[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1779 Introduced in Senate (IS)]

  1st Session
                                S. 1779

To amend title XVIII of the Social Security Act to provide for fairness 
           in the provision of medicare services for Indians.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 23, 2003

 Mr. Bingaman (for himself, Mr. Inouye, Mr. Daschle, Mrs. Murray, Mr. 
  Dayton, Mr. Johnson, Ms. Cantwell, and Ms. Stabenow) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to provide for fairness 
           in the provision of medicare services for Indians.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Indian Health Fairness Act 
of 2003''.

SEC. 2. AUTHORIZATION OF REIMBURSEMENT FOR ALL MEDICARE PART B SERVICES 
              FURNISHED BY CERTAIN INDIAN HOSPITALS AND CLINICS.

    (a) In General.--Section 1880(e) of the Social Security Act (42 
U.S.C. 1395qq(e)) is amended--
            (1) in paragraph (1)(A), by striking ``for services 
        described in paragraph (2)'' and inserting ``for all items and 
        services for which payment may be made under such part'';
            (2) by striking paragraph (2); and
            (3) by redesignating paragraph (3) as paragraph (2).
    (b) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after the first day of the 
sixth month beginning after the date of enactment of this Act.

SEC. 3. LIMITATION ON CHARGES FOR INPATIENT HOSPITAL CONTRACT HEALTH 
              SERVICES PROVIDED TO INDIANS BY MEDICARE PARTICIPATING 
              HOSPITALS.

    (a) In General.--Section 1866(a)(1) of the Social Security Act (42 
U.S.C. 1395cc(a)(1)) is amended--
            (1) in subparagraph (R), by striking ``and'' at the end;
            (2) in subparagraph (S), by striking the period and 
        inserting ``, and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(T) in the case of hospitals which furnish 
                inpatient hospital services for which payment may be 
                made under this title, to be a participating provider 
                of medical care--
                            ``(i) under the contract health services 
                        program funded by the Indian Health Service and 
                        operated by the Indian Health Service, an 
                        Indian tribe, or tribal organization (as those 
                        terms are defined in section 4 of the Indian 
                        Health Care Improvement Act), with respect to 
                        items and services that are covered under such 
                        program and furnished to an individual eligible 
                        for such items and services under such program; 
                        and
                            ``(ii) under a program funded by the Indian 
                        Health Service and operated by an urban Indian 
                        organization with respect to the purchase of 
                        items and services for an eligible urban Indian 
                        (as those terms are defined in such section 4),
                in accordance with regulations promulgated by the 
                Secretary regarding admission practices, payment 
                methodology, and rates of payment (including the 
                acceptance of no more than such payment rate as payment 
                in full for such items and services).''.
    (b) Effective Date.--The amendments made by this section shall 
apply as of a date specified by the Secretary of Health and Human 
Services (but in no case later than 6 months after the date of 
enactment of this Act) to medicare participation agreements in effect 
(or entered into) on or after such date.

SEC. 4. EQUAL PAYMENTS FOR CLINICS IN THE INDIAN HEALTH SERVICE 
              SUPPORTED HEALTH CARE SYSTEM.

    (a) In General.--Section 1880 of the Social Security Act (42 U.S.C. 
1395qq) is amended--
            (1) by redesignating subsection (f) as subsection (g); and
            (2) by inserting after subsection (e) the following new 
        subsection:
    ``(f) Notwithstanding any other provision of law, for purposes of 
determining the rate of reimbursement for items and services under this 
title, any outpatient or ambulatory care clinic (whether freestanding 
or provider-based) operated by the Indian Health Service, an Indian 
tribe, a tribal organization, or an urban Indian organization (as those 
terms are defined in section 4 of the Indian Health Care Improvement 
Act), shall, upon the election of such clinic, be reimbursed on the 
same basis as if such clinic were a hospital outpatient department of 
the Indian Health Service.''.
    (b) Effective Date.--The amendments made by this section shall 
apply to items and services furnished on or after the first day of the 
sixth month beginning after the date of enactment of this Act.
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