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"(E) the amendments made by section 2(a)(1) of the

Continuing Extension Act of 2010; and".

(c) EFFECTIVE DATE.-The amendments made by this section 26 USC 3304 shall take effect as if included in the enactment of the Temporary note. Extension Act of 2010 (Public Law 111-144).

SEC. 3. EXTENSION AND IMPROVEMENT OF PREMIUM ASSISTANCE
FOR COBRA BENEFITS.

(a) EXTENSION OF ELIGIBILITY PERIOD.-Subsection (a)(3)(A) of section 3001 of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5), as amended by section 3(a)

of the Temporary Extension Act of 2010 (Public Law 111-144), 26 USC 6432 is amended by striking "March 31, 2010" and inserting "May 31, 2010".

(b) RULES RELATING TO 2010 EXTENSION.-Subsection (a) of section 3001 of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5), as amended by section 3(b) of the Temporary Extension Act of 2010 (Public Law 111-144), is amended by adding at the end the following:

"(18) RULES RELATED TO APRIL AND MAY 2010 EXTENSION.—

In the case of an individual who, with regard to coverage Applicability. described in paragraph (10)(B), experiences a qualifying event related to a termination of employment on or after April 1, 2010 and prior to the date of the enactment of this paragraph, rules similar to those in paragraphs (4)(A) and (7)(C) shall apply with respect to all continuation coverage, including State continuation coverage programs.".

(c) EFFECTIVE DATE.-The amendments made by this section shall take effect as if included in the provisions of section 3001 of division B of the American Recovery and Reinvestment Act of 2009.

SEC. 4. INCREASE IN THE MEDICARE PHYSICIAN PAYMENT UPDATE.

Paragraph (10) of section 1848(d) of the Social Security Act, as added by section 1011(a) of the Department of Defense Appropriations Act, 2010 (Public Law 111-118) and as amended by section

5 of the Temporary Extension Act of 2010 (Public Law 111-144), 42 USC 1395w-4. is amended

(1) in subparagraph (A), by striking "March 31, 2010" and inserting "May 31, 2010"; and

(2) in subparagraph (B), by striking "April 1, 2010" and inserting "June 1, 2010".

SEC. 5. EHR CLARIFICATION.

(a) QUALIFICATION FOR CLINIC-BASED PHYSICIANS.—

(1) MEDICARE.-Section 1848(o)(1)(C)(ii) of the Social Security Act (42 U.S.C. 1395w-4(o)(1)(C)(ii)) is amended by striking "setting (whether inpatient or outpatient)" and inserting "inpatient or emergency room setting".

(2) MEDICAID.-Section 1903(t)(3)(D) of the Social Security Act (42 U.S.C. 1396b(t)(3)(D)) is amended by striking "setting (whether inpatient or outpatient)" and inserting "inpatient or emergency room setting".

(b) EFFECTIVE DATE.-The amendments made by subsection (a) shall be effective as if included in the enactment of the HITECH Act (included in the American Recovery and Reinvestment Act of 2009 (Public Law 111-5)).

42 USC
1395w-4 note.

123 Stat. 3474.

123 Stat. 2047.

Time period.

Effective date.

(c) 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. 6. EXTENSION OF USE OF 2009 POVERTY GUIDELINES.

Section 1012 of the Department of Defense Appropriations Act, 2010 (Public Law 111-118), as amended by section 7 of the Temporary Extension Act of 2010 (Public Law 111-144), is amended by striking "March 31, 2010" and inserting "May 31, 2010".

SEC. 7. EXTENSION OF NATIONAL FLOOD INSURANCE PROGRAM.

(a) EXTENSION.-Section 129 of the Continuing Appropriations Resolution, 2010 (Public Law 111-68), as amended by section 8 of Public Law 111-144, is amended by striking "by substituting" and all that follows through the period at the end and inserting "by substituting May 31, 2010, for the date specified in each such section.".

(b) EFFECTIVE DATE.-The amendments made by subsection (a) shall be considered to have taken effect on February 28, 2010. SEC. 8. COMPENSATION AND RATIFICATION OF AUTHORITY RELATED TO LAPSE IN HIGHWAY PROGRAMS.

(a) COMPENSATION FOR FEDERAL EMPLOYEES.-Any Federal employees furloughed as a result of the lapse in expenditure authority from the Highway Trust Fund after 11:59 p.m. on February 28, 2010, through March 2, 2010, shall be compensated for the period of that lapse at their standard rates of compensation, as determined under policies established by the Secretary of Transportation.

(b) RATIFICATION OF ESSENTIAL ACTIONS.-All actions taken by Federal employees, contractors, and grantees for the purposes of maintaining the essential level of Government operations, services, and activities to protect life and property and to bring about orderly termination of Government functions during the lapse in expenditure authority from the Highway Trust Fund after 11:59 p.m. on February 28, 2010, through March 2, 2010, are hereby ratified and approved if otherwise in accord with the provisions of the Continuing Appropriations Resolution, 2010 (division B of Public Law 111-68).

(c) FUNDING.-Funds used by the Secretary to compensate employees described in subsection (a) shall be derived from funds. previously authorized out of the Highway Trust Fund and made available or limited to the Department of Transportation by the Consolidated Appropriations Act, 2010 (Public Law 111-117) and shall be subject to the obligation limitations established in such Act.

(d) EXPENDITURES FROM HIGHWAY TRUST FUND.-To permit expenditures from the Highway Trust Fund to effectuate the purposes of this section, this section shall be deemed to be a section of the Continuing Appropriations Resolution, 2010 (division B of Public Law 111-68), as in effect on the date of the enactment of the last amendment to such Resolution.

