[Congressional Record Volume 145, Number 44 (Friday, March 19, 1999)]
[Senate]
[Pages S3006-S3007]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. INOUYE:
  S. 672. A bill to amend title XIX of the Social Security Act to 
extend the higher Federal medical assistance percentage for payment for 
Indian Health service facilities to urban Indian health programs under 
the Medicaid Program; to the Committee on Finance.


  LEGISLATION TO EXTEND THE FEDERAL MEDICAL ASSISTANCE PERCENTAGE TO 
                      URBAN INDIAN HEALTH PROGRAMS

 Mr. INOUYE. Mr. President, I rise today to introduce 
legislation that would correct an inequity in the current reimbursement 
rates for health care services provided to low-income Medicaid-eligible 
American Indians and Alaska Natives through the Indian Health Service 
(IHS) urban Indian health care programs.
  Mr. President, currently, a 100 percent Federal medical assistance 
percentage (FMAP) applies for the cost of services provided to Medicaid 
beneficiaries by a hospital, a clinic, or other IHS facility, under the 
condition that the facilities are operated by the IHS, a tribe, or 
tribal organization. IHS facilities which are predominately located in 
rural areas are eligible to receive the 100 percent FMAP, while similar 
services provided through IHS programs located in urban areas receive 
only 50-80 percent reimbursement depending on the type of service 
provided.
  This legislation would address this inequity by extending the Federal 
medical assistance percentage to payments for IHS facilities to urban 
Indian

[[Page S3007]]

health care programs under the Medicaid program, and informal estimates 
indicate that equalizing the FMAP for IHS programs would cost $17 
million over the next 5 years.
  With few employment opportunities in tribal reservation communities, 
most Indians are literally forced to relocate and seek employment in 
cities, and as a result, roughly half of the total American Indian/
Alaska Native population is now residing in urban areas. With that in 
mind, equalizing the Federal medical assistance percentage for health 
care provided to Medicaid-eligible Indians through the IHS urban Indian 
health care programs is essential.
  Mr. President, I urge my colleagues to support this 
legislation.
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