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

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

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.

END