Sec. 302. Allocation of Purchased/Referred Care program funds
1,172 words·~5 min read·
/bill/114/hr/5406/ih/section-302·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Title II of the Indian Health Care Improvement Act is amended by inserting after section 226 ( 25 U.S.C. 1621y ) the following new section: The Secretary shall, with respect to 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, review the distribution of funds pursuant to the program and initiate procedures under subchapter III of chapter 5 of title 5, United States Code, to negotiate or promulgate regulations to develop and implement a revised distribution formula in accordance with the subsequent subsections of this section.
In developing the revised distribution formula under subsection (a), the Secretary shall consider— the extent to which services are available at a Service hospital or facility of the Service rather than the mere existence of such a hospital or facility; population growth and the potential for population growth; the socioeconomic makeup of the population of each contract health service delivery area; the geographic makeup of each contract health service delivery area; the size of the hospital or facility; the relative regional cost of purchasing services; actual counts of Purchased/Referred Care users; and accreditation problems at the Service hospital or facility of the Service.
The revised distribution formula under subsection
(a)shall be implemented not later than the date that is 3 years after the first October 1 following the date of the enactment of this Act. Notwithstanding any other provision of law, for the period beginning on the first October 1 following the date of the enactment of this section and ending the day before the implementation date of the revised distribution formula under subsection (a), the Secretary shall provide for the distribution of funds, with respect to direct health care services provided by a Service facility, pursuant to the Purchased/Referred Care program (and with respect to services provided by any other facility under such program, at the option of such facility) be consistent with the following: During any portion of such period for which a Service area has been designated as a high IHS level area under paragraph (2)(B), such area shall not receive any funds pursuant to such program in addition to the base allotment determined under the distribution formula under the program for 2016 with respect to such area. In the case that during such period the amount of funds made available to the Service for such distribution under such program is in excess of the total amounts of base allotments for distribution under such program for 2016, the Secretary shall distribute such excess amount, in accordance with a methodology specified by the Secretary, to Service areas which for an applicable portion of such period of excess funding have been designated as a low IHS level area under paragraph (2)(A). For purposes of paragraph (1), the Secretary shall, with respect to each contract health service delivery area— review the services provided in the area to determine the IHS medical priority level pursuant to section 136.23(e) of title 42, Code of Federal Regulations, of such services; and in the case majority, as specified by the Secretary, of the services so provided in the area were determined to have— such a priority level of a I or II, designate such area as a low IHS level area; and any other priority level, designate such area as a high IHS level area. In the case of a facility that, as of the date of the enactment of this section, is under contract with the Secretary with respect to the Purchased/Referred Care program and such contract applies to a period to which subsection
(d)or the revised distribution formula under subsection
(a)applies, if application of subsection
(d)or the revised distribution formula results in the distribution of an amount of funds to such facility during such period that is less than the amount of funds that would be provided during such period to such facility under such contract with respect to the Purchased/Referred Care program before application of such subsection
(d)or such revised distribution formula, respectively, the Secretary may under section 106(b) of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450j–1(b) ) reduce such amount accordingly to be consistent with such subsection
(d)or revised distribution formula, respectively. Nothing in this section shall be construed to supersede a Tribe’s self-governance contract under the Indian Self-Determination and Education Assistance Act. The Secretary shall periodically, but not more frequently than once every 3 years and not less frequently than once every five years, review and, as necessary, update the formula implemented under subsection (a). In developing the formula under subsection
(a)and reviewing and making updates to such formula under subsection (f), the Secretary shall consult with Indian tribes, including such tribes consulted for purposes of carrying out section 226. Not later than one year after the date of the enactment of this section, and annually thereafter, the Secretary shall submit to Congress a report on the implementation of this section. Each such report shall include information, with respect to the period for such report, on— the distribution of funds for such period pursuant to the Purchased/Referred Care program among the contract health service delivery area, tribes, tribal organizations, and urban Indian organizations; whether during such period any contract health service delivery area, tribe, tribal organization, or urban Indian organization had a shortfall in such funding and, if so, the amount of such shortfall; and recommendations for such legislative action as the Secretary deems appropriate. . Section 226 of the Indian Health Care Improvement Act ( 25 U.S.C. 1621y ) is amended— in subsection (a)— by striking As soon as practicable after the date of enactment of the Indian Health Care Improvement Reauthorization and Extension Act of 2009 and inserting Not later than 2 years after the date of the enactment of section 227 ; by striking the study and inserting a study ; and by striking as requested by Congress in March 2009, or pursuant to section 830 and inserting , including as amended pursuant to section 227 ; in subsection (b)— in the matter preceding paragraph (1), by inserting , and submit, not later than one year after the date of the enactment of section 227 and annually thereafter, to Congress a report on after pursuant to the program ; in paragraph (3), by striking at the end and ; by redesignating paragraph
(4)as paragraph (5); by inserting after paragraph
(3)the following new paragraph: to determine whether during the period of the report any contract health service delivery area, tribe, tribal organization, or urban Indian organization had a shortfall in such funding and, if so, the amount of such shortfall; and recommendations for such legislative action as the Secretary deems appropriate. ; and in paragraph (5), as redesignated by subparagraph (C), by inserting , including recommendations for such legislative actions as the Secretary determines appropriate before the period at the end; and by striking subsection (c).
Connectionstraces to 1
Traces to 1 document
1 reference not yet in our index
- 25 USC 450j–1(b)
Citation graph
cites case law
Cites 2Cited by 0 across 0 sources