, or partnership or operated as a sole proprietorship.

(4) MOTION PICTURE THEATRE OPERATOR. — The term "motion picture theatre operator" means an individual or entity that —

(A) as the principal business activity of the individual or entity, owns or operates at least 1 place of public accommodation for the purpose of motion picture exhibition for a fee; and

(B) includes an individual or entity described in subparagraph (A) that —

(i) operates for profit;

(ii) is a nonprofit organization;

(iii) is government-owned; or

(iv) is a corporation, limited liability company, or partnership or operated as a sole proprietorship.

(5) NATIONAL SECURITIES EXCHANGE. — The term "national securities exchange" means an exchange registered as a national securities exchange under section 6 of the Securities Exchange Act of 1934 (15 U.S.C. 78f).

(6) NONPROFIT. — The term "nonprofit", with respect to an organization, means that the organization is exempt from taxation under section 501(a) of the Internal Revenue Code of 1986.

(7) RELEVANT MUSEUM. — The term "relevant museum" —

(A) has the meaning given the term "museum" in section 273 of the Museum and Library Services Act (20 U.S.C. 9172); and

(B) shall not include any entity that is organized as a for-profit entity.

(8) SEASONAL EMPLOYER. — The term "seasonal employer" has the meaning given that term in subparagraph (A) of section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)), as amended by this Act.

(9) STATE. — The term "State" means —

(A) a State;

(B) the District of Columbia;

(C) the Commonwealth of Puerto Rico; and

(D) any other territory or possession of the United States.

(10) TALENT REPRESENTATIVE. — The term "talent representative" —

(A) means an agent or manager that —

(i) as not less than 70 percent of the operations of the agent or manager, is engaged in representing or managing artists and entertainers;

(ii) books or represents musicians, comedians, actors, or similar performing artists primarily at live events in venues or at festivals; and

(iii) represents performers described in clause (ii) that are paid in an amount that is based on the number of tickets sold, or a similar basis; and

(B) includes an agent or manager described in subparagraph (A) that —

(iv) operates for profit;

(v) is a nonprofit organization;

(vi) is government-owned; or

(vii) is a corporation, limited liability company, or partnership or operated as a sole proprietorship.

(b) AUTHORITY. —

(1) IN GENERAL. —

(A) ADMINISTRATION. — The Associate Administrator for the Office of Disaster Assistance of the Administration shall coordinate and formulate policies relating to the administration of grants made under this section.

(B) CERTIFICATION OF NEED. — An eligible person or entity applying for a grant under this section shall submit a good faith certification that the uncertainty of current economic conditions makes necessary the grant to support the ongoing operations of the eligible person or entity.

(2) INITIAL GRANTS. —

(C) IN GENERAL. — The Administrator may make initial grants to eligible persons or entities in accordance with this section.

(D) INITIAL PRIORITIES FOR AWARDING GRANTS. —

(i) FIRST PRIORITY IN AWARDING GRANTS. — During the initial 14-day period during which the Administrator awards grants under this paragraph, the Administrator shall only award grants to an eligible person or entity with revenue, during the period beginning on April 1, 2020 and ending on December 31, 2020, that is not more than 10 percent of the revenue of the eligible person or entity during the period beginning on April 1, 2019 and ending on December 31, 2019, due to the COVID–19 pandemic.

(ii) SECOND PRIORITY IN AWARDING GRANTS. — During the 14-day period immediately following the 14-day period described in clause (i), the Administrator shall only award grants to an eligible person or entity with revenue, during the period beginning on April 1, 2020 and ending on December 31, 2020, that is not more than 30 percent of the revenue of the eligible person or entity during the period beginning on April 1, 2019 and ending on December 31, 2019, due to the COVID–19 pandemic.

(iii) DETERMINATION OF REVENUE. — For purposes of clauses (i) and (ii) —

(I) any amounts received by an eligible person or entity under the CARES Act (Public Law 116– 136; 134 Stat. 281) or an amendment made by the CARES Act shall not be counted as revenue of an eligible person or entity;

(II) the Administrator shall use an accrual method of accounting for determining revenue; and

(III) the Administrator may use alternative methods to establish revenue losses for an eligible person or entity that is a seasonal employer and that would be adversely impacted if January, February, and March are excluded from the calculation of year-over-year revenues.

(iv) LIMIT ON USE OF AMOUNTS FOR PRIORITY APPLICANTS. — The Administrator may use not more than 80 percent of the amounts appropriated under section 323(d)(1)(H) of this Act to carry out this section to make initial grants under this paragraph to eligible persons or entities described in clause (i) or (ii) of this subparagraph that apply for a grant under this paragraph during the initial 28-day period during which the Administrator awards grants under this paragraph.

(C) GRANTS AFTER PRIORITY PERIODS. — After the end of the initial 28-day period during which the Administrator awards grants under this paragraph, the Administrator may award an initial grant to any eligible person or entity.

(D) LIMITS ON NUMBER OF INITIAL GRANTS TO AFFILIATES. — Not more than 5 business entities of an eligible person or entity that would be considered affiliates under the affiliation rules of the Administration may receive a grant under this paragraph.

(E) SET-ASIDE FOR SMALL EMPLOYERS. —

(i) IN GENERAL. — Subject to clause (ii), not less than $2,000,000,000 of the total amount of grants made available under this paragraph shall be awarded to eligible persons or entities which employ not more than 50 full-time employees, determined in accordance with subsection (a)(1)(C).

(ii) TIME LIMIT. — Clause (i) shall not apply on and after the date that is 60 days after the Administrator begins awarding grants under this section and, on and after such date, amounts available for grants under this section may be used for grants under this section to any eligible person or entity.

(3) SUPPLEMENTAL GRANTS. —

(A) IN GENERAL. — Subject to subparagraph (B), the Administrator may make a supplemental grant in accordance with this section to an eligible person or entity that receives a grant under paragraph (2) if, as of April 1, 2021, the revenues of the eligible person or entity for the most recent calendar quarter are not more than 30 percent of the revenues of the eligible person or entity for the corresponding calendar quarter during 2019 due to the COVID–19 pandemic.

(B) PROCESSING TIMELY INITIAL GRANT APPLICATIONS FIRST. — The Administrator may not award a supplemental grant under subparagraph (A) until the Administrator has completed processing (including determining whether to award a grant) each application for an initial grant under paragraph (2) that is submitted by an eligible person or entity on or before the date that is 60 days after the date on which the Administrator begins accepting such applications.

(4) CERTIFICATION. — An eligible person or entity applying for a grant under this section that is an eligible business described in the matter preceding subclause (I) of section 4003(c)(3)(D)(i) of the CARES Act (15 U.S.C. 9042(c)(3)(D)(i)), shall make a good-faith certification described in subclauses (IX) and (X) of such section.

(c) AMOUNT. —

(1) INITIAL GRANTS. —

(A) IN GENERAL. — A grant under subsection (b)(2) shall be in the amount equal to the lesser of —

(i)(I) for an eligible person or entity that was in operation on January 1, 2019, the amount equal to 45 percent of the gross earned revenue of the eligible person or entity during 2019; or

(II) for an eligible person or entity that began operations after January 1, 2019, the amount equal to the product obtained by multiplying —

(aa) the average monthly gross earned revenue for each full month during which the eligible person or entity was in operation during 2019; by

(ab) 6; or

(B) APPLICATION TO RELEVANT MUSEUM OPERATORS. — A relevant museum operator may not receive grants under subsection (b)(2) in a total amount that is more than $10,000,000 with respect to all relevant museums operated by the relevant museum operator.

(2) SUPPLEMENTAL GRANTS. — A grant under subsection (b)(3) shall be in the amount equal to 50 percent of the grant received by the eligible person or entity under subsection (b)(2).

(3) OVERALL MAXIMUMS. — The total amount of grants received under paragraphs (2) and (3) of subsection (b) by an eligible person or entity shall be not more than $10,000,000.

(d) USE OF FUNDS. —

(1) TIMING. —

(A) EXPENSES INCURRED. —

(i) IN GENERAL. — Except as provided in clause (ii), amounts received under a grant under this section may be used for costs incurred during the period beginning on March 1, 2020, and ending on December 31, 2021.

(ii) EXTENSION FOR SUPPLEMENTAL GRANTS. — If an eligible person or entity receives a grant under subsection (b)(3), amounts received under either grant under this section may be used for costs incurred during the period beginning on March 1, 2020, and ending on June 30, 2022.

(B) EXPENDITURE. —

(i) IN GENERAL. — Except as provided in clause (ii), an eligible person or entity shall return to the Administrator any amounts received under a grant under this section that are not expended on or before the date that is 1 year after the date of disbursement of the grant.

(ii) EXTENSION FOR SUPPLEMENTAL GRANTS. — If an eligible person or entity receives a grant under subsection (b)(3), the eligible person or entity shall return to the Administrator any amounts received under either grant under this section that are not expended on or before the date that is 18 months after the date of disbursement to the eligible person or entity of the grant under subsection (b)(2).

(2) ALLOWABLE EXPENSES. —

(A) DEFINITIONS. — In this paragraph —

(i) the terms "covered mortgage obligation", "covered rent obligation", "covered utility payment", and "covered worker protection expenditure" have the meanings given those terms in section 7A(a) of the Small Business Act, as redesignated, transferred, and amended by this Act; and

(ii) the term "payroll costs" has the meaning given that term in section 7(a)(36)(A) of the Small Business Act (15 U.S.C. 636(a)(36)(A).

(B) EXPENSES. — An eligible person or entity may use amounts received under a grant under this section for —

(i) payroll costs;

(ii) payments on any covered rent obligation;

(iii) any covered utility payment;

(iv) scheduled payments of interest or principal on any covered mortgage obligation (which shall not include any prepayment of principal on a covered mortgage obligation);

(v) scheduled payments of interest or principal on any indebtedness or debt instrument (which shall not include any prepayment of principal) incurred in the ordinary course of business that is a liability of the eligible person or entity and was incurred prior to February 15, 2020;

(vi) covered worker protection expenditures;

(vii) payments made to independent contractors, as reported on Form–1099 MISC, not to exceed a total of $100,000 in annual compensation for any individual employee of an independent contractor; and

(viii) other ordinary and necessary business expenses, including —

(I) maintenance expenses;

(II) administrative costs, including fees and licensing costs;

(III) State and local taxes and fees;

(IV) operating leases in effect as of February 15, 2020;

(V) payments required for insurance on any insurance policy; and

(VI) advertising, production transportation, and capital expenditures related to producing a theatrical or live performing arts production, concert, exhibition, or comedy show, except that a grant under this section may not be used primarily for such expenditures.

(3) PROHIBITED EXPENSES. — An eligible person or entity may not use amounts received under a grant under this section —

(A) to purchase real estate;

(B) for payments of interest or principal on loans originated after February 15, 2020;

(C) to invest or relend funds;

(D) for contributions or expenditures to, or on behalf of, any political party, party committee, or candidate for elective office; or

(E) for any other use as may be prohibited by the Administrator.

(e) INCREASED OVERSIGHT OF SHUTTERED VENUE OPERATOR GRANTS. — The Administrator shall increase oversight of eligible persons and entities receiving grants under this section, which may include the following:

(1) DOCUMENTATION. — Additional documentation requirements that are consistent with the eligibility and other requirements under this section, including requiring an eligible person or entity that receives a grant under this section to retain records that document compliance with the requirements for grants under this section —

(A) with respect to employment records, for the 4-year period following receipt of the grant; and

(B) with respect to other records, for the 3-year period following receipt of the grant.

(2) REVIEWS OF USE. — Reviews of the use of the grant proceeds by an eligible person or entity to ensure compliance with requirements established under this section and by the Administrator, including that the Administrator may —

(C) review and audit grants under this section; and

(D) in the case of fraud or other material noncompliance with respect to a grant under this section —

(i) require repayment of misspent funds; or

(ii) pursue legal action to collect funds.

(f) SHUTTERED VENUE OVERSIGHT AND AUDIT PLAN. —

(1) IN GENERAL. — Not later than 45 days after the date of enactment of this Act, the Administrator shall submit to the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business of the House of Representatives an audit plan that details —

(A) the policies and procedures of the Administrator for conducting oversight and audits of grants under this section; and

(B) the metrics that the Administrator shall use to determine which grants under this section will be audited pursuant to subsection (e).

(2) REPORTS. — Not later than 60 days after the date of enactment of this Act, and each month thereafter until the date that is 1 year after the date on which all amounts made available under section 323(d)(1)(H) of this Act have been expended, the Administrator shall submit to the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business of the House of Representatives a report on the oversight and audit activities of the Administrator under this subsection, which shall include —

(A) the total number of initial grants approved and disbursed;

(B) the total amount of grants received by each eligible person or entity, including any supplemental grants;

(C) the number of active investigations and audits of grants under this section;

(D) the number of completed reviews and audits of grants under this section, including a description of any findings of fraud or other material noncompliance.

(E) any substantial changes made to the oversight and audit plan submitted under paragraph (1).

SEC. 325. EXTENSION OF THE DEBT RELIEF PROGRAM.

(a) IN GENERAL. — Section 1112 of the CARES Act (15 U.S.C. 9011) is amended —

(1) in subsection (c) —

(A) by striking paragraph (1) and inserting the following:

"(1) IN GENERAL. — Subject to the other provisions of this section, the Administrator shall pay the principal, interest, and any associated fees that are owed on a covered loan in a regular servicing status, without regard to the date on which the covered loan is fully disbursed, and subject to availability of funds, as follows:

"(A) With respect to a covered loan made before the date of enactment of this Act and not on deferment, the Administrator shall make those payments as follows:

"(i) The Administrator shall make those payments for the 6-month period beginning with the next payment due on the covered loan.

"(ii) In addition to the payments under clause (i) —

"(I) with respect to a covered loan other than a covered loan described in paragraph (1)(A)(i) or (2) of subsection (a), the Administrator shall make those payments for —

"(aa) the 3-month period beginning with the first payment due on the covered loan on or after February 1, 2021; and

"(bb) an additional 5-month period immediately following the end of the 3-month period provided under item (aa) if the covered loan is made to a borrower that, according to records of the Administration, is assigned a North American Industry Classification System code beginning with 61, 71, 72, 213, 315, 448, 451, 481, 485, 487, 511, 512, 515, 532, or 812; and

"(II) with respect to a covered loan described in paragraph (1)(A)(i) or (2) of subsection (a), the Administrator shall make those payments for the 8-month period beginning with the first payment due on the covered loan on or after February 1, 2021.

"(B) With respect to a covered loan made before the date of enactment of this Act and on deferment, the Administrator shall make those payments as follows:

"(i) The Administrator shall make those payments for the 6-month period beginning with the next payment due on the covered loan after the deferment period.

"(ii) In addition to the payments under clause (i) —

"(I) with respect to a covered loan other than a covered loan described in paragraph (1)(A)(i) or (2) of subsection (a), the Administrator shall make those payments for —

"(aa) the 3-month period (beginning on or after February 1, 2021) beginning with the later of —

"(AA) the next payment due on the covered loan after the deferment period; or

"(BB) the first month after the Administrator has completed the payments under clause (i); and

"(bb) an additional 5-month period immediately following the end of the 3-month period provided under item (aa) if the covered loan is made to a borrower that, according to records of the Administration, is assigned a North American Industry Classification System code beginning with 61, 71, 72, 213, 315, 448, 451, 481, 485, 487, 511, 512, 515, 532, or 812; and

"(II) with respect to a loan described in paragraph (1)(A)(i) or (2) of subsection (a), the 8-month period (beginning on or after February 1, 2021) beginning with the later of —

"(aa) the next payment due on the covered loan after the deferment period; or

"(bb) the first month after the payments under clause (i) are complete.

"(C) With respect to a covered loan made during the period beginning on the date of enactment of this Act and ending on the date that is 6 months after such date of enactment, for the 6-month period beginning with the first payment due on the covered loan.

"(D) With respect to a covered loan approved during the period beginning on February 1, 2021, and ending on September 30, 2021, for the 6-month period beginning with the first payment due on the covered loan."; and

(B) by adding at the end the following:

"(4) LIMITATION. —

"(A) IN GENERAL. — No single monthly payment of principal, interest, and associated fees made by the Administrator under subparagraph (A)(ii), (B)(ii), or (D) of paragraph (1) with respect to a covered loan may be in a total amount that is more than $9,000.

"(B) TREATMENT OF ADDITIONAL AMOUNTS OWED. — If, for a month, the total amount of principal, interest, and associated fees that are owed on a covered loan for which the Administration makes payments under paragraph (1) is more than $9,000 the Administrator may require the lender with respect to the covered loan to add the amount by which those costs exceed $9,000 for that month as interest to be paid by the borrower with respect to the covered loan at the end of the loan period.

"(5) ADDITIONAL PROVISIONS FOR NEW LOANS. — With respect to a loan described in paragraph (1)(C) —

"(A) the Administrator may further extend the period described in paragraph (1)(C) if there are sufficient funds to continue those payments; and

"(B) during the underwriting process, a lender of such a loan may consider the payments under this section as part of a comprehensive review to determine the ability to repay over the entire period of maturity of the loan.

"(6) ELIGIBILITY. — Eligibility for a covered loan to receive such payments of principal, interest, and any associated fees under this subsection shall be based on the date on which the covered loan is approved by the Administration.

"(7) AUTHORITY TO REVISE EXTENSIONS. —

"(A) IN GENERAL. — The Administrator shall monitor whether amounts made available to make payments under this subsection are sufficient to make the payments for the periods described in paragraph (1).

"(B) PLAN. — If the Administrator determines under subparagraph (A) that the amounts made available to make payments under this subsection are insufficient, the Administrator shall —

"(i) develop a plan to proportionally reduce the number of months provided for each period described in paragraph (1), while ensuring all amounts made available to make payments under this subsection are fully expended; and

"(ii) before taking action under the plan developed under clause (i), submit to Congress a report regarding the plan, which shall include the data that informs the plan.

"(8) ADDITIONAL REQUIREMENTS. — With respect to the payments made under this subsection —

"(A) no lender may charge a late fee to a borrower with respect to a covered loan during any period in which the Administrator makes payments with respect to the covered loan under paragraph (1); and

"(B) the Administrator shall, with respect to a covered loan, make all payments with respect to the covered loan under paragraph (1) not later than the 15th day of the applicable month.

"(9) RULE OF CONSTRUCTION. — Except as provided in paragraph (4), nothing in this subsection may be construed to preclude a borrower from receiving full payments of principal, interest, and any associated fees authorized under this subsection with respect to a covered loan.";

(2) by redesignating subsection (f) as subsection (i); and

(3) by inserting after subsection (e) the following:

"(f) ELIGIBILITY FOR NEW LOANS. — For each individual lending program under this section, the Administrator may establish a minimum loan maturity period, taking into consideration the normal underwriting requirements for each such program, with the goal of preventing abuse under the program.

"(g) LIMITATION ON ASSISTANCE. — A borrower may not receive assistance under subsection (c) for more than 1 covered loan of the borrower described in paragraph (1)(C) of that subsection.

"(h) REPORTING AND OUTREACH. —

"(1) UPDATED INFORMATION. —

"(A) IN GENERAL. — Not later than 14 days after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, the Administrator shall make publicly available information regarding the modifications to the assistance provided under this section under the amendments made by such Act.

"(B) GUIDANCE. — Not later than 21 days after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act the Administrator shall issue guidance on implementing the modifications to the assistance provided under this section under the amendments made by such Act.

"(2) PUBLICATION OF LIST. — Not later than March 1, 2021, the Administrator shall transmit to each lender of a covered loan a list of each borrower of a covered loan that includes the North American Industry Classification System code assigned to the borrower, based on the records of the Administration, to assist the lenders in identifying which borrowers qualify for an extension of payments under subsection (c).

"(3) EDUCATION AND OUTREACH. — The Administrator shall provide education, outreach, and communication to lenders, borrowers, district offices, and resource partners of the Administration in order to ensure full and proper compliance with this section, encourage broad participation with respect to covered loans that have not yet been approved by the Administrator, and help lenders transition borrowers from subsidy payments under this section directly to a deferral when suitable for the borrower.

"(4) NOTIFICATION. — Not later than 30 days after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, the Administrator shall mail a letter to each borrower of a covered loan that includes —

"(A) an overview of assistance provided under this section;

"(B) the rights of the borrower to receive that assistance;

"(C) how to seek recourse with the Administrator or the lender of the covered loan if the borrower has not received that assistance; and

"(D) the rights of the borrower to request a loan deferral from a lender, and guidance on how to do successfully transition directly to a loan deferral once subsidy payments under this section are concluded.

"(5) MONTHLY REPORTING. — Not later than the 15th of each month beginning after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, the Administrator shall submit to Congress a report on assistance provided under this section, which shall include — "(A) monthly and cumulative data on payments made under this section as of the date of the report, including a breakdown by —

"(i) the number of participating borrowers;

"(ii) the volume of payments made for each type of covered loan; and

"(iii) the volume of payments made for covered loans made before the date of enactment of this Act and loans made after such date of enactment;

"(B) the names of any lenders of covered loans that have not submitted information on the covered loans to the Administrator during the preceding month; and

"(C) an update on the education and outreach activities of the Administration carried out under paragraph (3).".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendments made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281).

SEC. 326. MODIFICATIONS TO 7(a) LOAN PROGRAMS.

(a) 7(a) LOAN GUARANTEES. —

(1) IN GENERAL. — Section 7(a)(2)(A) of the Small Business Act (15 U.S.C. 636(a)(2)(A)) is amended by striking "), such participation by the Administration shall be equal to" and all that follows through the period at the end and inserting "or the Community Advantage Pilot Program of the Administration), such participation by the Administration shall be equal to 90 percent of the balance of the financing outstanding at the time of disbursement of the loan.".

(2) PROSPECTIVE REPEAL. — Effective October 1, 2021, section 7(a)(2)(A) of the Small Business Act (15 U.S.C. 636(a)(2)(A)), as amended by paragraph (1), is amended to read as follows:

"(A) IN GENERAL. — Except as provided in subparagraphs (B), (D), (E), and (F), in an agreement to participate in a loan on a deferred basis under this subsection (including a loan made under the Preferred Lenders Program), such participation by the Administration shall be equal to —

"(i) 75 percent of the balance of the financing outstanding at the time of disbursement of the loan, if such balance exceeds $150,000; or

"(ii) 85 percent of the balance of the financing outstanding at the time of disbursement of the loan, if such balance is less than or equal to $150,000.".

(b) EXPRESS LOANS. —

(3) LOAN AMOUNT. — Section 1102(c)(2) of the CARES Act (Public Law 116–136; 15 U.S.C. 636 note) is amended to read as follows:

"(2) PROSPECTIVE REPEAL. — Effective on October 1, 2021, section 7(a)(31)(D) of the Small Business Act (15 U.S.C. 636(a)(31)(D)) is amended by striking ' $1,000,000' and inserting ' $500,000'.".

(4) GUARANTEE RATES. —

(A) TEMPORARY MODIFICATION. — Section 7(a)(31)(A)(iv) of the Small Business Act (15 U.S.C. 636(a)(31)(A)(iv)) is amended by striking "with a guaranty rate of not more than 50 percent." and inserting the following: "with a guarantee rate —

"(I) for a loan in an amount less than or equal to $350,000, of not more than 75 percent; and

"(II) for a loan in an amount greater than $350,000, of not more than 50 percent.".

(B) PROSPECTIVE REPEAL. — Effective October 1, 2021, section 7(a)(31)(A)(iv) of the Small Business Act (15 U.S.C. 636(a)(31)(iv)), as amended by subparagraph (A), is amended by striking "guarantee rate" and all that follows through the period at the end and inserting "guarantee rate of not more than 50 percent.".

SEC. 327. TEMPORARY FEE REDUCTIONS.

(a) ADMINISTRATIVE FEE WAIVER. —

(1) IN GENERAL. — During the period beginning on the date of enactment of this Act and ending on September 30, 2021, and to the extent that the cost of such elimination or reduction of fees is offset by appropriations, with respect to each loan guaranteed under section 7(a) of the Small Business Act (15 U.S.C. 636(a)) (including a recipient of assistance under the Community Advantage Pilot Program of the Administration) for which an application is approved or pending approval on or after the date of enactment of this Act, the Administrator shall —

(A) in lieu of the fee otherwise applicable under section 7(a)(23)(A) of the Small Business Act (15 U.S.C. 636(a)(23)(A)), collect no fee or reduce fees to the maximum extent possible; and

(B) in lieu of the fee otherwise applicable under section 7(a)(18)(A) of the Small Business Act (15 U.S.C. 636(a)(18)(A)), collect no fee or reduce fees to the maximum extent possible.

(2) APPLICATION OF FEE ELIMINATIONS OR REDUCTIONS. — To the extent that amounts are made available to the Administrator for the purpose of fee eliminations or reductions under paragraph (1), the Administrator shall —

(C) first use any amounts provided to eliminate or reduce fees paid by small business borrowers under clauses (i) through (iii) of section 7(a)(18)(A) of the Small Business Act (15 U.S.C. 636(a)(18)(A)), to the maximum extent possible; and

(D) then use any amounts provided to eliminate or reduce fees under 7(a)(23)(A) of the Small Business Act (15 U.S.C. 636(a)(23)(A)).

(b) TEMPORARY FEE ELIMINATION FOR THE 504 LOAN PROGRAM. —

(3) IN GENERAL. — During the period beginning on the date of enactment of this Act and ending on September 30, 2021, and to the extent the cost of such elimination in fees is offset by appropriations, with respect to each project or loan guaranteed by the Administrator pursuant to title V of the Small Business Investment Act of 1958 (15 U.S.C. 695 et seq.) for which an application is approved or pending approval on or after the date of enactment of this Act —

(A) the Administrator shall, in lieu of the fee otherwise applicable under section 503(d)(2) of the Small Business Investment Act of 1958 (15 U.S.C. 697(d)(2)), collect no fee; and

(B) a development company shall, in lieu of the processing fee under section 120.971(a)(1) of title 13, Code of Federal Regulations (relating to fees paid by borrowers), or any successor regulation, collect no fee.

(2) REIMBURSEMENT FOR WAIVED FEES. —

(A) IN GENERAL. — To the extent that the cost of such payments is offset by appropriations, the Administrator shall reimburse each development company that does not collect a processing fee pursuant to paragraph (1)(B).

(B) AMOUNT. — The payment to a development company under clause (i) shall be in an amount equal to 1.5 percent of the net debenture proceeds for which the development company does not collect a processing fee pursuant to paragraph (1)(B).

SEC. 328. LOW-INTEREST REFINANCING.

(a) LOW-INTEREST REFINANCING UNDER THE LOCAL DEVELOPMENT BUSINESS LOAN PROGRAM. —

(1) REPEAL. — Section 521(a) of title V of division E of the Consolidated Appropriations Act, 2016 (15 U.S.C. 696 note) is repealed.

(2) REFINANCING. — Section 502(7) of the Small Business Investment Act of 1958 (15 U.S.C. 696(7)) is amended —

(A) in subparagraph (B), in the matter preceding clause (i), by striking "50" and inserting "100"; and

(B) by adding at the end the following:

"(C) REFINANCING NOT INVOLVING EXPANSIONS. —

"(i) DEFINITIONS. — In this subparagraph —

"(I) the term 'borrower' means a small business concern that submits an application to a development company for financing under this subparagraph;

"(II) the term 'eligible fixed asset' means tangible property relating to which the Administrator may provide financing under this section; and

"(III) the term 'qualified debt' means indebtedness —

"(aa) that was incurred not less than 6 months before the date of the application for assistance under this subparagraph;

"(bb) that is a commercial loan;

"(cc) the proceeds of which were used to acquire an eligible fixed asset;

"(dd) that was incurred for the benefit of the small business concern; and

"(ee) that is collateralized by eligible fixed assets.

"(ii) AUTHORITY. — A project that does not involve the expansion of a small business concern may include the refinancing of qualified debt if —

"(I) the amount of the financing is not more than 90 percent of the value of the collateral for the financing, except that, if the appraised value of the eligible fixed assets serving as collateral for the financing is less than the amount equal to 125 percent of the amount of the financing, the borrower may provide additional cash or other collateral to eliminate any deficiency;

"(II) the borrower has been in operation for all of the 2-year period ending on the date the loan application is submitted; and

"(III) for a financing for which the Administrator determines there will be an additional cost attributable to the refinancing of the qualified debt, the borrower agrees to pay a fee in an amount equal to the anticipated additional cost.

"(iii) FINANCING FOR BUSINESS EXPENSES. —

"(I) FINANCING FOR BUSINESS EXPENSES. — The Administrator may provide financing to a borrower that receives financing that includes a refinancing of qualified debt under clause (ii), in addition to the refinancing under clause (ii), to be used solely for the payment of business expenses.

"(II) APPLICATION FOR FINANCING. — An application for financing under subclause (I) shall include —

"(aa) a specific description of the expenses for which the additional financing is requested; and

"(bb) an itemization of the amount of each expense.

"(III) CONDITION ON ADDITIONAL FINANCING. — A borrower may not use any part of the financing under this clause for non-business purposes.

"(iv) LOANS BASED ON JOBS. —

"(I) JOB CREATION AND RETENTION GOALS. —

"(aa) IN GENERAL. — The Administrator may provide financing under this subparagraph for a borrower that meets the job creation goals under subsection (d) or (e) of section 501.

"(bb) ALTERNATE JOB RETENTION GOAL. — The Administrator may provide financing under this subparagraph to a borrower that does not meet the goals described in item (aa) in an amount that is not more than the product obtained by multiplying the number of employees of the borrower by $75,000.

"(II) NUMBER OF EMPLOYEES. — For purposes of subclause (I), the number of employees of a borrower is equal to the sum of —

"(aa) the number of full-time employees of the borrower on the date on which the borrower applies for a loan under this subparagraph; and

"(bb) the product obtained by multiplying —

"(AA) the number of part-time employees of the borrower on the date on which the borrower applies for a loan under this subparagraph, by

"(BB) the quotient obtained by dividing the average number of hours each part time employee of the borrower works each week by 40.

"(v) TOTAL AMOUNT OF LOANS. — The Administrator may provide not more than a total of $7,500,000,000 of financing under this subparagraph for each fiscal year.".

(b) EXPRESS LOAN AUTHORITY FOR ACCREDITED LENDERS. —

(1) IN GENERAL. — Section 507 of the Small Business Investment Act of 1958 (15 U.S.C. 697d) is amended by striking subsection (e) and inserting the following:

"(e) EXPRESS LOAN AUTHORITY. — A local development company designated as an accredited lender in accordance with subsection (b) —

"(1) may —

"(A) approve, authorize, close, and service covered loans that are funded with proceeds of a debenture issued by the company; and

"(B) authorize the guarantee of a debenture described in subparagraph (A); and

"(2) with respect to a covered loan, shall be subject to final approval as to eligibility of any guarantee by the Administration pursuant to section 503(a), but such final approval shall not include review of decisions by the lender involving creditworthiness, loan closing, or compliance with legal requirements imposed by law or regulation. "(f) DEFINITIONS. — In this section —

"(1) the term 'accredited lender certified company' means a certified development company that meets the requirements under subsection (b), including a certified development company that the Administration has designated as an accredited lender under that subsection;

"(2) the term 'covered loan' —

"(A) means a loan made under section 502 in an amount that is not more than $500,000; and

"(B) does not include a loan made to a borrower that is in an industry that has a high rate of default, as annually determined by the Administrator and reported in rules of the Administration; and

"(3) the term 'qualified State or local development company' has the meaning given the term in section 503(e).".

(2) PROSPECTIVE REPEAL. — Effective on September 30, 2023, section 507 of the Small Business Investment Act of 1958 (15 U.S.C. 697d), as amended by paragraph (1), is amended by striking subsections (e) and (f) and inserting the following: "(e) DEFINITION. — In this section, the term 'qualified State or local development company' has the meaning given the term in section 503(e).".

(c) REFINANCING SENIOR PROJECT DEBT. — During the 1-year period beginning on the date of enactment of this Act, a development company described in title V of the Small Business Investment Act of 1958 (15 U.S.C. 695 et seq.) is authorized to allow the refinancing of a senior loan on an existing project in an amount that, when combined with the outstanding balance on the development company loan, is not more than 90 percent of the total loan to value. Proceeds of such refinancing can be used to support business operating expenses.

SEC. 329. RECOVERY ASSISTANCE UNDER THE MICROLOAN PROGRAM.

(a) LOANS TO INTERMEDIARIES. —

(1) IN GENERAL. — Section 7(m) of the Small Business Act (15 U.S.C. 636(m)) is amended —

(A) in paragraph (3)(C) —

(i) by striking "and $6,000,000" and inserting " $10,000,000 (in the aggregate)"; and

(ii) by inserting before the period at the end the following: ", and $4,500,000 in any of those remaining years";

(B) in paragraph (4) —

(iii) in subparagraph (A), by striking "subparagraph (C)" each place that term appears and inserting "subparagraphs (C) and (G)";

(iv) in subparagraph (C), by amending clause (i) to read as follows:

"(i) IN GENERAL. — In addition to grants made under subparagraph (A) or (G), each intermediary shall be eligible to receive a grant equal to 5 percent of the total outstanding balance of loans made to the intermediary under this subsection if —

"(I) the intermediary provides not less than 25 percent of its loans to small business concerns located in or owned by 1 or more residents of an economically distressed area; or

"(II) the intermediary has a portfolio of loans made under this subsection —

"(aa) that averages not more than $10,000 during the period of the intermediary's participation in the program; or

"(bb) of which not less than 25 percent is serving rural areas during the period of the intermediary's participation in the program."; and

(v) by adding at the end the following:

"(G) GRANT AMOUNTS BASED ON APPROPRIATIONS. — In any fiscal year in which the amount appropriated to make grants under subparagraph (A) is sufficient to provide to each intermediary that receives a loan under paragraph (1)(B)(i) a grant of not less than 25 percent of the total outstanding balance of loans made to the intermediary under this subsection, the Administration shall make a grant under subparagraph (A) to each intermediary of not less than 25 percent and not more than 30 percent of that total outstanding balance for the intermediary."; and

(C) in paragraph (11) —

(i) in subparagraph (C)(ii), by striking all after the semicolon and inserting "and"; and

(ii) by striking all after subparagraph (C) and inserting the following:

"(D) the term 'economically distressed area', as used in paragraph (4), means a county or equivalent division of local government of a State in which the small business concern is located, in which, according to the most recent data available from the Bureau of the Census, Department of Commerce, not less than 40 percent of residents have an annual income that is at or below the poverty level.".

(2) PROSPECTIVE AMENDMENT. — Effective on October 1, 2021, section 7(m)(3)(C) of the Small Business Act (15 U.S.C. 636(m)(3)(C)), as amended by paragraph (1)(A), is amended —

(A) by striking " $10,000,000" and by inserting " $7,000,000"; and

(B) by striking " $4,500,000" and inserting " $3,000,000".

(b) TEMPORARY WAIVER OF TECHNICAL ASSISTANCE GRANTS MATCHING REQUIREMENTS AND FLEXIBILITY ON PRE- AND POST-LOAN ASSISTANCE. — During the period beginning on the date of enactment of this Act and ending on September 30, 2021, the Administration shall waive —

(1) the requirement to contribute non-Federal funds under section 7(m)(4)(B) of the Small Business Act (15 U.S.C. 636(m)(4)(B)); and

(2) the limitation on amounts allowed to be expended to provide information and technical assistance under clause (i) of section 7(m)(4)(E) of the Small Business Act (15 U.S.C. 636(m)(4)(E)) and enter into third party contracts for the provision of technical assistance under clause (ii) of such section 7(m)(4)(E).

(c) TEMPORARY DURATION OF LOANS TO BORROWERS. —

(1) IN GENERAL. — During the period beginning on the date of enactment of this Act and ending on September 30, 2021, the duration of a loan made by an eligible intermediary under section 7(m) of the Small Business Act (15 U.S.C. 636(m)) —

(A) to an existing borrower may be extended to not more than 8 years; and

(B) to a new borrower may be not more than 8 years.

(d) FUNDING. — Section 20 of the Small Business Act (15 U.S.C. 631 note) is amended by adding at the end the following:

"(h) MICROLOAN PROGRAM. — For each of fiscal years 2021 through 2025, the Administration is authorized to make —

"(1) $80,000,000 in technical assistance grants, as provided in section 7(m); and

"(2) $110,000,000 in direct loans, as provided in section 7(m).".

(e) AUTHORIZATION OF APPROPRIATIONS. — In addition to amounts provided under the Consolidated Appropriations Act, 2020 (Public Law 116–93; 133 Stat. 2317) for the program established under section 7(m) of the Small Business Act (15 U.S.C. 636(m)) and amounts provided for fiscal year 2021 for that program, there is authorized to be appropriated for fiscal year 2021, to remain available until expended —

(1) $50,000,000 to provide technical assistance grants under such section 7(m); and

(2) $7,000,000 to provide direct loans under such section 7(m).

SEC. 330. EXTENSION OF PARTICIPATION IN 8(a) PROGRAM.

(a) IN GENERAL. — The Administrator shall ensure that a small business concern participating in the program established under section 8(a) of the Small Business Act (15 U.S.C. 637(a)) on or before September 9, 2020, may elect to extend such participation by a period of 1 year, regardless of whether the small business concern previously elected to suspend participation in the program pursuant to guidance of the Administrator.

(b) EMERGENCY RULEMAKING AUTHORITY. — Not later than 15 days after the date of enactment of this Act, the Administrator shall issue regulations to carry out this section without regard to the notice requirements under section 553(b) of title 5, United States Code.

SEC. 331. TARGETED EIDL ADVANCE FOR SMALL BUSINESS CONTINUITY, ADAPTATION, AND RESILIENCY.

(a) DEFINITIONS. — In this section:

(1) AGRICULTURAL ENTERPRISE. — The term "agricultural enterprise" has the meaning given the term in section 18(b) of the Small Business Act (15 U.S.C. 647(b)).

(2) COVERED ENTITY. — The term "covered entity" —

(A) means an eligible entity that —

(i) applies for a loan under section 7(b)(2) of the Small Business Act (15 U.S.C. 636(b)(2)) during the covered period, including before the date of enactment of this Act;

(ii) is located in a low-income community;

(iii) has suffered an economic loss of greater than 30 percent; and

(iv) employs not more than 300 employees; and

(3) COVERED PERIOD. — The term "covered period" has the meaning given the term in section 1110(a)(1) of the CARES Act (15 U.S.C. 9009(a)(1)), as amended by section 332 of this Act.

(4) ECONOMIC LOSS. — The term "economic loss" means, with respect to a covered entity —

(B) the amount by which the gross receipts of the covered entity declined during an 8-week period between March 2, 2020, and December 31, 2021, relative to a comparable 8-week period immediately preceding March 2, 2020, or during 2019; or

(C) if the covered entity is a seasonal business concern, such other amount determined appropriate by the Administrator.

(5) ELIGIBLE ENTITY. — The term "eligible entity" means an entity that, during the covered period, is eligible for a loan made under section 7(b)(2) of the Small Business Act (15 U.S.C. 636(b)(2)), as described in section 1110(b) of the CARES Act (15 U.S.C. 9009(b)).

(6) LOW-INCOME COMMUNITY. — The term "low-income community" has the meaning given the term in section 45D(e) of the Internal Revenue Code of 1986.

(b) ENTITLEMENT TO FULL AMOUNT. —

(1) IN GENERAL. — Subject to paragraph (2), a covered entity, after submitting a request to the Administrator that the Administrator verifies under subsection (c), shall receive a total of $10,000 under section 1110(e) of the CARES Act (15 U.S.C. 9009(e)), without regard to whether —

(A) the applicable loan for which the covered entity applies or applied under section 7(b)(2) of the Small Business Act (15 U.S.C. 636(b)(2)) is or was approved;

(B) the covered entity accepts or accepted the offer of the Administrator with respect to an approved loan described in subparagraph (A); or

(C) the covered entity has previously received a loan under section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)).

(2) EFFECT OF PREVIOUSLY RECEIVED AMOUNTS. —

(D) IN GENERAL. — With respect to a covered entity that received an emergency grant under section 1110(e) of the CARES Act (15 U.S.C. 9009(e)) before the date of enactment of this Act, the amount of the payment that the covered entity shall receive under this subsection (after satisfaction of the procedures required under subparagraph (B)) shall be the difference between $10,000 and the amount of that previously received grant.

(E) PROCEDURES. — If the Administrator receives a request under paragraph (1) from a covered entity described in subparagraph (A) of this paragraph, the Administrator shall, not later than 21 days after the date on which the Administrator receives the request —

(i) perform the verification required under subsection (c);

(ii) if the Administrator, under subsection (c), verifies that the entity is a covered entity, provide to the covered entity a payment in the amount described in subparagraph (A); and

(iii) with respect to a covered entity that the Administrator determines is not entitled to a payment under this section, provide the covered entity with a notification explaining why the Administrator reached that determination.

(C) RULE OF CONSTRUCTION. — Nothing in this paragraph may be construed to require any entity that received an emergency grant under section 1110(e) of the CARES Act (15 U.S.C. 9009(e)) before the date of enactment of this Act to repay any amount of that grant.

(c) VERIFICATION. — In carrying out this section, the Administrator shall require any information, including any tax records, from an entity submitting a request under subsection (b) that the Administrator determines to be necessary to verify that the entity is a covered entity, without regard to whether the entity has previously submitted such information to the Administrator.

(d) ORDER OF PROCESSING. — The Administrator shall process and approve requests for payments under subsection (b) in the order that the Administrator receives the requests, except that the Administrator shall give —

(1) first priority to covered entities described in subsection (b)(2)(A); and

(2) second priority to covered entities that have not received emergency grants under section 1110(e) of the CARES Act (15 U.S.C. 9009(e)), as of the date on which the Administrator receives such a request, because of the unavailability of funding to carry out such section 1110(e).

(e) APPLICABILITY. — In addition to any other restriction imposed under this section, any eligibility restriction applicable to a loan made under section 7(b)(2) of the Small Business Act (15 U.S.C. 636(b)(2)), including any restriction under section 123.300 or 123.301 of title 13, Code of Federal Regulations, or any successor regulation, shall apply with respect to funding provided under this section.

(f) NOTIFICATION REQUIRED. — The Administrator shall provide notice to each of the following entities stating that the entity may be eligible for a payment under this section if the entity satisfies the requirements under clauses (ii), (iii), and (iv) of subsection (a)(2)(A):

(1) Each entity that received an emergency grant under section 1110(e) of the CARES Act (15 U.S.C. 9009(e)) before the date of enactment of this Act.

(2) Each entity that, before the date of enactment of this Act —

(A) applied for a loan under section 7(b)(2) of the Small Business Act (15 U.S.C. 636(b)(2)); and

(B) did not receive an emergency grant under section 1110(e) of the CARES Act (15 U.S.C. 9009(e)) because of the unavailability of funding to carry out such section 1110(e).

(g) ADMINISTRATION. — In carrying out this section, the Administrator may rely on loan officers and other personnel of the Office of Disaster Assistance of the Administration and other resources of the Administration, including contractors of the Administration.

(h) AUTHORIZATION OF APPROPRIATIONS. — There are authorized to be appropriated to the Administrator $20,000,000,000 to carry out this section —

(3) which shall remain available through December 31, 2021; and

(4) of which $20,000,000 is authorized to be appropriated to the Inspector General of the Administration to prevent waste, fraud, and abuse with respect to funding provided under this section.

SEC. 332. EMERGENCY EIDL GRANTS.

Section 1110 of the CARES Act (15 U.S.C. 9009) is amended —

(1) in subsection (a)(1), by striking "December 31, 2020" and inserting "December 31, 2021";

(2) in subsection (d), by striking paragraphs (1) and (2) and inserting the following:

"(1) approve an applicant —

"(A) based solely on the credit score of the applicant; or

"(B) by using alternative appropriate methods to determine an applicant's ability to repay; and

"(2) use information from the Department of the Treasury to confirm that —

"(A) an applicant is eligible to receive such a loan; or

"(B) the information contained in an application for such a loan is accurate."; and

(3) in subsection (e) —

(A) in paragraph (1) —

(i) by striking "During the covered period" and inserting the following:

"(A) ADVANCES. — During the covered period";

(ii) in subparagraph (A), as so designated, by striking "within 3 days after the Administrator receives an application from such applicant"; and

(iii) by adding at the end the following:

"(B) TIMING. — With respect to each request submitted to the Administrator under subparagraph (A), the Administrator shall, not later than 21 days after the date on which the Administrator receives the request —

"(i) verify whether the entity is an entity that is eligible for a loan made under section 7(b)(2) of the Small Business Act (15 U.S.C. 636(b)(2)) during the covered period, as described in subsection (b);

"(ii) if the Administrator, under clause (i), verifies that the entity submitting the request is an entity that is eligible, as described in that clause, provide the advance requested by the entity; and

"(iii) with respect to an entity that the Administrator determines is not entitled to receive an advance under this subsection, provide the entity with a notification explaining why the Administrator reached that determination.";

(B) in paragraph (7), by striking " $20,000,000,000" and inserting " $40,000,000,000"; and

(C) in paragraph (8), by striking "December 31, 2020" and inserting "December 31, 2021".

SEC. 333. REPEAL OF EIDL ADVANCE DEDUCTION.

(a) DEFINITIONS. — In this section —

(1) the term "covered entity" means an entity that receives an advance under section 1110(e) of the CARES Act (15 U.S.C. 9009(e)), including an entity that received such an advance before the date of enactment of this Act; and

(2) the term "covered period" has the meaning given the term in section 1110(a)(1) of the CARES Act (15 U.S.C. 9009(a)(1)), as amended by section 332 of this Act.

(b) SENSE OF CONGRESS. — It is the sense of Congress that borrowers of loans made under section 7(b)(2) of the Small Business Act (15 U.S.C. 636(b)(2)) in response to COVID–19 during the covered period should be made whole, without regard to whether those borrowers are eligible for forgiveness with respect to those loans.

(c) REPEAL. — Section 1110(e)(6) of the CARES Act (15 U.S.C. 9009(e)(6)) is repealed.

(d) EFFECTIVE DATE; APPLICABILITY. — The amendment made by subsection (c) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281).

(e) RULEMAKING. —

(1) IN GENERAL. — Not later than 15 days after the date of enactment of this Act, the Administrator shall issue rules that ensure the equal treatment of all covered entities with respect to the amendment made by subsection (c), which shall include consideration of covered entities that, before the date of enactment of this Act, completed the loan forgiveness process described in section 1110(e)(6) of the CARES Act (15 U.S.C. 9009(e)(6)), as in effect before that date of enactment.

(2) NOTICE AND COMMENT. — The notice and comment requirements under section 553 of title 5, United States Code, shall not apply with respect to the rules issued under paragraph (1).

SEC. 334. FLEXIBILITY IN DEFERRAL OF PAYMENTS OF 7(a) LOANS.

Section 7(a)(7) of the Small Business Act (15 U.S.C. 636(a)(7)) is amended —

(1) by striking "The Administration" and inserting "(A) IN GENERAL. — The Administrator";

(2) in subparagraph (A), as so designated, by inserting "and interest" after "principal"; and

(3) by adding at the end the following:

"(B) DEFERRAL REQUIREMENTS. — With respect to a deferral provided under this paragraph, the Administrator may allow lenders under this subsection —

"(i) to provide full payment deferment relief (including payment of principal and interest) for a period of not more than 1 year; and

"(ii) to provide an additional deferment period if the borrower provides documentation justifying such additional deferment.

"(C) SECONDARY MARKET. —

"(i) IN GENERAL. — Except as provided in clause (ii), if an investor declines to approve a deferral or additional deferment requested by a lender under subparagraph (B), the Administrator shall exercise the authority to purchase the loan so that the borrower may receive full payment deferment relief (including payment of principal and interest) or an additional deferment as described in subparagraph (B).

"(ii) EXCEPTION. — If, in a fiscal year, the Administrator determines that the cost of implementing clause (i) is greater than zero, the Administrator shall not implement that clause.".

SEC.335. DOCUMENTATION REQUIRED FOR CERTAIN ELIGIBLE RECIPIENTS.

(a) IN GENERAL. — Section 7(a)(36)(D)(ii)(II) of the Small Business Act (15 U.S.C. 636(a)(36)(D)(ii)(II)) is amended by striking "as is necessary" and all that follows through the period at the end and inserting "as determined necessary by the Administrator and the Secretary, to establish the applicant as eligible.".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendment made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 336. ELECTION OF 12-WEEK PERIOD BY SEASONAL EMPLOYERS.

(a) IN GENERAL. — Section 7(a)(36)(E)(i)(I)(aa)(AA) of the Small Business Act (15 U.S.C. 636(a)(36)(E)(i)(I)(aa)(AA)) is amended by striking ", in the case of an applicant" and all that follows through "June 30, 2019" and inserting the following: "an applicant that is a seasonal employer shall use the average total monthly payments for payroll for any 12-week period selected by the seasonal employer between February 15, 2019, and February 15, 2020".

(b) EFFECTIVE DATE; APPLICABILITY. —

(1) IN GENERAL. — Except as provided in paragraph (2), the amendment made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

(2) EXCLUSION OF LOANS ALREADY FORGIVEN. — The amendment made by subsection (a) shall not apply to a loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) for which the borrower received forgiveness before the date of enactment of this Act under section 1106 of the CARES Act, as in effect on the day before such date of enactment.

SEC. 337. INCLUSION OF CERTAIN REFINANCING IN NONRECOURSE REQUIREMENTS.

(a) IN GENERAL. — Section 7(a)(36)(F)(v) of the Small Business Act (15 U.S.C. 636(a)(36)(F)(v)) is amended by striking "clause (i)" and inserting "clause (i) or (iv)".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendment made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 338. APPLICATION OF CERTAIN TERMS THROUGH LIFE OF COVERED LOAN.

(a) IN GENERAL. — Section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) is amended —

(1) in subparagraph (H), in the matter preceding clause (i), by striking "During the covered period, with" and inserting "With";

(2) in subparagraph (J), in the matter preceding clause (i), by striking "During the covered period, with" and inserting "With"; and

(3) in subparagraph (M) —

(A) in clause (ii), in the matter preceding subclause (I), by striking "During the covered period, the" and inserting "The"; and

(B) in clause (iii), by striking "During the covered period, with" and inserting "With".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendments made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 339. INTEREST CALCULATION ON COVERED LOANS.

(a) DEFINITIONS. — In this section, the terms "covered loan" and "eligible recipient" have the meanings given the terms in section 7(a)(36)(A) of the Small Business Act (15 U.S.C. 636(a)(36)(A)).

(b) CALCULATION. — Section 7(a)(36)(L) of the Small Business Act (15 U.S.C. 636(a)(36)(L)) is amended by inserting ", calculated on a non-compounding, non-adjustable basis" after "4 percent".

(c) APPLICABILITY. — The amendment made by subsection (b) may apply with respect to a covered loan made before the date of enactment of this Act, upon the agreement of the lender and the eligible recipient with respect to the covered loan.

SEC. 340. REIMBURSEMENT FOR PROCESSING.

(a) REIMBURSEMENT. — Section 7(a)(36)(P) of the Small Business Act (15 U.S.C. 636(a)(36)(P)) is amended —

(1) by amending clause (i) to read as follows:

"(i) IN GENERAL. — The Administrator shall reimburse a lender authorized to make a covered loan as follows:

"(I) With respect to a covered loan made during the period beginning on the date of enactment of this paragraph and ending on the day before the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, the Administrator shall reimburse such a lender at a rate, based on the balance of the financing outstanding at the time of disbursement of the covered loan, of —

"(aa) 5 percent for loans of not more than $350,000;

"(bb) 3 percent for loans of more than $350,000 and less than $2,000,000; and

"(cc) 1 percent for loans of not less than $2,000,000.

"(II) With respect to a covered loan made on or after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, the Administrator shall reimburse such a lender —

"(aa) for a covered loan of not more than $50,000, in an amount equal to the lesser of —

"(AA) 50 percent of the balance of the financing outstanding at the time of disbursement of the covered loan; or

"(BB) $2,500; and

"(bb) at a rate, based on the balance of the financing outstanding at the time of disbursement of the covered loan, of —

"(AA) 5 percent for a covered loan of more than $50,000 and not more than $350,000;

"(BB) 3 percent for a covered loan of more than $350,000 and less than $2,000,000; and

"(CC) 1 percent for a covered loan of not less than $2,000,000."; and

(2) by amending clause (iii) to read as follows:

"(iii) TIMING. — A reimbursement described in clause (i) shall be made not later than 5 days after the reported disbursement of the covered loan and may not be required to be repaid by a lender unless the lender is found guilty of an act of fraud in connection with the covered loan.".

(b) FEE LIMITS. —

(1) IN GENERAL. — Section 7(a)(36)(P)(ii) of the Small Business Act (15 U.S.C. 636(a)(36)(P)(ii)) is amended by adding at the end the following: "If an eligible recipient has knowingly retained an agent, such fees shall be paid by the eligible recipient and may not be paid out of the proceeds of a covered loan. A lender shall only be responsible for paying fees to an agent for services for which the lender directly contracts with the agent.".

(2) EFFECTIVE DATE; APPLICABILITY. — The amendment made by paragraph (1) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 341. DUPLICATION REQUIREMENTS FOR ECONOMIC INJURY DISASTER LOAN RECIPIENTS.

Section 7(a)(36)(Q) of the Small Business Act (15 U.S.C. 636(a)(36)(Q)) is amended by striking "during the period beginning on January 31, 2020, and ending on the date on which covered loans are made available".

SEC. 342. PROHIBITION OF ELIGIBILITY FOR PUBLICLY-TRADED COMPANIES.

Section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) is amended —

(1) in subparagraph (A), as amended by section 318 of this Act, by adding at the end the following:

"(xvi) the terms 'exchange', 'issuer', and 'security' have the meanings given those terms in section 3(a) of the Securities Exchange Act of 1934 (15 U.S.C. 78c(a))."; and

(2) in subparagraph (D), as amended by section 318 of this Act by adding at the end the following:

"(viii) INELIGIBILITY OF PUBLICLY-TRADED ENTITIES. — Notwithstanding any other provision of this paragraph, on and after the date of enactment of the Economic Aid to Hard-Hit Small Businesses, Non-profits, and Venues Act, an entity that is an issuer, the securities of which are listed on an exchange registered as a national securities exchange under section 6 of the Securities Exchange Act of 1934 (15 U.S.C. 78f), shall be ineligible to receive a covered loan under this paragraph.".

SEC. 343. COVERED PERIOD FOR NEW PARAGRAPH (36) LOANS.

(a) IN GENERAL. — Section 7(a)(36)(A)(iii) of the Small Business Act (15 U.S.C. 636(a)(36)(A)(iii)) is amended by striking "December 31, 2020" and inserting "March 31, 2021".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendment made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281) and shall apply to any loan made pursuant to section 7(a)(36) of the Small Business Act (15 U.S.C. 636(a)(36)) before, on, or after the date of enactment of this Act, including forgiveness of such a loan.

SEC. 344. APPLICABLE PERIODS FOR PRORATION.

Section 7(a)(36)(A)(viii) of the Small Business Act (15 U.S.C. 636(a)(36)(A)(viii)) is amended —

(1) in subclause (I)(bb), by striking "in 1 year, as prorated for the covered period" and inserting "on an annualized basis, as prorated for the period during which the payments are made or the obligation to make the payments is incurred"; and

(2) in subclause (II) —

(A) in item (aa), by striking "an annual salary of $100,000, as prorated for the covered period" and inserting " $100,000 on an annualized basis, as prorated for the period during which the compensation is paid or the obligation to pay the compensation is incurred"; and

(B) in item (bb), by striking "covered" and inserting "applicable".

SEC. 345. EXTENSION OF WAIVER OF MATCHING FUNDS REQUIREMENT UNDER THE WOMEN'S BUSINESS CENTER PROGRAM.

(a) IN GENERAL. — Section 1105 of the CARES Act (15 U.S.C. 9004) is amended by striking "the 3-month period beginning on the date of enactment of this Act" and inserting "the period beginning on the date of enactment of this Act and ending on June 30, 2021".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendment made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281).

SEC. 346. CLARIFICATION OF USE OF CARES ACT FUNDS FOR SMALL BUSINESS DEVELOPMENT CENTERS.

(a) IN GENERAL. — Section 1103(b)(3)(A) of the CARES Act (15 U.S.C. 9002(b)(3)(A)) is amended —

(1) by striking "The Administration" and inserting the following:

"(i) IN GENERAL. — The Administration"; and

(2) by adding at the end the following:

"(ii) CLARIFICATION OF USE. — Awards made under clause (i) shall be in addition to, and separate from, any amounts appropriated to make grants under section 21(a) of the Small Business Act (15 U.S.C. 648(a)) and such an award may be used to complement and support such a grant, except that priority with respect to the receipt of that assistance shall be given to small business development centers that have been affected by issues described in paragraph (2).".

(b) EFFECTIVE DATE; APPLICABILITY. — The amendments made by subsection (a) shall be effective as if included in the CARES Act (Public Law 116–136; 134 Stat. 281).

SEC. 347. GAO REPORT.

Not later than 120 days after the date of enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business of the House of Representatives a report regarding the use by the Administration of funds made available to the Administration through supplemental appropriations in fiscal year 2020, the purpose of which was for administrative expenses.

SEC. 348. EFFECTIVE DATE; APPLICABILITY.

Except as otherwise provided in this Act, this Act and the amendments made by this Act shall take effect on the date of enactment of this Act and apply to loans and grants made on or after the date of enactment of this Act.

* * *

DIVISION AA — WATER RESOURCES

* * *

SEC. 512. GREAT LAKES ST. LAWRENCE SEAWAY DEVELOPMENT CORPORATION.

(a) RENAMING THE SAINT LAWRENCE SEAWAY DEVELOPMENT CORPORATION. — The Act of May 13, 1954 (33 U.S.C. 981 et seq.) is amended —

(1) in section 1 (33 U.S.C. 981), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation"; and

(2) in section 2(b) (33 U.S.C. 982(b)), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation".

(b) REFERENCES. — Any reference to the Saint Lawrence Seaway Development Corporation in any law, regulation, document, record, Executive order, or other paper of the United States shall be deemed to be a reference to the Great Lakes St. Lawrence Seaway Development Corporation.

(c) TECHNICAL AND CONFORMING AMENDMENTS. —

(1) TITLE 5. — Section 5315 of title 5, United States Code, is amended by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation".

(2) TITLE 18. — Section 2282B of title 18, United States Code, is amended by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation".

(3) INTERNAL REVENUE CODE. — Section 9505(a)(2) of the Internal Revenue Code of 1986 (26 U.S.C. 9505(a)(2)) is amended by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation".

(4) TITLE 31. — Section 9101(3)(K) of title 31, United States Code, is amended by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation".

(5) WATER RESOURCES DEVELOPMENT ACT OF 1986. — The Water Resources Development Act of 1986 (33 U.S.C. 2211 et seq.) is amended —

(A) in section 206 (33 U.S.C. 2234), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation";

(B) in section 210(a)(1) (33 U.S.C. 2238(a)(1)), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation";

(C) in section 214(2)(B) (33 U.S.C. 2241(2)(B)), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation"; and

(D) in section 1132(b) (33 U.S.C. 2309(b)), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation" each place it appears.

(6) TITLE 46. — Title 46, United States Code, is amended —

(E) in section 2109, by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation";

(B) in section 8103(g), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation";

(C) in section 8503(c), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation";

(D) in section 55112(a)(3), by striking "St. Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation";

(E) in section 55331(3), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation"; and

(F) in section 70032, by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation" each place it appears.

(7) TITLE 49. —

(A) IN GENERAL. — Title 49, United States Code, is amended —

(i) in section 110 —

(I) in the heading, by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation"; and

(II) in subsection (a), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation"; and

(ii) in section 6314(c)(2)(G), by striking "Saint Lawrence Seaway Development Corporation" and inserting "Great Lakes St. Lawrence Seaway Development Corporation".

(B) TABLE OF SECTIONS. — The table of sections for chapter 1 of subtitle I of title 49, United States Code, is amended by amending the item relating to section 110 to read as follows:

"110. Great Lakes St. Lawrence Seaway Development Corporation.".

DIVISION BB — PRIVATE HEALTH INSURANCE AND PUBLIC HEALTH PROVISIONS

SEC. 1. TABLE OF CONTENTS.

The table of contents of the division is as follows:

DIVISION BB — PRIVATE HEALTH INSURANCE AND PUBLIC HEALTH PROVISIONS

Sec. 1. Table of contents.

TITLE I — NO SURPRISES ACT

Sec. 101. Short title.

Sec. 102. Health insurance requirements regarding surprise medical billing.

Sec. 103. Determination of out-of-network rates to be paid by health plans; Independent dispute resolution process.

Sec. 104. Health care provider requirements regarding surprise medical billing.

Sec. 105. Ending surprise air ambulance bills.

Sec. 106. Reporting requirements regarding air ambulance services.

Sec. 107. Transparency regarding in-network and out-of-network deductibles and out-of-pocket limitations.

Sec. 108. Implementing protections against provider discrimination.

Sec. 109. Reports.

Sec. 110. Consumer protections through application of health plan external review in cases of certain surprise medical bills.

Sec. 111. Consumer protections through health plan requirement for fair and honest advance cost estimate.

Sec. 112. Patient protections through transparency and patient-provider dispute resolution.

Sec. 113. Ensuring continuity of care.

Sec. 114. Maintenance of price comparison tool.

Sec. 115. State All Payer Claims Databases.

Sec. 116. Protecting patients and improving the accuracy of provider directory information.

Sec. 117. Advisory committee on ground ambulance and patient billing.

Sec. 118. Implementation funding.

TITLE II — TRANSPARENCY

Sec. 201. Increasing transparency by removing gag clauses on price and quality information.

Sec. 202. Disclosure of direct and indirect compensation for brokers and consultants to employer-sponsored health plans and enrollees in plans on the individual market.

Sec. 203. Strengthening parity in mental health and substance use disorder benefits.

Sec. 204. Reporting on pharmacy benefits and drug costs.

TITLE III — PUBLIC HEALTH PROVISIONS

Subtitle A — Extenders Provisions

Sec. 301. Extension for community health centers, the National Health Service Corps, and teaching health centers that operate GME programs.

Sec. 302. Diabetes programs.

Subtitle B — Strengthening Public Health

Sec. 311. Improving awareness of disease prevention.

Sec. 312. Guide on evidence-based strategies for public health department obesity prevention programs.

Sec. 313. Expanding capacity for health outcomes.

Sec. 314. Public health data system modernization.

Sec. 315. Native American suicide prevention.

Sec. 316. Reauthorization of the Young Women's Breast Health Education and Awareness Requires Learning Young Act of 2009.

Sec. 317. Reauthorization of school-based health centers.

Subtitle C — FDA Amendments

Sec. 321. Rare pediatric disease priority review voucher extension.

Sec. 322. Conditions of use for biosimilar biological products.

Sec. 323. Orphan drug clarification.

Sec. 324. Modernizing the labeling of certain generic drugs.

Sec. 325. Biological product patent transparency.

Subtitle D — Technical Corrections

Sec. 331. Technical corrections.

TITLE I — NO SURPRISES ACT

SEC. 101. SHORT TITLE.

This title may be cited as the "No Surprises Act".

SEC. 102. HEALTH INSURANCE REQUIREMENTS REGARDING SURPRISE MEDICAL BILLING.

(a) PUBLIC HEALTH SERVICE ACT AMENDMENTS. —

(1) IN GENERAL. — Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended by adding at the end the following new part:

"PART D — ADDITIONAL COVERAGE PROVISIONS

"SEC. 2799A–1. PREVENTING SURPRISE MEDICAL BILLS.

"(a) COVERAGE OF EMERGENCY SERVICES. —

"(1) IN GENERAL. — If a group health plan, or a health insurance issuer offering group or individual health insurance coverage, provides or covers any benefits with respect to services in an emergency department of a hospital or with respect to emergency services in an independent freestanding emergency department (as defined in paragraph (3)(D)), the plan or issuer shall cover emergency services (as defined in paragraph (3)(C)) —

"(A) without the need for any prior authorization determination;

"(B) whether the health care provider furnishing such services is a participating provider or a participating emergency facility, as applicable, with respect to such services;

"(C) in a manner so that, if such services are provided to a participant, beneficiary, or enrollee by a nonparticipating provider or a nonparticipating emergency facility —

"(i) such services will be provided without imposing any requirement under the plan or coverage for prior authorization of services or any limitation on coverage that is more restrictive than the requirements or limitations that apply to emergency services received from participating providers and participating emergency facilities with respect to such plan or coverage, respectively;

"(ii) the cost-sharing requirement is not greater than the requirement that would apply if such services were provided by a participating provider or a participating emergency facility;

"(iii) such cost-sharing requirement is calculated as if the total amount that would have been charged for such services by such participating provider or participating emergency facility were equal to the recognized amount (as defined in paragraph (3)(H)) for such services, plan or coverage, and year;

"(iv) the group health plan or health insurance issuer, respectively —

"(I) not later than 30 calendar days after the bill for such services is transmitted by such provider or facility, sends to the provider or facility, as applicable, an initial payment or notice of denial of payment; and

"(II) pays a total plan or coverage payment directly to such provider or facility, respectively (in accordance, if applicable, with the timing requirement described in subsection (c)(6)) that is, with application of any initial payment under subclause (I), equal to the amount by which the out-of-network rate (as defined in paragraph (3)(K)) for such services exceeds the cost-sharing amount for such services (as determined in accordance with clauses (ii) and (iii)) and year; and

"(v) any cost-sharing payments made by the participant, beneficiary, or enrollee with respect to such emergency services so furnished shall be counted toward any in-network deductible or out-of-pocket maximums applied under the plan or coverage, respectively (and such in-network deductible and out-of-pocket maximums shall be applied) in the same manner as if such cost-sharing payments were made with respect to emergency services furnished by a participating provider or a participating emergency facility; and

"(D) without regard to any other term or condition of such coverage (other than exclusion or coordination of benefits, or an affiliation or waiting period, permitted under section 2704 of this Act, including as incorporated pursuant to section 715 of the Employee Retirement Income Security Act of 1974 and section 9815 of the Internal Revenue Code of 1986, and other than applicable cost-sharing).

"(2) AUDIT PROCESS AND REGULATIONS FOR QUALIFYING PAYMENT AMOUNTS. —

"(A) AUDIT PROCESS. —

"(i) IN GENERAL. — Not later than October 1, 2021, the Secretary, in consultation with the Secretary of Labor and the Secretary of the Treasury, shall establish through rulemaking a process, in accordance with clause (ii), under which group health plans and health insurance issuers offering group or individual health insurance coverage are audited by the Secretary or applicable State authority to ensure that —

"(I) such plans and coverage are in compliance with the requirement of applying a qualifying payment amount under this section; and

"(II) such qualifying payment amount so applied satisfies the definition under paragraph (3)(E) with respect to the year involved, including with respect to a group health plan or health insurance issuer described in clause (ii) of such paragraph (3)(E).

"(ii) AUDIT SAMPLES. — Under the process established pursuant to clause (i), the Secretary —

"(I) shall conduct audits described in such clause, with respect to a year (beginning with 2022), of a sample with respect to such year of claims data from not more than 25 group health plans and health insurance issuers offering group or individual health insurance coverage; and

"(II) may audit any group health plan or health insurance issuer offering group or individual health insurance coverage if the Secretary has received any complaint or other information about such plan or coverage, respectively, that involves the compliance of the plan or coverage, respectively, with either of the requirements described in subclauses (I) and (II) of such clause.

"(iii) REPORTS. — Beginning for 2022, the Secretary shall annually submit to Congress a report on the number of plans and issuers with respect to which audits were conducted during such year pursuant to this subparagraph.

"(B) RULEMAKING. — Not later than July 1, 2021, the Secretary, in consultation with the Secretary of Labor and the Secretary of the Treasury, shall establish through rulemaking —

"(i) the methodology the group health plan or health insurance issuer offering group or individual health insurance coverage shall use to determine the qualifying payment amount, differentiating by individual market, large group market, and small group market;

"(ii) the information such plan or issuer, respectively, shall share with the nonparticipating provider or nonparticipating facility, as applicable, when making such a determination;

"(iii) the geographic regions applied for purposes of this subparagraph, taking into account access to items and services in rural and underserved areas, including health professional shortage areas, as defined in section 332; and

"(iv) a process to receive complaints of violations of the requirements described in subclauses (I) and (II) of subparagraph (A)(i) by group health plans and health insurance issuers offering group or individual health insurance coverage.

Such rulemaking shall take into account payments that are made by such plan or issuer, respectively, that are not on a fee-for-service basis. Such methodology may account for relevant payment adjustments that take into account quality or facility type (including higher acuity settings and the case-mix of various facility types) that are otherwise taken into account for purposes of determining payment amounts with respect to participating facilities. In carrying out clause (iii), the Secretary shall consult with the National Association of Insurance Commissioners to establish the geographic regions under such clause and shall periodically update such regions, as appropriate, taking into account the findings of the report submitted under section 109(a) of the No Surprises Act.

"(3) DEFINITIONS. — In this part and part E:

"(A) EMERGENCY DEPARTMENT OF A HOSPITAL. — The term 'emergency department of a hospital' includes a hospital outpatient department that provides emergency services (as defined in subparagraph (C)(i)).

"(B) EMERGENCY MEDICAL CONDITION. — The term 'emergency medical condition' means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in a condition described in clause (i), (ii), or (iii) of section 1867(e)(1)(A) of the Social Security Act.

"(C) EMERGENCY SERVICES. —

"(i) IN GENERAL. — The term 'emergency services', with respect to an emergency medical condition, means —

"(I) a medical screening examination (as required under section 1867 of the Social Security Act, or as would be required under such section if such section applied to an independent freestanding emergency department) that is within the capability of the emergency department of a hospital or of an independent freestanding emergency department, as applicable, including ancillary services routinely available to the emergency department to evaluate such emergency medical condition; and

"(II) within the capabilities of the staff and facilities available at the hospital or the independent freestanding emergency department, as applicable, such further medical examination and treatment as are required under section 1867 of such Act, or as would be required under such section if such section applied to an independent freestanding emergency department, to stabilize the patient (regardless of the department of the hospital in which such further examination or treatment is furnished).

"(ii) INCLUSION OF ADDITIONAL SERVICES. —

"(I) IN GENERAL. — For purposes of this subsection and section 2799B–1, in the case of a participant, beneficiary, or enrollee who is enrolled in a group health plan or group or individual health insurance coverage offered by a health insurance issuer and who is furnished services described in clause (i) with respect to an emergency medical condition, the term 'emergency services' shall include, unless each of the conditions described in subclause (II) are met, in addition to the items and services described in clause (i), items and services —

"(aa) for which benefits are provided or covered under the plan or coverage, respectively; and

"(bb) that are furnished by a nonparticipating provider or nonparticipating emergency facility (regardless of the department of the hospital in which such items or services are furnished) after the participant, beneficiary, or enrollee is stabilized and as part of out-patient observation or an inpatient or out-patient stay with respect to the visit in which the services described in clause (i) are furnished.

"(II) CONDITIONS. — For purposes of subclause (I), the conditions described in this subclause, with respect to a participant, beneficiary, or enrollee who is stabilized and furnished additional items and services described in subclause (I) after such stabilization by a provider or facility described in subclause (I), are the following;

"(aa) Such provider or facility determines such individual is able to travel using nonmedical transportation or nonemergency medical transportation.

"(bb) Such provider furnishing such additional items and services satisfies the notice and consent criteria of section 2799B–2(d) with respect to such items and services.

"(cc) Such individual is in a condition to receive (as determined in accordance with guidelines issued by the Secretary pursuant to rulemaking) the information described in section 2799B–2 and to provide informed consent under such section, in accordance with applicable State law.

"(dd) Such other conditions, as specified by the Secretary, such as conditions relating to coordinating care transitions to participating providers and facilities.

"(D) INDEPENDENT FREESTANDING EMERGENCY DEPARTMENT. — Theterm 'independent freestanding emergency department' means a health care facility that —

"(i) is geographically separate and distinct and licensed separately from a hospital under applicable State law; and

"(ii) provides any of the emergency services (as defined in subparagraph (C)(i)).

"(E) QUALIFYING PAYMENT AMOUNT. —

"(i) IN GENERAL. — The term 'qualifying payment amount' means, subject to clauses (ii) and (iii), with respect to a sponsor of a group health plan and health insurance issuer offering group or individual health insurance coverage —

"(I) for an item or service furnished during 2022, the median of the contracted rates recognized by the plan or issuer, respectively (determined with respect to all such plans of such sponsor or all such coverage offered by such issuer that are offered within the same insurance market (specified in subclause (I), (II), (III), or (IV) of clause (iv)) as the plan or coverage) as the total maximum payment (including the cost-sharing amount imposed for such item or service and the amount to be paid by the plan or issuer, respectively) under such plans or coverage, respectively, on January 31, 2019, for the same or a similar item or service that is provided by a provider in the same or similar specialty and provided in the geographic region in which the item or service is furnished, consistent with the methodology established by the Secretary under paragraph (2)(B), increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over 2019, such percentage increase over 2020, and such percentage increase over 2021; and

"(II) for an item or service furnished during 2023 or a subsequent year, the qualifying payment amount determined under this clause for such an item or service furnished in the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year.

"(ii) NEW PLANS AND COVERAGE. — The term 'qualifying payment amount' means, with respect to a sponsor of a group health plan or health insurance issuer offering group or individual health insurance coverage in a geographic region in which such sponsor or issuer, respectively, did not offer any group health plan or health insurance coverage during 2019 —

"(I) for the first year in which such group health plan, group health insurance coverage, or individual health insurance coverage, respectively, is offered in such region, a rate (determined in accordance with a methodology established by the Secretary) for items and services that are covered by such plan or coverage and furnished during such first year; and

"(II) for each subsequent year such group health plan, group health insurance coverage, or individual health insurance coverage, respectively, is offered in such region, the qualifying payment amount determined under this clause for such items and services furnished in the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year.

"(iii) INSUFFICIENT INFORMATION; NEWLY COVERED ITEMS AND SERVICES. — In the case of a sponsor of a group health plan or health insurance issuer offering group or individual health insurance coverage that does not have sufficient information to calculate the median of the contracted rates described in clause (i)(I) in 2019 (or, in the case of a newly covered item or service (as defined in clause (v)(III)), in the first coverage year (as defined in clause (v)(I)) for such item or service with respect to such plan or coverage) for an item or service (including with respect to provider type, or amount, of claims for items or services (as determined by the Secretary) provided in a particular geographic region (other than in a case with respect to which clause (ii) applies)) the term 'qualifying payment amount' —

"(I) for an item or service furnished during 2022 (or, in the case of a newly covered item or service, during the first coverage year for such item or service with respect to such plan or coverage), means such rate for such item or service determined by the sponsor or issuer, respectively, through use of any database that is determined, in accordance with rulemaking described in paragraph (2)(B), to not have any conflicts of interest and to have sufficient information reflecting allowed amounts paid to a health care provider or facility for relevant services furnished in the applicable geographic region (such as a State all-payer claims database);

"(II) for an item or service furnished in a subsequent year (before the first sufficient information year (as defined in clause (v)(II)) for such item or service with respect to such plan or coverage), means the rate determined under subclause (I) or this subclause, as applicable, for such item or service for the year previous to such subsequent year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year;

"(III) for an item or service furnished in the first sufficient information year for such item or service with respect to such plan or coverage, has the meaning given the term qualifying payment amount in clause (i)(I), except that in applying such clause to such item or service, the reference to 'furnished during 2022' shall be treated as a reference to furnished during such first sufficient information year, the reference to 'in 2019' shall be treated as a reference to such sufficient information year, and the increase described in such clause shall not be applied; and

"(IV) for an item or service furnished in any year subsequent to the first sufficient information year for such item or service with respect to such plan or coverage, has the meaning given such term in clause (i)(II), except that in applying such clause to such item or service, the reference to 'furnished during 2023 or a subsequent year' shall be treated as a reference to furnished during the year after such first sufficient information year or a subsequent year.

"(iv) INSURANCE MARKET. — For purposes of clause (i)(I), a health insurance market specified in this clause is one of the following:

"(I) The individual market.

"(II) The large group market (other than plans described in subclause (IV)).

"(III) The small group market (other than plans described in subclause (IV)).

"(IV) In the case of a self-insured group health plan, other self-insured group health plans.

"(v) DEFINITIONS. — For purposes of this subparagraph:

"(I) FIRST COVERAGE YEAR. — The term 'first coverage year' means, with respect to a group health plan or group or individual health insurance coverage offered by a health insurance issuer and an item or service for which coverage is not offered in 2019 under such plan or coverage, the first year after 2019 for which coverage for such item or service is offered under such plan or health insurance coverage.

"(II) FIRST SUFFICIENT INFORMATION YEAR. — The term 'first sufficient information year' means, with respect to a group health plan or group or individual health insurance coverage offered by a health insurance issuer —

"(aa) in the case of an item or service for which the plan or coverage does not have sufficient information to calculate the median of the contracted rates described in clause (i)(I) in 2019, the first year subsequent to 2022 for which the sponsor or issuer has such sufficient information to calculate the median of such contracted rates in the year previous to such first subsequent year; and

"(bb) in the case of a newly covered item or service, the first year subsequent to the first coverage year for such item or service with respect to such plan or coverage for which the sponsor or issuer has sufficient information to calculate the median of the contracted rates described in clause (i)(I) in the year previous to such first subsequent year.

"(III) NEWLY COVERED ITEM OR SERVICE. — The term 'newly covered item or service' means, with respect to a group health plan or group or individual health insurance issuer offering health insurance coverage, an item or service for which coverage was not offered in 2019 under such plan or coverage, but is offered under such plan or coverage in a year after 2019.

"(F) NONPARTICIPATING EMERGENCY FACILITY; PARTICIPATING EMERGENCY FACILITY. —

"(i) NONPARTICIPATING EMERGENCY FACILITY. — The term 'nonparticipating emergency facility' means, with respect to an item or service and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, an emergency department of a hospital, or an independent freestanding emergency department, that does not have a contractual relationship directly or indirectly with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.

