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25 U.S.C. § 1621k — Coverage of screening mammography

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

25 U.S.C. § 1621k — Coverage of screening mammography

Page 279 TITLE 25—INDIANS § 1621l 1 See References in Text note below. (d) Commencement and termination dates The demonstration program described in this section shall begin on January 1, 1993, and shall terminate on September 30, 1997. (e) Report Not later than July 1, 1998, the California Rural Indian Health Board shall submit to the Secretary a report on the demonstration pro- gram carried out under this section, including a statement of its findings regarding the impact of using a contract care intermediary on— (1) access to needed health services; (2) waiting periods for receiving such serv- ices; and (3) the efficient management of high-cost contract care cases. (f) ‘‘High-cost contract care cases’’ defined For the purposes of this section, the term ‘‘high-cost contract care cases’’ means those cases in which the cost of the medical treatment provided to an individual— (1) would otherwise be eligible for reimburse- ment from the Catastrophic Health Emer- gency Fund established under section 1621a of this title, except that the cost of such treat- ment does not meet the threshold cost re- quirement established pursuant to section 1621a(b)(2) 1 of this title; and (2) exceeds $1,000. (Pub. L. 94–437, title II, § 211, as added Pub. L. 102–573, title II, § 206(c), Oct. 29, 1992, 106 Stat. 4549; amended Pub. L. 104–313, § 2(c), Oct. 19, 1996, 110 Stat. 3822; Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes REFERENCES IN TEXT Section 1679 of this title, referred to in subsec. (b)(1), was repealed and a new section 1679 was enacted by Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935. Provisions describing California Indians, similar to those that appeared in former section 1679(b) are n

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Page 279 TITLE 25—INDIANS § 1621l 1 See References in Text note below. (d) Commencement and termination dates The demonstration program described in this section shall begin on January 1, 1993, and shall terminate on September 30, 1997. (e) Report Not later than July 1, 1998, the California Rural Indian Health Board shall submit to the Secretary a report on the demonstration pro- gram carried out under this section, including a statement of its findings regarding the impact of using a contract care intermediary on— (1) access to needed health services; (2) waiting periods for receiving such serv- ices; and (3) the efficient management of high-cost contract care cases. (f) ‘‘High-cost contract care cases’’ defined For the purposes of this section, the term ‘‘high-cost contract care cases’’ means those cases in which the cost of the medical treatment provided to an individual— (1) would otherwise be eligible for reimburse- ment from the Catastrophic Health Emer- gency Fund established under section 1621a of this title, except that the cost of such treat- ment does not meet the threshold cost re- quirement established pursuant to section 1621a(b)(2) 1 of this title; and (2) exceeds $1,000. (Pub. L. 94–437, title II, § 211, as added Pub. L. 102–573, title II, § 206(c), Oct. 29, 1992, 106 Stat. 4549; amended Pub. L. 104–313, § 2(c), Oct. 19, 1996, 110 Stat. 3822; Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes REFERENCES IN TEXT Section 1679 of this title, referred to in subsec. (b)(1), was repealed and a new section 1679 was enacted by Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935. Provisions describing California Indians, similar to those that appeared in former section 1679(b) are now contained in new section 1679(a). Section 1621a of this title, referred to in subsec. (f)(1), was amended generally by Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935, and, as so amend- ed, no longer contains a subsec. (b)(2). CODIFICATION Amendment by Pub. L. 111–148 is based on section 101(b)(3) of title I of S. 1790, One Hundred Eleventh Con- gress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. AMENDMENTS 2010—Subsec. (g). Pub. L. 111–148 struck out subsec. (g) which authorized appropriations for fiscal years 1996 through 2000. 1996—Subsec. (g). Pub. L. 104–313 substituted ‘‘1996 through 2000’’ for ‘‘1993, 1994, 1995, 1996, and 1997’’. Statutory Notes and Related Subsidiaries TERMINATION OF ADVISORY BOARDS Advisory boards established after Jan. 5, 1973, to ter- minate not later than the expiration of the 2-year pe- riod beginning on the date of their establishment, un- less, in the case of a board established by the President or an officer of the Federal Government, such board is renewed by appropriate action prior to the expiration of such 2-year period, or in the case of a board estab- lished by Congress, its duration is otherwise provided by law. See sections 1001(2) and 1013 of Title 5, Govern- ment Organization and Employees. § 1621k. Coverage of screening mammography The Secretary, through the Service, shall pro- vide for screening mammography (as defined in section 1861(jj) of the Social Security Act [42 U.S.C. 1395x(jj)]) for Indian and urban Indian women 35 years of age or older at a frequency, determined by the Secretary (in consultation with the Director of the National Cancer Insti- tute), appropriate to such women, and under such terms and conditions as are consistent with standards established by the Secretary to assure the safety and accuracy of screening mammog- raphy under part B of title XVIII of the Social Security Act [42 U.S.C. 1395j et seq.] and other cancer screenings. (Pub. L. 94–437, title II, § 212, as added Pub. L. 102–573, title II, § 207(a), Oct. 29, 1992, 106 Stat. 4550; amended Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.) Editorial Notes REFERENCES IN TEXT The Social Security Act, referred to in text, is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Part B of title XVIII of the Act is classified generally to part B (§ 1395j et seq.) of subchapter XVIII of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables. CODIFICATION Amendment by Pub. L. 111–148 is based on section 128 of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by sec- tion 10221(a) of Pub. L. 111–148. AMENDMENTS 2010—Pub. L. 111–148 inserted ‘‘and other cancer screenings’’ before period at end. § 1621l. Patient travel costs (a) Definition of qualified escort In this section, the term ‘‘qualified escort’’ means— (1) an adult escort (including a parent, guardian, or other family member) who is re- quired because of the physical or mental con- dition, or age, of the applicable patient; (2) a health professional for the purpose of providing necessary medical care during travel by the applicable patient; or (3) other escorts, as the Secretary or appli- cable Indian Health Program determines to be appropriate. (b) Provision of funds The Secretary, acting through the Service and Tribal Health Programs, is authorized to pro- vide funds for the following patient travel costs, including qualified escorts, associated with re- ceiving health care services provided (either through direct or contract care or through a contract or compact under the Indian Self-De- termination and Education Assistance Act (25 U.S.C. 450 et seq.)) 1 under this chapter—

