H.R. 1968

119th CONGRESS 1st Session

Making further continuing appropriations and other extensions for the fiscal year ending September 30, 2025, and for other purposes.

IN THE SENATE OF THE UNITED STATES · March 11 (legislative day, March 10), 2025

Sec. 1. Short title.

This Act may be cited as the Full-Year Continuing Appropriations and Extensions Act, 2025.

Sec. 2. Table of contents.

The table of contents of this Act is as follows:

• Sec. 1. Short title.
• Sec. 2. Table of contents.
• Sec. 3. References.
• Division A—Full-Year Continuing Appropriations Act, 2025
• Title I—General Provisions
• Title II—Agriculture, Rural Development, Food and Drug Administration, and Related Agencies
• Title III—Commerce, Justice, Science, and Related Agencies
• Title IV—Department of Defense
• Title V—Energy and Water Development and Related Agencies
• Title VI—Financial Services and General Government
• Title VII—Department of Homeland Security
• Title VIII—Department of the Interior, Environment, and Related Agencies
• Title IX—Departments of Labor, Health and Human Services, and Education, and Related Agencies
• Title X—Legislative Branch
• Title XI—Military Construction, Veterans Affairs, and Related Agencies
• Title XII—Department of State, Foreign Operations, and Related Programs
• Title XIII—Transportation, Housing and Urban Development, and Related Agencies
• Division B—Health
• Title I—Public health extenders
• Sec. 2101. Extension for community health centers, National Health Service Corps, and teaching health centers that operate GME programs.
• Sec. 2102. Extension of special diabetes programs.
• Sec. 2103. National health security extensions.
• Title II—Medicare
• Sec. 2201. Extension of increased inpatient hospital payment adjustment for certain low-volume hospitals.
• Sec. 2202. Extension of the Medicare-dependent hospital (MDH) program.
• Sec. 2203. Extension of add-on payments for ambulance services.
• Sec. 2204. Extension of funding for quality measure endorsement, input, and selection.
• Sec. 2205. Extension of funding outreach and assistance for low-income programs.
• Sec. 2206. Extension of the work geographic index floor.
• Sec. 2207. Extension of certain telehealth flexibilities.
• Sec. 2208. Extending acute hospital care at home waiver authorities.
• Sec. 2209. Extension of temporary inclusion of authorized oral antiviral drugs as covered part D drugs.
• Sec. 2210. Medicare improvement fund.
• Sec. 2211. Medicare sequestration.
• Title III—Human services
• Sec. 2301. Sexual risk avoidance education extension.
• Sec. 2302. Personal responsibility education extension.
• Sec. 2303. Extension of funding for family-to-family health information centers.
• Title IV—Medicaid
• Sec. 2401. Delaying Medicaid DSH reductions.
• Division C—Other Matters
• Sec. 3101. Commodity futures trading commission whistleblower program.
• Sec. 3102. Protection of certain facilities and assets from unmanned aircraft.
• Sec. 3103. Additional special assessment.
• Sec. 3104. National cybersecurity protection system authorization.
• Sec. 3105. Extension of temporary order for fentanyl-related substances.
• Sec. 3106. Budgetary effects.

Sec. 3. References.

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

Division A—Full-Year Continuing Appropriations Act, 2025

Title I—General Provisions

Title II—Agriculture, Rural Development, Food and Drug Administration, and Related Agencies

Title III—Commerce, Justice, Science, and Related Agencies

Title IV—Department of Defense

Title V—Energy and Water Development and Related Agencies

Title VI—Financial Services and General Government

Title VII—Department of Homeland Security

Title VIII—Department of the Interior, Environment, and Related Agencies

Title IX—Departments of Labor, Health and Human Services, and Education, and Related Agencies

Title X—Legislative Branch

Title XI—Military Construction, Veterans Affairs, and Related Agencies

Title XII—Department of State, Foreign Operations, and Related Programs

Title XIII—Transportation, Housing and Urban Development, and Related Agencies

Division B—Health

Title I—Public health extenders

Sec. 2101. Extension for community health centers, National Health Service Corps, and teaching health centers that operate GME programs.