"(ii) PARTICIPATING EMERGENCY FACILITY. — The term 'participating emergency facility' means, with respect to an item or service and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, an emergency department of a hospital, or an independent freestanding emergency department, that has a contractual relationship directly or indirectly with the plan or issuer, respectively, with respect to the furnishing of such an item or service at such facility.

"(G) NONPARTICIPATING PROVIDERS; PARTICIPATING PROVIDERS. —

"(i) NONPARTICIPATING PROVIDER. — The term 'non-participating provider' means, with respect to an item or service and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who does not have a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.

"(ii) PARTICIPATING PROVIDER. — The term 'participating provider' means, with respect to an item or service and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who has a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.

"(H) RECOGNIZED AMOUNT. — The term 'recognized amount' means, with respect to an item or service furnished by a nonparticipating provider or nonparticipating emergency facility during a year and a group health plan or group or individual health insurance coverage offered by a health insurance issuer —

"(i) subject to clause (iii), in the case of such item or service furnished in a State that has in effect a specified State law with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount determined in accordance with such law;

"(ii) subject to clause (iii), in the case of such item or service furnished in a State that does not have in effect a specified State law, with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount that is the qualifying payment amount (as defined in subparagraph (E)) for such year and determined in accordance with rulemaking described in paragraph (2)(B)) for such item or service; or

"(iii) in the case of such item or service furnished in a State with an All-Payer Model Agreement under section 1115A of the Social Security Act, the amount that the State approves under such system for such item or service so furnished.

"(I) SPECIFIED STATE LAW. — The term 'specified State law' means, with respect to a State, an item or service furnished by a nonparticipating provider or nonparticipating emergency facility during a year and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, a State law that provides for a method for determining the total amount payable under such a plan, coverage, or issuer, respectively (to the extent such State law applies to such plan, coverage, or issuer, subject to section 514 of the Employee Retirement Income Security Act of 1974) in the case of a participant, beneficiary, or enrollee covered under such plan or coverage and receiving such item or service from such a nonparticipating provider or nonparticipating emergency facility.

"(J) STABILIZE. — The term 'to stabilize', with respect to an emergency medical condition (as defined in subparagraph (B)), has the meaning give in section 1867(e)(3) of the Social Security Act (42 U.S.C. 1395dd(e)(3)).

"(K) OUT-OF-NETWORK RATE. — The term 'out-of-network rate' means, with respect to an item or service furnished in a State during a year to a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer receiving such item or service from a nonparticipating provider or nonparticipating emergency facility —

"(i) subject to clause (iii), in the case of such item or service furnished in a State that has in effect a specified State law with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount determined in accordance with such law;

"(ii) subject to clause (iii), in the case such State does not have in effect such a law with respect to such item or service, plan, and provider or facility —

"(I) subject to subclause (II), if the provider or facility (as applicable) and such plan or coverage agree on an amount of payment (including if such agreed on amount is the initial payment sent by the plan under subsection (a)(1)(C)(iv)(I), subsection (b)(1)(C), or section 2799A–2(a)(3)(A), as applicable, or is agreed on through open negotiations under subsection (c)(1)) with respect to such item or service, such agreed on amount; or

"(II) if such provider or facility (as applicable) and such plan or coverage enter the independent dispute resolution process under subsection (c) and do not so agree before the date on which a certified IDR entity (as defined in paragraph (4) of such subsection) makes a determination with respect to such item or service under such subsection, the amount of such determination; or

"(iii) in the case such State has an All-Payer Model Agreement under section 1115A of the Social Security Act, the amount that the State approves under such system for such item or service so furnished.

"(L) COST-SHARING. — The term 'cost-sharing' includes copayments, coinsurance, and deductibles.

"(b) COVERAGE OF NON-EMERGENCY SERVICES PERFORMED BY NONPARTICIPATING PROVIDERS AT CERTAIN PARTICIPATING FACILITIES. —

"(1) IN GENERAL. — In the case of items or services (other than emergency services to which subsection (a) applies) for which any benefits are provided or covered by a group health plan or health insurance issuer offering group or individual health insurance coverage furnished to a participant, beneficiary, or enrollee of such plan or coverage by a nonparticipating provider (as defined in subsection (a)(3)(G)(i)) (and who, with respect to such items and services, has not satisfied the notice and consent criteria of section 2799B–2(d)) with respect to a visit (as defined by the Secretary in accordance with paragraph (2)(B)) at a participating health care facility (as defined in paragraph (2)(A)), with respect to such plan or coverage, respectively, the plan or coverage, respectively —

"(A) shall not impose on such participant, beneficiary, or enrollee a cost-sharing requirement for such items and services so furnished that is greater than the cost-sharing requirement that would apply under such plan or coverage, respectively, had such items or services been furnished by a participating provider (as defined in subsection (a)(3)(G)(ii));

"(B) shall calculate such cost-sharing requirement as if the total amount that would have been charged for such items and services by such participating provider were equal to the recognized amount (as defined in subsection (a)(3)(H)) for such items and services, plan or coverage, and year;

"(C) not later than 30 calendar days after the bill for such services is transmitted by such provider, shall send to the provider an initial payment or notice of denial of payment;

"(D) shall pay a total plan or coverage payment directly, in accordance, if applicable, with the timing requirement described in subsection (c)(6), to such provider furnishing such items and services to such participant, beneficiary, or enrollee that is, with application of any initial payment under subparagraph (C), equal to the amount by which the out-of-network rate (as defined in subsection (a)(3)(K)) for such items and services involved exceeds the cost-sharing amount imposed under the plan or coverage, respectively, for such items and services (as determined in accordance with subparagraphs (A) and (B)) and year; and

"(E) shall count toward any in-network deductible and in-network out-of-pocket maximums (as applicable) applied under the plan or coverage, respectively, any cost-sharing payments made by the participant, beneficiary, or enrollee (and such in-network deductible and out-of-pocket maximums shall be applied) with respect to such items and services so furnished in the same manner as if such cost-sharing payments were with respect to items and services furnished by a participating provider.

"(2) DEFINITIONS. — In this section:

"(A) PARTICIPATING HEALTH CARE FACILITY. —

"(i) IN GENERAL. — The term 'participating health care facility' means, with respect to an item or service and a group health plan or health insurance issuer offering group or individual health insurance coverage, a health care facility described in clause (ii) that has a direct or indirect contractual relationship with the plan or issuer, respectively, with respect to the furnishing of such an item or service at the facility.

"(ii) HEALTH CARE FACILITY DESCRIBED. — A health care facility described in this clause, with respect to a group health plan or group or individual health insurance coverage, is each of the following:

"(I) A hospital (as defined in 1861(e) of the Social Security Act).

"(II) A hospital outpatient department.

"(III) A critical access hospital (as defined in section 1861(mm)(1) of such Act).

"(IV) An ambulatory surgical center described in section 1833(i)(1)(A) of such Act.

"(V) Any other facility, specified by the Secretary, that provides items or services for which coverage is provided under the plan or coverage, respectively.

"(B) VISIT. — The term 'visit' shall, with respect to items and services furnished to an individual at a health care facility, include equipment and devices, telemedicine services, imaging services, laboratory services, preoperative and postoperative services, and such other items and services as the Secretary may specify, regardless of whether or not the provider furnishing such items or services is at the facility.

"(c) CERTAIN ACCESS FEES TO CERTAIN DATABASES. — In the case of a sponsor of a group health plan or health insurance issuer offering group or individual health insurance coverage that, pursuant to subsection (a)(3)(E)(iii), uses a database described in such subsection to determine a rate to apply under such subsection for an item or service by reason of having insufficient information described in such subsection with respect to such item or service, such sponsor or issuer shall cover the cost for access to such database.".

(2) TRANSFER AMENDMENT. — Part D of title XXVII of the Public Health Service Act, as added by paragraph (1), is amended by adding at the end the following new section:

"SEC. 2799A–7. OTHER PATIENT PROTECTIONS.

"(a) CHOICE OF HEALTH CARE PROFESSIONAL. — If a group health plan, or a health insurance issuer offering group or individual health insurance coverage, requires or provides for designation by a participant, beneficiary, or enrollee of a participating primary care provider, then the plan or issuer shall permit each participant, beneficiary, and enrollee to designate any participating primary care provider who is available to accept such individual.

"(b) ACCESS TO PEDIATRIC CARE. —

"(1) PEDIATRIC CARE. — In the case of a person who has a child who is a participant, beneficiary, or enrollee under a group health plan, or group or individual health insurance coverage offered by a health insurance issuer, if the plan or issuer requires or provides for the designation of a participating primary care provider for the child, the plan or issuer shall permit such person to designate a physician (allopathic or osteopathic) who specializes in pediatrics as the child's primary care provider if such provider participates in the network of the plan or issuer.

"(2) CONSTRUCTION. — Nothing in paragraph (1) shall be construed to waive any exclusions of coverage under the terms and conditions of the plan or health insurance coverage with respect to coverage of pediatric care.

"(c) PATIENT ACCESS TO OBSTETRICAL AND GYNECOLOGICAL CARE. —

"(1) GENERAL RIGHTS. —

"(A) DIRECT ACCESS. — A group health plan, or health insurance issuer offering group or individual health insurance coverage, described in paragraph (2) may not require authorization or referral by the plan, issuer, or any person (including a primary care provider described in paragraph (2)(B)) in the case of a female participant, beneficiary, or enrollee who seeks coverage for obstetrical or gynecological care provided by a participating health care professional who specializes in obstetrics or gynecology. Such professional shall agree to otherwise adhere to such plan's or issuer's policies and procedures, including procedures regarding referrals and obtaining prior authorization and providing services pursuant to a treatment plan (if any) approved by the plan or issuer.

"(B) OBSTETRICAL AND GYNECOLOGICAL CARE. — A group health plan or health insurance issuer described in paragraph (2) shall treat the provision of obstetrical and gynecological care, and the ordering of related obstetrical and gynecological items and services, pursuant to the direct access described under subparagraph (A), by a participating health care professional who specializes in obstetrics or gynecology as the authorization of the primary care provider.

"(2) APPLICATION OF PARAGRAPH. — A group health plan, or health insurance issuer offering group or individual health insurance coverage, described in this paragraph is a group health plan or health insurance coverage that —

"(A) provides coverage for obstetric or gynecologic care; and

"(B) requires the designation by a participant, beneficiary, or enrollee of a participating primary care provider.

"(3) CONSTRUCTION. — Nothing in paragraph (1) shall be construed to —

"(A) waive any exclusions of coverage under the terms and conditions of the plan or health insurance coverage with respect to coverage of obstetrical or gynecological care; or

"(B) preclude the group health plan or health insurance issuer involved from requiring that the obstetrical or gynecological provider notify the primary care health care professional or the plan or issuer of treatment decisions.".

(3) CONFORMING AMENDMENTS. —

(A) Section 2719A of the Public Health Service Act (42 U.S.C. 300gg–19a) is amended by adding at the end the following new subsection:

"(e) APPLICATION. — The provisions of this section shall not apply with respect to a group health plan, health insurance issuers, or group or individual health insurance coverage with respect to plan years beginning on or on January 1, 2022.".

(B) Section 2722 of the Public Health Service Act (42 U.S.C. 300gg–21) is amended —

(i) in subsection (a)(1), by inserting "and part D" after "subparts 1 and 2";

(ii) in subsection (b), by inserting "and part D" after "subparts 1 and 2";

(iii) in subsection (c)(1), by inserting "and part D" after "subparts 1 and 2";

(iv) in subsection (c)(2), by inserting "and part D" after "subparts 1 and 2";

(v) in subsection (c)(3), by inserting "and part D" after "this part"; and

(vi) in subsection (d), in the matter preceding paragraph (1), by inserting "and part D" after "this part".

(C) Section 2723 of the Public Health Service Act (42 U.S.C. 300gg–22) is amended —

(vii) in subsection (a)(1), by inserting "and part D" after "this part";

(viii) in subsection (a)(2), by inserting "or part D" after "this part";

(ix) in subsection (b)(1), by inserting "or part D" after "this part";

(x) in subsection (b)(2)(A), by inserting "or part D" after "this part"; and

(xi) in subsection (b)(2)(C)(ii), by inserting "and part D" after "this part".

(D) Section 2724 of the Public Health Service Act (42 U.S.C. 300gg–23) is amended —

(xii) in subsection (a)(1) —

(I) by striking "this part and part C insofar as it relates to this part" and inserting "this part, part D, and part C insofar as it relates to this part or part D"; and

(II) by inserting "or part D" after "requirement of this part";

(ii) in subsection (a)(2), by inserting "or part D" after "this part"; and

(iii) in subsection (c), by inserting "or part D" after "this part (other than section 2704)".

(b) ERISA AMENDMENTS. —

(1) IN GENERAL. — Subpart B of part 7 of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following:

"SEC. 716. PREVENTING SURPRISE MEDICAL BILLS.

"(a) COVERAGE OF EMERGENCY SERVICES. —

"(1) IN GENERAL. — If a group health plan, or a health insurance issuer offering group health insurance coverage, provides or covers any benefits with respect to services in an emergency department of a hospital or with respect to emergency services in an independent freestanding emergency department (as defined in paragraph (3)(D)), the plan or issuer shall cover emergency services (as defined in paragraph (3)(C)) —

"(A) without the need for any prior authorization determination;

"(B) whether the health care provider furnishing such services is a participating provider or a participating emergency facility, as applicable, with respect to such services;

"(C) in a manner so that, if such services are provided to a participant or beneficiary by a nonparticipating provider or a nonparticipating emergency facility —

"(i) such services will be provided without imposing any requirement under the plan for prior authorization of services or any limitation on coverage that is more restrictive than the requirements or limitations that apply to emergency services received from participating providers and participating emergency facilities with respect to such plan or coverage, respectively;

"(ii) the cost-sharing requirement is not greater than the requirement that would apply if such services were provided by a participating provider or a participating emergency facility;

"(iii) such cost-sharing requirement is calculated as if the total amount that would have been charged for such services by such participating provider or participating emergency facility were equal to the recognized amount (as defined in paragraph (3)(H)) for such services, plan or coverage, and year;

"(iv) the group health plan or health insurance issuer, respectively —

"(I) not later than 30 calendar days after the bill for such services is transmitted by such provider or facility, sends to the provider or facility, as applicable, an initial payment or notice of denial of payment; and

"(II) pays a total plan or coverage payment directly to such provider or facility, respectively (in accordance, if applicable, with the timing requirement described in subsection (c)(6)) that is, with application of any initial payment under subclause (I), equal to the amount by which the out-of-network rate (as defined in paragraph (3)(K)) for such services exceeds the cost-sharing amount for such services (as determined in accordance with clauses (ii) and (iii)) and year; and

"(v) any cost-sharing payments made by the participant or beneficiary with respect to such emergency services so furnished shall be counted toward any in-network deductible or out-of-pocket maximums applied under the plan or coverage, respectively (and such in-network deductible and out-of-pocket maximums shall be applied) in the same manner as if such cost-sharing payments were made with respect to emergency services furnished by a participating provider or a participating emergency facility; and

"(D) without regard to any other term or condition of such coverage (other than exclusion or coordination of benefits, or an affiliation or waiting period, permitted under section 2704 of the Public Health Service Act, including as incorporated pursuant to section 715 of this Act and section 9815 of the Internal Revenue Code of 1986, and other than applicable cost-sharing).

"(2) REGULATIONS FOR QUALIFYING PAYMENT AMOUNTS. — Not later than July 1, 2021, the Secretary, in consultation with the Secretary of the Treasury and the Secretary of Health and Human Services, shall establish through rulemaking —

"(A) the methodology the group health plan or health insurance issuer offering health insurance coverage in the group market shall use to determine the qualifying payment amount, differentiating by large group market, and small group market;

"(B) the information such plan or issuer, respectively, shall share with the nonparticipating provider or non-participating facility, as applicable, when making such a determination;

"(C) the geographic regions applied for purposes of this subparagraph, taking into account access to items and services in rural and underserved areas, including health professional shortage areas, as defined in section 332 of the Public Health Service Act; and

"(D) a process to receive complaints of violations of the requirements described in subclauses (I) and (II) of subparagraph (A)(i) by group health plans and health insurance issuers offering health insurance coverage in the group market.

Such rulemaking shall take into account payments that are made by such plan or issuer, respectively, that are not on a fee-for-service basis. Such methodology may account for relevant payment adjustments that take into account quality or facility type (including higher acuity settings and the case-mix of various facility types) that are otherwise taken into account for purposes of determining payment amounts with respect to participating facilities. In carrying out clause (iii), the Secretary shall consult with the National Association of Insurance Commissioners to establish the geographic regions under such clause and shall periodically update such regions, as appropriate, taking into account the findings of the report submitted under section 109(a) of the No Surprises Act.

"(3) DEFINITIONS. — In this subpart:

"(A) EMERGENCY DEPARTMENT OF A HOSPITAL. — The term 'emergency department of a hospital' includes a hospital outpatient department that provides emergency services (as defined in subparagraph (C)(i)).

"(B) EMERGENCY MEDICAL CONDITION. — The term 'emergency medical condition' means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in a condition described in clause (i), (ii), or (iii) of section 1867(e)(1)(A) of the Social Security Act.

"(C) EMERGENCY SERVICES. —

"(i) IN GENERAL. — The term 'emergency services', with respect to an emergency medical condition, means —

"(I) a medical screening examination (as required under section 1867 of the Social Security Act, or as would be required under such section if such section applied to an independent freestanding emergency department) that is within the capability of the emergency department of a hospital or of an independent freestanding emergency department, as applicable, including ancillary services routinely available to the emergency department to evaluate such emergency medical condition; and

"(II) within the capabilities of the staff and facilities available at the hospital or the independent freestanding emergency department, as applicable, such further medical examination and treatment as are required under section 1867 of such Act, or as would be required under such section if such section applied to an independent freestanding emergency department, to stabilize the patient (regardless of the department of the hospital in which such further examination or treatment is furnished).

"(ii) INCLUSION OF ADDITIONAL SERVICES. —

"(I) IN GENERAL. — For purposes of this subsection and section 2799B–1 of the Public Health Service Act, in the case of a participant or beneficiary who is enrolled in a group health plan or group health insurance coverage offered by a health insurance issuer and who is furnished services described in clause (i) with respect to an emergency medical condition, the term 'emergency services' shall include, unless each of the conditions described in subclause (II) are met, in addition to the items and services described in clause (i), items and services —

"(aa) for which benefits are provided or covered under the plan or coverage, respectively; and

"(bb) that are furnished by a nonparticipating provider or nonparticipating emergency facility (regardless of the department of the hospital in which such items or services are furnished) after the participant or beneficiary is stabilized and as part of outpatient observation or an inpatient or outpatient stay with respect to the visit in which the services described in clause (i) are furnished.

"(II) CONDITIONS. — For purposes of subclause (I), the conditions described in this subclause, with respect to a participant or beneficiary who is stabilized and furnished additional items and services described in subclause (I) after such stabilization by a provider or facility described in subclause (I), are the following;

"(aa) Such provider or facility determines such individual is able to travel using nonmedical transportation or nonemergency medical transportation.

"(bb) Such provider furnishing such additional items and services satisfies the notice and consent criteria of section 2799B–2(d) with respect to such items and services.

"(cc) Such individual is in a condition to receive (as determined in accordance with guidelines issued by the Secretary pursuant to rulemaking) the information described in section 2799B–2 and to provide informed consent under such section, in accordance with applicable State law.

"(dd) Such other conditions, as specified by the Secretary, such as conditions relating to coordinating care transitions to participating providers and facilities.

"(D) INDEPENDENT FREESTANDING EMERGENCY DEPARTMENT. — Theterm 'independent freestanding emergency department' means a health care facility that —

"(i) is geographically separate and distinct and licensed separately from a hospital under applicable State law; and

"(ii) provides any of the emergency services (as defined in subparagraph (C)(i)).

"(E) QUALIFYING PAYMENT AMOUNT. —

"(i) IN GENERAL. — The term 'qualifying payment amount' means, subject to clauses (ii) and (iii), with respect to a sponsor of a group health plan and health insurance issuer offering group health insurance coverage —

"(I) for an item or service furnished during 2022, the median of the contracted rates recognized by the plan or issuer, respectively (determined with respect to all such plans of such sponsor or all such coverage offered by such issuer that are offered within the same insurance market (specified in subclause (I), (II), or (III) of clause (iv)) as the plan or coverage) as the total maximum payment (including the cost-sharing amount imposed for such item or service and the amount to be paid by the plan or issuer, respectively) under such plans or coverage, respectively, on January 31, 2019, for the same or a similar item or service that is provided by a provider in the same or similar specialty and provided in the geographic region in which the item or service is furnished, consistent with the methodology established by the Secretary under paragraph (2), increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over 2019, such percentage increase over 2020, and such percentage increase over 2021; and

"(II) for an item or service furnished during 2023 or a subsequent year, the qualifying payment amount determined under this clause for such an item or service furnished in the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year.

"(ii) NEW PLANS AND COVERAGE. — The term 'qualifying payment amount' means, with respect to a sponsor of a group health plan or health insurance issuer offering group health insurance coverage in a geographic region in which such sponsor or issuer, respectively, did not offer any group health plan or health insurance coverage during 2019 —

"(I) for the first year in which such group health plan or health insurance coverage, respectively, is offered in such region, a rate (determined in accordance with a methodology established by the Secretary) for items and services that are covered by such plan and furnished during such first year; and

"(II) for each subsequent year such group health plan or health insurance coverage, respectively, is offered in such region, the qualifying payment amount determined under this clause for such items and services furnished in the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year.

"(iii) INSUFFICIENT INFORMATION; NEWLY COVERED ITEMS AND SERVICES. — In the case of a sponsor of a group health plan or health insurance issuer offering group health insurance coverage that does not have sufficient information to calculate the median of the contracted rates described in clause (i)(I) in 2019 (or, in the case of a newly covered item or service (as defined in clause (v)(III)), in the first coverage year (as defined in clause (v)(I)) for such item or service with respect to such plan or coverage) for an item or service (including with respect to provider type, or amount, of claims for items or services (as determined by the Secretary) provided in a particular geographic region (other than in a case with respect to which clause (ii) applies)) the term 'qualifying payment amount' —

"(I) for an item or service furnished during 2022 (or, in the case of a newly covered item or service, during the first coverage year for such item or service with respect to such plan or coverage), means such rate for such item or service determined by the sponsor or issuer, respectively, through use of any database that is determined, in accordance with rulemaking described in paragraph (2), to not have any conflicts of interest and to have sufficient information reflecting allowed amounts paid to a health care provider or facility for relevant services furnished in the applicable geographic region (such as a State all-payer claims database);

"(II) for an item or service furnished in a subsequent year (before the first sufficient information year (as defined in clause (v)(II)) for such item or service with respect to such plan or coverage), means the rate determined under subclause (I) or this subclause, as applicable, for such item or service for the year previous to such subsequent year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year;

"(III) for an item or service furnished in the first sufficient information year for such item or service with respect to such plan or coverage, has the meaning given the term qualifying payment amount in clause (i)(I), except that in applying such clause to such item or service, the reference to 'furnished during 2022' shall be treated as a reference to furnished during such first sufficient information year, the reference to 'in 2019' shall be treated as a reference to such sufficient information year, and the increase described in such clause shall not be applied; and

"(IV) for an item or service furnished in any year subsequent to the first sufficient information year for such item or service with respect to such plan or coverage, has the meaning given such term in clause (i)(II), except that in applying such clause to such item or service, the reference to 'furnished during 2023 or a subsequent year' shall be treated as a reference to furnished during the year after such first sufficient information year or a subsequent year.

"(iv) INSURANCE MARKET. — For purposes of clause (i)(I), a health insurance market specified in this clause is one of the following:

"(I) The large group market (other than plans described in subclause (III)).

"(II) The small group market (other than plans described in subclause (III)).

"(III) In the case of a self-insured group health plan, other self-insured group health plans.

"(v) DEFINITIONS. — For purposes of this subparagraph:

"(I) FIRST COVERAGE YEAR. — The term 'first coverage year' means, with respect to a group health plan or group health insurance coverage offered by a health insurance issuer and an item or service for which coverage is not offered in 2019 under such plan or coverage, the first year after 2019 for which coverage for such item or service is offered under such plan or health insurance coverage.

"(II) FIRST SUFFICIENT INFORMATION YEAR. — The term 'first sufficient information year' means, with respect to a group health plan or group health insurance coverage offered by a health insurance issuer —

"(aa) in the case of an item or service for which the plan or coverage does not have sufficient information to calculate the median of the contracted rates described in clause (i)(I) in 2019, the first year subsequent to 2022 for which such sponsor or issuer has such sufficient information to calculate the median of such contracted rates in the year previous to such first subsequent year; and

"(bb) in the case of a newly covered item or service, the first year subsequent to the first coverage year for such item or service with respect to such plan or coverage for which the sponsor or issuer has sufficient information to calculate the median of the contracted rates described in clause (i)(I) in the year previous to such first subsequent year.

"(III) NEWLY COVERED ITEM OR SERVICE. — The term 'newly covered item or service' means, with respect to a group health plan or health insurance issuer offering group health insurance coverage, an item or service for which coverage was not offered in 2019 under such plan or coverage, but is offered under such plan or coverage in a year after 2019.

"(F) NONPARTICIPATING EMERGENCY FACILITY; PARTICIPATING EMERGENCY FACILITY. —

"(i) NONPARTICIPATING EMERGENCY FACILITY. — The term 'nonparticipating emergency facility' means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, an emergency department of a hospital, or an independent freestanding emergency department, that does not have a contractual relationship directly or indirectly with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.

"(ii) PARTICIPATING EMERGENCY FACILITY. — The term 'participating emergency facility' means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, an emergency department of a hospital, or an independent freestanding emergency department, that has a contractual relationship directly or indirectly with the plan or issuer, respectively, with respect to the furnishing of such an item or service at such facility.

"(G) NONPARTICIPATING PROVIDERS; PARTICIPATING PROVIDERS. —

"(i) NONPARTICIPATING PROVIDER. — The term 'non-participating provider' means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who does not have a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.

"(ii) PARTICIPATING PROVIDER. — The term 'participating provider' means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who has a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.

"(H) RECOGNIZED AMOUNT. — The term 'recognized amount' means, with respect to an item or service furnished by a nonparticipating provider or nonparticipating emergency facility during a year and a group health plan or group health insurance coverage offered by a health insurance issuer —

"(i) subject to clause (iii), in the case of such item or service furnished in a State that has in effect a specified State law with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount determined in accordance with such law;

"(ii) subject to clause (iii), in the case of such item or service furnished in a State that does not have in effect a specified State law, with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount that is the qualifying payment amount (as defined in subparagraph (E)) for such year and determined in accordance with rulemaking described in paragraph (2)) for such item or service; or

"(iii) in the case of such item or service furnished in a State with an All-Payer Model Agreement under section 1115A of the Social Security Act, the amount that the State approves under such system for such item or service so furnished.

"(I) SPECIFIED STATE LAW. — The term 'specified State law' means, with respect to a State, an item or service furnished by a nonparticipating provider or nonparticipating emergency facility during a year and a group health plan or group health insurance coverage offered by a health insurance issuer, a State law that provides for a method for determining the total amount payable under such a plan, coverage, or issuer, respectively (to the extent such State law applies to such plan, coverage, or issuer, subject to section 514) in the case of a participant or beneficiary covered under such plan or coverage and receiving such item or service from such a nonparticipating provider or nonparticipating emergency facility.

"(J) STABILIZE. — The term 'to stabilize', with respect to an emergency medical condition (as defined in subparagraph (B)), has the meaning give in section 1867(e)(3) of the Social Security Act (42 U.S.C. 1395dd(e)(3)).

"(K) OUT-OF-NETWORK RATE. — The term 'out-of-network rate' means, with respect to an item or service furnished in a State during a year to a participant or beneficiary of a group health plan or group health insurance coverage offered by a health insurance issuer receiving such item or service from a nonparticipating provider or nonparticipating emergency facility —

"(i) subject to clause (iii), in the case of such item or service furnished in a State that has in effect a specified State law with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount determined in accordance with such law;

"(ii) subject to clause (iii), in the case such State does not have in effect such a law with respect to such item or service, plan, and provider or facility —

"(I) subject to subclause (II), if the provider or facility (as applicable) and such plan or coverage agree on an amount of payment (including if such agreed on amount is the initial payment sent by the plan under subsection (a)(1)(C)(iv)(I), subsection (b)(1)(C), or section 717(a)(3)(A), as applicable, or is agreed on through open negotiations under subsection (c)(1)) with respect to such item or service, such agreed on amount; or

"(II) if such provider or facility (as applicable) and such plan or coverage enter the independent dispute resolution process under subsection (c) and do not so agree before the date on which a certified IDR entity (as defined in paragraph (4) of such subsection) makes a determination with respect to such item or service under such subsection, the amount of such determination; or

"(iii) in the case such State has an All-Payer Model Agreement under section 1115A of the Social Security Act, the amount that the State approves under such system for such item or service so furnished.

"(L) COST-SHARING. — The term 'cost-sharing' includes copayments, coinsurance, and deductibles.

"(b) COVERAGE OF NON-EMERGENCY SERVICES PERFORMED BY NONPARTICIPATING PROVIDERS AT CERTAIN PARTICIPATING FACILITIES. —

"(1) IN GENERAL. — In the case of items or services (other than emergency services to which subsection (a) applies) for which any benefits are provided or covered by a group health plan or health insurance issuer offering group health insurance coverage furnished to a participant or beneficiary of such plan or coverage by a nonparticipating provider (as defined in subsection (a)(3)(G)(i)) (and who, with respect to such items and services, has not satisfied the notice and consent criteria of section 2799B–2(d) of the Public Health Service Act) with respect to a visit (as defined by the Secretary in accordance with paragraph (2)(B)) at a participating health care facility (as defined in paragraph (2)(A)), with respect to such plan or coverage, respectively, the plan or coverage, respectively —

"(A) shall not impose on such participant or beneficiary a cost-sharing requirement for such items and services so furnished that is greater than the cost-sharing requirement that would apply under such plan or coverage, respectively, had such items or services been furnished by a participating provider (as defined in subsection (a)(3)(G)(ii));

"(B) shall calculate such cost-sharing requirement as if the total amount that would have been charged for such items and services by such participating provider were equal to the recognized amount (as defined in subsection (a)(3)(H)) for such items and services, plan or coverage, and year;

"(C) not later than 30 calendar days after the bill for such items or services is transmitted by such provider, shall send to the provider an initial payment or notice of denial of payment;

"(D) shall pay a total plan or coverage payment directly, in accordance, if applicable, with the timing requirement described in subsection (c)(6), to such provider furnishing such items and services to such participant or beneficiary that is, with application of any initial payment under subparagraph (C), equal to the amount by which the out-of-network rate (as defined in subsection (a)(3)(K)) for such items and services exceeds the cost-sharing amount imposed under the plan or coverage, respectively, for such items and services (as determined in accordance with subparagraphs (A) and (B)) and year; and

"(E) shall count toward any in-network deductible and in-network out-of-pocket maximums (as applicable) applied under the plan or coverage, respectively, any cost-sharing payments made by the participant or beneficiary (and such in-network deductible and out-of-pocket maximums shall be applied) with respect to such items and services so furnished in the same manner as if such cost-sharing payments were with respect to items and services furnished by a participating provider.

"(2) DEFINITIONS. — In this section:

"(A) PARTICIPATING HEALTH CARE FACILITY. —

"(i) IN GENERAL. — The term 'participating health care facility' means, with respect to an item or service and a group health plan or health insurance issuer offering group health insurance coverage, a health care facility described in clause (ii) that has a direct or indirect contractual relationship with the plan or issuer, respectively, with respect to the furnishing of such an item or service at the facility.

"(ii) HEALTH CARE FACILITY DESCRIBED. — A health care facility described in this clause, with respect to a group health plan or group health insurance coverage, is each of the following:

"(I) A hospital (as defined in 1861(e) of the Social Security Act).

"(II) A hospital outpatient department.

"(III) A critical access hospital (as defined in section 1861(mm)(1) of such Act).

"(IV) An ambulatory surgical center described in section 1833(i)(1)(A) of such Act.

"(V) Any other facility, specified by the Secretary, that provides items or services for which coverage is provided under the plan or coverage, respectively.

"(B) VISIT. — The term 'visit' shall, with respect to items and services furnished to an individual at a health care facility, include equipment and devices, telemedicine services, imaging services, laboratory services, preoperative and postoperative services, and such other items and services as the Secretary may specify, regardless of whether or not the provider furnishing such items or services is at the facility.

"(c) CERTAIN ACCESS FEES TO CERTAIN DATABASES. — In the case of a sponsor of a group health plan or health insurance issuer offering group health insurance coverage that, pursuant to subsection (a)(3)(E)(iii), uses a database described in such subsection to determine a rate to apply under such subsection for an item or service by reason of having insufficient information described in such subsection with respect to such item or service, such sponsor or issuer shall cover the cost for access to such database.".

(2) TRANSFER AMENDMENT. — Subpart B of part 7 of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.), as amended by paragraph (1), is further amended by adding at the end the following:

"SEC. 722. OTHER PATIENT PROTECTIONS.

"(a) CHOICE OF HEALTH CARE PROFESSIONAL. — If a group health plan, or a health insurance issuer offering group health insurance coverage, requires or provides for designation by a participant or beneficiary of a participating primary care provider, then the plan or issuer shall permit each participant and beneficiary to designate any participating primary care provider who is available to accept such individual.

"(b) ACCESS TO PEDIATRIC CARE. —

"(1) PEDIATRIC CARE. — In the case of a person who has a child who is a participant or beneficiary under a group health plan, or group health insurance coverage offered by a health insurance issuer, if the plan or issuer requires or provides for the designation of a participating primary care provider for the child, the plan or issuer shall permit such person to designate a physician (allopathic or osteopathic) who specializes in pediatrics as the child's primary care provider if such provider participates in the network of the plan or issuer.

"(2) CONSTRUCTION. — Nothing in paragraph (1) shall be construed to waive any exclusions of coverage under the terms and conditions of the plan or health insurance coverage with respect to coverage of pediatric care.

"(c) PATIENT ACCESS TO OBSTETRICAL AND GYNECOLOGICAL CARE. —

"(1) GENERAL RIGHTS. —

"(A) DIRECT ACCESS. — A group health plan, or health insurance issuer offering group health insurance coverage, described in paragraph (2) may not require authorization or referral by the plan, issuer, or any person (including a primary care provider described in paragraph (2)(B)) in the case of a female participant or beneficiary who seeks coverage for obstetrical or gynecological care provided by a participating health care professional who specializes in obstetrics or gynecology. Such professional shall agree to otherwise adhere to such plan's or issuer's policies and procedures, including procedures regarding referrals and obtaining prior authorization and providing services pursuant to a treatment plan (if any) approved by the plan or issuer.

"(B) OBSTETRICAL AND GYNECOLOGICAL CARE. — A group health plan or health insurance issuer described in paragraph (2) shall treat the provision of obstetrical and gynecological care, and the ordering of related obstetrical and gynecological items and services, pursuant to the direct access described under subparagraph (A), by a participating health care professional who specializes in obstetrics or gynecology as the authorization of the primary care provider.

"(2) APPLICATION OF PARAGRAPH. — A group health plan, or health insurance issuer offering group health insurance coverage, described in this paragraph is a group health plan or coverage that —

"(A) provides coverage for obstetric or gynecologic care; and

"(B) requires the designation by a participant or beneficiary of a participating primary care provider.

"(3) CONSTRUCTION. — Nothing in paragraph (1) shall be construed to —

"(A) waive any exclusions of coverage under the terms and conditions of the plan or health insurance coverage with respect to coverage of obstetrical or gynecological care; or

"(B) preclude the group health plan or health insurance issuer involved from requiring that the obstetrical or gynecological provider notify the primary care health care professional or the plan or issuer of treatment decisions.".

(3) CLERICAL AMENDMENT. — The table of contents of the Employee Retirement Income Security Act of 1974 is amended by inserting after the item relating to section 714 the following:

"Sec. 715. Additional market reforms.

"Sec. 716. Preventing surprise medical bills.

"Sec. 722. Other patient protections.".

(c) IRC AMENDMENTS. —

(1) IN GENERAL. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by adding at the end the following:

"SEC. 9816. PREVENTING SURPRISE MEDICAL BILLS.

"(a) COVERAGE OF EMERGENCY SERVICES. —

"(1) IN GENERAL. — If a group health plan provides or covers any benefits with respect to services in an emergency department of a hospital or with respect to emergency services in an independent freestanding emergency department (as defined in paragraph (3)(D)), the plan shall cover emergency services (as defined in paragraph (3)(C)) —

"(A) without the need for any prior authorization determination;

"(B) whether the health care provider furnishing such services is a participating provider or a participating emergency facility, as applicable, with respect to such services;

"(C) in a manner so that, if such services are provided to a participant or beneficiary by a nonparticipating provider or a nonparticipating emergency facility —

"(i) such services will be provided without imposing any requirement under the plan for prior authorization of services or any limitation on coverage that is more restrictive than the requirements or limitations that apply to emergency services received from participating providers and participating emergency facilities with respect to such plan;

"(ii) the cost-sharing requirement is not greater than the requirement that would apply if such services were provided by a participating provider or a participating emergency facility;

"(iii) such cost-sharing requirement is calculated as if the total amount that would have been charged for such services by such participating provider or participating emergency facility were equal to the recognized amount (as defined in paragraph (3)(H)) for such services, plan, and year;

"(iv) the group health plan —

"(I) not later than 30 calendar days after the bill for such services is transmitted by such provider or facility, sends to the provider or facility, as applicable, an initial payment or notice of denial of payment; and

"(II) pays a total plan payment directly to such provider or facility, respectively (in accordance, if applicable, with the timing requirement described in subsection (c)(6)) that is, with application of any initial payment under subclause (I), equal to the amount by which the out-of-network rate (as defined in paragraph (3)(K)) for such services exceeds the cost-sharing amount for such services (as determined in accordance with clauses (ii) and (iii)) and year; and

"(iv) any cost-sharing payments made by the participant or beneficiary with respect to such emergency services so furnished shall be counted toward any in-network deductible or out-of-pocket maximums applied under the plan (and such in-network deductible and out-of-pocket maximums shall be applied) in the same manner as if such cost-sharing payments were made with respect to emergency services furnished by a participating provider or a participating emergency facility; and

"(D) without regard to any other term or condition of such coverage (other than exclusion or coordination of benefits, or an affiliation or waiting period, permitted under section 2704 of the Public Health Service Act, including as incorporated pursuant to section 715 of the Employee Retirement Income Security Act of 1974 and section 9815 of this Act, and other than applicable cost-sharing).

"(2) AUDIT PROCESS AND REGULATIONS FOR QUALIFYING PAYMENT AMOUNTS. —

"(A) AUDIT PROCESS. —

"(i) IN GENERAL. — Not later than October 1, 2021, the Secretary, in consultation with the Secretary of Health and Human Services and the Secretary of Labor, shall establish through rulemaking a process, in accordance with clause (ii), under which group health plans are audited by the Secretary or applicable State authority to ensure that —

"(I) such plans are in compliance with the requirement of applying a qualifying payment amount under this section; and

"(II) such qualifying payment amount so applied satisfies the definition under paragraph (3)(E) with respect to the year involved, including with respect to a group health plan described in clause (ii) of such paragraph (3)(E).

"(ii) AUDIT SAMPLES. — Under the process established pursuant to clause (i), the Secretary —

"(I) shall conduct audits described in such clause, with respect to a year (beginning with 2022), of a sample with respect to such year of claims data from not more than 25 group health plans; and

"(II) may audit any group health plan if the Secretary has received any complaint or other information about such plan or coverage, respectively, that involves the compliance of the plan with either of the requirements described in subclauses (I) and (II) of such clause.

"(iii) REPORTS. — Beginning for 2022, the Secretary shall annually submit to Congress a report on the number of plans and issuers with respect to which audits were conducted during such year pursuant to this subparagraph.

"(B) RULEMAKING. — Not later than July 1, 2021, the Secretary, in consultation with the Secretary of Labor and the Secretary of Health and Human Services, shall establish through rulemaking —

"(i) the methodology the group health plan shall use to determine the qualifying payment amount, differentiating by large group market and small group market;

"(ii) the information such plan or issuer, respectively, shall share with the nonparticipating provider or nonparticipating facility, as applicable, when making such a determination;

"(iii) the geographic regions applied for purposes of this subparagraph, taking into account access to items and services in rural and underserved areas, including health professional shortage areas, as defined in section 332 of the Public Health Service Act; and

"(iv) a process to receive complaints of violations of the requirements described in subclauses (I) and (II) of subparagraph (A)(i) by group health plans.

Such rulemaking shall take into account payments that are made by such plan that are not on a fee-for-service basis. Such methodology may account for relevant payment adjustments that take into account quality or facility type (including higher acuity settings and the case-mix of various facility types) that are otherwise taken into account for purposes of determining payment amounts with respect to participating facilities. In carrying out clause (iii), the Secretary shall consult with the National Association of Insurance Commissioners to establish the geographic regions under such clause and shall periodically update such regions, as appropriate, taking into account the findings of the report submitted under section 109(a) of the No Surprises Act.

"(3) DEFINITIONS. — In this subchapter:

"(A) EMERGENCY DEPARTMENT OF A HOSPITAL. — The term 'emergency department of a hospital' includes a hospital outpatient department that provides emergency services (as defined in subparagraph (C)(i)).

"(B) EMERGENCY MEDICAL CONDITION. — The term 'emergency medical condition' means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in a condition described in clause (i), (ii), or (iii) of section 1867(e)(1)(A) of the Social Security Act.

"(C) EMERGENCY SERVICES. —

"(i) IN GENERAL. — The term 'emergency services', with respect to an emergency medical condition, means —

"(I) a medical screening examination (as required under section 1867 of the Social Security Act, or as would be required under such section if such section applied to an independent freestanding emergency department) that is within the capability of the emergency department of a hospital or of an independent freestanding emergency department, as applicable, including ancillary services routinely available to the emergency department to evaluate such emergency medical condition; and

"(II) within the capabilities of the staff and facilities available at the hospital or the independent freestanding emergency department, as applicable, such further medical examination and treatment as are required under section 1867 of such Act, or as would be required under such section if such section applied to an independent freestanding emergency department, to stabilize the patient (regardless of the department of the hospital in which such further examination or treatment is furnished).

"(ii) INCLUSION OF ADDITIONAL SERVICES. —

"(I) IN GENERAL. — For purposes of this subsection and section 2799B–1 of the Public Health Service Act, in the case of a participant or beneficiary who is enrolled in a group health plan and who is furnished services described in clause (i) with respect to an emergency medical condition, the term 'emergency services' shall include, unless each of the conditions described in subclause (II) are met, in addition to the items and services described in clause (i), items and services —

"(aa) for which benefits are provided or covered under the plan; and

"(bb) that are furnished by a nonparticipating provider or nonparticipating emergency facility (regardless of the department of the hospital in which such items or services are furnished) after the participant or beneficiary is stabilized and as part of outpatient observation or an inpatient or outpatient stay with respect to the visit in which the services described in clause (i) are furnished.

"(II) CONDITIONS. — For purposes of subclause (I), the conditions described in this subclause, with respect to a participant or beneficiary who is stabilized and furnished additional items and services described in subclause (I) after such stabilization by a provider or facility described in subclause (I), are the following;

"(aa) Such provider or facility determines such individual is able to travel using nonmedical transportation or nonemergency medical transportation.

"(bb) Such provider furnishing such additional items and services satisfies the notice and consent criteria of section 2799B–2(d) with respect to such items and services.

"(cc) Such individual is in a condition to receive (as determined in accordance with guidelines issued by the Secretary pursuant to rulemaking) the information described in section 2799B–2 and to provide informed consent under such section, in accordance with applicable State law.

"(dd) Such other conditions, as specified by the Secretary, such as conditions relating to coordinating care transitions to participating providers and facilities.

"(D) INDEPENDENT FREESTANDING EMERGENCY DEPARTMENT. — Theterm 'independent freestanding emergency department' means a health care facility that —

"(i) is geographically separate and distinct and licensed separately from a hospital under applicable State law; and

"(ii) provides any of the emergency services (as defined in subparagraph (C)(i)).

"(E) QUALIFYING PAYMENT AMOUNT. —

"(i) IN GENERAL. — The term 'qualifying payment amount' means, subject to clauses (ii) and (iii), with respect to a sponsor of a group health plan —

"(I) for an item or service furnished during 2022, the median of the contracted rates recognized by the plan (determined with respect to all such plans of such sponsor that are offered within the same insurance market (specified in subclause (I), (II), or (III) of clause (iv)) as the plan) as the total maximum payment (including the cost-sharing amount imposed for such item or service and the amount to be paid by the plan) under such plans on January 31, 2019 for the same or a similar item or service that is provided by a provider in the same or similar specialty and provided in the geographic region in which the item or service is furnished, consistent with the methodology established by the Secretary under paragraph (2)(B), increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over 2019, such percentage increase over 2020, and such percentage increase over 2021; and

"(II) for an item or service furnished during 2023 or a subsequent year, the qualifying payment amount determined under this clause for such an item or service furnished in the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year.

"(ii) NEW PLANS AND COVERAGE. — The term 'qualifying payment amount' means, with respect to a sponsor of a group health plan in a geographic region in which such sponsor, respectively, did not offer any group health plan or health insurance coverage during 2019 —

"(I) for the first year in which such group health plan is offered in such region, a rate (determined in accordance with a methodology established by the Secretary) for items and services that are covered by such plan and furnished during such first year; and

"(II) for each subsequent year such group health plan is offered in such region, the qualifying payment amount determined under this clause for such items and services furnished in the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year.

"(iii) INSUFFICIENT INFORMATION; NEWLY COVERED ITEMS AND SERVICES. — In the case of a sponsor of a group health plan that does not have sufficient information to calculate the median of the contracted rates described in clause (i)(I) in 2019 (or, in the case of a newly covered item or service (as defined in clause (v)(III)), in the first coverage year (as defined in clause (v)(I)) for such item or service with respect to such plan) for an item or service (including with respect to provider type, or amount, of claims for items or services (as determined by the Secretary) provided in a particular geographic region (other than in a case with respect to which clause (ii) applies)) the term 'qualifying payment amount' —

"(I) for an item or service furnished during 2022 (or, in the case of a newly covered item or service, during the first coverage year for such item or service with respect to such plan), means such rate for such item or service determined by the sponsor through use of any database that is determined, in accordance with rulemaking described in paragraph (2)(B), to not have any conflicts of interest and to have sufficient information reflecting allowed amounts paid to a health care provider or facility for relevant services furnished in the applicable geographic region (such as a State all-payer claims database);

"(II) for an item or service furnished in a subsequent year (before the first sufficient information year (as defined in clause (v)(II)) for such item or service with respect to such plan), means the rate determined under subclause (I) or this subclause, as applicable, for such item or service for the year previous to such subsequent year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year;

"(III) for an item or service furnished in the first sufficient information year for such item or service with respect to such plan, has the meaning given the term qualifying payment amount in clause (i)(I), except that in applying such clause to such item or service, the reference to 'furnished during 2022' shall be treated as a reference to furnished during such first sufficient information year, the reference to 'on January 31, 2019' shall be treated as a reference to in such sufficient information year, and the increase described in such clause shall not be applied; and

"(IV) for an item or service furnished in any year subsequent to the first sufficient information year for such item or service with respect to such plan, has the meaning given such term in clause (i)(II), except that in applying such clause to such item or service, the reference to 'furnished during 2023 or a subsequent year' shall be treated as a reference to furnished during the year after such first sufficient information year or a subsequent year.

"(iv) INSURANCE MARKET. — For purposes of clause (i)(I), a health insurance market specified in this clause is one of the following:

"(I) The large group market (other than plans described in subclause (III)).

"(II) The small group market (other than plans described in subclause (III)).

"(III) In the case of a self-insured group health plan, other self-insured group health plans.

"(v) DEFINITIONS. — For purposes of this subparagraph:

"(I) FIRST COVERAGE YEAR. — The term 'first coverage year' means, with respect to a group health plan and an item or service for which coverage is not offered in 2019 under such plan or coverage, the first year after 2019 for which coverage for such item or service is offered under such plan.

"(II) FIRST SUFFICIENT INFORMATION YEAR. — The term 'first sufficient information year' means, with respect to a group health plan —

"(aa) in the case of an item or service for which the plan does not have sufficient information to calculate the median of the contracted rates described in clause (i)(I) in 2019, the first year subsequent to 2022 for which such sponsor has such sufficient information to calculate the median of such contracted rates in the year previous to such first subsequent year; and

"(bb) in the case of a newly covered item or service, the first year subsequent to the first coverage year for such item or service with respect to such plan for which the sponsor has sufficient information to calculate the median of the contracted rates described in clause (i)(I) in the year previous to such first subsequent year.

"(III) NEWLY COVERED ITEM OR SERVICE. — The term 'newly covered item or service' means, with respect to a group health plan, an item or service for which coverage was not offered in 2019 under such plan or coverage, but is offered under such plan or coverage in a year after 2019.

"(F) NONPARTICIPATING EMERGENCY FACILITY; PARTICIPATING EMERGENCY FACILITY. —

"(i) NONPARTICIPATING EMERGENCY FACILITY. — The term 'nonparticipating emergency facility' means, with respect to an item or service and a group health plan, an emergency department of a hospital, or an independent freestanding emergency department, that does not have a contractual relationship directly or indirectly with the plan for furnishing such item or service under the plan.

"(ii) PARTICIPATING EMERGENCY FACILITY. — The term 'participating emergency facility' means, with respect to an item or service and a group health plan, an emergency department of a hospital, or an independent freestanding emergency department, that has a contractual relationship directly or indirectly with the plan, with respect to the furnishing of such an item or service at such facility.

"(G) NONPARTICIPATING PROVIDERS; PARTICIPATING PROVIDERS. —

"(i) NONPARTICIPATING PROVIDER. — The term 'non-participating provider' means, with respect to an item or service and a group health plan, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who does not have a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan.

"(ii) PARTICIPATING PROVIDER. — The term 'participating provider' means, with respect to an item or service and a group health plan, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who has a contractual relationship with the plan for furnishing such item or service under the plan.

"(H) RECOGNIZED AMOUNT. — The term 'recognized amount' means, with respect to an item or service furnished by a nonparticipating provider or nonparticipating emergency facility during a year and a group health plan —

"(i) subject to clause (iii), in the case of such item or service furnished in a State that has in effect a specified State law with respect to such plan; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount determined in accordance with such law;

"(ii) subject to clause (iii), in the case of such item or service furnished in a State that does not have in effect a specified State law, with respect to such plan; such a nonparticipating provider or non-participating emergency facility; and such an item or service, the amount that is the qualifying payment amount (as defined in subparagraph (E)) for such year and determined in accordance with rulemaking described in paragraph (2)(B)) for such item or service; or

"(iii) in the case of such item or service furnished in a State with an All-Payer Model Agreement under section 1115A of the Social Security Act, the amount that the State approves under such system for such item or service so furnished.

"(I) SPECIFIED STATE LAW. — The term 'specified State law' means, with respect to a State, an item or service furnished by a nonparticipating provider or nonparticipating emergency facility during a year and a group health plan, a State law that provides for a method for determining the total amount payable under such a plan (to the extent such State law applies to such plan, subject to section 514) in the case of a participant or beneficiary covered under such plan and receiving such item or service from such a nonparticipating provider or nonparticipating emergency facility.

"(J) STABILIZE. — The term 'to stabilize', with respect to an emergency medical condition (as defined in subparagraph (B)), has the meaning give in section 1867(e)(3) of the Social Security Act (42 U.S.C. 1395dd(e)(3)).

"(K) OUT-OF-NETWORK RATE. — The term 'out-of-network rate' means, with respect to an item or service furnished in a State during a year to a participant or beneficiary of a group health plan receiving such item or service from a nonparticipating provider or nonparticipating emergency facility —

"(i) subject to clause (iii), in the case of such item or service furnished in a State that has in effect a specified State law with respect to such plan; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount determined in accordance with such law;

"(ii) subject to clause (iii), in the case such State does not have in effect such a law with respect to such item or service, plan, and provider or facility —

"(I) subject to subclause (II), if the provider or facility (as applicable) and such plan or coverage agree on an amount of payment (including if such agreed on amount is the initial payment sent by the plan under subsection (a)(1)(C)(iv)(I), subsection (b)(1)(C), or section 9817(a)(3)(A), as applicable, or is agreed on through open negotiations under subsection (c)(1)) with respect to such item or service, such agreed on amount; or

"(II) if such provider or facility (as applicable) and such plan or coverage enter the independent dispute resolution process under subsection (c) and do not so agree before the date on which a certified IDR entity (as defined in paragraph (4) of such subsection) makes a determination with respect to such item or service under such subsection, the amount of such determination; or

"(iii) in the case such State has an All-Payer Model Agreement under section 1115A of the Social Security Act, the amount that the State approves under such system for such item or service so furnished.

"(L) COST-SHARING. — The term 'cost-sharing' includes copayments, coinsurance, and deductibles.

"(b) COVERAGE OF NON-EMERGENCY SERVICES PERFORMED BY NONPARTICIPATING PROVIDERS AT CERTAIN PARTICIPATING FACILITIES. —

"(1) IN GENERAL. — In the case of items or services (other than emergency services to which subsection (a) applies) for which any benefits are provided or covered by a group health plan furnished to a participant or beneficiary of such plan by a nonparticipating provider (as defined in subsection (a)(3)(G)(i)) (and who, with respect to such items and services, has not satisfied the notice and consent criteria of section 2799B–2(d) of the Public Health Service Act) with respect to a visit (as defined by the Secretary in accordance with paragraph (2)(B)) at a participating health care facility (as defined in paragraph (2)(A)), with respect to such plan, the plan —

"(A) shall not impose on such participant or beneficiary a cost-sharing requirement for such items and services so furnished that is greater than the cost-sharing requirement that would apply under such plan had such items or services been furnished by a participating provider (as defined in subsection (a)(3)(G)(ii));

"(B) shall calculate such cost-sharing requirement as if the total amount that would have been charged for such items and services by such participating provider were equal to the recognized amount (as defined in subsection (a)(3)(H)) for such items and services, plan, and year;

"(C) not later than 30 calendar days after the bill for such items or services is transmitted by such provider, shall send to the provider an initial payment or notice of denial of payment;

"(D) shall pay a total plan payment directly, in accordance, if applicable, with the timing requirement described in subsection (c)(6), to such provider furnishing such items and services to such participant or beneficiary that is, with application of any initial payment under subparagraph (C), equal to the amount by which the out-of-network rate (as defined in subsection (a)(3)(K)) for such items and services exceeds the cost-sharing amount imposed under the plan for such items and services (as determined in accordance with subparagraphs (A) and (B)) and year; and

"(E) shall count toward any in-network deductible and in-network out-of-pocket maximums (as applicable) applied under the plan, any cost-sharing payments made by the participant or beneficiary (and such in-network deductible and out-of-pocket maximums shall be applied) with respect to such items and services so furnished in the same manner as if such cost-sharing payments were with respect to items and services furnished by a participating provider.

"(2) DEFINITIONS. — In this section:

"(A) PARTICIPATING HEALTH CARE FACILITY. —

"(i) IN GENERAL. — The term 'participating health care facility' means, with respect to an item or service and a group health plan, a health care facility described in clause (ii) that has a direct or indirect contractual relationship with the plan, with respect to the furnishing of such an item or service at the facility.

"(ii) HEALTH CARE FACILITY DESCRIBED. — A health care facility described in this clause, with respect to a group health plan or health insurance coverage offered in the group or individual market, is each of the following:

"(I) A hospital (as defined in 1861(e) of the Social Security Act).

"(II) A hospital outpatient department.

"(III) A critical access hospital (as defined in section 1861(mm)(1) of such Act).

"(IV) An ambulatory surgical center described in section 1833(i)(1)(A) of such Act.

"(V) Any other facility, specified by the Secretary, that provides items or services for which coverage is provided under the plan or coverage, respectively.

"(B) VISIT. — The term 'visit' shall, with respect to items and services furnished to an individual at a health care facility, include equipment and devices, telemedicine services, imaging services, laboratory services, preoperative and postoperative services, and such other items and services as the Secretary may specify, regardless of whether or not the provider furnishing such items or services is at the facility.

"(c) CERTAIN ACCESS FEES TO CERTAIN DATABASES. — In the case of a sponsor of a group health plan that, pursuant to subsection (a)(3)(E)(iii), uses a database described in such subsection to determine a rate to apply under such subsection for an item or service by reason of having insufficient information described in such subsection with respect to such item or service, such sponsor shall cover the cost for access to such database.".

(2) TRANSFER AMENDMENT. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by paragraph (1), is further amended by adding at the end the following:

"SEC. 9822. OTHER PATIENT PROTECTIONS.

"(a) CHOICE OF HEALTH CARE PROFESSIONAL. — If a group health plan requires or provides for designation by a participant or beneficiary of a participating primary care provider, then the plan shall permit each participant and beneficiary to designate any participating primary care provider who is available to accept such individual.

"(b) ACCESS TO PEDIATRIC CARE. —

"(1) PEDIATRIC CARE. — In the case of a person who has a child who is a participant or beneficiary under a group health plan if the plan requires or provides for the designation of a participating primary care provider for the child, the plan shall permit such person to designate a physician (allopathic or osteopathic) who specializes in pediatrics as the child's primary care provider if such provider participates in the network of the plan.

"(2) CONSTRUCTION. — Nothing in paragraph (1) shall be construed to waive any exclusions of coverage under the terms and conditions of the plan with respect to coverage of pediatric care.

"(c) PATIENT ACCESS TO OBSTETRICAL AND GYNECOLOGICAL CARE. —

"(1) GENERAL RIGHTS. —

"(A) DIRECT ACCESS. — A group health plan described in paragraph (2) may not require authorization or referral by the plan, issuer, or any person (including a primary care provider described in paragraph (2)(B)) in the case of a female participant or beneficiary who seeks coverage for obstetrical or gynecological care provided by a participating health care professional who specializes in obstetrics or gynecology. Such professional shall agree to otherwise adhere to such plan's policies and procedures, including procedures regarding referrals and obtaining prior authorization and providing services pursuant to a treatment plan (if any) approved by the plan.

"(B) OBSTETRICAL AND GYNECOLOGICAL CARE. — A group health plan described in paragraph (2) shall treat the provision of obstetrical and gynecological care, and the ordering of related obstetrical and gynecological items and services, pursuant to the direct access described under subparagraph (A), by a participating health care professional who specializes in obstetrics or gynecology as the authorization of the primary care provider.

"(2) APPLICATION OF PARAGRAPH. — A group health plan described in this paragraph is a group health plan that —

"(A) provides coverage for obstetric or gynecologic care; and

"(B) requires the designation by a participant or beneficiary of a participating primary care provider.

"(3) CONSTRUCTION. — Nothing in paragraph (1) shall be construed to —

"(A) waive any exclusions of coverage under the terms and conditions of the plan with respect to coverage of obstetrical or gynecological care; or

"(B) preclude the group health plan involved from requiring that the obstetrical or gynecological provider notify the primary care health care professional or the plan or issuer of treatment decisions.".

(3) 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. 9815. Additional market reforms.

"Sec. 9816. Preventing surprise medical bills.

"Sec. 9822. Other patient protections.".

(4) CONFORMING AMENDMENTS. —

(A) IN GENERAL. — Section 223(c) of the Internal Revenue Code of 1986 is amended —

(i) in paragraph (1), by adding at the end the following:

"(D) SPECIAL RULE FOR INDIVIDUALS RECEIVING BENEFITS SUBJECT TO SURPRISE BILLING STATUTES. — An individual shall not fail to be treated as an eligible individual for any period merely because the individual receives benefits for medical care subject to and in accordance with section 9816 or 9817, section 2799A–1 or 2799A–2 of the Public Health Service Act, or section 716 or 717 of the Employee Retirement Income Security Act of 1974, or any State law providing similar protections to such individual."; and

(ii) in paragraph (2), by adding at the end the following:

"(F) SPECIAL RULE FOR SURPRISE BILLING. — A plan shall not fail to be treated as a high deductible health plan by reason of providing benefits for medical care in accordance with section 9816 or 9817, section 2799A–1 or 2799A–2 of the Public Health Service Act, or section 716 or 717 of the Employee Retirement Income Security Act of 1974, or any State law providing similar protections to individuals, prior to the satisfaction of the deductible under paragraph (2)(A)(i).".

(B) EFFECTIVE DATE. — The amendments made by subparagraph (A) shall apply for plan years beginning on or after January 1, 2022.

(d) ADDITIONAL APPLICATION PROVISIONS. —

(1) APPLICATION TO FEHB. — Section 8902 of title 5, United States Code, is amended by adding at the end the following new subsection:

"(p) Each contract under this chapter shall require the carrier to comply with requirements described in the provisions of sections 2799A–1, 2799A–2, and 2799A–7 of the Public Health Service Act, sections 716, 717, and 722 of the Employee Retirement Income Security Act of 1974, and sections 9816, 9817, and 9822 of the Internal Revenue Code of 1986 (as applicable) in the same manner as such provisions apply to a group health plan or health insurance issuer offering group or individual health insurance coverage, as described in such sections. The provisions of sections 2799B–1, 2799B–2, 2799B–3, and 2799B–5 of the Public Health Service Act shall apply to a health care provider and facility and an air ambulance provider described in such respective sections with respect to an enrollee in a health benefits plan under this chapter in the same manner as such provisions apply to such a provider and facility with respect to an enrollee in a group health plan or group or individual health insurance coverage offered by a health insurance issuer, as described in such sections.".

(2) APPLICATION TO GRANDFATHERED PLANS. — Section 1251(a) of the Patient Protection and Affordable Care Act (42 U.S.C. 18011(a)) is amended by adding at the end the following:

"(5) APPLICATION OF ADDITIONAL PROVISIONS. — Sections 2799A–1, 2799A–2, and 2799A–7 of the Public Health Service Act shall apply to grandfathered health plans for plan years beginning on or after January 1, 2022.".

(3) RULE OF CONSTRUCTION. — Nothing in this title, including the amendments made by this title may be construed as modifying, reducing, or eliminating —

(A) the protections under section 222 of the Indian Health Care Improvement Act (25 U.S.C. 1621u) and under subpart I of part 136 of title 42, Code of Federal Regulations (or any successor regulation), against payment liability for a patient who receives contract health services that are authorized by the Indian Health Service; or

(B) the requirements under section 1866(a)(1)(U) of the Social Security Act (42 U.S.C. 1395cc(a)(1)(U)).

(e) EFFECTIVE DATE. — The amendments made by this section shall apply with respect to plan years (or, in the case of the amendment made by subsection (d)(1), with respect to contracts entered into or renewed for contract years) beginning on or after January 1, 2022.

SEC. 103. DETERMINATION OF OUT-OF-NETWORK RATES TO BE PAID BY HEALTH PLANS; INDEPENDENT DISPUTE RESOLUTION PROCESS.

(a) PHSA. — Section 2799A–1, as added by section 102, is amended —

(1) by redesignating subsection (c) as subsection (d); and

(2) by inserting after subsection (b) the following new subsection:

"(c) DETERMINATION OF OUT-OF-NETWORK RATES TO BE PAID BY HEALTH PLANS; INDEPENDENT DISPUTE RESOLUTION PROCESS. —

"(1) DETERMINATION THROUGH OPEN NEGOTIATION. —

"(A) IN GENERAL. — With respect to an item or service furnished in a year by a nonparticipating provider or a nonparticipating facility, with respect to a group health plan or health insurance issuer offering group or individual health insurance coverage, in a State described in subsection (a)(3)(K)(ii) with respect to such plan or coverage and provider or facility, and for which a payment is required to be made by the plan or coverage pursuant to subsection (a)(1) or (b)(1), the provider or facility (as applicable) or plan or coverage may, during the 30-day period beginning on the day the provider or facility receives an initial payment or a notice of denial of payment from the plan or coverage regarding a claim for payment for such item or service, initiate open negotiations under this paragraph between such provider or facility and plan or coverage for purposes of determining, during the open negotiation period, an amount agreed on by such provider or facility, respectively, and such plan or coverage for payment (including any cost-sharing) for such item or service. For purposes of this subsection, the open negotiation period, with respect to an item or service, is the 30-day period beginning on the date of initiation of the negotiations with respect to such item or service.

"(B) ACCESSING INDEPENDENT DISPUTE RESOLUTION PROCESS IN CASE OF FAILED NEGOTIATIONS. — In the case of open negotiations pursuant to subparagraph (A), with respect to an item or service, that do not result in a determination of an amount of payment for such item or service by the last day of the open negotiation period described in such subparagraph with respect to such item or service, the provider or facility (as applicable) or group health plan or health insurance issuer offering group or individual health insurance coverage that was party to such negotiations may, during the 4-day period beginning on the day after such open negotiation period, initiate the independent dispute resolution process under paragraph (2) with respect to such item or service. The independent dispute resolution process shall be initiated by a party pursuant to the previous sentence by submission to the other party and to the Secretary of a notification (containing such information as specified by the Secretary) and for purposes of this subsection, the date of initiation of such process shall be the date of such submission or such other date specified by the Secretary pursuant to regulations that is not later than the date of receipt of such notification by both the other party and the Secretary.

"(2) INDEPENDENT DISPUTE RESOLUTION PROCESS AVAILABLE IN CASE OF FAILED OPEN NEGOTIATIONS. —

"(A) ESTABLISHMENT. — Not later than 1 year after the date of the enactment of this subsection, the Secretary, jointly with the Secretary of Labor and the Secretary of the Treasury, shall establish by regulation one independent dispute resolution process (referred to in this subsection as the 'IDR process') under which, in the case of an item or service with respect to which a provider or facility (as applicable) or group health plan or health insurance issuer offering group or individual health insurance coverage submits a notification under paragraph (1)(B) (in this subsection referred to as a 'qualified IDR item or service'), a certified IDR entity under paragraph (4) determines, subject to subparagraph (B) and in accordance with the succeeding provisions of this subsection, the amount of payment under the plan or coverage for such item or service furnished by such provider or facility.

"(B) AUTHORITY TO CONTINUE NEGOTIATIONS. — Under the independent dispute resolution process, in the case that the parties to a determination for a qualified IDR item or service agree on a payment amount for such item or service during such process but before the date on which the entity selected with respect to such determination under paragraph (4) makes such determination under paragraph (5), such amount shall be treated for purposes of subsection (a)(3)(K)(ii) as the amount agreed to by such parties for such item or service. In the case of an agreement described in the previous sentence, the independent dispute resolution process shall provide for a method to determine how to allocate between the parties to such determination the payment of the compensation of the entity selected with respect to such determination.

"(C) CLARIFICATION. — A nonparticipating provider may not, with respect to an item or service furnished by such provider, submit a notification under paragraph (1)(B) if such provider is exempt from the requirement under subsection (a) of section 2799B–2 with respect to such item or service pursuant to subsection (b) of such section.

"(3) TREATMENT OF BATCHING OF ITEMS AND SERVICES. —

"(A) IN GENERAL. — Under the IDR process, the Secretary shall specify criteria under which multiple qualified IDR dispute items and services are permitted to be considered jointly as part of a single determination by an entity for purposes of encouraging the efficiency (including minimizing costs) of the IDR process. Such items and services may be so considered only if —

"(i) such items and services to be included in such determination are furnished by the same provider or facility;

"(ii) payment for such items and services is required to be made by the same group health plan or health insurance issuer;

"(iii) such items and services are related to the treatment of a similar condition; and

"(iv) such items and services were furnished during the 30 day period following the date on which the first item or service included with respect to such determination was furnished or an alternative period as determined by the Secretary, for use in limited situations, such as by the consent of the parties or in the case of low-volume items and services, to encourage procedural efficiency and minimize health plan and provider administrative costs.

"(B) TREATMENT OF BUNDLED PAYMENTS. — In carrying out subparagraph (A), the Secretary shall provide that, in the case of items and services which are included by a provider or facility as part of a bundled payment, such items and services included in such bundled payment may be part of a single determination under this subsection.

"(4) CERTIFICATION AND SELECTION OF IDR ENTITIES. —

"(A) IN GENERAL. — The Secretary, in consultation with the Secretary of Labor and Secretary of the Treasury, shall establish a process to certify (including to recertify) entities under this paragraph. Such process shall ensure that an entity so certified —

"(i) has (directly or through contracts or other arrangements) sufficient medical, legal, and other expertise and sufficient staffing to make determinations described in paragraph (5) on a timely basis;

"(ii) is not —

"(I) a group health plan or health insurance issuer offering group or individual health insurance coverage, provider, or facility;

"(II) an affiliate or a subsidiary of such a group health plan or health insurance issuer, provider, or facility; or

"(III) an affiliate or subsidiary of a professional or trade association of such group health plans or health insurance issuers or of providers or facilities;

"(iii) carries out the responsibilities of such an entity in accordance with this subsection;

"(iv) meets appropriate indicators of fiscal integrity;

"(v) maintains the confidentiality (in accordance with regulations promulgated by the Secretary) of individually identifiable health information obtained in the course of conducting such determinations;

"(vi) does not under the IDR process carry out any determination with respect to which the entity would not pursuant to subclause (I), (II), or (III) of subparagraph (F)(i) be eligible for selection; and

"(vii) meets such other requirements as determined appropriate by the Secretary.

"(B) PERIOD OF CERTIFICATION. — Subject to subparagraph (C), each certification (including a recertification) of an entity under the process described in subparagraph (A) shall be for a 5-year period.

"(C) REVOCATION. — A certification of an entity under this paragraph may be revoked under the process described in subparagraph (A) if the entity has a pattern or practice of noncompliance with any of the requirements described in such subparagraph.

"(D) PETITION FOR DENIAL OR WITHDRAWAL. — The process described in subparagraph (A) shall ensure that an individual, provider, facility, or group health plan or health insurance issuer offering group or individual health insurance coverage may petition for a denial of a certification or a revocation of a certification with respect to an entity under this paragraph for failure of meeting a requirement of this subsection.

"(E) SUFFICIENT NUMBER OF ENTITIES. — The process described in subparagraph (A) shall ensure that a sufficient number of entities are certified under this paragraph to ensure the timely and efficient provision of determinations described in paragraph (5).

"(F) SELECTION OF CERTIFIED IDR ENTITY. — The Secretary shall, with respect to the determination of the amount of payment under this subsection of an item or service, provide for a method —

"(i) that allows for the group health plan or health insurance issuer offering group or individual health insurance coverage and the nonparticipating provider or the nonparticipating emergency facility (as applicable) involved in a notification under paragraph (1)(B) to jointly select, not later than the last day of the 3-business day period following the date of the initiation of the process with respect to such item or service, for purposes of making such determination, an entity certified under this paragraph that —

"(I) is not a party to such determination or an employee or agent of such a party;

"(II) does not have a material familial, financial, or professional relationship with such a party; and

"(III) does not otherwise have a conflict of interest with such a party (as determined by the Secretary); and

"(ii) that requires, in the case such parties do not make such selection by such last day, the Secretary to, not later than 6 business days after such date of initiation —

"(I) select such an entity that satisfies subclauses (I) through (III) of clause (i)); and

"(II) provide notification of such selection to the provider or facility (as applicable) and the plan or issuer (as applicable) party to such determination.

An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the 'certified IDR entity' with respect to such determination.

"(5) PAYMENT DETERMINATION. —

"(A) IN GENERAL. — Not later than 30 days after the date of selection of the certified IDR entity with respect to a determination for a qualified IDR item or service, the certified IDR entity shall —

"(i) taking into account the considerations specified in subparagraph (C), select one of the offers submitted under subparagraph (B) to be the amount of payment for such item or service determined under this subsection for purposes of subsection (a)(1) or (b)(1), as applicable; and

"(ii) notify the provider or facility and the group health plan or health insurance issuer offering group or individual health insurance coverage party to such determination of the offer selected under clause (i).

"(B) SUBMISSION OF OFFERS. — Not later than 10 days after the date of selection of the certified IDR entity with respect to a determination for a qualified IDR item or service, the provider or facility and the group health plan or health insurance issuer offering group or individual health insurance coverage party to such determination —

"(i) shall each submit to the certified IDR entity with respect to such determination —

"(I) an offer for a payment amount for such item or service furnished by such provider or facility; and

"(II) such information as requested by the certified IDR entity relating to such offer; and

"(ii) may each submit to the certified IDR entity with respect to such determination any information relating to such offer submitted by either party, including information relating to any circumstance described in subparagraph (C)(ii).

"(C) CONSIDERATIONS IN DETERMINATION. —

"(i) IN GENERAL. — In determining which offer is the payment to be applied pursuant to this paragraph, the certified IDR entity, with respect to the determination for a qualified IDR item or service shall consider —

"(I) the qualifying payment amounts (as defined in subsection (a)(3)(E)) for the applicable year for items or services that are comparable to the qualified IDR item or service and that are furnished in the same geographic region (as defined by the Secretary for purposes of such subsection) as such qualified IDR item or service; and

"(II) subject to subparagraph (D), information on any circumstance described in clause (ii), such information as requested in subparagraph (B)(i)(II), and any additional information provided in subparagraph (B)(ii).

"(ii) ADDITIONAL CIRCUMSTANCES. — For purposes of clause (i)(II), the circumstances described in this clause are, with respect to a qualified IDR item or service of a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer of group or individual health insurance coverage the following:

"(I) The level of training, experience, and quality and outcomes measurements of the provider or facility that furnished such item or service (such as those endorsed by the consensus-based entity authorized in section 1890 of the Social Security Act).

"(II) The market share held by the nonparticipating provider or facility or that of the plan or issuer in the geographic region in which the item or service was provided.

"(III) The acuity of the individual receiving such item or service or the complexity of furnishing such item or service to such individual.

"(IV) The teaching status, case mix, and scope of services of the nonparticipating facility that furnished such item or service.

"(V) Demonstrations of good faith efforts (or lack of good faith efforts) made by the nonparticipating provider or nonparticipating facility or the plan or issuer to enter into network agreements and, if applicable, contracted rates between the provider or facility, as applicable, and the plan or issuer, as applicable, during the previous 4 plan years.

"(D) PROHIBITION ON CONSIDERATION OF CERTAIN FACTORS. — In determining which offer is the payment to be applied with respect to qualified IDR items and services furnished by a provider or facility, the certified IDR entity with respect to a determination shall not consider usual and customary charges, the amount that would have been billed by such provider or facility with respect to such items and services had the provisions of section 2799B–1 or 2799B–2 (as applicable) not applied, or the payment or reimbursement rate for such items and services furnished by such provider or facility payable by a public payor, including under the Medicare program under title XVIII of the Social Security Act, under the Medicaid program under title XIX of such Act, under the Children's Health Insurance Program under title XXI of such Act, under the TRICARE program under chapter 55 of title 10, United States Code, or under chapter 17 of title 38, United States Code.

"(E) EFFECTS OF DETERMINATION. —

"(i) IN GENERAL. — A determination of a certified IDR entity under subparagraph (A) —

"(I) shall be binding upon the parties involved, in the absence of a fraudulent claim or evidence of misrepresentation of facts presented to the IDR entity involved regarding such claim; and

"(II) shall not be subject to judicial review, except in a case described in any of paragraphs (1) through (4) of section 10(a) of title 9, United States Code.

"(ii) SUSPENSION OF CERTAIN SUBSEQUENT IDR REQUESTS. — In the case of a determination of a certified IDR entity under subparagraph (A), with respect to an initial notification submitted under paragraph (1)(B) with respect to qualified IDR items and services and the two parties involved with such notification, the party that submitted such notification may not submit during the 90-day period following such determination a subsequent notification under such paragraph involving the same other party to such notification with respect to such an item or service that was the subject of such initial notification.

"(iii) SUBSEQUENT SUBMISSION OF REQUESTS PERMITTED. — In the case of a notification that pursuant to clause (ii) is not permitted to be submitted under paragraph (1)(B) during a 90-day period specified in such clause, if the end of the open negotiation period specified in paragraph (1)(A), that but for this clause would otherwise apply with respect to such notification, occurs during such 90-day period, such paragraph (1)(B) shall be applied as if the reference in such paragraph to the 4-day period beginning on the day after such open negotiation period were instead a reference to the 30-day period beginning on the day after the last day of such 90-day period.

"(iv) REPORTS. — The Secretary, jointly with the Secretary of Labor and the Secretary of the Treasury, shall examine the impact of the application of clause (ii) and whether the application of such clause delays payment determinations or impacts early, alternative resolution of claims (such as through open negotiations), and shall submit to Congress, not later than 2 years after the date of implementation of such clause an interim report (and not later than 4 years after such date of implementation, a final report) on whether any group health plans or health insurance issuers offering group or individual health insurance coverage or types of such plans or coverage have a pattern or practice of routine denial, low payment, or down-coding of claims, or otherwise abuse the 90-day period described in such clause, including recommendations on ways to discourage such a pattern or practice.

"(F) COSTS OF INDEPENDENT DISPUTE RESOLUTION PROCESS. — In the case of a notification under paragraph (1)(B) submitted by a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer offering group or individual health insurance coverage and submitted to a certified IDR entity —

"(i) if such entity makes a determination with respect to such notification under subparagraph (A), the party whose offer is not chosen under such subparagraph shall be responsible for paying all fees charged by such entity; and

"(ii) if the parties reach a settlement with respect to such notification prior to such a determination, each party shall pay half of all fees charged by such entity, unless the parties otherwise agree.

"(6) TIMING OF PAYMENT. — The total plan or coverage payment required pursuant to subsection (a)(1) or (b)(1), with respect to a qualified IDR item or service for which a determination is made under paragraph (5)(A) or with respect to an item or service for which a payment amount is determined under open negotiations under paragraph (1), shall be made directly to the nonparticipating provider or facility not later than 30 days after the date on which such determination is made.

