H.R. 1974 — Further Additional Continuing Appropriations and Other Extensions Act, 2025

This section provides additional funding for the period beginning April 1, 2025, and ending April 11, 2025, as follows: (1) $132,602,740 for community health centers (i.e., under section 330 of the Public Health Service Act); (2) $10,963,593 for the National Health Service Corps; and (3) $6,058,748 for teaching health centers that operate graduate medical education programs (i.e., payments for direct and indirect expenses associated with residency training). Amounts appropriated pursuant to these amendments are subject to requirements contained in Public Law 118-47 for such programs, and makes a conforming amendment to 18 U.S.C. 3014(h)(4).

This section extends funding for the Special Diabetes Program for Type 1 Diabetes (i.e., grants to support research on prevention and cure of type 1 diabetes) and the Special Diabetes Program for Indians (i.e., grants to Indian health programs for diabetes prevention, treatment, and management) by providing $4,798,658 for each program for the period beginning April 1, 2025, and ending April 11, 2025 (previously through March 31, 2025).

This section extends the expiration dates for multiple national health security authorities through April 11, 2025 (from March 31, 2025), including public health emergency provisions (Sec. 319(e)(8)), Biomedical Advanced Research and Development Authority (BARDA) authorities (Sec. 319L(e)(1)(D)), Strategic National Stockpile authorities (Sec. 319L–1(b)), medical countermeasures innovation, distribution, and enterprise programs (Secs. 2811A(g), 2811B(g)(1), and 2811C(g)(1)), and National Disaster Medical System authorities (Sec. 2812(c)(4)(B)).

This section extends the temporary increase in the Medicare inpatient prospective payment system (IPPS) adjustment for low-volume hospitals—rural hospitals with 800 or fewer Medicare discharges in the baseline year that are more than 25 road miles from the nearest other IPPS hospital—by 11 to 12 days, to April 11-12, 2025 (from March 31-April 1, 2025), in multiple clauses of SSA §1886(d)(12). (Thus, qualifying hospitals receive the higher adjustment amount for discharges during the extended period.)

This section extends the Medicare-dependent hospital (MDH) program—which provides additional payments under the inpatient prospective payment system (IPPS) to small rural hospitals with at least 60% Medicare inpatient utilization—to April 12, 2025 (from April 1, 2025). It makes conforming changes to related standardized amount and reclassification provisions to April 11 or 12, 2025 (from March 31 or April 1, 2025).

This section extends temporary add-on payments under Medicare for ground ambulance services furnished in rural areas (i.e., 22.6% of the base payment amount) and superb rural areas (i.e., an additional 20% or 22.6% depending on the area) through April 12, 2025 (from April 1, 2025).

This section extends funding for the consensus-based entity (e.g., National Quality Forum) under SSA §1890—which endorses standardized health care performance measures for Medicare, Medicaid, and other programs—to April 11, 2025 (from March 31, 2025).

This section extends the availability of funds for Medicare low-income beneficiary outreach and assistance programs—including State Health Insurance Assistance Programs, area agencies on aging, aging and disability resource centers, and coordination activities to inform older Americans of federal and state benefits—to April 11, 2025 (from March 31, 2025), and increases funding amounts as follows: (1) State Health Insurance Assistance Programs to $23,125,000 (from $22,500,000); (2) area agencies on aging to $23,125,000 (from $22,500,000); (3) aging and disability resource centers to $8,708,333 (from $8,500,000); and (4) coordination activities to $23,125,000 (from $22,500,000). (These programs provide counseling and assistance to help low-income seniors and others access Medicare benefits and low-income subsidies.)

This section extends multiple Medicare telehealth flexibilities—originally provided during the COVID-19 public health emergency to waive restrictions on geographic location, originating sites, eligible practitioners, and in-person requirements (i.e., allowing services via telecommunications technology)—to mid-April 2025 (from late March/early April 2025) as follows: (1) waiver of geographic and originating site requirements through April 11 (from March 31); (2) eligibility of additional practitioners through April 11 (from March 31); (3) services at federally qualified health centers and rural health clinics through April 11 (from March 31); (4) delay of in-person requirements for mental health telehealth services, including at rural health clinics and federally qualified health centers, through April 12 (from April 1); (5) audio-only telehealth services through April 11 (from March 31); and (6) use of telehealth for the face-to-face encounter prior to hospice recertification through April 11 (from March 31). The section further authorizes the Secretary of Health and Human Services to implement these amendments through program instruction or otherwise.

This section extends the Sexual Risk Avoidance Education program—which provides formula allotments to states (or competitive grants to other entities if a state does not apply) proportional to the number of low-income children in the state for education programs exclusively promoting sexual risk avoidance (i.e., abstinence)—through April 11, 2025 (from March 31, 2025), by (1) amending the final specified allotment period in subsection (a)(1) and (2) amending the final specified appropriation period in subsection (f)(1).

This section extends availability of allotments to states under the Personal Responsibility Education Program (PREP)—which provides formula grants to states for evidence-based programs to reduce teen pregnancy—through April 11, 2025 (from March 31, 2025), and makes conforming changes to the minimum allotment exception and related appropriations.

This section increases the authorization of appropriations for Family-to-Family Health Information Centers—which provide information, education, technical assistance, and peer-to-peer support to families of children and youth with special health care needs, disabilities, or other chronic or complex health conditions—to $3.2 million (from $3 million) and extends such authorization through April 12, 2025 (from April 1, 2025).

This section delays to April 12 (from April 1) the dates specified in clauses (i) and (ii) of section 1923(f)(7)(A) of the Social Security Act. (Thus, temporary reductions to certain states' Medicaid disproportionate share hospital (DSH) allotments—i.e., capped annual funding for supplemental payments to hospitals serving high shares of low-income patients—are delayed by 11 days.)