• (a) Extension for community health centers
  • Section 10503(b)(1) of the Patient Protection and Affordable Care Act () is amended— 42 U.S.C. 254b–2(b)(1)
    • in subparagraph (H), by striking and at the end;
    • in subparagraph (I), by striking the period at the end and inserting and inserting ; and; and
      • $2,135,835,616 for the period beginning on April 1, 2025, and ending on September 30, 2025; and
    • by adding at the end the following:
• (b) Extension for the National Health Service Corps
  • Section 10503(b)(2) of the Patient Protection and Affordable Care Act () is amended— 42 U.S.C. 254b–2(b)(2)
    • in subparagraph (I), by striking and at the end;
    • in subparagraph (J), by striking the period at the end and inserting ; and; and
      • $172,972,603 for the period beginning on April 1, 2025, and ending on September 30, 2025.
    • by adding at the end the following:
• (c) Teaching health centers that operate graduate medical education programs
  • Section 340H(g)(1) of the Public Health Service Act () is amended— 42 U.S.C. 256h(g)(1)
    • in subparagraph (D), by striking and at the end;
    • in subparagraph (E), by striking the period at the end and inserting ; and; and
      • $87,739,726 for the period beginning on April 1, 2025, and ending on September 30, 2025.
    • by adding at the end the following:
• (d) Application of provisions
  • Amounts appropriated pursuant to the amendments made by this section shall be subject to the requirements contained in for funds for programs authorized under sections 330 through 340 of the Public Health Service Act (). Public Law 117–328; 42 U.S.C. 254b et seq.
• (e) Conforming amendment
  • Section 3014(h)(4) of title 18, United States Code, is amended by striking and section 3101(d) of the Health Extensions and Other Matters Act, 2025and inserting section 3101(d) of the Health Extensions and Other Matters Act, 2025, and section 2101(d) of division B of the Full-Year Continuing Appropriations and Extensions Act, 2025.

Sec. 2102. Extension of special diabetes programs.

• (a) Extension of special diabetes programs for type I diabetes
  • Section 330B(b)(2) of the Public Health Service Act () is amended— 42 U.S.C. 254c–2(b)(2)
    • in subparagraph (E), by striking and at the end;
    • in subparagraph (F), by striking the period at the end and inserting ; and; and
      • $79,832,215 for the period beginning on April 1, 2025, and ending on September 30, 2025, to remain available until expended.
    • by adding at the end the following:
• (b) Extending funding for special diabetes programs for Indians
  • Section 330C(c)(2) of the Public Health Service Act () is amended— 42 U.S.C. 254c–3(c)(2)
    • in subparagraph (E), by striking and at the end;
    • in subparagraph (F), by striking the period at the end and inserting ; and; and
    • by adding at the end the following:
      • $79,832,215 for the period beginning on April 1, 2025, and ending on September 30, 2025, to remain available until expended.

Sec. 2103. National health security extensions.

• Section 319(e)(8) of the Public Health Service Act () is amended by striking March 31, 2025and inserting September 30, 2025. 42 U.S.C. 247d(e)(8)
• Section 319L(e)(1)(D) of the Public Health Service Act (42 U.S.C. 247d–7e(e)(1)(D)) is amended by striking March 31, 2025and inserting September 30, 2025.
• Section 319L–1(b) of the Public Health Service Act (42 U.S.C. 247d–7f(b)) is amended by striking March 31, 2025and inserting September 30, 2025.
• (d)
  • Section 2811A(g) of the Public Health Service Act (42 U.S.C. 300hh–10b(g)) is amended by striking March 31, 2025and inserting September 30, 2025.
  • Section 2811B(g)(1) of the Public Health Service Act (42 U.S.C. 300hh–10c(g)(1)) is amended by striking March 31, 2025and inserting September 30, 2025.
  • Section 2811C(g)(1) of the Public Health Service Act (42 U.S.C. 300hh–10d(g)(1)) is amended by striking March 31, 2025and inserting September 30, 2025.
  • Section 2812(c)(4)(B) of the Public Health Service Act () is amended by striking March 31, 2025and inserting September 30, 2025. 42 U.S.C. 300hh–11(c)(4)(B)

Title II—Medicare

Sec. 2201. Extension of increased inpatient hospital payment adjustment for certain low-volume hospitals.

