Sec. 5201. Community access, resources, and empowerment for moms

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A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

This section may be cited as the or the Community Access, Resources, and Empowerment for Moms Act . CARE for Moms Act Not later than one year after the date of enactment of this Act, the Secretary of Health and Human Services, acting through the Division of Reproductive Health of the Centers for Disease Control and Prevention (referred to in this paragraph as the Secretary ), shall establish a grant program to be known as the State-Based Perinatal Quality Collaborative Grant Program , under which the Secretary shall award grants to eligible entities for the purpose of development and sustainability of State-based perinatal quality collaboratives in every State, the District of Columbia, and eligible territories, in order to measurably improve perinatal care and perinatal health outcomes for pregnant and postpartum women and their infants.

Grants awarded under this paragraph shall be in amounts not to exceed $250,000 per year, for the duration of the grant period. For purposes of this paragraph, the term State-based perinatal quality collaborative means a network of teams that— is multidisciplinary in nature and includes the full range of perinatal and maternity care providers; works to improve measurable outcomes for maternal and infant health by advancing evidence-informed clinical practices using quality improvement principles; works with hospital-based or outpatient facility-based clinical teams, experts, and stakeholders, including patients and families, to spread best practices and optimize resources to improve perinatal care and outcomes; employs strategies that include the use of the collaborative learning model to provide opportunities for hospitals and clinical teams to collaborate on improvement strategies, rapid-response data to provide timely feedback to hospital and other clinical teams to track progress, and quality improvement science to provide support and coaching to hospital and clinical teams; has the goal of improving population-level outcomes in maternal and infant health; and has the goal of improving outcomes of all birthing people, through the coordination, integration, and collaboration across birth settings.

For purposes of carrying out this paragraph, there is authorized to be appropriated $35,000,000 for each of fiscal years 2025 through 2029. Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ), as amended by section 4251(d)(3)(A), is amended— in subsection (a)(4)— by striking ; and

(D)and inserting ;

(D); by striking ; and

(E)and inserting ;

(E); by striking ; and

(F)and inserting ;

(F); and by striking the semicolon at the end and inserting ; and

(G)oral health services for pregnant and postpartum women (as defined in subsection (nn)); ; and by adding at the end the following new subsection: For purposes of this title, the term oral health services for pregnant and postpartum women means dental services necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions that are furnished to a woman during pregnancy (or during the 1-year period beginning on the last day of the pregnancy). To satisfy the requirement to provide oral health services for pregnant and postpartum women, a State shall, at a minimum, provide coverage for preventive, diagnostic, periodontal, and restorative care consistent with recommendations for perinatal oral health care and dental care during pregnancy from the American Academy of Pediatric Dentistry and the American College of Obstetricians and Gynecologists. . Section 2103(c)(6) of the Social Security Act ( 42 U.S.C. 1397cc(c)(6) ) is amended— in subparagraph (A)— by inserting or a targeted low-income pregnant woman after targeted low-income child ; and by inserting , and, in the case of a targeted low-income child who is pregnant or a targeted low-income pregnant woman, satisfy the coverage requirements specified in section 1905(nn) after emergency conditions ; and in subparagraph (B), by inserting (but only if, in the case of a targeted low-income child who is pregnant or a targeted low-income pregnant woman, the benchmark dental benefit package satisfies the coverage requirements specified in section 1905(nn)) after subparagraph

(C). Section 1902 of the Social Security Act ( 42 U.S.C. 1396a ) is amended— in subsection (a)— in paragraph (86), by striking and at the end; in paragraph (87), by striking the period at the end and inserting ; and ; and by inserting after paragraph

(87)the following new paragraph: provide that the State plan is in compliance with subsection (e)(16). ; and in subsection (e)(16)— in subparagraph (A), by striking At the option of the State, the State plan (or waiver of such State plan) may provide and inserting A State plan (or waiver of such State plan) shall provide ; in subparagraph (B), in the matter preceding clause (i), by striking by a State making an election under this paragraph and inserting under a State plan (or a waiver of such State plan) ; and by striking subparagraph (C). Section 2107(e)(1)(J) of the Social Security Act ( 42 U.S.C. 1397gg(e)(1)(J) ), as inserted by section 9822 of the American Rescue Plan Act of 2021 ( Public Law 117–2 ), is amended to read as follows: Paragraphs