"(7) PUBLICATION OF INFORMATION RELATING TO THE IDR PROCESS. —

"(A) PUBLICATION OF INFORMATION. — For each calendar quarter in 2022 and each calendar quarter in a subsequent year, the Secretary shall make available on the public website of the Department of Health and Human Services —

"(i) the number of notifications submitted under paragraph (1)(B) during such calendar quarter;

"(ii) the size of the provider practices and the size of the facilities submitting notifications under paragraph (1)(B) during such calendar quarter;

"(iii) the number of such notifications with respect to which a determination was made under paragraph (5)(A);

"(iv) the information described in subparagraph (B) with respect to each notification with respect to which such a determination was so made;

"(v) the number of times the payment amount determined (or agreed to) under this subsection exceeds the qualifying payment amount, specified by items and services;

"(vi) the amount of expenditures made by the Secretary during such calendar quarter to carry out the IDR process;

"(vii) the total amount of fees paid under paragraph (8) during such calendar quarter; and

"(viii) the total amount of compensation paid to certified IDR entities under paragraph (5)(F) during such calendar quarter.

"(B) INFORMATION. — For purposes of subparagraph (A), the information described in this subparagraph is, with respect to a notification under paragraph (1)(B) by a non-participating provider, nonparticipating emergency facility, group health plan, or health insurance issuer offering group or individual health insurance coverage —

"(i) a description of each item and service included with respect to such notification;

"(ii) the geography in which the items and services with respect to such notification were provided;

"(iii) the amount of the offer submitted under paragraph (5)(B) by the group health plan or health insurance issuer (as applicable) and by the nonparticipating provider or nonparticipating emergency facility (as applicable) expressed as a percentage of the qualifying payment amount;

"(iv) whether the offer selected by the certified IDR entity under paragraph (5) to be the payment applied was the offer submitted by such plan or issuer (as applicable) or by such provider or facility (as applicable) and the amount of such offer so selected expressed as a percentage of the qualifying payment amount;

"(v) the category and practice specialty of each such provider or facility involved in furnishing such items and services;

"(vi) the identity of the health plan or health insurance issuer, provider, or facility, with respect to the notification;

"(vii) the length of time in making each determination;

"(viii) the compensation paid to the certified IDR entity with respect to the settlement or determination; and

"(ix) any other information specified by the Secretary.

"(C) IDR ENTITY REQUIREMENTS. — For 2022 and each subsequent year, an IDR entity, as a condition of certification as an IDR entity, shall submit to the Secretary such information as the Secretary determines necessary to carry out the provisions of this subsection.

"(D) CLARIFICATION. — The Secretary shall ensure the public reporting under this paragraph does not contain information that would disclose privileged or confidential information of a group health plan or health insurance issuer offering group or individual health insurance coverage or of a provider or facility.

"(8) ADMINISTRATIVE FEE. —

"(A) IN GENERAL. — Each party to a determination under paragraph (5) to which an entity is selected under paragraph (3) in a year shall pay to the Secretary, at such time and in such manner as specified by the Secretary, a fee for participating in the IDR process with respect to such determination in an amount described in subparagraph (B) for such year.

"(B) AMOUNT OF FEE. — The amount described in this subparagraph for a year is an amount established by the Secretary in a manner such that the total amount of fees paid under this paragraph for such year is estimated to be equal to the amount of expenditures estimated to be made by the Secretary for such year in carrying out the IDR process.

"(9) WAIVER AUTHORITY. — The Secretary may modify any deadline or other timing requirement specified under this subsection (other than the establishment date for the IDR process under paragraph (2)(A) and other than under paragraph (6)) in cases of extenuating circumstances, as specified by the Secretary, or to ensure that all claims that occur during a 90-day period described in paragraph (5)(E)(ii), but with respect to which a notification is not permitted by reason of such paragraph to be submitted under paragraph (1)(B) during such period, are eligible for the IDR process.".

(b) ERISA. — Section 716 of the Employee Retirement Income Security Act of 1974, as added by section 102, is amended —

(1) by redesignating subsection (c) as subsection (d); and

(2) by inserting after subsection (b) the following new subsection:

"(c) DETERMINATION OF OUT-OF-NETWORK RATES TO BE PAID BY HEALTH PLANS; INDEPENDENT DISPUTE RESOLUTION PROCESS. —

"(1) DETERMINATION THROUGH OPEN NEGOTIATION. —

"(A) IN GENERAL. — With respect to an item or service furnished in a year by a nonparticipating provider or a nonparticipating facility, with respect to a group health plan or health insurance issuer offering group health insurance coverage, in a State described in subsection (a)(3)(K)(ii) with respect to such plan or coverage and provider or facility, and for which a payment is required to be made by the plan or coverage pursuant to subsection (a)(1) or (b)(1), the provider or facility (as applicable) or plan or coverage may, during the 30-day period beginning on the day the provider or facility receives an initial payment or a notice of denial of payment from the plan or coverage regarding a claim for payment for such item or service, initiate open negotiations under this paragraph between such provider or facility and plan or coverage for purposes of determining, during the open negotiation period, an amount agreed on by such provider or facility, respectively, and such plan or coverage for payment (including any cost-sharing) for such item or service. For purposes of this subsection, the open negotiation period, with respect to an item or service, is the 30-day period beginning on the date of initiation of the negotiations with respect to such item or service.

"(B) ACCESSING INDEPENDENT DISPUTE RESOLUTION PROCESS IN CASE OF FAILED NEGOTIATIONS. — In the case of open negotiations pursuant to subparagraph (A), with respect to an item or service, that do not result in a determination of an amount of payment for such item or service by the last day of the open negotiation period described in such subparagraph with respect to such item or service, the provider or facility (as applicable) or group health plan or health insurance issuer offering group health insurance coverage that was party to such negotiations may, during the 4-day period beginning on the day after such open negotiation period, initiate the independent dispute resolution process under paragraph (2) with respect to such item or service. The independent dispute resolution process shall be initiated by a party pursuant to the previous sentence by submission to the other party and to the Secretary of a notification (containing such information as specified by the Secretary) and for purposes of this subsection, the date of initiation of such process shall be the date of such submission or such other date specified by the Secretary pursuant to regulations that is not later than the date of receipt of such notification by both the other party and the Secretary.

"(2) INDEPENDENT DISPUTE RESOLUTION PROCESS AVAILABLE IN CASE OF FAILED OPEN NEGOTIATIONS. —

"(A) ESTABLISHMENT. — Not later than 1 year after the date of the enactment of this subsection, the Secretary, jointly with the Secretary of Health and Human Services and the Secretary of the Treasury, shall establish by regulation one independent dispute resolution process (referred to in this subsection as the 'IDR process') under which, in the case of an item or service with respect to which a provider or facility (as applicable) or group health plan or health insurance issuer offering group health insurance coverage submits a notification under paragraph (1)(B) (in this subsection referred to as a 'qualified IDR item or service'), a certified IDR entity under paragraph (4) determines, subject to subparagraph (B) and in accordance with the succeeding provisions of this subsection, the amount of payment under the plan or coverage for such item or service furnished by such provider or facility.

"(B) AUTHORITY TO CONTINUE NEGOTIATIONS. — Under the independent dispute resolution process, in the case that the parties to a determination for a qualified IDR item or service agree on a payment amount for such item or service during such process but before the date on which the entity selected with respect to such determination under paragraph (4) makes such determination under paragraph (5), such amount shall be treated for purposes of subsection (a)(3)(K)(ii) as the amount agreed to by such parties for such item or service. In the case of an agreement described in the previous sentence, the independent dispute resolution process shall provide for a method to determine how to allocate between the parties to such determination the payment of the compensation of the entity selected with respect to such determination.

"(C) CLARIFICATION. — A nonparticipating provider may not, with respect to an item or service furnished by such provider, submit a notification under paragraph (1)(B) if such provider is exempt from the requirement under subsection (a) of section 2799B–2 of the Public Health Service Act with respect to such item or service pursuant to subsection (b) of such section.

"(3) TREATMENT OF BATCHING OF ITEMS AND SERVICES. —

"(A) IN GENERAL. — Under the IDR process, the Secretary shall specify criteria under which multiple qualified IDR dispute items and services are permitted to be considered jointly as part of a single determination by an entity for purposes of encouraging the efficiency (including minimizing costs) of the IDR process. Such items and services may be so considered only if —

"(i) such items and services to be included in such determination are furnished by the same provider or facility;

"(ii) payment for such items and services is required to be made by the same group health plan or health insurance issuer;

"(iii) such items and services are related to the treatment of a similar condition; and

"(iv) such items and services were furnished during the 30 day period following the date on which the first item or service included with respect to such determination was furnished or an alternative period as determined by the Secretary, for use in limited situations, such as by the consent of the parties or in the case of low-volume items and services, to encourage procedural efficiency and minimize health plan and provider administrative costs.

"(B) TREATMENT OF BUNDLED PAYMENTS. — In carrying out subparagraph (A), the Secretary shall provide that, in the case of items and services which are included by a provider or facility as part of a bundled payment, such items and services included in such bundled payment may be part of a single determination under this subsection.

"(4) CERTIFICATION AND SELECTION OF IDR ENTITIES. —

"(A) IN GENERAL. — The Secretary, jointly with the Secretary of Health and Human Services and Secretary of the Treasury, shall establish a process to certify (including to recertify) entities under this paragraph. Such process shall ensure that an entity so certified —

"(i) has (directly or through contracts or other arrangements) sufficient medical, legal, and other expertise and sufficient staffing to make determinations described in paragraph (5) on a timely basis;

"(ii) is not —

"(I) a group health plan or health insurance issuer offering group health insurance coverage, provider, or facility;

"(II) an affiliate or a subsidiary of such a group health plan or health insurance issuer, provider, or facility; or

"(III) an affiliate or subsidiary of a professional or trade association of such group health plans or health insurance issuers or of providers or facilities;

"(iii) carries out the responsibilities of such an entity in accordance with this subsection;

"(iv) meets appropriate indicators of fiscal integrity;

"(v) maintains the confidentiality (in accordance with regulations promulgated by the Secretary) of individually identifiable health information obtained in the course of conducting such determinations;

"(vi) does not under the IDR process carry out any determination with respect to which the entity would not pursuant to subclause (I), (II), or (III) of subparagraph (F)(i) be eligible for selection; and

"(vii) meets such other requirements as determined appropriate by the Secretary.

"(B) PERIOD OF CERTIFICATION. — Subject to subparagraph (C), each certification (including a recertification) of an entity under the process described in subparagraph (A) shall be for a 5-year period.

"(C) REVOCATION. — A certification of an entity under this paragraph may be revoked under the process described in subparagraph (A) if the entity has a pattern or practice of noncompliance with any of the requirements described in such subparagraph.

"(D) PETITION FOR DENIAL OR WITHDRAWAL. — The process described in subparagraph (A) shall ensure that an individual, provider, facility, or group health plan or health insurance issuer offering group health insurance coverage may petition for a denial of a certification or a revocation of a certification with respect to an entity under this paragraph for failure of meeting a requirement of this subsection.

"(E) SUFFICIENT NUMBER OF ENTITIES. — The process described in subparagraph (A) shall ensure that a sufficient number of entities are certified under this paragraph to ensure the timely and efficient provision of determinations described in paragraph (5).

"(F) SELECTION OF CERTIFIED IDR ENTITY. — The Secretary shall, with respect to the determination of the amount of payment under this subsection of an item or service, provide for a method —

"(i) that allows for the group health plan or health insurance issuer offering group health insurance coverage and the nonparticipating provider or the nonparticipating emergency facility (as applicable) involved in a notification under paragraph (1)(B) to jointly select, not later than the last day of the 3-business day period following the date of the initiation of the process with respect to such item or service, for purposes of making such determination, an entity certified under this paragraph that —

"(I) is not a party to such determination or an employee or agent of such a party;

"(II) does not have a material familial, financial, or professional relationship with such a party; and

"(III) does not otherwise have a conflict of interest with such a party (as determined by the Secretary); and

"(ii) that requires, in the case such parties do not make such selection by such last day, the Secretary to, not later than 6 business days after such date of initiation —

"(I) select such an entity that satisfies subclauses (I) through (III) of clause (i)); and

"(II) provide notification of such selection to the provider or facility (as applicable) and the plan or issuer (as applicable) party to such determination.

An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the 'certified IDR entity' with respect to such determination.

"(5) PAYMENT DETERMINATION. —

"(A) IN GENERAL. — Not later than 30 days after the date of selection of the certified IDR entity with respect to a determination for a qualified IDR item or service, the certified IDR entity shall —

"(i) taking into account the considerations specified in subparagraph (C), select one of the offers submitted under subparagraph (B) to be the amount of payment for such item or service determined under this subsection for purposes of subsection (a)(1) or (b)(1), as applicable; and

"(ii) notify the provider or facility and the group health plan or health insurance issuer offering group health insurance coverage party to such determination of the offer selected under clause (i).

"(B) SUBMISSION OF OFFERS. — Not later than 10 days after the date of selection of the certified IDR entity with respect to a determination for a qualified IDR item or service, the provider or facility and the group health plan or health insurance issuer offering group health insurance coverage party to such determination —

"(i) shall each submit to the certified IDR entity with respect to such determination —

"(I) an offer for a payment amount for such item or service furnished by such provider or facility; and

"(II) such information as requested by the certified IDR entity relating to such offer; and

"(ii) may each submit to the certified IDR entity with respect to such determination any information relating to such offer submitted by either party, including information relating to any circumstance described in subparagraph (C)(ii).

"(C) CONSIDERATIONS IN DETERMINATION. —

"(i) IN GENERAL. — In determining which offer is the payment to be applied pursuant to this paragraph, the certified IDR entity, with respect to the determination for a qualified IDR item or service shall consider —

"(I) the qualifying payment amounts (as defined in subsection (a)(3)(E)) for the applicable year for items or services that are comparable to the qualified IDR item or service and that are furnished in the same geographic region (as defined by the Secretary for purposes of such subsection) as such qualified IDR item or service; and

"(II) subject to subparagraph (D), information on any circumstance described in clause (ii), such information as requested in subparagraph (B)(i)(II), and any additional information provided in subparagraph (B)(ii).

"(ii) ADDITIONAL CIRCUMSTANCES. — For purposes of clause (i)(II), the circumstances described in this clause are, with respect to a qualified IDR item or service of a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer of group health insurance coverage the following:

"(I) The level of training, experience, and quality and outcomes measurements of the provider or facility that furnished such item or service (such as those endorsed by the consensus-based entity authorized in section 1890 of the Social Security Act).

"(II) The market share held by the nonparticipating provider or facility or that of the plan or issuer in the geographic region in which the item or service was provided.

"(III) The acuity of the individual receiving such item or service or the complexity of furnishing such item or service to such individual.

"(IV) The teaching status, case mix, and scope of services of the nonparticipating facility that furnished such item or service.

"(V) Demonstrations of good faith efforts (or lack of good faith efforts) made by the nonparticipating provider or nonparticipating facility or the plan or issuer to enter into network agreements and, if applicable, contracted rates between the provider or facility, as applicable, and the plan or issuer, as applicable, during the previous 4 plan years.

"(D) PROHIBITION ON CONSIDERATION OF CERTAIN FACTORS. — In determining which offer is the payment to be applied with respect to qualified IDR items and services furnished by a provider or facility, the certified IDR entity with respect to a determination shall not consider usual and customary charges, the amount that would have been billed by such provider or facility with respect to such items and services had the provisions of section 2799B– 1 of the Public Health Service Act or 2799B–2 of such Act(asapplicable)notapplied,orthepaymentor reimbursement rate for such items and services furnished by such provider or facility payable by a public payor, including under the Medicare program under title XVIII of the Social Security Act, under the Medicaid program under title XIX of such Act, under the Children's Health Insurance Program under title XXI of such Act, under the TRICARE program under chapter 55 of title 10, United States Code, or under chapter 17 of title 38, United States Code.

"(E) EFFECTS OF DETERMINATION. —

"(i) IN GENERAL. — A determination of a certified IDR entity under subparagraph (A) —

"(I) shall be binding upon the parties involved, in the absence of a fraudulent claim or evidence of misrepresentation of facts presented to the IDR entity involved regarding such claim; and

"(II) shall not be subject to judicial review, except in a case described in any of paragraphs (1) through (4) of section 10(a) of title 9, United States Code.

"(ii) SUSPENSION OF CERTAIN SUBSEQUENT IDR REQUESTS. — In the case of a determination of a certified IDR entity under subparagraph (A), with respect to an initial notification submitted under paragraph (1)(B) with respect to qualified IDR items and services and the two parties involved with such notification, the party that submitted such notification may not submit during the 90-day period following such determination asubsequentnotificationundersuchparagraph involving the same other party to such notification with respect to such an item or service that was the subject of such initial notification.

"(iii) SUBSEQUENT SUBMISSION OF REQUESTS PERMITTED. — In the case of a notification that pursuant to clause (ii) is not permitted to be submitted under paragraph (1)(B) during a 90-day period specified in such clause, if the end of the open negotiation period specified in paragraph (1)(A), that but for this clause would otherwise apply with respect to such notification, occurs during such 90-day period, such paragraph (1)(B) shall be applied as if the reference in such paragraph to the 4-day period beginning on the day after such open negotiation period were instead a reference to the 30-day period beginning on the day after the last day of such 90-day period.

"(iv) REPORTS. — The Secretary, jointly with the Secretary of Health and Human Services and the Secretary of the Treasury, shall examine the impact of the application of clause (ii) and whether the application of such clause delays payment determinations or impacts early, alternative resolution of claims (such as through open negotiations), and shall submit to Congress, not later than 2 years after the date of implementation of such clause an interim report (and not later than 4 years after such date of implementation, a final report) on whether any group health plans or health insurance issuers offering group or individual health insurance coverage or types of such plans or coverage have a pattern or practice of routine denial, low payment, or down-coding of claims, or otherwise abuse the 90-day period described in such clause, including recommendations on ways to discourage such a pattern or practice.

"(F) COSTS OF INDEPENDENT DISPUTE RESOLUTION PROCESS. — In the case of a notification under paragraph (1)(B) submitted by a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer offering group health insurance coverage and submitted to a certified IDR entity —

"(i) if such entity makes a determination with respect to such notification under subparagraph (A), the party whose offer is not chosen under such subparagraph shall be responsible for paying all fees charged by such entity; and

"(ii) if the parties reach a settlement with respect to such notification prior to such a determination, each party shall pay half of all fees charged by such entity, unless the parties otherwise agree.

"(6) TIMING OF PAYMENT. — The total plan or coverage payment required pursuant to subsection (a)(1) or (b)(1), with respect to a qualified IDR item or service for which a determination is made under paragraph (5)(A) or with respect to an item or service for which a payment amount is determined under open negotiations under paragraph (1), shall be made directly to the nonparticipating provider or facility not later than 30 days after the date on which such determination is made.

"(7) PUBLICATION OF INFORMATION RELATING TO THE IDR PROCESS. —

"(A) PUBLICATION OF INFORMATION. — For each calendar quarter in 2022 and each calendar quarter in a subsequent year, the Secretary shall make available on the public website of the Department of Labor —

"(i) the number of notifications submitted under paragraph (1)(B) during such calendar quarter;

"(ii) the size of the provider practices and the size of the facilities submitting notifications under paragraph (1)(B) during such calendar quarter;

"(iii) the number of such notifications with respect to which a determination was made under paragraph (5)(A);

"(iv) the information described in subparagraph (B) with respect to each notification with respect to which such a determination was so made;

"(v) the number of times the payment amount determined (or agreed to) under this subsection exceeds the qualifying payment amount, specified by items and services;

"(vi) the amount of expenditures made by the Secretary during such calendar quarter to carry out the IDR process;

"(vii) the total amount of fees paid under paragraph (8) during such calendar quarter; and

"(viii) the total amount of compensation paid to certified IDR entities under paragraph (5)(F) during such calendar quarter.

"(B) INFORMATION. — For purposes of subparagraph (A), the information described in this subparagraph is, with respect to a notification under paragraph (1)(B) by a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer offering group health insurance coverage —

"(i) a description of each item and service included with respect to such notification;

"(ii) the geography in which the items and services with respect to such notification were provided;

"(iii) the amount of the offer submitted under paragraph (5)(B) by the group health plan or health insurance issuer (as applicable) and by the nonparticipating provider or nonparticipating emergency facility (as applicable) expressed as a percentage of the qualifying payment amount;

"(iv) whether the offer selected by the certified IDR entity under paragraph (5) to be the payment applied was the offer submitted by such plan or issuer (as applicable) or by such provider or facility (as applicable) and the amount of such offer so selected expressed as a percentage of the qualifying payment amount;

"(v) the category and practice specialty of each such provider or facility involved in furnishing such items and services;

"(vi) the identity of the health plan or health insurance issuer, provider, or facility, with respect to the notification;

"(vii) the length of time in making each determination;

"(viii) the compensation paid to the certified IDR entity with respect to the settlement or determination; and

"(ix) any other information specified by the Secretary.

"(C) IDR ENTITY REQUIREMENTS. — For 2022 and each subsequent year, an IDR entity, as a condition of certification as an IDR entity, shall submit to the Secretary such information as the Secretary determines necessary to carry out the provisions of this subsection.

"(D) CLARIFICATION. — The Secretary shall ensure the public reporting under this paragraph does not contain information that would disclose privileged or confidential information of a group health plan or health insurance issuer offering group or individual health insurance coverage or of a provider or facility.

"(8) ADMINISTRATIVE FEE. —

"(A) IN GENERAL. — Each party to a determination under paragraph (5) to which an entity is selected under paragraph (3) in a year shall pay to the Secretary, at such time and in such manner as specified by the Secretary, a fee for participating in the IDR process with respect to such determination in an amount described in subparagraph (B) for such year.

"(B) AMOUNT OF FEE. — The amount described in this subparagraph for a year is an amount established by the Secretary in a manner such that the total amount of fees paid under this paragraph for such year is estimated to be equal to the amount of expenditures estimated to be made by the Secretary for such year in carrying out the IDR process.

"(9) WAIVER AUTHORITY. — The Secretary may modify any deadline or other timing requirement specified under this subsection (other than the establishment date for the IDR process under paragraph (2)(A) and other than under paragraph (6)) in cases of extenuating circumstances, as specified by the Secretary, or to ensure that all claims that occur during a 90-day period described in paragraph (5)(E)(ii), but with respect to which a notification is not permitted by reason of such paragraph to be submitted under paragraph (1)(B) during such period, are eligible for the IDR process.".

(c) IRC. — Section 9816 of the Internal Revenue Code of 1986, as added by section 102, is amended —

(1) by redesignating subsection (c) as subsection (d); and

(2) by inserting after subsection (b) the following new subsection:

"(c) DETERMINATION OF OUT-OF-NETWORK RATES TO BE PAID BY HEALTH PLANS; INDEPENDENT DISPUTE RESOLUTION PROCESS. —

"(1) DETERMINATION THROUGH OPEN NEGOTIATION. —

"(A) IN GENERAL. — With respect to an item or service furnished in a year by a nonparticipating provider or a nonparticipating facility, with respect to a group health plan, in a State described in subsection (a)(3)(K)(ii) with respect to such plan and provider or facility, and for which a payment is required to be made by the plan pursuant to subsection (a)(1) or (b)(1), the provider or facility (as applicable) or plan may, during the 30-day period beginning on the day the provider or facility receives an initial payment or a notice of denial of payment from the plan regarding a claim for payment for such item or service, initiate open negotiations under this paragraph between such provider or facility and plan for purposes of determining, during the open negotiation period, an amount agreed on by such provider or facility, respectively, and such plan for payment (including any cost-sharing) for such item or service. For purposes of this subsection, the open negotiation period, with respect to an item or service, is the 30-day period beginning on the date of initiation of the negotiations with respect to such item or service.

"(B) ACCESSING INDEPENDENT DISPUTE RESOLUTION PROCESS IN CASE OF FAILED NEGOTIATIONS. — In the case of open negotiations pursuant to subparagraph (A), with respect to an item or service, that do not result in a determination of an amount of payment for such item or service by the last day of the open negotiation period described in such subparagraph with respect to such item or service, the provider or facility (as applicable) or group health plan that was party to such negotiations may, during the 4-day period beginning on the day after such open negotiation period, initiate the independent dispute resolution process under paragraph (2) with respect to such item or service. The independent dispute resolution process shall be initiated by a party pursuant to the previous sentence by submission to the other party and to the Secretary of a notification (containing such information as specified by the Secretary) and for purposes of this subsection, the date of initiation of such process shall be the date of such submission or such other date specified by the Secretary pursuant to regulations that is not later than the date of receipt of such notification by both the other party and the Secretary.

"(2) INDEPENDENT DISPUTE RESOLUTION PROCESS AVAILABLE IN CASE OF FAILED OPEN NEGOTIATIONS. —

"(A) ESTABLISHMENT. — Not later than 1 year after the date of the enactment of this subsection, the Secretary, jointly with the Secretary of Health and Human Services and the Secretary of Labor, shall establish by regulation one independent dispute resolution process (referred to in this subsection as the 'IDR process') under which, in the case of an item or service with respect to which a provider or facility (as applicable) or group health plan submits a notification under paragraph (1)(B) (in this subsection referred to as a 'qualified IDR item or service'), a certified IDR entity under paragraph (4) determines, subject to subparagraph (B) and in accordance with the succeeding provisions of this subsection, the amount of payment under the plan for such item or service furnished by such provider or facility.

"(B) AUTHORITY TO CONTINUE NEGOTIATIONS. — Under the independent dispute resolution process, in the case that the parties to a determination for a qualified IDR item or service agree on a payment amount for such item or service during such process but before the date on which the entity selected with respect to such determination under paragraph (4) makes such determination under paragraph (5), such amount shall be treated for purposes of subsection (a)(3)(K)(ii) as the amount agreed to by such parties for such item or service. In the case of an agreement described in the previous sentence, the independent dispute resolution process shall provide for a method to determine how to allocate between the parties to such determination the payment of the compensation of the entity selected with respect to such determination.

"(C) CLARIFICATION. — A nonparticipating provider may not, with respect to an item or service furnished by such provider, submit a notification under paragraph (1)(B) if such provider is exempt from the requirement under subsection (a) of section 2799B–2 of the Public Health Service Act with respect to such item or service pursuant to subsection (b) of such section.

"(3) TREATMENT OF BATCHING OF ITEMS AND SERVICES. —

"(A) IN GENERAL. — Under the IDR process, the Secretary shall specify criteria under which multiple qualified IDR dispute items and services are permitted to be considered jointly as part of a single determination by an entity for purposes of encouraging the efficiency (including minimizing costs) of the IDR process. Such items and services may be so considered only if —

"(i) such items and services to be included in such determination are furnished by the same provider or facility;

"(ii) payment for such items and services is required to be made by the same group health plan or health insurance issuer;

"(iii) such items and services are related to the treatment of a similar condition; and

"(iv) such items and services were furnished during the 30 day period following the date on which the first item or service included with respect to such determination was furnished or an alternative period as determined by the Secretary, for use in limited situations, such as by the consent of the parties or in the case of low-volume items and services, to encourage procedural efficiency and minimize health plan and provider administrative costs.

"(B) TREATMENT OF BUNDLED PAYMENTS. — In carrying out subparagraph (A), the Secretary shall provide that, in the case of items and services which are included by a provider or facility as part of a bundled payment, such items and services included in such bundled payment may be part of a single determination under this subsection.

"(4) CERTIFICATION AND SELECTION OF IDR ENTITIES. —

"(A) IN GENERAL. — The Secretary, jointly with the Secretary of Health and Human Services and the Secretary of Labor, shall establish a process to certify (including to recertify) entities under this paragraph. Such process shall ensure that an entity so certified —

"(i) has (directly or through contracts or other arrangements) sufficient medical, legal, and other expertise and sufficient staffing to make determinations described in paragraph (5) on a timely basis;

"(ii) is not —

"(I) a group health plan, provider, or facility;

"(II) an affiliate or a subsidiary of such a group health plan, provider, or facility; or

"(III) an affiliate or subsidiary of a professional or trade association of such group health plans or of providers or facilities;

"(iii) carries out the responsibilities of such an entity in accordance with this subsection;

"(iv) meets appropriate indicators of fiscal integrity;

"(v) maintains the confidentiality (in accordance with regulations promulgated by the Secretary) of individually identifiable health information obtained in the course of conducting such determinations;

"(vi) does not under the IDR process carry out any determination with respect to which the entity would not pursuant to subclause (I), (II), or (III) of subparagraph (F)(i) be eligible for selection; and

"(vii) meets such other requirements as determined appropriate by the Secretary.

"(B) PERIOD OF CERTIFICATION. — Subject to subparagraph (C), each certification (including a recertification) of an entity under the process described in subparagraph (A) shall be for a 5-year period.

"(C) REVOCATION. — A certification of an entity under this paragraph may be revoked under the process described in subparagraph (A) if the entity has a pattern or practice of noncompliance with any of the requirements described in such subparagraph.

"(D) PETITION FOR DENIAL OR WITHDRAWAL. — The process described in subparagraph (A) shall ensure that an individual, provider, facility, or group health plan may petition for a denial of a certification or a revocation of a certification with respect to an entity under this paragraph for failure of meeting a requirement of this subsection.

"(E) SUFFICIENT NUMBER OF ENTITIES. — The process described in subparagraph (A) shall ensure that a sufficient number of entities are certified under this paragraph to ensure the timely and efficient provision of determinations described in paragraph (5).

"(F) SELECTION OF CERTIFIED IDR ENTITY. — The Secretary shall, with respect to the determination of the amount of payment under this subsection of an item or service, provide for a method —

"(i) that allows for the group health plan and the nonparticipating provider or the nonparticipating emergency facility (as applicable) involved in a notification under paragraph (1)(B) to jointly select, not later than the last day of the 3-business day period following the date of the initiation of the process with respect to such item or service, for purposes of making such determination, an entity certified under this paragraph that —

"(I) is not a party to such determination or an employee or agent of such a party;

"(II) does not have a material familial, financial, or professional relationship with such a party; and

"(III) does not otherwise have a conflict of interest with such a party (as determined by the Secretary); and

"(ii) that requires, in the case such parties do not make such selection by such last day, the Secretary to, not later than 6 business days after such date of initiation —

"(I) select such an entity that satisfies subclauses (I) through (III) of clause (i)); and

"(II) provide notification of such selection to the provider or facility (as applicable) and the plan or issuer (as applicable) party to such determination.

An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the 'certified IDR entity' with respect to such determination.

"(5) PAYMENT DETERMINATION. —

"(A) IN GENERAL. — Not later than 30 days after the date of selection of the certified IDR entity with respect to a determination for a qualified IDR item or service, the certified IDR entity shall —

"(i) taking into account the considerations specified in subparagraph (C), select one of the offers submitted under subparagraph (B) to be the amount of payment for such item or service determined under this subsection for purposes of subsection (a)(1) or (b)(1), as applicable; and

"(ii) notify the provider or facility and the group health plan party to such determination of the offer selected under clause (i).

"(B) SUBMISSION OF OFFERS. — Not later than 10 days after the date of selection of the certifed IDR entity with respect to a determination for a qualified IDR item or service, the provider or facility and the group health plan party to such determination —

"(i) shall each submit to the certified IDR entity with respect to such determination —

"(I) an offer for a payment amount for such item or service furnished by such provider or facility; and

"(II) such information as requested by the certified IDR entity relating to such offer; and

"(ii) may each submit to the certified IDR entity with respect to such determination any information relating to such offer submitted by either party, including information relating to any circumstance described in subparagraph (C)(ii).

"(C) CONSIDERATIONS IN DETERMINATION. —

"(i) IN GENERAL. — In determining which offer is the payment to be applied pursuant to this paragraph, the certified IDR entity, with respect to the determination for a qualified IDR item or service shall consider —

"(I) the qualifying payment amounts (as defined in subsection (a)(3)(E)) for the applicable year for items or services that are comparable to the qualified IDR item or service and that are furnished in the same geographic region (as defined by the Secretary for purposes of such subsection) as such qualified IDR item or service; and

"(II) subject to subparagraph (D), information on any circumstance described in clause (ii), such information as requested in subparagraph (B)(i)(II), and any additional information provided in subparagraph (B)(ii).

"(ii) ADDITIONAL CIRCUMSTANCES. — For purposes of clause (i)(II), the circumstances described in this clause are, with respect to a qualified IDR item or service of a nonparticipating provider, nonparticipating emergency facility, or group health plan, the following:

"(I) The level of training, experience, and quality and outcomes measurements of the provider or facility that furnished such item or service (such as those endorsed by the consensus-based entity authorized in section 1890 of the Social Security Act).

"(II) The market share held by the nonparticipating provider or facility or that of the plan or issuer in the geographic region in which the item or service was provided.

"(III) The acuity of the individual receiving such item or service or the complexity of furnishing such item or service to such individual.

"(IV) The teaching status, case mix, and scope of services of the nonparticipating facility that furnished such item or service.

"(V) Demonstrations of good faith efforts (or lack of good faith efforts) made by the nonparticipating provider or nonparticipating facility or the plan or issuer to enter into network agreements and, if applicable, contracted rates between the provider or facility, as applicable, and the plan or issuer, as applicable, during the previous 4 plan years.

"(D) PROHIBITION ON CONSIDERATION OF CERTAIN FACTORS. — In determining which offer is the payment to be applied with respect to qualified IDR items and services furnished by a provider or facility, the certified IDR entity with respect to a determination shall not consider usual and customary charges, the amount that would have been billed by such provider or facility with respect to such items and services had the provisions of section 2799B–1 of the Public Health Service Act or 2799B–2 of such Act (as applicable) not applied, or the payment or reimbursement rate for such items and services furnished by such provider or facility payable by a public payor, including under the Medicare program under title XVIII of the Social Security Act, under the Medicaid program under title XIX of such Act, under the Children's Health Insurance Program under title XXI of such Act, under the TRICARE program under chapter 55 of title 10, United States Code, or under chapter 17 of title 38, United States Code.

"(E) EFFECTS OF DETERMINATION. —

"(i) IN GENERAL. — A determination of a certified IDR entity under subparagraph (A) —

"(I) shall be binding upon the parties involved, in the absence of a fraudulent claim or evidence of misrepresentation of facts presented to the IDR entity involved regarding such claim; and

"(II) shall not be subject to judicial review, except in a case described in any of paragraphs (1) through (4) of section 10(a) of title 9, United States Code.

"(ii) SUSPENSION OF CERTAIN SUBSEQUENT IDR REQUESTS. — In the case of a determination of a certified IDR entity under subparagraph (A), with respect to an initial notification submitted under paragraph (1)(B) with respect to qualified IDR items and services and the two parties involved with such notification, the party that submitted such notification may not submit during the 90-day period following such determination a subsequent notification under such paragraph involving the same other party to such notification with respect to such an item or service that was the subject of such initial notification.

"(iii) SUBSEQUENT SUBMISSION OF REQUESTS PERMITTED. — In the case of a notification that pursuant to clause (ii) is not permitted to be submitted under paragraph (1)(B) during a 90-day period specified in such clause, if the end of the open negotiation period specified in paragraph (1)(A), that but for this clause would otherwise apply with respect to such notification, occurs during such 90-day period, such paragraph (1)(B) shall be applied as if the reference in such paragraph to the 4-day period beginning on the day after such open negotiation period were instead a reference to the 30-day period beginning on the day after the last day of such 90-day period.

"(iv) REPORTS. — The Secretary, jointly with the Secretary of Labor and the Secretary of the Health and Human Services, shall examine the impact of the application of clause (ii) and whether the application of such clause delays payment determinations or impacts early, alternative resolution of claims (such as through open negotiations), and shall submit to Congress, not later than 2 years after the date of implementation of such clause an interim report (and not later than 4 years after such date of implementation, a final report) on whether any group health plans or health insurance issuers offering group or individual health insurance coverage or types of such plans or coverage have a pattern or practice of routine denial, low payment, or down-coding of claims, or otherwise abuse the 90-day period described in such clause, including recommendations on ways to discourage such a pattern or practice.

"(F) COSTS OF INDEPENDENT DISPUTE RESOLUTION PROCESS. — In the case of a notification under paragraph (1)(B) submitted by a nonparticipating provider, nonparticipating emergency facility, or group health plan and submitted to a certified IDR entity —

"(i) if such entity makes a determination with respect to such notification under subparagraph (A), the party whose offer is not chosen under such subparagraph shall be responsible for paying all fees charged by such entity; and

"(ii) if the parties reach a settlement with respect to such notification prior to such a determination, each party shall pay half of all fees charged by such entity, unless the parties otherwise agree.

"(6) TIMING OF PAYMENT. — The total plan payment required pursuant to subsection (a)(1) or (b)(1), with respect to a qualified IDR item or service for which a determination is made under paragraph (5)(A) or with respect to an item or service for which a payment amount is determined under open negotiations under paragraph (1), shall be made directly to the nonparticipating provider or facility not later than 30 days after the date on which such determination is made.

"(7) PUBLICATION OF INFORMATION RELATING TO THE IDR PROCESS. —

"(A) PUBLICATION OF INFORMATION. — For each calendar quarter in 2022 and each calendar quarter in a subsequent year, the Secretary shall make available on the public website of the Department of the Treasury —

"(i) the number of notifications submitted under paragraph (1)(B) during such calendar quarter;

"(ii) the size of the provider practices and the size of the facilities submitting notifications under paragraph (1)(B) during such calendar quarter;

"(iii) the number of such notifications with respect to which a determination was made under paragraph (5)(A);

"(iv) the information described in subparagraph (B) with respect to each notification with respect to which such a determination was so made;

"(v) the number of times the payment amount determined (or agreed to) under this subsection exceeds the qualifying payment amount, specified by items and services;

"(vi) the amount of expenditures made by the Secretary during such calendar quarter to carry out the IDR process;

"(vii) the total amount of fees paid under paragraph (8) during such calendar quarter; and

"(viii) the total amount of compensation paid to certified IDR entities under paragraph (5)(F) during such calendar quarter.

"(B) INFORMATION. — For purposes of subparagraph (A), the information described in this subparagraph is, with respect to a notification under paragraph (1)(B) by a nonparticipating provider, nonparticipating emergency facility, or group health plan —

"(i) a description of each item and service included with respect to such notification;

"(ii) the geography in which the items and services with respect to such notification were provided;

"(iii) the amount of the offer submitted under paragraph (5)(B) by the group health plan and by the nonparticipating provider or nonparticipating emergency facility (as applicable) expressed as a percentage of the qualifying payment amount;

"(iv) whether the offer selected by the certified IDR entity under paragraph (5) to be the payment applied was the offer submitted by such plan or by such provider or facility (as applicable) and the amount of such offer so selected expressed as a percentage of the qualifying payment amount;

"(v) the category and practice specialty of each such provider or facility involved in furnishing such items and services;

"(vi) the identity of the group health plan, provider, or facility, with respect to the notification;

"(vii) the length of time in making each determination;

"(viii) the compensation paid to the certified IDR entity with respect to the settlement or determination; and

"(ix) any other information specified by the Secretary.

"(C) IDR ENTITY REQUIREMENTS. — For 2022 and each subsequent year, an IDR entity, as a condition of certification as an IDR entity, shall submit to the Secretary such information as the Secretary determines necessary to carry out the provisions of this subsection.

"(D) CLARIFICATION. — The Secretary shall ensure the public reporting under this paragraph does not contain information that would disclose privileged or confidential information of a group health plan or health insurance issuer offering group or individual health insurance coverage or of a provider or facility.

"(8) ADMINISTRATIVE FEE. —

"(A) IN GENERAL. — Each party to a determination under paragraph (5) to which an entity is selected under paragraph (3) in a year shall pay to the Secretary, at such time and in such manner as specified by the Secretary, a fee for participating in the IDR process with respect to such determination in an amount described in subparagraph (B) for such year.

"(B) AMOUNT OF FEE. — The amount described in this subparagraph for a year is an amount established by the Secretary in a manner such that the total amount of fees paid under this paragraph for such year is estimated to be equal to the amount of expenditures estimated to be made by the Secretary for such year in carrying out the IDR process.

"(9) WAIVER AUTHORITY. — The Secretary may modify any deadline or other timing requirement specified under this subsection (other than the establishment date for the IDR process under paragraph (2)(A) and other than under paragraph (6)) in cases of extenuating circumstances, as specified by the Secretary, or to ensure that all claims that occur during a 90-day period described in paragraph (5)(E)(ii), but with respect to which a notification is not permitted by reason of such paragraph to be submitted under paragraph (1)(B) during such period, are eligible for the IDR process.".

SEC. 104. HEALTH CARE PROVIDER REQUIREMENTS REGARDING SURPRISE MEDICAL BILLING.

(a) IN GENERAL. — Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended by inserting after part D, as added by section 102, the following:

"PART E — HEALTH CARE PROVIDER REQUIREMENTS

"SEC. 2799B–1. BALANCE BILLING IN CASES OF EMERGENCY SERVICES.

"(a) IN GENERAL. — In the case of a participant, beneficiary, or enrollee with benefits under a group health plan or group or individual health insurance coverage offered by a health insurance issuer and who is furnished during a plan year beginning on or after January 1, 2022, emergency services (for which benefits are provided under the plan or coverage) with respect to an emergency medical condition with respect to a visit at an emergency department of a hospital or an independent freestanding emergency department —

"(1) in the case that the hospital or independent freestanding emergency department is a nonparticipating emergency facility, the emergency department of a hospital or independent freestanding emergency department shall not bill, and shall not hold liable, the participant, beneficiary, or enrollee for a payment amount for such emergency services so furnished that is more than the cost-sharing requirement for such services (as determined in accordance with clauses (ii) and (iii) of section 2799A–1(a)(1)(C), of section 9816(a)(1)(C) of the Internal Revenue Code of 1986, and of section 716(a)(1)(C) of the Employee Retirement Income Security Act of 1974, as applicable); and

"(2) in the case that such services are furnished by a nonparticipating provider, the health care provider shall not bill, and shall not hold liable, such participant, beneficiary, or enrollee for a payment amount for an emergency service furnished to such individual by such provider with respect to such emergency medical condition and visit for which the individual receives emergency services at the hospital or emergency department that is more than the cost-sharing requirement for such services furnished by the provider (as determined in accordance with clauses (ii) and (iii) of section 2799A– 1(a)(1)(C), of section 9816(a)(1)(C) of the Internal Revenue Code of 1986, and of section 716(a)(1)(C) of the Employee Retirement Income Security Act of 1974, as applicable).

"(b) DEFINITION. — In this section, the term 'visit' shall have such meaning as applied to such term for purposes of section 2799A–1(b).

"SEC. 2799B–2. BALANCE BILLING IN CASES OF NON-EMERGENCY SERVICES PERFORMED BY NONPARTICIPATING PROVIDERS AT CERTAIN PARTICIPATING FACILITIES.

"(a) IN GENERAL. — Subject to subsection (b), in the case of a participant, beneficiary, or enrollee with benefits under a group health plan or group or individual health insurance coverage offered by a health insurance issuer and who is furnished during a plan year beginning on or after January 1, 2022, items or services (other than emergency services to which section 2799B–1 applies) for which benefits are provided under the plan or coverage at a participating health care facility by a nonparticipating provider, such provider shall not bill, and shall not hold liable, such participant, beneficiary, or enrollee for a payment amount for such an item or service furnished by such provider with respect to a visit at such facility that is more than the cost-sharing requirement for such item or service (as determined in accordance with subparagraphs (A) and (B) of section 2799A–1(b)(1) of section 9816(b)(1) of the Internal Revenue Code of 1986, and of section 716(b)(1) of the Employee Retirement Income Security Act of 1974, as applicable).

"(b) EXCEPTION. —

"(1) IN GENERAL. — Subsection (a) shall not apply with respect to items or services (other than ancillary services described in paragraph (2)) furnished by a nonparticipating provider to a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer, if the provider satisfies the notice and consent criteria of subsection (d).

"(2) ANCILLARY SERVICES DESCRIBED. — For purposes of paragraph (1), ancillary services described in this paragraph are, with respect to a participating health care facility —

"(A) subject to paragraph (3), items and services related to emergency medicine, anesthesiology, pathology, radiology, and neonatology, whether or not provided by a physician or non-physician practitioner, and items and services provided by assistant surgeons, hospitalists, and intensivists;

"(B) subject to paragraph (3), diagnostic services (including radiology and laboratory services);

"(C) items and services provided by such other specialty practitioners, as the Secretary specifies through rulemaking; and

"(D) items and services provided by a nonparticipating provider if there is no participating provider who can furnish such item or service at such facility.

"(3) EXCEPTION. — The Secretary may, through rulemaking, establish a list (and update such list periodically) of advanced diagnostic laboratory tests, which shall not be included as an ancillary service described in paragraph (2) and with respect to which subsection (a) would apply.

"(c) CLARIFICATION. — In the case of a nonparticipating provider that satisfies the notice and consent criteria of subsection (d) with respect to an item or service (referred to in this subsection as a 'covered item or service'), such notice and consent criteria may not be construed as applying with respect to any item or service that is furnished as a result of unforeseen, urgent medical needs that arise at the time such covered item or service is furnished. For purposes of the previous sentence, a covered item or service shall not include an ancillary service described in subsection (b)(2).

"(d) NOTICE AND CONSENT TO BE TREATED BY A NONPARTICIPATING PROVIDER OR NONPARTICIPATING FACILITY. —

"(1) IN GENERAL. — A nonparticipating provider or nonparticipating facility satisfies the notice and consent criteria of this subsection, with respect to items or services furnished by the provider or facility to a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer, if the provider (or, if applicable, the participating health care facility on behalf of such provider) or nonparticipating facility —

"(A) in the case that the participant, beneficiary, or enrollee makes an appointment to be furnished such items or services at least 72 hours prior to the date on which the individual is to be furnished such items or services, provides to the participant, beneficiary, or enrollee (or to an authorized representative of the participant, beneficiary, or enrollee) not later than 72 hours prior to the date on which the individual is furnished such items or services (or, in the case that the participant, beneficiary, or enrollee makes such an appointment within 72 hours of when such items or services are to be furnished, provides to the participant, beneficiary, or enrollee (or to an authorized representative of the participant, beneficiary, or enrollee) on such date the appointment is made), a written notice in paper or electronic form, as selected by the participant, beneficiary, or enrollee, (and including electronic notification, as practicable) specified by the Secretary, not later than July 1, 2021, through guidance (which shall be updated as determined necessary by the Secretary) that —

"(i) contains the information required under paragraph (2);

"(ii) clearly states that consent to receive such items and services from such nonparticipating provider or nonparticipating facility is optional and that the participant, beneficiary, or enrollee may instead seek care from a participating provider or at a participating facility, with respect to such plan or coverage, as applicable, in which case the cost-sharing responsibility of the participant, beneficiary, or enrollee would not exceed such responsibility that would apply with respect to such an item or service that is furnished by a participating provider or participating facility, as applicable with respect to such plan; and

"(iii) is available in the 15 most common languages in the geographic region of the applicable facility;

"(B) obtains from the participant, beneficiary, or enrollee (or from such an authorized representative) the consent described in paragraph (3) to be treated by a nonparticipating provider or nonparticipating facility; and

"(C) provides a signed copy of such consent to the participant, beneficiary, or enrollee through mail or email (as selected by the participant, beneficiary, or enrollee).

"(2) INFORMATION REQUIRED UNDER WRITTEN NOTICE. — For purposes of paragraph (1)(A)(i), the information described in this paragraph, with respect to a nonparticipating provider or nonparticipating facility and a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer, is each of the following:

"(A) Notification, as applicable, that the health care provider is a nonparticipating provider with respect to the health plan or the health care facility is a nonparticipating facility with respect to the health plan.

"(B) Notification of the good faith estimated amount that such provider or facility may charge the participant, beneficiary, or enrollee for such items and services involved, including a notification that the provision of such estimate or consent to be treated under paragraph (3) does not constitute a contract with respect to the charges estimated for such items and services.

"(C) In the case of a participating facility and a nonparticipating provider, a list of any participating providers at the facility who are able to furnish such items and services involved and notification that the participant, beneficiary, or enrollee may be referred, at their option, to such a participating provider.

"(D) Information about whether prior authorization or other care management limitations may be required in advance of receiving such items or services at the facility.

"(3) CONSENT DESCRIBED TO BE TREATED BY A NONPARTICIPATING PROVIDER OR NONPARTICIPATING FACILITY. — For purposes of paragraph (1)(B), the consent described in this paragraph, with respect to a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer who is to be furnished items or services by a nonparticipating provider or nonparticipating facility, is a document specified by the Secretary, in consultation with the Secretary of Labor, through guidance that shall be signed by the participant, beneficiary, or enrollee before such items or services are furnished and that —

"(A) acknowledges (in clear and understandable language) that the participant, beneficiary, or enrollee has been —

"(i) provided with the written notice under paragraph (1)(A);

"(ii) informed that the payment of such charge by the participant, beneficiary, or enrollee may not accrue toward meeting any limitation that the plan or coverage places on cost-sharing, including an explanation that such payment may not apply to an in-network deductible applied under the plan or coverage; and

"(iii) provided the opportunity to receive the written notice under paragraph (1)(A) in the form selected by the participant, beneficiary or enrollee; and

"(B) documents the date on which the participant, beneficiary, or enrollee received the written notice under paragraph (1)(A) and the date on which the individual signed such consent to be furnished such items or services by such provider or facility.

"(4) RULE OF CONSTRUCTION. — The consent described in paragraph (3), with respect to a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer, shall constitute only consent to the receipt of the information provided pursuant to this subsection and shall not constitute a contractual agreement of the participant, beneficiary, or enrollee to any estimated charge or amount included in such information.

"(e) RETENTION OF CERTAIN DOCUMENTS. — A nonparticipating facility (with respect to such facility or any nonparticipating provider at such facility) or a participating facility (with respect to nonparticipating providers at such facility) that obtains from a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer (or an authorized representative of such participant, beneficiary, or enrollee) a written notice in accordance with subsection (d)(1)(B), with respect to furnishing an item or service to such participant, beneficiary, or enrollee, shall retain such notice for at least a 7-year period after the date on which such item or service is so furnished.

"(f) DEFINITIONS. — In this section:

"(1) The terms 'nonparticipating provider' and 'participating provider' have the meanings given such terms, respectively, in subsection (a)(3) of section 2799A–1.

"(2) The term 'participating health care facility' has the meaning given such term in subsection (b)(2) of section 2799A– 1.

"(3) The term 'nonparticipating facility' means —

"(A) with respect to emergency services (as defined in section 2799A–1(a)(3)(C)(i)) and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, an emergency department of a hospital, or an independent freestanding emergency department, that does not have a contractual relationship with the plan or issuer, respectively, with respect to the furnishing of such services under the plan or coverage, respectively; and

"(B) with respect to services described in section 2799A–1(a)(3)(C)(ii) and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, a hospital or an independent freestanding emergency department, that does not have a contractual relationship with the plan or issuer, respectively, with respect to the furnishing of such services under the plan or coverage, respectively.

"(4) The term 'participating facility' means —

"(A) with respect to emergency services (as defined in clause (i) of section 2799A–1(a)(3)(C)) that are not described in clause(ii) of such section and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, an emergency department of a hospital, or an independent freestanding emergency department, that has a direct or indirect contractual relationship with the plan or issuer, respectively, with respect to the furnishing of such services under the plan or coverage, respectively; and

"(B) with respect to services that pursuant to clause (ii) of section 2799A–1(a)(3)(C), of section 9816(a)(3) of the Internal Revenue Code of 1986, and of section 716(a)(3) of the Employee Retirement Income Security Act of 1974, as applicable are included as emergency services (as defined in clause (i) of such section and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, a hospital or an independent freestanding emergency department, that has a contractual relationship with the plan or coverage, respectively, with respect to the furnishing of such services under the plan or coverage, respectively.

"SEC. 2799B–3. PROVIDER REQUIREMENTS WITH RESPECT TO DISCLOSURE ON PATIENT PROTECTIONS AGAINST BALANCE BILLING.

"Beginning not later than January 1, 2022, each health care provider and health care facility shall make publicly available, and (if applicable) post on a public website of such provider or facility and provide to individuals who are participants, beneficiaries, or enrollees of a group health plan or group or individual health insurance coverage offered by a health insurance issuer a one-page notice (either postal or electronic mail, as specified by the participant, beneficiary, or enrollee) in clear and understandable language containing information on —

"(1) the requirements and prohibitions of such provider or facility under sections 2799B–1 and 2799B–2 (relating to prohibitions on balance billing in certain circumstances);

"(2) any other applicable State law requirements on such provider or facility regarding the amounts such provider or facility may, with respect to an item or service, charge a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer with respect to which such provider or facility does not have a contractual relationship for furnishing such item or service under the plan or coverage, respectively, after receiving payment from the plan or coverage, respectively, for such item or service and any applicable cost-sharing payment from such participant, beneficiary, or enrollee; and

"(3) information on contacting appropriate State and Federal agencies in the case that an individual believes that such provider or facility has violated any requirement described in paragraph (1) or (2) with respect to such individual.

"SEC. 2799B–4. ENFORCEMENT.

"(a) STATE ENFORCEMENT. —

"(1) STATE AUTHORITY. — Each State may require a provider or health care facility (including a provider of air ambulance services) subject to the requirements of this part to satisfy such requirements applicable to the provider or facility.

"(2) FAILURE TO IMPLEMENT REQUIREMENTS. — In the case of a determination by the Secretary that a State has failed to substantially enforce the requirements to which paragraph (1) applies with respect to applicable providers and facilities in the State, the Secretary shall enforce such requirements under subsection (b) insofar as they relate to violations of such requirements occurring in such State.

"(3) NOTIFICATION OF APPLICABLE SECRETARY. — A State may notify the Secretary of Labor, Secretary of Health and Human Services, or the Secretary of the Treasury, as applicable, of instances of violations of sections 2799B–1, 2799B–2, or 2799B– 5 with respect to participants, beneficiaries, or enrollees under a group health plan or group or individual health insurance coverage, as applicable offered by a health insurance issuer and any enforcement actions taken against providers or facilities as a result of such violations, including the disposition of any such enforcement actions.

"(b) SECRETARIAL ENFORCEMENT AUTHORITY. —

"(1) IN GENERAL. — If a provider or facility is found by the Secretary to be in violation of a requirement to which subsection (a)(1) applies, the Secretary may apply a civil monetary penalty with respect to such provider or facility (including, as applicable, a provider of air ambulance services) in an amount not to exceed $10,000 per violation. The provisions of subsections (c) (with the exception of the first sentence of paragraph (1) of such subsection), (d), (e), (g), (h), (k), and (l) of section 1128A of the Social Security Act shall apply to a civil monetary penalty or assessment under this subsection in the same manner as such provisions apply to a penalty, assessment, or proceeding under subsection (a) of such section.

"(2) LIMITATION. — The provisions of paragraph (1) shall apply to enforcement of a provision (or provisions) specified in subsection (a)(1) only as provided under subsection (a)(2).

"(3) COMPLAINT PROCESS. — The Secretary shall, through rulemaking, establish a process to receive consumer complaints of violations of such provisions and provide a response to such complaints within 60 days of receipt of such complaints.

"(4) EXCEPTION. — The Secretary shall waive the penalties described under paragraph (1) with respect to a facility or provider (including a provider of air ambulance services) who does not knowingly violate, and should not have reasonably known it violated, section 2799B–1 or 2799B–2 (or, in the case of a provider of air ambulance services, section 2799B– 5) with respect to a participant, beneficiary, or enrollee, if such facility or provider, within 30 days of the violation, withdraws the bill that was in violation of such provision and reimburses the health plan or enrollee, as applicable, in an amount equal to the difference between the amount billed and the amount allowed to be billed under the provision, plus interest, at an interest rate determined by the Secretary.

"(5) HARDSHIP EXEMPTION. — The Secretary may establish a hardship exemption to the penalties under this subsection.

"(c) CONTINUED APPLICABILITY OF STATE LAW. — The sections specified in subsection (a)(1) shall not be construed to supersede any provision of State law which establishes, implements, or continues in effect any requirement or prohibition except to the extent that such requirement or prohibition prevents the application of a requirement or prohibition of such a section.".

(b) SECRETARY OF LABOR ENFORCEMENT. —

(1) IN GENERAL. — Part 5 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1131 et seq.) is amended by adding at the end the following new section:

"SEC. 522. COORDINATION OF ENFORCEMENT REGARDING VIOLATIONS OF CERTAIN HEALTH CARE PROVIDER REQUIREMENTS; COMPLAINT PROCESS.

"(a) INVESTIGATING VIOLATIONS. — Upon receiving a notice from a State or the Secretary of Health and Human Services of violations of sections 2799B–1, 2799B–2, or 2799B–5 of the Public Health Service Act, the Secretary of Labor shall identify patterns of such violations with respect to participants or beneficiaries under a group health plan or group health insurance coverage offered by a health insurance issuer and conduct an investigation pursuant to section 504 where appropriate, as determined by the Secretary. The Secretary shall coordinate with States and the Secretary of Health and Human Services, in accordance with section 506 and with section 104 of Health Insurance Portability and Accountability Act of 1996, where appropriate, as determined by the Secretary, to ensure that appropriate measures have been taken to correct such violations retrospectively and prospectively with respect to participants or beneficiaries under a group health plan or group health insurance coverage offered by a health insurance issuer.

"(b) COMPLAINT PROCESS. — Not later than January 1, 2022, the Secretary shall ensure a process under which the Secretary —

"(1) may receive complaints from participants and beneficiaries of group health plans or group health insurance coverage offered by a health insurance issuer relating to alleged violations of the sections specified in subsection (a); and

"(2) transmits such complaints to States or the Secretary of Health and Human Services (as determined appropriate by the Secretary) for potential enforcement actions.".

(2) TECHNICAL 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 521 the following new item:

"Sec. 522. Coordination of enforcement regarding violations of certain health care provider requirements; complaint process.".

SEC. 105. ENDING SURPRISE AIR AMBULANCE BILLS.

(a) GROUP HEALTH PLANS AND INDIVIDUAL AND GROUP HEALTH INSURANCE COVERAGE. —

(1) PHSA AMENDMENTS. — Part D of title XXVII of the Public Health Service Act, as added and amended by section 102 and further amended by the previous provisions of this title, is further amended by inserting after section 2799A–1 the following:

"SEC. 2799A–2. ENDING SURPRISE AIR AMBULANCE BILLS.

"(a) IN GENERAL. — In the case of a participant, beneficiary, or enrollee who is in a group health plan or group or individual health insurance coverage offered by a health insurance issuer and who receives air ambulance services from a nonparticipating provider (as defined in section 2799A–1(a)(3)(G)) with respect to such plan or coverage, if such services would be covered if provided by a participating provider (as defined in such section) with respect to such plan or coverage —

"(1) the cost-sharing requirement with respect to such services shall be the same requirement that would apply if such services were provided by such a participating provider, and any coinsurance or deductible shall be based on rates that would apply for such services if they were furnished by such a participating provider;

"(2) such cost-sharing amounts shall be counted towards the in-network deductible and in-network out-of-pocket maximum amount under the plan or coverage for the plan year (and such in-network deductible shall be applied) with respect to such items and services so furnished in the same manner as if such cost-sharing payments were with respect to items and services furnished by a participating provider; and

"(3) the group health plan or health insurance issuer, respectively, shall —

"(A) not later than 30 calendar days after the bill for such services is transmitted by such provider, send to the provider, an initial payment or notice of denial of payment; and

"(B) pay a total plan or coverage payment, in accordance with, if applicable, subsection (b)(6), directly to such provider furnishing such services to such participant, beneficiary, or enrollee that is, with application of any initial payment under subparagraph (A), equal to the amount by which the out-of-network rate (as defined in section 2799A–1(a)(3)(K)) for such services and year involved exceeds the cost-sharing amount imposed under the plan or coverage, respectively, for such services (as determined in accordance with paragraphs (1) and (2)).

"(b) DETERMINATION OF OUT-OF-NETWORK RATES TO BE PAID BY HEALTH PLANS; INDEPENDENT DISPUTE RESOLUTION PROCESS. —

"(1) DETERMINATION THROUGH OPEN NEGOTIATION. —

"(A) IN GENERAL. — With respect to air ambulance services furnished in a year by a nonparticipating provider, with respect to a group health plan or health insurance issuer offering group or individual health insurance coverage, and for which a payment is required to be made by the plan or coverage pursuant to subsection (a)(3), the provider or plan or coverage may, during the 30-day period beginning on the day the provider receives an initial payment or a notice of denial of payment from the plan or coverage regarding a claim for payment for such service, initiate open negotiations under this paragraph between such provider and plan or coverage for purposes of determining, during the open negotiation period, an amount agreed on by such provider, and such plan or coverage for payment (including any cost-sharing) for such service. For purposes of this subsection, the open negotiation period, with respect to air ambulance services, is the 30-day period beginning on the date of initiation of the negotiations with respect to such services.

"(B) ACCESSING INDEPENDENT DISPUTE RESOLUTION PROCESS IN CASE OF FAILED NEGOTIATIONS. — In the case of open negotiations pursuant to subparagraph (A), with respect to air ambulance services, that do not result in a determination of an amount of payment for such services by the last day of the open negotiation period described in such subparagraph with respect to such services, the provider or group health plan or health insurance issuer offering group or individual health insurance coverage that was party to such negotiations may, during the 4-day period beginning on the day after such open negotiation period, initiate the independent dispute resolution process under paragraph (2) with respect to such item or service. The independent dispute resolution process shall be initiated by a party pursuant to the previous sentence by submission to the other party and to the Secretary of a notification (containing such information as specified by the Secretary) and for purposes of this subsection, the date of initiation of such process shall be the date of such submission or such other date specified by the Secretary pursuant to regulations that is not later than the date of receipt of such notification by both the other party and the Secretary.

"(2) INDEPENDENT DISPUTE RESOLUTION PROCESS AVAILABLE IN CASE OF FAILED OPEN NEGOTIATIONS. —

"(A) ESTABLISHMENT. — Not later than 1 year after the date of the enactment of this subsection, the Secretary, jointly with the Secretary of Labor and the Secretary of the Treasury, shall establish by regulation one independent dispute resolution process (referred to in this subsection as the 'IDR process') under which, in the case of air ambulance services with respect to which a provider or group health plan or health insurance issuer offering group or individual health insurance coverage submits a notification under paragraph (1)(B) (in this subsection referred to as a 'qualified IDR air ambulance services'), a certified IDR entity under paragraph (4) determines, subject to subparagraph (B) and in accordance with the succeeding provisions of this subsection, the amount of payment under the plan or coverage for such services furnished by such provider.

"(B) AUTHORITY TO CONTINUE NEGOTIATIONS. — Under the independent dispute resolution process, in the case that the parties to a determination for qualified IDR air ambulance services agree on a payment amount for such services during such process but before the date on which the entity selected with respect to such determination under paragraph (4) makes such determination under paragraph (5), such amount shall be treated for purposes of section 2799A–1(a)(3)(K)(ii) as the amount agreed to by such parties for such services. In the case of an agreement described in the previous sentence, the independent dispute resolution process shall provide for a method to determine how to allocate between the parties to such determination the payment of the compensation of the entity selected with respect to such determination.

"(C) CLARIFICATION. — A nonparticipating provider may not, with respect to an item or service furnished by such provider, submit a notification under paragraph (1)(B) if such provider is exempt from the requirement under subsection (a) of section 2799B–2 with respect to such item or service pursuant to subsection (b) of such section.

"(3) TREATMENT OF BATCHING OF SERVICES. — The provisions of section 2799A–1(c)(3) shall apply with respect to a notification submitted under this subsection with respect to air ambulance services in the same manner and to the same extent such provisions apply with respect to a notification submitted under section 2799A–1(c) with respect to items and services described in such section.

"(4) IDR ENTITIES. —

"(A) ELIGIBILITY. — An IDR entity certified under this subsection is an IDR entity certified under section 2799A–1(c)(4).

"(B) SELECTION OF CERTIFIED IDR ENTITY. — The provisions of subparagraph (F) of section 2799A–1(c)(4) shall apply with respect to selecting an IDR entity certified pursuant to subparagraph (A) with respect to the determination of the amount of payment under this subsection of air ambulance services in the same manner as such provisions apply with respect to selecting an IDR entity certified under such section with respect to the determination of the amount of payment under section 2799A–1(c) of an item or service. An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the 'certified IDR entity' with respect to such determination.

"(5) PAYMENT DETERMINATION. —

"(A) IN GENERAL. — Not later than 30 days after the date of selection of the certified IDR entity with respect to a determination for qualified IDR ambulance services, the certified IDR entity shall —

"(i) taking into account the considerations specified in subparagraph (C), select one of the offers submitted under subparagraph (B) to be the amount of payment for such services determined under this subsection for purposes of subsection (a)(3); and

"(ii) notify the provider or facility and the group health plan or health insurance issuer offering group or individual health insurance coverage party to such determination of the offer selected under clause (i).

"(B) SUBMISSION OF OFFERS. — Not later than 10 days after the date of selection of the certified IDR entity with respect to a determination for qualified IDR air ambulance services, the provider and the group health plan or health insurance issuer offering group or individual health insurance coverage party to such determination —

"(i) shall each submit to the certified IDR entity with respect to such determination —

"(I) an offer for a payment amount for such services furnished by such provider; and

"(II) such information as requested by the certified IDR entity relating to such offer; and

"(ii) may each submit to the certified IDR entity with respect to such determination any information relating to such offer submitted by either party, including information relating to any circumstance described in subparagraph (C)(ii).

"(C) CONSIDERATIONS IN DETERMINATION. —

"(i) IN GENERAL. — In determining which offer is the payment to be applied pursuant to this paragraph, the certified IDR entity, with respect to the determination for a qualified IDR air ambulance service shall consider —

"(I) the qualifying payment amounts (as defined in section 2799A–1(a)(3)(E)) for the applicable year for items or services that are comparable to the qualified IDR air ambulance service and that are furnished in the same geographic region (as defined by the Secretary for purposes of such subsection) as such qualified IDR air ambulance service; and

"(II) subject to clause (iii), information on any circumstance described in clause (ii), such information as requested in subparagraph (B)(i)(II), and any additional information provided in subparagraph (B)(ii).

"(ii) ADDITIONAL CIRCUMSTANCES. — For purposes of clause (i)(II), the circumstances described in this clause are, with respect to air ambulance services included in the notification submitted under paragraph (1)(B) of a nonparticipating provider, group health plan, or health insurance issuer the following:

"(I) The quality and outcomes measurements of the provider that furnished such services.

"(II) The acuity of the individual receiving such services or the complexity of furnishing such services to such individual.

"(III) The training, experience, and quality of the medical personnel that furnished such services.

"(IV) Ambulance vehicle type, including the clinical capability level of such vehicle.

"(V) Population density of the pick up location (such as urban, suburban, rural, or frontier).

"(VI) Demonstrations of good faith efforts (or lack of good faith efforts) made by the nonparticipating provider or nonparticipating facility or the plan or issuer to enter into network agreements and, if applicable, contracted rates between the provider and the plan or issuer, as applicable, during the previous 4 plan years.

"(iii) PROHIBITION ON CONSIDERATION OF CERTAIN FACTORS. — In determining which offer is the payment amount to be applied with respect to qualified IDR air ambulance services furnished by a provider, the certified IDR entity with respect to such determination shall not consider usual and customary charges, the amount that would have been billed by such provider with respect to such services had the provisions of section 2799B–5 not applied, or the payment or reimbursement rate for such services furnished by such provider payable by a public payor, including under the Medicare program under title XVIII of the Social Security Act, under the Medicaid program under title XIX of such Act, under the Children's Health Insurance Program under title XXI of such Act, under the TRICARE program under chapter 55 of title 10, United States Code, or under chapter 17 of title 38, United States Code.

"(D) EFFECTS OF DETERMINATION. — The provisions of section 2799A–1(c)(5)(E)) shall apply with respect to a determination of a certified IDR entity under subparagraph (A), the notification submitted with respect to such determination, the services with respect to such notification, and the parties to such notification in the same manner as such provisions apply with respect to a determination of a certified IDR entity under section 2799A–1(c)(5)(E), the notification submitted with respect to such determination, the items and services with respect to such notification, and the parties to such notification.

"(E) COSTS OF INDEPENDENT DISPUTE RESOLUTION PROCESS. — The provisions of section 2799A–1(c)(5)(F) shall apply to a notification made under this subsection, the parties to such notification, and a determination under subparagraph (A) in the same manner and to the same extent such provisions apply to a notification under section 2799A–1(c), the parties to such notification and a determination made under section 2799A–1(c)(5)(A).

"(6) TIMING OF PAYMENT. — The total plan or coverage payment required pursuant to subsection (a)(3), with respect to qualified IDR air ambulance services for which a determination is made under paragraph (5)(A) or with respect to an air ambulance service for which a payment amount is determined under open negotiations under paragraph (1), shall be made directly to the nonparticipating provider not later than 30 days after the date on which such determination is made.

"(7) PUBLICATION OF INFORMATION RELATING TO THE IDR PROCESS. —

"(A) IN GENERAL. — For each calendar quarter in 2022 and each calendar quarter in a subsequent year, the Secretary shall publish on the public website of the Department of Health and Human Services —

"(i) the number of notifications submitted under the IDR process during such calendar quarter;

"(ii) the number of such notifications with respect to which a final determination was made under paragraph (5)(A);

"(iii) the information described in subparagraph (B) with respect to each notification with respect to which such a determination was so made.

"(iv) the number of times the payment amount determined (or agreed to) under this subsection exceeds the qualifying payment amount;

"(v) the amount of expenditures made by the Secretary during such calendar quarter to carry out the IDR process;

"(vi) the total amount of fees paid under paragraph (8) during such calendar quarter; and

"(vii) the total amount of compensation paid to certified IDR entities under paragraph (5)(E)during such calendar quarter.

"(B) INFORMATION WITH RESPECT TO REQUESTS. — For purposes of subparagraph (A), the information described in this subparagraph is, with respect to a notification under the IDR process of a nonparticipating provider, group health plan, or health insurance issuer offering group or individual health insurance coverage —

"(i) a description of each air ambulance service included in such notification;

"(ii) the geography in which the services included in such notification were provided;

"(iii) the amount of the offer submitted under paragraph (2) by the group health plan or health insurance issuer (as applicable) and by the nonparticipating provider expressed as a percentage of the qualifying payment amount;

"(iv) whether the offer selected by the certified IDR entity under paragraph (5) to be the payment applied was the offer submitted by such plan or issuer (as applicable) or by such provider and the amount of such offer so selected expressed as a percentage of the qualifying payment amount;

"(v) ambulance vehicle type, including the clinical capability level of such vehicle;

"(vi) the identity of the group health plan or health insurance issuer or air ambulance provider with respect to such notification;

"(vii) the length of time in making each determination;

"(viii) the compensation paid to the certified IDR entity with respect to the settlement or determination; and

"(ix) any other information specified by the Secretary.

"(C) IDR ENTITY REQUIREMENTS. — For 2022 and each subsequent year, an IDR entity, as a condition of certification as an IDR entity, shall submit to the Secretary such information as the Secretary determines necessary for the Secretary to carry out the provisions of this paragraph.

"(D) CLARIFICATION. — The Secretary shall ensure the public reporting under this paragraph does not contain information that would disclose privileged or confidential information of a group health plan or health insurance issuer offering group or individual health insurance coverage or of a provider or facility.

"(8) ADMINISTRATIVE FEE. —

"(A) IN GENERAL. — Each party to a determination under paragraph (5) to which an entity is selected under paragraph (4) in a year shall pay to the Secretary, at such time and in such manner as specified by the Secretary, a fee for participating in the IDR process with respect to such determination in an amount described in subparagraph (B) for such year.

"(B) AMOUNT OF FEE. — The amount described in this subparagraph for a year is an amount established by the Secretary in a manner such that the total amount of fees paid under this paragraph for such year is estimated to be equal to the amount of expenditures estimated to be made by the Secretary for such year in carrying out the IDR process.

"(9) WAIVER AUTHORITY. — The Secretary may modify any deadline or other timing requirement specified under this subsection (other than the establishment date for the IDR process under paragraph (2)(A) and other than under paragraph (6)) in cases of extenuating circumstances, as specified by the Secretary, or to ensure that all claims that occur during a 90-day period applied through paragraph (5)(D), but with respect to which a notification is not permitted by reason of such paragraph to be submitted under paragraph (1)(B) during such period, are eligible for the IDR process.

"(c) DEFINITIONS. — For purposes of this section:

"(1) AIR AMBULANCE SERVICE. — The term 'air ambulance service' means medical transport by helicopter or airplane for patients.

"(2) QUALIFYING PAYMENT AMOUNT. — The term 'qualifying payment amount' has the meaning given such term in section 2799A–1(a)(3).

"(3) NONPARTICIPATING PROVIDER. — The term 'nonparticipating provider' has the meaning given such term in section 2799A–1(a)(3).".

(2) ERISA AMENDMENT. —

(A) IN GENERAL. — Subpart B of part 7 of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.), as amended by section 102(b) and further amended by the previous provisions of this title, is further amended by inserting after section 716 the following:

"SEC. 717. ENDING SURPRISE AIR AMBULANCE BILLS.

"(a) IN GENERAL. — In the case of a participant or beneficiary who is in a group health plan or group health insurance coverage offered by a health insurance issuer and who receives air ambulance services from a nonparticipating provider (as defined in section 716(a)(3)(G)) with respect to such plan or coverage, if such services would be covered if provided by a participating provider (as defined in such section) with respect to such plan or coverage —

"(1) the cost-sharing requirement with respect to such services shall be the same requirement that would apply if such services were provided by such a participating provider, and any coinsurance or deductible shall be based on rates that would apply for such services if they were furnished by such a participating provider;

"(2) such cost-sharing amounts shall be counted towards the in-network deductible and in-network out-of-pocket maximum amount under the plan or coverage for the plan year (and such in-network deductible shall be applied) with respect to such items and services so furnished in the same manner as if such cost-sharing payments were with respect to items and services furnished by a participating provider; and

"(3) the group health plan or health insurance issuer, respectively, shall —

"(A) not later than 30 calendar days after the bill for such services is transmitted by such provider, send to the provider, an initial payment or notice of denial of payment; and

"(B) pay a total plan or coverage payment, in accordance with, if applicable, subsection (b)(6), directly to such provider furnishing such services to such participant, beneficiary, or enrollee that is, with application of any initial payment under subparagraph (A), equal to the amount by which the out-of-network rate (as defined in section 716(a)(3)(K)) for such services and year involved exceeds the cost-sharing amount imposed under the plan or coverage, respectively, for such services (as determined in accordance with paragraphs (1) and (2)).

"(b) DETERMINATION OF OUT-OF-NETWORK RATES TO BE PAID BY HEALTH PLANS; INDEPENDENT DISPUTE RESOLUTION PROCESS. —

"(1) DETERMINATION THROUGH OPEN NEGOTIATION. —

"(A) IN GENERAL. — With respect to air ambulance services furnished in a year by a nonparticipating provider, with respect to a group health plan or health insurance issuer offering group health insurance coverage, and for which a payment is required to be made by the plan or coverage pursuant to subsection (a)(3), the provider or plan or coverage may, during the 30-day period beginning on the day the provider receives a payment or a statement of denial of payment from the plan or coverage regarding a claim for payment for such service, initiate open negotiations under this paragraph between such provider and plan or coverage for purposes of determining, during the open negotiation period, an amount agreed on by such provider, and such plan or coverage for payment (including any cost-sharing) for such service. For purposes of this subsection, the open negotiation period, with respect to air ambulance services, is the 30-day period beginning on the date of initiation of the negotiations with respect to such services.

"(B) ACCESSING INDEPENDENT DISPUTE RESOLUTION PROCESS IN CASE OF FAILED NEGOTIATIONS. — In the case of open negotiations pursuant to subparagraph (A), with respect to air ambulance services, that do not result in a determination of an amount of payment for such services by the last day of the open negotiation period described in such subparagraph with respect to such services, the provider or group health plan or health insurance issuer offering group health insurance coverage that was party to such negotiations may, during the 4-day period beginning on the day after such open negotiation period, initiate the independent dispute resolution process under paragraph (2) with respect to such item or service. The independent dispute resolution process shall be initiated by a party pursuant to the previous sentence by submission to the other party and to the Secretary of a notification (containing such information as specified by the Secretary) and for purposes of this subsection, the date of initiation of such process shall be the date of such submission or such other date specified by the Secretary pursuant to regulations that is not later than the date of receipt of such notification by both the other party and the Secretary.

"(2) INDEPENDENT DISPUTE RESOLUTION PROCESS AVAILABLE IN CASE OF FAILED OPEN NEGOTIATIONS. —

"(A) ESTABLISHMENT. — Not later than 1 year after the date of the enactment of this subsection, the Secretary, jointly with the Secretary of Health and Human Services and the Secretary of the Treasury, shall establish by regulation one independent dispute resolution process (referred to in this subsection as the 'IDR process') under which, in the case of air ambulance services with respect to which a provider or group health plan or health insurance issuer offering group health insurance coverage submits a notification under paragraph (1)(B) (in this subsection referred to as a 'qualified IDR air ambulance services'), a certified IDR entity under paragraph (4) determines, subject to subparagraph (B) and in accordance with the succeeding provisions of this subsection, the amount of payment under the plan or coverage for such services furnished by such provider.

"(B) AUTHORITY TO CONTINUE NEGOTIATIONS. — Under the independent dispute resolution process, in the case that the parties to a determination for qualified IDR air ambulance services agree on a payment amount for such services during such process but before the date on which the entity selected with respect to such determination under paragraph (4) makes such determination under paragraph (5), such amount shall be treated for purposes of section 716(a)(3)(K)(ii) as the amount agreed to by such parties for such services. In the case of an agreement described in the previous sentence, the independent dispute resolution process shall provide for a method to determine how to allocate between the parties to such determination the payment of the compensation of the entity selected with respect to such determination.

