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25 U.S.C. § 1645 — Purchasing health care coverage

Federal law — U.S. Code and appendices · legal_authorities

25 U.S.C. § 1645 — Purchasing health care coverage

**(a) In general** Insofar as amounts are made available under law (including a provision of the Social Security Act [[42 U.S.C. 301](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section301&num=0&edition=prelim) et seq.], the Indian Self-Determination and Education Assistance Act ([25 U.S.C. 450](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section450&num=0&edition=prelim) et seq.),11 See References in Text note below. or other law, other than under [section 1644 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section1644&num=0&edition=prelim)) to Indian tribes, tribal organizations, and urban Indian organizations for health benefits for Service beneficiaries, Indian tribes, tribal organizations, and urban Indian organizations may use such amounts to purchase health benefits coverage (including coverage for a service, or service within a contract health service delivery area, or any portion of a contract health service delivery area that would otherwise be provided as a contract health service) for such beneficiaries in any manner, including through— (1) a tribally owned and operated health care plan; (2) a State or locally authorized or licensed health care plan; (3) a health insurance provider or managed care organization; (4) a self-insured plan; or (5) a high deductible or health savings account plan. **(b) Financial need** The purchase of coverage under subsection (a) by an Indian tribe, tribal organization, or urban Indian organization may be based on the financial needs of such beneficiaries (as determined by the 1 or more Indian tribes being served based on a schedule of income levels developed or implemented by such 1 ore 22 So in original. Probably should be “or”. more In

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Source location: Title 25, Chapter 18, § 1645; chapter-018-indian-health-care.md

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Federal law — U.S. Code and appendices · legal_authorities

25 U.S.C. § 1644 — Treatment of payments under Social Security Act health benefits programs

**(a) Disregard of Medicare, Medicaid, and CHIP payments in determining appropriations** Any payments received by an Indian health program or by an urban Indian organization under title XVIII, XIX, or XXI of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq., 1396 et seq., 1397aa et seq.] for services provided to Indians eligible for benefits under such respective titles shall not be considered in determining appropriations for the provision of health care and services to Indians. **(b) Nonpreferential treatment** Nothing in this chapter authorizes the Secretary to provide services to an Indian with coverage under title XVIII, XIX, or XI 11 So in original. Probably should be “XXI”. of the Social Security Act in preference to an Indian without such coverage. **(c) Use of funds** (1) **Special fund** (A) *100 percent pass-through of payments due to facilities* — Notwithstanding any other provision of law, but subject to paragraph (2), payments to which a facility of the Service is entitled by reason of a provision of title XVIII or XIX of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq., 1396 et seq.] shall be placed in a special fund to be held by the Secretary. In making payments from such fund, the Secretary shall ensure that each Service unit of the Service receives 100 percent of the amount to which the facilities of the Service, for which such Service unit makes collections, are entitled by reason of a provision of either such title. (B) *Use of funds* — Amounts received by a facility of the Service under subparagraph (A) by reason of a provision of title

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25 U.S.C. § 5301 — Application of other sections of this chapter

**(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.

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25 U.S.C. § 450 — Transferred

### Statutory Notes #### Codification Section 458aaa–18 was editorially reclassified as [section 5399 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section5399&num=0&edition=prelim).

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42 U.S.C. § 1396j — Indian Health Service facilities

**(a) Eligibility for reimbursement for medical assistance** A facility of the Indian Health Service (including a hospital, nursing facility, or any other type of facility which provides services of a type otherwise covered under the State plan), whether operated by such Service or by an Indian tribe or tribal organization (as those terms are defined in [section 1603 of title 25](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section1603&num=0&edition=prelim)), shall be eligible for reimbursement for medical assistance provided under a State plan if and for so long as it meets all of the conditions and requirements which are applicable generally to such facilities under this subchapter. **(b) Facilities deemed to meet requirements upon submission of acceptable plan for achieving compliance** Notwithstanding subsection (a), a facility of the Indian Health Service (including a hospital, nursing facility, or any other type of facility which provides services of a type otherwise covered under the State plan) which does not meet all of the conditions and requirements of this subchapter which are applicable generally to such facility, but which submits to the Secretary within six months after September 30, 1976, an acceptable plan for achieving compliance with such conditions and requirements, shall be deemed to meet such conditions and requirements (and to be eligible for reimbursement under this subchapter), without regard to the extent of its actual compliance with such conditions and requirements, during the first twelve months after the month in which such plan is submitted. **(c) Agreement to reimburse State agency for providing care and services** The Secretary is authorized to enter into agreements with the State agency for the purpose of reimb

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42 U.S.C. § 1396d — Definitions