• (a) In general
  • Section 1886(d)(12) of the Social Security Act () is amended— 42 U.S.C. 1395ww(d)(12)
    • in subparagraph (B), by striking ;
    • in subparagraph (C)(i)—
      • in the matter preceding subclause (I)—
        • (i) by striking ; and
        • (ii) by striking and inserting ;
      • in subclause (III), by striking and inserting ; and
      • in subclause (IV), by striking ; and
    • in subparagraph (D)—
      • in the matter preceding clause (i), by striking and inserting ; and
      • in clause (ii), by striking and inserting .
• (b) Implementation
  • Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendments made by this section by program instruction or otherwise.

Sec. 2202. Extension of the Medicare-dependent hospital (MDH) program.

• (a) In general
  • Section 1886(d)(5)(G) of the Social Security Act () is amended— 42 U.S.C. 1395ww(d)(5)(G)
    • in clause (i), by striking April 1, 2025and inserting October 1, 2025; and
    • in clause (ii)(II), by striking April 1, 2025and inserting October 1, 2025.
• (b) Conforming amendments
  • (1) In general
    • Section 1886(b)(3)(D) of the Social Security Act () is amended— 42 U.S.C. 1395ww(b)(3)(D)
      • in the matter preceding clause (i), by striking April 1, 2025and inserting October 1, 2025; and
      • in clause (iv), by striking and inserting .
  • (2) Permitting hospitals to decline reclassification
    • Section 13501(e)(2) of the Omnibus Budget Reconciliation Act of 1993 ( note) is amended by striking and inserting . 42 U.S.C. 1395ww

Sec. 2203. Extension of add-on payments for ambulance services.

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

• in paragraph (12)(A), by striking April 1, 2025and inserting October 1, 2025; and
• in paragraph (13), by striking each place it appears and inserting in each such place.

Sec. 2204. Extension of funding for quality measure endorsement, input, and selection.

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

• in the first sentence—
  • by striking striking1,030,000and inserting inserting4,030,000; and
  • by striking March 31, 2025and inserting September 30, 2025; and
• in the third sentence, by striking March 31, 2025and inserting September 30, 2025.

Sec. 2205. Extension of funding outreach and assistance for low-income programs.

• (a) State health insurance assistance programs
  • Subsection (a)(1)(B)(xiv) of section 119 of the Medicare Improvements for Patients and Providers Act of 2008 ( note) is amended by striking March 31, 2025, 2,500,000and inserting September 30, 2025, $30,000,000. 42 U.S.C. 1395b–3
• (b) Area agencies on aging
  • Subsection (b)(1)(B)(xiv) of such section 119 is amended by striking March 31, 2025, 2,500,000and inserting September 30, 2025, $30,000,000.
• (c) Aging and disability resource centers
  • Subsection (c)(1)(B)(xiv) of such section 119 is amended by striking March 31, 2025, $8,500,000and inserting September 30, 2025, inserting0,000,000.
• (d) Coordination of efforts to inform older Americans about benefits available under Federal and State programs
  • Subsection (d)(2)(xiv) of such section 119 is amended by striking March 31, 2025, 2,500,000and inserting September 30, 2025, $30,000,000.

Sec. 2206. Extension of the work geographic index floor.

Section 1848(e)(1)(E) of the Social Security Act () is amended by striking April 1, 2025and inserting October 1, 2025. 42 U.S.C. 1395w–4(e)(1)(E)

Sec. 2207. Extension of certain telehealth flexibilities.