(5)and

(16)of section 1902(e) (relating to the requirement to provide medical assistance under the State plan or waiver consisting of full benefits during pregnancy and throughout the 12-month postpartum period under title XIX). . Section 2112(d)(2)(A) of the Social Security Act ( 42 U.S.C. 1397ll(d)(2)(A) ) is amended by striking the month in which the 60-day period and all that follows through pursuant to section 2107(e)(1), . Section 1902(l) of the Social Security Act ( 42 U.S.C. 1396a(l) ) is amended by adding at the end the following new paragraph: During the period that begins on the date of enactment of this paragraph and ends on the date that is 5 years after such date of enactment, as a condition for receiving any Federal payments under section 1903(a) for calendar quarters occurring during such period, a State shall not have in effect, with respect to women who are eligible for medical assistance under the State plan or under a waiver of such plan on the basis of being pregnant or having been pregnant, eligibility standards, methodologies, or procedures under the State plan or waiver that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan or waiver that are in effect on the date of enactment of this paragraph. . Section 2105(d) of the Social Security Act ( 42 U.S.C. 1397ee(d) ) is amended by adding at the end the following new paragraph: During the period that begins on the date of enactment of this paragraph and ends on the date that is 5 years after such date of enactment, as a condition of receiving payments under subsection

(a)and section 1903(a), a State that elects to provide assistance to women on the basis of being pregnant (including pregnancy-related assistance provided to targeted low-income pregnant women (as defined in section 2112(d)), pregnancy-related assistance provided to women who are eligible for such assistance through application of section 1902(v)(4)(A)(i) under section 2107(e)(1), or any other assistance under the State child health plan (or a waiver of such plan) which is provided to women on the basis of being pregnant) shall not have in effect, with respect to such women, eligibility standards, methodologies, or procedures under such plan (or waiver) that are more restrictive than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) that are in effect on the date of enactment of this paragraph. . The Secretary of Health and Human Services shall make publicly available on the internet website of the Department of Health and Human Services, information regarding benefits available to pregnant and postpartum women and under the Medicaid program and the Children's Health Insurance Program, including information on— benefits that States are required to provide to pregnant and postpartum women under such programs; optional benefits that States may provide to pregnant and postpartum women under such programs; and the availability of different kinds of benefits for pregnant and postpartum women, including oral health and mental health benefits and breastfeeding services and supplies, under such programs. Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ), as amended by title IV and subparagraph (A)(i)(II), is further amended— in subsection (b), by striking and

(mm)and inserting (mm), and

(oo); and by adding at the end the following: Notwithstanding subsection (b), the Federal medical assistance percentage for a State, with respect to amounts expended by such State for medical assistance for an individual who is eligible for such assistance on the basis of being pregnant or having been pregnant that is provided during the 305-day period that begins on the 60th day after the last day of the individual's pregnancy (including any such assistance provided during the month in which such period ends), shall be equal to— during the first 20-quarter period for which this subsection is in effect with respect to a State, 100 percent; and with respect to a State, during each quarter thereafter, 90 percent. Any payment made to a territory for expenditures for medical assistance for an individual described in paragraph

(1)that is subject to the Federal medical assistance percentage specified under paragraph

(1)shall not be taken into account for purposes of applying payment limits under subsections

(f)and

(g)of section 1108. . Section 2105(c) of the Social Security Act ( 42 U.S.C. 1397ee(c) ) is amended by adding at the end the following new paragraph: Notwithstanding subsection (b), the enhanced FMAP, with respect to payments under subsection

(a)for expenditures under the State child health plan (or a waiver of such plan) for assistance provided under the plan (or waiver) to a woman who is eligible for such assistance on the basis of being pregnant (including pregnancy-related assistance provided to a targeted low-income pregnant woman (as defined in section 2112(d)), pregnancy-related assistance provided to a woman who is eligible for such assistance through application of section 1902(v)(4)(A)(i) under section 2107(e)(1), or any other assistance under the plan (or waiver) provided to a woman who is eligible for such assistance on the basis of being pregnant) during the 305-day period that begins on the 60th day after the last day of her pregnancy (including any such assistance provided during the month in which such period ends), shall be equal to— during the first 20-quarter period for which this subsection is in effect with respect to a State, 100 percent; and with respect to a State, during each quarter thereafter, 90 percent. . Not later than 1 year after the date of the enactment of this section, the Secretary of Health and Human Services shall issue guidance for the States concerning options for Medicaid coverage and payment for support services provided by doulas. Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ), as amended by title IV and subparagraphs

