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25 U.S.C. § 1621u — Contract health services payment study
Federal law — U.S. Code and appendices · legal_authorities
**(a) Duty of Secretary** The Secretary, acting through the Service and in consultation with representatives of Indian tribes and tribal organizations operating contract health care programs under the Indian Self-Determination Act ([25 U.S.C. 450f](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section450f&num=0&edition=prelim) et seq.) 11 See References in Text note below. or under self-governance compacts, Service personnel, private contract health services providers, the Indian Health Service Fiscal Intermediary, and other appropriate experts, shall conduct a study—
(1) to assess and identify administrative barriers that hinder the timely payment for services delivered by private contract health services providers to individual Indians by the Service and the Indian Health Service Fiscal Intermediary;
(2) to assess and identify the impact of such delayed payments upon the personal credit histories of individual Indians who have been treated by such providers; and
(3) to determine the most efficient and effective means of improving the Service’s contract health services payment system and ensuring the development of appropriate consumer protection policies to protect individual Indians who receive authorized services from private contract health services providers from billing and collection practices, including the development of materials and programs explaining patients’ rights and responsibilities.
**(b) Functions of study** The study required by subsection (a) shall—
(1) assess the impact of the existing contract health services regulations and policies upon the ability of the Service and the Indian Health Service Fiscal Intermediary to process, on a timely and efficient basis, the payment of bills submitted by private contract health se
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**(a) Duty of Secretary** The Secretary, acting through the Service and in consultation with representatives of Indian tribes and tribal organizations operating contract health care programs under the Indian Self-Determination Act ([25 U.S.C. 450f](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section450f&num=0&edition=prelim) et seq.) 11 See References in Text note below. or under self-governance compacts, Service personnel, private contract health services providers, the Indian Health Service Fiscal Intermediary, and other appropriate experts, shall conduct a study—
(1) to assess and identify administrative barriers that hinder the timely payment for services delivered by private contract health services providers to individual Indians by the Service and the Indian Health Service Fiscal Intermediary;
(2) to assess and identify the impact of such delayed payments upon the personal credit histories of individual Indians who have been treated by such providers; and
(3) to determine the most efficient and effective means of improving the Service’s contract health services payment system and ensuring the development of appropriate consumer protection policies to protect individual Indians who receive authorized services from private contract health services providers from billing and collection practices, including the development of materials and programs explaining patients’ rights and responsibilities.
**(b) Functions of study** The study required by subsection (a) shall—
(1) assess the impact of the existing contract health services regulations and policies upon the ability of the Service and the Indian Health Service Fiscal Intermediary to process, on a timely and efficient basis, the payment of bills submitted by private contract health services providers;
(2) assess the financial and any other burdens imposed upon individual Indians and private contract health services providers by delayed payments;
(3) survey the policies and practices of collection agencies used by contract health services providers to collect payments for services rendered to individual Indians;
(4) identify appropriate changes in Federal policies, administrative procedures, and regulations, to eliminate the problems experienced by private contract health services providers and individual Indians as a result of delayed payments; and
(5) compare the Service’s payment processing requirements with private insurance claims processing requirements to evaluate the systemic differences or similarities employed by the Service and private insurers.
**(c) Report to Congress** Not later than 12 months after October 29, 1992, the Secretary shall transmit to the Congress a report that includes—
(1) a detailed description of the study conducted pursuant to this section; and
(2) a discussion of the findings and conclusions of such study.
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Federal law — U.S. Code and appendices · legal_authorities
### Statutory Notes
#### Codification
Section 450 was editorially reclassified as [section 5301 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section5301&num=0&edition=prelim).
Source: Supplied U.S. Code snapshot — release unconfirmed · 25 U.S.C. § 450f
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Mandatory application** All provisions of sections 5305(b), 5306, 5307, 5321(c) and (d), 5323, 5324(k) and (l), 5325(a) through (k), and 5332 of this title and section 314 of Public Law 101–512 (coverage under chapter 171 of title 28, commonly known as the “Federal Tort Claims Act”), to the extent not in conflict with this subchapter, shall apply to compacts and funding agreements authorized by this subchapter.
**(b) Discretionary application** At the request of a participating Indian tribe, any other provision of subchapter I of this chapter, to the extent such provision is not in conflict with this subchapter, shall be made a part of a funding agreement or compact entered into under this subchapter. The Secretary is obligated to include such provision at the option of the participating Indian tribe or tribes. If such provision is incorporated it shall have the same force and effect as if it were set out in full in this subchapter. In the event an Indian tribe requests such incorporation at the negotiation stage of a compact or funding agreement, such incorporation shall be deemed effective immediately and shall control the negotiation and resulting compact and funding agreement.
Source: Supplied U.S. Code snapshot — release unconfirmed · 25 U.S.C. § 5301
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Federal law — U.S. Code and appendices · legal_authorities
**(a) No patient liability** A patient who receives contract health care services that are authorized by the Service shall not be liable for the payment of any charges or costs associated with the provision of such services.
**(b) Notification** The Secretary shall notify a contract care provider and any patient who receives contract health care services authorized by the Service that such patient is not liable for the payment of any charges or costs associated with the provision of such services not later than 5 business days after receipt of a notification of a claim by a provider of contract care services.
