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25 U.S.C. § 1680f — Health services for ineligible persons
Federal law — U.S. Code and appendices · legal_authorities
**(a) Children** Any individual who—
(1) has not attained 19 years of age;
(2) is the natural or adopted child, stepchild, foster child, legal ward, or orphan of an eligible Indian; and
(3) is not otherwise eligible for health services provided by the Service,
shall be eligible for all health services provided by the Service on the same basis and subject to the same rules that apply to eligible Indians until such individual attains 19 years of age. The existing and potential health needs of all such individuals shall be taken into consideration by the Service in determining the need for, or the allocation of, the health resources of the Service. If such an individual has been determined to be legally incompetent prior to attaining 19 years of age, such individual shall remain eligible for such services until 1 year after the date of a determination of competency.
**(b) Spouses** Any spouse of an eligible Indian who is not an Indian, or who is of Indian descent but is not otherwise eligible for the health services provided by the Service, shall be eligible for such health services if all such spouses or spouses who are married to members of each Indian tribe being served are made eligible, as a class, by an appropriate resolution of the governing body of the Indian tribe or tribal organization providing such services. The health needs of persons made eligible under this paragraph shall not be taken into consideration by the Service in determining the need for, or allocation of, its health resources.
**(c) Health facilities providing health services**
(1) **In general** — The Secretary is authorized to provide health services under this subsection through health facilities operated directly by the Service to individuals who reside within the Service unit and who are
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Source file: Laws/federal/codes/united-states-code/title-25/section-1680f-health-services-for-ineligible-persons--22baf453a2.md
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Source location: Title 25, Chapter 18, § 1680f; chapter-018-indian-health-care.md
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**(a) Children** Any individual who—
(1) has not attained 19 years of age;
(2) is the natural or adopted child, stepchild, foster child, legal ward, or orphan of an eligible Indian; and
(3) is not otherwise eligible for health services provided by the Service,
shall be eligible for all health services provided by the Service on the same basis and subject to the same rules that apply to eligible Indians until such individual attains 19 years of age. The existing and potential health needs of all such individuals shall be taken into consideration by the Service in determining the need for, or the allocation of, the health resources of the Service. If such an individual has been determined to be legally incompetent prior to attaining 19 years of age, such individual shall remain eligible for such services until 1 year after the date of a determination of competency.
**(b) Spouses** Any spouse of an eligible Indian who is not an Indian, or who is of Indian descent but is not otherwise eligible for the health services provided by the Service, shall be eligible for such health services if all such spouses or spouses who are married to members of each Indian tribe being served are made eligible, as a class, by an appropriate resolution of the governing body of the Indian tribe or tribal organization providing such services. The health needs of persons made eligible under this paragraph shall not be taken into consideration by the Service in determining the need for, or allocation of, its health resources.
**(c) Health facilities providing health services**
(1) **In general** — The Secretary is authorized to provide health services under this subsection through health facilities operated directly by the Service to individuals who reside within the Service unit and who are not otherwise eligible for such health services if—
(A) the Indian tribes served by such Service unit requests such provision of health services to such individuals, and
(B) the Secretary and the served Indian tribes have jointly determined that the provision of such health services will not result in a denial or diminution of health services to eligible Indians.
(2) **ISDEAA programs** — In the case of health facilities operated under a contract or compact entered into under 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. the governing body of the Indian tribe or tribal organization providing health services under such contract or compact is authorized to determine whether health services should be provided under such contract or compact to individuals who are not eligible for such health services under any other subsection of this section or under any other provision of law. In making such determinations, the governing body of the Indian tribe or tribal organization shall take into account the consideration described in paragraph (1)(B). Any services provided by the Indian tribe or tribal organization pursuant to a determination made under this subparagraph shall be deemed to be provided under the agreement entered into by the Indian tribe or tribal organization under the Indian Self-Determination and Education Assistance Act. The provisions of section 314 of Public Law 101–512 (104 Stat. 1959), as amended by section 308 of Public Law 103–138 (107 Stat. 1416), shall apply to any services provided by the Indian tribe or tribal organization pursuant to a determination made under this subparagraph.