"(C) CLARIFICATION. — A nonparticipating provider may not, with respect to an item or service furnished by such provider, submit a notification under paragraph (1)(B) if such provider is exempt from the requirement under subsection (a) of section 2799B–2 of the Public Health Service Act with respect to such item or service pursuant to subsection (b) of such section.

"(3) TREATMENT OF BATCHING OF SERVICES. — The provisions of section 716(c)(3) shall apply with respect to a notification submitted under this subsection with respect to air ambulance services in the same manner and to the same extent such provisions apply with respect to a notification submitted under section 716(c) with respect to items and services described in such section.

"(4) IDR ENTITIES. —

"(A) ELIGIBILITY. — An IDR entity certified under this subsection is an IDR entity certified under section 716(c)(4).

"(B) SELECTION OF CERTIFIED IDR ENTITY. — The provisions of subparagraph (F) of section 716(c)(4) shall apply with respect to selecting an IDR entity certified pursuant to subparagraph (A) with respect to the determination of the amount of payment under this subsection of air ambulance services in the same manner as such provisions apply with respect to selecting an IDR entity certified under such section with respect to the determination of the amount of payment under section 716(c) of an item or service. An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the 'certified IDR entity' with respect to such determination.

"(5) PAYMENT DETERMINATION. —

"(A) IN GENERAL. — Not later than 30 days after the date of selection of the certified IDR entity with respect to a determination for qualified IDR ambulance services, the certified IDR entity shall —

"(i) taking into account the considerations specified in subparagraph (C), select one of the offers submitted under subparagraph (B) to be the amount of payment for such services determined under this subsection for purposes of subsection (a)(3); and

"(ii) notify the provider or facility and the group health plan or health insurance issuer offering group health insurance coverage party to such determination of the offer selected under clause (i).

"(B) SUBMISSION OF OFFERS. — Not later than 10 days after the date of selection of the certified IDR entity with respect to a determination for qualified IDR air ambulance services, the provider and the group health plan or health insurance issuer offering group health insurance coverage party to such determination —

"(i) shall each submit to the certified IDR entity with respect to such determination —

"(I) an offer for a payment amount for such services furnished by such provider; and

"(II) such information as requested by the certified IDR entity relating to such offer; and

"(ii) may each submit to the certified IDR entity with respect to such determination any information relating to such offer submitted by either party, including information relating to any circumstance described in subparagraph (C)(ii).

"(C) CONSIDERATIONS IN DETERMINATION. —

"(i) IN GENERAL. — In determining which offer is the payment to be applied pursuant to this paragraph, the certified IDR entity, with respect to the determination for a qualified IDR air ambulance service shall consider —

"(I) the qualifying payment amounts (as defined in section 716(a)(3)(E)) for the applicable year for items and services that are comparable to the qualified IDR air ambulance service and that are furnished in the same geographic region (as defined by the Secretary for purposes of such subsection) as such qualified IDR air ambulance service; and

"(II) subject to clause (iii), information on any circumstance described in clause (ii), such information as requested in subparagraph (B)(i)(II), and any additional information provided in subparagraph (B)(ii).

"(ii) ADDITIONAL CIRCUMSTANCES. — For purposes of clause (i)(II), the circumstances described in this clause are, with respect to air ambulance services included in the notification submitted under paragraph (1)(B) of a nonparticipating provider, group health plan, or health insurance issuer the following:

"(I) The quality and outcomes measurements of the provider that furnished such services.

"(II) The acuity of the individual receiving such services or the complexity of furnishing such services to such individual.

"(III) The training, experience, and quality of the medical personnel that furnished such services.

"(IV) Ambulance vehicle type, including the clinical capability level of such vehicle.

"(V) Population density of the pick up location (such as urban, suburban, rural, or frontier).

"(VI) Demonstrations of good faith efforts (or lack of good faith efforts) made by the nonparticipating provider or nonparticipating facility or the plan or issuer to enter into network agreements and, if applicable, contracted rates between the provider and the plan or issuer, as applicable, during the previous 4 plan years.

"(iii) PROHIBITION ON CONSIDERATION OF CERTAIN FACTORS. — In determining which offer is the payment amount to be applied with respect to qualified IDR air ambulance services furnished by a provider, the certified IDR entity with respect to such determination shall not consider usual and customary charges, the amount that would have been billed by such provider with respect to such services had the provisions of section 2799B–5 of the Public Health Service Act not applied, or the payment or reimbursement rate for such services furnished by such provider payable by a public payor, including under the Medicare program under title XVIII of the Social Security Act, under the Medicaid program under title XIX of such Act, under the Children's Health Insurance Program under title XXI of such Act, under the TRICARE program under chapter 55 of title 10, United States Code, or under chapter 17 of title 38, United States Code.

"(D) EFFECTS OF DETERMINATION. — The provisions of section 716(c)(5)(E)) shall apply with respect to a determination of a certified IDR entity under subparagraph (A), the notification submitted with respect to such determination, the services with respect to such notification, and the parties to such notification in the same manner as such provisions apply with respect to a determination of a certified IDR entity under section 716(c)(5)(E), the notification submitted with respect to such determination, the items and services with respect to such notification, and the parties to such notification.

"(E) COSTS OF INDEPENDENT DISPUTE RESOLUTION PROCESS. — The provisions of section 716(c)(5)(F) shall apply to a notification made under this subsection, the parties to such notification, and a determination under subparagraph (A) in the same manner and to the same extent such provisions apply to a notification under section 716(c), the parties to such notification and a determination made under section 716(c)(5)(A).

"(6) TIMING OF PAYMENT. — The total plan or coverage payment required pursuant to subsection (a)(3), with respect to qualified IDR air ambulance services for which a determination is made under paragraph (5)(A) or with respect to air ambulance services for which a payment amount is determined under open negotiations under paragraph (1), shall be made directly to the nonparticipating provider not later than 30 days after the date on which such determination is made.

"(7) PUBLICATION OF INFORMATION RELATING TO THE IDR PROCESS. —

"(A) IN GENERAL. — For each calendar quarter in 2022 and each calendar quarter in a subsequent year, the Secretary shall publish on the public website of the Department of Labor —

"(i) the number of notifications submitted under the IDR process during such calendar quarter;

"(ii) the number of such notifications with respect to which a final determination was made under paragraph (5)(A);

"(iii) the information described in subparagraph (B) with respect to each notification with respect to which such a determination was so made.

"(iv) the number of times the payment amount determined (or agreed to) under this subsection exceeds the qualifying payment amount;

"(v) the amount of expenditures made by the Secretary during such calendar quarter to carry out the IDR process;

"(vi) the total amount of fees paid under paragraph (8) during such calendar quarter; and

"(vii) the total amount of compensation paid to certified IDR entities under paragraph (5)(E)during such calendar quarter.

"(B) INFORMATION WITH RESPECT TO REQUESTS. — For purposes of subparagraph (A), the information described in this subparagraph is, with respect to a notification under the IDR process of a nonparticipating provider, group health plan, or health insurance issuer offering group health insurance coverage —

"(i) a description of each air ambulance service included in such notification;

"(ii) the geography in which the services included in such notification were provided;

"(iii) the amount of the offer submitted under paragraph (2) by the group health plan or health insurance issuer (as applicable) and by the nonparticipating provider expressed as a percentage of the qualifying payment amount;

"(iv) whether the offer selected by the certified IDR entity under paragraph (5) to be the payment applied was the offer submitted by such plan or issuer (as applicable) or by such provider and the amount of such offer so selected expressed as a percentage of the qualifying payment amount;

"(v) ambulance vehicle type, including the clinical capability level of such vehicle;

"(vi) the identity of the group health plan or health insurance issuer or air ambulance provider with respect to such notification;

"(vii) the length of time in making each determination;

"(viii) the compensation paid to the certified IDR entity with respect to the settlement or determination; and

"(ix) any other information specified by the Secretary.

"(C) IDR ENTITY REQUIREMENTS. — For 2022 and each subsequent year, an IDR entity, as a condition of certification as an IDR entity, shall submit to the Secretary such information as the Secretary determines necessary for the Secretary to carry out the provisions of this paragraph.

"(D) CLARIFICATION. — The Secretary shall ensure the public reporting under this paragraph does not contain information that would disclose privileged or confidential information of a group health plan or health insurance issuer offering group or individual health insurance coverage or of a provider or facility.

"(8) ADMINISTRATIVE FEE. —

"(A) IN GENERAL. — Each party to a determination under paragraph (5) to which an entity is selected under paragraph (4) in a year shall pay to the Secretary, at such time and in such manner as specified by the Secretary, a fee for participating in the IDR process with respect to such determination in an amount described in subparagraph (B) for such year.

"(B) AMOUNT OF FEE. — The amount described in this subparagraph for a year is an amount established by the Secretary in a manner such that the total amount of fees paid under this paragraph for such year is estimated to be equal to the amount of expenditures estimated to be made by the Secretary for such year in carrying out the IDR process.

"(9) WAIVER AUTHORITY. — The Secretary may modify any deadline or other timing requirement specified under this subsection (other than the establishment date for the IDR process under paragraph (2)(A) and other than under paragraph (6)) in cases of extenuating circumstances, as specified by the Secretary, or to ensure that all claims that occur during a 90-day period applied through paragraph (5)(D), but with respect to which a notification is not permitted by reason of such paragraph to be submitted under paragraph (1)(B) during such period, are eligible for the IDR process.

"(c) DEFINITION. — For purposes of this section:

"(1) AIR AMBULANCE SERVICES. — The term 'air ambulance service' means medical transport by helicopter or airplane for patients.

"(2) QUALIFYING PAYMENT AMOUNT. — The term 'qualifying payment amount' has the meaning given such term in section 716(a)(3).

"(3) NONPARTICIPATING PROVIDER. — The term 'nonparticipating provider' has the meaning given such term in section 716(a)(3).".

(3) IRC AMENDMENTS. —

(A) IN GENERAL. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by section 102(c) and further amended by the previous provisions of this title, is further amended by inserting after section 9816 the following:

"SEC. 9817. ENDING SURPRISE AIR AMBULANCE BILLS.

"(a) IN GENERAL. — In the case of a participant or beneficiary in a group health plan who receives air ambulance services from a nonparticipating provider (as defined in section 9816(a)(3)(G)) with respect to such plan, if such services would be covered if provided by a participating provider (as defined in such section) with respect to such plan —

"(1) the cost-sharing requirement with respect to such services shall be the same requirement that would apply if such services were provided by such a participating provider, and any coinsurance or deductible shall be based on rates that would apply for such services if they were furnished by such a participating provider;

"(2) such cost-sharing amounts shall be counted towards the in-network deductible and in-network out-of-pocket maximum amount under the plan for the plan year (and such in-network deductible shall be applied) with respect to such items and services so furnished in the same manner as if such cost-sharing payments were with respect to items and services furnished by a participating provider; and

"(3) the group health plan shall —

"(A) not later than 30 calendar days after the bill for such services is transmitted by such provider, send to the provider, an initial payment or notice of denial of payment; and

"(B) pay a total plan payment, in accordance with, if applicable, subsection (b)(6), directly to such provider furnishing such services to such participant, beneficiary, or enrollee that is, with application of any initial payment under subparagraph (A), equal to the amount by which the out-of-network rate (as defined in section 9816(a)(3)(K)) for such services and year involved exceeds the cost-sharing amount imposed under the plan for such services (as determined in accordance with paragraphs (1) and (2)).

"(b) DETERMINATION OF OUT-OF-NETWORK RATES TO BE PAID BY HEALTH PLANS; INDEPENDENT DISPUTE RESOLUTION PROCESS. —

"(1) DETERMINATION THROUGH OPEN NEGOTIATION. —

"(A) IN GENERAL. — With respect to air ambulance services furnished in a year by a nonparticipating provider, with respect to a group health plan, and for which a payment is required to be made by the plan pursuant to subsection (a)(3), the provider or plan may, during the 30-day period beginning on the day the provider receives a payment or a statement of denial of payment from the plan regarding a claim for payment for such service, initiate open negotiations under this paragraph between such provider and plan for purposes of determining, during the open negotiation period, an amount agreed on by such provider, and such plan for payment (including any cost-sharing) for such service. For purposes of this subsection, the open negotiation period, with respect to air ambulance services, is the 30-day period beginning on the date of initiation of the negotiations with respect to such services.

"(B) ACCESSING INDEPENDENT DISPUTE RESOLUTION PROCESS IN CASE OF FAILED NEGOTIATIONS. — In the case of open negotiations pursuant to subparagraph (A), with respect to air ambulance services, that do not result in a determination of an amount of payment for such services by the last day of the open negotiation period described in such subparagraph with respect to such services, the provider or group health plan that was party to such negotiations may, during the 4-day period beginning on the day after such open negotiation period, initiate the independent dispute resolution process under paragraph (2) with respect to such services. The independent dispute resolution process shall be initiated by a party pursuant to the previous sentence by submission to the other party and to the Secretary of a notification (containing such information as specified by the Secretary) and for purposes of this subsection, the date of initiation of such process shall be the date of such submission or such other date specified by the Secretary pursuant to regulations that is not later than the date of receipt of such notification by both the other party and the Secretary.

"(2) INDEPENDENT DISPUTE RESOLUTION PROCESS AVAILABLE IN CASE OF FAILED OPEN NEGOTIATIONS. —

"(A) ESTABLISHMENT. — Not later than 1 year after the date of the enactment of this subsection, the Secretary, jointly with the Secretary of Health and Human Services and the Secretary of Labor, shall establish by regulation one independent dispute resolution process (referred to in this subsection as the 'IDR process') under which, in the case of air ambulance services with respect to which a provider or group health plan submits a notification under paragraph (1)(B) (in this subsection referred to as a 'qualified IDR air ambulance services'), a certified IDR entity under paragraph (4) determines, subject to subparagraph (B) and in accordance with the succeeding provisions of this subsection, the amount of payment under the plan for such services furnished by such provider.

"(B) AUTHORITY TO CONTINUE NEGOTIATIONS. — Under the independent dispute resolution process, in the case that the parties to a determination for qualified IDR air ambulance services agree on a payment amount for such services during such process but before the date on which the entity selected with respect to such determination under paragraph (4) makes such determination under paragraph (5), such amount shall be treated for purposes of section 9816(a)(3)(K)(ii) as the amount agreed to by such parties for such services. In the case of an agreement described in the previous sentence, the independent dispute resolution process shall provide for a method to determine how to allocate between the parties to such determination the payment of the compensation of the entity selected with respect to such determination.

"(C) CLARIFICATION. — A nonparticipating provider may not, with respect to an item or service furnished by such provider, submit a notification under paragraph (1)(B) if such provider is exempt from the requirement under subsection (a) of section 2799B–2 of the Public Health Service Act with respect to such item or service pursuant to subsection (b) of such section.

"(3) TREATMENT OF BATCHING OF SERVICES. — The provisions of section 9816(c)(3) shall apply with respect to a notification submitted under this subsection with respect to air ambulance services in the same manner and to the same extent such provisions apply with respect to a notification submitted under section 9816(c) with respect to items and services described in such section.

"(4) IDR ENTITIES. —

"(A) ELIGIBILITY. — An IDR entity certified under this subsection is an IDR entity certified under section 9816(c)(4).

"(B) SELECTION OF CERTIFIED IDR ENTITY. — The provisions of subparagraph (F) of section 9816(c)(4) shall apply with respect to selecting an IDR entity certified pursuant to subparagraph (A) with respect to the determination of the amount of payment under this subsection of air ambulance services in the same manner as such provisions apply with respect to selecting an IDR entity certified under such section with respect to the determination of the amount of payment under section 9816(c) of an item or service. An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the 'certified IDR entity' with respect to such determination.

"(5) PAYMENT DETERMINATION. —

"(A) IN GENERAL. — Not later than 30 days after the date of selection of the certified IDR entity with respect to a determination for qualified IDR ambulance services, the certified IDR entity shall —

"(i) taking into account the considerations specified in subparagraph (C), select one of the offers submitted under subparagraph (B) to be the amount of payment for such services determined under this subsection for purposes of subsection (a)(3); and

"(ii) notify the provider or facility and the group health plan party to such determination of the offer selected under clause (i).

"(B) SUBMISSION OF OFFERS. — Not later than 10 days after the date of selection of the certified IDR entity with respect to a determination for qualified IDR air ambulance services, the provider and the group health plan party to such determination —

"(i) shall each submit to the certified IDR entity with respect to such determination —

"(I) an offer for a payment amount for such services furnished by such provider; and

"(II) such information as requested by the certified IDR entity relating to such offer; and

"(ii) may each submit to the certified IDR entity with respect to such determination any information relating to such offer submitted by either party, including information relating to any circumstance described in subparagraph (C)(ii).

"(C) CONSIDERATIONS IN DETERMINATION. —

"(i) IN GENERAL. — In determining which offer is the payment to be applied pursuant to this paragraph, the certified IDR entity, with respect to the determination for a qualified IDR air ambulance service shall consider —

"(I) the qualifying payment amounts (as defined in section 9816(a)(3)(E)) for the applicable year for items or services that are comparable to the qualified IDR air ambulance service and that are furnished in the same geographic region (as defined by the Secretary for purposes of such subsection) as such qualified IDR air ambulance service; and

"(II) subject to clause (iii), information on any circumstance described in clause (ii), such information as requested in subparagraph (B)(i)(II), and any additional information provided in subparagraph (B)(ii).

"(ii) ADDITIONAL CIRCUMSTANCES. — For purposes of clause (i)(II), the circumstances described in this clause are, with respect to air ambulance services included in the notification submitted under paragraph (1)(B) of a nonparticipating provider, or group health plan the following:

"(I) The quality and outcomes measurements of the provider that furnished such services.

"(II) The acuity of the individual receiving such services or the complexity of furnishing such services to such individual.

"(III) The training, experience, and quality of the medical personnel that furnished such services.

"(IV) Ambulance vehicle type, including the clinical capability level of such vehicle.

"(V) Population density of the pick up location (such as urban, suburban, rural, or frontier).

"(VI) Demonstrations of good faith efforts (or lack of good faith efforts) made by the nonparticipating provider or nonparticipating facility or the plan to enter into network agreements and, if applicable, contracted rates between the provider and the plan during the previous 4 plan years.

"(iii) PROHIBITION ON CONSIDERATION OF CERTAIN FACTORS. — In determining which offer is the payment amount to be applied with respect to qualified IDR air ambulance services furnished by a provider, the certified IDR entity with respect to such determination shall not consider usual and customary charges, the amount that would have been billed by such provider with respect to such services had the provisions of section 2799B–5 of the Public Health Service Act not applied, or the payment or reimbursement rate for such services furnished by such provider payable by a public payor, including under the Medicare program under title XVIII of the Social Security Act, under the Medicaid program under title XIX of such Act, under the Children's Health Insurance Program under title XXI of such Act, under the TRICARE program under chapter 55 of title 10, United States Code, or under chapter 17 of title 38, United States Code.

"(D) EFFECTS OF DETERMINATION. — The provisions of section 9816(c)(5)(E)) shall apply with respect to a determination of a certified IDR entity under subparagraph (A), the notification submitted with respect to such determination, the services with respect to such notification, and the parties to such notification in the same manner as such provisions apply with respect to a determination of a certified IDR entity under section 9816(c)(5)(E), the notification submitted with respect to such determination, the items and services with respect to such notification, and the parties to such notification.

"(E) COSTS OF INDEPENDENT DISPUTE RESOLUTION PROCESS. — The provisions of section 9816(c)(5)(F) shall apply to a notification made under this subsection, the parties to such notification, and a determination under subparagraph (A) in the same manner and to the same extent such provisions apply to a notification under section 9816(c), the parties to such notification and a determination made under section 9816(c)(5)(A).

"(6) TIMING OF PAYMENT. — The total plan payment required pursuant to subsection (a)(3), with respect to qualified IDR air ambulance services for which a determination is made under paragraph (5)(A) or with respect to air ambulance services for which a payment amount is determined under open negotiations under paragraph (1), shall be made directly to the non-participating provider not later than 30 days after the date on which such determination is made.

"(7) PUBLICATION OF INFORMATION RELATING TO THE IDR PROCESS. —

"(A) IN GENERAL. — For each calendar quarter in 2022 and each calendar quarter in a subsequent year, the Secretary shall publish on the public website of the Department of the Treasury —

"(i) the number of notifications submitted under the IDR process during such calendar quarter;

"(ii) the number of such notifications with respect to which a final determination was made under paragraph (5)(A);

"(iii) the information described in subparagraph (B) with respect to each notification with respect to which such a determination was so made.

"(iv) the number of times the payment amount determined (or agreed to) under this subsection exceeds the qualifying payment amount;

"(v) the amount of expenditures made by the Secretary during such calendar quarter to carry out the IDR process;

"(vi) the total amount of fees paid under paragraph

(8) during such calendar quarter; and

"(vii) the total amount of compensation paid to certified IDR entities under paragraph (5)(E)during such calendar quarter.

"(B) INFORMATION WITH RESPECT TO REQUESTS. — For purposes of subparagraph (A), the information described in this subparagraph is, with respect to a notification under the IDR process of a nonparticipating provider, or group health plan —

"(i) a description of each air ambulance service included in such notification;

"(ii) the geography in which the services included in such notification were provided;

"(iii) the amount of the offer submitted under paragraph (2) by the group health plan and by the nonparticipating provider expressed as a percentage of the qualifying payment amount;

"(iv) whether the offer selected by the certified IDR entity under paragraph (5) to be the payment applied was the offer submitted by such plan or issuer (as applicable) or by such provider and the amount of such offer so selected expressed as a percentage of the qualifying payment amount;

"(v) ambulance vehicle type, including the clinical capability level of such vehicle;

"(vi) the identity of the group health plan or health insurance issuer or air ambulance provider with respect to such notification;

"(vii) the length of time in making each determination;

"(viii) the compensation paid to the certified IDR entity with respect to the settlement or determination; and

"(ix) any other information specified by the Secretary.

"(C) IDR ENTITY REQUIREMENTS. — For 2022 and each subsequent year, an IDR entity, as a condition of certification as an IDR entity, shall submit to the Secretary such information as the Secretary determines necessary for the Secretary to carry out the provisions of this paragraph.

"(D) CLARIFICATION. — The Secretary shall ensure the public reporting under this paragraph does not contain information that would disclose privileged or confidential information of a group health plan or health insurance issuer offering group or individual health insurance coverage or of a provider or facility.

"(8) ADMINISTRATIVE FEE. —

"(A) IN GENERAL. — Each party to a determination under paragraph (5) to which an entity is selected under paragraph (4) in a year shall pay to the Secretary, at such time and in such manner as specified by the Secretary, a fee for participating in the IDR process with respect to such determination in an amount described in subparagraph (B) for such year.

"(B) AMOUNT OF FEE. — The amount described in this subparagraph for a year is an amount established by the Secretary in a manner such that the total amount of fees paid under this paragraph for such year is estimated to be equal to the amount of expenditures estimated to be made by the Secretary for such year in carrying out the IDR process.

"(9) WAIVER AUTHORITY. — The Secretary may modify any deadline or other timing requirement specified under this subsection (other than the establishment date for the IDR process under paragraph (2)(A) and other than under paragraph (6)) in cases of extenuating circumstances, as specified by the Secretary, or to ensure that all claims that occur during a 90-day period applied through paragraph (5)(D), but with respect to which a notification is not permitted by reason of such paragraph to be submitted under paragraph (1)(B) during such period, are eligible for the IDR process.

"(c) DEFINITIONS. — For purposes of this section:

"(1) AIR AMBULANCE SERVICES. — The term 'air ambulance service' means medical transport by helicopter or airplane for patients.

"(2) QUALIFYING PAYMENT AMOUNT. — The term 'qualifying payment amount' has the meaning given such term in section 9816(a)(3).

"(3) NONPARTICIPTING PROVIDER. — The term 'nonparticipating provider' has the meaning given such term in section 9816(a)(3).".

(B) CLERICAL AMENDMENT. — The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by section 102(c)(3), is further amended by inserting after the item relating to section 9816 the following new item:

"Sec. 9817. Ending surprise air ambulance bills.".

(4) EFFECTIVE DATE. — The amendments made by this subsection shall apply with respect to plan years beginning on or after January 1, 2022.

(b) AIR AMBULANCE PROVIDER BALANCE BILLING. — Part E of title XXVII of the Public Health Service Act, as added and amended by section 104, is further amended by adding at the end the following new section:

"SEC. 2799B–5. AIR AMBULANCE SERVICES.

"In the case of a participant, beneficiary, or enrollee with benefits under a group health plan or group or individual health insurance coverage offered by a health insurance issuer and who is furnished in a plan year beginning on or after January 1, 2022, air ambulance services (for which benefits are available under such plan or coverage) from a nonparticipating provider (as defined in section 2799A–1(a)(3)(G)) with respect to such plan or coverage, such provider shall not bill, and shall not hold liable, such participant, beneficiary, or enrollee for a payment amount for such service furnished by such provider that is more than the cost-sharing amount for such service (as determined in accordance with paragraphs (1) and (2) of section 2799A–2(a), section 717(a) of the Employee Retirement Income Security Act of 1974, or section 9817(a) of the Internal Revenue Code of 1986, as applicable).".

SEC. 106. REPORTING REQUIREMENTS REGARDING AIR AMBULANCE SERVICES.

(a) REPORTING REQUIREMENTS FOR PROVIDERS OF AIR AMBULANCE SERVICES. —

(1) IN GENERAL. — A provider of air ambulance services shall submit to the Secretary of Health and Human Services and the Secretary of Transportation —

(A) not later than the date that is 90 days after the last day of the first calendar year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in subsection (d), the information described in paragraph (2) with respect to such plan year; and

(B) not later than the date that is 90 days after the last day of the plan year immediately succeeding the plan year described in subparagraph (A), such information with respect to such immediately succeeding plan year.

(2) INFORMATION DESCRIBED. — For purposes of paragraph (1), information described in this paragraph, with respect to a provider of air ambulance services, is each of the following:

(A) Cost data, as determined appropriate by the Secretary of Health and Human Services, in consultation with the Secretary of Transportation, for air ambulance services furnished by such provider, separated to the maximum extent possible by air transportation costs associated with furnishing such air ambulance services and costs of medical services and supplies associated with furnishing such air ambulance services.

(B) The number and location of all air ambulance bases operated by such provider.

(C) The number and type of aircraft operated by such provider.

(D) The number of air ambulance transports, disaggregated by payor mix, including —

(i)(I) group health plans;

(II) health insurance issuers; and

(III) State and Federal Government payors; and

(ii) uninsured individuals.

(E) The number of claims of such provider that have been denied payment by a group health plan or health insurance issuer and the reasons for any such denials.

(F) The number of emergency and nonemergency air ambulance transports, disaggregated by air ambulance base and type of aircraft.

(G) Such other information regarding air ambulance services as the Secretary of Health and Human Services may specify.

(b) REPORTING REQUIREMENTS FOR GROUP HEALTH PLANS AND HEALTH INSURANCE ISSUERS. —

(1) PHSA. — Part D of title XXVII of the Public Health Service Act, as added by section 102(a)(1), is amended by adding after section 2799A–7, as added by section 102(a)(2)(A) of this Act, the following new section:

"SEC. 2799A–8. AIR AMBULANCE REPORT REQUIREMENTS.

"(a) IN GENERAL. — Each group health plan and health insurance issuer offering group or individual health insurance coverage shall submit to the Secretary, jointly with the Secretary of Labor and the Secretary of the Treasury —

"(1) not later than the date that is 90 days after the last day of the first calendar year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in section 106(d) of the No Surprises Act, the information described in subsection (b) with respect to such plan year; and

"(2) not later than the date that is 90 days after the last day of the calendar year immediately succeeding the plan year described in paragraph (1), such information with respect to such immediately succeeding plan year.

"(b) INFORMATION DESCRIBED. — For purposes of subsection (a), information described in this subsection, with respect to a group health plan or a health insurance issuer offering group or individual health insurance coverage, is each of the following:

"(1) Claims data for air ambulance services furnished by providers of such services, disaggregated by each of the following factors:

"(A) Whether such services were furnished on an emergent or nonemergent basis.

"(B) Whether the provider of such services is part of a hospital-owned or sponsored program, municipality-sponsored program, hospital independent partnership (hybrid) program, independent program, or tribally operated program in Alaska.

"(C) Whether the transport in which the services were furnished originated in a rural or urban area.

"(D) The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services.

"(E) Whether the provider of such services has a contract with the plan or issuer, as applicable, to furnish such services under the plan or coverage, respectively.

"(2) Such other information regarding providers of air ambulance services as the Secretary may specify.".

(2) ERISA. —

(A) IN GENERAL. — Subpart B of part 7 of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding after section 722, as added by section 102(b)(2)(A) of this Act, the following new section:

"SEC. 723. AIR AMBULANCE REPORT REQUIREMENTS.

"(a) IN GENERAL. — Each group health plan and health insurance issuer offering group health insurance coverage shall submit to the Secretary, jointly with the Secretary of Health and Human Services and the Secretary of the Treasury —

"(1) not later than the date that is 90 days after the last day of the first calendar year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in section 106(d) of the No Surprises Act, the information described in subsection (b) with respect to such plan year; and

"(2) not later than the date that is 90 days after the last day of the plan year immediately succeeding the calendar year described in paragraph (1), such information with respect to such immediately succeeding plan year.

"(b) INFORMATION DESCRIBED. — For purposes of subsection (a), information described in this subsection, with respect to a group health plan or a health insurance issuer offering group health insurance coverage, is each of the following:

"(1) Claims data for air ambulance services furnished by providers of such services, disaggregated by each of the following factors:

"(A) Whether such services were furnished on an emergent or nonemergent basis.

"(B) Whether the provider of such services is part of a hospital-owned or sponsored program, municipality-sponsored program, hospital independent partnership (hybrid) program, independent program, or tribally operated program in Alaska.

"(C) Whether the transport in which the services were furnished originated in a rural or urban area.

"(D) The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services.

"(E) Whether the provider of such services has a contract with the plan or issuer, as applicable, to furnish such services under the plan or coverage, respectively.

"(2) Such other information regarding providers of air ambulance services as the Secretary may specify.".

(B) CLERICAL AMENDMENT. — The table of contents of the Employee Retirement Income Security Act of 1974 is amended by adding after the item relating to section 722, as added by section 102(b) the following:

"Sec. 723. Air ambulance report requirements.".

(3) IRC. —

(A) IN GENERAL. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by adding after section 9822, as added by section 102(c)(2)(A) of this Act, the following new section:

"SEC. 9823. AIR AMBULANCE REPORT REQUIREMENTS.

"(a) IN GENERAL. — Each group health plan shall submit to the Secretary, jointly with the Secretary of Labor and the Secretary of Health and Human Services —

"(1) not later than the date that is 90 days after the last day of the first calendar year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in section 106(d) of the No Surprises Act, the information described in subsection (b) with respect to such plan year; and

"(2) not later than the date that is 90 days after the last day of the calendar year immediately succeeding the plan year described in paragraph (1), such information with respect to such immediately succeeding plan year.

"(b) INFORMATION DESCRIBED. — For purposes of subsection (a), information described in this subsection, with respect to a group health plan is each of the following:

"(1) Claims data for air ambulance services furnished by providers of such services, disaggregated by each of the following factors:

"(A) Whether such services were furnished on an emergent or nonemergent basis.

"(B) Whether the provider of such services is part of a hospital-owned or sponsored program, municipality-sponsored program, hospital independent partnership (hybrid) program, independent program, or tribally operated program in Alaska.

"(C) Whether the transport in which the services were furnished originated in a rural or urban area.

"(D) The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services.

"(E) Whether the provider of such services has a contract with the plan or issuer, as applicable, to furnish such services under the plan or coverage, respectively.

"(2) Such other information regarding providers of air ambulance services as the Secretary may specify.".

(B) CLERICAL AMENDMENT. — The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by adding after the item relating to section 9822, as added by section 102(c), the following new item:

"Sec. 9823. Air ambulance report requirements.".

(c) PUBLICATION OF COMPREHENSIVE REPORT. —

(1) IN GENERAL. — Not later than the date that is one year after the date described in subsection (a)(2) of section 2799A– 8 of the Public Health Service Act, of section 723 of the Employee Retirement Income Security Act of 1974, and of section 9823 of the Internal Revenue Code of 1986, as such sections are added by subsection (b), the Secretary of Health and Human Services, in consultation with the Secretary of Transportation (referred to in this section as the "Secretaries"), shall develop, and make publicly available (subject to paragraph (3)), a comprehensive report summarizing the information submitted under subsection (a) and the amendments made by subsection (b) and including each of the following:

(A) The percentage of providers of air ambulance services that are part of a hospital-owned or sponsored program, municipality-sponsored program, hospital-independent partnership (hybrid) program, or independent program.

(B) An assessment of the extent of competition among providers of air ambulance services on the basis of price and services offered, and any changes in such competition over time.

(C) An assessment of the average charges for air ambulance services, amounts paid by group health plans and health insurance issuers offering group or individual health insurance coverage to providers of air ambulance services for furnishing such services, and amounts paid out-of-pocket by consumers, and any changes in such amounts paid over time.

(D) An assessment of the presence of air ambulance bases in, or with the capability to serve, rural areas, and the relative growth in air ambulance bases in rural and urban areas over time.

(E) Any evidence of gaps in rural access to providers of air ambulance services.

(F) The percentage of providers of air ambulance services that have contracts with group health plans or health insurance issuers offering group or individual health insurance coverage to furnish such services under such plans or coverage, respectively.

(G) An assessment of whether there are instances of unfair, deceptive, or predatory practices by providers of air ambulance services in collecting payments from patients to whom such services are furnished, such as referral of such patients to collections, lawsuits, and liens or wage garnishment actions.

(H) An assessment of whether there are, within the air ambulance industry, instances of unreasonable industry

concentration, excessive market domination, or other conditions that would allow at least one provider of air ambulance services to unreasonably increase prices or exclude competition in air ambulance services in a given geographic region.

(I) An assessment of the frequency of patient balance billing, patient referrals to collections, lawsuits to collect balance bills, and liens or wage garnishment actions by providers of air ambulance services as part of a collections process across hospital-owned or sponsored programs, municipality-sponsored programs, hospital-independent partnership (hybrid) programs, tribally operated programs in Alaska, or independent programs, providers of air ambulance services operated by public agencies (such as a State or county health department), and other independent providers of air ambulance services.

(J) An assessment of the frequency of claims appeals made by providers of air ambulance services to group health plans or health insurance issuers offering group or individual health insurance coverage with respect to air ambulance services furnished to enrollees of such plans or coverage, respectively.

(K) Any other cost, quality, or other data relating to air ambulance services or the air ambulance industry, as determined necessary and appropriate by the Secretaries.

(2) OTHER SOURCES OF INFORMATION. — The Secretaries may incorporate information from independent experts or third-party sources in developing the comprehensive report required under paragraph (1).

(3) PROTECTION OF PROPRIETARY INFORMATION. — The Secretaries may not make publicly available under this subsection any proprietary information.

(d) RULEMAKING. — Not later than the date that is one year after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with the Secretary of Transportation, shall, through notice and comment rulemaking, specify the form and manner in which reports described in subsection (a) and in the amendments made by subsection (b) shall be submitted to such Secretaries, taking into consideration (as applicable and to the extent feasible) any recommendations included in the report submitted by the Advisory Committee on Air Ambulance and Patient Billing under section 418(e) of the FAA Reauthorization Act of 2018 (Public Law 115-254; 49 U.S.C. 42301 note prec.).

(e) CIVIL MONEY PENALTIES. —

(1) IN GENERAL. — Subject to paragraph (2), a provider of air ambulance services who fails to submit all information required under subsection (a)(2) by the date described in subparagraph (A) or (B) of subsection (a)(1), as applicable, shall be subject to a civil money penalty of not more than $10,000.

(2) EXCEPTION. — In the case of a provider of air ambulance services that submits only some of the information required under subsection (a)(2) by the date described in subparagraph

(A) or (B) of subsection (a)(1), as applicable, the Secretary of Health and Human Services may waive the civil money penalty imposed under paragraph (1) if such provider demonstrates a good faith effort (as defined by the Secretary pursuant to regulation) in working with the Secretary to submit the remaining information required under subsection (a)(2).

(3) PROCEDURE. — The provisions of section 1128A of the Social Security Act (42 U.S.C. 1320a-7a), other than subsections (a) and (b) and the first sentence of subsection (c)(1), shall apply to civil money penalties under this subsection in the same manner as such provisions apply to a penalty or proceeding under such section.

(f) UNFAIR AND DECEPTIVE PRACTICES AND UNFAIR METHODS OF COMPETITION. — The Secretary of Transportation may use any information submitted under subsection (a) in determining whether a provider of air ambulance services has violated section 41712(a) of title 49, United States Code.

(g) ADVISORY COMMITTEE ON AIR AMBULANCE QUALITY AND (1) ESTABLISHMENT. — Not later than the date that is 60 days after the date of the enactment of this Act, the Secretary of Health and Human Services and the Secretary of Transportation, shall establish an Advisory Committee on Air Ambulance Quality and Patient Safety (referred to in this subsection as the "Committee") for the purpose of reviewing options to establish quality, patient safety, and clinical capability standards for each clinical capability level of air ambulances.

(2) MEMBERSHIP. — The Committee shall be composed of the following members:

(A) The Secretary of Health and Human Services, or a designee of the Secretary, who shall serve as the Chair of the Committee.

(B) The Secretary of Transportation, or a designee of the Secretary.

(C) One representative, to be appointed by the Secretary of Health and Human Services, of each of the following:

(i) State health insurance regulators.

(ii) Health care providers.

(iii) Group health plans and health insurance issuers offering group or individual health insurance coverage.

(iv) Patient advocacy groups.

(v) Accrediting bodies with experience in quality measures.

(D) Three representatives of the air ambulance industry, to be appointed by the Secretary of Transportation.

(E) Additional three representatives not covered under subparagraphs (A) through (D), as determined necessary and appropriate by the Secretary of Health and Human Services and Secretary of Transportation.

(3) FIRST MEETING. — Not later than the date that is 90 days after the date of the enactment of this Act, the Committee shall hold its first meeting.

(4) DUTIES. — The Committee shall study and make recommendations, as appropriate, to Congress regarding each of the following with respect to air ambulance services:

(A) Qualifications of different clinical capability levels and tiering of such levels.

(B) Patient safety and quality standards.

(C) Options for improving service reliability during poor weather, night conditions, or other adverse conditions.

(D) Differences between air ambulance vehicle types, services, and technologies, and other flight capability standards, and the impact of such differences on patient safety.

(E) Clinical triage criteria for air ambulances.

(h) DEFINITIONS. — In this section, the terms "group health plan", "health insurance coverage", "individual health insurance coverage", "group health insurance coverage", and "health insurance issuer" have the meanings given such terms in section 2791 of the Public Health Service Act (42 U.S.C. 300gg-91).

SEC. 107. TRANSPARENCY REGARDING IN-NETWORK AND OUT-OF-NET-WORK DEDUCTIBLES AND OUT-OF-POCKET LIMITATIONS.

(a) PHSA. — Section 2799A-1 of the Public Health Service Act, as added by section 102(a) and amended by section 103, is further amended by adding at the end the following new subsection:

"(e) TRANSPARENCY REGARDING IN-NETWORK AND OUT-OF-NETWORK DEDUCTIBLES AND OUT-OF-POCKET LIMITATIONS. — A group health plan or a health insurance issuer offering group or individual health insurance coverage and providing or covering any benefit with respect to items or services shall include, in clear writing, on any physical or electronic plan or insurance identification card issued to the participants, beneficiaries, or enrollees in the plan or coverage the following:

"(1) Any deductible applicable to such plan or coverage.

"(2) Any out-of-pocket maximum limitation applicable to such plan or coverage.

"(3) A telephone number and Internet website address through which such individual may seek consumer assistance information, such as information related to hospitals and urgent care facilities that have in effect a contractual relationship with such plan or coverage for furnishing items and services under such plan or coverage".

(b) ERISA. — Section 716 of the Employee Retirement Income Security Act of 1974, as added by section 102(b) and amended by section 103, is further amended by adding at the end the following new subsection:

"(e) TRANSPARENCY REGARDING IN-NETWORK AND OUT-OF-NETWORK DEDUCTIBLES AND OUT-OF-POCKET LIMITATIONS. — A group health plan or a health insurance issuer offering group health insurance coverage and providing or covering any benefit with respect to items or services shall include, in clear writing, on any physical or electronic plan or insurance identification card issued to the participants or beneficiaries in the plan or coverage the following:

"(1) Any deductible applicable to such plan or coverage.

"(2) Any out-of-pocket maximum limitation applicable to such plan or coverage.

"(3) A telephone number and Internet website address through which such individual may seek consumer assistance information, such as information related to hospitals and urgent care facilities that have in effect a contractual relationship with such plan or coverage for furnishing items and services under such plan or coverage".

(c) IRC. — Section 9816 of the Internal Revenue Code of 1986, as added by section 102(c) and amended by section 103, is further amended by adding at the end the following new subsection:

"(e) TRANSPARENCY REGARDING IN-NETWORK AND OUT-OF-NETWORK DEDUCTIBLES AND OUT-OF-POCKET LIMITATIONS. — A group health plan providing or covering any benefit with respect to items or services shall include, in clear writing, on any physical or electronic plan or insurance identification card issued to the participants or beneficiaries in the plan the following:

"(1) Any deductible applicable to such plan.

"(2) Any out-of-pocket maximum limitation applicable to such plan.

"(3) A telephone number and Internet website address through which such individual may seek consumer assistance information, such as information related to hospitals and urgent care facilities that have in effect a contractual relationship with such plan for furnishing items and services under such plan.".

(d) EFFECTIVE DATE. — The amendments made by this subsection shall apply with respect to plan years beginning on or after January 1, 2022.

SEC.108. IMPLEMENTING PROTECTIONS AGAINST PROVIDER DISCRIMINATION.

Not later than January 1, 2022, the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury shall issue a proposed rule implementing the protections of section 2706(a) of the Public Health Service Act (42 U.S.C. 300gg-5(a)). The Secretaries shall accept and consider public comments on any proposed rule issued pursuant to this subsection for a period of 60 days after the date of such issuance. Not later than 6 months after the date of the conclusion of the comment period, the Secretaries shall issue a final rule implementing the protections of section 2706(a) of the Public Health Service Act (42 U.S.C. 300gg-5(a)).

SEC. 109. REPORTS.

(a) REPORTS IN CONSULTATION WITH FTC AND AG. — Not later than January 1, 2023, and annually thereafter for each of the following 4 years, the Secretary of Health and Human Services, in consultation with the Federal Trade Commission and the Attorney General, shall —

(1) conduct a study on the effects of the provisions of, including amendments made by, this Act on —

(A) any patterns of vertical or horizontal integration of health care facilities, providers, group health plans, or health insurance issuers offering group or individual health insurance coverage;

(B) overall health care costs; and

(C) access to health care items and services, including specialty services, in rural areas and health professional shortage areas, as defined in section 332 of the Public Health Service Act (42 U.S.C. 254e);

(2) for purposes of the reports under paragraph (3), in consultation with the Secretary of Labor and the Secretary of the Treasury, make recommendations for the effective enforcement of subsections (a)(1)(C)(iv) and (b)(1)(C) of section 2799A-1 of the Public Health Service Act, subsections (a)(1)(C)(iv) and (b)(1)(C) of section 716 of the Employee Retirement Income Security Act of 1974, and subsections (a)(1)(C)(iv) and (b)(1)(C) of section 9816 of the Internal Revenue Code of 1986, including with respect to potential challenges to addressing anti-competitive consolidation of health care facilities, providers, group health plans, or health insurance issuers offering group or individual health insurance coverage; and

(3) submit a report on such study and including such recommendations to the Committees on Energy and Commerce; on Education and Labor; on Ways and Means; and on the Judiciary of the House of Representatives and the Committees on Health, Education, Labor, and Pensions; on Commerce, Science, and Transportation; on Finance; and on the Judiciary of the Senate.

(b) GAO REPORT ON IMPACT OF SURPRISE BILLING PROVISIONS. — Not later than January 1, 2025, the Comptroller General of the United States shall submit to Congress a report summarizing the effects of the provisions of this Act, including the amendments made by such provisions, on changes during the period since the date on the enactment of this Act in health care provider networks of group health plans and group and individual health insurance coverage offered by a health insurance issuer, in fee schedules and amounts for health care services, and to contracted rates under such plans or coverage. Such report shall —

(1) to the extent practicable, sample a statistically significant group of national health care providers;

(2) examine —

(A) provider network participation, including non-participating providers furnishing items and services at participating facilities;

(B) health care provider group network participation, including specialty, size, and ownership;

(C) the impact of State surprise billing laws and network adequacy standards on participation of health care providers and facilities in provider networks of group health plans and of group and individual health insurance coverage offered by health insurance issuers; and

(D) access to providers, including in rural and medically underserved communities and health professional shortage areas (as defined in section 332 of the Public Health Service Act), and the extent of provider shortages in such communities and areas;

(3) to the extent practicable, sample a statistically significant group of national health insurance plans and issuers and examine —

(E) the effects of the provisions of, including amendments made by, this Act on premiums and out-of-pocket costs with respect to group health plans or group or individual health insurance coverage;

(B) the adequacy of provider networks with respect to such plans or coverage; and

(C) categories of providers of ancillary services, as defined in section 2799B-2(b)(2) of the Public Health Service Act, for which such plans have no or a limited number of in-network providers; and

(4) such other relevant effects of such provisions and amendments.

(c) GAO REPORT ON ADEQUACY OF PROVIDER NETWORKS. — Not later than January 1, 2023, the Comptroller General of the United States shall submit to Congress, and make publicly available, a report on the adequacy of provider networks in group health plans and group and individual health insurance coverage, including legislative recommendations to improve the adequacy of such networks.

(d) GAO REPORT ON IDR PROCESS AND POTENTIAL FINANCIAL RELATIONSHIPS. — Not later than December 31, 2023, the Comptroller General of the United States shall conduct a study and submit to Congress a report on the IDR process established under this section. Such study and report shall include an analysis of potential financial relationships between providers and facilities that utilize the IDR process established by the amendments made by this Act and private equity investment firms.

SEC. 110.CONSUMER PROTECTIONS THROUGH APPLICATION OF HEALTH PLAN EXTERNAL REVIEW IN CASES OF CERTAIN SURPRISE MEDICAL BILLS.

(a) IN GENERAL. — In applying the provisions of section 2719(b) of the Public Health Service Act (42 U.S.C. 300gg-19(b)) to group health plans and health insurance issuers offering group or individual health insurance coverage, the Secretary of Health and Human Services, Secretary of Labor, and Secretary of the Treasury, shall require, beginning not later than January 1, 2022, the external review process described in paragraph (1) of such section to apply with respect to any adverse determination by such a plan or issuer under section 2799A-1 or 2799A-2, section 716 or 717 of the Employee Retirement Income Security Act of 1974, or section 9816 or 9817 of the Internal Revenue Code of 1986, including with respect to whether an item or service that is the subject to such a determination is an item or service to which such respective section applies.

(b) DEFINITIONS. — The terms "group health plan"; "health insurance issuer"; "group health insurance coverage", and "individual health insurance coverage" have the meanings given such terms in section 2791 of the Public Health Service Act (42 U.S.C. 300gg-91), section 733 of the Employee Retirement Income Security Act (29 U.S.C. 1191b), and section 9832 of the Internal Revenue Code, as applicable.

SEC.111. CONSUMER PROTECTIONS THROUGH HEALTH PLAN REQUIREMENT FOR FAIR AND HONEST ADVANCE COST ESTIMATE.

(a) PHSA AMENDMENT. — Section 2799A-1 of the Public Health Service Act (42 U.S.C. 300gg-19a), as added by section 102 and as further amended by the previous provisions of this title, is further amended by adding at the end the following new subsection:

"(f) ADVANCED EXPLANATION OF BENEFITS. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, each group health plan, or a health insurance issuer offering group or individual health insurance coverage shall, with respect to a notification submitted under section 2799B-6 by a health care provider or health care facility to the plan or issuer for a participant, beneficiary, or enrollee under plan or coverage scheduled to receive an item or service from the provider or facility (or authorized representative of such participant, beneficiary, or enrollee), not later than 1 business day (or, in the case such item or service was so scheduled at least 10 business days before such item or service is to be furnished (or in the case of a request made to such plan or coverage by such participant, beneficiary, or enrollee), 3 business days) after the date on which the plan or coverage receives such notification (or such request), provide to the participant, beneficiary, or enrollee (through mail or electronic means, as requested by the participant, beneficiary, or enrollee) a notification (in clear and understandable language) including the following:

"(A) Whether or not the provider or facility is a participating provider or a participating facility with respect to the plan or coverage with respect to the furnishing of such item or service and —

"(i) in the case the provider or facility is a participating provider or facility with respect to the plan or coverage with respect to the furnishing of such item or service, the contracted rate under such plan or coverage for such item or service (based on the billing and diagnostic codes provided by such provider or facility); and

"(ii) in the case the provider or facility is a non-participating provider or facility with respect to such plan or coverage, a description of how such individual may obtain information on providers and facilities that, with respect to such plan or coverage, are participating providers and facilities, if any.

"(B) The good faith estimate included in the notification received from the provider or facility (if applicable) based on such codes.

"(C) A good faith estimate of the amount the plan or coverage is responsible for paying for items and services included in the estimate described in subparagraph (B).

"(D) A good faith estimate of the amount of any cost-sharing for which the participant, beneficiary, or enrollee would be responsible for such item or service (as of the date of such notification).

"(E) A good faith estimate of the amount that the participant, beneficiary, or enrollee has incurred toward meeting the limit of the financial responsibility (including with respect to deductibles and out-of-pocket maximums) under the plan or coverage (as of the date of such notification).

"(F) In the case such item or service is subject to a medical management technique (including concurrent review, prior authorization, and step-therapy or fail-first protocols) for coverage under the plan or coverage, a disclaimer that coverage for such item or service is subject to such medical management technique.

"(G) A disclaimer that the information provided in the notification is only an estimate based on the items and services reasonably expected, at the time of scheduling (or requesting) the item or service, to be furnished and is subject to change.

"(H) Any other information or disclaimer the plan or coverage determines appropriate that is consistent with information and disclaimers required under this section.

"(2) AUTHORITY TO MODIFY TIMING REQUIREMENTS IN THE CASE OF SPECIFIED ITEMS AND SERVICES. —

"(A) IN GENERAL. — In the case of a participant, beneficiary, or enrollee scheduled to receive an item or service that is a specified item or service (as defined in subparagraph (B)), the Secretary may modify any timing requirements relating to the provision of the notification described in paragraph (1) to such participant, beneficiary, or enrollee with respect to such item or service. Any modification made by the Secretary pursuant to the previous sentence may not result in the provision of such notification after such participant, beneficiary, or enrollee has been furnished such item or service.

"(B) SPECIFIED ITEM OR SERVICE DEFINED. — For purposes of subparagraph (A), the term 'specified item or service' means an item or service that has low utilization or significant variation in costs (such as when furnished as part of a complex treatment), as specified by the Secretary.".

(b) IRC AMENDMENTS. — Section 9816 of the Internal Revenue Code of 1986, as added by section 102 and further amended by the previous provisions of this title, is further amended by inserting after subsection (e) the following new subsection:

"(f) ADVANCED EXPLANATION OF BENEFITS. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, each group health plan shall, with respect to a notification submitted under section 2799B-6 of the Public Health Service Act by a health care provider or health care facility to the plan for a participant or beneficiary under plan scheduled to receive an item or service from the provider or facility (or authorized representative of such participant or beneficiary), not later than 1 business day (or, in the case such item or service was so scheduled at least 10 business days before such item or service is to be furnished (or in the case of a request made to such plan or coverage by such participant or beneficiary), 3 business days) after the date on which the plan receives such notification (or such request), provide to the participant or beneficiary (through mail or electronic means, as requested by the participant or beneficiary) a notification (in clear and understandable language) including the following:

"(A) Whether or not the provider or facility is a participating provider or a participating facility with respect to the plan with respect to the furnishing of such item or service and —

"(i) in the case the provider or facility is a participating provider or facility with respect to the plan or coverage with respect to the furnishing of such item or service, the contracted rate under such plan for such item or service (based on the billing and diagnostic codes provided by such provider or facility); and

"(ii) in the case the provider or facility is a non-participating provider or facility with respect to such plan, a description of how such individual may obtain information on providers and facilities that, with respect to such plan, are participating providers and facilities, if any.

"(B) The good faith estimate included in the notification received from the provider or facility (if applicable) based on such codes.

"(C) A good faith estimate of the amount the plan is responsible for paying for items and services included in the estimate described in subparagraph (B).

"(D) A good faith estimate of the amount of any cost-sharing for which the participant or beneficiary would be responsible for such item or service (as of the date of such notification).

"(E) A good faith estimate of the amount that the participant or beneficiary has incurred toward meeting the limit of the financial responsibility (including with respect to deductibles and out-of-pocket maximums) under the plan (as of the date of such notification).

"(F) In the case such item or service is subject to a medical management technique (including concurrent review, prior authorization, and step-therapy or fail-first protocols) for coverage under the plan, a disclaimer that coverage for such item or service is subject to such medical management technique.

"(G) A disclaimer that the information provided in the notification is only an estimate based on the items and services reasonably expected, at the time of scheduling (or requesting) the item or service, to be furnished and is subject to change.

"(H) Any other information or disclaimer the plan determines appropriate that is consistent with information and disclaimers required under this section.

"(2) AUTHORITY TO MODIFY TIMING REQUIREMENTS IN THE CASE OF SPECIFIED ITEMS AND SERVICES. —

"(A) IN GENERAL. — In the case of a participant or beneficiary scheduled to receive an item or service that is a specified item or service (as defined in subparagraph (B)), the Secretary may modify any timing requirements relating to the provision of the notification described in paragraph

(1) to such participant or beneficiary with respect to such item or service. Any modification made by the Secretary pursuant to the previous sentence may not result in the provision of such notification after such participant or beneficiary has been furnished such item or service.

"(B) SPECIFIED ITEM OR SERVICE DEFINED. — For purposes of subparagraph (A), the term 'specified item or service' means an item or service that has low utilization or significant variation in costs (such as when furnished as part of a complex treatment), as specified by the Secretary.".

(c) ERISA AMENDMENTS. — Section 716 of the Employee Retirement Income Security Act of 1974, as added by section 102 and further amended by the previous amendments of this title, is further amended by adding at the end the following new subsection:

"(f) ADVANCED EXPLANATION OF BENEFITS. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, each group health plan, or a health insurance issuer offering group health insurance coverage shall, with respect to a notification submitted under section 2799B-6 of the Public Health Service Act by a health care provider or health care facility to the plan or issuer for a participant or beneficiary under plan or coverage scheduled to receive an item or service from the provider or facility (or authorized representative of such participant or beneficiary), not later than 1 business day (or, in the case such item or service was so scheduled at least 10 business days before such item or service is to be furnished (or in the case of a request made to such plan or coverage by such participant or beneficiary), 3 business days) after the date on which the plan or coverage receives such notification (or such request), provide to the participant or beneficiary (through mail or electronic means, as requested by the participant or beneficiary) a notification (in clear and understandable language) including the following: "(A) Whether or not the provider or facility is a participating provider or a participating facility with respect to the plan or coverage with respect to the furnishing of such item or service and —

"(i) in the case the provider or facility is a participating provider or facility with respect to the plan or coverage with respect to the furnishing of such item or service, the contracted rate under such plan for such item or service (based on the billing and diagnostic codes provided by such provider or facility); and

"(ii) in the case the provider or facility is a non-participating provider or facility with respect to such plan or coverage, a description of how such individual may obtain information on providers and facilities that, with respect to such plan or coverage, are participating providers and facilities, if any.

"(B) The good faith estimate included in the notification received from the provider or facility (if applicable) based on such codes.

"(C) A good faith estimate of the amount the health plan is responsible for paying for items and services included in the estimate described in subparagraph (B).

"(D) A good faith estimate of the amount of any cost-sharing for which the participant or beneficiary would be responsible for such item or service (as of the date of such notification).

"(E) A good faith estimate of the amount that the participant or beneficiary has incurred toward meeting the limit of the financial responsibility (including with respect to deductibles and out-of-pocket maximums) under the plan or coverage (as of the date of such notification).

"(F) In the case such item or service is subject to a medical management technique (including concurrent review, prior authorization, and step-therapy or fail-first protocols) for coverage under the plan or coverage, a disclaimer that coverage for such item or service is subject to such medical management technique.

"(G) A disclaimer that the information provided in the notification is only an estimate based on the items and services reasonably expected, at the time of scheduling (or requesting) the item or service, to be furnished and is subject to change.

"(H) Any other information or disclaimer the plan or coverage determines appropriate that is consistent with information and disclaimers required under this section.

"(2) AUTHORITY TO MODIFY TIMING REQUIREMENTS IN THE CASE OF SPECIFIED ITEMS AND SERVICES. —

"(A) IN GENERAL. — In the case of a participant or beneficiary scheduled to receive an item or service that is a specified item or service (as defined in subparagraph (B)), the Secretary may modify any timing requirements relating to the provision of the notification described in paragraph

(1) to such participant or beneficiary with respect to such item or service. Any modification made by the Secretary pursuant to the previous sentence may not result in the provision of such notification after such participant or beneficiary has been furnished such item or service.

"(B) SPECIFIED ITEM OR SERVICE DEFINED. — For purposes of subparagraph (A), the term 'specified item or service' means an item or service that has low utilization or significant variation in costs (such as when furnished as part of a complex treatment), as specified by the Secretary.".

SEC. 112. PATIENT PROTECTIONS THROUGH TRANSPARENCY AND PATIENT-PROVIDER DISPUTE RESOLUTION.

Part E of title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), as added by section 104 and further amended by the previous provisions of this title, is further amended by adding at the end the following new sections:

"SEC. 2799B-6. PROVISION OF INFORMATION UPON REQUEST AND FOR SCHEDULED APPOINTMENTS.

"Each health care provider and health care facility shall, beginning January 1, 2022, in the case of an individual who schedules an item or service to be furnished to such individual by such provider or facility at least 3 business days before the date such item or service is to be so furnished, not later than 1 business day after the date of such scheduling (or, in the case of such an item or service scheduled at least 10 business days before the date such item or service is to be so furnished (or if requested by the individual), not later than 3 business days after the date of such scheduling or such request) —

"(1) inquire if such individual is enrolled in a group health plan, group or individual health insurance coverage offered by a health insurance issuer, or a Federal health care program (and if is so enrolled in such plan or coverage, seeking to have a claim for such item or service submitted to such plan or coverage); and

"(2) provide a notification (in clear and understandable language) of the good faith estimate of the expected charges for furnishing such item or service (including any item or service that is reasonably expected to be provided in conjunction with such scheduled item or service and such an item or service reasonably expected to be so provided by another health care provider or health care facility), with the expected billing and diagnostic codes for any such item or service, to —

"(A) in the case the individual is enrolled in such a plan or such coverage (and is seeking to have a claim for such item or service submitted to such plan or coverage), such plan or issuer of such coverage; and

"(B) in the case the individual is not described in subparagraph (A) and not enrolled in a Federal health care program, the individual.

"SEC. 2799B-7. PATIENT-PROVIDER DISPUTE RESOLUTION.

"(a) IN GENERAL. — Not later than January 1, 2022, the Secretary shall establish a process (in this subsection referred to as the 'patient-provider dispute resolution process') under which an uninsured individual, with respect to an item or service, who received, pursuant to section 2799B-6, from a health care provider or health care facility a good-faith estimate of the expected charges for furnishing such item or service to such individual and who after being furnished such item or service by such provider or facility is billed by such provider or facility for such item or service for charges that are substantially in excess of such estimate, may seek a determination from a selected dispute resolution entity for the charges to be paid by such individual (in lieu of such amount so billed) to such provider or facility for such item or service. For purposes of this subsection, the term 'uninsured individual' means, with respect to an item or service, an individual who does not have benefits for such item or service under a group health plan, group or individual health insurance coverage offered by a health insurance issuer, Federal health care program (as defined in section 1128B(f) of the Social Security Act), or a health benefits plan under chapter 89 of title 5, United States Code (or an individual who has benefits for such item or service under a group health plan or individual or group health insurance coverage offered by a health insurance issuer, but who does not seek to have a claim for such item or service submitted to such plan or coverage).

"(b) SELECTION OF ENTITIES. — Under the patient-provider dispute resolution process, the Secretary shall, with respect to a determination sought by an individual under subsection (a), with respect to charges to be paid by such individual to a health care provider or health care facility described in such paragraph for an item or service furnished to such individual by such provider or facility, provide for —

"(1) a method to select to make such determination an entity certified under subsection (d) that —

"(A) is not a party to such determination or an employee or agent of such party;

"(B) does not have a material familial, financial, or professional relationship with such a party; and

"(C) does not otherwise have a conflict of interest with such a party (as determined by the Secretary); and

"(2) the provision of a notification of such selection to the individual and the provider or facility (as applicable) party to such determination.

An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the 'selected dispute resolution entity' with respect to such determination.

"(c) ADMINISTRATIVE FEE. — The Secretary shall establish a fee to participate in the patient-provider dispute resolution process in such a manner as to not create a barrier to an uninsured individual's access to such process.

"(d) CERTIFICATION. — The Secretary shall establish or recognize a process to certify entities under this subparagraph. Such process shall ensure that an entity so certified satisfies at least the criteria specified in section 2799A-1(c).".

SEC. 113. ENSURING CONTINUITY OF CARE.

(a) PUBLIC HEALTH SERVICE ACT. — Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended, in the part D, as added and amended by section 102(a) and further amended by the previous provisions of this title, by inserting after section 2799A-2 the following new section:

"SEC. 2799A-3. CONTINUITY OF CARE.

"(a) ENSURING CONTINUITY OF CARE WITH RESPECT TO TERMINATIONS OF CERTAIN CONTRACTUAL RELATIONSHIPS RESULTING IN CHANGES IN PROVIDER NETWORK STATUS. —

"(1) IN GENERAL. — In the case of an individual with benefits under a group health plan or group or individual health insurance coverage offered by a health insurance issuer and with respect to a health care provider or facility that has a contractual relationship with such plan or such issuer (as applicable) for furnishing items and services under such plan or such coverage, if, while such individual is a continuing care patient (as defined in subsection (b)) with respect to such provider or facility —

"(A) such contractual relationship is terminated (as defined in subsection (b));

"(B) benefits provided under such plan or such health insurance coverage with respect to such provider or facility are terminated because of a change in the terms of the participation of such provider or facility in such plan or coverage; or

"(C) a contract between such group health plan and a health insurance issuer offering health insurance
coverage in connection with such plan is terminated, resulting in a loss of benefits provided under such plan with respect to such provider or facility; the plan or issuer, respectively, shall meet the requirements of paragraph (2) with respect to such individual.

"(2) REQUIREMENTS. — The requirements of this paragraph are that the plan or issuer —

"(A) notify each individual enrolled under such plan or coverage who is a continuing care patient with respect to a provider or facility at the time of a termination described in paragraph (1) affecting such provider or facility on a timely basis of such termination and such individual's right to elect continued transitional care from such provider or facility under this section;

"(B) provide such individual with an opportunity to notify the plan or issuer of the individual's need for transitional care; and

"(C) permit the patient to elect to continue to have benefits provided under such plan or such coverage, under the same terms and conditions as would have applied and with respect to such items and services as would have been covered under such plan or coverage had such termination not occurred, with respect to the course of treatment furnished by such provider or facility relating to such individual's status as a continuing care patient during the period beginning on the date on which the notice under subparagraph (A) is provided and ending on the earlier of —

"(i) the 90-day period beginning on such date; or

"(ii) the date on which such individual is no longer a continuing care patient with respect to such provider or facility.

"(b) DEFINITIONS. — In this section:

"(1) CONTINUING CARE PATIENT. — The term 'continuing care patient' means an individual who, with respect to a provider or facility —

"(A) is undergoing a course of treatment for a serious and complex condition from the provider or facility;

"(B) is undergoing a course of institutional or inpatient care from the provider or facility;

"(C) is scheduled to undergo nonelective surgery from the provider, including receipt of postoperative care from such provider or facility with respect to such a surgery;

"(D) is pregnant and undergoing a course of treatment for the pregnancy from the provider or facility; or

"(E) is or was determined to be terminally ill (as determined under section 1861(dd)(3)(A) of the Social Security Act) and is receiving treatment for such illness from such provider or facility.

"(2) SERIOUS AND COMPLEX CONDITION. — The term 'serious and complex condition' means, with respect to a participant, beneficiary, or enrollee under a group health plan or group or individual health insurance coverage —

"(A) in the case of an acute illness, a condition that is serious enough to require specialized medical treatment to avoid the reasonable possibility of death or permanent harm; or

"(B) in the case of a chronic illness or condition, a condition that is —

"(i) is life-threatening, degenerative, potentially disabling, or congenital; and

"(ii) requires specialized medical care over a prolonged period of time.

"(3) TERMINATED. — The term 'terminated' includes, with respect to a contract, the expiration or nonrenewal of the contract, but does not include a termination of the contract for failure to meet applicable quality standards or for fraud.".

(b) INTERNAL REVENUE CODE. —

(1) IN GENERAL. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by sections 102(c) and 105(a)(3), is further amended by inserting after section 9817 the following new section:

"SEC. 9818. CONTINUITY OF CARE.

"(a) ENSURING CONTINUITY OF CARE WITH RESPECT TO TERMINATIONS OF CERTAIN CONTRACTUAL RELATIONSHIPS RESULTING IN CHANGES IN PROVIDER NETWORK STATUS. —

"(1) IN GENERAL. — In the case of an individual with benefits under a group health plan and with respect to a health care provider or facility that has a contractual relationship with such plan for furnishing items and services under such plan, if, while such individual is a continuing care patient (as defined in subsection (b)) with respect to such provider or facility —

"(A) such contractual relationship is terminated (as defined in paragraph (b));

"(B) benefits provided under such plan with respect to such provider or facility are terminated because of a change in the terms of the participation of such provider or facility in such plan; or

"(C) a contract between such group health plan and a health insurance issuer offering health insurance coverage in connection with such plan is terminated, resulting in a loss of benefits provided under such plan with respect to such provider or facility;

the plan shall meet the requirements of paragraph (2) with respect to such individual.

"(2) REQUIREMENTS. — The requirements of this paragraph are that the plan —

"(A) notify each individual enrolled under such plan who is a continuing care patient with respect to a provider or facility at the time of a termination described in paragraph (1) affecting such provider on a timely basis of such termination and such individual's right to elect continued transitional care from such provider or facility under this section;

"(B) provide such individual with an opportunity to notify the plan of the individual's need for transitional care; and

"(C) permit the patient to elect to continue to have benefits provided under such plan, under the same terms and conditions as would have applied and with respect to such items and services as would have been covered under such plan had such termination not occurred, with respect to the course of treatment furnished by such provider or facility relating to such individual's status as a continuing care patient during the period beginning on the date on which the notice under subparagraph (A) is provided and ending on the earlier of —

"(i) the 90-day period beginning on such date; or

"(ii) the date on which such individual is no longer a continuing care patient with respect to such provider or facility.

"(b) DEFINITIONS. — In this section:

"(1) CONTINUING CARE PATIENT. — The term 'continuing care patient' means an individual who, with respect to a provider or facility —

"(A) is undergoing a course of treatment for a serious and complex condition from the provider or facility;

"(B) is undergoing a course of institutional or inpatient care from the provider or facility;

"(C) is scheduled to undergo nonelective surgery from the provider or facility, including receipt of postoperative care from such provider or facility with respect to such a surgery;

"(D) is pregnant and undergoing a course of treatment for the pregnancy from the provider or facility; or

"(E) is or was determined to be terminally ill (as determined under section 1861(dd)(3)(A) of the Social Security Act) and is receiving treatment for such illness from such provider or facility.

"(2) SERIOUS AND COMPLEX CONDITION. — The term 'serious and complex condition' means, with respect to a participant or beneficiary under a group health plan —

"(A) in the case of an acute illness, a condition that is serious enough to require specialized medical treatment to avoid the reasonable possibility of death or permanent harm; or

"(B) in the case of a chronic illness or condition, a condition that —

"(i) is life-threatening, degenerative, potentially disabling, or congenital; and

"(ii) requires specialized medical care over a prolonged period of time.

"(3) TERMINATED. — The term 'terminated' includes, with respect to a contract, the expiration or nonrenewal of the contract, but does not include a termination of the contract for failure to meet applicable quality standards or for fraud.".

(2) CLERICAL AMENDMENT. — The table of sections for such subchapter, as amended by the previous sections, is further amended by inserting after the item relating to section 9817 the following new item:

"Sec. 9818. Continuity of care.".

(c) EMPLOYEE RETIREMENT INCOME SECURITY ACT. —

(1) IN GENERAL. — Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.), as amended by section 102(c) and further amended by the previous provisions of this title, is further amended by inserting after section 717 the following new section:

"SEC. 718. CONTINUITY OF CARE.

"(a) ENSURING CONTINUITY OF CARE WITH RESPECT TO TERMINATIONS OF CERTAIN CONTRACTUAL RELATIONSHIPS RESULTING IN CHANGES IN PROVIDER NETWORK STATUS. —

"(1) IN GENERAL. — In the case of an individual with benefits under a group health plan or group health insurance coverage offered by a health insurance issuer and with respect to a health care provider or facility that has a contractual relationship with such plan or such issuer (as applicable) for furnishing items and services under such plan or such coverage, if, while such individual is a continuing care patient (as defined in subsection (b)) with respect to such provider or facility —

"(A) such contractual relationship is terminated (as defined in paragraph (b));

"(B) benefits provided under such plan or such health insurance coverage with respect to such provider or facility are terminated because of a change in the terms of the participation of the provider or facility in such plan or coverage; or

"(C) a contract between such group health plan and a health insurance issuer offering health insurance coverage in connection with such plan is terminated, resulting in a loss of benefits provided under such plan with respect to such provider or facility; the plan or issuer, respectively, shall meet the requirements of paragraph (2) with respect to such individual.

"(2) REQUIREMENTS. — The requirements of this paragraph are that the plan or issuer —

"(A) notify each individual enrolled under such plan or coverage who is a continuing care patient with respect to a provider or facility at the time of a termination described in paragraph (1) affecting such provider or facility on a timely basis of such termination and such individual's right to elect continued transitional care from such provider or facility under this section;

"(B) provide such individual with an opportunity to notify the plan or issuer of the individual's need for transitional care; and

"(C) permit the patient to elect to continue to have benefits provided under such plan or such coverage, under the same terms and conditions as would have applied and with respect to such items and services as would have been covered under such plan or coverage had such termination not occurred, with respect to the course of treatment furnished by such provider or facility relating to such individual's status as a continuing care patient during the period beginning on the date on which the notice under subparagraph (A) is provided and ending on the earlier of —

"(i) the 90-day period beginning on such date; or

"(ii) the date on which such individual is no longer a continuing care patient with respect to such provider or facility.

"(b) DEFINITIONS. — In this section:

"(1) CONTINUING CARE PATIENT. — The term 'continuing care patient' means an individual who, with respect to a provider or facility —

"(A) is undergoing a course of treatment for a serious and complex condition from the provider or facility;

"(B) is undergoing a course of institutional or inpatient care from the provider or facility;

"(C) is scheduled to undergo nonelective surgery from the provide or facility, including receipt of postoperative care from such provider or facility with respect to such a surgery;

"(D) is pregnant and undergoing a course of treatment for the pregnancy from the provider or facility; or

"(E) is or was determined to be terminally ill (as determined under section 1861(dd)(3)(A) of the Social Security Act) and is receiving treatment for such illness from such provider or facility.

"(2) SERIOUS AND COMPLEX CONDITION. — The term 'serious and complex condition' means, with respect to a participant or beneficiary under a group health plan or group health insurance coverage —

"(A) in the case of an acute illness, a condition that is serious enough to require specialized medical treatment to avoid the reasonable possibility of death or permanent harm; or

"(B) in the case of a chronic illness or condition, a condition that —

"(i) is life-threatening, degenerative, potentially disabling, or congenital; and

"(ii) requires specialized medical care over a prolonged period of time.

"(3) TERMINATED. — The term 'terminated' includes, with respect to a contract, the expiration or nonrenewal of the contract, but does not include a termination of the contract for failure to meet applicable quality standards or for fraud.".

(2) CLERICAL AMENDMENT. — The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 is amended by inserting after the item relating to section 716 the following new item:

"Sec. 718. Continuity of care.".

(d) PROVIDER REQUIREMENT. — Part E of title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), as added by section 104 and further amended by the previous provisions of this title, is further amended by adding at the end the following new section:

"SEC. 2799B-8. CONTINUITY OF CARE.

"A health care provider or health care facility shall, in the case of an individual furnished items and services by such provider or facility for which coverage is provided under a group health plan or group or individual health insurance coverage pursuant to section 2799A-3, section 9818 of the Internal Revenue Code of 1986, or section 718 of the Employee Retirement Income Security Act of 1974 —

"(1) accept payment from such plan or such issuer (as applicable) (and cost-sharing from such individual, if applicable, in accordance with subsection (a)(2)(C) of such section 2799A-3, 9818, or 718) for such items and services as payment in full for such items and services; and

"(2) continue to adhere to all policies, procedures, and quality standards imposed by such plan or issuer with respect to such individual and such items and services in the same manner as if such termination had not occurred.".

(e) EFFECTIVE DATE. — The amendments made by subsections (a), (b), and (c) shall apply with respect to plan years beginning on or after January 1, 2022.

SEC. 114. MAINTENANCE OF PRICE COMPARISON TOOL.

(a) PUBLIC HEALTH SERVICE ACT. — Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended, in part D, as added and amended by section 102 and further amended by the previous provisions of this title, by inserting after section 2799A-3 the following new section:

"SEC. 2799A-4. MAINTENANCE OF PRICE COMPARISON TOOL.

"A group health plan or a health insurance issuer offering group or individual health insurance coverage shall offer price comparison guidance by telephone and make available on the Internet website of the plan or issuer a price comparison tool that (to the extent practicable) allows an individual enrolled under such plan or coverage, with respect to such plan year, such geographic region, and participating providers with respect to such plan or coverage, to compare the amount of cost-sharing that the individual would be responsible for paying under such plan or coverage with respect to the furnishing of a specific item or service by any such provider.".

(b) INTERNAL REVENUE CODE. —

(1) IN GENERAL. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by sections 102, 105, and 113, is further amended by inserting after section 9818 the following new section:

"SEC. 9819. MAINTENANCE OF PRICE COMPARISON TOOL.

"A group health plan shall offer price comparison guidance by telephone and make available on the Internet website of the plan or issuer a price comparison tool that (to the extent practicable) allows an individual enrolled under such plan, with respect to such plan year, such geographic region, and participating providers with respect to such plan or coverage, to compare the amount of cost-sharing that the individual would be responsible for paying under such plan with respect to the furnishing of a specific item or service by any such provider.".

(2) CLERICAL AMENDMENT. — The table of sections for such subchapter, as amended by the previous sections, is further amended by inserting after the item relating to section 9818 the following new item:

"Sec. 9819. Maintenance of price comparison tool.".

(c) EMPLOYEE RETIREMENT INCOME SECURITY ACT. —

(1) IN GENERAL. — Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.), as amended by sections 102, 105, and 113, is further amended by inserting after section 718 the following new section:

"SEC. 719. MAINTENANCE OF PRICE COMPARISON TOOL.

"A group health plan or a health insurance issuer offering group health insurance coverage shall offer price comparison guidance by telephone and make available on the Internet website of the plan or issuer a price comparison tool that (to the extent practicable) allows an individual enrolled under such plan or coverage, with respect to such plan year, such geographic region, and participating providers with respect to such plan or coverage, to compare the amount of cost-sharing that the individual would be responsible for paying under such plan or coverage with respect to the furnishing of a specific item o r service by any such provider.".

(2) CLERICAL AMENDMENT. — The table of contents in section 1 of the Employee Retirement Income Security Act of 1974, as amended by the previous provisions of this title, is further amended by inserting after the item relating to section 716 the following new item:

"Sec. 719. Maintenance of price comparison tool.".

(d) EFFECTIVE DATE. — The amendments made by this section shall apply with respect to plan years beginning on or after January 1, 2022.

SEC. 115. STATE ALL PAYER CLAIMS DATABASES.

(a) GRANTS TO STATES. — Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by adding at the end the following:

"SEC. 320B. STATE ALL PAYER CLAIMS DATABASES.

"(a) IN GENERAL. — The Secretary shall make one-time grants to eligible States for the purposes described in subsection (b).

"(b) USES. — A State may use a grant received under subsection (a) for one of the following purposes:

"(1) To establish a State All Payer Claims Database.

"(2) To improve an existing State All Payer Claims Databases.

"(c) ELIGIBILITY. — To be eligible to receive a grant under subsection (a), a State shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary specifies, including, with respect to a State All Payer Claims Database, at least specifics on how the State will ensure uniform data collection and the privacy and security of such data.

"(d) GRANT PERIOD AND AMOUNT. — Grants awarded under this section shall be for a period of 3-years, and in an amount of $2,500,000, of which $1,000,000 shall be made available to the State for each of the first 2 years of the grant period, and $500,000 shall be made available to the State for the third year of the grant period.

"(e) AUTHORIZED USERS. —

"(1) APPLICATION. — An entity desiring authorization for access to a State All Payer Claims Database that has received a grant under this section shall submit to the State All Payer Claims Database an application for such access, which shall include —

"(A) in the case of an entity requesting access for research purposes —

"(i) a description of the uses and methodologies for evaluating health system performance using such data; and

"(ii) documentation of approval of the research by an institutional review board, if applicable for a particular plan of research; or

"(B) in the case of an entity such as an employer, health insurance issuer, third-party administrator, or health care provider, requesting access for the purpose of quality improvement or cost-containment, a description of the intended uses for such data.

