This bill amends the Federal Water Pollution Control Act to strengthen state review requirements for water quality standards, particularly concerning municipal combined sewer discharges. It requires states to hold public hearings to review standards for bodies of water receiving discharges from municipal combined storm and sanitary sewers , ensuring that combined sewer overflow controls are cost-effective. Furthermore, when reviewing water quality standards, states must consider the cost and commercial availability of treatment technologies necessary for point sources to achieve compliance. The Environmental Protection Agency (EPA) is also directed to factor in the cost and commercial availability of such treatment technologies when developing or revising water quality criteria. These provisions aim to integrate economic feasibility and technological availability into the process of setting and attaining water quality standards.