• (a) Removing geographic requirements and expanding originating sites for telehealth services
  • Section 1834(m) of the Social Security Act () is amended— 42 U.S.C. 1395m(m)
    • in paragraph (2)(B)(iii), by striking ending March 31, 2025and inserting ending September 30, 2025; and
    • in paragraph (4)(C)(iii), by striking ending on March 31, 2025and inserting ending on September 30, 2025.
• (b) Expanding practitioners eligible To furnish telehealth services
  • Section 1834(m)(4)(E) of the Social Security Act () is amended by striking ending on March 31, 2025and inserting ending on September 30, 2025. 42 U.S.C. 1395m(m)(4)(E)
• (c) Extending telehealth services for federally qualified health centers and rural health clinics
  • Section 1834(m)(8)(A) of the Social Security Act () is amended by striking ending on March 31, 2025and inserting ending on September 30, 2025. 42 U.S.C. 1395m(m)(8)(A)
• (d) Delaying the in-Person requirements under Medicare for mental health services furnished through telehealth and telecommunications technology
  • (1) Delay in requirements for mental health services furnished through telehealth
    • Section 1834(m)(7)(B)(i) of the Social Security Act () is amended, in the matter preceding subclause (I), by striking on or after April 1, 2025and inserting on or after October 1, 2025,. 42 U.S.C. 1395m(m)(7)(B)(i)
  • (2) Mental health visits furnished by rural health clinics
    • Section 1834(y)(2) of the Social Security Act () is amended by striking April 1, 2025and inserting October 1, 2025. 42 U.S.C. 1395m(y)(2)
  • (3) Mental health visits furnished by Federally qualified health centers
    • Section 1834(o)(4)(B) of the Social Security Act () is amended by striking April 1, 2025and inserting October 1, 2025. 42 U.S.C. 1395m(o)(4)(B)
• (e) Allowing for the furnishing of audio-only telehealth services
  • Section 1834(m)(9) of the Social Security Act () is amended by striking ending on March 31, 2025and inserting ending on September 30, 2025. 42 U.S.C. 1395m(m)(9)
• (f) Extending use of telehealth To conduct face-to-Face encounter prior to recertification of eligibility for hospice care
  • Section 1814(a)(7)(D)(i)(II) of the Social Security Act () is amended by striking ending on March 31, 2025and inserting ending on September 30, 2025. 42 U.S.C. 1395f(a)(7)(D)(i)(II)
• (g) Program instruction authority
  • The Secretary of Health and Human Services may implement the amendments made by this section through program instruction or otherwise.

Sec. 2208. Extending acute hospital care at home waiver authorities.

Section 1866G(a)(1) of the Social Security Act () is amended by striking March 31, 2025and inserting September 30, 2025. 42 U.S.C. 1395cc–7(a)(1)

Sec. 2209. Extension of temporary inclusion of authorized oral antiviral drugs as covered part D drugs.

Section 1860D–2(e)(1)(C) of the Social Security Act () is amended by striking March 31, 2025and inserting September 30, 2025. 42 U.S.C. 1395w–102(e)(1)(C)

Sec. 2210. Medicare improvement fund.

Section 1898(b)(1) of the Social Security Act () is amended by striking striking,251,000,000and inserting inserting,804,000,000. 42 U.S.C. 1395iii(b)(1)

Sec. 2211. Medicare sequestration.

Section 251A(6)(D) of the Balanced Budget and Emergency Deficit Control Act of 1985 () is amended— 2 U.S.C. 901a(6)(D)

• in clause (i), by striking 8 monthsand inserting 10 months; and
• in clause (ii), by striking 4 monthsand inserting 2 months.

Title III—Human services

Sec. 2301. Sexual risk avoidance education extension.

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

• in subsection (a)(1)—
  • by striking the period beginning on October 1, 2024, and ending on March 31, 2025and inserting fiscal year 2025; and
  • by striking ; and
• in subsection (f)(1), by striking the period beginning on October 1, 2024, and ending on March 31, 2025, an amount equal to the pro rata portion of the amount appropriated for the corresponding period forand inserting for fiscal year 2025, an amount equal to the amount appropriated for.