(A)and (E), is further amended— in subsection (b), by striking and

(oo)and inserting (oo), and

(pp); and by adding at the end the following new subsection: Notwithstanding subsection (b), the Federal medical assistance percentage for a State, with respect to amounts expended by such State for medical assistance for obstetric or gynecological services that are furnished in a hospital that is located in a rural area (as defined for purposes of section 1886) shall be equal to 90 percent for each calendar quarter beginning with the first calendar quarter during which this subsection is in effect. Any payment made to a territory for expenditures for medical assistance described in paragraph

(1)that is subject to the Federal medical assistance percentage specified under paragraph

(1)shall not be taken into account for purposes of applying payment limits under subsections

(f)and

(g)of section 1108. . Subject to clauses

(ii)and (iii)— the amendments made by subparagraphs (A), (B), and

(E)shall take effect on the first day of the first calendar quarter that begins on or after the date that is 1 year after the date of enactment of this section; the amendments made by subparagraph

(C)shall take effect on the date of enactment of this section; and the amendments made by subparagraph

(G)shall take effect on the first day of the first calendar quarter that begins on or after the date of enactment of this section. In the case of a State plan under title XIX of the Social Security Act or a State child health plan under title XXI of such Act that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this paragraph, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this section. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature. A State may elect to have subsection (e)(16) of section 1902 of the Social Security Act ( 42 U.S.C. 1396a ) and subparagraph

(J)of section 2107(e)(1) of the Social Security Act ( 42 U.S.C. 1397gg(e)(1) ), as amended by subparagraph (B), and subsection

(oo)of section 1905 of the Social Security Act ( 42 U.S.C. 1396d ) and paragraph

(13)of section 2105(c) of the Social Security Act ( 42 U.S.C. 1397ee(c) ), as added by subparagraph (E), take effect with respect to the State on the first day of any fiscal quarter that begins before the date described in clause

(i)and apply to amounts payable to the State for expenditures for medical assistance, child health assistance, or pregnancy-related assistance to pregnant or postpartum individuals furnished on or after such day. Part P of title III of the Public Health Service Act ( 42 U.S.C. 280g et seq. ) (as amended by section 5101) is amended by adding at the end the following: Not later than one year after the date of enactment of this section, the Secretary, in consultation with such other agency heads as the Secretary determines appropriate, shall award cooperative agreements for the establishment or support of regional centers of excellence addressing implicit bias, cultural competency, and respectful care practices in patient-provider interactions education for the purpose of enhancing and improving how health care professionals are educated in implicit bias and delivering culturally competent health care. To be eligible to receive a cooperative agreement under subsection (a), an entity shall— be a public or other nonprofit entity specified by the Secretary that provides educational and training opportunities for students and health care professionals, which may be a health system, teaching hospital, community health center, medical school, school of public health, school of nursing, dental school, social work school, school of professional psychology, or any other health professional school or program at an institution of higher education (as defined in section 101 of the Higher Education Act of 1965) focused on the prevention, treatment, or recovery of health conditions that contribute to maternal mortality and the prevention of maternal mortality and severe maternal morbidity; demonstrate community engagement and participation, such as through partnerships with home visiting and case management programs and community-based organizations serving minority populations; demonstrate engagement with groups engaged in the implementation of health care professional training in implicit bias and delivering culturally competent care, such as departments of public health, perinatal quality collaboratives, hospital systems, and health care professional groups, in order to obtain input on resources needed for effective implementation strategies; and provide to the Secretary such information, at such time and in such manner, as the Secretary may require. In awarding a cooperative agreement under subsection (a), the Secretary shall take into account any regional differences among eligible entities and make an effort to ensure geographic diversity among award recipients. The Secretary shall make publicly available on the internet website of the Department of Health and Human Services information submitted to the Secretary under subsection (b)(4). The Secretary shall evaluate each regional center of excellence established or supported pursuant to subsection

(a)and disseminate the findings resulting from each such evaluation to the appropriate public and private entities. The Secretary shall share evaluations and overall findings with State departments of health and other relevant State level offices to inform State and local best practices. In this section, the term maternal mortality means death of a woman that occurs during pregnancy or within the one-year period following the end of such pregnancy. For purposes of carrying out this section, there is authorized to be appropriated $5,000,000 for each of fiscal years 2025 through 2029. . Section 17(d)(3)(A)(ii) of the Child Nutrition Act of 1966 ( 42 U.S.C. 1786(d)(3)(A)(ii) ) is amended— by striking the clause designation and heading and all that follows through A State and inserting the following: A State ; in subclause