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

25 U.S.C. § 1621k — Mental health prevention and treatment services

**(a) National plan for Indian Mental Health Services** (1) Not later than 120 days after November 28, 1990, the Secretary, acting through the Service, shall develop and publish in the Federal Register a final national plan for Indian Mental Health Services. The plan shall include— (A) an assessment of the scope of the problem of mental illness and dysfunctional and self-destructive behavior, including child abuse and family violence, among Indians, including— (i) the number of Indians served by the Service who are directly or indirectly affected by such illness or behavior, and (ii) an estimate of the financial and human cost attributable to such illness or behavior; (B) an assessment of the existing and additional resources necessary for the prevention and treatment of such illness and behavior; and (C) an estimate of the additional funding needed by the Service to meet its responsibilities under the plan. (2) The Secretary shall submit a copy of the national plan to the Congress. **(b) Memorandum of agreement** Not later than 180 days after November 28, 1990, the Secretary and the Secretary of the Interior shall develop and enter into a memorandum of agreement under which the Secretaries shall, among other things— (1) determine and define the scope and nature of mental illness and dysfunctional and self-destructive behavior, including child abuse and family violence, among Indians; (2) make an assessment of the existing Federal, tribal, State, local, and private services, resources, and programs available to provide mental health services for Indians; (3) make an initial determination of the unmet need for additional services, resources, and programs necessary to meet the needs identified pursuant to paragraph (1); (4) (A) ensure that Ind

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

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

25 U.S.C. § 450 — Transferred

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

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

42 U.S.C. § 1395j — Conditions of and limitations on payment for services

**(a) Requirement of requests and certifications** Except as provided in subsections (d) and (g) and in [section 1395mm of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395mm&num=0&edition=prelim), payment for services furnished an individual may be made only to providers of services which are eligible therefor under [section 1395cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395cc&num=0&edition=prelim) and only if— (1) written request, signed by such individual, except in cases in which the Secretary finds it impracticable for the individual to do so, is filed for such payment in such form, in such manner, and by such person or persons as the Secretary may by regulation prescribe, no later than the close of the period ending 1 calendar year after the date of service; (2) a physician, or, in the case of services described in subparagraph (B), a physician, or a nurse practitioner, a clinical nurse specialist, or a physician assistant (as those terms are defined in [section 1395x(aa)(5) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa/5&num=0&edition=prelim)) who does not have a direct or indirect employment relationship with the facility but is working in collaboration with a physician,,11 So in original. or, in the case of services described in subparagraph (C), a physician, a nurse practitioner or clinical nurse specialist (as such terms are defined in [section 1395x(aa)(5) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa/5&num=0&edition=prelim)) who is working in accordance with State law, or a physician assistant (as defined in [section 1395x(aa)(5) of this title](https://usc

