109th CONGRESS
1st Session
S. 2074
To amend title XIX of the Social Security Act to provide for fair
treatment of services furnished to Indians under the medicaid program, and
for other purposes.
IN THE SENATE OF THE UNITED STATES
November 18, 2005
Mr. BINGAMAN (for himself, Mr. BAUCUS, Mr. DORGAN, Mrs. MURRAY, Ms. CANTWELL,
and Mr. JOHNSON) introduced the following bill; which was read twice and
referred to the Committee on Finance
A BILL
To amend title XIX of the Social Security Act to provide for fair
treatment of services furnished to Indians under the medicaid program, and
for other purposes.
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 `Medicaid Indian Health Act of 2005'.
SEC. 2. APPLICATION OF 100 PERCENT FMAP FOR SERVICES FURNISHED TO AN INDIAN
BY AN URBAN INDIAN HEALTH PROGRAM.
(a) In General- The third sentence of section 1905(b) of the Social Security
Act (42 U.S.C. 1396d(b)), is amended by inserting before the period at the
end the following: `, or through an urban Indian health program receiving
funds under title V of the Indian Health Care Improvement Act'.
(b) Conforming Amendment- Section 1911(c) of such Act (42 U.S.C. 1396j(c)),
is amended by inserting `, or through an urban Indian health program receiving
funds under title V of the Indian Health Care Improvement Act' after `facilities'.
SEC. 3. PROHIBITION ON IMPOSITION OF PREMIUMS, DEDUCTIBLES, COPAYMENTS,
AND OTHER COST-SHARING ON INDIANS.
Section 1916 of the Social Security Act (42 U.S.C. 1396o) is amended--
(1) in subsection (a)(3), by inserting `(other than such individuals who
are Indians (as defined in section 4 of the Indian Health Care Improvement
Act)' after `other such individuals';
(2) in subsection (b), in the matter preceding paragraph (1), by inserting
`or who are Indians (as defined in section 4 of the Indian Health Care
Improvement Act)' after `section 1902(a)(10)'; and
(3) in subsection (c)(1), by inserting `(other than such an individual
who is an Indian (as defined in section 4 of the Indian Health Care Improvement
Act))' after `section 1902(l)(1)'.
SEC. 4. PROHIBITION ON RECOVERY AGAINST ESTATES OF INDIANS.
Section 1917(b)(1) of the Social Security Act (42 U.S.C. 1396p(b)(1)) is
amended, in the matter preceding subparagraph (A), by inserting ` who is
not an Indian (as defined in section 4 of the Indian Health Care Improvement
Act)' after `an individual' the second place it appears.
SEC. 5. REQUIREMENT FOR CONSULTATION WITH INDIAN TRIBES PRIOR TO APPROVAL
OF SECTION 1115 WAIVERS.
Section 1115 of the Social Security Act (42 U.S.C. 1315) is amended by adding
at the end the following:
`(g) In the case of an application for a waiver of compliance with the requirements
of section 1902 (or a renewal or extension of such a waiver) that is likely
to affect members of an Indian tribe (as defined in section 4 of the Indian
Health Care Improvement Act) or a tribal health program (whether operated
by an Indian tribe or a tribal organization (as so defined) serving such
members, the Secretary shall, prior to granting such a waiver under subsection
(a) or renewing or extending such a waiver under subsection (e), consult
with each such Indian tribe.'.
SEC. 6. REQUIREMENT FOR FAIR PAYMENT BY MEDICAID MANAGED CARE ENTITIES
TO INDIAN HEALTH PROGRAM PROVIDERS.
Section 1903(m)(2)(A)(ii) of the Social Security Act (42 U.S.C. 1396b(m)(2)(A)(ii))
is amended to read as follows:
`(ii) such contract provides, in the case of entity that has entered
into a contract for the provision of services with a facility or program
of the Indian Health Service, whether operated by the Service or an
Indian tribe or tribal organization (as defined in section 4 of the
Indian Health Care Improvement Act) or an urban Indian health program
receiving funds under title V of the Indian Health Care Improvement
Act , that is not a Federally-qualified health center or a rural health
clinic, that the entity shall provide payment that is not less than
the highest level and amount of payment that the entity would make
for the services if the services were furnished by a provider that
is not a facility or program of the Indian Health Service;'.
SEC. 7. TREATMENT OF MEDICAL EXPENSES PAID BY OR ON BEHALF OF AN INDIAN
BY AN INDIAN HEALTH PROGRAM AS COSTS INCURRED FOR MEDICAL CARE FOR PURPOSES
OF DETERMINING MEDICALLY NEEDY ELIGIBILITY.
Section 1902(a)(17)(D) of the Social Security Act (42 U.S.C. 1396a(a)(17)(D))
is amended by inserting `or by the Indian Health Service or an Indian tribe
or tribal organization (as defined in section 4 of the Indian Health Care
Improvement Act)' after `political subdivision thereof'.
SEC. 8. STATE OPTION TO EXEMPT INDIANS FROM REDUCTIONS IN ELIGIBILITY
OR BENEFITS.
Section 1902 of the Social Security Act (42 U.S.C. 1396a)) is amended by
inserting after subsection (j) the following:
`(k) The Secretary shall not disapprove a State plan amendment, or deny
a State request for a waiver under section 1115 (or a renewal or extension
of such a waiver), on the grounds that the amendment or waiver would exempt
Indians (as defined in section 4 of the Indian Health Care Improvement Act)
eligible for medical assistance from--
`(1) any restriction on eligibility for medical assistance under this
title that would otherwise apply under the amendment or waiver;
`(2) any imposition of premiums, deductibles, copayments, or other cost-sharing
that would otherwise apply under the amendment or waiver; or
`(3) any reduction in covered services or supplies that would otherwise
apply under the amendment or waiver.'.
SEC. 9. EFFECTIVE DATE.
(a) In General- Except as provided in subsection (b), this Act and the amendments
made by this Act apply to items or services furnished on or after January
1, 2006.
(b) Extension of Effective Date for State Law Amendment- In the case of
a State plan under title XIX of the Social Security Act which the Secretary
of Health and Human Services determines requires State legislation in order
for the plan to meet the additional requirements imposed by the amendments
made by a provision of this Act, the State plan shall not be regarded as
failing to comply with the requirements of this Act solely on the basis
of its failure to meet these additional requirements before the first day
of the first calendar quarter beginning after the close of the first regular
session of the State legislature that begins after the date of enactment
of this Act. For purposes of the previous sentence, in the case of a State
that has a 2-year legislative session, each year of the session shall be
considered to be a separate regular session of the State legislature.
END