"(2) REQUIREMENTS. —

"(A) ACCESS FOR RESEARCH PURPOSES. — Upon approval of an application for research purposes under paragraph (1)(A), the authorized user shall enter into a data use and confidentiality agreement with the State All Payer Claims Database that has received a grant under this subsection, which shall include a prohibition on attempts to reidentify and disclose individually identifiable health information and proprietary financial information.

"(B) CUSTOMIZED REPORTS. — Employers and employer organizations may request customized reports from a State All Payer Claims Database that has received a grant under this section, at cost, subject to the requirements of this section with respect to privacy, security, and proprietary financial information.

"(C) NON-CUSTOMIZED REPORTS. — A State All Payer Claims Database that has received a grant under this section shall make available to all authorized users aggregate data sets available through the State All Payer Claims Database, free of charge.

"(3) WAIVERS. — The Secretary may waive the requirements of this subsection of a State All Payer Claims Database to provide access of entities to such database if such State All Payer Claims Database is substantially in compliance with this subsection.

"(f) EXPANDED ACCESS. —

"(1) MULTI-STATE APPLICATIONS. — The Secretary may prioritize applications submitted by a State whose application demonstrates that the State will work with other State All Payer Claims Databases to establish a single application for access to data by authorized users across multiple States.

"(2) EXPANSION OF DATA SETS. — The Secretary may prioritize applications submitted by a State whose application demonstrates that the State will implement the reporting format for self-insured group health plans described in section 735 of the Employee Retirement Income Security Act of 1974.

"(g) DEFINITIONS. — In this section —

"(1) the term 'individually identifiable health information' has the meaning given such term in section 1171(6) of the Social Security Act;

"(2) the term 'proprietary financial information' means data that would disclose the terms of a specific contract between an individual health care provider or facility and a specific group health plan, managed care entity (as defined in section 1932(a)(1)(B) of the Social Security Act) or other managed care organization, or health insurance issuer offering group or individual health insurance coverage; and

"(3) the term 'State All Payer Claims Database' means, with respect to a State, a database that may include medical claims, pharmacy claims, dental claims, and eligibility and provider files, which are collected from private and public payers.

"(h) AUTHORIZATION OF APPROPRIATIONS. — To carry out this section, there is authorized to be appropriated $50,000,000 for each of fiscal years 2022 and 2023, and $25,000,000 for fiscal year 2024, to remain available until expended.".

(b) STANDARDIZED REPORTING FORMAT. — Subpart C of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1191 et seq.) is amended by adding at the end the following:

"SEC. 735. STANDARDIZED REPORTING FORMAT.

"(a) IN GENERAL. — Not later than 1 year after the date of enactment of this section, the Secretary shall establish (and periodically update) a standardized reporting format for the voluntary reporting, by group health plans to State All Payer Claims Databases, of medical claims, pharmacy claims, dental claims, and eligibility and provider files that are collected from private and public payers, and shall provide guidance to States on the process by which States may collect such data from such plans in the standardized reporting format.

"(b) CONSULTATION. —

"(1) ADVISORY COMMITTEE. — Not later than 90 days after the date of enactment of this section, the Secretary shall convene an Advisory Committee (referred to in this section as the 'Committee'), consisting of 15 members to advise the Secretary regarding the format and guidance described in paragraph (1).

"(2) MEMBERSHIP. —

"(A) APPOINTMENT. — In accordance with subparagraph (B), not later than 90 days after the date of enactment this section, the Secretary, in coordination with the Secretary of Health and Human Services, shall appoint under subparagraph (B)(iii), and the Comptroller General of the United States shall appoint under subparagraph (B)(iv), members who have distinguished themselves in the fields of health services research, health economics, health informatics, data privacy and security, or the governance of State All Payer Claims Databases, or who represent organizations likely to submit data to or use the database, including patients, employers, or employee organizations that sponsor group health plans, health care providers, health insurance issuers, or third-party administrators of group health plans. Such members shall serve 3-year terms on a staggered basis. Vacancies on the Committee shall be filled by appointment consistent with this paragraph not later than 3 months after the vacancy arises.

"(B) COMPOSITION. — The Committee shall be comprised of —

"(i) the Assistant Secretary of Employee Benefits and Security Administration of the Department of Labor, or a designee of such Assistant Secretary;

"(ii) the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services, or a designee of such Assistant Secretary;

"(iii) members appointed by the Secretary, in coordination with the Secretary of Health and Human Services, including —

"(I) 1 member to serve as the chair of the Committee;

"(II) 1 representative of the Centers for Medicare & Medicaid Services;

"(III) 1 representative of the Agency for Healthcare Research and Quality;

"(IV) 1 representative of the Office for Civil Rights of the Department of Health and Human Services with expertise in data privacy and security;

"(V) 1 representative of the National Center for Health Statistics;

"(VI) 1 representative of the Office of the National Coordinator for Health Information Technology; and

"(VII) 1 representative of a State All-Payer Claims Database;

"(iv) members appointed by the Comptroller General of the United States, including —

"(I) 1 representative of an employer that sponsors a group health plan;

"(II) 1 representative of an employee organization that sponsors a group health plan;

"(III) 1 academic researcher with expertise in health economics or health services research;

"(IV) 1 consumer advocate; and

"(V) 2 additional members.

"(3) REPORT. — Not later than 180 days after the date of enactment of this section, the Committee shall report to the Secretary, the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce and the Committee on Education and Labor of the House of Representatives. Such report shall include recommendations on the establishment of the format and guidance described in subsection (a).

"(c) STATE ALL PAYER CLAIMS DATABASE. — In this section, the term 'State All Payer Claims Database' means, with respect to a State, a database that may include medical claims, pharmacy claims, dental claims, and eligibility and provider files, which are collected from private and public payers.

"(d) AUTHORIZATION OF APPROPRIATIONS. — To carry out this section, there are authorized to be appropriated $5,000,000 for fiscal year 2021, to remain available until expended or, if sooner, until the date described in subsection (e).

"(e) SUNSET. — Beginning on the date on which the report is submitted under subsection (b)(3), subsection (b) shall have no force or effect.".

SEC. 116. PROTECTING PATIENTS AND IMPROVING THE ACCURACY OF PROVIDER DIRECTORY INFORMATION.

(a) PHSA. — Part D of title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), as added and amended by section 102 and further amended by the previous provisions of this title, is further amended by inserting after section 2799A-4 the following:

"SEC.2799A-5. PROTECTING PATIENTS AND IMPROVING THE ACCURACY OF PROVIDER DIRECTORY INFORMATION.

"(a) PROVIDER DIRECTORY INFORMATION REQUIREMENTS. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, each group health plan and health insurance

issuer offering group or individual health insurance coverage shall —

"(A) establish the verification process described in paragraph (2);

"(B) establish the response protocol described in paragraph (3);

"(C) establish the database described in paragraph (4); and

"(D) include in any directory (other than the database described in subparagraph (C)) containing provider directory information with respect to such plan or such coverage the information described in paragraph (5).

"(2) VERIFICATION PROCESS. — The verification process described in this paragraph is, with respect to a group health plan or a health insurance issuer offering group or individual health insurance coverage, a process —

"(A) under which, not less frequently than once every 90 days, such plan or such issuer (as applicable) verifies and updates the provider directory information included on the database described in paragraph (4) of such plan or issuer of each health care provider and health care facility included in such database;

"(B) that establishes a procedure for the removal of such a provider or facility with respect to which such plan or issuer has been unable to verify such information during a period specified by the plan or issuer; and

"(C) that provides for the update of such database within 2 business days of such plan or issuer receiving from such a provider or facility information pursuant to section 2799B-9.

"(3) RESPONSE PROTOCOL. — The response protocol described in this paragraph is, in the case of an individual enrolled under a group health plan or group or individual health insurance coverage offered by a health insurance issuer who requests information through a telephone call or electronic, web-based, or Internet-based means on whether a health care provider or health care facility has a contractual relationship to furnish items and services under such plan or such coverage, a protocol under which such plan or such issuer (as applicable), in the case such request is made through a telephone call —

"(A) responds to such individual as soon as practicable and in no case later than 1 business day after such call is received, through a written electronic or print (as requested by such individual) communication; and

"(B) retains such communication in such individual's file for at least 2 years following such response.

"(4) DATABASE. — The database described in this paragraph is, with respect to a group health plan or health insurance issuer offering group or individual health insurance coverage, a database on the public website of such plan or issuer that contains —

"(A) a list of each health care provider and health care facility with which such plan or such issuer has a direct or indirect contractual relationship for furnishing items and services under such plan or such coverage; and

"(B) provider directory information with respect to each such provider and facility.

"(5) INFORMATION. — The information described in this paragraph is, with respect to a print directory containing provider directory information with respect to a group health plan or individual or group health insurance coverage offered by a health insurance issuer, a notification that such information contained in such directory was accurate as of the date of publication of such directory and that an individual enrolled under such plan or such coverage should consult the database described in paragraph (4) with respect to such plan or such coverage or contact such plan or the issuer of such coverage to obtain the most current provider directory information with respect to such plan or such coverage.

"(6) DEFINITION. — For purposes of this subsection, the term 'provider directory information' includes, with respect to a group health plan and a health insurance issuer offering group or individual health insurance coverage, the name, address, specialty, telephone number, and digital contact information of each health care provider or health care facility with which such plan or such issuer has a contractual relationship for furnishing items and services under such plan or such coverage.

"(7) RULE OF CONSTRUCTION. — Nothing in this section shall be construed to preempt any provision of State law relating to health care provider directories.

"(b) COST-SHARING FOR SERVICES PROVIDED BASED ON RELIANCE ON INCORRECT PROVIDER NETWORK INFORMATION. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, in the case of an item or service furnished to a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer by a nonparticipating provider or a nonparticipating facility, if such item or service would otherwise be covered under such plan or coverage if furnished by a participating provider or participating facility and if either of the criteria described in paragraph (2) applies with respect to such participant, beneficiary, or enrollee and item or service, the plan or coverage —

"(A) shall not impose on such participant, beneficiary, or enrollee a cost-sharing amount for such item or service so furnished that is greater than the cost-sharing amount that would apply under such plan or coverage had such item or service been furnished by a participating provider; and

"(B) shall apply the deductible or out-of-pocket maximum, if any, that would apply if such services were furnished by a participating provider or a participating facility.

"(2) CRITERIA DESCRIBED. — For purposes of paragraph (1), the criteria described in this paragraph, with respect to an item or service furnished to a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer by a nonparticipating provider or a nonparticipating facility, are the following:

"(A) The participant, beneficiary, or enrollee received through a database, provider directory, or response protocol described in subsection (a) information with respect to such item and service to be furnished and such information provided that the provider was a participating provider or facility was a participating facility, with respect to the plan for furnishing such item or service.

"(B) The information was not provided, in accordance with subsection (a), to the participant, beneficiary, or enrollee and the participant, beneficiary, or enrollee requested through the response protocol described in subsection (a)(3) of the plan or coverage information on whether the provider was a participating provider or facility was a participating facility with respect to the plan for furnishing such item or service and was informed through such protocol that the provider was such a participating provider or facility was such a participating facility.

"(c) DISCLOSURE ON PATIENT PROTECTIONS AGAINST BALANCE BILLING. — For plan years beginning on or after January 1, 2022, each group health plan and health insurance issuer offering group or individual health insurance coverage shall make publicly available, post on a public website of such plan or issuer, and include on each explanation of benefits for an item or service with respect to which the requirements under section 2799A-1 applies —

"(1) information in plain language on —

"(A) the requirements and prohibitions applied under sections 2799B-1 and 2799B-2 (relating to prohibitions on balance billing in certain circumstances);

"(B) if provided for under applicable State law, any other requirements on providers and facilities regarding the amounts such providers and facilities may, with respect to an item or service, charge a participant, beneficiary, or enrollee of such plan or coverage with respect to which such a provider or facility does not have a contractual relationship for furnishing such item or service under the plan or coverage after receiving payment from the plan or coverage for such item or service and any applicable cost sharing payment from such participant, beneficiary, or enrollee; and

"(C) the requirements applied under section 2799A-1; and

"(2) information on contacting appropriate State and Federal agencies in the case that an individual believes that such a provider or facility has violated any requirement described in paragraph (1) with respect to such individual.".

(b) ERISA. — Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.), as amended by sections 102, 105, 113, and 114, is further amended by inserting after section 719 the following:

"SEC. 720. PROTECTING PATIENTS AND IMPROVING THE ACCURACY OF PROVIDER DIRECTORY INFORMATION.

"(a) PROVIDER DIRECTORY INFORMATION REQUIREMENTS. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, each group health plan and health insurance issuer offering group health insurance coverage shall —

"(A) establish the verification process described in paragraph (2);

"(B) establish the response protocol described in paragraph (3);

"(C) establish the database described in paragraph (4); and

"(D) include in any directory (other than the database described in subparagraph (C)) containing provider directory information with respect to such plan or such coverage the information described in paragraph (5).

"(2) VERIFICATION PROCESS. — The verification process described in this paragraph is, with respect to a group health plan or a health insurance issuer offering group health insurance coverage, a process —

"(A) under which, not less frequently than once every 90 days, such plan or such issuer (as applicable) verifies and updates the provider directory information included on the database described in paragraph (4) of such plan or issuer of each health care provider and health care facility included in such database;

"(B) that establishes a procedure for the removal of such a provider or facility with respect to which such plan or issuer has been unable to verify such information during a period specified by the plan or issuer; and

"(C) that provides for the update of such database within 2 business days of such plan or issuer receiving from such a provider or facility information pursuant to section 2799B-9 of the Public Health Service Act.

"(3) RESPONSE PROTOCOL. — The response protocol described in this paragraph is, in the case of an individual enrolled under a group health plan or group health insurance coverage offered by a health insurance issuer who requests information through a telephone call or electronic, web-based, or Internet-based means on whether a health care provider or health care facility has a contractual relationship to furnish items and services under such plan or such coverage, a protocol under which such plan or such issuer (as applicable), in the case such request is made through a telephone call —

"(A) responds to such individual as soon as practicable and in no case later than 1 business day after such call is received, through a written electronic or print (as requested by such individual) communication; and

"(B) retains such communication in such individual's file for at least 2 years following such response.

"(4) DATABASE. — The database described in this paragraph is, with respect to a group health plan or health insurance issuer offering group health insurance coverage, a database on the public website of such plan or issuer that contains —

"(A) a list of each health care provider and health care facility with which such plan or such issuer has a direct or indirect contractual relationship for furnishing items and services under such plan or such coverage; and "(B) provider directory information with respect to each such provider and facility.

"(5) INFORMATION. — The information described in this paragraph is, with respect to a print directory containing provider directory information with respect to a group health plan or group health insurance coverage offered by a health insurance issuer, a notification that such information contained in such directory was accurate as of the date of publication of such directory and that an individual enrolled under such plan or such coverage should consult the database described in paragraph (4) with respect to such plan or such coverage or contact such plan or the issuer of such coverage to obtain the most current provider directory information with respect to such plan or such coverage.

"(6) DEFINITION. — For purposes of this subsection, the term 'provider directory information' includes, with respect to a group health plan and a health insurance issuer offering group health insurance coverage, the name, address, specialty, telephone number, and digital contact information of each health care provider or health care facility with which such plan or such issuer has a contractual relationship for furnishing items and services under such plan or such coverage.

"(7) RULE OF CONSTRUCTION. — Nothing in this section shall be construed to preempt any provision of State law relating to health care provider directories, to the extent such State law applies to such plan, coverage, or issuer, subject to section 514.

"(b) COST-SHARING FOR SERVICES PROVIDED BASED ON RELIANCE ON INCORRECT PROVIDER NETWORK INFORMATION. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, in the case of an item or service furnished to a participant or beneficiary of a group health plan or group health insurance coverage offered by a health insurance issuer by a nonparticipating provider or a nonparticipating facility, if such item or service would otherwise be covered under such plan or coverage if furnished by a participating provider or participating facility and if either of the criteria described in paragraph (2) applies with respect to such participant or beneficiary and item or service, the plan or coverage —

"(A) shall not impose on such participant or beneficiary a cost-sharing amount for such item or service so furnished that is greater than the cost-sharing amount that would apply under such plan or coverage had such item or service been furnished by a participating provider; and

"(B) shall apply the deductible or out-of-pocket maximum, if any, that would apply if such services were furnished by a participating provider or a participating facility.

"(2) CRITERIA DESCRIBED. — For purposes of paragraph (1), the criteria described in this paragraph, with respect to an item or service furnished to a participant or beneficiary of a group health plan or group health insurance coverage offered by a health insurance issuer by a nonparticipating provider or a nonparticipating facility, are the following:

"(A) The participant or beneficiary received through a database, provider directory, or response protocol described in subsection (a) information with respect to such item and service to be furnished and such information provided that the provider was a participating provider or facility was a participating facility, with respect to the plan for furnishing such item or service.

"(B) The information was not provided, in accordance with subsection (a), to the participant or beneficiary and the participant or beneficiary requested through the response protocol described in subsection (a)(3) of the plan or coverage information on whether the provider was a participating provider or facility was a participating facility with respect to the plan for furnishing such item or service and was informed through such protocol that the provider was such a participating provider or facility was such a participating facility.

"(c) DISCLOSURE ON PATIENT PROTECTIONS AGAINST BALANCE BILLING. — For plan years beginning on or after January 1, 2022, each group health plan and health insurance issuer offering group health insurance coverage shall make publicly available, post on a public website of such plan or issuer, and include on each explanation of benefits for an item or service with respect to which the requirements under section 716 applies —

"(1) information in plain language on —

"(A) the requirements and prohibitions applied under sections 2799B-1 and 2799B-2 of the Public Health Service Act (relating to prohibitions on balance billing in certain circumstances);

"(B) if provided for under applicable State law, any other requirements on providers and facilities regarding the amounts such providers and facilities may, with respect to an item or service, charge a participant or beneficiary of such plan or coverage with respect to which such a provider or facility does not have a contractual relationship for furnishing such item or service under the plan or coverage after receiving payment from the plan or coverage for such item or service and any applicable cost sharing payment from such participant or beneficiary; and

"(C) the requirements applied under section 716; and "(2) information on contacting appropriate State and Federal agencies in the case that an individual believes that such a provider or facility has violated any requirement described in paragraph (1) with respect to such individual.".

(c) IRC. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by sections 102, 105, 113, and 114, is further amended by inserting after section 9819 the following:

"SEC. 9820. PROTECTING PATIENTS AND IMPROVING THE ACCURACY OF PROVIDER DIRECTORY INFORMATION.

"(a) PROVIDER DIRECTORY INFORMATION REQUIREMENTS. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, each group health plan shall —

"(A) establish the verification process described in paragraph (2);

"(B) establish the response protocol described in paragraph (3);

"(C) establish the database described in paragraph (4); and

"(D) include in any directory (other than the database described in subparagraph (C)) containing provider directory information with respect to such plan the information described in paragraph (5).

"(2) VERIFICATION PROCESS. — The verification process described in this paragraph is, with respect to a group health plan, a process —

"(A) under which, not less frequently than once every 90 days, such plan verifies and updates the provider directory information included on the database described in paragraph (4) of such plan or issuer of each health care provider and health care facility included in such database;

"(B) that establishes a procedure for the removal of such a provider or facility with respect to which such plan or issuer has been unable to verify such information during a period specified by the plan or issuer; and

"(C) that provides for the update of such database within 2 business days of such plan or issuer receiving from such a provider or facility information pursuant to section 2799B-9 of the Public Health Service Act.

"(3) RESPONSE PROTOCOL. — The response protocol described in this paragraph is, in the case of an individual enrolled under a group health plan who requests information through a telephone call or electronic, web-based, or Internet-based means on whether a health care provider or health care facility has a contractual relationship to furnish items and services under such plan, a protocol under which such plan or such issuer (as applicable), in the case such request is made through a telephone call —

"(A) responds to such individual as soon as practicable and in no case later than 1 business day after such call is received, through a written electronic or print (as requested by such individual) communication; and

"(B) retains such communication in such individual's file for at least 2 years following such response.

"(4) DATABASE. — The database described in this paragraph is, with respect to a group health plan, a database on the public website of such plan or issuer that contains —

"(A) a list of each health care provider and health care facility with which such plan or such issuer has a direct or indirect contractual relationship for furnishing items and services under such plan; and

"(B) provider directory information with respect to each such provider and facility.

"(5) INFORMATION. — The information described in this paragraph is, with respect to a print directory containing provider directory information with respect to a group health plan, a notification that such information contained in such directory was accurate as of the date of publication of such directory and that an individual enrolled under such plan should consult the database described in paragraph (4) with respect to such plan or contact such plan to obtain the most current provider directory information with respect to such plan.

"(6) DEFINITION. — For purposes of this subsection, the term 'provider directory information' includes, with respect to a group health plan, the name, address, specialty, telephone number, and digital contact information of each health care provider or health care facility with which such plan has a contractual relationship for furnishing items and services under such plan.

"(7) RULE OF CONSTRUCTION. — Nothing in this section shall be construed to preempt any provision of State law relating to health care provider directories.

"(b) COST-SHARING FOR SERVICES PROVIDED BASED ON RELIANCE ON INCORRECT PROVIDER NETWORK INFORMATION. —

"(1) IN GENERAL. — For plan years beginning on or after January 1, 2022, in the case of an item or service furnished to a participant or beneficiary of a group health plan by a nonparticipating provider or a nonparticipating facility, if such item or service would otherwise be covered under such plan if furnished by a participating provider or participating facility and if either of the criteria described in paragraph (2) applies with respect to such participant or beneficiary and item or service, the plan —

"(A) shall not impose on such participant or beneficiary a cost-sharing amount for such item or service so furnished that is greater than the cost-sharing amount that would apply under such plan had such item or service been furnished by a participating provider; and

"(B) shall apply the deductible or out-of-pocket maximum, if any, that would apply if such services were furnished by a participating provider or a participating facility.

"(2) CRITERIA DESCRIBED. — For purposes of paragraph (1), the criteria described in this paragraph, with respect to an item or service furnished to a participant or beneficiary of a group health plan by a nonparticipating provider or a nonparticipating facility, are the following:

"(A) The participant or beneficiary received through a database, provider directory, or response protocol described in subsection (a) information with respect to such item and service to be furnished and such information provided that the provider was a participating provider or facility was a participating facility, with respect to the plan for furnishing such item or service.

"(B) The information was not provided, in accordance with subsection (a), to the participant or beneficiary and the participant or beneficiary requested through the response protocol described in subsection (a)(3) of the plan information on whether the provider was a participating provider or facility was a participating facility with respect to the plan for furnishing such item or service and was informed through such protocol that the provider was such a participating provider or facility was such a participating facility.

"(c) DISCLOSURE ON PATIENT PROTECTIONS AGAINST BALANCE BILLING. — For plan years beginning on or after January 1, 2022, each group health plan shall make publicly available, post on a public website of such plan or issuer, and include on each explanation of benefits for an item or service with respect to which the requirements under section 9816 applies —

"(1) information in plain language on —

"(A) the requirements and prohibitions applied under sections 2799B-1 and 2799B-2 of the Public Health Service Act(relating to prohibitions on balance billing in certain circumstances);

"(B) if provided for under applicable State law, any other requirements on providers and facilities regarding the amounts such providers and facilities may, with respect to an item or service, charge a participant or beneficiary of such plan with respect to which such a provider or facility does not have a contractual relationship for furnishing such item or service under the plan after receiving payment from the plan for such item or service and any applicable cost sharing payment from such participant or beneficiary; and

"(C) the requirements applied under section 9816; and "(2) information on contacting appropriate State and Federal agencies in the case that an individual believes that such a provider or facility has violated any requirement described in paragraph (1) with respect to such individual.".

(d) CLERICAL AMENDMENTS. —

(1) ERISA. — The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.), as amended by the previous provisions of this title, is further amended by inserting after the item relating to section 719 the following new item:

"720. Protecting patients and improving the accuracy of provider directory information.".

(2) IRC. — The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by the previous provisions of this title, is further amended by inserting after the item relating to section 9819 the following new item:

"9820. Protecting patients and improving the accuracy of provider directory information.".

(e) PROVIDER REQUIREMENTS. — Part E of title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), as added by section 104 and as further amended by the previous provisions of this title, is further amended by adding at the end the following:

"SEC. 2799B-9. PROVIDER REQUIREMENTS TO PROTECT PATIENTS AND IMPROVE THE ACCURACY OF PROVIDER DIRECTORY INFORMATION.

"(a) PROVIDER BUSINESS PROCESSES. — Beginning not later than January 1, 2022, each health care provider and each health care facility shall have in place business processes to ensure the timely provision of provider directory information to a group health plan or a health insurance issuer offering group or individual health insurance coverage to support compliance by such plans or issuers with section 2799A-5(a)(1), section 720(a)(1) of the Employee Retirement Income Security Act of 1974, or section 9820(a)(1) of the Internal Revenue Code of 1986, as applicable. Such providers shall submit provider directory information to a plan or issuers, at a minimum —

"(1) when the provider or facility begins a network agreement with a plan or with an issuer with respect to certain coverage;

"(2) when the provider or facility terminates a network agreement with a plan or with an issuer with respect to certain coverage;

"(3) when there are material changes to the content of provider directory information of the provider or facility described in section 2799A-5(a)(1), section 720(a)(1) of the Employee Retirement Income Security Act of 1974, or section 9820(a)(1) of the Internal Revenue Code of 1986, as applicable; and

"(4) at any other time (including upon the request of such issuer or plan) determined appropriate by the provider, facility, or the Secretary.

"(b) REFUNDS TO ENROLLEES. — If a health care provider submits a bill to an enrollee based on cost-sharing for treatment or services provided by the health care provider that is in excess of the normal cost-sharing applied for such treatment or services provided in-network, as prohibited under section 2799A-5(b), section 720(b) of the Employee Retirement Income Security Act of 1974, or section 9820(b) of the Internal Revenue Code of 1986, as applicable, and the enrollee pays such bill, the provider shall reimburse the enrollee for the full amount paid by the enrollee in excess of the in-network cost-sharing amount for the treatment or services involved, plus interest, at an interest rate determined by the Secretary.

"(c) LIMITATION. — Nothing in this section shall prohibit a provider from requiring in the terms of a contract, or contract termination, with a group health plan or health insurance issuer — "(1) that the plan or issuer remove, at the time of termination of such contract, the provider from a directory of the plan or issuer described in section 2799A-5(a), section 720(a) of the Employee Retirement Income Security Act of 1974, or section 9820(a) of the Internal Revenue Code of 1986, as applicable; or

"(2) that the plan or issuer bear financial responsibility, including under section 2799A-5(b), section 720(b) of the Employee Retirement Income Security Act of 1974, or section 9820(b) of the Internal Revenue Code of 1986, as applicable, for providing inaccurate network status information to an enrollee.

"(d) DEFINITION. — For purposes of this section, the term 'provider directory information' includes the names, addresses, specialty, telephone numbers, and digital contact information of individual health care providers, and the names, addresses, telephone numbers, and digital contact information of each medical group, clinic, or facility contracted to participate in any of the networks of the group health plan or health insurance coverage involved.

"(e) RULE OF CONSTRUCTION. — Nothing in this section shall be construed to preempt any provision of State law relating to health care provider directories.".

SEC. 117. ADVISORY COMMITTEE ON GROUND AMBULANCE AND PATIENT BILLING.

(a) IN GENERAL. — Not later than 90 days after the date of enactment of this Act, the Secretary of Labor, Secretary of Health and Human Services, and the Secretary of the Treasury (the Secretaries) shall jointly establish an advisory committee for the purpose of reviewing options to improve the disclosure of charges and fees for ground ambulance services, better inform consumers of insurance options for such services, and protect consumers from balance billing.

(b) COMPOSITION OF THE ADVISORY COMMITTEE. — The advisory committee shall be composed of the following members:

(1) The Secretary of Labor, or the Secretary's designee.

(2) The Secretary of Health and Human Services, or the Secretary's designee.

(3) The Secretary of the Treasury, or the Secretary's designee.

(4) One representative, to be appointed jointly by the Secretaries, for each of the following:

(A) Each relevant Federal agency, as determined by the Secretaries.

(B) State insurance regulators.

(C) Health insurance providers.

(D) Patient advocacy groups.

(E) Consumer advocacy groups.

(F) State and local governments.

(G) Physician specializing in emergency, trauma, cardiac, or stroke.

(H) State Emergency Medical Services Officials.

(I) Emergency medical technicians, paramedics, and other emergency medical services personnel.

(5) Three representatives, to be appointed jointly by the Secretaries, to represent the various segments of the ground ambulance industry.

(6) Up to an additional 2 representatives otherwise not described in paragraphs (1) through (5), as determined necessary and appropriate by the Secretaries.

(c) CONSULTATION. — The advisory committee shall, as appropriate, consult with relevant experts and stakeholders, including those not otherwise included under subsection (b), while conducting the review described in subsection (a).

(d) RECOMMENDATIONS. — The advisory committee shall make recommendations with respect to disclosure of charges and fees for ground ambulance services and insurance coverage, consumer protection and enforcement authorities of the Departments of Labor, Health and Human Services, and the Treasury and State authorities, and the prevention of balance billing to consumers. The recommendations shall address, at a minimum —

(1) options, best practices, and identified standards to prevent instances of balance billing;

(2) steps that can be taken by State legislatures, State insurance regulators, State attorneys general, and other State officials as appropriate, consistent with current legal authorities regarding consumer protection; and

(3) legislative options for Congress to prevent balance billing.

(e) REPORT. — Not later than 180 days after the date of the first meeting of the advisory committee, the advisory committee shall submit to the Secretaries, and the Committees on Education and Labor, Energy and Commerce, and Ways and Means of the House of Representatives and the Committees on Finance and Health, Education, Labor, and Pensions a report containing the recommendations made under subsection (d).

SEC. 118. IMPLEMENTATION FUNDING.

(a) IN GENERAL. — For the purposes described in subsection (b), there are appropriated, out of amounts in the Treasury not otherwise appropriated, to the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury, $500,000,000 for fiscal year 2021, to remain available until expended through 2024.

(b) PERMITTED PURPOSES. — The purposes described in this subsection are limited to the following purposes, insofar as such purposes are to carry out the provisions of, including the amendments made by, this title and title II:

(1) Preparing, drafting, and issuing proposed and final regulations or interim regulations.

(2) Preparing, drafting, and issuing guidance and public information.

(3) Preparing and holding public meetings.

(4) Preparing, drafting, and publishing reports.

(5) Enforcement of such provisions.

(6) Reporting, collection, and analysis of data.

(7) Establishment and initial implementation of the processes for independent dispute resolution and implementation of patient provider dispute resolution under such provisions.

(8) Conducting audits.

(9) Other administrative duties necessary for implementation of such provisions.

(c) TRANSPARENCY OF IMPLEMENTATION FUNDS. — Each Secretary described in subsection (a) shall annually submit to the Committees on Energy and Commerce, on Ways and Means, on Education and Labor, and on Appropriations of the House of Representatives and on the Committees on Health, Education, Labor, and Pensions and on Appropriations of the Senate a report on funds expended pursuant to funds appropriated under this section.

TITLE II — TRANSPARENCY

SEC. 201. INCREASING TRANSPARENCY BY REMOVING GAG CLAUSES ON PRICE AND QUALITY INFORMATION.

(a) PHSA. — Part D of title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), as added and amended by title I, is further amended by adding at the end the following:

"SEC.2799A-9. INCREASING TRANSPARENCY BY REMOVING GAG CLAUSES ON PRICE AND QUALITY INFORMATION.

"(a) INCREASING PRICE AND QUALITY TRANSPARENCY FOR PLAN SPONSORS AND GROUP AND INDIVIDUAL MARKET CONSUMERS. —

"(1) GROUP HEALTH PLANS. — A group health plan or health insurance issuer offering group health insurance coverage may not enter into an agreement with a health care provider, network or association of providers, third-party administrator, or other service provider offering access to a network of providers that would directly or indirectly restrict a group health plan or health insurance issuer offering such coverage from —

"(A) providing provider-specific cost or quality of care information or data, through a consumer engagement tool or any other means, to referring providers, the plan sponsor, enrollees, or individuals eligible to become enrollees of the plan or coverage;

"(B) electronically accessing deidentified claims and encounter information or data for each enrollee in the plan or coverage, upon request and consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990, including, on a per claim basis —

"(i) financial information, such as the allowed amount, or any other claim-related financial obligations included in the provider contract;

"(ii) provider information, including name and clinical designation;

"(iii) service codes; or

"(iv) any other data element included in claim or encounter transactions; or

"(C) sharing information or data described in subparagraph (A) or (B), or directing that such data be shared, with a business associate as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations), consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990.

"(2) INDIVIDUAL HEALTH INSURANCE COVERAGE. — A health insurance issuer offering individual health insurance coverage may not enter into an agreement with a health care provider, network or association of providers, or other service provider offering access to a network of providers that would directly or indirectly restrict the health insurance issuer from —

"(A) providing provider-specific price or quality of care information, through a consumer engagement tool or any other means, to referring providers, enrollees, or individuals eligible to become enrollees of the plan or coverage; or

"(B) sharing, for plan design, plan administration, and plan, financial, legal, and quality improvement activities, data described in subparagraph (A) with a business associate as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations), consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990.

"(3) CLARIFICATION REGARDING PUBLIC DISCLOSURE OF INFORMATION. — Nothing in paragraph (1)(A) or (2)(A) prevents a health care provider, network or association of providers, or other service provider from placing reasonable restrictions on the public disclosure of the information described in such paragraphs (1) and (2).

"(4) ATTESTATION. — A group health plan or a health insurance issuer offering group or individual health insurance coverage shall annually submit to the Secretary an attestation that such plan or issuer of such coverage is in compliance with the requirements of this subsection.

"(5) RULES OF CONSTRUCTION. — Nothing in this section shall be construed to modify or eliminate existing privacy protections and standards under State and Federal law. Nothing in this subsection shall be construed to otherwise limit access by a group health plan, plan sponsor, or health insurance issuer to data as permitted under the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990.".

(b) ERISA. — Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.), as amended by title I, is further amended by adding at the end the following:

"SEC. 724. INCREASING TRANSPARENCY BY REMOVING GAG CLAUSES ON PRICE AND QUALITY INFORMATION.

"(a) INCREASING PRICE AND QUALITY TRANSPARENCY FOR PLAN SPONSORS AND CONSUMERS. —

"(1) IN GENERAL. — A group health plan (or an issuer of health insurance coverage offered in connection with such a plan) may not enter into an agreement with a health care provider, network or association of providers, third-party administrator, or other service provider offering access to a network of providers that would directly or indirectly restrict a group health plan or health insurance issuer offering such coverage from —

"(A) providing provider-specific cost or quality of care information or data, through a consumer engagement tool or any other means, to referring providers, the plan sponsor, participants or beneficiaries, or individuals eligible to become participants or beneficiaries of the plan or coverage;

"(B) electronically accessing deidentified claims and encounter information or data for each participant or beneficiary in the plan or coverage, upon request and consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990, including, on a per claim basis —

"(i) financial information, such as the allowed amount, or any other claim-related financial obligations included in the provider contract;

"(ii) provider information, including name and clinical designation;

"(iii) service codes; or

"(iv) any other data element included in claim or encounter transactions; or

"(C) sharing information or data described in subparagraph (A) or (B), or directing that such data be shared, with a business associate as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations), consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990.

"(2) CLARIFICATION REGARDING PUBLIC DISCLOSURE OF INFORMATION. — Nothing in paragraph (1)(A) prevents a health care provider, network or association of providers, or other service provider from placing reasonable restrictions on the public disclosure of the information described in such paragraph (1).

"(3) ATTESTATION. — A group health plan (or health insurance coverage offered in connection with such a plan) shall annually submit to the Secretary an attestation that such plan or issuer of such coverage is in compliance with the requirements of this subsection.

"(4) RULES OF CONSTRUCTION. — Nothing in this section shall be construed to modify or eliminate existing privacy protections and standards under State and Federal law. Nothing in this subsection shall be construed to otherwise limit access by a group health plan, plan sponsor, or health insurance issuer to data as permitted under the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990.".

(c) IRC. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by title I, is further amended by adding at the end the following:

"SEC. 9824. INCREASING TRANSPARENCY BY REMOVING GAG CLAUSES ON PRICE AND QUALITY INFORMATION.

"(a) INCREASING PRICE AND QUALITY TRANSPARENCY FOR PLAN SPONSORS AND CONSUMERS. —

"(1) IN GENERAL. — A group health plan may not enter into an agreement with a health care provider, network or association of providers, third-party administrator, or other service provider offering access to a network of providers that would directly or indirectly restrict a group health plan from —

"(A) providing provider-specific cost or quality of care information or data, through a consumer engagement tool or any other means, to referring providers, the plan sponsor, participants or beneficiaries, or individuals eligible to become participants or beneficiaries of the plan;

"(B) electronically accessing deidentified claims and encounter information or data for each participant or beneficiary in the plan, upon request and consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990, including, on a per claim basis —

"(i) financial information, such as the allowed amount, or any other claim-related financial obligations included in the provider contract;

"(ii) provider information, including name and clinical designation;

"(iii) service codes; or

"(iv) any other data element included in claim or encounter transactions; or

"(C) sharing information or data described in subparagraph (A) or (B), or directing that such data be shared, with a business associate as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations), consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990.

"(2) CLARIFICATION REGARDING PUBLIC DISCLOSURE OF INFORMATION. — Nothing in paragraph (1)(A) prevents a health care provider, network or association of providers, or other service provider from placing reasonable restrictions on the public disclosure of the information described in such paragraph (1).

"(3) ATTESTATION. — A group health plan shall annually submit to the Secretary an attestation that such plan is in compliance with the requirements of this subsection.

"(4) RULES OF CONSTRUCTION. — Nothing in this section shall be construed to modify or eliminate existing privacy protections and standards under State and Federal law. Nothing in this subsection shall be construed to otherwise limit access by a group health plan or plan sponsor to data as permitted under the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990.".

(d) CLERICAL AMENDMENTS. —

(1) ERISA. — The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.), as amended by title I, is further amended by inserting after the item relating to section 723 the following new item:

"Sec. 724. Increasing transparency by removing gag clauses on price and quality information.".

(2) IRC. — The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by title I, is further amended by adding at the end the following new item:

"Sec. 9824. Increasing transparency by removing gag clauses on price and quality information.".

SEC. 202. DISCLOSURE OF DIRECT AND INDIRECT COMPENSATION FOR BROKERS AND CONSULTANTS TO EMPLOYER-SPONSORED HEALTH PLANS AND ENROLLEES IN PLANS ON THE INDIVIDUAL MARKET.

(a) GROUP HEALTH PLANS. — Section 408(b)(2) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2)) is amended —

(1) by striking "(2) Contracting or making" and inserting "(2)(A) Contracting or making"; and

(2) by adding at the end the following:

"(B)(i) No contract or arrangement for services between a covered plan and a covered service provider, and no extension or renewal of such a contract or arrangement, is reasonable within the meaning of this paragraph unless the requirements of this clause are met.

"(ii)(I) For purposes of this subparagraph:

"(aa) The term 'covered plan' means a group health plan as defined section 733(a).

"(bb) The term 'covered service provider' means a service provider that enters into a contract or arrangement with the covered plan and reasonably expects $1,000 (or such amount as the Secretary may establish in regulations to account for inflation since the date of enactment of the Consolidated Appropriations Act, 2021, as appropriate) or more in compensation, direct or indirect, to be received in connection with providing one or more of the following services, pursuant to the contract or arrangement, regardless of whether such services will be performed, or such compensation received, by the covered service provider, an affiliate, or a subcontractor:

"(AA) Brokerage services, for which the covered service provider, an affiliate, or a subcontractor reasonably expects to receive indirect compensation or direct compensation described in item (dd), provided to a covered plan with respect to selection of insurance products (including vision and dental), recordkeeping services, medical management vendor, benefits administration (including vision and dental), stop loss insurance, pharmacy benefit management services, wellness services, transparency tools and vendors, group purchasing organization preferred vendor panels, disease management vendors and products, compliance services, employee assistance programs, or third party administration services.

"(BB) Consulting, for which the covered service provider, an affiliate, or a subcontractor reasonably expects to receive indirect compensation or direct compensation described in item (dd), related to the development or implementation of plan design, insurance or insurance product selection (including vision and dental), recordkeeping, medical management, benefits administration selection (including vision and dental), stoploss 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.

"(cc) The term 'affiliate', with respect to a covered service provider, means an entity that directly or indirectly (through one or more intermediaries) controls, is controlled by, or is under common control with, such provider, or is an officer, director, or employee of, or partner in, such provider.

"(dd)(AA) The term 'compensation' means anything of monetary value, but does not include nonmonetary compensation valued at $250 (or such amount as the Secretary may establish in regulations to account for inflation since the date of enactment of the Consolidated Appropriations Act, 2021, as appropriate) or less, in the aggregate, during the term of the contract or arrangement.

"(BB) The term 'direct compensation' means compensation received directly from a covered plan.

"(CC) The term 'indirect compensation' means compensation received from any source other than the covered plan, the plan sponsor, the covered service provider, or an affiliate. Compensation received from a subcontractor is indirect compensation, unless it is received in connection with services performed under a contract or arrangement with a subcontractor.

"(ee) The term 'responsible plan fiduciary' means a fiduciary with authority to cause the covered plan to enter into, or extend or renew, the contract or arrangement.

"(ff) The term 'subcontractor' means any person or entity (or an affiliate of such person or entity) that is not an affiliate of the covered service provider and that, pursuant to a contract or arrangement with the covered service provider or an affiliate, reasonably expects to receive $1,000 (or such amount as the Secretary may establish in regulations to account for inflation since the date of enactment of the Consolidated Appropriations Act, 2021, as appropriate) or more in compensation for performing one or more services described in item (bb) under a contract or arrangement with the covered plan.

"(II) For purposes of this subparagraph, a description of compensation or cost may be expressed as a monetary amount, formula, or a per capita charge for each enrollee or, if the compensation or cost cannot reasonably be expressed in such terms, by any other reasonable method, including a disclosure that additional compensation may be earned but may not be calculated at the time of contract if such a disclosure includes a description of the circumstances under which the additional compensation may be earned and a reasonable and good faith estimate if the covered service provider cannot otherwise readily describe compensation or cost and explains the methodology and assumptions used to prepare such estimate. Any such description shall contain sufficient information to permit evaluation of the reasonableness of the compensation or cost.

"(III) No person or entity is a 'covered service provider' within the meaning of subclause (I)(bb) solely on the basis of providing services as an affiliate or a subcontractor that is performing one or more of the services described in subitem (AA) or (BB) of such subclause under the contract or arrangement with the covered plan.

"(iii) A covered service provider shall disclose to a responsible plan fiduciary, in writing, the following:

"(I) A description of the services to be provided to the covered plan pursuant to the contract or arrangement.

"(II) If applicable, a statement that the covered service provider, an affiliate, or a subcontractor will provide, or reasonably expects to provide, services pursuant to the contract or arrangement directly to the covered plan as a fiduciary (within the meaning of section 3(21)).

"(III) A description of all direct compensation, either in the aggregate or by service, that the covered service provider, an affiliate, or a subcontractor reasonably expects to receive in connection with the services described in subclause (I).

"(IV)(aa) A description of all indirect compensation that the covered service provider, an affiliate, or a subcontractor reasonably expects to receive in connection with the services described in subclause (I) —

"(AA) including compensation from a vendor to a brokerage firm based on a structure of incentives not solely related to the contract with the covered plan; and

"(BB) not including compensation received by an employee from an employer on account of work performed by the employee.

"(bb) A description of the arrangement between the payer and the covered service provider, an affiliate, or a subcontractor, as applicable, pursuant to which such indirect compensation is paid.

"(cc) Identification of the services for which the indirect compensation will be received, if applicable.

"(dd) Identification of the payer of the indirect compensation.

"(V) A description of any compensation that will be paid among the covered service provider, an affiliate, or a subcontractor, in connection with the services described in subclause (I) if such compensation is set on a transaction basis (such as commissions, finder's fees, or other similar incentive compensation based on business placed or retained), including identification of the services for which such compensation will be paid and identification of the payers and recipients of such compensation (including the status of a payer or recipient as an affiliate or a subcontractor), regardless of whether such compensation also is disclosed pursuant to subclause (III) or (IV).

"(VI) A description of any compensation that the covered service provider, an affiliate, or a subcontractor reasonably expects to receive in connection with termination of the contract or arrangement, and how any prepaid amounts will be calculated and refunded upon such termination.

"(iv) A covered service provider shall disclose to a responsible plan fiduciary, in writing a description of the manner in which the compensation described in clause (iii), as applicable, will be received.

"(v)(I) A covered service provider shall disclose the information required under clauses (iii) and (iv) to the responsible plan fiduciary not later than the date that is reasonably in advance of the date on which the contract or arrangement is entered into, and extended or renewed.

"(II) A covered service provider shall disclose any change to the information required under clause (iii) and (iv) as soon as practicable, but not later than 60 days from the date on which the covered service provider is informed of such change, unless such disclosure is precluded due to extraordinary circumstances beyond the covered service provider's control, in which case the information shall be disclosed as soon as practicable.

"(vi)(I) Upon the written request of the responsible plan fiduciary or covered plan administrator, a covered service provider shall furnish any other information relating to the compensation received in connection with the contract or arrangement that is required for the covered plan to comply with the reporting and disclosure requirements under this Act.

"(II) The covered service provider shall disclose the information required under clause (iii)(I) reasonably in advance of the date upon which such responsible plan fiduciary or covered plan administrator states that it is required to comply with the applicable reporting or disclosure requirement, unless such disclosure is precluded due to extraordinary circumstances beyond the covered service provider's control, in which case the information shall be disclosed as soon as practicable.

"(vii) No contract or arrangement will fail to be reasonable under this subparagraph solely because the covered service provider, acting in good faith and with reasonable diligence, makes an error or omission in disclosing the information required pursuant to clause (iii) (or a change to such information disclosed pursuant to clause (v)(II)) or clause (vi), provided that the covered service provider discloses the correct information to the responsible plan fiduciary as soon as practicable, but not later than 30 days from the date on which the covered service provider knows of such error or omission.

"(viii)(I) Pursuant to subsection (a), subparagraphs (C) and (D) of section 406(a)(1) shall not apply to a responsible plan fiduciary, notwithstanding any failure by a covered service provider to disclose information required under clause (iii), 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 disclosures and reasonably believed that the covered service provider disclosed the information required to be disclosed.

"(bb) The responsible plan fiduciary, upon discovering that the covered service provider failed to disclose the required information, requests in writing that the covered service provider furnish such information.

"(cc) If the covered service provider fails to comply with a written request described in subclause (II) within 90 days of the request, the responsible plan fiduciary notifies the Secretary of the covered service provider's failure, in accordance with subclauses (II) and (III).

"(II) A notice described in subclause (I)(cc) shall contain — "(aa) the name of the covered plan;

"(bb) the plan number used for the annual report on the covered plan;

"(cc) the plan sponsor's name, address, and employer identification number;

"(dd) the name, address, and telephone number of the responsible plan fiduciary;

"(ee) the name, address, phone number, and, if known, employer identification number of the covered service provider;

"(ff) a description of the services provided to the covered plan;

"(gg) a description of the information that the covered service provider failed to disclose;

"(hh) the date on which such information was requested in writing from the covered service provider; and

"(ii) a statement as to whether the covered service provider continues to provide services to the plan.

"(III) A notice described in subclause (I)(cc) shall be filed with the Department not later than 30 days following the earlier of —

"(aa) The covered service provider's refusal to furnish the information requested by the written request described in subclause (I)(bb); or

"(bb) 90 days after the written request referred to in subclause (I)(cc) is made.

"(IV) If the covered service provider fails to comply with the written request under subclause (I)(bb) within 90 days of such request, the responsible plan fiduciary shall determine whether to terminate or continue the contract or arrangement under section 404. If the requested information relates to future services and is not disclosed promptly after the end of the 90-day period, the responsible plan fiduciary shall terminate the contract or arrangement as expeditiously as possible, consistent with such duty of prudence.

"(ix) Nothing in this subparagraph shall be construed to supersede any provision of State law that governs disclosures by parties that provide the services described in this section, except to the extent that such law prevents the application of a requirement of this section.".

(b) APPLICABILITY OF EXISTING REGULATIONS. — Nothing in the amendments made by subsection (a) shall be construed to affect the applicability of section 2550.408b-2 of title 29, Code of Federal Regulations (or any successor regulations), with respect to any applicable entity other than a covered plan or a covered service provider (as defined in section 408(b)(2)(B)(ii) of the Employee Retirement Income Security Act of 1974, as amended by subsection (a)).

(c) INDIVIDUAL MARKET COVERAGE. — Subpart 1 of part B of title XXVII of the Public Health Service Act (42 U.S.C. 300gg-41 et seq.) is amended by adding at the end the following:

"SEC. 2746. DISCLOSURE TO ENROLLEES OF INDIVIDUAL MARKET COVERAGE.

"(a) IN GENERAL. — A health insurance issuer offering individual health insurance coverage or a health insurance issuer offering short-term limited duration insurance coverage shall make disclosures to enrollees in such coverage, as described in subsection (b), and reports to the Secretary, as described in subsection (c), regarding direct or indirect compensation provided by the issuer to an agent or broker associated with enrolling individuals in such coverage.

"(b) DISCLOSURE. — A health insurance issuer described in subsection (a) shall disclose to an enrollee the amount of direct or indirect compensation provided to an agent or broker for services provided by such agent or broker associated with plan selection and enrollment. Such disclosure shall be —

"(1) made prior to the individual finalizing plan selection; and

"(2) included on any documentation confirming the individual's enrollment.

"(c) REPORTING. — A health insurance issuer described in subsection (a) shall annually report to the Secretary, prior to the beginning of open enrollment, any direct or indirect compensation provided to an agent or broker associated with enrolling individuals in such coverage.

"(d) RULEMAKING. — Not later than 1 year after the date of enactment of the Consolidated Appropriations Act, 2021, the Secretary shall finalize, through notice-and-comment rulemaking, the timing, form, and manner in which issuers described in subsection (a) are required to make the disclosures described in subsection

(b) and the reports described in subsection (c). Such rulemaking may also include adjustments to notice requirements to reflect the different processes for plan renewals, in order to provide enrollees with full, timely information.".

(d) TRANSITION RULE. — No contract executed prior to the effective date described in subsection (e) by a group health plan subject to the requirements of section 408(b)(2)(B) of the Employee Retirement Income Security Act of 1974 (as amended by subsection (a)) or by a health insurance issuer subject to the requirements of section 2746 of the Public Health Service Act (as added by subsection (c)) shall be subject to the requirements of such section 408(b)(2)(B) or such section 2746, as applicable.

(e) APPLICATION. — The amendments made by subsections (a) and (c) shall apply beginning 1 year after the date of enactment of this Act.

SEC. 203. STRENGTHENING PARITY IN MENTAL HEALTH AND SUBSTANCE USE DISORDER BENEFITS.

(a) IN GENERAL. —

(1) PHSA. — Section 2726(a) of the Public Health Service Act (42 U.S.C. 300gg-26(a)) is amended by adding at the end the following:

"(8) COMPLIANCE REQUIREMENTS. —

"(A) NONQUANTITATIVE TREATMENT LIMITATION (NQTL) REQUIREMENTS. — In the case of a group health plan or a health insurance issuer offering group or individual health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits and that imposes nonquantitative treatment limitations (referred to in this section as 'NQTLs') on mental health or substance use disorder benefits, such plan or issuer shall perform and document comparative analyses of the design and application of NQTLs and, beginning 45 days after the date of enactment of the Consolidated Appropriations Act, 2021, make available to the applicable State authority (or, as applicable, to the Secretary of Labor or the Secretary of Health and Human Services), upon request, the comparative analyses and the following information:

"(i) The specific plan or coverage terms or other relevant terms regarding the NQTLs and a description of all mental health or substance use disorder and medical or surgical benefits to which each such term applies in each respective benefits classification.

"(ii) The factors used to determine that the NQTLs will apply to mental health or substance use disorder benefits and medical or surgical benefits.

"(iii) The evidentiary standards used for the factors identified in clause (ii), when applicable, provided that every factor shall be defined, and any other source or evidence relied upon to design and apply the NQTLs to mental health or substance use disorder benefits and medical or surgical benefits.

"(iv) The comparative analyses demonstrating that the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to mental health or substance use disorder benefits, as written and in operation, are comparable to, and are applied no more stringently than, the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to medical or surgical benefits in the benefits classification.

"(v) The specific findings and conclusions reached by the group health plan or health insurance issuer with respect to the health insurance coverage, including any results of the analyses described in this subparagraph that indicate that the plan or coverage is or is not in compliance with this section.

"(B) SECRETARY REQUEST PROCESS. —

"(i) SUBMISSION UPON REQUEST. — The Secretary shall request that a group health plan or a health insurance issuer offering group or individual health insurance coverage submit the comparative analyses described in subparagraph (A) for plans that involve potential violations of this section or complaints regarding noncompliance with this section that concern NQTLs and any other instances in which the Secretary determines appropriate. The Secretary shall request not fewer than 20 such analyses per year.

"(ii) ADDITIONAL INFORMATION. — In instances in which the Secretary has concluded that the group health plan or health insurance issuer with respect to health insurance coverage has not submitted sufficient information for the Secretary to review the comparative analyses described in subparagraph (A), as requested under clause (i), the Secretary shall specify to the plan or issuer the information the plan or issuer must submit to be responsive to the request under clause (i) for the Secretary to review the comparative analyses described in subparagraph (A) for compliance with this section. Nothing in this paragraph shall require the Secretary to conclude that a group health plan or health insurance issuer is in compliance with this section solely based upon the inspection of the comparative analyses described in subparagraph (A), as requested under clause (i).

"(iii) REQUIRED ACTION. —

"(I) IN GENERAL. — In instances in which the Secretary has reviewed the comparative analyses described in subparagraph (A), as requested under clause (i), and determined that the group health plan or health insurance issuer is not in compliance with this section, the plan or issuer —

"(aa) shall specify to the Secretary the actions the plan or issuer will take to be in compliance with this section and provide to the Secretary additional comparative analyses described in subparagraph (A) that demonstrate compliance with this section not later than 45 days after the initial determination by the Secretary that the plan or issuer is not in compliance; and

"(bb) following the 45-day corrective action period under item (aa), if the Secretary makes a final determination that the plan or issuer still is not in compliance with this section, not later than 7 days after such determination, shall notify all individuals enrolled in the plan or applicable health insurance coverage offered by the issuer that the plan or issuer, with respect to such coverage, has been determined to be not in compliance with this section.

"(II) EXEMPTION FROM DISCLOSURE. — Documents or communications produced in connection with the Secretary's recommendations to a group health plan or health insurance issuer shall not be subject to disclosure pursuant to section 552 of title 5, United States Code.

"(iv) REPORT. — Not later than 1 year after the date of enactment of this paragraph, and not later than October 1 of each year thereafter, the Secretary shall submit to Congress, and make publicly available, a report that contains —

"(I) a summary of the comparative analyses requested under clause (i), including the identity of each group health plan or health insurance issuer, with respect to particular health insurance coverage that is determined to be not in compliance after the final determination by the Secretary described in clause (iii)(I)(bb);

"(II) the Secretary's conclusions as to whether each group health plan or health insurance issuer submitted sufficient information for the Secretary to review the comparative analyses requested under clause (i) for compliance with this section;

"(III) for each group health plan or health insurance issuer that did submit sufficient information for the Secretary to review the comparative analyses requested under clause (i), the Secretary's conclusions as to whether and why the plan or issuer is in compliance with the requirements under this section;

"(IV) the Secretary's specifications described in clause (ii) for each group health plan or health insurance issuer that the Secretary determined did not submit sufficient information for the Secretary to review the comparative analyses requested under clause (i) for compliance with this section; and

"(V) the Secretary's specifications described in clause (iii) of the actions each group health plan or health insurance issuer that the Secretary determined is not in compliance with this section must take to be in compliance with this section, including the reason why the Secretary determined the plan or issuer is not in compliance.

"(C) COMPLIANCE PROGRAM GUIDANCE DOCUMENT UPDATE PROCESS. —

"(i) IN GENERAL. — The Secretary shall include instances of noncompliance that the Secretary discovers upon reviewing the comparative analyses requested under subparagraph (B)(i) in the compliance program guidance document described in paragraph (6), as it is updated every 2 years, except that such instances shall not disclose any protected health information or individually identifiable information.

"(ii) GUIDANCE AND REGULATIONS. — Not later than 18 months after the date of enactment of this paragraph, the Secretary shall finalize any draft or interim guidance and regulations relating to mental health parity under this section. Such draft guidance shall include guidance to clarify the process and timeline for current and potential participants and beneficiaries (and authorized representatives and health care providers of such participants and beneficiaries) with respect to plans to file complaints of such plans or issuers being in violation of this section, including guidance, by plan type, on the relevant State, regional, or national office with which such complaints should be filed.

"(iii) STATE. — The Secretary shall share information on findings of compliance and noncompliance discovered upon reviewing the comparative analyses requested under subparagraph (B)(i) shall be shared with the State where the group health plan is located or the State where the health insurance issuer is licensed to do business for coverage offered by a health insurance issuer in the group market, in accordance with paragraph (6)(B)(iii)(II).".

(2) ERISA. — Section 712(a) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185a(a)) is amended by adding at the end the following:

"(6) COMPLIANCE PROGRAM GUIDANCE DOCUMENT. —

"(A) IN GENERAL. — The Secretary, the Secretary of Health and Human Services, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall issue a compliance program guidance document to help improve compliance with this section, section 2726 of the Public Health Service Act, and section 9812 of the Internal Revenue Code of 1986, as applicable. In carrying out this paragraph, the Secretaries may take into consideration the 2016 publication of the Department of Health and Human Services and the Department of Labor, entitled 'Warning Signs — Plan or Policy Non-Quantitative Treatment Limitations (NQTLs) that Require Additional Analysis to Determine Mental Health Parity Compliance'.

"(B) EXAMPLES ILLUSTRATING COMPLIANCE AND NON-COMPLIANCE. —

"(i) IN GENERAL. — The compliance program guidance document required under this paragraph shall provide illustrative, deidentified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable, based on investigations of violations of such sections, including —

"(I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and

"(II) descriptions of the violations uncovered during the course of such investigations.

"(ii) NONQUANTITATIVE TREATMENT LIMITATIONS. —

To the extent that any example described in clause (i) involves a finding of compliance or noncompliance with regard to any requirement for nonquantitative treatment limitations, the example shall provide sufficient detail to fully explain such finding, including a full description of the criteria involved for approving medical and surgical benefits and the criteria involved for approving mental health and substance use disorder benefits.

"(iii) ACCESS TO ADDITIONAL INFORMATION REGARDING COMPLIANCE. — In developing and issuing the compliance program guidance document required under this paragraph, the Secretaries specified in subparagraph (A) —

"(I) shall enter into interagency agreements with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable; and

"(II) shall seek to enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable.

"(C)RECOMMENDATIONS. — The compliance program guidance document shall include recommendations to advance compliance with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable, and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits.

"(D) UPDATING THE COMPLIANCE PROGRAM GUIDANCE DOCUMENT. — The Secretary, the Secretary of Health and Human Services, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall update the compliance program guidance document every 2 years to include illustrative, deidentified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable.

"(7) ADDITIONAL GUIDANCE. —

"(A) IN GENERAL. — The Secretary, the Secretary of Health and Human Services, and the Secretary of the Treasury shall issue guidance to group health plans and health insurance issuers offering group health insurance coverage to assist such plans and issuers in satisfying the requirements of this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable.

"(B) DISCLOSURE. —

"(i) GUIDANCE FOR PLANS AND ISSUERS. — The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use for disclosing information to ensure compliance with the requirements under this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such sections, as applicable).

"(ii) DOCUMENTS FOR PARTICIPANTS, BENEFICIARIES, CONTRACTING PROVIDERS, OR AUTHORIZED REPRESENTATIVES. — The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group health insurance coverage may use to provide any participant, beneficiary, contracting provider, or authorized
representative, as applicable, with documents containing information that the health plans or issuers are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable, compliance with any regulation issued pursuant to such respective section, or compliance with any other applicable law or regulation. Such guidance shall include information that is comparative in nature with respect to —

"(I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits;

"(II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and

"(III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits.

"(C) NONQUANTITATIVE TREATMENT LIMITATIONS. — The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans and health insurance issuers offering group health insurance coverage may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable, (and any regulations promulgated pursuant to such respective section), including —

"(i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to —

"(I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative;

"(II) limitations with respect to prescription drug formulary design; and

"(III) use of fail-first or step therapy protocols;

"(ii) examples of methods of determining —

"(I) network admission standards (such as credentialing); and

"(II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy;

"(iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations;

"(iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans or issuers in performing a nonquantitative treatment limitation analysis;

"(v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative;

"(vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits;

"(vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques;

"(viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and

"(ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 2726 of the Public Health Service Act, or section 9812 of the Internal Revenue Code of 1986, as applicable.

"(D) PUBLIC COMMENT. — Prior to issuing any final guidance under this paragraph, the Secretary shall provide a public comment period of not less than 60 days during which any member of the public may provide comments on a draft of the guidance.

"(8) COMPLIANCE REQUIREMENTS. —

"(A) NONQUANTITATIVE TREATMENT LIMITATION (NQTL) REQUIREMENTS. — In the case of a group health plan or a health insurance issuer offering group health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits and that imposes nonquantitative treatment limitations (referred to in this section as 'NQTLs') on mental health or substance use disorder benefits, such plan or issuer shall perform and document comparative analyses of the design and application of NQTLs and, beginning 45 days after the date of enactment of the Consolidated Appropriations Act, 2021, make available to the Secretary, upon request, the comparative analyses and the following information:

"(i) The specific plan or coverage terms or other relevant terms regarding the NQTLs, that applies to such plan or coverage, and a description of all mental health or substance use disorder and medical or surgical benefits to which each such term applies in each respective benefits classification.

"(ii) The factors used to determine that the NQTLs will apply to mental health or substance use disorder benefits and medical or surgical benefits.

"(iii) The evidentiary standards used for the factors identified in clause (ii), when applicable, provided that every factor shall be defined, and any other source or evidence relied upon to design and apply the NQTLs to mental health or substance use disorder benefits and medical or surgical benefits.

"(iv) The comparative analyses demonstrating that the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to mental health or substance use disorder benefits, as written and in operation, are comparable to, and are applied no more stringently than, the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to medical or surgical benefits in the benefits classification.

"(v) The specific findings and conclusions reached by the group health plan or health insurance issuer with respect to the health insurance coverage, including any results of the analyses described in this subparagraph that indicate that the plan or coverage is or is not in compliance with this section.

"(B) SECRETARY REQUEST PROCESS. —

"(i) SUBMISSION UPON REQUEST. — The Secretary shall request that a group health plan or a health insurance issuer offering group health insurance coverage submit the comparative analyses described in subparagraph (A) for plans that involve potential violations of this section or complaints regarding noncompliance with this section that concern NQTLs and any other instances in which the Secretary determines appropriate. The Secretary shall request not fewer than 20 such analyses per year.

"(ii) ADDITIONAL INFORMATION. — In instances in which the Secretary has concluded that the group health plan or health insurance issuer with respect to group health insurance coverage has not submitted sufficient information for the Secretary to review the comparative analyses described in subparagraph (A), as requested under clause (i), the Secretary shall specify to the plan or issuer the information the plan or issuer must submit to be responsive to the request under clause (i) for the Secretary to review the comparative analyses described in subparagraph (A) for compliance with this section. Nothing in this paragraph shall require the Secretary to conclude that a group health plan or health insurance issuer is in compliance with this section solely based upon the inspection of the comparative analyses described in subparagraph (A), as requested under clause (i).

"(iii) REQUIRED ACTION. —

"(I) IN GENERAL. — In instances in which the Secretary has reviewed the comparative analyses described in subparagraph (A), as requested under clause (i), and determined that the group health plan or health insurance issuer is not in compliance with this section, the plan or issuer —

"(aa) shall specify to the Secretary the actions the plan or issuer will take to be in compliance with this section and provide to the Secretary additional comparative analyses described in subparagraph (A) that demonstrate compliance with this section not later than 45 days after the initial determination by the Secretary that the plan or issuer is not in compliance; and

"(bb) following the 45-day corrective action period under item (aa), if the Secretary makes a final determination that the plan or issuer still is not in compliance with this section, not later than 7 days after such determination, shall notify all individuals enrolled in the plan or applicable health insurance coverage offered by the issuer that the plan or issuer, with respect to such coverage, has been determined to be not in compliance with this section.

"(II) EXEMPTION FROM DISCLOSURE. — Documents or communications produced in connection with the Secretary's recommendations to a group health plan or health insurance issuer shall not be subject to disclosure pursuant to section 552 of title 5, United States Code.

"(iv) REPORT. — Not later than 1 year after the date of enactment of this paragraph, and not later than October 1 of each year thereafter, the Secretary shall submit to Congress, and make publicly available, a report that contains —

"(I) a summary of the comparative analyses requested under clause (i), including the identity of each group health plan or health insurance issuer, with respect to certain health insurance coverage that is determined to be not in compliance after the final determination by the Secretary described in clause (iii)(I)(bb);

"(II) the Secretary's conclusions as to whether each group health plan or health insurance issuer submitted sufficient information for the Secretary to review the comparative analyses requested under clause (i) for compliance with this section;

"(III) for each group health plan or health insuranceissuerthatdidsubmitsufficient information for the Secretary to review the comparative analyses requested under clause (i), the Secretary's conclusions as to whether and why the plan or issuer is in compliance with the disclosure requirements under this section;

"(IV) the Secretary's specifications described in clause (ii) for each group health plan or health insurance issuer that the Secretary determined did not submit sufficient information for the Secretary to review the comparative analyses requested under clause (i) for compliance with this section; and

"(V) the Secretary's specifications described in clause (iii) of the actions each group health plan or health insurance issuer that the Secretary determined is not in compliance with this section must take to be in compliance with this section, including the reason why the Secretary determined the plan or issuer is not in compliance.

"(C) COMPLIANCE PROGRAM GUIDANCE DOCUMENT UPDATE PROCESS. —

"(i) IN GENERAL. — The Secretary shall include instances of noncompliance that the Secretary discovers upon reviewing the comparative analyses requested under subparagraph (B)(i) in the compliance program guidance document described in paragraph (6), as it is updated every 2 years, except that such instances shall not disclose any protected health information or individually identifiable information.

"(ii) GUIDANCE AND REGULATIONS. — Not later than 18 months after the date of enactment of this paragraph, the Secretary shall finalize any draft or interim guidance and regulations relating to mental health parity under this section. Such draft guidance shall include guidance to clarify the process and timeline for current and potential participants and beneficiaries (and authorized representatives and health care providers of such participants and beneficiaries) with respect to plans to file complaints of such plans or issuers being in violation of this section, including guidance, by plan type, on the relevant State, regional, or national office with which such complaints should be filed.

"(iii) STATE. — The Secretary shall share information on findings of compliance and noncompliance discovered upon reviewing the comparative analyses requested under subparagraph (B)(i) shall be shared with the State where the group health plan is located or the State where the health insurance issuer is licensed to do business for coverage offered by a health insurance issuer in the group market, in accordance with paragraph (6)(B)(iii)(II).".

(3) IRC. — Section 9812(a) of the Internal Revenue Code of 1986 is amended by adding at the end the following:

"(6) COMPLIANCE PROGRAM GUIDANCE DOCUMENT. —

"(A) IN GENERAL. — The Secretary, the Secretary of Health and Human Services, and the Secretary of Labor, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall issue a compliance program guidance document to help improve compliance with this section, section 2726 of the Public Health Service Act, and section 712 of the Employee Retirement Income Security Act of 1974, as applicable. In carrying out this paragraph, the Secretaries may take into consideration the 2016 publication of the Department of Health and Human Services and the Department of Labor, entitled 'Warning Signs — Plan or Policy Non-Quantitative Treatment Limitations (NQTLs) that Require Additional Analysis to Determine Mental Health Parity Compliance'.

"(B) EXAMPLES ILLUSTRATING COMPLIANCE AND NONCOMPLIANCE. —

"(i) IN GENERAL. — The compliance program guidance document required under this paragraph shall provide illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, based on investigations of violations of such sections, including —

"(I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and

"(II) descriptions of the violations uncovered during the course of such investigations.

"(ii) NONQUANTITATIVE TREATMENT LIMITATIONS. — To the extent that any example described in clause (i) involves a finding of compliance or noncompliance with regard to any requirement for nonquantitative treatment limitations, the example shall provide sufficient detail to fully explain such finding, including a full description of the criteria involved for approving medical and surgical benefits and the criteria involved for approving mental health and substance use disorder benefits.

"(iii) ACCESS TO ADDITIONAL INFORMATION REGARDING COMPLIANCE. — In developing and issuing the compliance program guidance document required under this paragraph, the Secretaries specified in subparagraph (A) —

"(I) shall enter into interagency agreements with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable; and

"(II) shall seek to enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.

"(C) RECOMMENDATIONS. — The compliance program guidance document shall include recommendations to advance compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits.

"(D) UPDATING THE COMPLIANCE PROGRAM GUIDANCE-DOCUMENT. — The Secretary, the Secretary of Health and Human Services, and the Secretary of Labor, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall update the compliance program guidance document every 2 years to include illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.

"(7) ADDITIONAL GUIDANCE. —

"(A) IN GENERAL. — The Secretary, the Secretary of Health and Human Services, and the Secretary of Labor shall issue guidance to group health plans to assist such plans in satisfying the requirements of this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.

"(B) DISCLOSURE. —

"(i) GUIDANCE FOR PLANS. — The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans may use for disclosing information to ensure compliance with the requirements under this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, (and any regulations promulgated pursuant to such sections, as applicable).

"(ii) DOCUMENTS FOR PARTICIPANTS, BENEFICIARIES, CONTRACTING PROVIDERS, OR AUTHORIZED REPRESENTATIVES. — The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans may use to provide any participant, beneficiary, contracting provider, or authorized representative, as applicable, with documents containing information that the health plans are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, compliance with any regulation issued pursuant to such respective section, or compliance with any other applicable law or regulation. Such guidance shall include information that is comparative in nature with respect to —

"(I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits;

"(II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and

"(III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits.

"(C) NONQUANTITATIVE TREATMENT LIMITATIONS. — The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable, (and any regulations promulgated pursuant to such respective section), including —

"(i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to —

"(I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative;

"(II) limitations with respect to prescription drug formulary design; and

"(III) use of fail-first or step therapy protocols;

"(ii) examples of methods of determining —

"(I) network admission standards (such as credentialing); and

"(II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy;

"(iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations;

"(iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans in performing a nonquantitative treatment limitation analysis;

"(v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative;

"(vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits;

"(vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques;

"(viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and

"(ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 2726 of the Public Health Service Act, or section 712 of the Employee Retirement Income Security Act of 1974, as applicable.

"(D) PUBLIC COMMENT. — Prior to issuing any final guidance under this paragraph, the Secretary shall provide a public comment period of not less than 60 days during which any member of the public may provide comments on a draft of the guidance.

"(8) COMPLIANCE REQUIREMENTS. —

"(A) NONQUANTITATIVE TREATMENT LIMITATION (NQTL) REQUIREMENTS. — In the case of a group health plan that provides both medical and surgical benefits and mental health or substance use disorder benefits and that imposes nonquantitative treatment limitations (referred to in this section as 'NQTLs') on mental health or substance use disorder benefits, such plan shall perform and document comparative analyses of the design and application of NQTLs and, beginning 45 days after the date of enactment of the Consolidated Appropriations Act, 2021, make available to the Secretary, upon request, the comparative analyses and the following information:

"(i) The specific plan terms or other relevant terms regarding the NQTLs and a description of all mental health or substance use disorder and medical or surgical benefits to which each such term applies in each respective benefits classification.

"(ii) The factors used to determine that the NQTLs will apply to mental health or substance use disorder benefits and medical or surgical benefits.

"(iii) The evidentiary standards used for the factors identified in clause (ii), when applicable, provided that every factor shall be defined, and any other source or evidence relied upon to design and apply the NQTLs to mental health or substance use disorder benefits and medical or surgical benefits.

"(iv) The comparative analyses demonstrating that the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to mental health or substance use disorder benefits, as written and in operation, are comparable to, and are applied no more stringently than, the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to medical or surgical benefits in the benefits classification.

"(v) A disclosure of the specific findings and conclusions reached by the group health plan, including any results of the analyses described in this subparagraph that indicate that the plan is or is not in compliance with this section.

"(B) SECRETARY REQUEST PROCESS. —

"(i) SUBMISSION UPON REQUEST. — The Secretary shall request that a group health plan submit the comparative analyses described in subparagraph (A) for plans that involve potential violations of this section or complaints regarding noncompliance with this section that concern NQTLs and any other instances in which the Secretary determines appropriate. The Secretary shall request not fewer than 20 such analyses per year.

"(ii) ADDITIONAL INFORMATION. — In instances in which the Secretary has concluded that the group health plan has not submitted sufficient information for the Secretary to review the comparative analyses described in subparagraph (A), as requested under clause (i), the Secretary shall specify to the plan the information the plan must submit to be responsive to the request under clause (i) for the Secretary to review the comparative analyses described in subparagraph (A) for compliance with this section. Nothing in this paragraph shall require the Secretary to conclude that a group health plan is in compliance with this section solely based upon the inspection of the comparative analyses described in subparagraph (A), as requested under clause (i).

"(iii) REQUIRED ACTION. —

"(I) IN GENERAL. — In instances in which the Secretary has reviewed the comparative analyses described in subparagraph (A), as requested under clause (i), and determined that the group health plan is not in compliance with this section, the plan —

"(aa) shall specify to the Secretary the actions the plan will take to be in compliance with this section and provide to the Secretary additional comparative analyses described in subparagraph (A) that demonstrate compliance with this section not later than 45 days after the initial determination by the Secretary that the plan is not in compliance; and

"(bb) following the 45-day corrective action period under item (aa), if the Secretary makes a final determination that the plan still is not in compliance with this section, not later than 7 days after such determination, shall notify all individuals enrolled in the plan that the plan has been determined to be not in compliance with this section.

"(II) EXEMPTION FROM DISCLOSURE. — Documents or communications produced in connection with the Secretary's recommendations to a group health plan shall not be subject to disclosure pursuant to section 552 of title 5, United States Code.

"(iv) REPORT. — Not later than 1 year after the date of enactment of this paragraph, and not later than October 1 of each year thereafter, the Secretary shall submit to Congress, and make publicly available, a report that contains —

"(I) a summary of the comparative analyses requested under clause (i), including the identity of each group plan that is determined to be not in compliance after the final determination by the Secretary described in clause (iii)(I)(bb);

"(II) the Secretary's conclusions as to whether each group health plan submitted sufficient information for the Secretary to review the comparative analyses requested under clause (i) for compliance with this section;

"(III) for each group health plan that did submit sufficient information for the Secretary to review the comparative analyses requested under clause (i), the Secretary's conclusions as to whether and why the plan is in compliance with the disclosure requirements under this section;

"(IV) the Secretary's specifications described in clause (ii) for each group health plan that the Secretary determined did not submit sufficient information for the Secretary to review the comparative analyses requested under clause (i) for compliance with this section; and

"(V) the Secretary's specifications described in clause (iii) of the actions each group health plan that the Secretary determined is not in compliance with this section must take to be in compliance with this section, including the reason why the Secretary determined the plan is not in compliance.

"(C) COMPLIANCEPROGRAMGUIDANCEDOCUMENT UPDATE PROCESS. —

"(i) IN GENERAL. — The Secretary shall include instances of noncompliance that the Secretary discovers upon reviewing the comparative analyses requested under subparagraph (B)(i) in the compliance program guidance document described in paragraph (6), as it is updated every 2 years, except that such instances shall not disclose any protected health information or individually identifiable information.

"(ii) GUIDANCE AND REGULATIONS. — Not later than 18 months after the date of enactment of this paragraph, the Secretary shall finalize any draft or interim guidance and regulations relating to mental health parity under this section. Such draft guidance shall include guidance to clarify the process and timeline for current and potential participants and beneficiaries (and authorized representatives and health care providers of such participants and beneficiaries) with respect to plans to file complaints of such plans being in violation of this section, including guidance, by plan type, on the relevant State, regional, or national office with which such complaints should be filed.

"(iii) STATE. — The Secretary shall share information on findings of compliance and noncompliance discovered upon reviewing the comparative analyses requested under subparagraph (B)(i) shall be shared with the State where the group health plan is located, in accordance with paragraph (6)(B)(iii)(II).".

(4) MEDICAID AND CHIP COMPLIANCE. —

(A) MEDICAID MANAGED CARE ORGANIZATIONS. — Section 1932(b)(8) of the Social Security Act (42 U.S.C. 1396u–2(b)(8)) is amended by adding at the end the following new sentence: "In applying the previous sentence with respect to requirements under paragraph (8) of section 2726(a) of the Public Health Service Act, a Medicaid managed care organization (or a prepaid inpatient health plan (as defined by the Secretary) or prepaid ambulatory health plan (as defined by the Secretary) that offers services to enrollees of a Medicaid managed care organization) shall be treated as in compliance with such requirements if the Medicaid managed care organization (or prepaid inpatient health plan or prepaid ambulatory health plan) is in compliance with subpart K of part 438 of title 42, Code of Federal Regulations, and section 438.3(n) of such title, or any successor regulation.".

(B) OTHER BENCHMARK BENEFIT PACKAGES OR BENCHMARK EQUIVALENT COVERAGE. — Section 1937(b)(6)(A) of such Act (42 U.S.C. 1396u–7(b)(6)(A)) is amended —

(i) by striking "section 2705(a) " and inserting "section 2726(a) "; and

(ii) by adding at the end the following new sentence: "In applying the previous sentence with respect to requirements under paragraph (8) of section 2726(a) of the Public Health Service Act, a benchmark benefit package or benchmark equivalent coverage described in such sentence shall be treated as in compliance with such requirements if the State plan under this title or the benchmark benefit package or benefit equivalent coverage, as applicable, is in compliance with subpart C of part 440 of title 42, Code of Federal Regulations, or any successor regulation.".