SEC. 9. SATELLITE TELEVISION EXTENSION.

(a) AMENDMENTS TO SECTION 119 OF TITLE 17, UNITED STATES CODE.

(1) IN GENERAL.-Section 119 of title 17, United States Code, is amended

(A) in subsection (c)(1)(E), by striking "April 30, 2010" and inserting "May 31, 2010"; and

(B) in subsection (e), by striking "April 30, 2010" and

inserting "May 31, 2010".

(2) TERMINATION OF LICENSE.-Section 1003(a)(2)(A) of

Public Law 111-118 is amended by striking "April 30, 2010", 17 USC 119 note. and inserting "May 31, 2010".

(b) AMENDMENTS TO COMMUNICATIONS ACT OF 1934.-Section

325(b) of the Communications Act of 1934 (47 U.S.C. 325(b)) is

amended

(1) in paragraph (2)(C), by striking "April 30, 2010" and inserting "May 31, 2010"; and

(2) in paragraph (3)(C), by striking "May 1, 2010" each place it appears in clauses (ii) and (iii) and inserting "June 1, 2010".

SEC. 10. EXTENSION OF SMALL BUSINESS LOAN GUARANTEE PRO-
GRAM.

(a) APPROPRIATION.-There is appropriated, out of any funds in the Treasury not otherwise appropriated, $80,000,000, for an additional amount for "Small Business Administration-Business Loans Program Account", to remain available until expended, for the cost of fee reductions and eliminations under section 501 of division A of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5; 123 Stat. 151) and loan guarantees under section 502 of division A of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5; 123 Stat. 152), as amended by this section: Provided, That such costs shall be as defined in section 502 of the Congressional Budget Act of 1974.

(b) EXTENSION OF SUNSET DATE.-Section 502(f) of division A of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5; 123 Stat. 153) is amended by striking "April 30, 2010" and inserting "May 31, 2010".

SEC. 11. SENSE OF THE SENATE REGARDING A VALUE ADDED TAX.

It is the sense of the Senate that the Value Added Tax is a massive tax increase that will cripple families on fixed income and only further push back America's economic recovery and the Senate opposes a Value Added Tax.

SEC. 12. DETERMINATION OF BUDGETARY EFFECTS.

(a) IN GENERAL.-The budgetary effects of this Act, 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 Act, submitted for printing in the Congressional Record by the Chairman of the Senate Budget Committee, provided that such statement has been submitted prior to the vote on passage.

(b) EMERGENCY DESIGNATION FOR CONGRESSIONAL ENFORCEMENT. This Act, with the exception of section 4, is designated as an emergency for purposes of pay-as-you-go principles. In the Senate, this Act is designated as an emergency requirement pursuant to section 403(a) of S. Con. Res. 13 (111th Congress), the concurrent resolution on the budget for fiscal year 2010.

(c) EMERGENCY DESIGNATION FOR STATUTORY PAYGO.-This Act, with the exception of section 4, is designated as an emergency requirement pursuant to section 4(g) of the Statutory Pay-As-YouGo Act of 2010 (Public Law 111-139; 2 U.S.C. 933(g)).

Approved April 15, 2010.

LEGISLATIVE HISTORY-H.R. 4851 (S. 3153):

CONGRESSIONAL RECORD, Vol. 156 (2010):

Mar. 17, considered and passed House.

Apr. 13, 14, considered in Senate.

Apr. 15, considered and passed Senate, amended. House concurred in Senate amendment.

Public Law 111-158

111th Congress

An Act

To urge the Secretary of the Treasury to instruct the United States Executive Directors at the International Monetary Fund, the World Bank, the Inter-American Development Bank, and other multilateral development institutions to use the voice, vote, and influence of the United States to cancel immediately and completely Haiti's debts to such institutions, 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.

Apr. 26, 2010 [H.R. 4573]

Haiti Debt Relief and Earthquake Recovery Act of 2010.

This Act may be cited as the "Haiti Debt Relief and Earthquake 22 USC 261 note. Recovery Act of 2010".

SEC. 2. DEBT RELIEF FOR HAITI.

Title XVI of the International Financial Institutions Act (22 U.S.C. 262p et seq.) is amended by adding at the end the following new section:

"SEC. 1628. CANCELLATION OF HAITI'S DEBTS TO INTERNATIONAL FINANCIAL INSTITUTIONS.

"(a) IN GENERAL.-The Secretary of the Treasury should direct the United States Executive Director at the International Monetary Fund, the International Development Association, the Inter-American Development Bank, the International Fund for Agricultural Development, and other multilateral development institutions (as defined in section 1701(c)(3)) to use the voice, vote and influence of the United States at each such institution to seek to achieve"(1) the immediate and complete cancellation of any and all remaining debts owed by Haiti to such institutions;

"(2) the suspension of Haiti's debt service payments to such institutions until such time as the debts are canceled completely; and

"(3) the provision, before February 1, 2015, of emergency, humanitarian and reconstruction assistance from such institutions to Haiti in the form of grants or other assistance such that Haiti does not accumulate debt.

"(b) USE OF CERTAIN FUNDS FOR ASSISTANCE TO HAITI.-The Secretary of the Treasury should instruct the United States Executive Director of the International Monetary Fund to advocate the use of some of the realized windfall profits that exceed the required contribution to the Poverty Reduction and Growth Trust (as referenced in the IMF Reforms Financial Facilities for Low-Income Countries Public Information Notice (PIN) No. 09/94) from the ongoing sale of 12,965,649 ounces of gold acquired since the second Amendment of the Fund's Article of Agreement, to provide debt

22 USC 262p-12.

Deadline.

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