(3) **Payment for services**
(A) *In general* — Persons receiving health services provided by the Service under this subsection shall be liable for payment of such health services under a schedule of charges prescribed by the Secretary which, in the judgment of the Secretary, results in reimbursement in an amount not less than the actual cost of providing the health services. Notwithstanding [section 1621f of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section1621f&num=0&edition=prelim) or any other provision of law, amounts collected under this subsection, including Medicare, Medicaid, or children’s health insurance program reimbursements under titles XVIII, XIX, and 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.], shall be credited to the account of the program providing the service and shall be used for the purposes listed in [section 1641(d)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section1641/d/2&num=0&edition=prelim) and amounts collected under this subsection shall be available for expenditure within such program.
(B) *Indigent people* — Health services may be provided by the Secretary through the Service under this subsection to an indigent individual who would not be otherwise eligible for such health services but for the provisions of paragraph (1) only if an agreement has been entered into with a State or local government under which the State or local government agrees to reimburse the Service for the expenses incurred by the Service in providing such health services to such indigent individual.
(4) **Revocation of consent for services**
(A) *Single tribe service area* — In the case of a Service Area which serves only 1 Indian tribe, the authority of the Secretary to provide health services under paragraph (1) shall terminate at the end of the fiscal year succeeding the fiscal year in which the governing body of the Indian tribe revokes its concurrence to the provision of such health services.
(B) *Multitribal service area* — In the case of a multitribal Service Area, the authority of the Secretary to provide health services under paragraph (1) shall terminate at the end of the fiscal year succeeding the fiscal year in which at least 51 percent of the number of Indian tribes in the Service Area revoke their concurrence to the provisions of such health services.
**(d) Other services** The Service may provide health services under this subsection to individuals who are not eligible for health services provided by the Service under any other provision of law in order to—
(1) achieve stability in a medical emergency;
(2) prevent the spread of a communicable disease or otherwise deal with a public health hazard;
(3) provide care to non-Indian women pregnant with an eligible Indian’s child for the duration of the pregnancy through postpartum; or
(4) provide care to immediate family members of an eligible individual if such care is directly related to the treatment of the eligible individual.
**(e) Hospital privileges for practitioners**
(1) **In general** — Hospital privileges in health facilities operated and maintained by the Service or operated under a contract or compact pursuant to 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.) 1 may be extended to non-Service health care practitioners who provide services to individuals described in subsection (a), (b), (c), or (d). Such non-Service health care practitioners may, as part of the privileging process, be designated as employees of the Federal Government for purposes of section 1346(b) and chapter 171 of title 28 (relating to Federal tort claims) only with respect to acts or omissions which occur in the course of providing services to eligible individuals as a part of the conditions under which such hospital privileges are extended.
(2) **Definition** — For purposes of this subsection, the term “non-Service health care practitioner” means a practitioner who is not—
(A) an employee of the Service; or
(B) an employee of an Indian tribe or tribal organization operating a contract or compact under 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.) 1 or an individual who provides health care services pursuant to a personal services contract with such Indian tribe or tribal organization.
**(f) Eligible Indian** For purposes of this section, the term “eligible Indian” means any Indian who is eligible for health services provided by the Service without regard to the provisions of this section.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Findings respecting historical and special legal relationship, and resultant responsibilities** The Congress, after careful review of the Federal Government’s historical and special legal relationship with, and resulting responsibilities to, American Indian people, finds that—
(1) the prolonged Federal domination of Indian service programs has served to retard rather than enhance the progress of Indian people and their communities by depriving Indians of the full opportunity to develop leadership skills crucial to the realization of self-government, and has denied to the Indian people an effective voice in the planning and implementation of programs for the benefit of Indians which are responsive to the true needs of Indian communities; and
(2) the Indian people will never surrender their desire to control their relationships both among themselves and with non-Indian governments, organizations, and persons.
**(b) Further findings** The Congress further finds that—
(1) true self-determination in any society of people is dependent upon an educational process which will insure the development of qualified people to fulfill meaningful leadership roles;
(2) the Federal responsibility for and assistance to education of Indian children has not effected the desired level of educational achievement or created the diverse opportunities and personal satisfaction which education can and should provide; and
(3) parental and community control of the educational process is of crucial importance to the Indian people.