For purposes of this subchapter— **(a) Medical assistance** The term “medical assistance” means payment of part or all of the cost of the following care and services or the care and services themselves, or both (if provided in or after the third month before the month in which the recipient makes application for assistance or, in the case of medicare cost-sharing with respect to a qualified medicare beneficiary described in subsection (p)(1), if provided after the month in which the individual becomes such a beneficiary) for individuals, and, with respect to physicians’ or dentists’ services, at the option of the State, to individuals (other than individuals with respect to whom there is being paid, or who are eligible, or would be eligible if they were not in a medical institution, to have paid with respect to them a State supplementary payment and are eligible for medical assistance equal in amount, duration, and scope to the medical assistance made available to individuals described in [section 1396a(a)(10)(A) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396a/a/10/A&num=0&edition=prelim)) not receiving aid or assistance under any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV, and with respect to whom supplemental security income benefits are not being paid under subchapter XVI, who are— (i) under the age of 21, or, at the option of the State, under the age of 20, 19, or 18 as the State may choose, (ii) relatives specified in section 606(b)(1) 11 See References in Text note below. of this title with whom a child is living if such child is (or would, if needy, be) a dependent child under part A of subchapter IV, (iii) 65 years of age or older, (iv) blind, with respect to Sta

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42 U.S.C. § 1305 — Short title of chapter

This chapter may be cited as the “Social Security Act”.

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42 U.S.C. § 301 — Authorization of appropriations

For the purpose of enabling each State, as far as practicable under the conditions in such State, to furnish financial assistance to aged needy individuals, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purposes of this subchapter. The sums made available under this section shall be used for making payments to States which have submitted, and had approved by the Secretary of Health and Human Services (hereinafter referred to as the “Secretary”), State plans for old-age assistance.

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25 U.S.C. § 1611 — Congressional findings

The Congress finds the following: (1) Federal health services to maintain and improve the health of the Indians are consonant with and required by the Federal Government’s historical and unique legal relationship with, and resulting responsibility to, the American Indian people. (2) A major national goal of the United States is to provide the resources, processes, and structure that will enable Indian tribes and tribal members to obtain the quantity and quality of health care services and opportunities that will eradicate the health disparities between Indians and the general population of the United States. (3) A major national goal of the United States is to provide the quantity and quality of health services which will permit the health status of Indians to be raised to the highest possible level and to encourage the maximum participation of Indians in the planning and management of those services. (4) Federal health services to Indians have resulted in a reduction in the prevalence and incidence of preventable illnesses among, and unnecessary and premature deaths of, Indians. (5) Despite such services, the unmet health needs of the American Indian people are severe and the health status of the Indians is far below that of the general population of the United States.

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38 U.S.C. § 1703 — Veterans Community Care Program

**(a) In General.—** (1) There is established a program to furnish hospital care, medical services, and extended care services to covered veterans through health care providers specified in subsection (c). (2) The Secretary shall coordinate the furnishing of hospital care, medical services, and extended care services under this section to covered veterans, including coordination of, at a minimum, the following: (A) Ensuring the scheduling of medical appointments in a timely manner and the establishment of a mechanism to receive medical records from non-Department providers. (B) Ensuring continuity of care and services. (C) Ensuring coordination among regional networks if the covered veteran accesses care and services in a different network than the regional network in which the covered veteran resides. (D) Ensuring that covered veterans do not experience a lapse in care resulting from errors or delays by the Department or its contractors or an unusual or excessive burden in accessing hospital care, medical services, or extended care services. (3) A covered veteran may only receive care or services under this section upon the authorization of such care or services by the Secretary. (4) Nothing in this section shall be construed to authorize the Secretary to suspend the program established under paragraph (1). **(b) Covered Veterans.—** For purposes of this section, a covered veteran is any veteran who— (1) is enrolled in the system of annual patient enrollment established and operated under [section 1705 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section1705&num=0&edition=prelim); or (2) is not enrolled in such system but is otherwise entitled to hospital care, medical services, or extended care services under s

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42 U.S.C. § 1395aaa–1 — Indian Health Service facilities

**(a) Eligibility for payments; conditions and requirements** A hospital or skilled nursing facility of the Indian Health Service, whether operated by such Service or by an Indian tribe or tribal organization (as those terms are defined in [section 1603 of title 25](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section1603&num=0&edition=prelim)), shall be eligible for payments under this subchapter, notwithstanding sections 1395f(c) and 1395n(d) of this title, if and for so long as it meets all of the conditions and requirements for such payments which are applicable generally to hospitals or skilled nursing facilities (as the case may be) under this subchapter. **(b) Eligibility based on submission of plan to achieve compliance with conditions and requirements; twelve-month period** Notwithstanding subsection (a), a hospital or skilled nursing facility of the Indian Health Service which does not meet all of the conditions and requirements of this subchapter which are applicable generally to hospitals or skilled nursing facilities (as the case may be), but which submits to the Secretary within six months after September 30, 1976, an acceptable plan for achieving compliance with such conditions and requirements, shall be deemed to meet such conditions and requirements (and to be eligible for payments under this subchapter), without regard to the extent of its actual compliance with such conditions and requirements, during the first 12 months after the month in which such plan is submitted. **(c) Payments into special fund for improvements to achieve compliance with conditions and requirements; certification of compliance by Secretary** Notwithstanding any other provision of this subchapter, payments to which any hospital or skilled nursing facili

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