(C) STATE CHILD HEALTH PLANS. — Section 2103(c)(7)(A) of the Social Security Act (42 U.S.C. 1397cc(c)(7)(A)) is amended —

(i) by striking "section 2705(a) " and inserting "section 2726(a) "; and

(ii) by adding at the end the following new sentence: "In applying the previous sentence with respect to requirements under paragraph (8) of section 2726(a) of the Public Health Service Act, a State child health plan described in such sentence shall be treated as in compliance with such requirements if the State child health plan is in compliance with section 457.496 of title 42, Code of Federal Regulations, or any successor regulation.".

(b) GUIDANCE. — The Secretary of Health and Human Services, jointly with the Secretary of Labor and the Secretary of the Treasury, shall issue guidance to carry out the amendments made by paragraphs (1), (2), and (3) of subsection (a).

SEC. 204. REPORTING ON PHARMACY BENEFITS AND DRUG COSTS.

(a) PHSA. — Part D of title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), as amended by section 201, is further amended by adding at the end the following:

"SEC. 2799A–10. REPORTING ON PHARMACY BENEFITS AND DRUG COSTS.

"(a) IN GENERAL. — Not later than 1 year after the date of enactment of the Consolidated Appropriations Act, 2021, and not later than June 1 of each year thereafter, a group health plan or health insurance issuer offering group or individual health insurance coverage (except for a church plan) shall submit to the Secretary, the Secretary of Labor, and the Secretary of the Treasury the following information with respect to the health plan or coverage in the previous plan year:

"(1) The beginning and end dates of the plan year.

"(2) The number of enrollees.

"(3) Each State in which the plan or coverage is offered.

"(4) The 50 brand prescription drugs most frequently dispensed by pharmacies for claims paid by the plan or coverage, and the total number of paid claims for each such drug.

"(5) The 50 most costly prescription drugs with respect to the plan or coverage by total annual spending, and the annual amount spent by the plan or coverage for each such drug.

"(6) The 50 prescription drugs with the greatest increase in plan expenditures over the plan year preceding the plan year that is the subject of the report, and, for each such drug, the change in amounts expended by the plan or coverage in each such plan year.

"(7) Total spending on health care services by such group health plan or health insurance coverage, broken down by —

"(A) the type of costs, including —

"(i) hospital costs;

"(ii) health care provider and clinical service costs, for primary care and specialty care separately;

"(iii) costs for prescription drugs; and

"(iv) other medical costs, including wellness services; and

"(B) spending on prescription drugs by —

"(i) the health plan or coverage; and

"(ii) the enrollees.

"(8) The average monthly premium —

"(A) paid by employers on behalf of enrollees, as applicable; and

"(B) paid by enrollees.

"(9) Any impact on premiums by rebates, fees, and any other remuneration paid by drug manufacturers to the plan or coverage or its administrators or service providers, with respect to prescription drugs prescribed to enrollees in the plan or coverage, including —

"(A) the amounts so paid for each therapeutic class of drugs; and

"(B) the amounts so paid for each of the 25 drugs that yielded the highest amount of rebates and other remuneration under the plan or coverage from drug manufacturers during the plan year.

"(10) Any reduction in premiums and out-of-pocket costs associated with rebates, fees, or other remuneration described in paragraph (9).

"(b) REPORT. — Not later than 18 months after the date on which the first report is required under subsection (a) and biannually thereafter, the Secretary, acting through the Assistant Secretary of Planning and Evaluation and in coordination with the Inspector General of the Department of Health and Human Services, shall make available on the internet website of the Department of Health and Human Services a report on prescription drug reimbursements under group health plans and group and individual health insurance coverage, prescription drug pricing trends, and the role of prescription drug costs in contributing to premium increases or decreases under such plans or coverage, aggregated in such a way as no drug or plan specific information will be made public.

"(c) PRIVACY PROTECTIONS. — No confidential or trade secret information submitted to the Secretary under subsection (a) shall be included in the report under subsection (b).".

(b) ERISA. — Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.), as amended by section 201, is further amended by adding at the end the following:

"SEC. 725. REPORTING ON PHARMACY BENEFITS AND DRUG COSTS.

"(a) IN GENERAL. — Not later than 1 year after the date of enactment of the Consolidated Appropriations Act, 2021, and not later than June 1 of each year thereafter, a group health plan (or health insurance coverage offered in connection with such a plan) shall submit to the Secretary, the Secretary of Health and Human Services, and the Secretary of the Treasury the following information with respect to the health plan or coverage in the previous plan year:

"(1) The beginning and end dates of the plan year.

"(2) The number of participants and beneficiaries.

"(3) Each State in which the plan or coverage is offered.

"(4) The 50 brand prescription drugs most frequently dispensed by pharmacies for claims paid by the plan or coverage, and the total number of paid claims for each such drug.

"(5) The 50 most costly prescription drugs with respect to the plan or coverage by total annual spending, and the annual amount spent by the plan or coverage for each such drug.

"(6) The 50 prescription drugs with the greatest increase in plan expenditures over the plan year preceding the plan year that is the subject of the report, and, for each such drug, the change in amounts expended by the plan or coverage in each such plan year.

"(7) Total spending on health care services by such group health plan or health insurance coverage, broken down by —

"(A) the type of costs, including —

"(i) hospital costs;

"(ii) health care provider and clinical service costs, for primary care and specialty care separately;

"(iii) costs for prescription drugs; and

"(iv) other medical costs, including wellness services; and

"(B) spending on prescription drugs by —

"(i) the health plan or coverage; and

"(ii) the participants and beneficiaries.

"(8) The average monthly premium —

"(A) paid by employers on behalf of participants and beneficiaries, as applicable; and

"(B) paid by participants and beneficiaries.

"(9) Any impact on premiums by rebates, fees, and any other remuneration paid by drug manufacturers to the plan or coverage or its administrators or service providers, with respect to prescription drugs prescribed to participants or beneficiaries in the plan or coverage, including —

"(A) the amounts so paid for each therapeutic class of drugs; and

"(B) the amounts so paid for each of the 25 drugs that yielded the highest amount of rebates and other remuneration under the plan or coverage from drug manufacturers during the plan year.

"(10) Any reduction in premiums and out-of-pocket costs associated with rebates, fees, or other remuneration described in paragraph (9).

"(b) REPORT. — Not later than 18 months after the date on which the first report is required under subsection (a) and biannually thereafter, the Secretary, acting in coordination with the Inspector General of the Department of Labor, shall make available on the internet website of the Department of Labor a report on prescription drug reimbursements under group health plans (or health insurance coverage offered in connection with such a plan), prescription drug pricing trends, and the role of prescription drug costs in contributing to premium increases or decreases under such plans or coverage, aggregated in such a way as no drug or plan specific information will be made public.

"(c) PRIVACY PROTECTIONS. — No confidential or trade secret information submitted to the Secretary under subsection (a) shall be included in the report under subsection (b).".

(c) IRC. — Subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by section 201, is further amended by adding at the end the following:

"SEC. 9825. REPORTING ON PHARMACY BENEFITS AND DRUG COSTS.

"(a) IN GENERAL. — Not later than 1 year after the date of enactment of the Consolidated Appropriations Act, 2021, and not later than June 1 of each year thereafter, a group health plan shall submit to the Secretary, the Secretary of Health and Human Services, and the Secretary of Labor the following information with respect to the health plan in the previous plan year:

"(1) The beginning and end dates of the plan year.

"(2) The number of participants and beneficiaries.

"(3) Each State in which the plan is offered.

"(4) The 50 brand prescription drugs most frequently dispensed by pharmacies for claims paid by the plan, and the total number of paid claims for each such drug.

"(5) The 50 most costly prescription drugs with respect to the plan by total annual spending, and the annual amount spent by the plan for each such drug.

"(6) The 50 prescription drugs with the greatest increase in plan expenditures over the plan year preceding the plan year that is the subject of the report, and, for each such drug, the change in amounts expended by the plan in each such plan year.

"(7) Total spending on health care services by such group health plan, broken down by —

"(A) the type of costs, including —

"(i) hospital costs;

"(ii) health care provider and clinical service costs, for primary care and specialty care separately;

"(iii) costs for prescription drugs; and

"(iv) other medical costs, including wellness services; and

"(B) spending on prescription drugs by —

"(i) the health plan; and

"(ii) the participants and beneficiaries.

"(8) The average monthly premium —

"(A) paid by employers on behalf of participants and beneficiaries, as applicable; and

"(B) paid by participants and beneficiaries.

"(9) Any impact on premiums by rebates, fees, and any other remuneration paid by drug manufacturers to the plan or its administrators or service providers, with respect to prescription drugs prescribed to participants or beneficiaries in the plan, including —

"(A) the amounts so paid for each therapeutic class of drugs; and

"(B) the amounts so paid for each of the 25 drugs that yielded the highest amount of rebates and other remuneration under the plan from drug manufacturers during the plan year.

"(10) Any reduction in premiums and out-of-pocket costs associated with rebates, fees, or other remuneration described in paragraph (9).

"(b) REPORT. — Not later than 18 months after the date on which the first report is required under subsection (a) and biannually thereafter, the Secretary, acting in coordination with the Inspector General of the Department of the Treasury, shall make available on the internet website of the Department of the Treasury a report on prescription drug reimbursements under group health plans, prescription drug pricing trends, and the role of prescription drug costs in contributing to premium increases or decreases under such plans, aggregated in such a way as no drug or plan specific information will be made public.

"(c) PRIVACY PROTECTIONS. — No confidential or trade secret information submitted to the Secretary under subsection (a) shall be included in the report under subsection (b).".

(d) CLERICAL AMENDMENTS. —

(1) ERISA. — The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.), as amended by section 201, is further amended by inserting after the item relating to section 724 the following new item:

"Sec. 725. Reporting on pharmacy benefits and drug costs.".

(2) IRC. — The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986, as amended by section 201, is further amended by adding at the end the following new item:

"Sec. 9825. Reporting on pharmacy benefits and drug costs.".

TITLE III — PUBLIC HEALTH PROVISIONS

Subtitle A — Extenders Provisions

SEC. 301. EXTENSION FOR COMMUNITY HEALTH CENTERS, THE NATIONAL HEALTH SERVICE CORPS, AND TEACHING HEALTH CENTERS THAT OPERATE GME PROGRAMS.

(a) COMMUNITY HEALTH CENTERS. — Section 10503(b)(1)(F) of the Patient Protection and Affordable Care Act (42 U.S.C. 254b–2(b)(1)(F)) is amended by striking ", $4,000,000,000 for fiscal year 2019, $4,000,000,000 for fiscal year 2020, and $865,753,425 for the period beginning on October 1, 2020, and ending on December 18, 2020" and inserting "and $4,000,000,000 for each of fiscal years 2019 through 2023".

(b) NATIONAL HEALTH SERVICE CORPS. — Section 10503(b)(2)(H) of the Patient Protection and Affordable Care Act (42 U.S.C. 254b–2(b)(2)(H)) is amended by striking " $67,095,890 for the period beginning on October 1, 2020, and ending on December 18, 2020" and inserting " $310,000,000 for each of fiscal years 2021 through 2023".

(c) TEACHING HEALTH CENTERS THAT OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS. — Section 340H(g)(1) of the Public Health Service Act (42 U.S.C. 256h(g)(1)) is amended —

(1) by inserting "and" after "2017,"; and

(2) by striking "fiscal year 2020, and $27,379,452 for the period beginning on October 1, 2020, and ending on December 18, 2020" and inserting "2023".

(d) APPLICATION OF PROVISIONS. — Amounts appropriated pursuant to the amendments made by this section for fiscal years 2021 through 2023 shall be subject to the requirements contained in Public Law 116–94 for funds for programs authorized under sections 330 through 340 of the Public Health Service Act.

(e) CONFORMING AMENDMENTS. — Paragraph (4) of section 3014(h) of title 18, United States Code, as amended by section 1201(e) of the Further Continuing Appropriations Act, 2021, and Other Extensions Act, is amended by striking "and section 1201(d) of the Further Continuing Appropriations Act, 2021, and Other Extensions Act" and inserting ", section 1201(d) of the Further Continuing Appropriations Act, 2021, and Other Extensions Act, and section 301(d) of division BB of the Consolidated Appropriations Act, 2021.".

SEC. 302. DIABETES PROGRAMS.

(a) TYPE I. — Section 330B(b)(2)(D) of the Public Health Service Act (42 U.S.C. 254c–2(b)(2)(D)) is amended by striking "2020, and $32,465,753 for the period beginning on October 1, 2020, and ending on December 18, 2020" and inserting "2023".

(b) INDIANS. — Section 330C(c)(2)(D) of the Public Health Service Act (42 U.S.C. 254c–3(c)(2)(D)) is amended by striking "2020, and $32,465,753 for the period beginning on October 1, 2020, and ending on December 18, 2020" and inserting "2023".

Subtitle B — Strengthening Public Health

SEC. 311. IMPROVING AWARENESS OF DISEASE PREVENTION.

(a) IN GENERAL. — The Public Health Service Act is amended by striking section 313 of such Act (42 U.S.C. 245) and inserting the following:

"SEC. 313. PUBLIC AWARENESS CAMPAIGN ON THE IMPORTANCE OF VACCINATIONS.

"(a) IN GENERAL. — The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in coordination with other offices and agencies, as appropriate, shall award competitive grants or contracts to one or more public or private entities to carry out a national, evidence-based campaign to increase awareness and knowledge of the safety and effectiveness of vaccines for the prevention and control of diseases, combat misinformation about vaccines, and disseminate scientific and evidence-based vaccine-related information, with the goal of increasing rates of vaccination across all ages, as applicable, particularly in communities with low rates of vaccination, to reduce and eliminate vaccine preventable diseases.

"(b) CONSULTATION. — In carrying out the campaign under this section, the Secretary shall consult with appropriate public health and medical experts, including the National Academy of Medicine and medical and public health associations and nonprofit organizations, in the development, implementation, and evaluation of the evidence-based public awareness campaign.

"(c) REQUIREMENTS. — The campaign under this section shall —

"(1) be a nationwide, evidence-based media and public engagement initiative;

"(2) include the development of resources for communities with low rates of vaccination, including culturally and linguistically appropriate resources, as applicable;

"(3) include the dissemination of vaccine information and communication resources to public health departments, health care providers, and health care facilities, including such providers and facilities that provide prenatal and pediatric care;

"(4) be complementary to, and coordinated with, any other Federal, State, local, or Tribal efforts, as appropriate; and

"(5) assess the effectiveness of communication strategies to increase rates of vaccination.

"(d) ADDITIONAL ACTIVITIES. — The campaign under this section may —

"(1) include the use of television, radio, the internet, and other media and telecommunications technologies;

"(2) include the use of in-person activities;

"(3) be focused to address specific needs of communities and populations with low rates of vaccination; and

"(4) include the dissemination of scientific and evidencebased vaccine-related information, such as —

"(A) advancements in evidence-based research related to diseases that may be prevented by vaccines and vaccine development;

"(B) information on vaccinations for individuals and communities, including individuals for whom vaccines are not recommended by the Advisory Committee for Immunization Practices, and the effects of low vaccination rates within a community on such individuals;

"(C) information on diseases that may be prevented by vaccines; and

"(D) information on vaccine safety and the systems in place to monitor vaccine safety.

"(e) EVALUATION. — The Secretary shall —

"(1) establish benchmarks and metrics to quantitatively measure and evaluate the awareness campaign under this section;

"(2) conduct qualitative assessments regarding the awareness campaign under this section; and

"(3) prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and Committee on Energy and Commerce of the House of Representatives an evaluation of the awareness campaign under this section.

"(f) SUPPLEMENT NOT SUPPLANT. — Funds appropriated under this section shall be used to supplement and not supplant other Federal, State, and local public funds provided for activities described in this section.

"(g) AUTHORIZATION OF APPROPRIATIONS. — There are authorized to be appropriated to carry out this section and subsections (k) and (n) of section 317, $15,000,000 for each of fiscal years 2021 through 2025.".

(b) GRANTS TO ADDRESS VACCINE-PREVENTABLE DISEASES. — Section 317 of the Public Health Service Act (42 U.S.C. 247b) is amended —

(1) in subsection (k)(1) —

(A) in subparagraph (C), by striking "; and" and inserting a semicolon;

(B) in subparagraph (D), by striking the period and inserting a semicolon; and

(C) by adding at the end the following:

"(E) planning, implementation, and evaluation of activities to address vaccine-preventable diseases, including activities to —

"(i) identify communities at high risk of outbreaks related to vaccine-preventable diseases, including through improved data collection and analysis;

"(ii) pilot innovative approaches to improve vaccination rates in communities and among populations with low rates of vaccination;

"(iii) reduce barriers to accessing vaccines and evidence-based information about the health effects of vaccines;

"(iv) partner with community organizations and health care providers to develop and deliver evidence-based interventions, including culturally and linguistically appropriate interventions, to increase vaccination rates;

"(v) improve delivery of evidence-based vaccine-related information to parents and others; and

"(vi) improve the ability of State, local, Tribal, and territorial public health departments to engage communities at high risk for outbreaks related to vaccine-preventable diseases, including, as appropriate, with local educational agencies, as defined in section 8101 of the Elementary and Secondary Education Act of 1965; and

"(F) research related to strategies for improving awareness of scientific and evidence-based vaccine-related information, including for communities with low rates of vaccination, in order to understand barriers to vaccination, improve vaccination rates, and assess the public health outcomes of such strategies."; and

(2) by adding at the end the following:

"(n) VACCINATION DATA. — The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall expand and enhance, and, as appropriate, establish and improve, programs and conduct activities to collect, monitor, and analyze vaccination coverage data to assess levels of protection from vaccinepreventable diseases, including by assessing factors contributing to underutilization of vaccines and variations of such factors, and identifying communities at high risk of outbreaks associated with vaccine-preventable diseases.".

(c) SUPPLEMENTAL GRANT FUNDS. — Section 330(d)(1) of the Public Health Service Act (42 U.S.C. 254b) is amended —

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

(2) in subparagraph (G), by striking the period and inserting "; and"; and

(3) by adding at the end the following:

"(H) improving access to recommended immunizations.".

(d) UPDATE OF 2015 NVAC REPORT. — The National Vaccine Advisory Committee established under section 2105 of the Public Health Service Act (42 U.S.C. 300aa–5) shall, as appropriate, update the report entitled, "Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee", approved by the National Vaccine Advisory Committee on June 10, 2015, with respect to factors affecting childhood vaccination.

SEC. 312. GUIDE ON EVIDENCE-BASED STRATEGIES FOR PUBLIC HEALTH DEPARTMENT OBESITY PREVENTION PROGRAMS.

(a) DEVELOPMENT AND DISSEMINATION OF AN EVIDENCE-BASED STRATEGIES GUIDE. — The Secretary of Health and Human Services (referred to in this section as the "Secretary"), acting through the Director of the Centers for Disease Control and Prevention, not later than 2 years after the date of enactment of this Act, may —

(1) develop a guide on evidence-based strategies for State, territorial, and local health departments to use to build and maintain effective obesity prevention and reduction programs, and, in consultation with Indian Tribes, Tribal organizations, and urban Indian organizations, a guide on such evidencebased strategies with respect to Indian Tribes and Tribal organizations for such Indian Tribes and Tribal organizations to use for such purpose, both of which guides shall —

(A) describe an integrated program structure for implementing interventions proven to be effective in preventing and reducing the incidence of obesity; and

(B) recommend —

(i) optimal resources, including staffing and infrastructure, for promoting nutrition and obesity prevention and reduction; and

(ii) strategies for effective obesity prevention programs for State, territorial, and local health departments, Indian Tribes, and Tribal organizations, including strategies related to —

(I) the application of evidence-based and evidence-informed practices to prevent and reduce obesity rates;

(II) the development, implementation, and evaluation of obesity prevention and reduction strategies for specific communities and populations;

(III) demonstrated knowledge of obesity prevention practices that reduce associated preventable diseases, health conditions, death, and health care costs;

(IV) best practices for the coordination of efforts to prevent and reduce obesity and related chronic diseases;

(V) addressing the underlying risk factors and social determinants of health that impact obesity rates; and

(VI) interdisciplinary coordination between relevant public health officials specializing in fields such as nutrition, physical activity, epidemiology, communications, and policy implementation, and collaboration between public health officials, community-based organizations, and others, as appropriate; and

(2) disseminate the guides and current research, evidence-based practices, tools, and educational materials related to obesity prevention, consistent with the guides, to State, territorial, and local health departments, Indian Tribes, and Tribal organizations.

(b) TECHNICAL ASSISTANCE. — The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall provide technical assistance to State, territorial, and local health departments, Indian Tribes, and Tribal organizations to support such health departments in implementing the guide developed under subsection (a)(1).

(c) INDIAN TRIBES; TRIBAL ORGANIZATIONS; URBAN INDIAN ORGANIZATIONS. — In this section —

(1) the terms "Indian Tribe" and "Tribal organization" have the meanings given the terms "Indian tribe" and "tribal organization", respectively, in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304); and

(2) the term "urban Indian organization" has the meaning given such term in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603).

SEC. 313. EXPANDING CAPACITY FOR HEALTH OUTCOMES.

Title III of the Public Health Service Act is amended by inserting after section 330M (42 U.S.C. 254c–19) the following:

"SEC. 330N. EXPANDING CAPACITY FOR HEALTH OUTCOMES.

"(a) DEFINITIONS. — In this section:

"(1) ELIGIBLE ENTITY. — The term 'eligible entity' means an entity that provides, or supports the provision of, health care services in rural areas, frontier areas, health professional shortage areas, or medically underserved areas, or to medically underserved populations or Native Americans, including Indian Tribes, Tribal organizations, and urban Indian organizations, and which may include entities leading, or capable of leading, a technology-enabled collaborative learning and capacity building model or engaging in technology-enabled collaborative training of participants in such model.

"(2) HEALTH PROFESSIONAL SHORTAGE AREA. — The term 'health professional shortage area' means a health professional shortage area designated under section 332.

"(3) INDIAN TRIBE. — The terms 'Indian Tribe' and 'Tribal organization' have the meanings given the terms 'Indian tribe' and 'tribal organization' in section 4 of the Indian Self-Determination and Education Assistance Act.

"(4) MEDICALLY UNDERSERVED POPULATION. — The term 'medically underserved population' has the meaning given the term in section 330(b)(3).

"(5) NATIVE AMERICANS. — The term 'Native Americans' has the meaning given the term in section 736 and includes Indian Tribes and Tribal organizations.

"(6) TECHNOLOGY-ENABLED COLLABORATIVE LEARNING AND CAPACITY BUILDING MODEL. — The term 'technology-enabled collaborative learning and capacity building model' means a distance health education model that connects health care professionals, and particularly specialists, with multiple other health care professionals through simultaneous interactive videoconferencing for the purpose of facilitating case-based learning, disseminating best practices, and evaluating outcomes.

"(7) URBAN INDIAN ORGANIZATION. — The term 'urban Indian organization' has the meaning given the term in section 4 of the Indian Health Care Improvement Act.

"(b) PROGRAM ESTABLISHED. — The Secretary shall, as appropriate, award grants to evaluate, develop, and, as appropriate, expand the use of technology-enabled collaborative learning and capacity building models, to improve retention of health care providers and increase access to health care services, such as those to address chronic diseases and conditions, infectious diseases, mental health, substance use disorders, prenatal and maternal health, pediatric care, pain management, palliative care, and other specialty care in rural areas, frontier areas, health professional shortage areas, or medically underserved areas and for medically underserved populations or Native Americans.

"(c) USE OF FUNDS. —

"(1) IN GENERAL. — Grants awarded under subsection (b) shall be used for —

"(A) the development and acquisition of instructional programming, and the training of health care providers and other professionals that provide or assist in the provision of services through models described in subsection (b), such as training on best practices for data collection and leading or participating in such technology-enabled activities consistent with technology-enabled collaborative learning and capacity-building models;

"(B) information collection and evaluation activities to study the impact of such models on patient outcomes and health care providers, and to identify best practices for the expansion and use of such models; or

"(C) other activities consistent with achieving the objectives of the grants awarded under this section, as determined by the Secretary.

"(2) OTHER USES. — In addition to any of the uses under paragraph (1), grants awarded under subsection (b) may be used for —

"(A) equipment to support the use and expansion of technology-enabled collaborative learning and capacity building models, including for hardware and software that enables distance learning, health care provider support, and the secure exchange of electronic health information; or

"(B) support for health care providers and other professionals that provide or assist in the provision of services through such models.

"(d) LENGTH OF GRANTS. — Grants awarded under subsection

(b) shall be for a period of up to 5 years.

"(e) GRANT REQUIREMENTS. — The Secretary may require entities awarded a grant under this section to collect information on the effect of the use of technology-enabled collaborative learning and capacity building models, such as on health outcomes, access to health care services, quality of care, and provider retention in areas and populations described in subsection (b). The Secretary may award a grant or contract to assist in the coordination of such models, including to assess outcomes associated with the use of such models in grants awarded under subsection (b), including for the purpose described in subsection (c)(1)(B).

"(f) APPLICATION. — An eligible entity that seeks to receive a grant under subsection (b) shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require. Such application shall include plans to assess the effect of technology-enabled collaborative learning and capacity building models on patient outcomes and health care providers.

"(g) ACCESS TO BROADBAND. — In administering grants under this section, the Secretary may coordinate with other agencies to ensure that funding opportunities are available to support access to reliable, high-speed internet for grantees.

"(h) TECHNICAL ASSISTANCE. — The Secretary shall provide (either directly through the Department of Health and Human Services or by contract) technical assistance to eligible entities, including recipients of grants under subsection (b), on the development, use, and evaluation of technology-enabled collaborative learning and capacity building models in order to expand access to health care services provided by such entities, including for medically underserved areas and to medically underserved populations or Native Americans.

"(i) RESEARCH AND EVALUATION. — The Secretary, in consultation with stakeholders with appropriate expertise in such models, shall develop a strategic plan to research and evaluate the evidence for such models. The Secretary shall use such plan to inform the activities carried out under this section.

"(j) REPORT BY SECRETARY. — Not later than 4 years after the date of enactment of this section, the Secretary shall prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, and post on the internet website of the Department of Health and Human Services, a report including, at minimum —

"(1) a description of any new and continuing grants awarded to entities under subsection (b) and the specific purpose and amounts of such grants;

"(2) an overview of —

"(A) the evaluations conducted under subsections (b);

"(B) technical assistance provided under subsection (h); and

"(C) activities conducted by entities awarded grants under subsection (b); and

"(3) a description of any significant findings or developments related to patient outcomes or health care providers and best practices for eligible entities expanding, using, or evaluating technology-enabled collaborative learning and capacity building models, including through the activities described in subsection (h).

"(k) AUTHORIZATION OF APPROPRIATIONS. — There are authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2022 through 2026.".

SEC. 314. PUBLIC HEALTH DATA SYSTEM MODERNIZATION.

Subtitle C of title XXVIII of the Public Health Service Act (42 U.S.C. 300hh–31 et seq.) is amended by adding at the end the following:

"SEC. 2823. PUBLIC HEALTH DATA SYSTEM MODERNIZATION.

"(a) EXPANDING CDC AND PUBLIC HEALTH DEPARTMENT CAPABILITIES. —

"(1) IN GENERAL. — The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall —

"(A) conduct activities to expand, modernize, improve, and sustain applicable public health data systems used by the Centers for Disease Control and Prevention, including with respect to the interoperability and improvement of such systems (including as it relates to preparedness for, prevention and detection of, and response to public health emergencies); and

"(B) award grants or cooperative agreements to State, local, Tribal, or territorial public health departments for the expansion and modernization of public health data systems, to assist public health departments and public health laboratories in —

"(i) assessing current data infrastructure capabilities and gaps to —

"(I) improve and increase consistency in data collection, storage, and analysis; and

"(II) as appropriate, improve dissemination of public health-related information;

"(ii) improving secure public health data collection, transmission, exchange, maintenance, and analysis, including with respect to demographic data, as appropriate;

"(iii) improving the secure exchange of data between the Centers for Disease Control and Prevention, State, local, Tribal, and territorial public health departments, public health laboratories, public health organizations, and health care providers, including by public health officials in multiple jurisdictions within such State, as appropriate, and by simplifying and supporting reporting by health care providers, as applicable, pursuant to State law, including through the use of health information technology;

"(iv) enhancing the interoperability of public health data systems (including systems created or accessed by public health departments) with health information technology, including with health information technology certified under section 3001(c)(5);

"(v) supporting and training data systems, data science, and informatics personnel;

"(vi) supporting earlier disease and health condition detection, such as through near real-time data monitoring, to support rapid public health responses;

"(vii) supporting activities within the applicable jurisdiction related to the expansion and modernization of electronic case reporting; and

"(viii) developing and disseminating information related to the use and importance of public health data.

"(2) DATA STANDARDS. — In carrying out paragraph (1), the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall, as appropriate and in consultation with the Office of the National Coordinator for Health Information Technology, designate data and technology standards (including standards for interoperability) for public health data systems, with deference given to standards published by consensus-based standards development organizations with public input and voluntary consensus-based standards bodies.

"(3) PUBLIC-PRIVATE PARTNERSHIPS. — The Secretary may develop and utilize public-private partnerships for technical assistance, training, and related implementation support for State, local, Tribal, and territorial public health departments, and the Centers for Disease Control and Prevention, on the expansion and modernization of electronic case reporting and public health data systems, as applicable.

"(b) REQUIREMENTS. —

"(1) HEALTH INFORMATION TECHNOLOGY STANDARDS. — The Secretary may not award a grant or cooperative agreement under subsection (a)(1)(B) unless the applicant uses or agrees to use standards endorsed by the National Coordinator for Health Information Technology pursuant to section 3001(c)(1) or adopted by the Secretary under section 3004.

"(2) WAIVER. — The Secretary may waive the requirement under paragraph (1) with respect to an applicant if the Secretary determines that the activities under subsection (a)(1)(B) cannot otherwise be carried out within the applicable jurisdiction.

"(3) APPLICATION. — A State, local, Tribal, or territorial health department applying for a grant or cooperative agreement under this section shall submit an application to the Secretary at such time and in such manner as the Secretary may require. Such application shall include information describing —

"(A) the activities that will be supported by the grant or cooperative agreement; and

"(B) how the modernization of the public health data systems involved will support or impact the public health infrastructure of the health department, including a description of remaining gaps, if any, and the actions needed to address such gaps.

"(c) STRATEGY AND IMPLEMENTATION PLAN. — Not later than 180 days after the date of enactment of this section, the Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a coordinated strategy and an accompanying implementation plan that identifies and demonstrates the measures the Secretary will utilize to —

"(1) update and improve applicable public health data systems used by the Centers for Disease Control and Prevention; and

"(2) carry out the activities described in this section to support the improvement of State, local, Tribal, and territorial public health data systems.

"(d) CONSULTATION. — The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall consult with State, local, Tribal, and territorial health departments, professional medical and public health associations, associations representing hospitals or other health care entities, health information technology experts, and other appropriate public or private entities regarding the plan and grant program to modernize public health data systems pursuant to this section. Activities under this subsection may include the provision of technical assistance and training related to the exchange of information by such public health data systems used by relevant health care and public health entities at the local, State, Federal, Tribal, and territorial levels, and the development and utilization of public-private partnerships for implementation support applicable to this section.

"(e) REPORT TO CONGRESS. — Not later than 1 year after the date of enactment of this section, the Secretary shall submit a report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives that includes —

"(1) a description of any barriers to —

"(A) public health authorities implementing interoperable public health data systems and electronic case reporting;

"(B) the exchange of information pursuant to electronic case reporting;

"(C) reporting by health care providers using such public health data systems, as appropriate, and pursuant to State law; or

"(D) improving demographic data collection or analysis;

"(2) an assessment of the potential public health impact of implementing electronic case reporting and interoperable public health data systems; and

"(3) a description of the activities carried out pursuant to this section.

"(f) ELECTRONIC CASE REPORTING. — In this section, the term 'electronic case reporting' means the automated identification, generation, and bilateral exchange of reports of health events among electronic health record or health information technology systems and public health authorities.

"(g) AUTHORIZATION OF APPROPRIATIONS. — To carry out this section, there are authorized to be appropriated $100,000,000 for each of fiscal years 2021 through 2025.".

SEC. 315. NATIVE AMERICAN SUICIDE PREVENTION.

Section 520E(b) of the Public Health Service Act (42 U.S.C. 290bb–36(b) is amended by inserting after paragraph (3) the following:

"(4) CONSULTATION. — An entity described in paragraph (1)(A) or (1)(B) that applies for a grant or cooperative agreement under this section shall agree to consult or confer with entities described in paragraph (1)(C) and Native Hawaiian Health Care Systems, as applicable, in the applicable State with respect to the development and implementation of a statewide early intervention strategy.".

SEC. 316. REAUTHORIZATION OF THE YOUNG WOMEN'S BREAST HEALTH EDUCATION AND AWARENESS REQUIRES LEARNING YOUNG ACT OF 2009.

Section 399NN(h) of the Public Health Service Act (42 U.S.C. 280m(h)) is amended by striking " $4,900,000 for each of fiscal years 2015 through 2019" and inserting " $9,000,000 for each of fiscal years 2022 through 2026".

SEC. 317. REAUTHORIZATION OF SCHOOL-BASED HEALTH CENTERS.

Section 399Z–1(l) of the Public Health Service Act (42 U.S.C. 280h–5(l)) is amended by striking "2010 through 2014" and inserting "2022 through 2026".

Subtitle C — FDA Amendments

SEC. 321. RARE PEDIATRIC DISEASE PRIORITY REVIEW VOUCHER EXTENSION.

Section 529(b)(5) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360ff(b)(5)) is amended —

(1) by striking "December 18, 2020" each place it appears and inserting "September 30, 2024"; and

(2) in subparagraph (B), by striking "December 18, 2022" and inserting "September 30, 2026".

SEC. 322. CONDITIONS OF USE FOR BIOSIMILAR BIOLOGICAL PRODUCTS.

Section 351(k)(2)(A)(iii) of the Public Health Service Act (42 U.S.C.262(k)(2)(A)(iii)) is amended —

(1) in subclause (I), by striking "; and" and inserting a semicolon;

(2) in subclause (II), by striking the period and inserting "; and"; and

(3) by adding at the end the following:

"(III) may include information to show that the conditions of use prescribed, recommended, or suggested in the labeling proposed for the biological product have been previously approved for the reference product.".

SEC. 323. ORPHAN DRUG CLARIFICATION.

Section 527(c) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360cc(c)) is amended by adding at the end the following:

"(3) APPLICABILITY. — This subsection applies to any drug designated under section 526 for which an application was approved under section 505 of this Act or licensed under section 351 of the Public Health Service Act after the date of enactment of the FDA Reauthorization Act of 2017, regardless of the date on which such drug was designated under section 526.".

SEC. 324. MODERNIZING THE LABELING OF CERTAIN GENERIC DRUGS.

Chapter V of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 351 et seq.) is amended by inserting after section 503C the following:

"SEC. 503D. PROCESS TO UPDATE LABELING FOR CERTAIN GENERIC DRUGS.

"(a) DEFINITIONS. — For purposes of this section:

"(1) The term 'covered drug' means a drug approved under section 505(c) —

"(A) for which there are no unexpired patents included in the list under section 505(j)(7) and no unexpired period of exclusivity;

"(B) for which the approval of the application has been withdrawn for reasons other than safety or effectiveness; and

"(C) for which —

"(i)(I) there is new scientific evidence available pertaining to new or existing conditions of use that is not reflected in the approved labeling;

"(II) the approved labeling does not reflect current legal and regulatory requirements for content or format; or

"(III) there is a relevant accepted use in clinical practice that is not reflected in the approved labeling; and

"(ii) updating the approved labeling would benefit the public health.

"(2) The term 'period of exclusivity', with respect to a drug approved under section 505(c), means any period of exclusivity under clause (ii), (iii), or (iv) of section 505(c)(3)(E), clause (ii), (iii), or (iv) of section 505(j)(5)(F), or section 505A, 505E, or 527.

"(3) The term 'generic version' means a drug approved under section 505(j) whose reference listed drug is a covered drug.

"(4) The term 'relevant accepted use' means a use for a drug in clinical practice that is supported by scientific evidence that appears to the Secretary to meet the standards for approval under section 505.

"(5) The term 'selected drug' means a covered drug for which the Secretary has determined through the process under subsection (c) that the labeling should be changed.

"(b) IDENTIFICATION OF COVERED DRUGS. — The Secretary may identify covered drugs for which labeling updates would provide a public health benefit. To assist in identifying covered drugs, the Secretary may do one or both of the following:

"(1) Enter into cooperative agreements or contracts with public or private entities to review the available scientific evidence concerning such drugs.

"(2) Seek public input concerning such drugs, including input on whether there is a relevant accepted use in clinical practice that is not reflected in the approved labeling of such drugs or whether new scientific evidence is available regarding the conditions of use for such drug, by —

"(A) holding one or more public meetings;

"(B) opening a public docket for the submission of public comments; or

"(C) other means, as the Secretary determines appropriate.

"(c) SELECTION OF DRUGS FOR UPDATING. — If the Secretary determines, with respect to a covered drug, that the available scientific evidence meets the standards under section 505 for adding or modifying information to the labeling or providing supplemental information to the labeling regarding the use of the covered drug, the Secretary may initiate the process under subsection (d).

"(d) INITIATION OF THE PROCESS OF UPDATING. — If the Secretary determines that labeling changes are appropriate for a selected drug pursuant to subsection (c), the Secretary shall provide notice to the holders of approved applications for a generic version of such drug that —

"(1) summarizes the findings supporting the determination of the Secretary that the available scientific evidence meets the standards under section 505 for adding or modifying information or providing supplemental information to the labeling of the covered drug pursuant to subsection (c);

"(2) provides a clear statement regarding the additional, modified, or supplemental information for such labeling, according to the determination by the Secretary (including, as applicable, modifications to add the relevant accepted use to the labeling of the drug as an additional indication for the drug); and

"(3) states whether the statement under paragraph (2) applies to the selected drug as a class of covered drugs or only to a specific drug product.

"(e) RESPONSE TO NOTIFICATION. — Within 30 days of receipt of notification provided by the Secretary pursuant to subsection (d), the holder of an approved application for a generic version of the selected drug shall —

"(1) agree to change the approved labeling to reflect the additional, modified, or supplemental information the Secretary has determined to be appropriate; or

"(2) notify the Secretary that the holder of the approved application does not believe that the requested labeling changes are warranted and submit a statement detailing the reasons why such changes are not warranted.

"(f) REVIEW OF APPLICATION HOLDER'S RESPONSE. —

"(1) IN GENERAL. — Upon receipt of the application holder's response, the Secretary shall promptly review each statement received under subsection (e)(2) and determine which labeling changes pursuant to the Secretary's notice under subsection

(d) are appropriate, if any. If the Secretary disagrees with the reasons why such labeling changes are not warranted, the Secretary shall provide opportunity for discussions with the application holders to reach agreement on whether the labeling for the covered drug should be updated to reflect available scientific evidence, and if so, the content of such labeling changes.

"(2) CHANGES TO LABELING. — After considering all responses from the holder of an approved application under paragraph (1) or (2) of subsection (e), and any discussion under paragraph (1), the Secretary may order such holder to make the labeling changes the Secretary determines are appropriate. Such holder of an approved application shall —

"(A) update its paper labeling for the drug at the next printing of that labeling;

"(B) update any electronic labeling for the drug within 30 days of such order; and

"(C) submit the revised labeling through the form, 'Supplement — Changes Being Effected'.

"(g) VIOLATION. — If the holder of an approved application for the generic version of the selected drug does not comply with the requirements of subsection (f)(2), such generic version of the selected drug shall be deemed to be misbranded under section 502.

"(h) LIMITATIONS; GENERIC DRUGS. —

"(1) IN GENERAL. — With respect to any labeling change required under this section, the generic version shall be deemed to have the same conditions of use and the same labeling as its reference listed drug for purposes of clauses (i) and

(v) of section 505(j)(2)(A). Any labeling change so required shall not have any legal effect for the applicant that is different than the legal effect that would have resulted if a supplemental application had been submitted and approved to conform the labeling of the generic version to a change in the labeling of the reference drug.

"(2) SUPPLEMENTAL APPLICATIONS. — Changes to labeling made in accordance with this section shall not be eligible for an exclusivity period under this Act.

"(3) SELECTION OF DRUGS. — The Secretary shall not identify a drug as a covered drug or select a drug label for updating under subsection (b) or (c) solely based on the availability of new safety information. Upon identification of a drug as a covered drug under subsection (b), the Secretary may then consider the availability of new safety information (as defined in section 505–1(b)) in determining whether the drug is a selected drug and in determining what labeling changes are appropriate.

"(i) RULES OF CONSTRUCTION. —

"(1) APPROVAL STANDARDS. — This section shall not be construed as altering the applicability of the standards for approval of an application under section 505. No order shall be issued under this subsection unless the scientific evidence supporting the changed labeling meets the standards for approval applicable to any change to labeling under section 505.

"(2) REMOVAL OF INFORMATION. — Nothing in this section shall be construed to give the Secretary additional authority to remove approved indications for drugs, other than the authority described in this section.

"(3) SECRETARY AUTHORITY. — Nothing in this section shall be construed to limit the authority of the Secretary to require labeling changes under section 505(o).

"(4) MAINTENANCE OF LABELING. — Nothing in this section shall be construed to affect the responsibility of the holder of an approved application under section 505(j) to maintain its labeling in accordance with existing requirements, including subpart B of part 201 and sections 314.70 and 314.97 of title 21, Code of Federal Regulations (or any successor regulations).

"(j) REPORTS. — Not later than 4 years after the date of the enactment of this section, and every 4 years thereafter, the Secretary shall prepare and 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 that —

"(1) describes the actions of the Secretary under this section, including —

"(A) the number of covered drugs and description of the types of drugs the Secretary has selected for labeling changes and the rationale for such recommended changes; and

"(B) the number of times the Secretary entered into discussions concerning a disagreement with an application holder or holders and a summary of the decision regarding a labeling change, if any; and

"(2) includes any recommendations of the Secretary for modifying the program under this section.".

SEC. 325. BIOLOGICAL PRODUCT PATENT TRANSPARENCY.

(a) IN GENERAL. — Section 351(k) of the Public Health Service Act (42 U.S.C. 262(k)) is amended by adding at the end the following:

"(9) PUBLIC LISTING. —

"(A) IN GENERAL. —

"(i) INITIAL PUBLICATION. — Not later than 180 days after the date of enactment of this paragraph, the Secretary shall publish and make available to the public in a searchable, electronic format —

"(I) a list of each biological product, by nonproprietary name (proper name), for which, as of such date of enactment, a biologics license under subsection (a) or this subsection is in effect, or that, as of such date of enactment, is deemed to be licensed under this section pursuant to section 7002(e)(4) of the Biologics Price Competition and Innovation Act of 2009;

"(II) the date of licensure of the marketing application and the application number; and

"(III) with respect to each biological product described in subclause (I), the licensure status, and, as available, the marketing status.

"(ii) REVISIONS. — Every 30 days after the publication of the first list under clause (i), the Secretary shall revise the list to include each biological product which has been licensed under subsection (a) or this subsection during the 30-day period or deemed licensed under this section pursuant to section 7002(e)(4) of the Biologics Price Competition and Innovation Act of 2009.

"(iii) PATENT INFORMATION. — Not later than 30 days after a list of patents under subsection (l)(3)(A), or a supplement to such list under subsection (l)(7), has been provided by the reference product sponsor to the subsection (k) applicant respecting a biological product included on the list published under this subparagraph, the reference product sponsor shall provide such list of patents (or supplement thereto) and their corresponding expiry dates to the Secretary, and the Secretary shall, in revisions made under clause (ii), include such information for such biological product. Within 30 days of providing any subsequent or supplemental list of patents to any subsequent subsection (k) applicant under subsection (l)(3)(A) or (l)(7), the reference product sponsor shall update the information provided to the Secretary under this clause with any additional patents from such subsequent or supplemental list and their corresponding expiry dates.

"(iv) LISTING OF EXCLUSIVITIES. — For each biological product included on the list published under this subparagraph, the Secretary shall specify each exclusivity period under paragraph (6) or paragraph

(7) for which the Secretary has determined such biological product to be eligible and that has not concluded.

"(B) REVOCATION OR SUSPENSION OF LICENSE. — If the license of a biological product is determined by the Secretary to have been revoked or suspended for safety, purity, or potency reasons, it may not be published in the list under subparagraph (A). If such revocation or suspension occurred after inclusion of such biological product in the list published under subparagraph (A), the reference product sponsor shall notify the Secretary that —

"(i) the biological product shall be immediately removed from such list for the same period as the revocation or suspension; and

"(ii) a notice of the removal shall be published in the Federal Register.".

(b) REVIEW AND REPORT ON TYPES OF INFORMATION TO BE LISTED. — Not later than 3 years after the date of enactment of this Act, the Secretary of Health and Human Services shall —

(1) solicit public comment regarding the type of information, if any, that should be added to or removed from the list required by paragraph (9) of section 351(k) of the Public Health Service Act (42 U.S.C. 262(k)), as added by subsection (a); and

(2) transmit to Congress an evaluation of such comments, including any recommendations about the types of information that should be added to or removed from the list.

Subtitle D — Technical Corrections

SEC. 331. TECHNICAL CORRECTIONS.

(a) EDUCATION AND TRAINING RELATING TO GERIATRICS. — Section 753(a)(7)(B) of the Public Health Service Act (42 U.S.C. 294c(a)(7)(B)) is amended, in the matter preceding clause (i), by striking "Title VII Health Care Workforce Reauthorization Act of 2019" and inserting "Coronavirus Aid, Relief, and Economic Security Act".

(b) NURSING. — Section 851(d)(3) of the Public Health Service Act (42 U.S.C. 297t(d)(3)) is amended by striking "Title VIII Nursing Reauthorization Act" and inserting "Coronavirus Aid, Relief, and Economic Security Act".

(c) CITATION. — Section 3404(a)(9) of the Coronavirus Aid, Relief, and Economic Security Act (Public Law 116–136) is amended by striking "section 846A (42 U.S.C. 247n–1) " and inserting "section 846A (42 U.S.C. 297n–1) ".

(d) EFFECTIVE DATE. — The amendments made by subsections (a), (b), and (c) shall take effect as if included in the enactment of the Coronavirus Aid, Relief, and Economic Security Act (Public Law 116-136).

* * *

DIVISION EE — TAXPAYER CERTAINTY AND DISASTER TAX RELIEF ACT OF 2020

SEC. 1. SHORT TITLE; TABLE OF CONTENTS.

(a) SHORT TITLE. — This division may be cited as the "Taxpayer Certainty and Disaster Tax Relief Act of 2020".

(b) AMENDMENT OF 1986 CODE. — Except as otherwise expressly provided, whenever in this division an amendment or repeal is expressed in terms of an amendment to, or repeal of, a section or other provision, the reference shall be considered to be made to a section or other provision of the Internal Revenue Code of 1986.

(c) TABLE OF CONTENTS. — The table of contents of this division is as follows:

Sec. 1. Short title; table of contents.

TITLE I — EXTENSION OF CERTAIN EXPIRING PROVISIONS

Subtitle A — Certain Provisions Made Permanent

Sec. 101. Reduction in medical expense deduction floor.

Sec. 102. Energy efficient commercial buildings deduction.

Sec. 103. Benefits provided to volunteer firefighters and emergency medical responders.

Sec. 104. Transition from deduction for qualified tuition and related expenses to increased income limitation on lifetime learning credit.

Sec. 105. Railroad track maintenance credit.

Sec. 106. Certain provisions related to beer, wine, and distilled spirits.

Sec. 107. Refunds in lieu of reduced rates for certain craft beverages produced outside the United States.

Sec. 108. Reduced rates not allowed for smuggled or illegally produced beer, wine, and spirits.

Sec. 109. Minimum processing requirements for reduced distilled spirits rates.

Sec. 110. Modification of single taxpayer rules.

Subtitle B — Certain Provisions Extended Through 2025

Sec. 111. Look-thru rule for related controlled foreign corporations.

Sec. 112. New markets tax credit.

Sec. 113. Work opportunity credit.

Sec. 114. Exclusion from gross income of discharge of qualified principal residence indebtedness.

Sec. 115. 7-year recovery period for motorsports entertainment complexes.

Sec. 116. Expensing rules for certain productions.

Sec. 117. Oil spill liability trust fund rate.

Sec. 118. Empowerment zone tax incentives.

Sec. 119. Employer credit for paid family and medical leave.

Sec. 120. Exclusion for certain employer payments of student loans.

Sec. 121. Extension of carbon oxide sequestration credit.

Subtitle C — Extension of Certain Other Provisions

Sec. 131. Credit for electricity produced from certain renewable resources.

Sec. 132. Extension and phaseout of energy credit.

Sec. 133. Treatment of mortgage insurance premiums as qualified residence interest.

Sec. 134. Credit for health insurance costs of eligible individuals.

Sec. 135. Indian employment credit.

Sec. 136. Mine rescue team training credit.

Sec. 137. Classification of certain race horses as 3-year property.

Sec. 138. Accelerated depreciation for business property on Indian reservations.

Sec. 139. American Samoa economic development credit.

Sec. 140. Second generation biofuel producer credit.

Sec. 141. Nonbusiness energy property.

Sec. 142. Qualified fuel cell motor vehicles.

Sec. 143. Alternative fuel refueling property credit.

Sec. 144. 2-wheeled plug-in electric vehicle credit.

Sec. 145. Production credit for Indian coal facilities.

Sec. 146. Energy efficient homes credit.

Sec. 147. Extension of excise tax credits relating to alternative fuels.

Sec. 148. Extension of residential energy-efficient property credit and inclusion of biomass fuel property expenditures.

Sec. 149. Black lung disability trust fund excise tax.

TITLE II — OTHER PROVISIONS

Sec. 201. Minimum low-income housing tax credit rate.

Sec. 202. Depreciation of certain residential rental property over 30-year period.

Sec. 203. Waste energy recovery property eligible for energy credit.

Sec. 204. Extension of energy credit for offshore wind facilities.

Sec. 205. Minimum rate of interest for certain determinations related to life insurance contracts.

Sec. 206. Clarifications and technical improvements to CARES Act employee retention credit.

Sec. 207. Extension and modification of employee retention and rehiring tax credit.

Sec. 208. Minimum age for distributions during working retirement.

Sec. 209. Temporary rule preventing partial plan termination.

Sec. 210. Temporary allowance of full deduction for business meals.

Sec. 211. Temporary special rule for determination of earned income.

Sec. 212. Certain charitable contributions deductible by non-itemizers.

Sec. 213. Modification of limitations on charitable contributions.

Sec. 214. Temporary special rules for health and dependent care flexible spending arrangements.

TITLE III — DISASTER TAX RELIEF

Sec. 301. Definitions.

Sec. 302. Special disaster-related rules for use of retirement funds.

Sec. 303. Employee retention credit for employers affected by qualified disasters.

Sec. 304. Other disaster-related tax relief provisions.

Sec. 305. Low-income housing tax credit.

Sec. 306. Treatment of certain possessions.

TITLE I — EXTENSION OF CERTAIN EXPIRING PROVISIONS

Subtitle A — Certain Provisions Made Permanent

SEC. 101. REDUCTION IN MEDICAL EXPENSE DEDUCTION FLOOR.

(a) IN GENERAL. — Section 213 is amended —

(1) by striking "10 percent" in subsection (a) and inserting "7.5 percent", and

(2) by striking subsection (f).

(b) EFFECTIVE DATE. — The amendments made by this section shall apply to taxable years beginning after December 31, 2020.

SEC. 102. ENERGY EFFICIENT COMMERCIAL BUILDINGS DEDUCTION.

(a) DEDUCTION MADE PERMANENT. — Section 179D is amended by striking subsection (h).

(b) INFLATION ADJUSTMENT. — Section 179D, as amended by subsection (a), is amended by redesignating subsection (g) as subsection

(h) and by inserting after subsection (f) the following new subsection:

"(g) INFLATION ADJUSTMENT. — In the case of a taxable year beginning after 2020, each dollar amount in subsection (b) or subsection (d)(1)(A) shall be increased by an amount equal to —

"(1) such dollar amount, multiplied by

"(2) the cost-of-living adjustment determined under section 1(f)(3) for the calendar year in which the taxable year begins, determined by substituting 'calendar year 2019' for 'calendar year 2016' in subparagraph (A)(ii) thereof.

Any increase determined under the preceding sentence which is not a multiple of 1 cent shall be rounded to the nearest cent.".

(c) UPDATE OF STANDARDS. —

(1) ASHRAE STANDARDS. — Section 179D(c) is amended —

(A) in paragraphs (1)(B)(ii) and (1)(D), by striking "Standard 90.1–2007" and inserting "Reference Standard 90.1", and

(B) by amending paragraph (2) to read as follows:

"(2) REFERENCE STANDARD 90.1. — The term 'Reference Standard 90.1' means, with respect to any property, the most recent Standard 90.1 published by the American Society of Heating, Refrigerating, and Air Conditioning Engineers and the Illuminating Engineering Society of North America which has been affirmed by the Secretary, after consultation with the Secretary of Energy, for purposes of this section not later than the date that is 2 years before the date that construction of such property begins.".

(2) CALIFORNIA NONRESIDENTIAL ALTERNATIVE CALCULATION METHOD APPROVAL MANUAL. — Section 179D(d)(2) is amended by striking ", based on the provisions of the 2005 California Nonresidential Alternative Calculation Method Approval Manual" and inserting "with respect to any property, based on the provisions of the most recent California Nonresidential Alternative Calculation Method Approval Manual which has been affirmed by the Secretary, after consultation with the Secretary of Energy, for purposes of this section not later than the date that is 2 years before the date that construction of such property begins".

(d) EFFECTIVE DATE. — The amendments made by this section shall apply to property placed in service after December 31, 2020.

SEC. 103. BENEFITS PROVIDED TO VOLUNTEER FIREFIGHTERS AND EMERGENCY MEDICAL RESPONDERS.

(a) IN GENERAL. — Section 139B is amended by striking subsection (d).

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to taxable years beginning after December 31, 2020.

SEC. 104. TRANSITION FROM DEDUCTION FOR QUALIFIED TUITION AND RELATED EXPENSES TO INCREASED INCOME LIMITATION ON LIFETIME LEARNING CREDIT.

(a) INCREASED INCOME LIMITATIONS FOR PHASEOUT OF LIFETIME LEARNING CREDIT. —

(1) IN GENERAL. — Section 25A(d) is amended by striking paragraphs (1) and (2), by redesignating paragraph (3) as paragraph (2), and by inserting before paragraph (2) (as so redesignated) the following new paragraph:

"(1) IN GENERAL. — The American Opportunity Tax Credit and the Lifetime Learning Credit shall each (determined without regard to this paragraph) be reduced (but not below zero) by the amount which bears the same ratio to each such credit (as so determined) as —

"(A) the excess of —

"(i) the taxpayer's modified adjusted gross income for such taxable year, over

"(ii) $80,000 ( $160,000 in the case of a joint return), bears to

"(B) $10,000 ( $20,000 in the case of a joint return).".

(2) CONFORMING AMENDMENT. — Section 25A is amended by striking subsection (h).

(b) REPEAL OF DEDUCTION FOR QUALIFIED TUITION AND RELATED EXPENSES. —

(1) IN GENERAL. — Part VII of subchapter B of chapter 1 is amended by striking section 222 (and by striking the item relating to such section in the table of sections for such part).

(2) CONFORMING AMENDMENTS. —

(A) Section 62(a) is amended by striking paragraph (18).

(B) Section 74(d)(2)(B) is amended by striking "222,".

(C) Section 86(b)(2)(A) is amended by striking "222,".

(D) Section 135(c)(4)(A) is amended by striking "222,".

(E) Section 137(b)(3)(A) is amended by striking "222,".

(F) Section 219(g)(3)(A)(ii) is amended by striking "222,".

(G) Section 221(b)(2)(C)(i) is amended by striking "222,".

(H) Section 469(i)(3)(E)(iii) is amended by striking "222,".

(c) EFFECTIVE DATE. — The amendments made by this section shall apply to taxable years beginning after December 31, 2020.

SEC. 105. RAILROAD TRACK MAINTENANCE CREDIT.

(a) MADE PERMANENT. — Section 45G is amended by striking subsection (f).

(b) MODIFICATION OF CREDIT RATE. — Section 45G(a) is amended by striking "50 percent" and inserting "40 percent (50 percent in the case of any taxable year beginning before January 1, 2023) ".

(c) EFFECTIVE DATE. — The amendments made by this section shall apply to taxable years ending after the date of the enactment of this Act.

SEC. 106. CERTAIN PROVISIONS RELATED TO BEER, WINE, AND DISTILLED SPIRITS.

(a) PRODUCTION PERIOD FOR BEER, WINE, AND DISTILLED SPIRITS. —

(1) IN GENERAL. — Section 263A(f)(4) is amended to read as follows:

"(4) EXEMPTION FOR AGING PROCESS OF BEER, WINE, AND DISTILLED SPIRITS. — For purposes of this subsection, the production period shall not include the aging period for —

"(A) beer (as defined in section 5052(a)),

"(B) wine (as described in section 5041(a)), or

"(C) distilled spirits (as defined in section 5002(a)(8)), except such spirits that are unfit for use for beverage purposes.".

(2) EFFECTIVE DATE. — The amendment made by this subsection shall apply to interest costs paid or accrued after December 31, 2020.

(b) REDUCED RATE OF EXCISE TAX ON BEER. —

(1) IN GENERAL. — Section 5051(a)(1) is amended to read as follows:

"(1) IN GENERAL. —

"(A) IMPOSITION OF TAX. — A tax is hereby imposed on all beer brewed or produced, and removed for consumption or sale, within the United States, or imported into the United States. Except as provided in paragraph (2), the rate of such tax shall be —

"(i) $16 on the first 6,000,000 barrels of beer —

"(I) brewed by the brewer and removed during the calendar year for consumption or sale, or

"(II) imported by the importer into the United States during the calendar year, and

"(ii) $18 on any barrels of beer to which clause (i) does not apply.

"(B) BARREL. — For purposes of this section, a barrel shall contain not more than 31 gallons of beer, and any tax imposed under this section shall be applied at a like rate for any other quantity or for fractional parts of a barrel.".

(2) REDUCED RATE FOR CERTAIN DOMESTIC PRODUCTION. — Section 5051(a)(2)(A) is amended —

(A) in the heading, by inserting " $3.50 A BARREL" before "RATE", and

(B) by striking " $7" and all that follows through "January 1, 2021) " and inserting " $3.50".

(3) APPLICATION OF REDUCED TAX RATE FOR FOREIGN MANUFACTURERS AND IMPORTERS. — Section 5051(a) is amended —

(A) in paragraph (1)(A)(i)(II), as amended by paragraph

(1) of this subsection, by inserting "but only if the importer is an electing importer under paragraph (4) and the barrels have been assigned to the importer pursuant to such paragraph" after "during the calendar year", and

(B) in paragraph (4) —

(i) in subparagraph (A), by striking "paragraph (1)(C) " and inserting "paragraph (1)(A) ", and

(ii) in subparagraph (B), by striking "The Secretary" and inserting "The Secretary, after consultation with the Secretary of the Department of Homeland Security,".

(4) CONTROLLED GROUP AND SINGLE TAXPAYER RULES. — Section 5051(a)(5) is amended by striking "paragraph (1)(C)(i) " each place it appears and inserting "paragraph (1)(A)(i) ".

(5) EFFECTIVE DATE. — The amendments made by this subsection shall apply to beer removed after December 31, 2020.

(c) TRANSFER OF BEER BETWEEN BONDED FACILITIES. —

(1) IN GENERAL. — Section 5414 is amended to read as follows:

"SEC. 5414. TRANSFER OF BEER BETWEEN BONDED FACILITIES.

"(a) IN GENERAL. — Beer may be removed from one brewery to another brewery, without payment of tax, and may be mingled with beer at the receiving brewery, subject to such conditions, including payment of the tax, and in such containers, as the Secretary by regulations shall prescribe, which shall include —

"(1) any removal from one brewery to another brewery belonging to the same brewer,

"(2) any removal from a brewery owned by one corporation to a brewery owned by another corporation when —

"(A) one such corporation owns the controlling interest in the other such corporation, or

"(B) the controlling interest in each such corporation is owned by the same person or persons, and

"(3) any removal from one brewery to another brewery when —

"(A) the proprietors of transferring and receiving premises are independent of each other and neither has a proprietary interest, directly or indirectly, in the business of the other, and

"(B) the transferor has divested itself of all interest in the beer so transferred and the transferee has accepted responsibility for payment of the tax.

"(b) TRANSFER OF LIABILITY FOR TAX. — For purposes of subsection (a)(3), such relief from liability shall be effective from the time of removal from the transferor's premises, or from the time of divestment of interest, whichever is later.".

(2) EFFECTIVE DATE. — The amendment made by this subsection shall apply to any calendar quarters beginning after December 31, 2020.

(d) REDUCED RATE OF EXCISE TAX ON CERTAIN WINE. —

(1) IN GENERAL. — Section 5041(c) is amended —

(A) in the heading, by striking "FOR SMALL DOMESTIC PRODUCERS",

(B) by amending paragraph (1) to read as follows:

"(1) ALLOWANCE OF CREDIT. —

"(A) IN GENERAL. — There shall be allowed as a credit against any tax imposed by this title (other than chapters 2, 21, and 22) an amount equal to the sum of —

"(i) $1 per wine gallon on the first 30,000 wine gallons of wine, plus

"(ii) 90 cents per wine gallon on the first 100,000 wine gallons of wine to which clause (i) does not apply, plus

"(iii) 53.5 cents per wine gallon on the first 620,000 wine gallons of wine to which clauses (i) and (ii) do not apply,

which are produced by the producer and removed during the calendar year for consumption or sale, or which are imported by the importer into the United States during the calendar year.

"(B) ADJUSTMENT OF CREDIT FOR HARD CIDER. — In the case of wine described in subsection (b)(6), subparagraph (A) of this paragraph shall be applied —

"(i) in clause (i) of such subparagraph, by substituting '6.2 cents' for ' $1',

"(ii) in clause (ii) of such subparagraph, by substituting '5.6 cents' for '90 cents', and

"(iii) in clause (iii) of such subparagraph, by substituting '3.3 cents' for '53.5 cents'.",

(C) by striking paragraphs (2) and (8),

(D) by redesignating paragraphs (3) through (6) as paragraphs (2) through (5), respectively,

(E) by redesignating paragraph (9) as paragraph (6), and

(F) by amending paragraph (7) to read as follows:

"(7) REGULATIONS. — The Secretary may prescribe such regulations as may be necessary to carry out the purposes of this subsection, including regulations to ensure proper calculation of the credit provided in this subsection.".

(2) ALLOWANCE OF CREDIT FOR FOREIGN MANUFACTURERS AND IMPORTERS. — Section 5041(c), as amended by paragraph (1), is amended —

(A) in paragraph (1)(A), by inserting "but only if the importer is an electing importer under paragraph (6) and the wine gallons of wine have been assigned to the importer pursuant to such paragraph" after "into the United States during the calendar year", and

(B) in paragraph (6) —

(i) in subparagraph (A), by striking "paragraph (8) " and inserting "paragraph (1) ",

(ii) in subparagraph (B), by striking "The Secretary" and inserting "The Secretary of the Treasury, after consultation with the Secretary of the Department of Homeland Security,", and

(iii) in subparagraph (C), by striking "paragraph (4) " and inserting "paragraph (3) ".

(3) EFFECTIVE DATE. — The amendments made by this subsection shall apply to wine removed after December 31, 2020.

(e) ADJUSTMENT OF ALCOHOL CONTENT LEVEL FOR APPLICATION OF EXCISE TAX RATES. —

(1) IN GENERAL. — Paragraphs (1) and (2) of section 5041(b) are each amended by striking "14 percent" and all that follows through "January 1, 2021" and inserting "16 percent".

(2) EFFECTIVE DATE. — The amendments made by this subsection shall apply to wine removed after December 31, 2020.

(f) DEFINITION OF MEAD AND LOW ALCOHOL BY VOLUME WINE. —

(1) IN GENERAL. — Section 5041(h) is amended —

(A) in paragraph (2), by striking "the Secretary shall" each place it appears and inserting "the Secretary may", and

(B) by striking paragraph (3).

(2) EFFECTIVE DATE. — The amendments made by this subsection shall apply to wine removed after December 31, 2020.

(g) REDUCED RATE OF EXCISE TAX ON CERTAIN DISTILLED SPIRITS. —

(1) IN GENERAL. — Section 5001(c) is amended —

(A) in the heading, by striking "TEMPORARY REDUCED RATE" and inserting "REDUCED RATE",

(B) in paragraph (3)(B), by striking "The Secretary" and inserting "The Secretary of the Treasury, after consultation with the Secretary of the Department of Homeland Security,", and

(C) by striking paragraph (4).

(2) EFFECTIVE DATE. — The amendments made by this subsection shall apply to distilled spirits removed after December 31, 2020.

(h) BULK DISTILLED SPIRITS. —

(1) IN GENERAL. — Section 5212 is amended by striking "and before January 1, 2021," and inserting "between bonded premises belonging to the same person or members of the same controlled group (within the meaning of section 5001(c)(2)) ".

(2) NON-BULK TRANSFERS RELATED TO BOTTLING OR STORAGE. — Section 5212 is amended by adding at the end the following new sentence: "In the case of distilled spirits transferred in bond from the person who distilled or processed such distilled spirits (hereinafter referred to as 'transferor') to another person for bottling or storage of such distilled spirits, and returned to the transferor for removal, this section shall be applied without regard to whether distilled spirits are bulk distilled spirits, but only if the transferor retains title during the entire period between such distillation, or processing, and removal.".

(3) EFFECTIVE DATE. — The amendments made by this subsection shall apply to distilled spirits transferred in bond after December 31, 2020.

(i) SIMPLIFICATION OF RULES REGARDING RECORDS, STATEMENTS, AND RETURNS. —

(1) IN GENERAL. — Section 5555(a) is amended by striking "For calendar quarters beginning after the date of the enactment of this sentence, and before January 1, 2021, the Secretary" and inserting "The Secretary".

(2) EFFECTIVE DATE. — The amendment made by this subsection shall apply to calendar quarters beginning after December 31, 2020.

SEC. 107. REFUNDS IN LIEU OF REDUCED RATES FOR CERTAIN CRAFT BEVERAGES PRODUCED OUTSIDE THE UNITED STATES.

(a) DISTILLED SPIRITS. —

(1) IN GENERAL. — Section 5001(c), as amended by the preceding provisions of this Act, is amended by adding at the end the following new paragraph:

"(4) REFUNDS IN LIEU OF REDUCED RATES FOR FOREIGN PRODUCTION REMOVED AFTER DECEMBER 31, 2022. —

"(A) IN GENERAL. — In the case of any proof gallons of distilled spirits which have been produced outside the United States and imported into the United States, if such proof gallons of distilled spirits are removed after December 31, 2022 —

"(i) paragraph (1) shall not apply, and

"(ii) the amount determined under subparagraph

(B) shall be allowed as a refund, determined for periods not less frequently than quarterly, to the importer in the same manner as if such amount were an overpayment of tax imposed by this section.

"(B) AMOUNT OF REFUND. — The amount determined under this subparagraph with respect to any importer for any period is an amount equal to the sum of —

"(i) the excess (if any) of —

"(I) the amount of tax imposed under this subpart on proof gallons of distilled spirits referred to in subparagraph (A) which were removed during such period, over

"(II) the amount of tax which would have been imposed under this subpart on such proof gallons of distilled spirits if this section were applied without regard to this paragraph, plus

"(ii) the amount of interest which would be allowed and paid on an overpayment of tax at the overpayment rate established under section 6621(a)(1) (without regard to the second sentence thereof) were such rate applied to the excess (if any) determined under clause

(i) for the number of days in the filing period for which the refund under this paragraph is being determined.

"(C) APPLICATION OF RULES RELATED TO ELECTIONS AND ASSIGNMENTS. — Subparagraph (A)(ii) shall apply only if the importer is an electing importer under paragraph (3) and the proof gallons of distilled spirits have been assigned to the importer pursuant to such paragraph.

"(D) RULES FOR REFUNDS WITHIN 90 DAYS. — For purposes of refunds allowed under this paragraph, section 6611(e) shall be applied by substituting '90 days' for '45 days' each place it appears.".

(2) COORDINATION WITH DETERMINATION FOR COVER OVER TO PUERTO RICO AND VIRGIN ISLANDS. —

(A) IN GENERAL. — Section 7652 is amended by adding at the end the following new subsection:

"(i) DETERMINATION OF TAXES COLLECTED. — For purposes of subsections (a)(3), (b)(3), and (e)(1), refunds under section 5001(c)(4) shall not be taken into account as a refund, and the amount of taxes imposed by and collected under section 5001(a)(1) shall be determined without regard to section 5001(c).".

(B) CONFORMING AMENDMENT. — Section 7652(e) is amended by striking paragraph (5).

(3) EFFECTIVE DATE. — The amendments made by this subsection shall apply to distilled spirits brought into the United States and removed after December 31, 2022.

(b) BEER. —

(1) IN GENERAL. — Section 5051(a) is amended by adding at the end the following new paragraph:

"(6) REFUNDS IN LIEU OF REDUCED RATES FOR FOREIGN PRODUCTION REMOVED AFTER DECEMBER 31, 2022. —

"(A) IN GENERAL. — In the case of any barrels of beer which have been produced outside the United States and imported into the United States, if such barrels of beer are removed after December 31, 2022 —

"(i) paragraph (1)(A)(i) shall not apply, and

"(ii) the amount determined under subparagraph

(B) shall be allowed as a refund, determined for periods not less frequently than quarterly, to the importer in the same manner as if such amount were an overpayment of tax imposed by this section.

"(B) AMOUNT OF REFUND. — The amount determined under this subparagraph with respect to any importer for any period is an amount equal to the sum of —

"(i) excess (if any) of —

"(I) the amount of tax imposed under this section on barrels of beer referred to in subparagraph (A) which were removed during such period, over

"(II) the amount of tax which would have been imposed under this section on such barrels of beer if this section were applied without regard to this paragraph, plus

"(ii) the amount of interest which would be allowed and paid on an overpayment of tax at the overpayment rate established under section 6621(a)(1) (without regard to the second sentence thereof) were such rate applied to the excess (if any) determined under clause (i) for the number of days in the filing period for which the refund under this paragraph is being determined.

"(C) APPLICATION OF RULES RELATED TO ELECTIONS AND ASSIGNMENTS. — Subparagraph (A)(ii) shall apply only if the importer is an electing importer under paragraph (4) and the barrels of beer have been assigned to the importer pursuant to such paragraph.

"(D) RULES FOR REFUNDS WITHIN 90 DAYS. — For purposes of refunds allowed under this paragraph, section 6611(e) shall be applied by substituting '90 days' for '45 days' each place it appears.".

(2) EFFECTIVE DATE. — The amendment made by this subsection shall apply to beer removed after December 31, 2022.

(c) WINE. —

(1) IN GENERAL. — Section 5041(c), as amended by the preceding provisions of this Act, is amended by redesignating paragraph (7) as paragraph (8) and by inserting after paragraph (6) the following new paragraph:

"(7) REFUNDS IN LIEU OF TAX CREDITS FOR FOREIGN PRODUCTION REMOVED AFTER DECEMBER 31, 2022. —

"(A) IN GENERAL. — In the case of any wine gallons of wine which have been produced outside the United States and imported into the United States, if such wine gallons are removed after December 31, 2022 —

"(i) paragraph (1) shall not apply, and

"(ii) the amount determined under subparagraph (B) shall be allowed as a refund, determined for periods not less frequently than quarterly, to the importer in the same manner as if such amount were an overpayment of tax imposed by this section.

"(B) AMOUNT OF REFUND. — The amount determined under this subparagraph with respect to any importer for any period is an amount equal to the sum of —

"(i) excess (if any) of —

"(I) the amount of tax imposed under this section on wine gallons of wine referred to in subparagraph (A) which were removed during such period, over

"(II) the amount of tax which would have been imposed under this section (including any allowable credits) on such gallons of wine if this section were applied without regard to this paragraph, plus

"(ii) the amount of interest which would be allowed and paid on an overpayment of tax at the overpayment rate established under section 6621(a)(1) (without regard to the second sentence thereof) were such rate applied to the excess (if any) determined under clause

(i) for the number of days in the filing period for which the refund under this paragraph is being determined.

"(C) APPLICATION OF RULES RELATED TO ELECTIONS AND ASSIGNMENTS. — Subparagraph (A)(ii) shall apply only if the importer is an electing importer under paragraph (6) and the wine gallons of wine have been assigned to the importer pursuant to such paragraph.

"(D) RULES FOR REFUNDS WITHIN 90 DAYS. — For purposes of refunds allowed under this paragraph, section 6611(e) shall be applied by substituting '90 days' for '45 days' each place it appears.".

(2) EFFECTIVE DATE. — The amendments made by this subsection shall apply to wine removed after December 31, 2022.

(d) INFORMATION REPORTING IN CASE OF ASSIGNMENT OF LOWER RATES OR REFUNDS BY FOREIGN PRODUCERS OF BEER, WINE, AND DISTILLED SPIRITS. —

(1) IN GENERAL. — Subpart A of part III of subchapter A of chapter 61 is amended by inserting after section 6038D the following new section:

"SEC. 6038E. INFORMATION WITH RESPECT TO ASSIGNMENT OF LOWER RATES OR REFUNDS BY FOREIGN PRODUCERS OF BEER, WINE, AND DISTILLED SPIRITS.

"Any foreign producer that elects to make an assignment described in section 5001(c), 5041(c), or 5051(a) shall provide such information, at such time and in such manner, as the Secretary may prescribe in order to make such assignment, including information about the controlled group structure of such foreign producer.".

(2) CLERICAL AMENDMENT. — Table of sections for subpart A of part III of subchapter A of chapter 61 is amended by inserting after the item relating to section 6038D the following new item:

"Sec. 6038E. Information with respect to assignment of lower rates or refunds by foreign producers of beer, wine, and distilled spirits.".

(3) EFFECTIVE DATE. — The amendments made by this subsection shall apply to elections to make an assignment under section 5001(c), 5041(c), or 5051(a) of the Internal Revenue Code of 1986 after December 31, 2020.

(e) ADMINISTRATION OF REFUNDS. — The Secretary of the Treasury (or the Secretary's delegate within the Department of the Treasury) shall implement and administer sections 5001(c)(4), 5041(c)(7), and 5051(a)(6) of the Internal Revenue Code of 1986, as added by this Act, in coordination with the United States Customs and Border Protection of the Department of Homeland Security.

(f) REGULATIONS. — The Secretary of the Treasury (or the Secretary's delegate within the Department of the Treasury) shall prescribe such regulations as may be necessary or appropriate to carry out the purposes of this section, including regulations to require foreign producers to provide information necessary to enforce the volume limitations under sections 5001(c), 5041(c), and 5051(a) of such Code.

(g) REPORT. — Not later than 180 days after the date of the enactment of this Act, the Secretary of the Treasury (or the Secretary's delegate within the Department of the Treasury) shall, in coordination with the United States Customs and Border Protection of the Department of Homeland Security, prepare, submit to Congress, and make publicly available a report detailing the plans for implementing and administering sections 5001(c)(4), 5041(c)(7), and 5051(a)(6) of such Code, as added by this Act.

SEC. 108. REDUCED RATES NOT ALLOWED FOR SMUGGLED OR ILLEGALLY PRODUCED BEER, WINE, AND SPIRITS.

(a) IN GENERAL. — Subpart E of part I of subchapter A of chapter 51 is amended by redesignating section 5067 as section 5068 and by inserting after section 5066 the following new section:

"SEC. 5067. REDUCED RATES NOT ALLOWED FOR SMUGGLED OR ILLEGALLY PRODUCED BEER, WINE, OR SPIRITS.

"In the case of beer, wine, or distilled spirits that are smuggled into the United States or produced other than as authorized by this chapter —

"(1) the rates of tax under paragraphs (1)(A)(i) and (2) of section 5051(a) shall not apply in the case of any such beer,

"(2) the credit under section 5041(c) shall not apply in the case of any such wine, and

"(3) the rates of tax under section 5001(c) shall not apply in the case of any such distilled spirits.".

(b) CLERICAL AMENDMENT. — The table of sections for subpart E of part I of subchapter A of chapter 51 is amended by striking the last item and inserting the following new items:

"Sec. 5067. Reduced rates not allowed for illegally produced beer, wine, or spirits.

"Sec. 5068. Cross reference.".

(c) EFFECTIVE DATE. — The amendments made by this section shall apply to beer, wine, or distilled spirits, as the case may be, produced after the date of the enactment of this Act.

SEC. 109. MINIMUM PROCESSING REQUIREMENTS FOR REDUCED DISTILLED SPIRITS RATES.

(a) IN GENERAL. — Section 5001(c), as amended by the preceding provisions of this Act, is amended by adding at the end the following:

"(5) PROCESSED DISTILLED SPIRITS. — A distilled spirit shall not be treated as processed for purposes of this subsection unless a process described in section 5002(a)(5)(A) (other than bottling) is performed with respect to such distilled spirit.".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to distilled spirits removed after December 31, 2021.

SEC. 110. MODIFICATION OF SINGLE TAXPAYER RULES.

(a) BEER. — Section 5051(a)(5)(C) is amended by striking "marketed under a similar brand, license" and inserting "under a license".

(b) WINE. — For single taxpayer rules relating to wine, see cross reference under section 5041(c)(3) of the Internal Revenue Code of 1986, as redesignated by this Act.

(c) DISTILLED SPIRITS. —

(1) IN GENERAL. — Section 5001(c)(2)(D) is amended by striking "marketed under a similar brand, license" and inserting "under a license".

