April 30, 2026
Ms. Murkowski (for herself, Mr. Coons, Ms. Collins, Ms. Klobuchar, Mr. Padilla, Mrs. Capito, Mr. Curtis, Mrs. Gillibrand, Ms. Hassan, Mr. Banks, Mr. Markey, and Mr. Daines) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions
July 16, 2026
Reported by Mr. Cassidy, with an amendment
Strike out all after the enacting clause and insert the part printed in italic
To amend the Accelerating Access to Critical Therapies for ALS Act to reauthorize the provisions of such Act through fiscal year 2031, 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 Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026
.
Sec. 2. Reauthorization of Accelerating Access to Critical Therapies for ALS Act
(a) In general
Section 7 of the Accelerating Access to Critical Therapies for ALS Act (Public Law 117–79) is amended by striking 2026
and inserting 2031
.
(b) Grants for ALS research
Section 2(f) of the Accelerating Access to Critical Therapies for ALS Act (21 U.S.C. 360ee note) is amended by striking 2026
and inserting 2031
.
Sec. 3. Improvements to program for grants for research on therapies for ALS
(a) Clinical trial status review
Section 2(b) of the Accelerating Access to Critical Therapies for ALS Act (21 U.S.C. 360ee note) is amended by adding at the end the following:
(4) Clinical trial status review
(A) In general
In reviewing applications for renewals of a grant awarded under this section with respect to an investigational drug, the Secretary shall assess the status of a clinical trial carried out for such drug with respect to data on enrollment of patients in such clinical trial.
(B) Interim clinical trial data
To enable the Secretary to make the assessment under subparagraph (A) with respect to an investigational drug, the Secretary shall request that the manufacturer of the investigational drug share interim clinical trial data with respect to such drug with the Secretary.
(b) Clarifying participating clinical trial definition
Section 2(e) of the Accelerating Access to Critical Therapies for ALS Act (21 U.S.C. 360ee note) is amended by adding at the end the following:
(4)
The term phase 3, with respect to a clinical trial, includes a phase 2/3 combined trial and a planned phase 3 clinical trial that is not yet enrolling participants.
Sec. 4. Report on ALS and other rare neurodegenerative disease action plans
Section 4 of the Accelerating Access to Critical Therapies for ALS Act (21 U.S.C. 360aa note) is amended by adding at the end the following:
(c) Report on ALS and other rare neurodegenerative disease action plans
Not later than one year after the date of enactment of the Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026, the Commissioner of Food and Drugs shall publish on the website of the Food and Drug Administration a report that contains—
(1)
an updated action plan, including—
(A)
a description of the actions the Food and Drug Administration intends to take during the 5-year period following publication of the plan with respect to the program enhancements, policy development, regulatory science initiatives, and other appropriate initiatives described in subsection (a);
(B)
a description of the resources necessary to implement each section of the plan within such 5-year period; and
(C)
specific approaches the Commissioner will take to improve coordination of implementation of the plan with rare neurodegenerative disease communities that are not specifically ALS communities; and
(2)
with respect to the Action Plan for Rare Neurodegenerative Diseases including Amyotrophic Lateral Sclerosis (ALS) published by the Food and Drug Administration on June 23, 2022 (referred to in this section as the
2022 Action Plan), a description of—(A)
the actions taken by the Food and Drug Administration under the 2022 Action Plan;
(B)
the effect of the implementation of the 2022 Action Plan on the development of therapies and regulatory consideration of therapies for ALS and other rare neurodegenerative diseases;
(C)
any programs and initiatives that established or carried out as part of the implementation of the 2022 Action Plan; and
(D)
the extent to which the 2022 Action Plan was implemented with respect to rare neurodegenerative diseases that are not amyotrophic lateral sclerosis.
Sec. 5. GAO report
Section 6 of the Accelerating Access to Critical Therapies for ALS Act (Public Law 117–79) is amended, in the matter preceding paragraph (1)—
(1)
by striking 4 years after the date of the enactment of this Act
and inserting 5 years after the date of enactment of the Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026
; and
(2)
by inserting , with respect to the 10-year period starting on the date of enactment of this Act
after containing
.
Section 1. Short title
This Act may be cited as the Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026
.
Sec. 2. Reauthorization of Accelerating Access to Critical Therapies for ALS Act
(a) In general
Section 7 of the Accelerating Access to Critical Therapies for ALS Act (Public Law 117–79) is amended by striking 2022 through 2026
and inserting 2027 through 2031
.
(b) Grants for ALS research
Section 2(f) of the Accelerating Access to Critical Therapies for ALS Act (21 U.S.C. 360ee note) is amended by striking 2026
and inserting 2031
.