Sec. 2302. Personal responsibility education extension.

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

• in subsection (a)(1)—
  • in subparagraph (A), in the matter preceding clause (i), by striking the period beginning on October 1, 2024, and ending on March 31, 2025and inserting fiscal year 2025; and
  • in subparagraph (B)(i), by striking the period beginning on October 1, 2024, and ending on March 31, 2025and inserting fiscal year 2025; and
• in subsection (f), by striking the period beginning on October 1, 2024, and ending on March 31, 2025, an amount equal to the pro rata portion of the amount appropriated for the corresponding periodand inserting fiscal year 2025, an amount equal to the amount appropriated for fiscal year 2024.

Sec. 2303. Extension of funding for family-to-family health information centers.

Section 501(c)(1)(A)(viii) of the Social Security Act () is amended by striking $3,000,000 for the portion of fiscal year 2025 before April 1, 2025.and inserting $6,000,000 for fiscal year 2025. 42 U.S.C. 701(c)(1)(A)(viii)

Title IV—Medicaid

Sec. 2401. Delaying Medicaid DSH reductions.

Section 1923(f)(7)(A) of the Social Security Act () is amended— 42 U.S.C. 1396r–4(f)(7)(A)

• in clause (i)—
  • in the matter preceding subclause (I)—
    • (i) by striking For the period beginning April 1, 2025, and ending September 30, 2025, and forand inserting For; and
    • (ii) by striking through 2027and inserting through 2028;
  • in subclause (I), by striking ; and
  • in subclause (II), by striking ; and
• in clause (ii)—
  • by striking ; and
  • by striking through 2027and inserting through 2028.

Division C—Other Matters

Sec. 3101. Commodity futures trading commission whistleblower program.

Section 1(b) of (135 Stat. 297; 136 Stat. 2133; 136 Stat. 5984) is amended in each of paragraphs (3) and (4) by striking March 14, 2025and inserting September 30, 2025. Public Law 117–25

Sec. 3102. Protection of certain facilities and assets from unmanned aircraft.

Section 210G(i) of the Homeland Security Act of 2002 () is amended by striking March 14, 2025and inserting September 30, 2025. 6 U.S.C. 124n(i)

Sec. 3103. Additional special assessment.

Section 3014 of title 18, United States Code, is amended by striking March 14, 2025and inserting September 30, 2025.

Sec. 3104. National cybersecurity protection system authorization.

Section 227(a) of the Federal Cybersecurity Enhancement Act of 2015 () is amended by striking March 14, 2025and inserting September 30, 2025. 6 U.S.C. 1525(a)

Sec. 3105. Extension of temporary order for fentanyl-related substances.

Effective as if included in the enactment of the Temporary Reauthorization and Study of the Emergency Scheduling of Fentanyl Analogues Act (), section 2 of such Act is amended by striking March 31, 2025and inserting September 30, 2025. Public Law 116–114

Sec. 3106. Budgetary effects.

• (a) Statutory PAYGO scorecards
  • The budgetary effects of divisions B and C shall not be entered on either PAYGO scorecard maintained pursuant to section 4(d) of the Statutory Pay-As-You-Go Act of 2010.
• (b) Senate PAYGO scorecards
  • The budgetary effects of divisions B and C shall not be entered on any PAYGO scorecard maintained for purposes of section 4106 of H. Con. Res. 71 (115th Congress).
• (c) Classification of budgetary effects
  • Notwithstanding Rule 3 of the Budget Scorekeeping Guidelines set forth in the joint explanatory statement of the committee of conference accompanying Conference Report 105–217 and section 250(c)(8) of the Balanced Budget and Emergency Deficit Control Act of 1985, the budgetary effects of divisions B and C shall not be estimated—
    • for purposes of section 251 of such Act;
    • for purposes of an allocation to the Committee on Appropriations pursuant to section 302(a) of the Congressional Budget Act of 1974; and
    • for purposes of paragraph (4)(C) of section 3 of the Statutory Pay-As-You-Go Act of 2010 as being included in an appropriation Act.