(2) APPLICATION TO PROCESSORS. — Section 5001(c)(2)(D) is further amended by inserting "or process" after "that produce".

(d) EFFECTIVE DATE. — The amendments made by this section shall apply to beer, wine, and distilled spirits removed after December 31, 2020.

Subtitle B — Certain Provisions Extended Through 2025

SEC. 111. LOOK-THRU RULE FOR RELATED CONTROLLED FOREIGN CORPORATIONS.

(a) IN GENERAL. — Section 954(c)(6)(C) is amended by striking "January 1, 2021" and inserting "January 1, 2026".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to taxable years of foreign corporations beginning after December 31, 2020, and to taxable years of United States shareholders with or within which such taxable years of foreign corporations end.

SEC. 112. NEW MARKETS TAX CREDIT.

(a) IN GENERAL. — Section 45D(f)(1)(H) is amended by striking "2020" and inserting "for each of calendar years 2020 through 2025".

(b) CARRYOVER OF UNUSED LIMITATION. — Section 45D(f)(3) is amended by striking "2025" and inserting "2030".

(c) EFFECTIVE DATE. — The amendments made by this section shall apply to calendar years beginning after December 31, 2020.

SEC. 113. WORK OPPORTUNITY CREDIT.

(a) IN GENERAL. — Section 51(c)(4) is amended by striking "December 31, 2020" and inserting "December 31, 2025".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to individuals who begin work for the employer after December 31, 2020.

SEC. 114. EXCLUSION FROM GROSS INCOME OF DISCHARGE OF QUALIFIED PRINCIPAL RESIDENCE INDEBTEDNESS.

(a) IN GENERAL. — Section 108(a)(1)(E) is amended by striking "January 1, 2021" both places it appears and inserting "January 1, 2026".

(b) MODIFICATION OF MAXIMUM ACQUISITION INDEBTEDNESS TAKEN INTO ACCOUNT. — Section 108(h)(2) is amended by striking " $2,000,000 ( $1,000,000" and inserting " $750,000 ( $375,000".

(c) EFFECTIVE DATE. — The amendments made by this section shall apply to discharges of indebtedness after December 31, 2020.

SEC. 115. 7-YEAR RECOVERY PERIOD FOR MOTORSPORTS ENTERTAINMENT COMPLEXES.

(a) IN GENERAL. — Section 168(i)(15)(D) is amended by striking "December 31, 2020" and inserting "December 31, 2025".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to property placed in service after December 31, 2020.

SEC. 116. EXPENSING RULES FOR CERTAIN PRODUCTIONS.

(a) EXTENSION. — Section 181(g) is amended by striking "December 31, 2020" and inserting "December 31, 2025".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to productions commencing after December 31, 2020.

SEC. 117. OIL SPILL LIABILITY TRUST FUND RATE.

(a) IN GENERAL. — Section 4611(f)(2) is amended by striking "December 31, 2020" and inserting "December 31, 2025".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply on and after January 1, 2021.

SEC. 118. EMPOWERMENT ZONE TAX INCENTIVES.

(a) IN GENERAL. — Section 1391(d)(1)(A)(i) is amended by striking "December 31, 2020" and inserting "December 31, 2025".

(b) TERMINATION OF INCREASE IN EXPENSING UNDER SECTION 179. — Section 1397A is amended by adding at the end the following new subsection:

"(c) TERMINATION. — This section shall not apply to any property placed in service in taxable years beginning after December 31, 2020.".

(c) TERMINATION OF NONRECOGNITION OF GAIN ON ROLLOVER OF EMPOWERMENT ZONE INVESTMENTS. — Section 1397B is amended by adding at the end the following new subsection:

"(c) TERMINATION. — This section shall not apply to sales in taxable years beginning after December 31, 2020.".

(d) TREATMENT OF CERTAIN TERMINATION DATES SPECIFIED IN NOMINATIONS. — In the case of a designation of an empowerment zone the nomination for which included a termination date which is contemporaneous with the date specified in subparagraph (A)(i) of section 1391(d)(1) of the Internal Revenue Code of 1986 (as in effect before the enactment of this Act), subparagraph (B) of such section shall not apply with respect to such designation if, after the date of the enactment of this section, the entity which made such nomination amends the nomination to provide for a new termination date in such manner as the Secretary of the Treasury (or the Secretary's designee) may provide.

(e) EFFECTIVE DATE. — The amendments made by this section shall apply to taxable years beginning after December 31, 2020.

SEC. 119. EMPLOYER CREDIT FOR PAID FAMILY AND MEDICAL LEAVE.

(a) IN GENERAL. — Section 45S(i) is amended by striking "December 31, 2020" and inserting "December 31, 2025".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to wages paid in taxable years beginning after December 31, 2020.

SEC. 120. EXCLUSION FOR CERTAIN EMPLOYER PAYMENTS OF STUDENT LOANS.

(a) IN GENERAL. — Section 127(c)(1)(B) is amended by striking "January 1, 2021" and inserting "January 1, 2026".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to payments made after December 31, 2020.

SEC. 121. EXTENSION OF CARBON OXIDE SEQUESTRATION CREDIT.

Section 45Q(d)(1) is amended by striking "January 1, 2024" and inserting "January 1, 2026".

Subtitle C — Extension of Certain Other Provisions

SEC. 131. CREDIT FOR ELECTRICITY PRODUCED FROM CERTAIN RENEWABLE RESOURCES.

(a) IN GENERAL. — The following provisions of section 45(d) are each amended by striking "January 1, 2021" each place it appears and inserting "January 1, 2022":

(1) Paragraph (1).

(2) Paragraph (2)(A).

(3) Paragraph (3)(A).

(4) Paragraph (4)(B).

(5) Paragraph (6).

(6) Paragraph (7).

(7) Paragraph (9).

(8) Paragraph (11)(B).

(b) EXTENSION OF ELECTION TO TREAT QUALIFIED FACILITIES AS ENERGY PROPERTY. — Section 48(a)(5)(C)(ii) is amended by striking "January 1, 2021" and inserting "January 1, 2022".

(c) CONFORMING AMENDMENTS RELATED TO APPLICATION OF PHASEOUT PERCENTAGE. —

(1) Section 45(b)(5)(D) is amended by striking "January 1, 2021" and inserting "January 1, 2022".

(2) Section 48(a)(5)(E)(iv) is amended by striking "January 1, 2021" and inserting "January 1, 2022".

(d) EFFECTIVE DATE. — The amendments made by this section shall take effect on January 1, 2021.

SEC. 132. EXTENSION AND PHASEOUT OF ENERGY CREDIT.

(a) EXTENSIONS. — Section 48 is amended —

(1) in subsection (a) —

(A) in paragraph (2)(A)(i)(II), by striking "January 1, 2022" and inserting "January 1, 2024", and

(B) in paragraph (3)(A) —

(i) in clause (ii), by striking "January 1, 2022" and inserting "January 1, 2024", and

(ii) in clause (vii), by striking "January 1, 2022" and inserting "January 1, 2024", and

(2) in subsection (c) —

(A) in paragraph (1)(D), by striking "January 1, 2022" and inserting "January 1, 2024",

(B) in paragraph (2)(D), by striking "January 1, 2022" and inserting "January 1, 2024",

(C) in paragraph (3)(A)(iv), by striking "January 1, 2022" and inserting "January 1, 2024", and

(D) in paragraph (4)(C), by striking "January 1, 2022" and inserting "January 1, 2024".

(b) PHASEOUTS. —

(1) SOLAR ENERGY PROPERTY. — Section 48(a)(6) is amended —

(A) in subparagraph (A) —

(i) by striking "January 1, 2022, the energy percentage" and inserting "January 1, 2024, the energy percentage",

(ii) in clause (i), by striking "January 1, 2021" and inserting "January 1, 2023", and

(iii) in clause (ii), by striking "after December 31, 2020, and before January 1, 2022" and inserting "after December 31, 2022, and before January 1, 2024", and

(B) in subparagraph (B), by striking "begins before January 1, 2022, and which is not placed in service before January 1, 2024" and inserting "begins before January 1, 2024, and which is not placed in service before January 1, 2026".

(2) FIBER-OPTIC SOLAR, QUALIFIED FUEL CELL, AND QUALIFIED SMALL WIND ENERGY PROPERTY. — Section 48(a)(7) is amended —

(A) in subparagraph (A) —

(i) in clause (i), by striking "January 1, 2021" and inserting "January 1, 2023", and

(ii) in clause (ii), by striking "after December 31, 2020, and before January 1, 2022" and inserting "after December 31, 2022, and before January 1, 2024", and

(B) in subparagraph (B), by striking "January 1, 2024" and inserting "January 1, 2026".

(c) EFFECTIVE DATE. — The amendments made by this section shall take effect on January 1, 2020.

SEC. 133. TREATMENT OF MORTGAGE INSURANCE PREMIUMS AS QUALIFIED RESIDENCE INTEREST.

(a) IN GENERAL. — Section 163(h)(3)(E)(iv)(I) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to amounts paid or accrued after December 31, 2020.

SEC. 134. CREDIT FOR HEALTH INSURANCE COSTS OF ELIGIBLE INDIVIDUALS.

(a) IN GENERAL. — Section 35(b)(1)(B) is amended by striking "January 1, 2021" and inserting "January 1, 2022".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to months beginning after December 31, 2020.

SEC. 135. INDIAN EMPLOYMENT CREDIT.

(a) IN GENERAL. — Section 45A(f) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to taxable years beginning after December 31, 2020.

SEC. 136. MINE RESCUE TEAM TRAINING CREDIT.

(a) IN GENERAL. — Section 45N(e) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to taxable years beginning after December 31, 2020.

SEC. 137. CLASSIFICATION OF CERTAIN RACE HORSES AS 3-YEAR PROPERTY.

(a) IN GENERAL. — Section 168(e)(3)(A)(i) is amended —

(1) by striking "January 1, 2021" in subclause (I) and inserting "January 1, 2022", and

(2) by striking "December 31, 2020" in subclause (II) and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendments made by this section shall apply to property placed in service after December 31, 2020.

SEC. 138. ACCELERATED DEPRECIATION FOR BUSINESS PROPERTY ON INDIAN RESERVATIONS.

(a) IN GENERAL. — Section 168(j)(9) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to property placed in service after December 31, 2020.

SEC. 139. AMERICAN SAMOA ECONOMIC DEVELOPMENT CREDIT.

(a) IN GENERAL. — Section 119(d) of division A of the Tax Relief and Health Care Act of 2006 is amended —

(1) by striking "January 1, 2021" each place it appears and inserting "January 1, 2022",

(2) by striking "first 15 taxable years" in paragraph (1) and inserting "first 16 taxable years", and

(3) by striking "first 9 taxable years" in paragraph (2) and inserting "first 10 taxable years".

(b) EFFECTIVE DATE. — The amendments made by this section shall apply to taxable years beginning after December 31, 2020.

SEC. 140. SECOND GENERATION BIOFUEL PRODUCER CREDIT.

(a) IN GENERAL. — Section 40(b)(6)(J)(i) is amended by striking "January 1, 2021" and inserting "January 1, 2022".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to qualified second generation biofuel production after December 31, 2020.

SEC. 141. NONBUSINESS ENERGY PROPERTY.

(a) IN GENERAL. — Section 25C(g)(2) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to property placed in service after December 31, 2020.

SEC. 142. QUALIFIED FUEL CELL MOTOR VEHICLES.

(a) IN GENERAL. — Section 30B(k)(1) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to property purchased after December 31, 2020.

SEC. 143. ALTERNATIVE FUEL REFUELING PROPERTY CREDIT.

(a) IN GENERAL. — Section 30C(g) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to property placed in service after December 31, 2020.

SEC. 144. 2-WHEELED PLUG-IN ELECTRIC VEHICLE CREDIT.

(a) IN GENERAL. — Section 30D(g)(3)(E)(ii) is amended by striking "January 1, 2021" and inserting "January 1, 2022".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to vehicles acquired after December 31, 2020.

SEC. 145. PRODUCTION CREDIT FOR INDIAN COAL FACILITIES.

(a) IN GENERAL. — Section 45(e)(10)(A) is amended by striking "15-year period" each place it appears and inserting "16-year period".

(b) EFFECTIVE DATE. — The amendments made by this section shall apply to coal produced after December 31, 2020.

SEC. 146. ENERGY EFFICIENT HOMES CREDIT.

(a) IN GENERAL. — Section 45L(g) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to homes acquired after December 31, 2020.

SEC. 147. EXTENSION OF EXCISE TAX CREDITS RELATING TO ALTERNATIVE FUELS.

(a) IN GENERAL. — Sections 6426(d)(5) and 6426(e)(3) are each amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) OUTLAY PAYMENTS FOR ALTERNATIVE FUELS. — Section 6427(e)(6)(C) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(c) EFFECTIVE DATE. — The amendments made by this subsection shall apply to fuel sold or used after December 31, 2020.

SEC. 148. EXTENSION OF RESIDENTIAL ENERGY-EFFICIENT PROPERTY CREDIT AND INCLUSION OF BIOMASS FUEL PROPERTY EXPENDITURES.

(a) EXTENSION. —

(1) IN GENERAL. — Section 25D(h) is amended by striking "December 31, 2021" and inserting "December 31, 2023".

(2) PHASEDOWN. — Section 25D(g) is amended —

(A) by striking "January 1, 2021" in paragraph (2) and inserting "January 1, 2023", and

(B) by striking "after December 31, 2020, and before January 1, 2022" in paragraph (3) and inserting "after December 31, 2022, and before January 1, 2024".

(b) QUALIFIED BIOMASS FUEL PROPERTY EXPENDITURES. —

(1) IN GENERAL. — Section 25D(a) is amended by striking "and" at the end of paragraph (4), by inserting "and" at the end of paragraph (5), and by inserting after paragraph (5) the following new paragraph:

"(6) the qualified biomass fuel property expenditures, and".

(2) QUALIFIED BIOMASS FUEL PROPERTY EXPENDITURES DEFINED. — Section 25D(d) is amended by adding at the end the following new paragraph:

"(6) QUALIFIED BIOMASS FUEL PROPERTY EXPENDITURE. —

"(A) IN GENERAL. — The term 'qualified biomass fuel property expenditure' means an expenditure for property —

"(i) which uses the burning of biomass fuel to heat a dwelling unit located in the United States and used as a residence by the taxpayer, or to heat water for use in such a dwelling unit, and

"(ii) which has a thermal efficiency rating of at least 75 percent (measured by the higher heating value of the fuel).

"(B) BIOMASS FUEL. — For purposes of this section, the term 'biomass fuel' means any plant-derived fuel available on a renewable or recurring basis.".

(3) DENIAL OF DOUBLE BENEFIT FOR BIOMASS STOVES. —

(A) IN GENERAL. — Section 25C(d)(3) is amended by adding "and" at the end of subparagraph (C), by striking ", and" at the end of subparagraph (D) and inserting a period, and by striking subparagraph (E).

(B) CONFORMING AMENDMENT. — Section 25C(d) is amended by striking paragraph (6).

(c) EFFECTIVE DATE. —

(1) EXTENSION. — The amendments made by subsection (a) shall apply to property placed in service after December 31, 2020.

(2) QUALIFIED BIOMASS FUEL PROPERTY EXPENDITURES. — The amendments made by subsection (b) shall apply to expenditures paid or incurred in taxable years beginning after December 31, 2020.

SEC. 149. BLACK LUNG DISABILITY TRUST FUND EXCISE TAX.

(a) IN GENERAL. — Section 4121(e)(2)(A) is amended by striking "December 31, 2020" and inserting "December 31, 2021".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to sales after December 31, 2020.

TITLE II — OTHER PROVISIONS

SEC. 201. MINIMUM LOW-INCOME HOUSING TAX CREDIT RATE.

(a) IN GENERAL. — Subsection (b) of section 42 is amended —

(1) by redesignating paragraph (3) as paragraph (4), and

(2) by inserting after paragraph (2) the following new paragraph:

"(3) MINIMUM CREDIT RATE. — In the case of any new or existing building to which paragraph (2) does not apply and which is placed in service by the taxpayer after December 31, 2020, the applicable percentage shall not be less than 4 percent.".

(b) EFFECTIVE DATE. — The amendments made by this section shall apply to —

(1) any building which receives an allocation of housing credit dollar amount after December 31, 2020, and

(2) in the case of any building any portion of which is financed with an obligation described in section 42(h)(4)(A), any such building if any such obligation which so finances such building is issued after December 31, 2020.

SEC. 202. DEPRECIATION OF CERTAIN RESIDENTIAL RENTAL PROPERTY OVER 30-YEAR PERIOD.

Section 13204(b) of Public Law 115–97 is amended —

(1) in paragraph (1), by striking "paragraph (2)" and inserting "paragraphs (2) and (3)", and

(2) by adding at the end the following:

"(3) CERTAIN RESIDENTIAL RENTAL PROPERTY. — In the case of any residential rental property —

"(A) which was placed in service before January 1, 2018,

"(B) which is held by an electing real property trade or business (as defined in section 163(j)(7)(B) of the Internal Revenue Code of 1986), and

"(C) for which subparagraph (A), (B), (C), (D), or (E) of section 168(g)(1) of the Internal Revenue Code of 1986 did not apply prior to such date,

the amendments made by subsection (a)(3)(C) shall apply to taxable years beginning after December 31, 2017.".

SEC.203. WASTE ENERGY RECOVERY PROPERTY ELIGIBLE FOR ENERGY CREDIT.

(a) IN GENERAL. — Section 48(a)(3)(A) is amended by striking "or" at the end of clause (vi), by inserting "or" at the end of clause (vii), and by adding at the end the following new clause:

"(viii) waste energy recovery property,".

(b) APPLICATION OF 30 PERCENT CREDIT. — Section 48(a)(2)(A)(i) is amended by striking "and" at the end of subclause (III) and by adding at the end the following new subclause:

"(V) waste energy recovery property, and".

(c) APPLICATION OF PHASEOUT. — Section 48(a)(7) is amended —

(1) by inserting "waste energy recovery property," after "qualified small wind property,", and

(2) by striking "FIBER-OPTIC SOLAR, QUALIFIED FUEL CELL, AND QUALIFIED SMALL WIND" in the heading thereof and inserting "CERTAIN OTHER".

(d) DEFINITION. — Section 48(c) is amended by adding at the end the following new paragraphs:

"(5) WASTE ENERGY RECOVERY PROPERTY. —

"(A) IN GENERAL. — The term 'waste energy recovery property' means property that generates electricity solely from heat from buildings or equipment if the primary purpose of such building or equipment is not the generation of electricity.

"(B) CAPACITY LIMITATION. — The term 'waste energy recovery property' shall not include any property which has a capacity in excess of 50 megawatts.

"(C) NO DOUBLE BENEFIT. — Any waste energy recovery property (determined without regard to this subparagraph) which is part of a system which is a combined heat and power system property shall not be treated as waste energy recovery property for purposes of this section unless the taxpayer elects to not treat such system as a combined heat and power system property for purposes of this section.

"(D) TERMINATION. — The term 'waste energy recovery property' shall not include any property the construction of which does not begin before January 1, 2024.".

(e) EFFECTIVE DATE. — The amendments made by this section shall apply to periods after December 31, 2020, under rules similar to the rules of section 48(m) as in effect on the day before the date of the enactment of the Revenue Reconciliation Act of 1990.

SEC. 204. EXTENSION OF ENERGY CREDIT FOR OFFSHORE WIND FACILITIES.

(a) IN GENERAL. — Section 48(a)(5) is amended by adding at the end the following new subparagraph:

"(F) QUALIFIED OFFSHORE WIND FACILITIES. —

"(i) IN GENERAL. — In the case of any qualified offshore wind facility —

"(I) subparagraph (C)(ii) shall be applied by substituting 'January 1, 2026' for 'January 1, 2022',

"(II) subparagraph (E) shall not apply, and

"(III) for purposes of this paragraph, section 45(d)(1) shall be applied by substituting 'January 1, 2026" for 'January 1, 2022'.

"(ii) QUALIFIED OFFSHORE WIND FACILITY. — For purposes of this subparagraph, the term 'qualified offshore wind facility' means a qualified facility (within the meaning of section 45) described in paragraph (1) of section 45(d) (determined without regard to any date by which the construction of the facility is required to begin) which is located in the inland navigable waters of the United States or in the coastal waters of the United States.".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to periods after December 31, 2016, under rules similar to the rules of section 48(m) of the Internal Revenue Code of 1986 (as in effect on the day before the date of the enactment of the Revenue Reconciliation Act of 1990).

SEC. 205. MINIMUM RATE OF INTEREST FOR CERTAIN DETERMINATIONS RELATED TO LIFE INSURANCE CONTRACTS.

(a) MODIFICATION OF MINIMUM RATE FOR PURPOSES OF CASH VALUE ACCUMULATION TEST. —

(1) IN GENERAL. — Section 7702(b)(2)(A) is amended by striking "an annual effective rate of 4 percent" and inserting "the applicable accumulation test minimum rate".

(2) APPLICABLE ACCUMULATION TEST MINIMUM RATE. — Section 7702(b) is amended by adding at the end the following new paragraph:

"(3) APPLICABLE ACCUMULATION TEST MINIMUM RATE. — For purposes of paragraph (2)(A), the term 'applicable accumulation test minimum rate' means the lesser of —

"(A) an annual effective rate of 4 percent, or

"(B) the insurance interest rate (as defined in subsection (f)(11)) in effect at the time the contract is issued.".

(b) MODIFICATION OF MINIMUM RATE FOR PURPOSES OF GUIDELINE PREMIUM REQUIREMENTS. —

(1) IN GENERAL. — Section 7702(c)(3)(B)(iii) is amended by striking "an annual effective rate of 6 percent" and inserting "the applicable guideline premium minimum rate".

(2) APPLICABLE GUIDELINE PREMIUM MINIMUM RATE. — Section 7702(c)(3) is amended by adding at the end the following new subparagraph:

"(E) APPLICABLE GUIDELINE PREMIUM MINIMUM RATE. — For purposes of subparagraph (B)(iii), the term 'applicable guideline premium minimum rate' means the applicable accumulation test minimum rate (as defined in subsection (b)(3)) plus 2 percentage points.".

(c) APPLICATION OF MODIFIED MINIMUM RATES TO DETERMINATION OF GUIDELINE LEVEL PREMIUM. — Section 7702(c)(4) is amended —

(1) by striking "4 percent" and inserting "the applicable accumulation test minimum rate", and

(2) by striking "6 percent" and inserting "the applicable guideline premium minimum rate".

(d) INSURANCE INTEREST RATE. — Section 7702(f) is amended by adding at the end the following new paragraph:

"(11) INSURANCE INTEREST RATE. — For purposes of this section —

"(A) IN GENERAL. — The term 'insurance interest rate' means, with respect to any contract issued in any calendar year, the lesser of —

"(i) the section 7702 valuation interest rate for such calendar year (or, if such calendar year is not an adjustment year, the most recent adjustment year), or

"(ii) the section 7702 applicable Federal interest rate for such calendar year (or, if such calendar year is not an adjustment year, the most recent adjustment year).

"(B) SECTION 7702 VALUATION INTEREST RATE. — The term 'section 7702 valuation interest rate' means, with respect to any adjustment year, the prescribed U.S. valuation interest rate for life insurance with guaranteed durations of more than 20 years (as defined in the National Association of Insurance Commissioners' Standard Valuation Law) as effective in the calendar year immediately preceding such adjustment year.

"(C) SECTION 7702 APPLICABLE FEDERAL INTEREST RATE. — The term 'section 7702 applicable Federal interest rate' means, with respect to any adjustment year, the average (rounded to the nearest whole percentage point) of the applicable Federal midterm rates (as defined in section 1274(d) but based on annual compounding) effective as of the beginning of each of the calendar months in the most recent 60-month period ending before the second calendar year prior to such adjustment year.

"(D) ADJUSTMENT YEAR. — The term 'adjustment year' means the calendar year following any calendar year that includes the effective date of a change in the prescribed U.S. valuation interest rate for life insurance with guaranteed durations of more than 20 years (as defined in the National Association of Insurance Commissioners' Standard Valuation Law).

"(E) TRANSITION RULE. — Notwithstanding subparagraph (A), the insurance interest rate shall be 2 percent in the case of any contract which is issued during the period that —

"(i) begins on January 1, 2021, and

"(ii) ends immediately before the beginning of the first adjustment year that beings after December 31, 2021.".

(e) EFFECTIVE DATE. — The amendments made by this section shall apply to contracts issued after December 31, 2020.

SEC. 206. CLARIFICATIONS AND TECHNICAL IMPROVEMENTS TO CARES ACT EMPLOYEE RETENTION CREDIT.

(a) GROSS RECEIPTS OF TAX-EXEMPT ORGANIZATIONS. — Section 2301(c)(2)(C) of the CARES Act is amended —

(1) by striking "of such Code, clauses (i) and (ii)(I)" and inserting "of such Code —

"(i) clauses (i) and (ii)(I)",

(2) by striking the period at the end and inserting ", and", and

(3) by adding at the end the following new clause:

"(ii) any reference in this section to gross receipts shall be treated as a reference to gross receipts within the meaning of section 6033 of such Code.".

(b) MODIFICATION OF TREATMENT OF HEALTH PLAN EXPENSES. —

(1) by striking subparagraph (C) of paragraph (3), and

(2) in paragraph (5) —

(A) by striking "The term" and inserting the following: "(A) IN GENERAL. — The term", and

(B) by adding at the end the following new subparagraph:

"(B) ALLOWANCE FOR CERTAIN HEALTH PLAN EXPENSES. —

"(i) IN GENERAL. — Such term shall include amounts paid by the eligible employer to provide and maintain a group health plan (as defined in section 5000(b)(1) of the Internal Revenue Code of 1986), but only to the extent that such amounts are excluded from the gross income of employees by reason of section 106(a) of such Code.

"(ii) ALLOCATION RULES. — For purposes of this section, amounts treated as wages under clause (i) shall be treated as paid with respect to any employee (and with respect to any period) to the extent that such amounts are properly allocable to such employee (and to such period) in such manner as the Secretary may prescribe. Except as otherwise provided by the Secretary, such allocation shall be treated as properly made if made on the basis of being pro rata among periods of coverage.".

(c) IMPROVED COORDINATION BETWEEN PAYCHECK PROTECTION PROGRAM AND EMPLOYEE RETENTION TAX CREDIT. —

(1) AMENDMENT TO PAYCHECK PROTECTION PROGRAM. — Section 7A(a)(12) of the Small Business Act, as redesignated, transferred, and amended by the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act, is amended by adding at the end the following: "Such payroll costs shall not include qualified wages taken into account in determining the credit allowed under section 2301 of the CARES Act or qualified wages taken into account in determining the credit allowed under subsection (a) or (d) of section 303 of the Taxpayer Certainty and Disaster Relief Act of 2020.".

(2) AMENDMENTS TO EMPLOYEE RETENTION TAX CREDIT. —

(A) IN GENERAL. — Section 2301(g) of the CARES Act is amended to read as follows:

"(g) ELECTION TO NOT TAKE CERTAIN WAGES INTO ACCOUNT. —

"(1) IN GENERAL. — This section shall not apply to so much of the qualified wages paid by an eligible employer as such employer elects (at such time and in such manner as the Secretary may prescribe) to not take into account for purposes of this section.

"(2) COORDINATION WITH PAYCHECK PROTECTION PROGRAM. — The Secretary, in consultation with the Administrator of the Small Business Administration, shall issue guidance providing that payroll costs paid during the covered period shall not fail to be treated as qualified wages under this section by reason of an election under paragraph (1) to the extent that a covered loan of the eligible employer is not forgiven by reason of a decision under section 7A(g) of the Small Business Act. Terms used in the preceding sentence which are also used in section 7A of the Small Business Act shall have the same meaning as when used in such section.".

(B) CONFORMING AMENDMENTS. —

(i) Section 2301 of the CARES Act is amended by striking subsection (j).

(ii) Section 2301(l) of the CARES Act is amended by striking paragraph (3) and by redesignating paragraphs (4) and (5) as paragraphs (3) and (4), respectively.

(d) REGULATIONS AND GUIDANCE. — Section 2301(l) of the CARES Act, as amended by subsection (c)(2)(B)(ii), is amended by striking "and" at the end of paragraph (3), by striking the period at the end of paragraph (4) and inserting ", and", and by adding at the end the following new paragraph:

"(5) to prevent the avoidance of the purposes of the limitations under this section, including through the leaseback of employees.".

(e) EFFECTIVE DATE. —

(1) IN GENERAL. — The amendments made by this section shall take effect as if included in the provisions of the CARES Act to which they relate.

(2) SPECIAL RULE. —

(A) IN GENERAL. — For purposes of section 2301 of the CARES Act, an employer who has filed a return of tax with respect to applicable employment taxes (as defined in section 2301(c)(1) of division A of such Act) before the date of the enactment of this Act may elect (in such manner as the Secretary of the Treasury (or the Secretary's delegate) shall prescribe) to treat any applicable amount as an amount paid in the calendar quarter which includes the date of the enactment of this Act.

(B) APPLICABLE AMOUNT. — For purposes of subparagraph (A), the term "applicable amount" means the amount of wages which —

(i) are —

(I) described in section 2301(c)(5)(B) of the CARES Act, as added by the amendments made by subsection (b), or

(II) permitted to be treated as qualified wages under guidance issued pursuant to section 2301(g)(2) of the CARES Act (as added by subsection (c)), and

(ii) were —

(I) paid in a calendar quarter beginning after December 31, 2019, and before October 1, 2020, and

(II) not taken into account by the taxpayer in calculating the credit allowed under section 2301(a) of division A of such Act for such calendar quarter.

SEC. 207. EXTENSION AND MODIFICATION OF EMPLOYEE RETENTION AND REHIRING TAX CREDIT.

(a) EXTENSION. —

(1) IN GENERAL. — Section 2301(m) of the CARES Act is amended by striking "January 1, 2021" and inserting "July 1, 2021".

(2) CONFORMING AMENDMENT. — Section 2301(c)(2)(A)(i) of the CARES Act is amended by striking "during calendar year 2020" and inserting "during the calendar quarter for which the credit is determined under subsection (a)".

(b) INCREASE IN CREDIT PERCENTAGE. — Section 2301(a) of the CARES Act is amended by striking "50 percent" and inserting "70 percent".

(c) INCREASE IN PER EMPLOYEE LIMITATION. — Section 2301(b)(1) of the CARES Act is amended by striking "for all calendar quarters shall not exceed $10,000" and inserting "for any calendar quarter shall not exceed $10,000".

(d) MODIFICATIONS TO DEFINITION OF ELIGIBLE EMPLOYER. —

(1) DECREASE IN REDUCTION IN GROSS RECEIPTS NECESSARY TO QUALIFY AS ELIGIBLE EMPLOYER. —

(A) IN GENERAL. — Section 2301(c)(2)(A)(ii)(II) of the CARES Act is amended to read as follows:

"(II) the gross receipts (within the meaning of section 448(c) of the Internal Revenue Code of 1986) of such employer for such calendar quarter are less than 80 percent of the gross receipts of such employer for the same calendar quarter in calendar year 2019.".

(B) APPLICATION TO EMPLOYERS NOT IN EXISTENCE IN 2019. — Section 2301(c)(2)(A) of the CARES Act, as amended by subparagraph (A), is amended by adding at the end the following new flush sentence:

"With respect to any employer for any calendar quarter, if such employer was not in existence as of the beginning of the same calendar quarter in calendar year 2019, clause (ii)(II) shall be applied by substituting '2020' for '2019'.".

(2) ELECTION TO DETERMINE GROSS RECEIPTS TEST BASED ON PRIOR QUARTER. —

(A) IN GENERAL. — Subparagraph (B) of section 2301(c)(2) of the CARES Act is amended to read as follows:

"(B) ELECTION TO USE ALTERNATIVE QUARTER. — At the election of the employer —

"(i) subparagraph (A)(ii)(II) shall be applied —

"(I) by substituting 'for the immediately preceding calendar quarter' for 'for such calendar quarter', and

"(II) by substituting 'the corresponding calendar quarter in calendar year 2019' for 'the same calendar quarter in calendar year 2019', and

"(ii) the last sentence of subparagraph (A) shall be applied by substituting 'the corresponding calendar quarter in calendar year 2019' for 'the same calendar quarter in calendar year 2019'.

An election under this subparagraph shall be made at such time and in such manner as the Secretary shall prescribe.".

(B) CONFORMING AMENDMENT. — Section 2301(l) of the CARES Act, as amended by section 206, is amended by inserting "and" at the end of paragraph (3), by striking paragraph (4), and by redesignating paragraph (5) as paragraph (4).

(3) APPLICATION TO CERTAIN GOVERNMENTAL EMPLOYERS. —

(A) IN GENERAL. — Section 2301(f) of the CARES Act is amended —

(i) by striking "This" and inserting the following: "(1) IN GENERAL. — This", and

(ii) by adding at the end the following new paragraph:

"(2) EXCEPTION. — Paragraph (1) shall not apply to —

"(A) any organization described in section 501(c)(1) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code, or

"(B) any entity described in paragraph (1) if —

"(i) such entity is a college or university, or

"(ii) the principal purpose or function of such entity is providing medical or hospital care.

In the case of any entity described in subparagraph (B), such entity shall be treated as satisfying the requirements of subsection (c)(2)(A)(i).".

(B) CONFORMING AMENDMENT. — Section 2301(c)(5)(A) of the CARES Act, as amended by section 206(b)(2), is amended by adding at the end the following new sentence: "For purposes of the preceding sentence, in the case of any organization or entity described in subsection (f)(2), wages as defined in section 3121(a) of the Internal Revenue Code of 1986 shall be determined without regard to paragraphs (5), (6), (7), (10), and (13) of section 3121(b) of such Code (except with respect to services performed in a penal institution by an inmate thereof).".

(e) MODIFICATION OF DETERMINATION OF QUALIFIED WAGES. —

(1) MODIFICATION OF THRESHOLD FOR TREATMENT AS A LARGE EMPLOYER. — Section 2301(c)(3)(A) of the CARES Act is amended by striking "100" each place it appears in clauses (i) and (ii) and inserting "500".

(2) ELIMINATION OF LIMITATION. — Section 2301(c)(3) of the CARES Act is amended —

(A) by striking subparagraph (B), and

(B) by striking "Such term" in the second sentence of subparagraph (A) and inserting the following:

"(B) EXCEPTION. — The term 'qualified wages' ".

(f) DENIAL OF DOUBLE BENEFIT. — Section 2301(h) of the CARES Act is amended —

(1) by striking paragraphs (1) and (2) and inserting the following:

"(1) DENIAL OF DOUBLE BENEFIT. — Any wages taken into account in determining the credit allowed under this section shall not be taken into account as wages for purposes of sections 41, 45A, 45P, 45S, 51, and 1396 of the Internal Revenue Code of 1986.".

(2) by redesignating paragraph (3) as paragraph (2).

(g) ADVANCE PAYMENTS. —

(3) IN GENERAL. — Section 2301 of the CARES Act, as amended by section 206(c)(2)(B)(i), is amended by inserting after subsection (i) the following new subsection:

"(j) ADVANCE PAYMENTS. —

"(1) IN GENERAL. — Except as provided in paragraph (2), no advance payment of the credit under subsection (a) shall be allowed.

"(2) ADVANCE PAYMENTS TO SMALL EMPLOYERS. —

"(A) IN GENERAL. — Under rules provided by the Secretary, an eligible employer for which the average number of full-time employees (within the meaning of section 4980H of the Internal Revenue Code of 1986) employed by such eligible employer during 2019 was not greater than 500 may elect for any calendar quarter to receive an advance payment of the credit under subsection (a) for such quarter in an amount not to exceed 70 percent of the average quarterly wages paid by the employer in calendar year 2019.

"(B) SPECIAL RULE FOR SEASONAL EMPLOYERS. — In the case of any employer who employs seasonal workers (as defined in section 45R(d)(5)(B) of the Internal Revenue Code of 1986), the employer may elect to substitute 'the wages for the calendar quarter in 2019 which corresponds to the calendar quarter to which the election relates' for 'the average quarterly wages paid by the employer in calendar year 2019'.

"(C) SPECIAL RULE FOR EMPLOYERS NOT IN EXISTENCE IN 2019. — In the case of any employer that was not in existence in 2019, subparagraphs (A) and (B) shall each be applied by substituting '2020' for '2019' each place it appears.

"(3) RECONCILIATION OF CREDIT WITH ADVANCE PAYMENTS. —

"(A) IN GENERAL. — The amount of credit which would (but for this subsection) be allowed under this section shall be reduced (but not below zero) by the aggregate payment allowed to the taxpayer under paragraph (2). Any failure to so reduce the credit shall be treated as arising out of a mathematical or clerical error and assessed according to section 6213(b)(1) of the Internal Revenue Code of 1986.

"(B) EXCESS ADVANCE PAYMENTS. — If the advance payments to a taxpayer under paragraph (2) for a calendar quarter exceed the credit allowed by this section (determined without regard to subparagraph (A)), the tax imposed by chapter 21 or 22 of the Internal Revenue Code of 1986 (whichever is applicable) for the calendar quarter shall be increased by the amount of such excess.".

(2) CONFORMING AMENDMENTS. — Section 2301(l) of the CARES Act, as amended by section 206 and subsection (d)(2)(B), is amended —

(A) by inserting "as provided in subsection (j)(2)" after "subsection (a)" in paragraph (1),

(B) by striking paragraph (2), and

(C) by redesignating paragraphs (3) and (4) as paragraphs (2) and (3), respectively.

(h) THIRD-PARTY PAYORS. — Section 2301(l) of the CARES Act, as amended by section 206 and subsections (d)(2)(B) and (g)(2), is amended by adding at the end the following flush sentence: "Any forms, instructions, regulations, or guidance described in paragraph (2) shall require the customer to be responsible for the accounting of the credit and for any liability for improperly claimed credits and shall require the certified professional employer organization or other third party payor to accurately report such tax credits based on the information provided by the customer.".

(i) PUBLIC AWARENESS CAMPAIGN. — Section 2301 of the CARES Act is amended by adding at the end the following new subsection:

"(n) PUBLIC AWARENESS CAMPAIGN. —

"(1) IN GENERAL. — The Secretary shall conduct a public awareness campaign, in coordination with the Administrator of the Small Business Administration, to provide information regarding the availability of the credit allowed under this section.

"(2) OUTREACH. — Under the campaign conducted under paragraph (1), the Secretary shall —

"(A) provide to all employers which reported not more than 500 employees on the most recently filed return of applicable employment taxes a notice about the credit allowed under this section and the requirements for eligibility to claim the credit, and

"(B) not later than 30 days after the date of the enactment of this subsection, provide to all employers educational materials relating to the credit allowed under this section, including specific materials for businesses with not more than 500 employees.".

(j) COORDINATION WITH CERTAIN PAYROLL PROTECTION PROGRAM LOANS. — Section 2301(g)(2) of the CARES Act, as added by section 206(c)(2)(A), is amended by striking "section 7A(g) of the Small Business Act" and all that follows and inserting "section 7A(g) of the Small Business Act or the application of section 7(a)(37)(J) of the Small Business Act. Terms used in the preceding sentence which are also used in section 7A(g) or 7(a)(37)(J) of the Small Business Act shall, when applied in connection with either such section, have the same meaning as when used in such section, respectively.".

(k) EFFECTIVE DATE. — The amendments made by this section shall apply to calendar quarters beginning after December 31, 2020.

SEC. 208. MINIMUM AGE FOR DISTRIBUTIONS DURING WORKING RETIREMENT.

(a) IN GENERAL. — Paragraph (36) of section 401(a) is amended to read as follows:

"(36) DISTRIBUTIONS DURING WORKING RETIREMENT. —

"(A) IN GENERAL. — A trust forming part of a pension plan shall not be treated as failing to constitute a qualified trust under this section solely because the plan provides that a distribution may be made from such trust to an employee who has attained age 59½ and who is not separated from employment at the time of such distribution.

"(B) CERTAIN EMPLOYEES IN THE BUILDING AND CONSTRUCTION INDUSTRY. — Subparagraph (A) shall be applied by substituting 'age 55' for 'age 59½' in the case of a multiemployer plan described in section 4203(b)(1)(B)(i) of the Employee Retirement Income Security Act of 1974, with respect to individuals who were participants in such plan on or before April 30, 2013, if —

"(i) the trust to which subparagraph (A) applies was in existence before January 1, 1970, and

"(ii) before December 31, 2011, at a time when the plan provided that distributions may be made to an employee who has attained age 55 and who is not separated from employment at the time of such distribution, the plan received at least 1 written determination from the Internal Revenue Service that the trust to which subparagraph (A) applies constituted a qualified trust under this section.".

(b) EFFECTIVE DATE. — The amendment made by this section shall apply to distributions made before, on, or after the date of the enactment of this Act.

SEC. 209. TEMPORARY RULE PREVENTING PARTIAL PLAN TERMINATION.

A plan shall not be treated as having a partial termination (within the meaning of 411(d)(3) of the Internal Revenue Code of 1986) during any plan year which includes the period beginning on March 13, 2020, and ending on March 31, 2021, if the number of active participants covered by the plan on March 31, 2021 is at least 80 percent of the number of active participants covered by the plan on March 13, 2020.

SEC. 210. TEMPORARY ALLOWANCE OF FULL DEDUCTION FOR BUSINESS MEALS.

(a) IN GENERAL. — Section 274(n)(2) of the Internal Revenue Code of 1986 is amended by striking "or" at the end of subparagraph (B), by striking the period at the end of subparagraph (C)(iv) and inserting ", or", and by inserting after subparagraph (C) the following new subparagraph:

"(D) such expense is —

"(i) for food or beverages provided by a restaurant, and

"(ii) paid or incurred before January 1, 2023.".

(b) EFFECTIVE DATE. — The amendments made by this section shall apply to amounts paid or incurred after December 31, 2020.

SEC. 211. TEMPORARY SPECIAL RULE FOR DETERMINATION OF EARNED INCOME.

(a) IN GENERAL. — If the earned income of the taxpayer for the taxpayer's first taxable year beginning in 2020 is less than the earned income of the taxpayer for the preceding taxable year, the credits allowed under sections 24(d) and 32 of the Internal Revenue Code of 1986 may, at the election of the taxpayer, be determined by substituting —

(1) such earned income for the preceding taxable year, for

(2) such earned income for the taxpayer's first taxable year beginning in 2020.

(b) EARNED INCOME. —

(1) IN GENERAL. — For purposes of this section, the term "earned income" has the meaning given such term under section 32(c) of the Internal Revenue Code of 1986.

(2) APPLICATION TO JOINT RETURNS. — For purposes of subsection (a), in the case of a joint return, the earned income of the taxpayer for the preceding taxable year shall be the sum of the earned income of each spouse for such preceding taxable year.

(c) SPECIAL RULES. —

(1) ERRORS TREATED AS MATHEMATICAL ERROR. — For purposes of section 6213 of the Internal Revenue Code of 1986, an incorrect use on a return of earned income pursuant to subsection (a) shall be treated as a mathematical or clerical error.

(2) NO EFFECT ON DETERMINATION OF GROSS INCOME, ETC. — Except as otherwise provided in this section, the Internal Revenue Code of 1986 shall be applied without regard to any substitution under subsection (a).

SEC. 212. CERTAIN CHARITABLE CONTRIBUTIONS DEDUCTIBLE BY NON-ITEMIZERS.

(a) IN GENERAL. — Section 170 is amended by redesignating subsection (p) as subsection (q) and by inserting after subsection (o) the following new subsection:

"(p) SPECIAL RULE FOR TAXPAYERS WHO DO NOT ELECT TO ITEMIZE DEDUCTIONS. — In the case of any taxable year beginning in 2021, if the individual does not elect to itemize deductions for such taxable year, the deduction under this section shall be equal to the deduction, not in excess of $300 ( $600 in the case of a joint return), which would be determined under this section if the only charitable contributions taken into account in determining such deduction were contributions made in cash during such taxable year (determined without regard to subsections (b)(1)(G)(ii) and (d)(1)) to an organization described in section 170(b)(1)(A) and not —

"(1) to an organization described in section 509(a)(3), or "(2) for the establishment of a new, or maintenance of an existing, donor advised fund (as defined in section 4966(d)(2)).".

(b) PENALTY FOR UNDERPAYMENTS ATTRIBUTABLE TO OVERSTATED DEDUCTION. —

(1) IN GENERAL. — Section 6662(b) is amended by inserting after paragraph (8) the following:

"(9) Any overstatement of the deduction provided in section 170(p).".

(2) INCREASED PENALTY. — Section 6662 is amended by adding at the end the following new subsection:

"(l) INCREASE IN PENALTY IN CASE OF OVERSTATEMENT OF QUALIFIED CHARITABLE CONTRIBUTIONS. — In the case of any portion of an underpayment which is attributable to one or more overstatements of the deduction provided in section 170(p), subsection (a) shall be applied with respect to such portion by substituting '50 percent' for '20 percent'.".

(3) EXCEPTION TO APPROVAL OF ASSESSMENT. — Section 6751(b)(2)(A) is amended by striking "or 6655" and inserting "6655, or 6662 (but only with respect to an addition to tax by reason of subsection (b)(9) thereof)".

(b) CONFORMING AMENDMENTS. —

(1) Section 63(b) is amended by striking "and" at the end of paragraph (2), by striking the period at the end of paragraph (3) and inserting ", and", and by adding at the end the following new paragraph:

"(4) the deduction provided in section 170(p).".

(2) Section 63(d) is amended by adding "and" at the end of paragraph (1), by striking paragraphs (2) and (3), and by inserting after paragraph (1) the following new paragraph:

"(2) any deduction referred to in any paragraph of subsection (b).".

(c) REPEAL OF SUPERSEDED PROVISIONS. —

(1) IN GENERAL. — Section 62(a) is amended by striking paragraph (22).

(2) CONFORMING AMENDMENT. — Section 62 is amended by striking subsection (f).

(d) EFFECTIVE DATE. — The amendments made by this section shall apply to taxable years beginning after December 31, 2020.

SEC. 213. MODIFICATION OF LIMITATIONS ON CHARITABLE CONTRIBUTIONS.

(a) IN GENERAL. — Subsections (a)(3)(A)(i) and (b) of section 2205 of the CARES Act are each amended by inserting "or 2021" after "2020".

(b) CONFORMING AMENDMENT. — The heading of section 2205 of the CARES Act is amended by striking "modification of limitations on charitable contributions during 2020" and inserting "temporary modification of limitations on charitable contributions".

(c) EFFECTIVE DATE. — The amendments made by this section shall apply to contributions made after December 31, 2020.

SEC. 214. TEMPORARY SPECIAL RULES FOR HEALTH AND DEPENDENT CARE FLEXIBLE SPENDING ARRANGEMENTS.

(a) CARRYOVER FROM 2020 PLAN YEAR. — For plan years ending in 2020, a plan that includes a health flexible spending arrangement or dependent care flexible spending arrangement shall not fail to be treated as a cafeteria plan under the Internal Revenue Code of 1986 merely because such plan or arrangement permits participants to carry over (under rules similar to the rules applicable to health flexible spending arrangements) any unused benefits or contributions remaining in any such flexible spending arrangement from such plan year to the plan year ending in 2021.

(b) CARRYOVER FROM 2021 PLAN YEAR. — For plan years ending in 2021, a plan that includes a health flexible spending arrangement or dependent care flexible spending arrangement shall not fail to be treated as a cafeteria plan under the Internal Revenue Code of 1986 merely because such plan or arrangement permits participants to carry over (under rules similar to the rules applicable to health flexible spending arrangements) any unused benefits or contributions remaining in any such flexible spending arrangement from such plan year to the plan year ending in 2022.

(c) EXTENSION OF GRACE PERIODS, ETC. —

(1) IN GENERAL. — A plan that includes a health flexible spending arrangement or dependent care flexible spending arrangement shall not fail to be treated as a cafeteria plan under the Internal Revenue Code of 1986 merely because such plan or arrangement extends the grace period for a plan year ending in 2020 or 2021 to 12 months after the end of such plan year, with respect to unused benefits or contributions remaining in a health flexible spending arrangement or a dependent care flexible spending arrangement.

(2) POST-TERMINATION REIMBURSEMENTS FROM HEALTH FSAs. — A plan that includes a health flexible spending arrangement shall not fail to be treated as a cafeteria plan under the Internal Revenue Code of 1986 merely because such plan or arrangement allows (under rules similar to the rules applicable to dependent care flexible spending arrangements) an employee who ceases participation in the plan during calendar year 2020 or 2021 to continue to receive reimbursements from unused benefits or contributions through the end of the plan year in which such participation ceased (including any grace period, taking into account any modification of a grace period permitted under paragraph (1)).

(d) SPECIAL CARRY FORWARD RULE FOR DEPENDENT CARE FLEXIBLE SPENDING ARRANGEMENTS WHERE DEPENDENT AGED OUT DURING PANDEMIC. —

(1) IN GENERAL. — In the case of any eligible employee, section 21(b)(1)(A) of the Internal Revenue Code of 1986 shall be applied by substituting "age 14" for "age 13" for purposes of determining the dependent care assistance which may be paid or reimbursed with respect to such employee under the dependent care flexible spending arrangement referred to in paragraph (3)(A) with respect to such employee during —

(A) the plan year described in paragraph (3)(A), and

(B) in the case of an employee described in paragraph (3)(B)(ii), the subsequent plan year.

(2) APPLICATION TO SUBSEQUENT PLAN YEAR LIMITED TO UNUSED BALANCE FROM PRECEDING PLAN YEAR. — Paragraph (1)(B) shall only apply to so much of the amounts paid for dependent care assistance with respect to the dependents referred to in paragraph (3)(B) as does not exceed the unused balance described in paragraph (3)(B)(ii).

(3) ELIGIBLE EMPLOYEE. — For purposes of this section, the term "eligible employee" means any employee who —

(A) is enrolled in a dependent care flexible spending arrangement for the last plan year with respect to which the end of the regular enrollment period for such plan year was on or before January 31, 2020, and

(B) has one or more dependents (as defined in section 152(a)(1) of the Internal Revenue Code of 1986) who attain the age of 13 —

(i) during such plan year, or

(ii) in the case of an employee who (after the application of this section) has an unused balance in the employee's account under such arrangement for such plan year (determined as of the close of the last day on which, under the terms of the plan, claims for reimbursement may be made with respect to such plan year), the subsequent plan year.

(e) CHANGE IN ELECTION AMOUNT. — For plan years ending in 2021, a plan that includes a health flexible spending arrangement or dependent care flexible spending arrangement shall not fail to be treated as a cafeteria plan under the Internal Revenue Code of 1986 merely because such plan or arrangement allows an employee to make an election to modify prospectively the amount (but not in excess of any applicable dollar limitation) of such employee's contributions to any such flexible spending arrangement (without regard to any change in status).

(f) DEFINITIONS. — Any term used in this section which is also used in section 106, 125, or 129 of the Internal Revenue Code of 1986, or the regulations or guidance thereunder, shall have the same meaning as when used in such section, regulations, or guidance.

(g) PLAN AMENDMENTS. — A plan that includes a health flexible spending arrangement or dependent care flexible spending arrangement shall not fail to be treated as a cafeteria plan under the Internal Revenue Code of 1986 merely because such plan or arrangement is amended pursuant to a provision under this section and such amendment is retroactive, if —

(1) such amendment is adopted not later than the last day of the first calendar year beginning after the end of the plan year in which the amendment is effective, and

(2) the plan or arrangement is operated consistent with the terms of such amendment during the period beginning on the effective date of the amendment and ending on the date the amendment is adopted.

TITLE III — DISASTER TAX RELIEF

SEC. 301. DEFINITIONS.

For purposes of this title —

(1) QUALIFIED DISASTER AREA. —

(A) IN GENERAL. — The term "qualified disaster area" means any area with respect to which a major disaster was declared, during the period beginning on January 1, 2020, and ending on the date which is 60 days after the date of the enactment of this Act, by the President under section 401 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act if the incident period of the disaster with respect to which such declaration is made begins on or after December 28, 2019, and on or before the date of the enactment of this Act.

(B) COVID–19 EXCEPTION. — Such term shall not include any area with respect to which such a major disaster has been so declared only by reason of COVID–19.

(2) QUALIFIED DISASTER ZONE. — The term "qualified disaster zone" means that portion of any qualified disaster area which was determined by the President, during the period beginning on January 1, 2020, and ending on the date which is 60 days after the date of the enactment of this Act, to warrant individual or individual and public assistance from the Federal Government under the Robert T. Stafford Disaster Relief and Emergency Assistance Act by reason of the qualified disaster with respect to such disaster area.

(3) QUALIFIED DISASTER. — The term "qualified disaster" means, with respect to any qualified disaster area, the disaster by reason of which a major disaster was declared with respect to such area.

(4) INCIDENT PERIOD. — The term "incident period" means, with respect to any qualified disaster, the period specified by the Federal Emergency Management Agency as the period during which such disaster occurred (except that for purposes of this title such period shall not be treated as ending after the date which is 30 days after the date of the enactment of this Act).

SEC. 302. SPECIAL DISASTER-RELATED RULES FOR USE OF RETIREMENT FUNDS.

(a) TAX-FAVORED WITHDRAWALS FROM RETIREMENT PLANS. —

(1) IN GENERAL. — Section 72(t) of the Internal Revenue Code of 1986 shall not apply to any qualified disaster distribution.

(2) AGGREGATE DOLLAR LIMITATION. —

(A) IN GENERAL. — For purposes of this subsection, the aggregate amount of distributions received by an individual which may be treated as qualified disaster distributions for any taxable year shall not exceed the excess (if any) of —

(i) $100,000, over

(ii) the aggregate amounts treated as qualified disaster distributions received by such individual for all prior taxable years.

(B) TREATMENT OF PLAN DISTRIBUTIONS. — If a distribution to an individual would (without regard to subparagraph (A)) be a qualified disaster distribution, a plan shall not be treated as violating any requirement of the Internal Revenue Code of 1986 merely because the plan treats such distribution as a qualified disaster distribution, unless the aggregate amount of such distributions from all plans maintained by the employer (and any member of any controlled group which includes the employer) to such individual exceeds $100,000.

(C) CONTROLLED GROUP. — For purposes of subparagraph (B), the term "controlled group" means any group treated as a single employer under subsection (b), (c), (m), or (o) of section 414 of the Internal Revenue Code of 1986.

(D) SPECIAL RULE FOR INDIVIDUALS AFFECTED BY MORE THAN ONE DISASTER. — The limitation of subparagraph (A) shall be applied separately with respect to distributions made with respect to each qualified disaster.

(3) AMOUNT DISTRIBUTED MAY BE REPAID. —

(E) IN GENERAL. — Any individual who receives a qualified disaster distribution may, at any time during the 3-year period beginning on the day after the date on which such distribution was received, make 1 or more contributions in an aggregate amount not to exceed the amount of such distribution to an eligible retirement plan of which such individual is a beneficiary and to which a rollover contribution of such distribution could be made under section 402(c), 403(a)(4), 403(b)(8), 408(d)(3), or 457(e)(16), of the Internal Revenue Code of 1986, as the case may be.

(F) TREATMENT OF REPAYMENTS OF DISTRIBUTIONS FROM ELIGIBLE RETIREMENT PLANS OTHER THAN IRAS. — For purposes of the Internal Revenue Code of 1986, if a contribution is made pursuant to subparagraph (A) with respect to a qualified disaster distribution from an eligible retirement plan other than an individual retirement plan, then the taxpayer shall, to the extent of the amount of the contribution, be treated as having received the qualified disaster distribution in an eligible rollover distribution (as defined in section 402(c)(4) of such Code) and as having transferred the amount to the eligible retirement plan in a direct trustee to trustee transfer within 60 days of the distribution.

(C) TREATMENT OF REPAYMENTS OF DISTRIBUTIONS FROM IRAS. — For purposes of the Internal Revenue Code of 1986, if a contribution is made pursuant to subparagraph (A) with respect to a qualified disaster distribution from an individual retirement plan (as defined by section 7701(a)(37) of such Code), then, to the extent of the amount of the contribution, the qualified disaster distribution shall be treated as a distribution described in section 408(d)(3) of such Code and as having been transferred to the eligible retirement plan in a direct trustee to trustee transfer within 60 days of the distribution.

(4) DEFINITIONS. — For purposes of this subsection —

(A) QUALIFIED DISASTER DISTRIBUTION. — Except as provided in paragraph (2), the term "qualified disaster distribution" means any distribution from an eligible retirement plan made —

(i) on or after the first day of the incident period of a qualified disaster and before the date which is 180 days after the date of the enactment of this Act, and

(ii) to an individual whose principal place of abode at any time during the incident period of such qualified disaster is located in the qualified disaster area with respect to such qualified disaster and who has sustained an economic loss by reason of such qualified disaster.

(B) ELIGIBLE RETIREMENT PLAN. — The term "eligible retirement plan" shall have the meaning given such term by section 402(c)(8)(B) of the Internal Revenue Code of 1986.

(5) INCOME INCLUSION SPREAD OVER 3-YEAR PERIOD. —

(A) IN GENERAL. — In the case of any qualified disaster distribution, unless the taxpayer elects not to have this paragraph apply for any taxable year, any amount required to be included in gross income for such taxable year shall be so included ratably over the 3-taxable-year period beginning with such taxable year.

(B) SPECIAL RULE. — For purposes of subparagraph (A), rules similar to the rules of subparagraph (E) of section 408A(d)(3) of the Internal Revenue Code of 1986 shall apply.

(6) SPECIAL RULES. —

(C) EXEMPTION OF DISTRIBUTIONS FROM TRUSTEE TO TRUSTEE TRANSFER AND WITHHOLDING RULES. — For purposes of sections 401(a)(31), 402(f), and 3405 of the Internal Revenue Code of 1986, qualified disaster distributions shall not be treated as eligible rollover distributions.

(B) QUALIFIED DISASTER DISTRIBUTIONS TREATED AS MEETING PLAN DISTRIBUTION REQUIREMENTS. — For purposes of the Internal Revenue Code of 1986, a qualified disaster distribution shall be treated as meeting the requirements of sections 401(k)(2)(B)(i), 403(b)(7)(A)(i), 403(b)(11), and 457(d)(1)(A) of such Code and section 8433(h)(1) of title 5, United States Code, and, in the case of a money purchase pension plan, a qualified disaster distribution which is an in-service withdrawal shall be treated as meeting the distribution rules of section 401(a) of such Code.

(b) RECONTRIBUTIONS OF WITHDRAWALS FOR HOME PURCHASES. —

(1) RECONTRIBUTIONS. —

(A) IN GENERAL. — Any individual who received a qualified distribution may, during the applicable period, make 1 or more contributions in an aggregate amount not to exceed the amount of such qualified distribution to an eligible retirement plan (as defined in section 402(c)(8)(B) of the Internal Revenue Code of 1986) of which such individual is a beneficiary and to which a rollover contribution of such distribution could be made under section 402(c), 403(a)(4), 403(b)(8), or 408(d)(3), of such Code, as the case may be.

(B) TREATMENT OF REPAYMENTS. — Rules similar to the rules of subparagraphs (B) and (C) of subsection (a)(3) shall apply for purposes of this subsection.

(2) QUALIFIED DISTRIBUTION. — For purposes of this subsection, the term "qualified distribution" means any distribution —

(A) described in section 401(k)(2)(B)(i)(IV), 403(b)(7)(A)(i)(V), 403(b)(11)(B), or 72(t)(2)(F), of the Internal Revenue Code of 1986,

(B) which was to be used to purchase or construct a principal residence in a qualified disaster area, but which was not so used on account of the qualified disaster with respect to such area, and

(C) which was received during the period beginning on the date which is 180 days before the first day of the incident period of such qualified disaster and ending on the date which is 30 days after the last day of such incident period.

(3) APPLICABLE PERIOD. — For purposes of this subsection, the term "applicable period" means, in the case of a principal residence in a qualified disaster area with respect to any qualified disaster, the period beginning on the first day of the incident period of such qualified disaster and ending on the date which is 180 days after the date of the enactment of this Act.

(c) LOANS FROM QUALIFIED PLANS. —

(1) INCREASE IN LIMIT ON LOANS NOT TREATED AS DISTRIBUTIONS. — In the case of any loan from a qualified employer plan (as defined under section 72(p)(4) of the Internal Revenue Code of 1986) to a qualified individual made during the 180-day period beginning on the date of the enactment of this Act —

(A) clause (i) of section 72(p)(2)(A) of such Code shall be applied by substituting " $100,000" for " $50,000", and

(B) clause (ii) of such section shall be applied by substituting "the present value of the nonforfeitable accrued benefit of the employee under the plan" for "one-half of the present value of the nonforfeitable accrued benefit of the employee under the plan".

(2) DELAY OF REPAYMENT. — In the case of a qualified individual (with respect to any qualified disaster) with an outstanding loan (on or after the first day of the incident period of such qualified disaster) from a qualified employer plan (as defined in section 72(p)(4) of the Internal Revenue Code of 1986) —

(A) if the due date pursuant to subparagraph (B) or (C) of section 72(p)(2) of such Code for any repayment with respect to such loan occurs during the period beginning on the first day of the incident period of such qualified disaster and ending on the date which is 180 days after the last day of such incident period, such due date shall be delayed for 1 year (or, if later, until the date which is 180 days after the date of the enactment of this Act),

(B) any subsequent repayments with respect to any such loan shall be appropriately adjusted to reflect the delay in the due date under subparagraph (A) and any interest accruing during such delay, and

(C) in determining the 5-year period and the term of a loan under subparagraph (B) or (C) of section 72(p)(2) of such Code, the period described in subparagraph (A) of this paragraph shall be disregarded.

(3) QUALIFIED INDIVIDUAL. — For purposes of this subsection, the term "qualified individual" means any individual —

(A) whose principal place of abode at any time during the incident period of any qualified disaster is located in the qualified disaster area with respect to such qualified disaster, and

(B) who has sustained an economic loss by reason of such qualified disaster.

(d) PROVISIONS RELATING TO PLAN AMENDMENTS. —

(1) IN GENERAL. — If this subsection applies to any amendment to any plan or annuity contract, such plan or contract shall be treated as being operated in accordance with the terms of the plan during the period described in paragraph (2)(B)(i).

(2) AMENDMENTS TO WHICH SUBSECTION APPLIES. —

(A) IN GENERAL. — This subsection shall apply to any amendment to any plan or annuity contract which is made —

(i) pursuant to any provision of this section, or pursuant to any regulation issued by the Secretary or the Secretary of Labor under any provision of this section, and

(ii) on or before the last day of the first plan year beginning on or after January 1, 2022, or such later date as the Secretary may prescribe.

In the case of a governmental plan (as defined in section 414(d) of the Internal Revenue Code of 1986), clause (ii) shall be applied by substituting the date which is 2 years after the date otherwise applied under clause (ii).

(B) CONDITIONS. — This subsection shall not apply to any amendment unless —

(i) during the period —

(I) beginning on the date that this section or the regulation described in subparagraph (A)(i) takes effect (or in the case of a plan or contract amendment not required by this section or such regulation, the effective date specified by the plan), and

(II) ending on the date described in subparagraph (A)(ii) (or, if earlier, the date the plan or contract amendment is adopted),

the plan or contract is operated as if such plan or contract amendment were in effect, and

(ii) such plan or contract amendment applies retroactively for such period.

SEC. 303. EMPLOYEE RETENTION CREDIT FOR EMPLOYERS AFFECTED BY QUALIFIED DISASTERS.

(a) IN GENERAL. — For purposes of section 38 of the Internal Revenue Code of 1986, in the case of an eligible employer, the 2020 qualified disaster employee retention credit shall be treated as a credit listed at the end of subsection (b) of such section. For purposes of this subsection, the 2020 qualified disaster employee retention credit for any taxable year is an amount equal to 40 percent of the qualified wages with respect to each eligible employee of such employer for such taxable year. The amount of qualified wages with respect to any employee which may be taken into account under this subsection by the employer for any taxable year shall not exceed $6,000 (reduced by the amount of qualified wages with respect to such employee taken into account for any prior taxable year).

(b) DEFINITIONS. — For purposes of this section —

(1) ELIGIBLE EMPLOYER. — The term "eligible employer" means any employer —

(A) which conducted an active trade or business in a qualified disaster zone at any time during the incident period of the qualified disaster with respect to such qualified disaster zone, and

(B) with respect to whom the trade or business described in subparagraph (A) is inoperable at any time during the period beginning on the first day of the incident period of such qualified disaster and ending on the date of the enactment of this Act, as a result of damage sustained by reason of such qualified disaster.

(2) ELIGIBLE EMPLOYEE. — The term "eligible employee" means with respect to an eligible employer an employee whose principal place of employment with such eligible employer (determined immediately before the qualified disaster referred to in paragraph (1)) was in the qualified disaster zone referred to in such paragraph.

(3) QUALIFIED WAGES. — The term "qualified wages" means wages (as defined in section 51(c)(1) of the Internal Revenue Code of 1986, but without regard to section 3306(b)(2)(B) of such Code) paid or incurred by an eligible employer with respect to an eligible employee at any time on or after the date on which the trade or business described in paragraph (1) first became inoperable at the principal place of employment of the employee (determined immediately before the qualified disaster referred to in such paragraph) and before the earlier of —

(A) the date on which such trade or business has resumed significant operations at such principal place of employment, or

(B) the date which is 150 days after the last day of the incident period of the qualified disaster referred to in paragraph (1).

Such term shall include wages paid without regard to whether the employee performs no services, performs services at a different place of employment than such principal place of employment, or performs services at such principal place of employment before significant operations have resumed. Such term shall not include any wages taken into account under section 2301 of the CARES Act.

(c) SPECIAL RULES. —

(1) DENIAL OF DOUBLE BENEFIT. — Any wages taken into account in determining any credit allowed under this section shall not be taken into account as wages for purposes of sections 41, 45A, 45P, 45S, 51, and 1396 of the Internal Revenue Code of 1986.

(2) CERTAIN OTHER RULES TO APPLY. — For purposes of this section, rules similar to the rules of sections 51(i)(1), 52, and 280C(a) of the Internal Revenue Code of 1986 shall apply.

(d) PAYROLL TAX CREDIT FOR CERTAIN TAX-EXEMPT ORGANIZATIONS. —

(1) IN GENERAL. — In the case of any qualified tax-exempt organization, there shall be allowed as a credit against the tax imposed by section 3111(a) of the Internal Revenue Code of 1986 on wages paid with respect to employment of all employees of the organization during the calendar quarter an amount equal to 40 percent of the qualified wages paid to eligible employees of such organization during such calendar quarter.

(2) APPLICATION OF AGGREGATE DOLLAR LIMITATION PER EMPLOYEE. — The amount of qualified wages with respect to any employee which may be taken into account under this subsection by the employer for any calendar quarter shall not exceed $6,000 (reduced by the amount of qualified wages with respect to which credit was allowed under this subsection for any prior calendar quarter with respect to such employee).

(3) OVERALL LIMITATION. —

(A) IN GENERAL. — The aggregate amount allowed as a credit under this subsection for all eligible employees of any employer for any calendar quarter shall not exceed the amount of the tax imposed by section 3111(a) of the Internal Revenue Code of 1986 on wages paid with respect to employment of all employees of such employer during such calendar quarter (reduced by any credits allowed under subsections (e) and (f) of section 3111 of such Code for such quarter).

(B) CARRYFORWARD. — If the amount of the credit under paragraph (1) exceeds the limitation of subparagraph (A) for any calendar quarter, such excess shall be carried to the succeeding calendar quarter and allowed as a credit under paragraph (1) for such quarter.

(C) COORDINATION WITH OTHER PAYROLL TAX CREDITS. —

(i) Section 7001(b)(3) of the Families First Coronavirus Response Act is amended by inserting ", and section 303(d) of the Taxpayer Certainty and Disaster Tax Relief Act of 2020," after "subsections (e) and (f) of section 3111 of such Code".

(ii) Section 7003(b)(2) of the Families First Coronavirus Response Act is amended by striking "and section 7001 of this Act," and inserting "section 7001 of this Act, and section 303(d) of the Taxpayer Certainty and Disaster Tax Relief Act of 2020,".

(iii) Section 2301(b)(2) of the CARES Act is amended by striking "and sections 7001 and 7003 of the Families First Coronavirus Response Act" and inserting ", sections 7001 and 7003 of the Families First Coronavirus Response Act, and section 303(d) of the Taxpayer Certainty and Disaster Tax Relief Act of 2020".

(4) DEFINITIONS. —

(A) QUALIFIED TAX-EXEMPT ORGANIZATION. — For purposes of this subsection, the term "qualified tax-exempt organization" means an organization described in section 501(c) of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code if such organization would be an eligible employer if the activities of such organization were an active trade or business.

(B) APPLICATION OF CERTAIN TERMS WITH RESPECT TO QUALIFIED TAX-EXEMPT ORGANIZATIONS. — For purposes of this subsection, the terms "eligible employee" and "qualified wages" shall be applied with respect to any qualified tax-exempt organization —

(i) by treating the activities of such organization as an active trade or business, and

(ii) by substituting "wages (within the meaning of subsection (d)(4)(C))" for "wages (as defined in section 51(c)(1) of the Internal Revenue Code of 1986, but without regard to section 3306(b)(2)(B) of such Code)" in subsection (b)(3).

(C) OTHER TERMS. — Except as otherwise provided in this subsection, any term used in this subsection which is also used in chapter 21 or 22 of the Internal Revenue Code of 1986 shall have the same meaning as when used in such chapter.

(5) TRANSFERS TO CERTAIN TRUST FUNDS. — There are hereby appropriated to the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund established under section 201 of the Social Security Act (42 U.S.C. 401) and the Social Security Equivalent Benefit Account established under section 15A(a) of the Railroad Retirement Act of 1974 (45 U.S.C. 231n–1(a)) amounts equal to the reduction in revenues to the Treasury by reason of this subsection (without regard to this paragraph). Amounts appropriated by the preceding sentence shall be transferred from the general fund at such times and in such manner as to replicate to the extent possible the transfers which would have occurred to such Trust Fund or Account had this subsection not been enacted.

(6) TREATMENT OF DEPOSITS. — The Secretary shall waive any penalty under section 6656 of such Code for any failure to make a deposit of applicable employment taxes if the Secretary determines that such failure was due to the anticipation of the credit allowed under this subsection.

(7) THIRD PARTY PAYORS. — Any credit allowed under this subsection shall be treated as a credit described in section 3511(d)(2) of such Code.

(8) COORDINATION WITH SUBSECTION (a) CREDIT. — Any wages taken into account in determining the credit allowed under this subsection shall not be take into account as wages for purposes of subsection (a).

(9) REGULATIONS AND GUIDANCE. — The Secretary shall issue such forms, instructions, regulations, and guidance as are necessary —

(A) to allow the advance payment of the credit under paragraph (1), subject to the limitations provided in this subsection, based on such information as the Secretary shall require,

(B) regulations or other guidance to provide for the reconciliation of such advance payment with the amount of the credit under this subsection at the time of filing the return of tax for the applicable quarter or taxable year,

(C) with respect to the application of the credit under paragraph (1) to third party payors (including professional employer organizations, certified professional employer organizations, or agents under section 3504 of the Internal Revenue Code of 1986), including regulations or guidance allowing such payors to submit documentation necessary to substantiate the eligible employer status of employers that use such payors, and

(D) for recapturing the benefit of credits determined under this subsection in cases where there is a subsequent adjustment to the credit determined under paragraph (1).

(e) ELECTION TO NOT TAKE CERTAIN WAGES INTO ACCOUNT. —

(1) IN GENERAL. — This section shall not apply to qualified wages paid by an eligible employer with respect to which such employer makes an election (at such time and in such manner as the Secretary may prescribe) to have this section not apply to such wages.

(2) COORDINATION WITH PAYCHECK PROTECTION PROGRAM. — The Secretary, in consultation with the Administrator of the Small Business Administration, shall issue guidance providing that payroll costs paid or incurred during the covered period shall not fail to be treated as qualified wages under this section by reason of an election under paragraph (1) to the extent that a covered loan of the eligible employer is not forgiven by reason of a decision under section 7A(g) of the Small Business Act. Terms used in the preceding sentence which are also used in section 7A(g) of such Act shall have the same meaning as when used in such section.

(f) CERTAIN GOVERNMENTAL EMPLOYERS. —

(1) IN GENERAL. — The credits under this section shall not apply to the Government of the United States, the government of any State or political subdivision thereof, or any agency or instrumentality of any of the foregoing.

(2) EXCEPTION. — Paragraph (1) shall not apply to —

(A) any organization described in section 501(c)(1) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code, or

(B) any entity described in paragraph (1) if —

(i) such entity is a college or university, or

(ii) the principal purpose or function of such entity is providing medical or hospital care.

An entity described in subparagraph (B) shall be treated for purposes of this section in the same manner as an organization described in section 501(c) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code.

(g) AMENDMENT TO PAYCHECK PROTECTION PROGRAM. — Section 7A(a)(12) of the Small Business Act (as redesignated, transferred, and amended by the Economic Aid to Hard-Hit Small Businesses, Nonprofits, and Venues Act and as amended by section 206(c) of this division) is amended by adding at the end the following: "Such payroll costs shall not include qualified wages taken into account in determining the credit allowed under subsection (a) or (d) of section 303 of the Taxpayer Certainty and Disaster Tax Relief Act of 2020.".

SEC. 304. OTHER DISASTER-RELATED TAX RELIEF PROVISIONS.

(a) SPECIAL RULES FOR QUALIFIED DISASTER RELIEF CONTRIBUTIONS. —

(1) IN GENERAL. — In the case of a qualified disaster relief contribution made by a corporation —

(A) section 2205(a)(2)(B) of the CARES Act shall be applied first to qualified contributions without regard to any qualified disaster relief contributions and then separately to such qualified disaster relief contribution, and

(B) in applying such section to such qualified disaster relief contributions, clause (i) thereof shall be applied —

(i) by substituting "100 percent" for "25 percent", and

(ii) by treating qualified contributions other than qualified disaster relief contributions as contributions allowed under section 170(b)(2) of the Internal Revenue Code of 1986.

(2) QUALIFIED DISASTER RELIEF CONTRIBUTION. — For purposes of this subsection, the term "qualified disaster relief contribution" means any qualified contribution (as defined in section 2205(a)(3) of the CARES Act) if —

(A) such contribution —

(i) is paid, during the period beginning on January 1, 2020, and ending on the date which is 60 days after the date of the enactment of this Act, and

(ii) is made for relief efforts in one or more qualified disaster areas,

(B) the taxpayer obtains from such organization contemporaneous written acknowledgment (within the meaning of section 170(f)(8) of such Code) that such contribution was used (or is to be used) for relief efforts described in subparagraph (A)(ii), and

(C) the taxpayer has elected the application of this subsection with respect to such contribution.

(3) CROSS-REFERENCE. — For the suspension of the limitation on qualified disaster relief contributions made by an individual during 2020, see section 2205(a) of the CARES Act.

(b) SPECIAL RULES FOR QUALIFIED DISASTER-RELATED PERSONAL CASUALTY LOSSES. —

(1) IN GENERAL. — If an individual has a net disaster loss for any taxable year —

(A) the amount determined under section 165(h)(2)(A)(ii) of the Internal Revenue Code of 1986 shall be equal to the sum of —

(i) such net disaster loss, and

(ii) so much of the excess referred to in the matter preceding clause (i) of section 165(h)(2)(A) of such Code (reduced by the amount in clause (i) of this subparagraph) as exceeds 10 percent of the adjusted gross income of the individual,

(B) in the case of qualified disaster-related personal casualty losses, section 165(h)(1) of such Code shall be applied to by substituting " $500" for " $500 ( $100 for taxable years beginning after December 31, 2009)",

(C) the standard deduction determined under section 63(c) of such Code shall be increased by the net disaster loss, and

(D) section 56(b)(1)(E) of such Code shall not apply to so much of the standard deduction as is attributable to the increase under subparagraph (C) of this paragraph.

(2) NET DISASTER LOSS. — For purposes of this subsection, the term "net disaster loss" means the excess of qualified disaster-related personal casualty losses over personal casualty gains (as defined in section 165(h)(3)(A) of the Internal Revenue Code of 1986).

(3) QUALIFIED DISASTER-RELATED PERSONAL CASUALTY LOSSES. — For purposes of this subsection, the term "qualified disaster-related personal casualty losses" means losses described in section 165(c)(3) of the Internal Revenue Code of 1986 which arise in a qualified disaster area on or after the first day of the incident period of the qualified disaster to which such area relates, and which are attributable to such qualified disaster.

SEC. 305. LOW-INCOME HOUSING TAX CREDIT.

(a) ADDITIONAL LOW-INCOME HOUSING CREDIT ALLOCATIONS. —

(1) IN GENERAL. — For purposes of section 42 of the Internal Revenue Code of 1986, the State housing credit ceiling for any State for each of calendar years 2021 and 2022 shall be increased by the aggregate housing credit dollar amount allocated by the State housing credit agencies of such State for such calendar year to buildings located in any qualified disaster zone in such State.

(2) LIMITATION. —

(A) APPLICATION OF AGGREGATE LIMITATION. — The increase determined under paragraph (1) with respect to any State shall not exceed —

(i) in the case of any such increase determined for calendar year 2021, the applicable dollar limitation for such State, and

(ii) in the case of any such increase determined for calendar year 2022, the applicable dollar limitation for such State reduced by the amount of any increase determined under paragraph (1) with respect to such State for calendar year 2021.

(B) APPLICABLE DOLLAR LIMITATION. — For purposes of this paragraph, the term "applicable dollar limitation" means, with respect to any State, the lesser of —

(i) the product of $3.50 multiplied by the population of such State (as determined for calendar year 2020) which resides in qualified disaster zones in such State, or

(ii) 65 percent of the State housing credit ceiling for such State for calendar year 2020.

