; and (B) by inserting the 1 nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5)), or the physician assistant (as defined in section 1861(aa)(5)) after physician ; and (2) in subsection (e)— (A) in paragraph (1)(A), by inserting or a nurse practitioner or clinical nurse specialist (as those terms are defined in section 1861(aa)(5)) after physician ; and (B) in paragraph (2)— (i) in the heading, by striking Physician certification and inserting Rule of construction regarding requirement for certification ; and (ii) by striking physician . (e) Application to Medicaid The amendments made under this section shall apply under title XIX of the Social Security Act in the same manner and to the same extent as such requirements apply under title XVIII of such Act or regulations promulgated thereunder. (f) Effective date The Secretary of Health and Human Services shall prescribe regulations to apply the amendments made by this section to items and services furnished, which shall become effective no later than six months after the enactment of this legislation. The Secretary shall promulgate an interim final rule if necessary, to comply with the required effective date. 4408. Adjustment of sequestration (a) Temporary suspension of Medicare sequestration During the period beginning on May 1, 2020 and ending on December 31, 2020, the Medicare programs under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq.) shall be exempt from reduction under any sequestration order issued before, on, or after the date of enactment of this Act. (b) Extension of direct spending reductions through fiscal year 2030 Section 251A(6) of the Balanced Budget and Emergency Deficit Control Act of 1985 ( 2 U.S.C. 901a(6) ) is amended— (1) in subparagraph (B), in the matter preceding clause (i), by striking through 2029 and inserting through 2030