**(c) No recourse** Following receipt of the notice provided under subsection (b), or, if a claim has been deemed accepted under [section 1621s(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section1621s/b&num=0&edition=prelim), the provider shall have no further recourse against the patient who received the services.
Source: Supplied U.S. Code snapshot — release unconfirmed · 25 U.S.C. § 1621x
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Filing of agreements; eligibility for payment; charges with respect to items and services**
(1) Any provider of services (except a fund designated for purposes of section 1395f(g) and [section 1395n(e) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395n/e&num=0&edition=prelim)) shall be qualified to participate under this subchapter and shall be eligible for payments under this subchapter if it files with the Secretary an agreement—
(A)
(i) not to charge, except as provided in paragraph (2), any individual or any other person for items or services for which such individual is entitled to have payment made under this subchapter (or for which he would be so entitled if such provider of services had complied with the procedural and other requirements under or pursuant to this subchapter or for which such provider is paid pursuant to the provisions of [section 1395f(e) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395f/e&num=0&edition=prelim)), and (ii) not to impose any charge that is prohibited under [section 1396a(n)(3) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/n/3&num=0&edition=prelim),
(B) not to charge any individual or any other person for items or services for which such individual is not entitled to have payment made under this subchapter because payment for expenses incurred for such items or services may not be made by reason of the provisions of paragraph (1) or (9) of [section 1395y(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395y/a&num=0&edition=prelim), but only if (i) such individual was without fault in incurring such expenses and (ii) the Secret
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395ii
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Federal law — U.S. Code and appendices · legal_authorities
Page 285
TITLE 25—INDIANS
§ 1621v
1 See References in Text note below.
with either an individual purchase order or a de-
nial of the claim within 5 working days after the
receipt of such notification.
(b) Failure to timely respond
If the Service fails to respond to a notification
of a claim in accordance with subsection (a), the
Service shall accept as valid the claim sub-
mitted by the provider of a contract care serv-
ice.
(c) Time of payment
The Service shall pay a completed contract
care service claim within 30 days after comple-
tion of the claim.
(Pub. L. 94–437, title II, § 220, as added Pub. L.
102–573, title II, § 215, Oct. 29, 1992, 106 Stat. 4558.)
§ 1621t. Licensing
Licensed health professionals employed by a
tribal health program shall be exempt, if li-
censed in any State, from the licensing require-
ments of the State in which the tribal health
program performs the services described in the
contract or compact of the tribal health pro-
gram under the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450 et seq.).1
(Pub. L. 94–437, title II, § 221, as added Pub. L.
102–573, title II, § 215, Oct. 29, 1992, 106 Stat. 4559;
amended Pub. L. 111–148, title X, § 10221(a), Mar.
23, 2010, 124 Stat. 935.)
Editorial Notes
REFERENCES IN TEXT
The Indian Self-Determination and Education Assist-
ance Act (25 U.S.C. 450 et seq.), referred to in text, is
Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2203, which was clas-
sified principally to subchapter II (§ 450 et seq.) of chap-
ter 14 of this title prior to editorial reclassification as
chapter 46 (§ 5301 et seq.) of this title. For complete
classification of this Act to the Code, see Short Title
note set out under section 5301 of this title and Tables.
CODIFICATION
Amendment by P
Source: Supplied 2024 U.S. Code historical extraction · 25 U.S.C. § 1621u
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Federal law — U.S. Code and appendices · legal_authorities
Page 141
TITLE 25—INDIANS
§ 450f
Section was formerly classified to section 93 of Title
45, Railroads.
§ 443c. Transferred
Editorial Notes
CODIFICATION
Section 443c was editorially reclassified as section
1684 of this title.
§ 443d. Transferred
Editorial Notes
CODIFICATION
Section 443d was editorially reclassified as section
1685 of this title.
§§ 444 to 449. Repealed. Aug. 5, 1954, ch. 658, § 5,
68 Stat. 675
Sections, act Apr. 3, 1952, ch. 129, §§ 1–6, 66 Stat. 35, re-
lated to Indian hospital services and facilities. See sec-
tion 2001 et seq. of Title 42, The Public Health and Wel-
fare.
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE OF REPEAL
Repeal effective July 1, 1959, see section 6 of act Aug.
5, 1954, set out as an Effective Date note under section
2001 of Title 42, The Public Health and Welfare.
SUBCHAPTER
II—INDIAN
SELF-DETER-
MINATION AND EDUCATION ASSISTANCE
§ 450. Transferred
Editorial Notes
CODIFICATION
Section 450 was editorially reclassified as section 5301
of this title.
§ 450a. Transferred
Editorial Notes
CODIFICATION
Section 450a was editorially reclassified as section
5302 of this title.
§ 450a–1. Transferred
Editorial Notes
CODIFICATION
Section 450a–1 was editorially reclassified as section
5303 of this title.
§ 450b. Transferred
Editorial Notes
CODIFICATION
Section 450b was editorially reclassified as section
5304 of this title.
§ 450c. Transferred
Editorial Notes
CODIFICATION
Section 450c was editorially reclassified as section
5305 of this title.
§ 450d. Transferred
Editorial Notes
CODIFICATION
Section 450d was editorially reclassified as section
5306 of this title.
§ 450e. Transferred
Editorial Notes
CODIFICATION
Section 450e was editorially reclassified as section
5307 of this title.
§ 4
Source: Supplied 2024 U.S. Code historical extraction · 25 U.S.C. § 450f
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