Sec. 203. Mandatory funding for Indian Health Service
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There is established in the Treasury an account, to be known as the Indian Health Services Operations Account , into which shall be deposited all amounts appropriated or otherwise made available according to the recommendations of the national Tribal Budget Formulation Workgroup, as of the date of enactment of this Act, to carry out the Indian Health Care Improvement Act ( 25 U.S.C. 1601 et seq. ) and any other program relating to or operated by the Indian Health Service. There are authorized to be appropriated, and there are appropriated, out of any monies in the Treasury not otherwise appropriated, the following amounts, which shall be deposited in the Indian Health Services Operations Account:
For fiscal year 2023, $50,138,679,000. For fiscal year 2024, $51,416,373,000. For fiscal year 2025 and each fiscal year thereafter, an amount equal to the sum of— the amount appropriated for the previous fiscal year, as adjusted annually to reflect the change in the medical care component of the consumer price index for all urban consumers (U.S. city average); and as applicable— 1.8 percent of the amount appropriated for the previous fiscal year; or the percentage of the amount appropriated for the previous fiscal year determined under subsection (c)(2).
Not later than September 30, 2024, and not less frequently than once every 10 years thereafter, the Comptroller General of the United States shall conduct a study, in consultation with Indian tribes, to determine whether the population served by the Indian Health Service has continued to grow by 1.8 percent per year. If the Comptroller General determines under the study conducted under paragraph
(1)that the actual rate of growth of the population described in that paragraph is higher than 1.8 percent, for purposes of subsection (b)(3)(B)(ii), the percentage by which the amount appropriated for the previous fiscal year shall be adjusted to reflect the actual rate of growth determined by the study. Not later than the end of fiscal year 2023, the Secretary of Health and Human Services shall submit to the Committees on the Budget, Health, Education, Labor, and Pensions, and Indian Affairs of the Senate and the Committee on the Budget, the Subcommittee on Health of the Committee on Energy and Commerce, and the Subcommittee for Indigenous Peoples of the United States of the Committee on Natural Resources of the House of Representatives a publicly available report, developed in consultation with Indian tribes, that proposes an item of appropriation, according to the recommendations of the national Tribal Budget Formulation Workgroup, for shortfalls for funds related to the lease of a facility used for administration and delivery of Indian Health Service programs pursuant to section 105(l) of the Indian Self-Determination Act ( 25 U.S.C. 5324(l) ), including supporting documentation on the methods used by the Secretary of Health and Human Services to determine the amount of shortfalls. In addition to the amount appropriated for a fiscal year for the Indian Health Services Operations Account, there is authorized to be appropriated for fiscal year 2023, and each fiscal year thereafter, and there is appropriated, out of any monies in the Treasury not otherwise appropriated, the amount requested by the report under paragraph (1). The amount made available under clause
(i)for fiscal year 2024 and each fiscal year thereafter shall be adjusted annually to reflect the change in the medical care component of the consumer price index for all urban consumers (U.S. city average). In addition to the amount appropriated for a fiscal year for the Indian Health Services Operations Account, there is authorized to be appropriated for fiscal year 2023, and each fiscal year thereafter, for contract support costs described in section 106 of the Indian Self-Determination Act ( 25 U.S.C. 5325 ) an amount determined by the Secretary of the Interior to cover any shortfalls for the operation of the programs and portions for periods covered by the contract support costs.
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