I 110th CONGRESS 2d Session S. 1200 IN THE HOUSE OF REPRESENTATIVES February 28, 2008 Referred to the Committee on Natural Resources, and in addition to the Committee on Energy and Commerce and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned AN ACT To amend the Indian Health Care Improvement Act to revise and extend that Act.

1.

Short title; table of contents

(a)

Short title

This Act may be cited as the Indian Health Care Improvement Act Amendments of 2008. (b)

Table of contents

The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. TITLE I—Amendments to Indian laws Sec. 101. Indian Health Care Improvement Act amended. Sec. 102. Soboba sanitation facilities. Sec. 103. Native American Health and Wellness Foundation. Sec. 104. Modification of term. Sec. 105. GAO study and report on payments for contract health services. Sec. 106. GAO study of membership criteria for federally recognized Indian tribes. Sec. 107. GAO study of tribal justice systems. TITLE II—Improvement of Indian health care provided under the Social Security Act Sec. 201. Expansion of payments under Medicare, Medicaid, and SCHIP for all covered services furnished by Indian Health Programs. Sec. 202. Increased outreach to Indians under Medicaid and SCHIP and improved cooperation in the provision of items and services to Indians under Social Security Act health benefit programs. Sec. 203. Additional provisions to increase outreach to, and enrollment of, Indians in SCHIP and Medicaid. Sec. 204. Premiums and cost sharing protections under Medicaid, eligibility determinations under Medicaid and SCHIP, and protection of certain Indian property from Medicaid estate recovery. Sec. 205. Nondiscrimination in qualifications for payment for services under Federal health care programs. Sec. 206. Consultation on Medicaid, SCHIP, and other health care programs funded under the Social Security Act involving Indian Health Programs and Urban Indian Organizations. Sec. 207. Exclusion waiver authority for affected Indian Health Programs and safe harbor transactions under the Social Security Act. Sec. 208. Rules applicable under Medicaid and SCHIP to managed care entities with respect to Indian enrollees and Indian health care providers and Indian managed care entities. Sec. 209. Annual report on Indians served by Social Security Act health benefit programs. Sec. 210. Development of recommendations to improve interstate coordination of Medicaid and SCHIP coverage of Indian children and other children who are outside of their State of residency because of educational or other needs. Sec. 211. Establishment of National Child Welfare Resource Center for Tribes. Sec. 212. Adjustment to the Medicare Advantage stabilization fund. Sec. 213. Moratorium on implementation of changes to case management and targeted case management payment requirements under Medicaid. Sec. 214. Increased civil money penalties and criminal fines for Medicare fraud and abuse. Sec. 215. Increased sentences for felonies involving Medicare fraud and abuse. TITLE III—Miscellaneous Sec. 301. Resolution of apology to Native Peoples of United States.

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102.

Soboba sanitation facilities

The Act of December 17, 1970 (84 Stat. 1465), is amended by adding at the end the following:

9.Nothing in this Act shall preclude the Soboba Band of Mission Indians and the Soboba Indian Reservation from being provided with sanitation facilities and services under the authority of section 7 of the Act of August 5, 1954 (68 Stat. 674), as amended by the Act of July 31, 1959 (73 Stat. 267).

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103.

Native American Health and Wellness Foundation

(a)

In general

The Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.) is amended by adding at the end the following: . (b)

Technical amendments

The Indian Self-Determination and Education Assistance Act is amended— (1)by redesignating title V (25 U.S.C. 458bbb et seq.) as title VII; (2)by redesignating sections 501, 502, and 503 (25 U.S.C. 458bbb, 458bbb–1, 458bbb–2) as sections 701, 702, and 703, respectively; and (3)in subsection (a)(2) of section 702 and paragraph (2) of section 703 (as redesignated by paragraph (2)), by striking section 501 and inserting section 701.

104.

