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Code · BILL · 113th Congress · H.R. 4843 (Introduced in House) — To amend title XVIII of the Social Security Act to provide for a limitation under the Medicare program on charges for... · Sec. 3

Sec. 3. Limitation on charges for certain contract health services provided to Indians by Medicare providers of services and suppliers

566 words·~3 min read·/bill/113/hr/4843/ih/section-3

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Section 1866(a)(1)(U) of the Social Security Act ( 42 U.S.C. 1395cc(a)(1)(U) ) is amended, in the matter preceding clause (i), by striking in the case of hospitals which furnish inpatient hospital services for which payment may be made under this title, . The Secretary of Health and Human Services shall promulgate regulations to account for the amendment made by paragraph (1). The amendment made by paragraph
(1)shall apply to Medicare participation agreements in effect (or entered into) on or after the date that is 90 days after the date of enactment of this Act. Section 1834 of the Social Security Act ( 42 U.S.C. 1395m ) is amended by adding at the end the following new subsection: No payment may be made under this title for an item or service furnished by a supplier (as defined in section 1861(d)) unless the supplier agrees (pursuant to a process established by the Secretary) to be a participating provider of medical and other health services both— under the Purchased/Referred Care program (formerly referred to as 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 under any 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 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). . The amendment made by paragraph
(1)shall apply to items and services furnished on or after the date that is 90 days after the date of enactment of this Act. There shall be no reduction, offset, or limitation to any appropriations made to the Indian Health Service under the Indian Health Care Improvement Act (25 U.S.C. 1621 et seq.), the Act of November 2, 1921 ( 25 U.S.C. 13 ) (commonly known as the Snyder Act ), or any other provision of law as a result of the provisions of, including amendments made by, this Act. The Secretary of Health and Human Services (in this subsection referred to as the Secretary ), acting through the Director of the Indian Health Service, shall conduct a study on the impact of the amendments made by this section on access to care under the Purchased/Referred Care program of the Indian Health Service. Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to Congress a report containing the results of the study conducted under paragraph (1), including recommendations for such legislation and administrative action as the Secretary determines appropriate. 219(c) study and report Section 219(c) of the Indian Health Care Improvement Act ( 25 U.S.C. 1621r(c) ) is amended by striking 12 months after the date of the enactment of this section and inserting 12 months after the date of the enactment of the Native Contract and Rate Expenditure Act of 2014, and biennially thereafter through 2020 .
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Sec. 3
Limitation on charges for certain contract health services provided to Indians by Medicare providers of services and suppliers
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