Eligibility for reimbursement for medical assistance
section 1603 of title 25A 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 ), 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.
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 , 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.
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 reimbursing such agency for health care and services provided in Indian Health Service facilities to Indians who are eligible for medical assistance under the State plan.
Cross reference
section 1645 of title 251
Aug. 14, 1935, ch. 531 Pub. L. 94–437, title IV, § 402(a)90 Stat. 1409 Pub. L. 100–203, title IV101 Stat. 1330–155 Pub. L. 100–360, title IV, § 411(k)(10)(E)102 Stat. 796 Pub. L. 106–417, § 3(b)(2)114 Stat. 1815 (, title XIX, § 1911, as added , , ; amended , §§ 4118(f)(1), 4211(h)(8), , , 1330–206; , , ; , , .)
Editorial Notes
References in Text
Section 1645 of title 25Pub. L. 111–148, title X, § 10221(a)124 Stat. 935 , referred to in subsec. (d), was amended generally by , , , and, as so amended, no longer contains provisions relating to direct billing of medicare, medicaid, and other third party payors.
Amendments
Pub. L. 106–4172000—Subsec. (d). added subsec. (d).
Pub. L. 100–360, § 411(k)(10)(E)Pub. L. 100–203, § 4118(f)(1)(A)1988—Subsecs. (a), (b). , made technical correction to directory language of , see 1987 Amendment note below.
Pub. L. 100–203, § 4118(f)(1)(A)Pub. L. 100–360, § 411(k)(10)(E)1987—Subsecs. (a), (b). , as amended by , substituted “, nursing facility, or any other type of facility which provides services of a type otherwise covered under the State plan” for “or nursing facility”.
Pub. L. 100–203, § 4211(h)(8), substituted “or nursing facility” for “, intermediate care facility, or skilled nursing facility” wherever appearing.
Pub. L. 100–203, § 4118(f)(1)(B)Subsec. (c). , added subsec. (c).
Statutory Notes and Related Subsidiaries
Effective Date of 2000 Amendment
Pub. L. 106–417section 3(c) of Pub. L. 106–417section 1645 of Title 25Amendment by effective , see , set out as a note under , Indians.
Effective Date of 1988 Amendment
section 411 of Pub. L. 100–360Pub. L. 100–360Pub. L. 100–203Pub. L. 100–203section 411(a) of Pub. L. 100–360section 106 of Title 1Except as specifically provided in , amendment by , as it relates to a provision in the Omnibus Budget Reconciliation Act of 1987, , effective as if included in the enactment of that provision in , see , set out as a Reference to OBRA; Effective Date note under , General Provisions.
Effective Date of 1987 Amendment
Pub. L. 100–203, title IV, § 4118(f)(2)101 Stat. 1330–156
section 4211(h)(8) of Pub. L. 100–203section 1396r of this titlePub. L. 100–203section 1396r of this titleAmendment by applicable to nursing facility services furnished on or after , without regard to whether regulations implementing such amendment are promulgated by such date, except as otherwise specifically provided in , with transitional rule, see section 4214(a), (b)(2) of , as amended, set out as an Effective Date note under .
Agreements To Reimburse State Agency for Health Care and Services Provided by Agency to Indians
Pub. L. 94–437, title IV, § 402(b)90 Stat. 1409 Pub. L. 100–713, title IV, § 401(b)102 Stat. 4818 , , , which authorized Secretary to enter into agreements to reimburse State agencies for health care and services provided in Service facilities to Indians eligible for medical assistance under this subchapter, was repealed by , , , applicable to services performed on or after the .
Payments Into Special Fund To Improve Indian Health Service Facilities To Achieve Compliance With Conditions and Requirements
Pub. L. 94–437, title IV, § 402(c)90 Stat. 1409 Pub. L. 100–713, title IV, § 401(a)102 Stat. 4818 section 402(c) of Pub. L. 94–437section 402 of Pub. L. 94–437Pub. L. 102–573, title IV, § 401(b)(1)106 Stat. 4565 section 401(c) of Pub. L. 94–437section 1641(c) of Title 25, , , as amended by , , , provided that payments to which any Indian Health Service facility was entitled by reason of this section were to be placed in a special fund of the Secretary for improvements of facilities of the Service to comply with requirements of this subchapter, required minimum funding for each service unit making collections for such facilities, and provided for to cease to apply when Secretary determined that substantially all such facilities complied with requirements of this subchapter, prior to the general amendment of by , , . Similar provisions are contained in , which is classified to , Indians.
Medicaid Payments Not Considered in Determining Appropriations for Indian Health Care
Pub. L. 94–437, title IV, § 402(d)90 Stat. 1410 section 402 of Pub. L. 94–437Pub. L. 102–573, title IV, § 401(b)(1)106 Stat. 4565 section 401(a) of Pub. L. 94–437section 1641(a) of Title 25, , , provided that any payments received for services provided recipients under this section were not to be considered in determining appropriations for the provision of health care and services to Indians, prior to the general amendment of by , , . Similar provisions are contained in , which is classified to , Indians.