Modification of term

(a)

In general

Except as provided in subsection (b), the Indian Health Care Improvement Act (as amended by section 101) and each provision of the Social Security Act amended by title II are amended (as applicable)— (1)by striking Urban Indian Organizations each place it appears and inserting urban Indian organizations; (2)by striking Urban Indian Organization each place it appears and inserting urban Indian organization; (3)by striking Urban Indians each place it appears and inserting urban Indians; (4)by striking Urban Indian each place it appears and inserting urban Indian; (5)by striking Urban Centers each place it appears and inserting urban centers; and (6)by striking Urban Center each place it appears and inserting urban center. (b)

Exception

The amendments made by subsection (a) shall not apply with respect to— (1)the matter preceding paragraph (1) of section 510 of the Indian Health Care Improvement Act (as amended by section 101); and (2)Urban Indian the first place it appears in section 513(a) of the Indian Health Care Improvement Act (as amended by section 101). (c)

Modification of definition

Section 4 of the Indian Health Care Improvement Act (as amended by section 101) is amended by striking paragraph (27) and inserting the following: (27)The term urban Indian means any individual who resides in an urban center and who meets 1 or more of the 4 criteria in subparagraphs (A) through (D) of paragraph (12). .

105.

GAO study and report on payments for contract health services

(a)

Study

(1)

In general

The Comptroller General of the United States (in this section referred to as the Comptroller General) shall conduct a study on the utilization of health care furnished by health care providers under the contract health services program funded by the Indian Health Service and operated by the Indian Health Service, an Indian Tribe, or a Tribal Organization (as those terms are defined in section 4 of the Indian Health Care Improvement Act). (2)

Analysis

The study conducted under paragraph (1) shall include an analysis of— (A)the amounts reimbursed under the contract health services program described in paragraph (1) for health care furnished by entities, individual providers, and suppliers, including a comparison of reimbursement for such health care through other public programs and in the private sector; (B)barriers to accessing care under such contract health services program, including, but not limited to, barriers relating to travel distances, cultural differences, and public and private sector reluctance to furnish care to patients under such program; (C)the adequacy of existing Federal funding for health care under such contract health services program; and (D)any other items determined appropriate by the Comptroller General. (b)

Report

Not later than 18 months after the date of enactment of this Act, the Comptroller General shall submit to Congress a report on the study conducted under subsection (a), together with recommendations regarding— (1)the appropriate level of Federal funding that should be established for health care under the contract health services program described in subsection (a)(1); and (2)how to most efficiently utilize such funding. (c)

Consultation

In conducting the study under subsection (a) and preparing the report under subsection (b), the Comptroller General shall consult with the Indian Health Service, Indian Tribes, and Tribal Organizations.

106.

GAO study of membership criteria for federally recognized Indian tribes

Not later than 1 year after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study of membership criteria for federally recognized Indian tribes, including— (1)the number of federally recognized Indian tribes in existence on the date on which the study is conducted; (2)the number of those Indian tribes that use blood quantum as a criterion for membership in the Indian tribe and the importance assigned to that criterion; (3)the percentage of members of federally recognized Indian tribes that possesses degrees of Indian blood of— (A)1/4; (B)1/8; and (C)1/16; and (4)the variance in wait times and rationing of health care services within the Service between federally recognized Indian Tribes that use blood quantum as a criterion for membership and those Indian Tribes that do not use blood quantum as such a criterion.

107.

GAO study of tribal justice systems

(a)

In general

Not later than 1 year after the date of enactment of this Act, the Comptroller General of the United States shall conduct, and submit to Congress a report describing the results of, a study of the tribal justice systems of Indian tribes located in the States of North Dakota and South Dakota. (b)

Inclusions

The study under subsection (a) shall include, with respect to the tribal system of each Indian tribe described in subsection (a) and the tribal justice system as a whole— (1)(A)a description of how the tribal justice systems function, or are supposed to function; and (B)a description of the components of the tribal justice systems, such as tribal trial courts, courts of appeal, applicable tribal law, judges, qualifications of judges, the selection and removal of judges, turnover of judges, the creation of precedent, the recording of precedent, the jurisdictional authority of the tribal court system, and the separation of powers between the tribal court system, the tribal council, and the head of the tribal government; (2)a review of the origins of the tribal justice systems, such as the development of the systems pursuant to the Act of June 18, 1934 (25 U.S.C. 461 et seq.) (commonly known as the Indian Reorganization Act), which promoted tribal constitutions and addressed the tribal court system; (3)an analysis of the weaknesses of the tribal justice systems, including the adequacy of law enforcement personnel and detention facilities, in particular in relation to crime rates; and (4)an analysis of the measures that tribal officials suggest could be carried out to improve the tribal justice systems, including an analysis of how Federal law could improve and stabilize the tribal court system.

Passed the Senate February 26, 2008. Nancy Erickson, Secretary