I 111th CONGRESS 1st Session H. R. 2708 IN THE HOUSE OF REPRESENTATIVES June 4, 2009 Mr. Pallone (for himself, Mr. Rahall, Mr. Kildee, Mr. Young of Alaska, Mr. Grijalva, Ms. Bordallo, Mr. Boren, Mr. Inslee, Mr. Baca, Mr. Heinrich, Mr. Teague, Ms. McCollum, Ms. Linda T. Sánchez of California, Mr. Kagen, Mr. Luján, Mr. Salazar, Mr. Schauer, and Mrs. Bono Mack) introduced the following bill; which was referred to the Committee on Natural Resources, and in addition to the Committees 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 A BILL To amend the Indian Health Care Improvement Act to revise and extend that Act, and for other purposes.

1.

Short title; table of contents

(a)

Short title

This Act may be cited as the Indian Health Care Improvement Act Amendments of 2009. (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. GAO study and report on payments for contract health services. 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. Nondiscrimination in qualifications for payment for services under Federal health care programs. Sec. 205. Solicitation of proposals for safe harbors under the Social Security Act for facilities of Indian Health Programs and urban Indian organizations. Sec. 206. Annual report on Indians served by Social Security Act health benefit programs. Sec. 207. 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.

. (b)

Rate of pay

(1)

Positions at level IV

Section 5315 of title 5, United States Code, is amended by striking Assistant Secretaries of Health and Human Services (6). and inserting Assistant Secretaries of Health and Human Services (7). (2)

Positions at level V

Section 5316 of title 5, United States Code, is amended by striking Director, Indian Health Service, Department of Health and Human Services. (c)

Amendments to other provisions of law

(1)Section 3307(b)(1)(C) of the Children’s Health Act of 2000 (25 U.S.C. 1671 note; Public Law 106–310) is amended by striking Director of the Indian Health Service and inserting Assistant Secretary for Indian Health. (2)The Indian Lands Open Dump Cleanup Act of 1994 is amended— (A)in section 3 (25 U.S.C. 3902)— (i)by striking paragraph (2); (ii)by redesignating paragraphs (1), (3), (4), (5), and (6) as paragraphs (4), (5), (2), (6), and (1), respectively, and moving those paragraphs so as to appear in numerical order; and (iii)by inserting before paragraph (4) (as redesignated by subclause (II)) the following: (3)

Assistant Secretary

The term Assistant Secretary means the Assistant Secretary for Indian Health.; (B)in section 5 (25 U.S.C. 3904), by striking the section designation and heading and inserting the following:

5.

Authority of Assistant Secretary for Indian Health

; (C)in section 6(a) (25 U.S.C. 3905(a)), in the subsection heading, by striking Director and inserting Assistant Secretary; (D)in section 9(a) (25 U.S.C. 3908(a)), in the subsection heading, by striking Director and inserting Assistant Secretary; and (E)by striking Director each place it appears and inserting Assistant Secretary. (3)Section 5504(d)(2) of the Augustus F. Hawkins-Robert T. Stafford Elementary and Secondary School Improvement Amendments of 1988 (25 U.S.C. 2001 note; Public Law 100–297) is amended by striking Director of the Indian Health Service and inserting Assistant Secretary for Indian Health. (4)Section 203(a)(1) of the Rehabilitation Act of 1973 (29 U.S.C. 763(a)(1)) is amended by striking Director of the Indian Health Service and inserting Assistant Secretary for Indian Health. (5)Subsections (b) and (e) of section 518 of the Federal Water Pollution Control Act (33 U.S.C. 1377) are amended by striking Director of the Indian Health Service each place it appears and inserting Assistant Secretary for Indian Health. (6)Section 317M(b) of the Public Health Service Act (42 U.S.C. 247b–14(b)) is amended— (A)by striking Director of the Indian Health Service each place it appears and inserting Assistant Secretary for Indian Health; and (B)in paragraph (2)(A), by striking the Directors referred to in such paragraph and inserting the Director of the Centers for Disease Control and Prevention and the Assistant Secretary for Indian Health. (7)Section 417C(b) of the Public Health Service Act (42 U.S.C. 285–9(b)) is amended by striking Director of the Indian Health Service and inserting Assistant Secretary for Indian Health. (8)Section 1452(i) of the Safe Drinking Water Act (42 U.S.C. 300j–12(i)) is amended by striking Director of the Indian Health Service each place it appears and inserting Assistant Secretary for Indian Health. (9)Section 803B(d)(1) of the Native American Programs Act of 1974 (42 U.S.C. 2991b–2(d)(1)) is amended in the last sentence by striking Director of the Indian Health Service and inserting Assistant Secretary for Indian Health. (10)Section 203(b) of the Michigan Indian Land Claims Settlement Act (Public Law 105–143; 111 Stat. 2666) is amended by striking Director of the Indian Health Service and inserting Assistant Secretary for Indian Health.

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).

.

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.

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.