(I)(as so designated), by striking 1 year and all that follows through earlier and inserting 2 years postpartum ; and by adding at the end the following: A State may elect to certify a postpartum woman for a period of 2 years. . The Secretary of Health and Human Services shall establish and implement a program to award grants or contracts to health professions schools, schools of public health, academic health centers, State or local governments, territories, Indian Tribes and Tribal organizations, Urban Indian organizations, Native Hawaiian organizations, or other appropriate public or private nonprofit entities or community-based organizations (or consortia of any such entities, including entities promoting multidisciplinary approaches), to establish or expand programs to grow and diversify the doula workforce, including through improving the capacity and supply of health care providers. Amounts made available by paragraph

(1)shall be used for the following activities: Establishing programs that provide education and training to individuals seeking appropriate training or certification as full spectrum doulas. Expanding the capacity of existing programs described in subparagraph (A), for the purpose of increasing the number of students enrolled in such programs, including by awarding scholarships for students who agree to work in underserved communities after receiving such education and training. Developing and implementing strategies to recruit and retain students from underserved communities, particularly from demographic groups experiencing high rates of maternal mortality and severe maternal morbidity, including racial and ethnic minority groups, into programs described in subparagraphs

(A)and (B). In addition to amounts otherwise available, there is appropriated to the Secretary of Health and Human Services for fiscal year 2025, out of any money in the Treasury not otherwise appropriated, $50,000,000, to remain available until expended, for carrying out this subsection. 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: The Secretary, acting through the Administrator of the Health Resources and Services Administration (referred to in this section as the Secretary ), shall establish a pilot program under which the Secretary shall make grants to States— to purchase and equip rural mobile health units for the purpose of providing pre-conception, pregnancy, postpartum, and obstetric emergency services in rural and underserved communities; to train providers including obstetrician-gynecologists, certified nurse-midwives, nurse practitioners, nurses, and midwives to operate and provide obstetric services, including training and planning for obstetric emergencies, in such mobile health units; and to address access issues, including social determinants of health and wrap-around clinical and community services including nutrition, housing, lactation services, and transportation support and referrals. As a condition of receiving a grant under this section, a State shall submit to the Secretary an assurance that the State will not make available to Federal or State law enforcement any personally identifiable information regarding any pregnant or postpartum individual collected pursuant to such grant. The period of a grant under this section shall not exceed 5 years. States that receive pilot grants under this section shall— implement the program funded by the pilot grants; and not later than 3 years after the date of enactment of this section, and not later than 6 years after such date of enactment, submit to the Secretary a report that describes the results of such program, including— relevant information and relevant quantitative indicators of the programs’ success in improving the standard of care and maternal health outcomes for individuals in rural and underserved communities seen for pre-conception, pregnancy, or postpartum visits in the rural mobile health units, stratified by the categories of data specified in paragraph (2); relevant qualitative evaluations from individuals receiving pre-conception, pregnant, or postpartum care from rural mobile health units, including measures of patient-reported experience of care and measures of patient-reported issues with access to care without the rural mobile health unit pilot; and strategies to sustain such programs beyond the duration of the grant and expand such programs to other rural and underserved communities. The categories of data specified in this paragraph are the following: Race, ethnicity, sex, gender, gender identity, primary language, age, geography, insurance status, disability status. Number of visits provided for preconception, prenatal, or postpartum care. Number of repeat visits provided for preconception, prenatal, or postpartum care. Number of screenings or tests provided for smoking, substance use, hypertension, sexually-transmitted diseases, diabetes, HIV, depression, intimate partner violence, pap smears, and pregnancy. The reports referred to in paragraph (1)(B) shall not contain any personally identifiable information regarding any pregnant or postpartum individual. The Secretary shall conduct an evaluation of the pilot program under this section to determine the impact of the pilot program with respect to— the effectiveness of the grants awarded under this section to improve maternal health outcomes in rural and underserved communities, with data stratified by race, ethnicity, primary language, socioeconomic status, geography, insurance type, and other factors as the Secretary determines appropriate; spending on maternity care by States participating in the pilot program; to the extent practicable, qualitative and quantitative measures of patient experience; and any other areas of assessment that the Secretary determines relevant. Not later than one year after the completion of the pilot program under this section, the Secretary shall submit to Congress, and make publicly available, a report that describes— the results of the evaluation conducted under subsection (e); and a recommendation regarding whether the pilot program should be continued after fiscal year 2029 and expanded on a national basis. There is authorized to be appropriated to the Secretary to carry out this section $10,000,000 for each of fiscal years 2025 through 2029. . Section 1866(a)(1) of the Social Security Act ( 42 U.S.C. 1395cc(a)(1) ) is amended— in subparagraph (X), by striking and at the end; in subparagraph (Y)(ii)(V), by striking the period and inserting , and ; and by inserting after subparagraph