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

42 U.S.C. § 1395j — Establishment of supplementary medical

Page 3018 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395j (I) a range of remedies to apply to hos- pice programs under the conditions de- scribed in paragraphs (1) through (4); and (II) appropriate procedures for appeal- ing determinations relating to the impo- sition of such remedies. Remedies developed pursuant to the pre- ceding sentence shall include the remedies specified in subparagraph (B). (ii) Conditions of imposition of remedies Not later than October 1, 2022, the Sec- retary shall develop and implement spe- cific procedures with respect to the condi- tions under which each of the remedies de- veloped under clause (i) is to be applied, including the amount of any fines and the severity of each of these remedies. Such procedures shall be designed so as to mini- mize the time between identification of de- ficiencies and imposition of these remedies and shall provide for the imposition of in- crementally more severe fines for repeated or uncorrected deficiencies. (B) Specified remedies The remedies specified in this subpara- graph are the following: (i) Civil money penalties in an amount not to exceed $10,000 for each day of non- compliance by a hospice program with the requirements specified in section 1395x(dd) of this title. (ii) Suspension of all or part of the pay- ments to which a hospice program would otherwise be entitled under this sub- chapter with respect to items and services furnished by a hospice program on or after the date on which the Secretary deter- mines that remedies should be imposed pursuant to paragraphs (1) and (2). (iii) The appointment of temporary man- agement to oversee the operation of the hospice program and to protect and assure the health and safety of the individuals under the care of the program while im-

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

42 U.S.C. § 1395x — Manufacturer discount program

**(a) Establishment** The Secretary shall establish a manufacturer discount program (in this section referred to as the “program”). Under the program, the Secretary shall enter into agreements described in subsection (b) with manufacturers and provide for the performance of the duties described in subsection (c). **(b) Terms of agreement** (1) **In general** (A) *Agreement* — An agreement under this section shall require the manufacturer to provide, in accordance with this section, discounted prices for applicable drugs of the manufacturer that are dispensed to applicable beneficiaries on or after January 1, 2025. (B) *Clarification* — Nothing in this section shall be construed as affecting— (i) the application of a coinsurance of 25 percent of the negotiated price, as applied under paragraph (2)(A) of [section 1395w–102(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395w–102/b&num=0&edition=prelim), for costs described in such paragraph; or (ii) the application of the copayment amount described in paragraph (4)(A) of such section, with respect to costs described in such paragraph. (C) *Timing of agreement* (i) *Special rule for 2025* — In order for an agreement with a manufacturer to be in effect under this section with respect to the period beginning on January 1, 2025, and ending on December 31, 2025, the manufacturer shall enter into such agreement not later than March 1, 2024. (ii) *2026 and subsequent years* — In order for an agreement with a manufacturer to be in effect under this section with respect to plan year 2026 or a subsequent plan year, the manufacturer shall enter into such agreement not later than a calendar quarter or semi-annual deadline established by the Secretary. (2)

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

42 U.S.C. § 1395x — Definitions

Page 3523 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1395x Revenue Code of 1986 with respect to the man- ufacturer. (d) Definition of manufacturer In this section, the term ‘‘manufacturer’’ has the meaning given such term in section 1395w–114a(g)(5) of this title. (Aug. 14, 1935, ch. 531, title XVIII, § 1860D–43, as added Pub. L. 111–148, title III, § 3301(a), Mar. 23, 2010, 124 Stat. 461; amended Pub. L. 111–152, title I, § 1101(b)(1), Mar. 30, 2010, 124 Stat. 1037; Pub. L. 117–169, title I, §§ 11001(b)(1)(G)(i), 11201(e)(7), Aug. 16, 2022, 136 Stat. 1853, 1892.) Editorial Notes REFERENCES IN TEXT Section 5000D(c)(1) of the Internal Revenue Code of 1986, referred to in subsec. (c)(2), is classified to section 5000D(c)(1) of Title 26, Internal Revenue Code. AMENDMENTS 2022—Subsec. (a)(1). Pub. L. 117–169, § 11201(e)(7)(A)(i), added par. (1) and struck out former par. (1) which read as follows: ‘‘participate in the Medicare coverage gap discount program under section 1395w–114a of this title;’’. Subsec. (a)(2). Pub. L. 117–169, § 11201(e)(7)(A)(ii), added par. (2) and struck out former par. (2) which read as follows: ‘‘have entered into and have in effect an agreement described in subsection (b) of such section with the Secretary; and’’. Subsec. (a)(3). Pub. L. 117–169, § 11201(e)(7)(A)(iii), sub- stituted ‘‘section 1395w–114a of this title’’ for ‘‘such sec- tion’’. Subsec. (b). Pub. L. 117–169, § 11201(e)(7)(B), added sub- sec. (b) and struck out former subsec. (b). Prior to amendment, text read as follows: ‘‘Subsection (a) shall apply to covered part D drugs dispensed under this part on or after January 1, 2011.’’ Subsec. (c). Pub. L. 117–169, § 11001(b)(1)(G)(i), des- ignated existing provisions as par. (1) and inserted heading, sub

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