Source: Supplied U.S. Code snapshot — release unconfirmed · 25 U.S.C. § 5321
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Determinations regarding diabetes** The Secretary, acting through the Service, and in consultation with Indian tribes and tribal organizations, shall determine—
(1) by Indian tribe and by Service unit, the incidence of, and the types of complications resulting from, diabetes among Indians; and
(2) based on the determinations made pursuant to paragraph (1), the measures (including patient education and effective ongoing monitoring of disease indicators) each Service unit should take to reduce the incidence of, and prevent, treat, and control the complications resulting from, diabetes among Indian tribes within that Service unit.
**(b) Diabetes screening** To the extent medically indicated and with informed consent, the Secretary shall screen each Indian who receives services from the Service for diabetes and for conditions which indicate a high risk that the individual will become diabetic and establish a cost-effective approach to ensure ongoing monitoring of disease indicators. Such screening and monitoring may be conducted by a tribal health program and may be conducted through appropriate Internet-based health care management programs.
**(c) Diabetes projects** The Secretary shall continue to maintain each model diabetes project in existence on March 23, 2010, any such other diabetes programs operated by the Service or tribal health programs, and any additional diabetes projects, such as the Medical Vanguard program provided for in title IV of Public Law 108–87, as implemented to serve Indian tribes. tribal 11 So in original. Probably should be capitalized. health programs shall receive recurring funding for the diabetes projects that they operate pursuant to this section, both at March 23, 2010, and for projects which are added and funded thereafter.
**(d
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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
### 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).
Source: Supplied U.S. Code snapshot — release unconfirmed · 25 U.S.C. § 450
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Federal law — U.S. Code and appendices · legal_authorities
This chapter may be cited as the “Social Security Act”.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Conditions of participation; protection of individual rights; notification of State entities; use of home health aides; medical equipment; individual’s plan of care; compliance with Federal, State, and local laws and regulations** The conditions of participation that a home health agency is required to meet under this subsection are as follows:
(1) The agency protects and promotes the rights of each individual under its care, including each of the following rights:
(A) The right to be fully informed in advance about the care and treatment to be provided by the agency, to be fully informed in advance of any changes in the care or treatment to be provided by the agency that may affect the individual’s well-being, and (except with respect to an individual adjudged incompetent) to participate in planning care and treatment or changes in care or treatment.
(B) The right to voice grievances with respect to treatment or care that is (or fails to be) furnished without discrimination or reprisal for voicing grievances.
(C) The right to confidentiality of the clinical records described in section 1395x(o)(3) of this title.
(D) The right to have one’s property treated with respect.
(E) The right to be fully informed orally and in writing (in advance of coming under the care of the agency) of—
(i) all items and services furnished by (or under arrangements with) the agency for which payment may be made under this subchapter,
(ii) the coverage available for such items and services under this subchapter, subchapter XIX, and any other Federal program of which the agency is reasonably aware,
(iii) any charges for items and services not covered under this subchapter and any charges the individual may have to pay with respect to items and services furn
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Federal law — U.S. Code and appendices · legal_authorities
For the purposes of this title—
(1) The terms “Secretary” and “Department” mean the Secretary of Veterans Affairs and the Department of Veterans Affairs, respectively.
(2) The term “veteran” means a person who served in the active military, naval, air, or space service, and who was discharged or released therefrom under conditions other than dishonorable.
(3) The term “surviving spouse” means (except for purposes of chapter 19 of this title) a person who was the spouse of a veteran at the time of the veteran’s death, and who lived with the veteran continuously from the date of marriage to the date of the veteran’s death (except where there was a separation which was due to the misconduct of, or procured by, the veteran without the fault of the spouse) and who has not remarried.