Sec. 3. Improvements to program for grants for research on therapies for ALS
Section 2 of the Accelerating Access to Critical Therapies for ALS Act (21 U.S.C. 360ee note) is amended—
(1)
in subsection (a), by inserting (referred to in this section as
before the period at the end of the first sentence;expanded access grants
)
(2)
in subsection (b)—
(A)
by striking (b) Application—
and all that follows through A participating
in paragraph (1) and inserting the following:
(b) Application
A participating;
(B)
by redesignating paragraphs (2) and (3) as paragraphs (1) and (2) respectively;
(C)
in the matter preceding paragraph (1), as so redesignated, by striking the period at the end and inserting including—
;
(D)
by amending paragraph (1), as so redesignated, to read as follows:
(1)
a description of how data generated through the proposed expanded access grant will be used to support research or development related to the prevention, diagnosis, mitigation, treatment, or cure of amyotrophic lateral sclerosis;;
(E)
in paragraph (2), as so redesignated—
(i)
by striking Noninterference with clinical trials—
and all that follows through shall include
;
(ii)
by striking program
and inserting grant
; and
(iii)
by striking the period at the end and inserting ; and
; and
(F)
by adding at the end the following:
(3)
an assurance that such entity will promptly report to the Secretary available safety data from any ongoing clinical trial of the investigational drug as set forth in the terms and conditions of the grant.;
(3)
in subsection (c)—
(A)
by redesignating subparagraphs (A) and (B) of paragraph (2) as clauses (i) and (ii), respectively, and adjusting the margins accordingly;
(B)
by redesignating paragraphs (1) through (3) as subparagraphs (A) through (C), respectively, and adjusting the margins accordingly;
(C)
in subparagraph (C), as so redesignated, by striking the period at the end and inserting ; and
;
(D)
in the matter preceding subparagraph (A), as so redesignated, by striking this section, confirm that—
and inserting the following: “this section—
(1)
confirm that—; and
(E)
by adding at the end the following:
(2)
in the case of a renewal of such a grant, request from the sponsor of the investigational new drug application involved, and assess, the enrollment, safety, and any available efficacy data of the drug related to the prevention, diagnosis, mitigation, treatment, or cure of amyotrophic lateral sclerosis.;
(4)
in subsection (d)(1), by striking request described in subsection (a)
and inserting grant
; and
(5)
in subsection (e)—
(A)
in paragraph (2), by inserting , and that begins enrollment within a timeframe as determined by the Secretary through the terms and conditions of the grant
before the period at the end; and
(B)
by adding at the end the following:
(4)
The term phase 3 clinical trial includes a phase 2/3 combined trial and a planned phase 3 clinical trial that is not yet enrolling participants.
Sec. 4. Report on ALS and other rare neurodegenerative disease action plans
Section 4 of the Accelerating Access to Critical Therapies for ALS Act (21 U.S.C. 360aa note) is amended—
(1)
in the section heading, by striking ALS and other
and inserting FDA
;
(2)
in subsection (a), in the matter preceding paragraph (1)—
(A)
by inserting and not later than 1 year after the date of enactment of the Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026 and every 5 years thereafter,
after this Act,
; and
(B)
by inserting develop, or update, as applicable, and
before publish on
;
(3)
in subsection (b)—
(A)
in the matter preceding paragraph (1), by striking initial
;
(B)
in paragraph (2)—
(i)
in subparagraph (A), by inserting of relevant investigational new drug applications
after sponsors
;
(ii)
in subparagraph (C) by inserting for the prevention, diagnosis, mitigation, treatment, or cure of rare neurodegenerative diseases
before the semicolon; and
(iii)
in subparagraph (D), by striking ; and
and inserting a semicolon;
(C)
in paragraph (3), by striking the period at the end and inserting ; and
; and
(D)
by adding at the end the following:
(4)
for each action plan published after the date of enactment of the Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026, include a description of—
(A)
previous actions taken by the Food and Drug Administration to implement the previous action plan published under subsection (a);
(B)
any other planned actions to implement such action plan; and
(C)
any barriers to implementing such action plan and related recommendations, which may include an estimate of resources necessary to address such barriers.
Sec. 5. Reports
Section 6 of the Accelerating Access to Critical Therapies for ALS Act (Public Law 117–79) is amended—
(1)
in the heading, by striking GAO Report
and inserting Reports
;
(2)
by striking Not later than
and inserting the following:
(a) GAO report
Not later than;
(3)
in the matter preceding paragraph (1) of subsection (a), as so designated, by striking this Act
and inserting the Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026
; and
(4)
by adding at the end the following:
(b) HHS report
Not later than 4 years after the date of enactment of the Accelerating Access to Critical Therapies for ALS Reauthorization Act of 2026, the Secretary of Health and Human Services shall, in a manner that does not duplicate the information described in the action plan published pursuant to section 4, 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 report assessing the effectiveness of the activities carried out under sections 2, 3, and 5 and making recommendations to improve such activities.
Sec. 6. Technical amendments
Section 3 of the Accelerating Access to Critical Therapies for ALS Act (42 U.S.C. 280g–7b) is amended—
(1)
in subsection (a), in the matter preceding paragraph (1), by striking amytrophic
and inserting amyotrophic
; and
(2)
in subsection (b)(3)(A)(iii), by striking rational
.