(Y)the following new subparagraph: beginning 180 days after the date of the enactment of this subparagraph, in the case of a hospital, not less than 90 days prior to the closure of any obstetric unit of the hospital, to submit to the Secretary a notification which shall include— a report analyzing the impact the closure will have on the community; steps the hospital will take to identify other health care providers that can alleviate any service gaps as a result of the closure; and any additional information as may be required by the Secretary. . Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall conduct, and submit to Congress a report that describes the results of, an evaluation of— where the maternal health needs are greatest in the United States; and the Federal expenditures made to address such needs. The evaluation under paragraph

(1)shall cover the period of calendar years 2000 through 2023. The evaluation under paragraph

(1)shall include analysis of the following: How Federal funds provided to States for maternal health were distributed across regions, States, and localities or counties. Barriers to applying for and receiving Federal funds for maternal health, including, with respect to initial applications— requirements for submission in partnership with other entities; and stringent network requirements. Why applicants did not receive funding, including limited availability of funds, the strength of the respective applications, and failure to adhere to requirements. The report under paragraph

(1)shall disaggregate data on mothers served by race, ethnicity, insurance status, and language spoken. Section 5701(g) of the Internal Revenue Code of 1986 is amended by striking $24.78 and inserting $49.56 . Section 5701(f) of the Internal Revenue Code of 1986 is amended by striking $2.8311 cents and inserting $49.56 . Section 5701(e) of the Internal Revenue Code of 1986 is amended— in paragraph (1), by striking $1.51 and inserting $26.84 ; in paragraph (2), by striking 50.33 cents and inserting $10.74 ; and by adding at the end the following: On discrete single-use units, $100.66 per thousand. . Section 5702(m) of such Code is amended— in paragraph (1), by striking or chewing tobacco and inserting , chewing tobacco, or discrete single-use unit ; in paragraphs

(2)and (3), by inserting that is not a discrete single-use unit before the period in each such paragraph; and by adding at the end the following: The term discrete single-use unit means any product containing, made from, or derived from tobacco or nicotine that— is not intended to be smoked; and is in the form of a lozenge, tablet, pill, pouch, dissolvable strip, or other discrete single-use or single-dose unit. . Paragraph

(1)of section 5701(a) of the Internal Revenue Code of 1986 is amended by striking $50.33 and inserting $100.66 . Paragraph

(2)of section 5701(a) of the Internal Revenue Code of 1986 is amended by striking 52.75 percent and all that follows through the period and inserting the following: $49.56 per pound and a proportionate tax at the like rate on all fractional parts of a pound but not less than 10.066 cents per cigar. . The Secretary of the Treasury, or the Secretary's delegate, may issue guidance regarding the appropriate method for determining the weight of large cigars for purposes of calculating the applicable tax under section 5701(a)(2) of the Internal Revenue Code of 1986. Section 5702 of such Code is amended by striking subsection (l). Subsection

(o)of section 5702 of the Internal Revenue Code of 1986 is amended by inserting , and includes processed tobacco that is removed for delivery or delivered to a person other than a person with a permit provided under section 5713, but does not include removals of processed tobacco for exportation after wrappers thereof . Section 5701 of the Internal Revenue Code of 1986 is amended by adding at the end the following new subsection: Any product not otherwise described under this section that has been determined to be a tobacco product by the Food and Drug Administration through its authorities under the Family Smoking Prevention and Tobacco Control Act shall be taxed at a level of tax equivalent to the tax rate for cigarettes on an estimated per use basis as determined by the Secretary. . For purposes of section 5701(i) of the Internal Revenue Code of 1986, not later than 12 months after the later of the date of the enactment of this Act or the date that a product has been determined to be a tobacco product by the Food and Drug Administration, the Secretary of the Treasury (or the Secretary of the Treasury's delegate) shall issue final regulations establishing the level of tax for such product that is equivalent to the tax rate for cigarettes on an estimated per use basis. Subsection

