25 U.S.C. § 1646 — Authorization for emergency contract

Page 306 TITLE 25—INDIANS § 1646 bursed which are in excess of the amount necessary to achieve or maintain such conditions or requirements shall be used— ‘‘(A) solely for improving the health resources defi- ciency level of the Indian tribe, and ‘‘(B) in accordance with the regulations of the Serv- ice applicable to funds provided by the Service under any contract entered into under the Indian Self-De- termination Act. ‘‘(2) The amounts paid to the hospitals and clinics participating in the demonstration program described in subsection (a) of this section shall be subject to all auditing requirements applicable to programs adminis- tered directly by the Service and to facilities partici- pating in the medicare and medicaid programs. ‘‘(3) The Secretary shall monitor the performance of hospitals and clinics participating in the demonstra- tion program described in subsection (a) of this section, and shall require such hospitals and clinics to submit reports on the program to the Secretary on a quarterly basis (or more frequently if the Secretary deems it to be necessary). ‘‘(4) Notwithstanding section 1880(c) of the Social Se- curity Act or section 1642(a) of this title, no payment may be made out of the special fund described in sec- tion 1880(c) of the Social Security Act, or section 1642(a) of this title, for the benefit of any hospital or clinic participating in the demonstration program de- scribed in subsection (a) of this section during the pe- riod of such participation. ‘‘(c)(1) In order to be considered for participation in the demonstration program described in subsection (a) of this section, a hospital or clinic must submit an ap- plication to the Secretary which establishes to the sat- isfaction of the Secretary that— ‘‘(A) the Indian tribe, tribal organization, or Alaska Native health organization contracts the entire oper- ation of the Service facility; ‘‘(B) the facility is eligible to participate in the medicare and medicaid programs under sections 1880 and 1911 of the Social Security Act; ‘‘(C) the facility meets any requirements which apply to programs operated directly by the Service; and ‘‘(D) the facility is accredited by the Joint Commis- sion on Accreditation of Hospitals, or has submitted a plan, which has been approved by the Secretary, for achieving such accreditation prior to October 1, 1990. ‘‘(2) From among the qualified applicants, the Sec- retary shall, prior to October 1, 1989, select no more than 4 facilities to participate in the demonstration program described in subsection (a) of this section. The demonstration program described in subsection (a) of this section shall begin by no later than October 1, 1991, and end on September 30, 2000. ‘‘(d)(1) On November 23, 1988, the Secretary, acting through the Service, shall commence an examination of— ‘‘(A) any administrative changes which may be nec- essary to allow direct billing and reimbursement under the demonstration program described in sub- section (a) of this section, including any agreements with States which may be necessary to provide for such direct billing under the medicaid program; and ‘‘(B) any changes which may be necessary to enable participants in such demonstration program to pro- vide to the Service medical records information on patients served under such demonstration program which is consistent with the medical records informa- tion system of the Service. ‘‘(2) Prior to the commencement of the demonstra- tion program described in subsection (a) of this section, the Secretary shall implement all changes required as a result of the examinations conducted under para- graph (1). ‘‘(3) Prior to October 1, 1990, the Secretary shall de- termine any accounting information which a partici- pant in the demonstration program described in sub- section (a) of this section would be required to report. ‘‘(e) The Secretary shall submit a final report at the end of fiscal year 1996, on the activities carried out under the demonstration program described in sub- section (a) of this section which shall include an eval- uation of whether such activities have fulfilled the ob- jectives of such program. In such report the Secretary shall provide a recommendation, based upon the results of such demonstration program, as to whether direct billing of, and reimbursement by, the medicare and medicaid programs and other third-party payors should be authorized for all Indian tribes and Alaska Native health organizations which are contracting the entire operation of a facility of the Service. ‘‘(f) The Secretary shall provide for the retrocession of any contract entered into between a participant in the demonstration program described in subsection (a) of this section and the Service under the authority of the Indian Self-Determination Act. All cost accounting and billing authority shall be retroceded to the Sec- retary upon the Secretary’s acceptance of a retroceded contract.’’ Subsec. (c)(2). Pub. L. 105–277 substituted ‘‘2000’’ for ‘‘1998’’. 1996—Subsec. (c)(2). Pub. L. 104–313 substituted ‘‘1998’’ for ‘‘1996’’. 1992—Subsec. (b)(1). Pub. L. 102–573, § 701(c)(3)(A), sub- stituted ‘‘sections 1642(a)’’ for ‘‘sections 402(c)’’ and made technical amendment to reference to section 1680c(b)(2)(A) to reflect renumbering of corresponding section of original act. Subsec. (b)(4). Pub. L. 102–573, § 701(c)(3)(B), sub- stituted ‘‘section 1642(a)’’ for ‘‘section 402(c)’’ in two places. Subsec. (c)(2). Pub. L. 102–573, § 404(1), substituted ‘‘1996’’ for ‘‘1995’’. Subsec. (e). Pub. L. 102–573, § 404(2), substituted ‘‘1996’’ for ‘‘1995’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2000 AMENDMENT Pub. L. 106–417, § 3(c), Nov. 1, 2000, 114 Stat. 1816, pro- vided that: ‘‘The amendments made by this section [amending this section and sections 1395qq and 1396j of Title 42, The Public Health and Welfare] shall take ef- fect on October 1, 2000.’’ Pub. L. 106–417, § 4(a), Nov. 1, 2000, 114 Stat. 1816, pro- vided that the reenactment of this section by section 4(a) is effective Nov. 9, 1998. Pub. L. 106–417, § 4(b), Nov. 1, 2000, 114 Stat. 1816, pro- vided that the amendment made by section 4(b) is effec- tive Nov. 10, 1998. FINDINGS Pub. L. 106–417, § 2, Nov. 1, 2000, 114 Stat. 1812, pro- vided findings of Congress relating to amendment of this section by Pub. L. 106–417. § 1646. Authorization for emergency contract health services With respect to an elderly or disabled Indian receiving emergency medical care or services from a non-Service provider or in a non-Service facility under the authority of this chapter, the time limitation (as a condition of payment) for notifying the Service of such treatment or ad- mission shall be 30 days. (Pub. L. 94–437, title IV, § 406, as added Pub. L. 102–573, title IV, § 405, Oct. 29, 1992, 106 Stat. 4566.) Editorial Notes REFERENCES IN TEXT This chapter, referred to in text, was in the original ‘‘this Act’’, meaning Pub. L. 94–437, Sept. 30, 1976, 90 Stat. 1400, known as the Indian Health Care Improve- ment Act, which is classified principally to this chap- Page 307 TITLE 25—INDIANS § 1647a 1 See References in Text note below. ter. For complete classification of this Act to the Code, see Short Title note set out under section 1601 of this title and Tables. § 1647. Eligible Indian veteran services (a) Findings; purpose (1) Findings Congress finds that— (A) collaborations between the Secretary and the Secretary of Veterans Affairs re- garding the treatment of Indian veterans at facilities of the Service should be encour- aged to the maximum extent practicable; and (B) increased enrollment for services of the Department of Veterans Affairs by veterans who are members of Indian tribes should be encouraged to the maximum extent prac- ticable. (2) Purpose The purpose of this section is to reaffirm the goals stated in the document entitled ‘‘Memo- randum of Understanding Between the VA/ Veterans Health Administration And HHS/In- dian Health Service’’ and dated February 25, 2003 (relating to cooperation and resource sharing between the Veterans Health Adminis- tration and Service). (b) Definitions In this section: (1) Eligible Indian veteran The term ‘‘eligible Indian veteran’’ means an Indian or Alaska Native veteran who re- ceives any medical service that is— (A) authorized under the laws adminis- tered by the Secretary of Veterans Affairs; and (B) administered at a facility of the Serv- ice (including a facility operated by an In- dian tribe or tribal organization through a contract or compact with the Service under the Indian Self-Determination and Edu- cation Assistance Act (25 U.S.C. 450 et seq.)) 1 pursuant to a local memorandum of under- standing. (2) Local memorandum of understanding The term ‘‘local memorandum of under- standing’’ means a memorandum of under- standing between the Secretary (or a designee, including the director of any area office of the Service) and the Secretary of Veterans Affairs (or a designee) to implement the document en- titled ‘‘Memorandum of Understanding Be- tween the VA/Veterans Health Administration And HHS/Indian Health Service’’ and dated February 25, 2003 (relating to cooperation and resource sharing between the Veterans Health Administration and Indian Health Service). (c) Eligible Indian veterans expenses (1) In general Notwithstanding any other provision of law, the Secretary shall provide for veteran-related expenses incurred by eligible Indian veterans as described in subsection (b)(1)(B). (2) Method of payment The Secretary shall establish such guide- lines as the Secretary determines to be appro- priate regarding the method of payments to the Secretary of Veterans Affairs under para- graph (1). (d) Tribal approval of memoranda In negotiating a local memorandum of under- standing with the Secretary of Veterans Affairs regarding the provision of services to eligible In- dian veterans, the Secretary shall consult with each Indian tribe that would be affected by the local memorandum of understanding. (e) Funding (1) Treatment Expenses incurred by the Secretary in car- rying out subsection (c)(1) shall not be consid- ered to be Contract Health Service expenses. (2) Use of funds Of funds made available to the Secretary in appropriations Acts for the Service (excluding funds made available for facilities, Contract Health Services, or contract support costs), the Secretary shall use such sums as are nec- essary to carry out this section. (Pub. L. 94–437, title IV, § 407, as added 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 subsec. (b)(1)(B), is Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2203, which was classified principally to subchapter II (§ 450 et seq.) of chapter 14 of this title prior to editorial re- classification 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 Section 407 of Pub. L. 94–437 is based on section 155 of title I of S. 1790, One Hundred Eleventh Congress, as re- ported by the Committee on Indian Affairs of the Sen- ate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. PRIOR PROVISIONS A prior section 1647, Pub. L. 94–437, title IV, § 407, as added Pub. L. 102–573, title IV, § 406, Oct. 29, 1992, 106 Stat. 4566, authorized appropriations through fiscal year 2000 to carry out this subchapter, prior to repeal by Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935. The repeal is based on section 101(b)(7) of title I of S. 1790, One Hundred Eleventh Congress, as re- ported by the Committee on Indian Affairs of the Sen- ate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148. § 1647a. Nondiscrimination under Federal health care programs in qualifications for reim- bursement for services (a) Requirement to satisfy generally applicable participation requirements (1) In general A Federal health care program must accept an entity that is operated by the Service, an Indian tribe, tribal organization, or urban In- dian organization as a provider eligible to re- ceive payment under the program for health care services furnished to an Indian on the