(4)
(A) The term “child” means (except for purposes of chapter 19 of this title (other than with respect to a child who is an insurable dependent under subparagraph (B) or (C) of section 1965(10) of such chapter) and [section 8502(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section8502/b&num=0&edition=prelim)) a person who is unmarried and—
(i) who is under the age of eighteen years;
(ii) who, before attaining the age of eighteen years, became permanently incapable of self-support; or
(iii) who, after attaining the age of eighteen years and until completion of education or training (but not after attaining the age of twenty-three years), is pursuing a course of instruction at an approved educational institution;
and who is a legitimate child, a legally adopted child, a stepchild who is a member of a veteran’s household or was a member at the time of the veteran’s death, or an illegitimate child but, as to the alleged father, onl
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Federal law — U.S. Code and appendices · legal_authorities
Page 349
TITLE 25—INDIANS
§ 1680g
members of the Turtle Mountain Band of Chip-
pewa Indians that reside in the Trenton Service
Area of Divide, McKenzie, and Williams counties
in the State of North Dakota and the adjoining
counties of Richland, Roosevelt, and Sheridan in
the State of Montana.
(b) Band member eligibility not expanded
Nothing in this section may be construed as
expanding the eligibility of members of the Tur-
tle Mountain Band of Chippewa Indians for
health services provided by the Service beyond
the scope of eligibility for such health services
that applied on May 1, 1986.
(Pub. L. 94–437, title VIII, § 815, formerly title
VII, § 715, as added Pub. L. 100–713, title VII, § 709,
Nov. 23, 1988, 102 Stat. 4831; renumbered title
VIII, § 815, Pub. L. 102–573, title VII, § 701(a), (b),
Oct. 29, 1992, 106 Stat. 4572.)
§ 1680f. Indian Health Service and Department of
Veterans Affairs health facilities and services
sharing
(a) Feasibility study and report
The Secretary shall examine the feasibility of
entering into an arrangement for the sharing of
medical facilities and services between the In-
dian Health Service and the Department of Vet-
erans Affairs and shall, in accordance with sub-
section (b), prepare a report on the feasibility of
such an arrangement and submit such report to
the Congress by no later than September 30,
1990.
(b) Nonimpairment of service quality, eligibility,
or priority of access
The Secretary shall not take any action under
this section or under subchapter IV of chapter 81
of title 38 which would impair—
(1) the priority access of any Indian to
health care services provided through the In-
dian Health Service;
(2) the quality of health care services pro-
vided to any Indian through the Indian Health
Ser
Source: Supplied 2024 U.S. Code historical extraction · 25 U.S.C. § 1680f
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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. § 450
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Federal law — U.S. Code and appendices · legal_authorities
Page 2893
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1395a
(i) shared savings and competitive bidding in FFS
Medicare;
(ii) use of MA-negotiated rates to set FFS Medicare
rates; and
(iii) novel approaches to information development
and sharing that may enable markets to lower cost and
improve quality for FFS Medicare beneficiaries.
SEC. 10. Reducing Obstacles to Improved Patient Care.
Within 1 year of the date of this order, the Secretary
shall propose regulatory changes to the Medicare pro-
gram to reduce the burden on providers and eliminate
regulations that create inefficiencies or otherwise un-
dermine patient outcomes.
SEC. 11. Maximizing Freedom for Medicare Patients and
Providers. (a) Within 180 days of the date of this order,
the Secretary, in coordination with the Commissioner
of Social Security, shall revise current rules or policies
to preserve the Social Security retirement insurance
benefits of seniors who choose not to receive benefits
under Medicare Part A, and propose other administra-
tive improvements to Medicare enrollment processes
for beneficiaries.
(b) Within 1 year of the date of this order, the Sec-
retary shall identify and remove unnecessary barriers
to private contracts that allow Medicare beneficiaries
to obtain the care of their choice and facilitate the de-
velopment of market-driven prices.
SEC. 12. General Provisions. (a) Nothing in this order
shall be construed to impair or otherwise affect:
(i) the authority granted by law to an executive de-
partment or agency, or the head thereof; or
(ii) the functions of the Director of the Office of Man-
agement and Budget relating to budgetary, administra-
tive, or legislative proposals.
(b) This order shall be implemented consistent with
applicable law and subject to the
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1395
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