(c)of section 5702 of the Internal Revenue Code of 1986 is amended to read as follows: The term tobacco products means— cigars, cigarettes, smokeless tobacco, pipe tobacco, and roll-your-own tobacco, and any other product subject to tax pursuant to section 5701(i). . Subsection

(d)of section 5702 of such Code is amended by striking cigars, cigarettes, smokeless tobacco, pipe tobacco, or roll-your-own tobacco each place it appears and inserting tobacco products . Section 5701(b)(1) of such Code is amended by striking $50.33 and inserting $100.66 . Section 5701(b)(2) of such Code is amended by striking $105.69 and inserting $211.38 . Section 5701 of such Code, as amended by paragraph (7), is amended by adding at the end the following new subsection: In the case of any calendar year beginning after 2024, the dollar amounts provided under this chapter shall each be increased by an amount equal to— such dollar amount, multiplied by the cost-of-living adjustment determined under section 1(f)(3) for the calendar year, determined by substituting ‘calendar year 2023’ for ‘calendar year 2016’ in subparagraph (A)(ii) thereof. If any amount as adjusted under paragraph

(1)is not a multiple of $0.01, such amount shall be rounded to the next highest multiple of $0.01. . On tobacco products manufactured in or imported into the United States which are removed before any tax increase date and held on such date for sale by any person, there is hereby imposed a tax in an amount equal to the excess of— the tax which would be imposed under section 5701 of the Internal Revenue Code of 1986 on the article if the article had been removed on such date, over the prior tax (if any) imposed under section 5701 of such Code on such article. Each person shall be allowed as a credit against the taxes imposed by subparagraph

(A)an amount equal to the lesser of $1,000 or the amount of such taxes. For purposes of the preceding sentence, all persons treated as a single employer under subsection (b), (c), (m), or

(o)of section 414 of the Internal Revenue Code of 1986 shall be treated as 1 person for purposes of this subparagraph. A person holding tobacco products on any tax increase date to which any tax imposed by subparagraph

(A)applies shall be liable for such tax. The tax imposed by subparagraph

(A)shall be paid in such manner as the Secretary shall prescribe by regulations. The tax imposed by subparagraph

(A)shall be paid on or before the date that is 120 days after the effective date of the tax rate increase. Notwithstanding the Act of June 18, 1934 (commonly known as the Foreign Trade Zone Act, 48 Stat. 998, 19 U.S.C. 81a et seq. ), or any other provision of law, any article which is located in a foreign trade zone on any tax increase date shall be subject to the tax imposed by subparagraph

(A)if— internal revenue taxes have been determined, or customs duties liquidated, with respect to such article before such date pursuant to a request made under the first proviso of section 3(a) of such Act, or such article is held on such date under the supervision of an officer of the United States Customs and Border Protection of the Department of Homeland Security pursuant to the second proviso of such section 3(a). For purposes of this paragraph— Any term used in this paragraph which is also used in section 5702 of such Code shall have the same meaning as such term has in such section. The term tax increase date means the effective date of any increase in any tobacco product excise tax rate pursuant to the amendments made by this subsection (other than paragraph

(10)thereof). The term Secretary means the Secretary of the Treasury or the Secretary’s delegate. Rules similar to the rules of section 5061(e)(3) of such Code shall apply for purposes of this paragraph. All provisions of law, including penalties, applicable with respect to the taxes imposed by section 5701 of such Code shall, insofar as applicable and not inconsistent with the provisions of this paragraph, apply to the floor stocks taxes imposed by subparagraph (A), to the same extent as if such taxes were imposed by such section 5701. The Secretary may treat any person who bore the ultimate burden of the tax imposed by subparagraph

(A)as the person to whom a credit or refund under such provisions may be allowed or made. Except as provided in subparagraphs

(B)and (C), the amendments made by this subsection shall apply to articles removed (as defined in section 5702(j) of the Internal Revenue Code of 1986) after the last day of the month which includes the date of the enactment of this Act. The amendments made by paragraphs (3)(A)(iii), (3)(B), (5), and

(6)shall apply to articles removed (as defined in section 5702(j) of the Internal Revenue Code of 1986) after the date that is 6 months after the date of the enactment of this Act. The amendments made by paragraph (7)(A) shall apply to products removed after the last day of the month which includes the date that the Secretary of the Treasury (or the Secretary of the Treasury's delegate) issues final regulations establishing the level of tax for such product.

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