(3) EXTENSION OF PLACED IN SERVICE DEADLINE FOR DESIGNATED HOUSING CREDIT DOLLARS AMOUNTS. —

(A) IN GENERAL. — In the case of any housing credit dollar amount which is allocated by a State housing credit agency of a State for calendar year 2021 or 2022 to a building located in a qualified disaster zone in such State and which is designated (at such time and in such manner as the Secretary may provide) by such State housing credit agency as housing credit dollar amount to which this paragraph applies, section 42(h)(1)(E) of the Internal Revenue Code of 1986 shall be applied —

(i) by substituting "third calendar year" for "second calendar year" both places it appears, and

(ii) by substituting "2 years" for "1 year" in clause (ii) thereof.

(B) APPLICATION OF LIMITATION. — The aggregate amount of housing credit dollar amount designated under subparagraph (A) for any calendar year by all State housing credit agencies of a State shall not exceed the amount determined under paragraph (2)(A) with respect to such State for such calendar year.

(4) ALLOCATIONS TREATED AS MADE FIRST FROM ADDITIONAL ALLOCATION FOR PURPOSES OF DETERMINING CARRYOVER. — For purposes of determining the unused State housing credit ceiling for any calendar year under section 42(h)(3)(C) of the Internal Revenue Code of 1986, any increase in the State housing credit ceiling under paragraph (1) shall be treated as an amount described in clause (ii) of such section.

SEC. 306. TREATMENT OF CERTAIN POSSESSIONS.

(a) PAYMENTS TO POSSESSIONS WITH MIRROR CODE TAX SYSTEMS. — The Secretary of the Treasury shall pay to each possession of the United States which has a mirror code tax system amounts equal to the loss (if any) to that possession by reason of the application of the provisions of this title. Such amounts shall be determined by the Secretary of the Treasury based on information provided by the government of the respective possession.

(b) PAYMENTS TO OTHER POSSESSIONS. — The Secretary of the Treasury shall pay to each possession of the United States which does not have a mirror code tax system amounts estimated by the Secretary of the Treasury as being equal to the aggregate benefits (if any) that would have been provided to residents of such possession by reason of the provisions of this title if a mirror code tax system had been in effect in such possession. The preceding sentence shall not apply unless the respective possession has a plan, which has been approved by the Secretary of the Treasury, under which such possession will promptly distribute such payments to its residents.

(c) MIRROR CODE TAX SYSTEM. — For purposes of this section, the term "mirror code tax system" means, with respect to any possession of the United States, the income tax system of such possession if the income tax liability of the residents of such possession under such system is determined by reference to the income tax laws of the United States as if such possession were the United States.

(d) TREATMENT OF PAYMENTS. — For purposes of section 1324 of title 31, United States Code, the payments under this section shall be treated in the same manner as a refund due from a credit provision referred to in subsection (b)(2) of such section.

DIVISION FF — OTHER MATTER

TITLE I — CONTINUING EDUCATION AT AFFECTED FOREIGN INSTITUTIONS AND MODIFICATION OF CERTAIN PROTECTIONS FOR TAXPAYER RETURN INFORMATION

SEC. 101. CONTINUING EDUCATION AT AFFECTED FOREIGN INSTITUTIONS.

(a) IN GENERAL. — Section 3510 of the CARES Act (20 U.S.C. 1001 note) is amended —

(1) in subsection (a), by striking "for the duration of such emergency" and all that follows through the period at the end and inserting "for purposes of title IV of the Higher Education Act of 1965 (20 U.S.C. 1070 et seq.) until the end of the covered period applicable to the institution.";

(2) in subsection (b), by striking "for the duration of the qualifying emergency and the following payment period for purposes of title IV of the Higher Education Act of 1965 (20 U.S.C. 1070 et seq.)." and inserting "until the end of the covered period applicable to the institution.";

(3) in subsection (c), by striking "for the duration of the qualifying emergency and the following payment period," and inserting "until all covered periods for foreign institutions carrying out a distance education program authorized under this section have ended,";

(4) in subsection (d) —

(A) in paragraph (1) —

(i) by striking "for the duration of a qualifying emergency and the following payment period," and inserting "until the end of the covered period applicable to a foreign institution,"; and

(ii) by striking "allow a foreign institution" and inserting "allow the foreign institution";

(B) in each of subparagraphs (A) and (B) of paragraph (2), by striking "subsection (a)" and inserting "paragraph (1)";

(C) in paragraph (3)(B), by striking "30 days" and inserting "10 days"; and

(D) in paragraph (4) —

(i) by striking "for the duration of the qualifying emergency and the following payment period," and inserting "until all covered periods for foreign institutions that entered into written arrangements under paragraph (1) have ended,"; and

(ii) by striking "identifies each foreign institution that entered into a written arrangement under subsection (a)." and inserting the following: identifies, for each such foreign institution —

"(A) the name of the foreign institution;

"(B) the name of the institution of higher education located in the United States that has entered into a written arrangement with such foreign institution; and

"(C) information regarding the nature of such written arrangement, including which coursework or program requirements are accomplished at each respective institution."; and

(5) by adding at the end the following:

"(e) DEFINITION OF COVERED PERIOD. —

"(1) IN GENERAL. — In this section, the term 'covered period', when used with respect to a foreign institution of higher education, means the period —

"(A) beginning on the first day of —

"(i) a qualifying emergency; or

"(ii) a public health emergency, major disaster or emergency, or national emergency declared by the applicable government authorities in the country in which the foreign institution is located; and

"(B) ending on the later of —

"(i) subject to paragraph (2), the last day of the payment period, for purposes of title IV of the Higher Education Act of 1965 (20 U.S.C. 1070 et seq.), following the end of any qualifying emergency or any emergency or disaster described in subparagraph (A)(ii) applicable to the foreign institution; or

"(ii) June 30, 2022.

"(2) SPECIAL RULE FOR CERTAIN PAYMENT PERIODS. — For purposes of subparagraph (B)(i), if the following payment period for an award year ends before June 30 of such award year, the covered period shall be extended until June 30 of such award year.".

(b) EFFECTIVE DATE. — The amendments made by subsection (a) shall take effect as if included in the enactment of the CARES Act (Public Law 116–136).

SEC. 102. DISCLOSURES TO IDENTIFY TAX RECEIVABLES NOT ELIGIBLE FOR COLLECTION PURSUANT TO QUALIFIED TAX COLLECTION CONTRACTS.

(a) IN GENERAL. — Section 1106 of the Social Security Act (42 U.S.C. 1306) is amended by adding at the end the following:

"(g) Notwithstanding any other provision of this section, the Commissioner of Social Security shall enter into an agreement with the Secretary of the Treasury under which —

"(1) if the Secretary provides the Commissioner with the information described in section 6103(k)(15) of the Internal Revenue Code of 1986 with respect to any individual, the Commissioner shall indicate to the Secretary as to whether such individual receives disability insurance benefits under section 223 or supplemental security income benefits under title XVI (including State supplementary payments of the type referred to in section 1616(a) or payments of the type described in section 212(a) of Public Law 93-66);

"(2) appropriate safeguards are included to assure that the indication described in paragraph (1) will be used solely for the purpose of determining if tax receivables involving such individual are not eligible for collection pursuant to a qualified tax collection contract by reason of section 6306(d)(3)(E) of the Internal Revenue Code of 1986; and

"(3) the Secretary shall pay the Commissioner of Social Security the full costs (including systems and administrative costs) of providing the indication described in paragraph (1).".

(b) AUTHORIZATION OF DISCLOSURE BY SECRETARY OF THE TREASURY. —

(1) IN GENERAL. — Section 6103(k) of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph:

"(15) DISCLOSURES TO SOCIAL SECURITY ADMINISTRATION TO IDENTIFY TAX RECEIVABLES NOT ELIGIBLE FOR COLLECTION PURSUANT TO QUALIFIED TAX COLLECTION CONTRACTS. — In the case of any individual involved with a tax receivable which the Secretary has identified for possible collection pursuant to a qualified tax collection contract (as defined in section 6306(b)), the Secretary may disclose the taxpayer identity and date of birth of such individual to officers, employees, and contractors of the Social Security Administration to determine if such tax receivable is not eligible for collection pursuant to such a qualified tax collection contract by reason of section 6306(d)(3)(E).".

(2) CONFORMING AMENDMENTS RELATED TO SAFEGUARDS. —

(A) Section 6103(a)(3) of such Code is amended by striking "or (14)" and inserting "(14), or (15)".

(B) Section 6103(p)(4) of such Code is amended —

(i) by striking "(k)(8), (10) or (11)" both places it appears and inserting "(k)(8), (10), (11), or (15)", and

(ii) by striking "any other person described in subsection (k)(10)" each place it appears and inserting "any other person described in subsection (k)(10) or (15)".

(C) Section 7213(a)(2) of such Code is amended by striking "(k)(10), (13), or (14)" and inserting "(k)(10), (13), (14), or (15)".

(c) EFFECTIVE DATE. — The amendments made by this section shall apply to disclosures made on or after the date of the enactment of this Act.

SEC. 103. MODIFICATION OF CERTAIN PROTECTIONS FOR TAXPAYER RETURN INFORMATION.

(a) AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986. —

(1) IN GENERAL. — Subparagraph (D) of section 6103(l)(13) of the Internal Revenue Code of 1986 is amended —

(A) by inserting at the end of clause (iii) the following new sentence: "Under such terms and conditions as may be prescribed by the Secretary, after consultation with the Department of Education, an institution of higher education described in subclause (I) or a State higher education agency described in subclause (II) may designate a contractor of such institution or state agency to receive return information on behalf of such institution or state agency to administer aspects of the institution's or state agency's activities for the application, award, and administration of such financial aid.", and

(B) by adding at the end the following:

"(iv) REDISCLOSURE TO OFFICE OF INSPECTOR GENERAL, INDEPENDENT AUDITORS, AND CONTRACTORS. — Any return information which is redisclosed under clause (iii) —

"(I) may be further disclosed by persons described in subclauses (I), (II), or (III) of clause (iii) or persons designated in the last sentence of clause (iii) to the Office of Inspector General of the Department of Education and independent auditors conducting audits of such person's administration of the programs for which the return information was received, and

"(II) may be further disclosed by persons described in subclauses (I), (II), or (III) of clause (iii) to contractors of such entities,

but only to the extent necessary in carrying out the purposes described in such clause (iii).

"(v) REDISCLOSURE TO FAMILY MEMBERS. — In addition to the purposes for which information is disclosed and used under subparagraphs (A) and (C), or redisclosed under clause (iii), any return information so disclosed or redisclosed may be further disclosed to any individual certified by the Secretary of Education as having provided approval under paragraph (1) or (2) of section 494(a) of the Higher Education Act of 1965, as the case may be, for disclosure related to the income-contingent or income-based repayment plan under subparagraph (A) or the eligibility for, and amount of, Federal student financial aid described in subparagraph (C).

"(vi) REDISCLOSURE OF FAFSA INFORMATION. — Return information received under subparagraph (C) may be redisclosed in accordance with subsection (c) of section 494 of the Higher Education Act of 1965 as in effect on the date of enactment of the Consolidated Appropriations Act, 2021 to carry out the purposes specified in such subsection.".

(2) CONFORMING AMENDMENT. — Subparagraph (F) of section 6103(l)(13) of such Code is amended by inserting ", and any redisclosure authorized under clause (iii), (iv) (v), or (vi) of subparagraph (D)," after " or (C)".

(3) CONFIDENTIALITY OF RETURN INFORMATION. —

(A) Section 6103(a)(3) of such Code, as amended by section 3516(a)(1) of the CARES Act (Public Law 116–136), is amended by striking "(13)(A), (13)(B), (13)(C), (13)(D)(i)," and inserting "(13) (other than subparagraphs (D)(v) and (D)(vi) thereof),".

(B) Section 6103(p)(3)(A) of such Code, as amended by section 3516(a)(2) of such Act, is amended by striking "(13)(A), (13)(B), (13)(C), (13)(D)(i)," and inserting "(13)(D)(iv), (13)(D)(v), (13)(D)(vi)".

(4) EFFECTIVE DATE. — The amendments made by this subsection shall apply to disclosures made after the date of the enactment of the FUTURE Act (Public Law 116–91).

(b) AMENDMENTS TO THE HIGHER EDUCATION ACT OF 1965. —

(1) IN GENERAL. — Section 494 of the Higher Education Act of 1965 (20 U.S.C. 1098h(a)) is amended —

(A) in subsection (a)(1) —

(i) in the matter preceding subparagraph (A), by inserting ", including return information," after "financial information";

(ii) in subparagraph (A) —

(I) in clause (i) —

(aa) by striking "subparagraph (B), the" and inserting the following: "subparagraph (B) —

"(I) the"; and

(bb) by adding at the end the following:

"(II) the return information of such individuals may be redisclosed pursuant to clauses (iii), (iv), (v), and (vi) of section 6103(l)(13)(D) of the Internal Revenue Code of 1986, for the relevant purposes described in such section; and"; and

(II) in clause (ii), by striking "such disclosure" and inserting "the disclosures described in subclauses (I) and (II) of clause (i)"; and

(iii) in subparagraph (B), by striking "disclosure described in subparagraph (A)(i)" and inserting "disclosures described in subclauses (I) and (II) of subparagraph (A)(i)";

(B) in subsection (a)(2)(A)(ii), by striking "affirmatively approve the disclosure described in paragraph (1)(A)(i) and agree that such approval shall serve as an ongoing approval of such disclosure until the date on which the individual elects to opt out of such disclosure" and inserting "affirmatively approve the disclosures described in subclauses (I) and (II) of paragraph (1)(A)(i), to the extent applicable, and agree that such approval shall serve as an ongoing approval of such disclosures until the date on which the individual elects to opt out of such disclosures"; and

(C) by adding at the end the following:

"(c) ACCESS TO FAFSA INFORMATION. —

"(1) REDISCLOSURE OF INFORMATION. — The information in a complete, unredacted Student Aid Report (including any return information disclosed under section 6103(l)(13) of the Internal Revenue Code of 1986 (26 U.S.C. 6103(l)(13))) with respect to an application described in subsection (a)(1) of an applicant for Federal student financial aid —

"(A) upon request for such information by such applicant, shall be provided to such applicant by —

"(i) the Secretary; or

"(ii) in a case in which the Secretary has requested that institutions of higher education carry out the requirements of this subparagraph, an institution of higher education that has received such information; and

"(B) with the written consent by the applicant to an institution of higher education, may be provided by such institution of higher education as is necessary to a scholarship granting organization (including a tribal organization (defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304))), or to an organization assisting the applicant in applying for and receiving Federal, State, local, or tribal assistance, that is designated by the applicant to assist the applicant in applying for and receiving financial assistance for any component of the applicant's cost of attendance (defined in section 472) at that institution.

"(2) DISCUSSION OF INFORMATION. — A discussion of the information in an application described in subsection (a)(1) (including any return information disclosed under section 6103(l)(13) of the Internal Revenue Code of 1986 (26 U.S.C. 6103(l)(13)) of an applicant between an institution of higher education and the applicant may, with the written consent of the applicant, include an individual selected by the applicant (such as an advisor) to participate in such discussion.

"(3) RESTRICTION ON DISCLOSING INFORMATION. — A person receiving information under paragraph (1)(B) or (2) with respect to an applicant shall not use the information for any purpose other than the express purpose for which consent was granted by the applicant and shall not disclose such information to any other person without the express permission of, or request by, the applicant.

"(4) DEFINITIONS. — In this subsection:

"(A) STUDENT AID REPORT. — The term 'Student Aid Report' has the meaning given the term in section 668.2 of title 34, Code of Federal Regulations (or successor regulations).

"(B) WRITTEN CONSENT. — The term 'written consent' means a separate, written document that is signed and dated (which may include by electronic format) by an applicant, which —

"(i) indicates that the information being disclosed includes return information disclosed under section 6103(l)(13) of the Internal Revenue Code of 1986 (26 U.S.C. 6103(l)(13)) with respect to the applicant;

"(ii) states the purpose for which the information is being disclosed; and

"(iii) states that the information may only be used for the specific purpose and no other purposes.

"(5) RECORD KEEPING REQUIREMENT. — An institution of higher education shall —

"(A) keep a record of each written consent made under this subsection for a period of at least 3 years from the date of the student's last date of attendance at the institution; and

"(B) make each such record readily available for review by the Secretary.".

(2) CONFORMING AMENDMENT. — Section 494(a)(3) of the Higher Education Act of 1965 (20 U.S.C. 1098h(a)(3)) is amended by striking "paragraph (1)(A)(i)" both places the term appears and inserting "paragraph (1)(A)(i)(I)".

SEC. 104. RESCHEDULING OF THE NAEP MANDATED BIENNIAL 4TH AND 8TH GRADE ASSESSMENT AND ALIGNMENT OF THE MANDATED QUADRENNIAL 12TH GRADE ASSESSMENT.

(a) CURRENT ASSESSMENT ADMINISTRATION RESCHEDULING. — Notwithstanding any other provision of law and due to the public health emergency declared by the Secretary of Health and Human Services under section 319 of the Public Health Service Act (42 U.S.C. 247d) on January 31, 2020, with respect to COVID–19 —

(1) the biennial 4th and 8th grade reading and mathematics assessments scheduled to be conducted during the 2020–2021 school year in accordance with paragraphs (2)(B) and (3)(A)(i) of section 303(b) of the National Assessment of Educational Progress Authorization Act (20 U.S.C. 9622(b)) and, as practicable and subject to the discretion of the National Assessment Governing Board, the Trial Urban District Assessment, shall be conducted during the 2021–2022 school year; and

(2) the next quadrennial 12th grade reading and mathematics assessments carried out in accordance with section 303(b)(2)(C) of the National Assessment of Educational Progress Authorization Act (20 U.S.C. 9622(b)(2)(C)) after the date of enactment of this section, shall be conducted during the 2023–2024 school year.

(b) FUTURE ASSESSMENT ADMINISTRATION. — In accordance with section 303(b)(2)(B) of the National Assessment of Educational Progress Authorization Act (20 U.S.C. 9622(b)(2)(B)), the next biennial assessments following the 2021–2022 administration, as authorized under subsection (a), shall occur in the 2023–2024 school year and, as practicable and subject to the discretion of the National Assessment Governing Board, the next Trial Urban District Assessment following the 2021–2022 administration, as authorized under subsection (a), shall occur in the 2023–2024 school year.

TITLE II — PUBLIC LANDS

SEC. 201. SAGUARO NATIONAL PARK BOUNDARY EXPANSION.

(a) SHORT TITLE. — This section may be cited as the "Saguaro National Park Boundary Expansion Act".

(b) BOUNDARY OF SAGUARO NATIONAL PARK. — Section 4 of the Saguaro National Park Establishment Act of 1994 (Public Law 103–364; 108 Stat. 3467) is amended —

(1) in subsection (a) —

(A) by inserting "(1)" before "The boundaries of the park"; and

(B) by adding at the end the following:

"(2)(A) The boundaries of the park are further modified to include approximately 1,152 acres, as generally depicted on the map titled 'Saguaro National Park Proposed Boundary Adjustment', numbered 151/80,045G, and dated December 2020.

"(B) The map referred to in subparagraph (A) shall be on file and available for inspection in the appropriate offices of the National Park Service."; and

(2) by striking subsection (b)(2) and inserting the following new paragraphs:

"(2) The Secretary may, with the consent of the State of Arizona and in accordance with Federal and State law, acquire land or interests therein owned by the State of Arizona within the boundary of the park.

"(3) If the Secretary is unable to acquire the State land under paragraph (2), the Secretary may enter into an agreement with the State that would allow the National Park Service to manage State land within the boundary of the park.".

SEC. 202. NEW RIVER GORGE NATIONAL PARK AND PRESERVE DESIGNATION.

(a) SHORT TITLE. — This section may be cited as the "New River Gorge National Park and Preserve Designation Act".

(b) DESIGNATION OF NEW RIVER GORGE NATIONAL PARK AND NEW RIVER GORGE NATIONAL PRESERVE, WEST VIRGINIA. —

(1) REDESIGNATION. — The New River Gorge National River established under section 1101 of the National Parks and Recreation Act of 1978 (16 U.S.C. 460m–15) shall be known and designated as the "New River Gorge National Park and Preserve", consisting of —

(A) the New River Gorge National Park; and

(B) the New River Gorge National Preserve.

(2) NEW RIVER GORGE NATIONAL PARK. — The boundaries of the New River Gorge National Park referred to in paragraph (1)(A) shall be the boundaries depicted as "Proposed National Park Area" on the map entitled "New River Gorge National Park and Preserve Proposed Boundary", numbered 637/ 163,199A, and dated September 2020.

(3) NEW RIVER GORGE NATIONAL PRESERVE; BOUNDARY. — The boundaries of the New River Gorge National Preserve referred to in paragraph (1)(B) shall be the boundaries depicted as "Proposed National Preserve Area" on the map entitled "New River Gorge National Park and Preserve Proposed Boundary", numbered 637/163,199A, and dated September 2020.

(c) ADMINISTRATION. —

(1) IN GENERAL. — The New River Gorge National Park and Preserve shall be administered by the Secretary of the Interior (referred to in this section as the "Secretary") in accordance with —

(A) this section;

(B) the laws generally applicable to units of the National Park System, including —

(i) section 100101(a), chapter 1003, and sections 100751(a), 100752, 100753, and 102101 of title 54, United States Code; and

(ii) chapter 3201 of title 54, United States Code; and

(C) title XI of the National Parks and Recreation Act of 1978 (16 U.S.C. 460m–15 et seq.), except that the provisions of section 1106 of that Act (16 U.S.C. 460m–20) relating to hunting shall not apply to the New River Gorge National Park.

(2) HUNTING AND FISHING. —

(D) HUNTING. — Hunting within the New River Gorge National Preserve shall be administered by the Secretary —

(i) in the same manner as hunting was administered on the day before the date of enactment of this Act in those portions of the New River Gorge National River designated as the New River Gorge National Preserve by subsection (b)(3); and

(ii) in accordance with —

(I) section 1106 of the National Parks and Recreation Act of 1978 (16 U.S.C. 460m–20); and

(II) other applicable laws.

(i) in the same manner as fishing was administered within the New River Gorge National River on the day before the date of enactment of this Act; and

(ii) in accordance with —

(I) section 1106 of the National Parks and Recreation Act of 1978 (16 U.S.C. 460m–20); and

(II) other applicable laws.

(3) LAND ACQUISITION. —

(A) ADDITIONAL LAND FOR NATIONAL PRESERVE. —

(i) IN GENERAL. — The Secretary may acquire land or any interest in land identified as "Proposed Additional Lands" on the map entitled "New River Gorge National Park and Preserve Proposed Boundary", numbered 637/163,199A, and dated September 2020, by purchase from a willing seller, donation, or exchange.

(ii) BOUNDARY MODIFICATION. — On acquisition of any land or interest in land under clause (i), the Secretary shall —

(I) modify the boundary of the New River Gorge National Preserve to reflect the acquisition; and

(II) administer the land or interest in land in accordance with the laws applicable to the New River Gorge National Preserve.

(B) VISITOR PARKING. —

(i) IN GENERAL. — The Secretary may acquire not more than 100 acres of land in the vicinity of the New River Gorge National Park and Preserve by purchase from a willing seller, donation, or exchange to provide for —

(I) visitor parking; and

(II) improved public access to the New River Gorge National Park and Preserve.

(ii) ADMINISTRATION. — On acquisition of the land under clause (i), the acquired land shall be administered as part of the New River Gorge National Park or the New River Gorge National Preserve, as appropriate.

(4) COMMERCIAL RECREATIONAL WATERCRAFT SERVICES. — Commercial recreational watercraft services within the New River Gorge National Park and Preserve shall be administered by the Secretary in accordance with section 402 of the West Virginia National Interest River Conservation Act of 1987 (16 U.S.C. 460m–15 note; Public Law 100–534).

(5) REFERENCES. — Any reference in a law, map, regulation, document, paper, or other record of the United States to the New River Gorge National River shall be considered to be a reference to the "New River Gorge National Park" or the "New River Gorge National Preserve", as appropriate.

(d) AUTHORIZATION OF APPROPRIATIONS. — There are authorized to be appropriated such sums as are necessary to carry out this section.

SEC. 203. DESIGNATION OF MIRACLE MOUNTAIN.

(a) SHORT TITLE. — This section may be cited as the "Miracle Mountain Designation Act".

(b) FINDINGS. — Congress finds as follows:

(1) On September 13, 2018, the Bald Mountain Fire burned nearly 20,000 acres of land in Utah.

(2) Elk Ridge City, located in Utah County, was nearly the victim of this fire.

(3) Suddenly, the fire halted its progression and, instead of burning into Elk Ridge City, stayed behind the mountain and spared the city.

(4) Congress, in acknowledgment of this event, believes this mountain holds special significance to the residents of Elk Ridge City and surrounding communities.

(5) The presently unnamed peak has been referred to as "Miracle Mountain" by many residents since the fire that nearly went into Elk Ridge City.

(c) DESIGNATION. — The mountain in the State of Utah, located at 39° 59′ 02N, 111° 40′ 12W, shall be known and designated as "Miracle Mountain".

(d) REFERENCES. — Any reference in a law, map, regulation, document, record, or other paper of the United States to the mountain described in subsection (c) shall be considered to be a reference to "Miracle Mountain".

TITLE III — FOREIGN RELATIONS AND DEPARTMENT OF STATE PROVISIONS

Subtitle A — Robert Levinson Hostage Recovery and Hostage-taking Accountability Act

SEC. 301. SHORT TITLE.

This subtitle may be cited as the "Robert Levinson Hostage Recovery and Hostage-Taking Accountability Act".

SEC. 302. ASSISTANCE FOR UNITED STATES NATIONALS UNLAWFULLY OR WRONGFULLY DETAINED ABROAD.

(a) REVIEW. — The Secretary of State shall review the cases of United States nationals detained abroad to determine if there is credible information that they are being detained unlawfully or wrongfully, based on criteria which may include whether —

(1) United States officials receive or possess credible information indicating innocence of the detained individual;

(2) the individual is being detained solely or substantially because he or she is a United States national;

(3) the individual is being detained solely or substantially to influence United States Government policy or to secure economic or political concessions from the United States Government;

(4) the detention appears to be because the individual sought to obtain, exercise, defend, or promote freedom of the press, freedom of religion, or the right to peacefully assemble;

(5) the individual is being detained in violation of the laws of the detaining country;

(6) independent nongovernmental organizations or journalists have raised legitimate questions about the innocence of the detained individual;

(7) the United States mission in the country where the individual is being detained has received credible reports that the detention is a pretext for an illegitimate purpose;

(8) the individual is detained in a country where the Department of State has determined in its annual human rights reports that the judicial system is not independent or impartial, is susceptible to corruption, or is incapable of rendering just verdicts;

(9) the individual is being detained in inhumane conditions;

(10) due process of law has been sufficiently impaired so as to render the detention arbitrary; and

(11) United States diplomatic engagement is likely necessary to secure the release of the detained individual.

(b) REFERRALS TO THE SPECIAL ENVOY. — Upon a determination by the Secretary of State, based on the totality of the circumstances, that there is credible information that the detention of a United States national abroad is unlawful or wrongful, and regardless of whether the detention is by a foreign government or a nongovernmental actor, the Secretary shall transfer responsibility for such case from the Bureau of Consular Affairs of the Department of State to the Special Envoy for Hostage Affairs created pursuant to section 303.

(c) REPORT. —

(1) ANNUAL REPORT. —

(A) IN GENERAL. — The Secretary of State shall submit to the appropriate congressional committees an annual report with respect to United States nationals for whom the Secretary determines there is credible information of unlawful or wrongful detention abroad.

(B) FORM. — The report required under this paragraph shall be submitted in unclassified form, but may include a classified annex if necessary.

(2) COMPOSITION. — The report required under paragraph (1) shall include current estimates of the number of individuals so detained, as well as relevant information about particular cases, such as —

(A) the name of the individual, unless the provision of such information is inconsistent with section 552a of title 5, United States Code (commonly known as the "Privacy Act of 1974");

(B) basic facts about the case;

(C) a summary of the information that such individual may be detained unlawfully or wrongfully;

(D) a description of specific efforts, legal and diplomatic, taken on behalf of the individual since the last reporting period, including a description of accomplishments and setbacks; and

(E) a description of intended next steps.

(d) RESOURCE GUIDANCE. —

(1) ESTABLISHMENT. — Not later than 180 days after the date of the enactment of this Act and after consulting with relevant organizations that advocate on behalf of United States nationals detained abroad and the Family Engagement Coordinator established pursuant to section 304(c)(2), the Secretary of State shall provide resource guidance in writing for government officials and families of unjustly or wrongfully detained individuals.

(2) CONTENT. — The resource guidance required under paragraph (1) should include —

(A) information to help families understand United States policy concerning the release of United States nationals unlawfully or wrongfully held abroad;

(B) contact information for officials in the Department of State or other government agencies suited to answer family questions;

(C) relevant information about options available to help families obtain the release of unjustly or wrongfully detained individuals, such as guidance on how families may engage with United States diplomatic and consular channels to ensure prompt and regular access for the detained individual to legal counsel, family members, humane treatment, and other services;

(D) guidance on submitting public or private letters from members of Congress or other individuals who may be influential in securing the release of an individual; and

(E) appropriate points of contacts, such as legal resources and counseling services, who have a record of assisting victims' families.

SEC. 303. SPECIAL ENVOY FOR HOSTAGE AFFAIRS.

(a) ESTABLISHMENT. — There shall be a Special Presidential Envoy for Hostage Affairs, who shall be appointed by the President, by and with the advice and consent of the Senate, and shall report to the Secretary of State.

(b) RANK. — The Special Envoy shall have the rank and status of ambassador.

(c) RESPONSIBILITIES. — The Special Presidential Envoy for Hostage Affairs shall —

(1) lead diplomatic engagement on United States hostage policy;

(2) coordinate all diplomatic engagements and strategy in support of hostage recovery efforts, in coordination with the Hostage Recovery Fusion Cell and consistent with policy guidance communicated through the Hostage Response Group;

(3) in coordination with the Hostage Recovery Fusion Cell as appropriate, coordinate diplomatic engagements regarding cases in which a foreign government has detained a United States national and the United States Government regards such detention as unlawful or wrongful;

(4) provide senior representation from the Special Envoy's office to the Hostage Recovery Fusion Cell established under section 304 and the Hostage Response Group established under section 305; and

(5) ensure that families of United States nationals unlawfully or wrongly detained abroad receive updated information about developments in cases and government policy.

SEC. 304. HOSTAGE RECOVERY FUSION CELL.

(a) ESTABLISHMENT. — The President shall establish an inter-agency Hostage Recovery Fusion Cell.

(b) PARTICIPATION. — The President shall direct the heads of each of the following executive departments, agencies, and offices to make available personnel to participate in the Hostage Recovery Fusion Cell:

(1) The Department of State.

(2) The Department of the Treasury.

(3) The Department of Defense.

(4) The Department of Justice.

(5) The Office of the Director of National Intelligence.

(6) The Federal Bureau of Investigation.

(7) The Central Intelligence Agency.

(8) Other agencies as the President, from time to time, may designate.

(c) PERSONNEL. — The Hostage Recovery Fusion Cell shall include —

(1) a Director, who shall be a full-time senior officer or employee of the United States Government;

(2) a Family Engagement Coordinator who shall —

(A) work to ensure that all interactions by executive branch officials with a hostage's family occur in a coordinated fashion and that the family receives consistent and accurate information from the United States Government; and

(B) if directed, perform the same function as set out in subparagraph (A) with regard to the family of a United States national who is unlawfully or wrongfully detained abroad; and

(3) other officers and employees as deemed appropriate by the President.

(d) DUTIES. — The Hostage Recovery Fusion Cell shall —

(1) coordinate efforts by participating agencies to ensure that all relevant information, expertise, and resources are brought to bear to secure the safe recovery of United States nationals held hostage abroad;

(2) if directed, coordinate the United States Government's response to other hostage-takings occurring abroad in which the United States has a national interest;

(3) if directed, coordinate or assist the United States Government's response to help secure the release of United States nationals unlawfully or wrongfully detained abroad; and

(4) pursuant to policy guidance coordinated through the National Security Council —

(A) identify and recommend hostage recovery options and strategies to the President through the National Security Council or the Deputies Committee of the National Security Council;

(B) coordinate efforts by participating agencies to ensure that information regarding hostage events, including potential recovery options and engagements with families and external actors (including foreign governments), is appropriately shared within the United States Government to facilitate a coordinated response to a hostage-taking;

(C) assess and track all hostage-takings of United States nationals abroad and provide regular reports to the President and Congress on the status of such cases and any measures being taken toward the hostages' safe recovery;

(D) provide a forum for intelligence sharing and, with the support of the Director of National Intelligence, coordinate the declassification of relevant information;

(E) coordinate efforts by participating agencies to provide appropriate support and assistance to hostages and their families in a coordinated and consistent manner and to provide families with timely information regarding significant events in their cases;

(F) make recommendations to agencies in order to reduce the likelihood of United States nationals' being taken hostage abroad and enhance United States Government preparation to maximize the probability of a favorable outcome following a hostage-taking; and

(G) coordinate with agencies regarding congressional, media, and other public inquiries pertaining to hostage events.

(e) ADMINISTRATION. — The Hostage Recovery Fusion Cell shall be located within the Federal Bureau of Investigation for administrative purposes.

SEC. 305. HOSTAGE RESPONSE GROUP.

(a) ESTABLISHMENT. — The President shall establish a Hostage Response Group, chaired by a designated member of the National Security Council or the Deputies Committee of the National Security Council, to be convened on a regular basis, to further the safe recovery of United States nationals held hostage abroad or unlawfully or wrongfully detained abroad, and to be tasked with coordinating the United States Government response to other hostage-takings occurring abroad in which the United States has a national interest.

(b) MEMBERSHIP. — The regular members of the Hostage Response Group shall include the Director of the Hostage Recovery Fusion Cell, the Hostage Recovery Fusion Cell's Family Engagement Coordinator, the Special Envoy appointed pursuant to section 303, and representatives from the Department of the Treasury, the Department of Defense, the Department of Justice, the Federal Bureau of Investigation, the Office of the Director of National Intelligence, the Central Intelligence Agency, and other agencies as the President, from time to time, may designate.

(c) DUTIES. — The Hostage Recovery Group shall —

(1) identify and recommend hostage recovery options and strategies to the President through the National Security Council;

(2) coordinate the development and implementation of United States hostage recovery policies, strategies, and procedures;

(3) receive regular updates from the Hostage Recovery Fusion Cell and the Special Envoy for Hostage Affairs on the status of United States nationals being held hostage or unlawfully or wrongfully detained abroad and measures being taken to effect safe recoveries;

(4) coordinate the provision of policy guidance to the Hostage Recovery Fusion Cell, including reviewing recovery options proposed by the Hostage Recovery Fusion Cell and working to resolve disputes within the Hostage Recovery Fusion Cell;

(5) as appropriate, direct the use of resources at the Hostage Recovery Fusion Cell to coordinate or assist in the safe recovery of United States nationals unlawfully or wrongfully detained abroad; and

(6) as appropriate, direct the use of resources at the Hostage Recovery Fusion Cell to coordinate the United States Government response to other hostage-takings occurring abroad in which the United States has a national interest.

(d) MEETINGS. — The Hostage Response Group shall meet regularly.

(e) REPORTING. — The Hostage Response Group shall regularly provide recommendations on hostage recovery options and strategies to the National Security Council.

SEC. 306. AUTHORIZATION OF IMPOSITION OF SANCTIONS.

(a) IN GENERAL. — The President may impose the sanctions described in subsection (b) with respect to any foreign person the President determines, based on credible evidence —

(1) is responsible for or is complicit in, or responsible for ordering, controlling, or otherwise directing, the hostage-taking of a United States national abroad or the unlawful or wrongful detention of a United States national abroad; or

(2) knowingly provides financial, material, or technological support for, or goods or services in support of, an activity described in paragraph (1).

(b) SANCTIONS DESCRIBED. — The sanctions described in this subsection are the following:

(1) INELIGIBILITY FOR VISAS, ADMISSION, OR PAROLE. —

(A) VISAS, ADMISSION, OR PAROLE. — An alien described in subsection (a) may be —

(i) inadmissible to the United States;

(ii) ineligible to receive a visa or other documentation to enter the United States; and

(iii) otherwise ineligible to be admitted or paroled into the United States or to receive any other benefit under the Immigration and Nationality Act (8 U.S.C. 1101 et seq.).

(B) CURRENT VISAS REVOKED. —

(i) IN GENERAL. — An alien described in subsection (a) may be subject to revocation of any visa or other entry documentation regardless of when the visa or other entry documentation is or was issued.

(ii) IMMEDIATE EFFECT. — A revocation under clause (i) may —

(I) take effect immediately; and

(II) cancel any other valid visa or entry documentation that is in the alien's possession.

(2) BLOCKING OF PROPERTY. —

(A) INAPPLICABILITY OF NATIONAL EMERGENCY REQUIREMENT. — The requirements of section 202 of the International Emergency Economic Powers Act (50 U.S.C. 1701) shall not apply for purposes of this section.

(c) EXCEPTIONS. —

(1) EXCEPTION FOR INTELLIGENCE ACTIVITIES. — Sanctions under this section shall not apply to any activity subject to the reporting requirements under title V of the National Security Act of 1947 (50 U.S.C. 3091 et seq.) or any authorized intelligence activities of the United States.

(2) EXCEPTION TO COMPLY WITH INTERNATIONAL OBLIGATIONS AND FOR LAW ENFORCEMENT ACTIVITIES. — Sanctions under subsection (b)(1) shall not apply with respect to an alien if admitting or paroling the alien into the United States is necessary —

(A) to permit the United States to comply with the Agreement regarding the Headquarters of the United Nations, signed at Lake Success June 26, 1947, and entered into force November 21, 1947, between the United Nations and the United States, or other applicable international obligations; or

(B) to carry out or assist law enforcement activity in the United States.

(d) PENALTIES. — A person that violates, attempts to violate, conspires to violate, or causes a violation of subsection (b)(2) or any regulation, license, or order issued to carry out that subsection shall be subject to the penalties set forth in subsections (b) and (c) of section 206 of the International Emergency Economic Powers Act (50 U.S.C. 1705) to the same extent as a person that commits an unlawful act described in subsection (a) of that section.

(e) TERMINATION OF SANCTIONS. — The President may terminate the application of sanctions under this section with respect to a person if the President determines that —

(1) information exists that the person did not engage in the activity for which sanctions were imposed;

(2) the person has been prosecuted appropriately for the activity for which sanctions were imposed;

(3) the person has credibly demonstrated a significant change in behavior, has paid an appropriate consequence for the activity for which sanctions were imposed, and has credibly committed to not engage in an activity described in subsection (a) in the future; or

(4) the termination of the sanctions is in the national security interests of the United States.

(f) REPORTING REQUIREMENT. — If the President terminates sanctions pursuant to subsection (d), the President shall report to the appropriate congressional committees a written justification for such termination within 15 days.

(g) IMPLEMENTATION OF REGULATORY AUTHORITY. — The President may exercise all authorities provided under sections 203 and 205 of the International Emergency Economic Powers Act (50 U.S.C. 1702 and 1704) to carry out this section.

(h) EXCEPTION RELATING TO IMPORTATION OF GOODS. —

(1) IN GENERAL. — The authorities and requirements to impose sanctions authorized under this subtitle shall not include the authority or a requirement to impose sanctions on the importation of goods.

(2) GOOD DEFINED. — In this paragraph, the term "good" means any article, natural or manmade substance, material, supply or manufactured product, including inspection and test equipment, and excluding technical data.

(i) DEFINITIONS. — In this section:

(1) FOREIGN PERSON. — The term "foreign person" means —

(A) any citizen or national of a foreign country (including any such individual who is also a citizen or national of the United States); or

(B) any entity not organized solely under the laws of the United States or existing solely in the United States.

(2) UNITED STATES PERSON. — The term "United States person" means —

(A) an individual who is a United States citizen or an alien lawfully admitted for permanent residence to the United States;

(B) an entity organized under the laws of the United States or any jurisdiction within the United States, including a foreign branch of such an entity; or

(C) any person in the United States.

SEC. 307. DEFINITIONS.

In this Act:

(1) APPROPRIATE CONGRESSIONAL COMMITTEES. — The term "appropriate congressional committees" means —

(A) the Committee on Foreign Relations, the Committee on Appropriations, the Committee on Banking, Housing, and Urban Affairs, the Committee on the Judiciary, the Committee on Armed Services, and the Select Committee on Intelligence of the United States Senate; and

(B) the Committee on Foreign Affairs, the Committee on Appropriations, the Committee on Financial Services, the Committee on the Judiciary, the Committee on Armed Services, and the Permanent Select Committee on Intelligence of the House of Representatives.

(2) UNITED STATES NATIONAL. — The term "United States national" means —

(A) a United States national as defined in section 101(a)(22) or section 308 of the Immigration and Nationality Act (8 U.S.C. 1101(a)(22), 8 U.S.C. 1408); and

(B) a lawful permanent resident alien with significant ties to the United States.

SEC. 308. RULE OF CONSTRUCTION.

Nothing in this Act may be construed to authorize a private right of action.

Subtitle B — Taiwan Assurance Act of 2020

SEC. 311. SHORT TITLE.

This subtitle may be cited as the "Taiwan Assurance Act of 2020".

SEC. 312. FINDINGS.

Congress makes the following findings:

(1) April 10, 2019, marked the 40th anniversary of the Taiwan Relations Act of 1979 (Public Law 96–8).

(2) Since 1949, the close relationship between the United States and Taiwan has benefitted both parties and the broader Indo-Pacific region.

(3) The security of Taiwan and its democracy are key elements of continued peace and stability of the greater Indo-Pacific region, which is in the political, security, and economic interests of the United States.

(4) The People's Republic of China is currently engaged in a comprehensive military modernization campaign to enhance the power-projection capabilities of the People's Liberation Army and its ability to conduct joint operations, which is shifting the military balance of power across the Taiwan Strait.

(5) Taiwan and its diplomatic partners continue to face sustained pressure and coercion from the People's Republic of China, which seeks to isolate Taiwan from the international community.

(6) It is the policy of the United States to reinforce its commitments to Taiwan under the Taiwan Relations Act in a manner consistent with the "Six Assurances" and in accordance with the United States "One China" policy.

(7) In the Taiwan Travel Act, which became law on March 16, 2018, Congress observed that the "self-imposed restrictions that the United States maintains on high-level visits" between the United States and Taiwan have resulted in insufficient high-level communication.

SEC. 313. SENSE OF CONGRESS.

It is the sense of Congress that —

(1) Taiwan is a vital part of the United States Free and Open Indo-Pacific Strategy;

(2) the United States Government —

(A) supports Taiwan's continued pursuit of asymmetric capabilities and concepts; and

(B) urges Taiwan to increase its defense spending in order to fully resource its defense strategy; and

(3) the United States should conduct regular sales and transfers of defense articles to Taiwan in order to enhance its self-defense capabilities, particularly its efforts to develop and integrate asymmetric capabilities, including undersea warfare and air defense capabilities, into its military forces.

SEC. 314. TAIWAN'S INCLUSION IN INTERNATIONAL ORGANIZATIONS.

(a) SENSE OF CONGRESS. — It is the sense of Congress that the People's Republic of China's attempts to dictate the terms of Taiwan's participation in international organizations, has, in many cases, resulted in Taiwan's exclusion from such organizations even when statehood is not a requirement, and that such exclusion —

(1) is detrimental to global health, civilian air safety, and efforts to counter transnational crime;

(2) negatively impacts the safety and security of citizens globally; and

(3) negatively impacts the security of Taiwan and its democracy.

(b) STATEMENT OF POLICY. — It is the policy of the United States to advocate for Taiwan's meaningful participation in the United Nations, the World Health Assembly, the International Civil Aviation Organization, the International Criminal Police Organization, and other international bodies, as appropriate, and to advocate for Taiwan's membership in the Food and Agriculture Organization, the United Nations Educational, Scientific and Cultural Organization, and other international organizations for which statehood is not a requirement for membership.

SEC. 315. REVIEW OF DEPARTMENT OF STATE TAIWAN GUIDELINES.

(a) IN GENERAL. — Not later than 180 days after the date of the enactment of this Act, the Secretary of State shall conduct a review of the Department of State's guidance that governs relations with Taiwan, including the periodic memorandum entitled "Guidelines on Relations with Taiwan" and related documents, and reissue such guidance to executive branch departments and agencies.

(b) SENSE OF CONGRESS. — It is the sense of Congress that the Department of State's guidance regarding relations with Taiwan —

(1) should be crafted with the intent to deepen and expand United States-Taiwan relations, and be based on the value, merits, and importance of the United States-Taiwan relationship;

(2) should be crafted giving due consideration to the fact that Taiwan is governed by a representative democratic government that is peacefully constituted through free and fair elections that reflect the will of the people of Taiwan, and that Taiwan is a free and open society that respects universal human rights and democratic values; and

(3) should ensure that the conduct of relations with Taiwan reflects the longstanding, comprehensive, and values-based relationship the United States shares with Taiwan, and contribute to the peaceful resolution of cross-strait issues.

(c) REPORTING REQUIREMENTS. — Not later than 180 days after the date of the enactment of this Act, the Secretary of State shall submit to the Committee on Foreign Relations of the Senate and the Committee on Foreign Affairs of the House of Representatives a report that includes a description of —

(1) the results of the review pursuant to subsection (a) of the Department of State's guidance on relations with Taiwan, including a copy of the reissued "Guidelines of Relations with Taiwan" memorandum; and

(2) the implementation of the Taiwan Travel Act (Public Law 115–135) and any changes to guidance on relations with Taiwan that are the result of such implementation.

Subtitle C — Support for Human Rights in Belarus

SEC. 321. SHORT TITLE.

This subtitle may be cited as the "Belarus Democracy, Human Rights, and Sovereignty Act of 2020".

SEC. 322. FINDINGS.

Section 2 of the Belarus Democracy Act of 2004 (Public Law 109–480; 22 U.S.C. 5811 note) is amended to read as follows:

"SEC. 2. FINDINGS.

"Congress finds the following:

"(1) The International Covenant on Civil and Political Rights, done at New York December 19, 1966, was ratified by Belarus in 1973, guaranteeing Belarusians the freedom of expression and the freedom of association.

"(2) Alyaksandr Lukashenka has ruled Belarus as an undemocratic dictatorship since the first presidential election in Belarus in 1994.

"(3) Subsequent presidential elections in Belarus have been neither free nor fair and have been rejected by the international community as not meeting minimal electoral standards, with the jailing of opposition activists frequently used as a tool of government repression before and after the elections.

"(4) In response to the repression and violence during the 2006 presidential election, Congress passed the Belarus Democracy Reauthorization Act of 2006 (Public Law 109–480).

"(5) In 2006, President George W. Bush issued Executive Order 13405, titled 'Blocking Property of Certain Persons Undermining Democratic Processes or Institutions in Belarus', which authorized the imposition of sanctions against persons responsible for —

"(A) undermining democratic processes in Belarus; or

"(B) participating in human rights abuses related to political repression in Belarus.

"(6) In March 2011, the Senate unanimously passed Senate Resolution 105, which —

"(A) condemned the December 2010 election in Belarus as 'illegitimate, fraudulent, and not representative of the will or the aspirations of the voters in Belarus'; and

"(B) called on the Lukashenka regime 'to immediately and unconditionally release all political prisoners in Belarus who were arrested in association with the December 19, 2010, election'.

"(7) The Government of Belarus, led illegally by Alyaksandr Lukashenka, continues to engage in a pattern of clear and persistent violations of human rights and fundamental freedoms.

"(8) The Government of Belarus, led illegally by Alyaksandr Lukashenka, continues to engage in a pattern of clear and uncorrected violations of basic principles of democratic governance, including through a series of fundamentally flawed presidential and parliamentary elections undermining the legitimacy of executive and legislative authority in that country.

"(9) The Government of Belarus, led illegally by Alyaksandr Lukashenka, continues to subject thousands of pro-democracy political activists and peaceful protesters to harassment, beatings, and imprisonment, particularly as a result of their attempts to peacefully exercise their right to freedom of assembly and association.

"(10) The Government of Belarus, led illegally by Alyaksandr Lukashenka, continues to suppress independent media and journalists and to restrict access to the internet, including social media and other digital communication platforms, in violation of the right to freedom of speech and expression of those dissenting from the dictatorship of Alyaksandr Lukashenka.

"(11) The Government of Belarus, led illegally by Alyaksandr Lukashenka, continues a systematic campaign of harassment, repression, and closure of nongovernmental organizations, including independent trade unions and entrepreneurs, creating a climate of fear that inhibits the development of civil society and social solidarity.

"(12) The Government of Belarus, led illegally by Alyaksandr Lukashenka, has pursued a policy undermining the country's sovereignty and independence by making Belarus political, economic, cultural, and societal interests subservient to those of Russia.

"(13) The Government of Belarus, led illegally by Alyaksandr Lukashenka, continues to reduce the independence of Belarus through integration into a so-called 'Union State' that is under the control of Russia.

"(14) In advance of the August 2020 presidential elections in Belarus, authorities acting on behalf of President Lukashenka arrested journalists, bloggers, political activists, and opposition leaders, including 3 leading presidential candidates (Syarhey Tsikhanouski, Mikalay Statkevich, and Viktar Babaryka), who were barred from running in the election by the Central Election Commission of the Republic of Belarus.

"(15) While the 3 opposition candidates were imprisoned, 2 of their wives and 1 of their campaign managers (Sviatlana Tsikhanouskaya, Veranika Tsepkala, and Maria Kalesnikava) joined together and ran in place of the candidates.

"(16) Thousands of Belarusian people demonstrated their support for these candidates by attending rallies, including 1 rally that included an estimated 63,000 participants.

"(17) On August, 5, 2020, the Senate unanimously passed Senate Resolution 658, which calls for a free, fair, and transparent presidential election in Belarus, including the unimpeded participation of all presidential candidates.

"(18) On August 9, 2020, the Government of Belarus conducted a presidential election that —

"(A) was held under undemocratic conditions that did not meet international standards;

"(B) involved government malfeasance and serious irregularities with ballot counting and the reporting of election results, including —

"(i) early voting ballot stuffing;

"(ii) ballot burning;

"(iii) pressuring poll workers; and

"(iv) removing bags full of ballots by climbing out of windows;

"(C) included restrictive measures that impeded the work of local independent observers and did not provide sufficient notice to the OSCE to allow for the OSCE to monitor the elections, as is customary.

"(19) Incumbent president Alyaksandr Lukashenka declared a landslide victory in the election and claimed to have received more than 80 percent of the votes cast in the election.

"(20) The leading opposition candidate, Sviatlana Tsikhanouskaya —

"(A) formally disputed the government's reported election results;

"(B) explained that her staff had examined the election results from more than 50 polling places; and

"(C) found that her share of the vote exceeded Lukashenka's share by many times.

"(21) On August 10, 2020, Sviatlana Tsikhanouskaya was detained while attending a meeting with the Central Election Commission of the Republic of Belarus and forced to flee to Lithuania under pressure from government authorities.

"(22) On August 11, 2020, Lithuanian Foreign Minister Linas Linkevicˇius announced that Sviatlana Tsikhanouskaya was safe in Lithuania and has continued to be one of the strongest voices supporting the pro-democracy movement in Belarus within the European Union and globally.

"(23) On August 18, 2020, Sviatlana Tsikhanouskaya announced the formation of a Coordination Council to oversee a resolution to the crisis in Belarus and a peaceful transition of power by subjecting the Council's senior members to violence, detention, and forced exile. The Government of Belarus, led illegally by Alyaksandr Lukashenka, has sought to stop the work of the Coordination Council.

"(24) Before the European Parliament on August 25, 2020, Sviatlana Tsikhanouskaya stressed that a 'peaceful revolution' was underway in Belarus, and that 'It is neither a pro-Russian nor anti-Russian revolution. It is neither an anti-European Union nor a pro-European Union revolution. It is a democratic revolution.'.

"(25) On or around September 6, 2020, opposition leader Maria Kalesnikava and members of the Coordination Council, including Anton Ronenkov, Ivan Kravtsov, and Maxim Bogretsov, were detained by authorities who sought to forcibly expel them to Ukraine. Ms. Kalesnikava tore up her passport at the Ukrainian border in a successful effort to prevent this expulsion, subsequently disappeared, and was discovered in a Minsk prison on September 9, 2020.

"(26) On August 11, 2020, the European Union High Representative for Foreign and Security Policy, Josep Borrell, issued a declaration on the presidential election in Belarus stating that the elections were neither free nor fair.

"(27) On August 28, 2020, United States Deputy Secretary of State Stephen Biegun declared that the August 9th election in Belarus was fraudulent.

"(28) Following Alyaksandr Lukashenka's September 23, 2020, secret inauguration, the United States, the European Union, numerous European Union member states, the United Kingdom, and Canada announced that they did not recognize Mr. Lukashenka as the legitimately elected leader of Belarus.

"(29) Since the sham election on August 9, 2020, tens of thousands of Belarusian citizens have participated in daily peaceful protests calling for a new, free, and fair election, and the release of political prisoners.

"(30) According to Amnesty International, on August 30, 2020, Belarusians held one of the largest protest rallies in the country's modern history in Minsk and in other cities, which was attended by at least 100,000 people who demanded the resignation of President Lukashenka and an investigation into the human rights violations in Belarus.

"(31) Women have served as the leading force in demonstrations across the country, protesting the police brutality and mass detentions by wearing white, carrying flowers, forming 'solidarity chains', and unmasking undercover police trying to arrest demonstrators.

"(32) The Government of Belarus has responded to the peaceful opposition protests, which are the largest in Belarus history, with a violent crackdown, including, according to the United Nations Special Rapporteur, the detention by government authorities of more than 10,000 peaceful protestors as of September 18, 2020, mostly for taking part in or observing peaceful protests, with many of these arrests followed by beatings and torture at the hands of Belarusian law enforcement.

"(33) According to the Viasna Human Rights Centre, at least 450 detainees have reported being tortured or otherwise ill-treated while held in incommunicado detention for up to 10 days, including through —

"(A) severe beatings;

"(B) forced performance of humiliating acts; and

"(C) sexual violence and other forms of violence.

"(34) At least 4 Belarusians have been killed at protests, and dozens of Belarusians who were detained during the protests are still missing.

"(35) The Belarus Ministry of Defense threatened to send the army to confront protestors, warning that in case of any violation of peace and order in areas around national monuments, 'you will have the army to deal with now, not the police'.

"(36) The Government of Belarus, led illegally by Alyaksandr Lukashenka, has consistently restricted the free flow of information to silence the opposition and to conceal the regime's violent crackdown on peaceful protestors, including by —

"(A) stripping the accreditation of journalists from major foreign news outlets;

"(B) detaining and harassing countless journalists.

"(C) arresting dozens of journalists, 6 of whom report for Radio Free Europe/Radio Liberty;

"(D) halting the publishing of 2 independent newspapers; and

"(E) disrupting internet access;

"(F) blocking more than 50 news websites that were covering the protests; and

"(G) limiting access to social media and other digital communication platforms.

"(37) Internet access in Belarus has been repeatedly disrupted and restricted since August 9, 2020, which independent experts and monitoring groups have attributed to government interference.

"(38) Thousands of employees at Belarusian state-owned enterprises, who have been seen as Alyaksandr Lukashenka's traditional base during his 26-year rule, went on strike across the country to protest Lukashenka's illegitimate election and the subsequent crackdowns, including at some of Belarus's largest factories such as the BelAZ truck plant, the Minsk Tractor Works, and the Minsk Automobile Plant.

"(39) After the employees of state media outlets walked off the job in protest rather than help report misleading government propaganda, Lukashenka confirmed that he 'asked the Russians' to send teams of Russian journalists to replace local employees.

"(40) On August 19, 2020, European Council President Charles Michel announced that the European Union would impose sanctions on a substantial number of individuals responsible for violence, repression, and election fraud in Belarus.

"(41) On October 2, 2020, the Department of Treasury announced new sanctions under Executive Order 13405 on eight individuals 'for their roles in the fraudulent August 9, 2020 Belarus presidential election or the subsequent violent crackdown on peaceful protesters'.

"(42) Similar sanctions have also been applied to Belarusian human rights violators by the Government of Canada and the Government of the United Kingdom.

"(43) Against the will of the majority of the Belarusian people —

"(A) Alyaksandr Lukashenka appealed to Russian President Vladimir Putin to provide security assistance to his government, if requested; and

"(B) President Putin has agreed to prop up the Alyaksandr Lukashenka regime by —

"(i) confirming that a Russian police force was ready to be deployed if 'the situation gets out of control';

"(ii) providing significant financial support; and

"(iii) sending Russian propagandists to help disseminate pro-regime propaganda on Belarus state television.

"(44) The Governments of the United States, the European Union, the United Kingdom, and Canada have —

"(A) condemned the violent crackdown on peaceful protestors;

"(B) refused to accept the results of the fraudulent election; and

"(C) called for new free and fair elections under independent observation.".

SEC. 323. STATEMENT OF POLICY.

Section 3 of the Belarus Democracy Act of 2004 (Public Law 109-480; 22 U.S.C. 5811 note) is amended to read as follows:

"SEC. 3. STATEMENT OF POLICY.

"It is the policy of the United States —

"(1) to condemn —

"(A) the conduct of the August 9, 2020, presidential election in Belarus, which was neither free nor fair;

"(B) the Belarusian authorities' unrelenting crackdown on, arbitrary arrests of, and violence against opposition candidates, peaceful protestors, human rights activists, employees from state-owned enterprises participating in strikes, independent election observers, and independent journalists and bloggers; and

"(C) the unjustified detention and forced or attempted expulsion of members of the Coordination Council in Belarus;

"(2) to continue demanding the immediate release without preconditions of all political prisoners in Belarus and those arrested for peacefully protesting, including all those individuals detained in connection with the August 9, 2020, presidential election;

"(3) to stand in solidarity with the people of Belarus, including human rights defenders, bloggers, and journalists, who are exercising their right to freedom of assembly, freedom of expression, and rule of law and to continue supporting the aspirations of the people of Belarus for democracy, human rights, and the rule of law;

"(4) to continue actively supporting the aspirations of the people of the Republic of Belarus —

"(A) to preserve the independence and sovereignty of their country; and

"(B) to freely exercise their religion, including the head of the Catholic Church in Belarus, Archbishop Tadeusz Kondrusiewicz, who was barred from entering the country after criticizing Belarusian authorities;

"(5) to recognize the leading role of women in the peaceful protests and pro-democracy movement in Belarus;

"(6) to continue —

"(A) rejecting the invalid results of the fraudulent August 9, 2020 presidential election in Belarus announced by the Central Election Commission of the Republic of Belarus; and

"(B) supporting calls for new presidential and parliamentary elections, conducted in a manner that is free and fair according to OSCE standards and under the supervision of OSCE observers and independent domestic observers;

"(7) to refuse to recognize Alyaksandr Lukashenka as the legitimately elected leader of Belarus;

"(8) to not recognize any incorporation of Belarus into a 'Union State' with Russia, since this so-called 'Union State' would be both an attempt to absorb Belarus and a step to reconstituting the totalitarian Soviet Union;

"(9) to continue calling for the fulfillment by the Government of Belarus of Belarus's freely undertaken obligations as an OSCE participating state and as a signatory of the Charter of the United Nations;

"(10) to support an OSCE role in mediating a dialogue within Belarus between the government and genuine representatives of Belarusian society;

"(11) to recognize the Coordination Council as a legitimate institution to participate in a dialogue on a peaceful transition of power;

"(12) to applaud the commitment by foreign diplomats in Minsk to engage with Coordination Council member and Nobel Laureate, Svetlana Alexievich, and to encourage an ongoing dialogue with her and with other leaders of the democratically-oriented political opposition in Belarus;

"(13) to urge an expanded United States diplomatic presence in Belarus to advocate for the aspirations of the people of Belarus for democracy, human rights, and the rule of law;

"(14) to encourage the United States Government —

"(A) to continue working closely with the European Union, the United Kingdom, Canada, and other countries and international organizations to promote the principles of democracy, the rule of law, and human rights in Belarus; and

"(B) to impose targeted sanctions, in coordination with the European Union and other international partners, against officials in Belarus who are responsible for —

"(i) undermining democratic processes in Belarus; or

"(ii) participating in human rights abuses related to political repression in Belarus;

"(15) to call on the Government of Belarus to uphold its human rights obligations, including those rights enumerated in the International Covenant on Civil and Political Rights; and

"(16) to support —

"(A) the continued territorial integrity of Belarus; and

"(B) the right of the Belarusian people to determine their future.".

SEC. 324. ASSISTANCE TO PROMOTE DEMOCRACY, CIVIL SOCIETY, AND SOVEREIGNTY IN BELARUS.

Section 4 of the Belarus Democracy Act of 2004 (Public Law 109-480; 22 U.S.C. 5811 note) is amended —

(1) by amending the section heading to read as follows: "assistance to promote democracy, civil society, and sovereignty in belarus.";

(2) in subsection (a) —

(A) in paragraph (1), by striking "European" and inserting "Trans-Atlantic"; and

(B) by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and

(C) by inserting after paragraph (1) the following:

"(2) To assist the people of Belarus in building the sovereignty and independence of their country.";

(3) in subsection (b) —

(A) by inserting "and Belarusian groups outside of Belarus" after "indigenous Belarusian groups"; and

(B) by inserting "and Belarusian sovereignty" before the period at the end;

(4) in subsection (c) —

(A) by striking paragraph (8);

(B) by redesignating paragraphs (3) through (7) as paragraphs (4) through (8), respectively;

(C) by inserting after paragraph (2) the following:

"(3) countering internet censorship and repressive surveillance technology that seek to limit free association, control access to information, and prevent citizens from exercising their rights to free speech;";

(D) in paragraph (8), as redesignated, by striking "and" at the end; and

(E) by adding at the end the following:

"(9) supporting the work of women advocating freedom, human rights, and human progress;

"(10) supporting the development of Belarusian language education;

"(11) enhancing the development of the private sector, particularly the information technology sector, and its role in the economy of Belarus, including by increasing the capacity of private sector actors, developing business support organizations, offering entrepreneurship training, and expanding access to finance for small and medium enterprises;

"(12) supporting political refugees in neighboring European countries fleeing the crackdown in Belarus;

"(13) supporting the gathering of evidence on and investigating of the human rights abuses in Belarus;

"(14) supporting the public health response, including filling the information void, in Belarus during the COVID-19 pandemic; and

"(15) other activities consistent with the purposes of this Act.";

(5) by redesignating subsection (d) as subsection (g);

(6) by inserting after subsection (c) the following:

"(d) SENSE OF CONGRESS. — It is the sense of Congress that, in light of the political crisis in Belarus and the unprecedented mobilization of the Belarusian people, United States foreign assistance to Belarusian civil society should be reevaluated and increased —

"(1) to carry out the purposes described in subsection (a); and

"(2) to include the activities described in subsection (c).

"(e) COORDINATION WITH EUROPEAN PARTNERS. — In order to maximize impact, eliminate duplication, and further the achievement of the purposes described in subsection (a), the Secretary of State shall ensure coordination with the European Union and its institutions, the governments of countries that are members of the European Union, the United Kingdom, and Canada.

"(f) REPORT ON ASSISTANCE. — Not later than 1 year after the date of the enactment of the Belarus Democracy, Human Rights, and Sovereignty Act of 2020, the Secretary of State, acting through the Office of the Coordinator of U.S. Assistance to Europe and Eurasia, and in coordination with the Administrator of the United States Agency for International Development, shall submit a report to the appropriate congressional committees describing the programs and activities carried out to achieve the purposes described in subsection (a), including an assessment of whether or not progress was made in achieving those purposes."; and

(7) in subsection (g), as redesignated —

(A) in the subsection heading, by striking "AUTHORIZATION OF APPROPRIATIONS" and all that follows through "There are" and inserting "AUTHORIZATION OF APPROPRIATIONS. — There are";

(B) by striking "fiscal years 2007 and 2008" and inserting "fiscal years 2021 and 2022"; and

(C) by striking paragraph (2).

SEC. 325. INTERNATIONAL BROADCASTING, INTERNET FREEDOM, AND ACCESS TO INFORMATION IN BELARUS.

Section 5 of the Belarus Democracy Act of 2004 (Public Law 109-480; 22 U.S.C. 5811 note) is amended to read as follows:

"SEC. 5. INTERNATIONAL BROADCASTING, INTERNET FREEDOM, AND ACCESS TO INFORMATION IN BELARUS.

"(a) SENSE OF CONGRESS. — It is the sense of Congress that —

"(1) the President should support and reallocate resources to radio, television, and internet broadcasting conducted by Radio Free Europe/Radio Liberty in languages spoken in Belarus;

"(2) the United States should also support other independent media providing objective information to the Belarusian people, particularly in the Belarusian language;

"(3) the President should provide the United States Agency for Global Media with a surge capacity (as such term is defined in section 316 of the United States International Broadcasting Act (22 U.S.C. 6216)) for programs and activities in Belarus; "(4) the Chief Executive Officer of the United States Agency for Global Media, working through the Open Technology Fund and in coordination with the Secretary of State, should expand and prioritize efforts to provide anti-censorship technology and services to journalists and civil society in Belarus in order to enhance their ability to safely access or share digital news and information without fear of repercussions or surveillance; and

"(5) the United States should continue to condemn the Belarusian authorities' crackdown on independent media, including the harassment and mass detentions of independent and foreign journalists and the denial of accreditation.

"(b) STRATEGY TO PROMOTE EXPANDED BROADCASTING, INTERNET FREEDOM, AND ACCESS TO INFORMATION IN BELARUS. —

"(1) IN GENERAL. — Not later than 120 days after the date of the enactment of the Belarus Democracy, Human Rights, and Sovereignty Act of 2020, the Chief Executive Officer of the United States Agency for Global Media and the Secretary of State shall jointly submit to the appropriate congressional committees a comprehensive strategy, including a cost estimate, to carry out the following:

"(A) Expand independent radio, television, live stream, and social network broadcasting and communications in Belarus to provide news and information, particularly in the Belarusian language, that is credible, comprehensive, and accurate.

"(B) Support the development and use of anti-censorship and circumvention technologies by the Open Technology Fund and the Bureau of Democracy Human Rights and Labor that enable the citizens of Belarus to communicate securely and undertake internet activities without interference from the Government of Belarus.

"(C) Assist efforts to overcome attempts by the Government of Belarus to disrupt internet access and block content online.

"(D) Monitor the cooperation of the Government of Belarus with any foreign government or organization for purposes related to the censorship or surveillance of the internet, including an assessment of any such cooperation in the preceding ten years.

"(E) Monitor the purchase or receipt by the Government of Belarus of any technology or training from any foreign government or organization for purposes related to the censorship or surveillance of the internet, including an assessment of any such purchase or receipt in the preceding ten years.

"(F) Assist with the protection of journalists who have been targeted for free speech activities, including through the denial of accreditation.

"(G) Provide cyber-attack mitigation services to civil society organizations in Belarus.

"(H) Provide resources for educational materials and training on digital literacy, bypassing internet censorship, digital safety, and investigative and analytical journalism for independent journalists working in Belarus.

"(I) Build the capacity of civil society, media, and other nongovernmental and organizations to identify, track, and counter disinformation, including from proxies of the Government of Russia working at Belarusian state television.

"(2) FORM. — The report required under paragraph (1) shall be transmitted in unclassified form, but may contain a classified annex.".

SEC. 326. SANCTIONS AGAINST THE GOVERNMENT OF BELARUS.

Section 6 of the Belarus Democracy Act of 2004 (Public Law 109-480; 22 U.S.C. 5811 note) is amended —

(1) in subsection (b) —

(A) by striking "December 19, 2010" each place it appears and inserting "August 9, 2020";

(B) in paragraph (2), by inserting ", peaceful protesters," after "all opposition activists";

(C) by striking paragraphs (3) and (6); and

(D) by redesignating paragraphs (4), (5), and (7) as paragraphs (3), (4), and (5), respectively;

(2) in subsection (c) —

(A) in the subsection heading, by inserting "AND RUSSIAN INDIVIDUALS COMPLICIT IN THE CRACKDOWN THAT OCCURRED AFTER THE AUGUST 9, 2020, ELECTION" after "BELARUS";

(B) by redesignating paragraphs (4) and (5) as paragraphs (5) and (6), respectively;

(C) by inserting after paragraph (3) the following:

"(4) is a member of the Central Election Commission of Belarus or assisted the Commission in manipulating the presidential election of August 9, 2020;";

(D) in paragraph (5), as redesignated, to read as follows:

"(5) is a member of any branch of the security or law enforcement services of Belarus, including the KGB, Interior Ministry, and OMON special police unit, and is responsible for, or complicit in, ordering, controlling, materially assisting, sponsoring, or providing financial, material, or technological support for, or otherwise directing, the crackdown on opposition leaders, journalists, and peaceful protestors that occurred in connection with the presidential election of August 9, 2020; or"; and

(E) by adding at the end the following:

"(7) is a government official, including at the Information Ministry, responsible for the crackdown on independent media, including revoking the accreditation of journalists, disrupting internet access, and restricting online content;

"(8) is an official in the so-called 'Union State' between Russia and Belarus (regardless of nationality of the individual); or

"(9) is a Russian individual that has significantly participated in the crackdown on independent press or human rights abuses related to political repression in Belarus, including the Russian propagandists sent to replace local employees at Belarusian state media outlets.";

(3) in subsection (d)(1), by striking "the Overseas Private Investment Corporation" and inserting "the United States International Development Finance Corporation";

(4) in subsection (e), by striking "(including any technical assistance or grant) of any kind"; and

(5) in subsection (f) —

(A) in paragraph (1)(A), by striking "or by any member or family member closely linked to any member of the senior leadership of the Government of Belarus" and inserting "or by the senior leadership of the Government of Belarus or by any member or family member closely linked to the senior leadership of the Government of Belarus, or an official of the so-called 'Union State' with Russia"; and

(B) in paragraph (2) —

(i) in subparagraph (A), by adding at the end before the semicolon the following: ", or an official of the so-called 'Union State' with Russia"; and

(ii) in subparagraph (B), by inserting ", or the so-called 'Union State' with Russia," after "the Government of Belarus".

SEC. 327. MULTILATERAL COOPERATION.

Section 7 of the Belarus Democracy Act of 2004 (Public Law 109-480; 22 U.S.C. 5811 note) is amended to read as follows:

"SEC. 7. MULTILATERAL COOPERATION.

"It is the sense of Congress that the President should continue to coordinate with the European Union and its institutions, European Union member states, the United Kingdom, and Canada to develop a comprehensive, multilateral strategy —

"(1) to further the purposes of this Act, including, as appropriate, encouraging other countries to take measures with respect to the Republic of Belarus that are similar to measures described in this Act; and

"(2) to deter the Government of the Russian Federation from undermining democratic processes and institutions in Belarus or threatening the independence, sovereignty, and territorial integrity of Belarus.".

SEC. 328. REPORTS.

Section 8 of the Belarus Democracy Act of 2004 (Public Law 109-480; 22 U.S.C. 5811 note) is amended to read as follows:

"SEC. 8. REPORTS.

"(a) REPORT ON THREAT TO SOVEREIGNTY AND INDEPENDENCE OF BELARUS. —

"(1) IN GENERAL. — Not later than 120 days after the date of the enactment of the Belarus Democracy, Human Rights, and Sovereignty Act of 2020, the Secretary of State, in coordination with the Director of National Intelligence and the Secretary of the Treasury, shall transmit to the appropriate congressional committees a report describing the threat that the Government of Russia poses to the sovereignty and independence of Belarus.

"(2) MATTERS TO BE INCLUDED. — The report required under paragraph (1) shall include —

"(A) an assessment of how the Government of Russia is exploiting the current political crisis in Belarus to push for deeper political and economic control of or integration with Belarus;

"(B) a description of the economic and energy assets in Belarus that the Government of Russia, including Russian state-owned or state-controlled companies, controls;

"(C) a description of Belarus major enterprises that are vulnerable of being taken over by Russian entities amid the country's worsening financial crisis;

"(D) a description of how and to what ends the Government of Russia seeks to augment its military presence in Belarus;

"(E) a description of Russian influence over the media and information space in Belarus and how the Government of Russia uses disinformation and other malign techniques to undermine Belarusian history, culture, and language;

"(F) a description of other actors in Belarus that the Government of Russia uses to advance its malign influence, including veterans' organizations and extrajudicial networks;

"(G) a description of efforts to undermine Belarusian language, cultural, and national symbols, including the traditional red and white flag and the 'Pahonia' mounted knight; and

"(H) the identification of Russian individuals and government agencies that are significantly supporting or involved in the crackdown on peaceful protestors and the opposition or the repression of independent media following the August 9, 2020, presidential election.

"(3) FORM. — The report required under this subsection shall be transmitted in unclassified form, but may contain a classified annex.

"(b) REPORT ON PERSONAL ASSETS OF ALYAKSANDR LUKASHENKA. —

"(1) IN GENERAL. — Not later than 90 days after the date of the enactment of the Belarus Democracy, Human Rights, and Sovereignty Act of 2020, the Director of National Intelligence, in consultation with the Secretary of the Treasury and the Secretary of State, shall submit to the appropriate congressional committees a report describing —

"(A) the total assets under the direct or indirect control of Alyaksandr Lukashenka, including estimated assets and known sources of income of Alyaksandr Lukashenka and his immediate family members, including assets, investments, bank accounts, and other business interests; and

"(B) an identification of the most significant senior foreign political figures in Belarus, as determined by their closeness to Alyaksandr Lukashenka.

"(2) WAIVER. — The Director of National Intelligence may waive, in whole or in part, the reporting requirement under paragraph (1)(A) if the Director submits to the appropriate congressional committees —

"(A) a written justification stating that the waiver is in the national interest of the United States; and

"(B) a detailed explanation of the reasons therefor. "(3) FORM. — The report required under this subsection shall be transmitted in unclassified form, but may contain a classified annex.".

SEC. 329. DEFINITIONS.

Section 9 of the Belarus Democracy Act of 2004 (Public Law 109-480; 22 U.S.C. 5811 note) is amended —

(1) by amending paragraph (1) to read as follows:

"(1) APPROPRIATE CONGRESSIONAL COMMITTEES. — The term 'appropriate congressional committees' means —

"(A) the Committee on Foreign Relations of the Senate;

"(B) the Committee on Banking, Housing, and Urban Affairs of the Senate;

"(C) the Committee on Appropriations of the Senate;

"(D) the Committee on Foreign Affairs of the House of Representatives;

"(E) the Committee on Financial Services of the House of Representatives; and

"(F) the Committee on Appropriations of the House of Representatives."; and

(2) in paragraph (3)(B) —

(A) in clause (i), by inserting "members of the security and intelligence services," after "prosecutors,"; and

(B) in clause (ii), by inserting ", electoral fraud, online censorship, or restrictions on independent media and journalists" after "public corruption".

SEC. 330. DETERMINATION OF BUDGETARY EFFECTS.

The budgetary effects of this subtitle, for the purpose of complying with the Statutory Pay-As-You-Go Act of 2010, shall be determined by reference to the latest statement titled "Budgetary Effects of PAYGO Legislation" for this subtitle, submitted for printing in the Congressional Record by the Chairman of the House Budget Committee, provided that such statement has been submitted prior to the vote on passage.

Subtitle D — Gandhi-King Scholarly Exchange Initiative Act

SEC. 331. SHORT TITLE.

This subtitle may be cited as the "Gandhi-King Scholarly Exchange Initiative Act".

SEC. 332. FINDINGS.

Congress makes the following findings:

(1) The peoples of the United States and India have a long history of friendship and the interests of the peoples of the United States, India, and the world will benefit from a stronger United States-India partnership.

(2) Mohandas Karamchand Gandhi and Martin Luther King, Jr., were dedicated leaders fighting for social justice and social change, peace, and civil rights in their respective communities, and countries and in the world.

(3) The use of nonviolent civil disobedience is a shared tactic that has played a key role in defeating social injustice in India, the United States, and in other parts of the world.

(4) Mohandas Gandhi, who was born on October 2, 1869, was murdered on January 30, 1948, after dedicating his life to the peaceful empowerment of the people of India and to the end of British colonial rule.

(5) Martin Luther King, Jr., who was born on January 15, 1929, was murdered on April 4, 1968, after a life dedicated to peaceful movements against segregation, discrimination, racial injustice, and poverty.

(6) In February 1959, Dr. King and his wife, Coretta Scott King, traveled throughout India. By the end of his monthlong visit, Dr. King said, "I am more convinced than ever before that the method of nonviolent resistance is the most potent weapon available to oppressed people in their struggle for justice and human dignity.".

(7) Fifty years after Dr. King's visit, All India Radio, the national radio station of India, discovered a taped message by Dr. King that emphasized the intellectual harmony between the messages of Dr. King and Mohandas Gandhi on nonviolent social action.

(8) On August 22, 2011, the Dr. Martin Luther King, Jr., National Memorial opened to the public in Washington, DC. This newest memorial on the National Mall pays tribute to Dr. King's national and international contributions to world peace through nonviolent social change.

(9) The 116th Congress coincides with both the 150th birth anniversary of Mohandas Gandhi and the 90th birth anniversary of Dr. Martin Luther King, Jr.

(10) Mohandas Gandhi, who employed the principle of satyagraha, or "fighting with peace", has come to represent the moral force inspiring many civil and social rights movement around the world.

(11) Dr. King's effective use of Gandhi's principles was instrumental to the American civil rights movement.

(12) There is a long history of civil and social rights movements in the United States and in India. As the relationship between the United States and India evolves, a binational foundation through which the governments of each country can work together and catalyze private investment toward development objectives would provide an ongoing, productive institution and symbol of the friendship and common ideals of the respective governments and their peoples.

(13) There is a global goal of ending tuberculosis by 2030, the United States and India seek a TB-Free India by 2025, and the United States-India Gandhi-King Development Foundation, as described in this subtitle, could help address gaps across the TB value chain in prevention, detection, diagnosis, and treatment, and catalyze market-based strategies to bridge the service gap for the "last mile".

(14) Leaders in both countries have prioritized the United States-India relationship and continue to support a strengthene