[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3378 Engrossed Amendment Senate (EAS)]

  
  
  
  
  
  
  
  
  
  

                  In the Senate of the United States,

                                                    September 19, 1996.
      Resolved, That the bill from the House of Representatives (H.R. 
3378) entitled ``An Act to amend the Indian Health Care Improvement Act 
to extend the demonstration program for direct billing of Medicare, 
Medicaid, and other third party payors.'', do pass with the following

                               AMENDMENT:

            Strike out all after the enacting clause and insert:

SECTION 1. SHORT TITLE; REFERENCES.

    (a) Short Title.--This Act may be cited as the ``Indian Health Care 
Improvement Technical Corrections Act of 1996''.
    (b) References.--Whenever in this Act an amendment or repeal is 
expressed in terms of an amendment to or repeal of a section or other 
provision, the reference shall be considered to be made to a section or 
other provision of the Indian Health Care Improvement Act.

SEC. 2. TECHNICAL CORRECTIONS IN THE INDIAN HEALTH CARE IMPROVEMENT 
              ACT.

    (a) Definition of Health Profession.--Section 4(n) (25 U.S.C. 
1603(n)) is amended--
            (1) by inserting ``allopathic medicine,'' before ``family 
        medicine''; and
            (2) by striking ``and allied health professions'' and 
        inserting ``an allied health profession, or any other health 
        profession''.
    (b) Indian Health Professions Scholarships.--Section 104(b) of the 
Indian Health Care Improvement Act (25 U.S.C. 1613a(b)) is amended--
            (1) in paragraph (3)--
                    (A) in subparagraph (A)--
                            (i) by striking the matter preceding clause 
                        (i) and inserting the following:
    ``(3)(A) The active duty service obligation under a written 
contract with the Secretary under section 338A of the Public Health 
Service Act (42 U.S.C. 254l) that an individual has entered into under 
that section shall, if that individual is a recipient of an Indian 
Health Scholarship, be met in full-time practice, by service--'';
                            (ii) by striking ``or'' at the end of 
                        clause (iii);
                            (iii) by striking the period at the end of 
                        clause (iv) and inserting ``; or''; and
                            (iv) by adding at the end the following new 
                        clause:
            ``(v) in an academic setting (including a program that 
        receives funding under section 102, 112, or 114, or any other 
        academic setting that the Secretary, acting through the 
        Service, determines to be appropriate for the purposes of this 
        clause) in which the major duties and responsibilities of the 
        recipient are the recruitment and training of Indian health 
        professionals in the discipline of that recipient in a manner 
        consistent with the purpose of this title, as specified in 
        section 101.'';
                    (B) by redesignating subparagraphs (B) and (C) as 
                subparagraphs (C) and (D), respectively;
                    (C) by inserting after subparagraph (A) the 
                following new subparagraph:
    ``(B) At the request of any individual who has entered into a 
contract referred to in subparagraph (A) and who receives a degree in 
medicine (including osteopathic or allopathic medicine), dentistry, 
optometry, podiatry, or pharmacy, the Secretary shall defer the active 
duty service obligation of that individual under that contract, in 
order that such individual may complete any internship, residency, or 
other advanced clinical training that is required for the practice of 
that health profession, for an appropriate period (in years, as 
determined by the Secretary), subject to the following conditions:
            ``(i) No period of internship, residency, or other advanced 
        clinical training shall be counted as satisfying any period of 
        obligated service that is required under this section.
            ``(ii) The active duty service obligation of that 
        individual shall commence not later than 90 days after the 
        completion of that advanced clinical training (or by a date 
        specified by the Secretary).
            ``(iii) The active duty service obligation will be served 
        in the health profession of that individual, in a manner 
        consistent with clauses (i) through (v) of subparagraph (A).'';
                    (D) in subparagraph (C), as so redesignated, by 
                striking ``prescribed under section 338C of the Public 
                Health Service Act (42 U.S.C. 254m) by service in a 
                program specified in subparagraph (A)'' and inserting 
                ``described in subparagraph (A) by service in a program 
                specified in that subparagraph''; and
                    (E) in subparagraph (D), as so redesignated--
                            (i) by striking ``Subject to subparagraph 
                        (B),'' and inserting ``Subject to subparagraph 
                        (C),''; and
                            (ii) by striking ``prescribed under section 
                        338C of the Public Health Service Act (42 
                        U.S.C. 254m)'' and inserting ``described in 
                        subparagraph (A)'';
            (2) in paragraph (4)--
                    (A) in subparagraph (B), by striking the matter 
                preceding clause (i) and inserting the following:
            ``(B) the period of obligated service described in 
        paragraph (3)(A) shall be equal to the greater of--''; and
                    (B) in subparagraph (C), by striking ``(42 U.S.C. 
                254m(g)(1)(B))'' and inserting ``(42 U.S.C. 
                254l(g)(1)(B))''; and
            (3) in paragraph (5), by adding at the end the following 
        new subparagraphs:
    ``(C) Upon the death of an individual who receives an Indian Health 
Scholarship, any obligation of that individual for service or payment 
that relates to that scholarship shall be canceled.
    ``(D) The Secretary shall provide for the partial or total waiver 
or suspension of any obligation of service or payment of a recipient of 
an Indian Health Scholarship if the Secretary determines that--
            ``(i) it is not possible for the recipient to meet that 
        obligation or make that payment;
            ``(ii) requiring that recipient to meet that obligation or 
        make that payment would result in extreme hardship to the 
        recipient; or
            ``(iii) the enforcement of the requirement to meet the 
        obligation or make the payment would be unconscionable.
    ``(E) Notwithstanding any other provision of law, in any case of 
extreme hardship or for other good cause shown, the Secretary may 
waive, in whole or in part, the right of the United States to recover 
funds made available under this section.
    ``(F) Notwithstanding any other provision of law, with respect to a 
recipient of an Indian Health Scholarship, no obligation for payment 
may be released by a discharge in bankruptcy under title 11, United 
States Code, unless that discharge is granted after the expiration of 
the 5-year period beginning on the initial date on which that payment 
is due, and only if the bankruptcy court finds that the nondischarge of 
the obligation would be unconscionable.''.
    (c) California Contract Health Services Demonstration Program.--
Section 211(g) (25 U.S.C. 1621j(g)) is amended by striking ``1993, 
1994, 1995, 1996, and 1997'' and inserting ``1996 through 2000''.
    (d) Extension of Certain Demonstration Program.--Section 405(c)(2) 
(25 U.S.C. 1645(c)(2)) is amended by striking ``September 30, 1996'' 
and inserting ``September 30, 1998''.
    (e) Gallup Alcohol and Substance Abuse Treatment Center.--Section 
706(d) (25 U.S.C. 1665e(d)) is amended to read as follows:
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated, for each of fiscal years 1996 through 2000, such sums as 
may be necessary to carry out subsection (b).''.
    (f) Substance Abuse Counselor Education Demonstration Program.--
Section 711(h) (25 U.S.C. 1665j(h)) is amended by striking ``1993, 
1994, 1995, 1996, and 1997'' and inserting ``1996 through 2000''.
    (g) Home and Community-Based Care Demonstration Program.--Section 
821(i) (25 U.S.C. 1680k(i)) is amended by striking ``1993, 1994, 1995, 
1996, and 1997'' and inserting ``1996 through 2000''.

            Attest:

                                                             Secretary.
104th CONGRESS

  2d Session

                               H. R. 3378

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                               AMENDMENT

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