This bill aims to crack down on the production of counterfeit fentanyl pills by regulating pill press molds, which are devices used to imprint fake markings on pills to make them appear legitimate. The legislation requires the Food and Drug Administration to mandate that all pill press molds bear unique serial numbers and that manufacturers register their molds with the FDA within two years of new regulations being issued. The bill also makes it a federal crime, punishable by up to 20 years in prison, to knowingly possess a pill press mold with the intent to manufacture counterfeit controlled substances like fentanyl. Additionally, the law directs the U.S. Sentencing Commission to increase criminal penalties by at least two offense levels for anyone convicted of this new crime, and requires the FDA and Department of Justice to coordinate in enforcing these regulations. The legislation affects drug manufacturers, law enforcement agencies, and anyone involved in the possession or distribution of these molds.