
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document affected by Public Law 106-417 Section 3(b)(2)]
[CITE: 42USC1396j]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
    SUBCHAPTER XIX--GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS
 
Sec. 1396j. Indian health service facilities


(a) Eligibility for reimbursement for medical assistance

    A facility of the Indian Health Service (including a hospital, 
nursing facility, or any other type of facility which provides services 
of a type otherwise covered under the State plan), whether operated by 
such Service or by an Indian tribe or tribal organization (as those 
terms are defined in section 1603 of title 25), shall be eligible for 
reimbursement for medical assistance provided under a State plan if and 
for so long as it meets all of the conditions and requirements which are 
applicable generally to such facilities under this subchapter.

(b) Facilities deemed to meet requirements upon submission of acceptable 
        plan for achieving compliance

    Notwithstanding subsection (a) of this section, a facility of the 
Indian Health Service (including a hospital, nursing facility, or any 
other type of facility which provides services of a type otherwise 
covered under the State plan) which does not meet all of the conditions 
and requirements of this title which are applicable generally to such 
facility, but which submits to the Secretary within six months after 
September 30, 1976, an acceptable plan for achieving compliance with 
such conditions and requirements, shall be deemed to meet such 
conditions and requirements (and to be eligible for reimbursement under 
this subchapter), without regard to the extent of its actual compliance 
with such conditions and requirements, during the first twelve months 
after the month in which such plan is submitted.

(c) Agreement to reimburse State agency for providing care and services

    The Secretary is authorized to enter into agreements with the State 
agency for the purpose of reimbursing such agency for health care and 
services provided in Indian Health Service facilities to Indians who are 
eligible for medical assistance under the State plan.

(Aug. 14, 1935, ch. 531, title XIX, Sec. 1911, as added Pub. L. 94-437, 
title IV, Sec. 402(a), Sept. 30, 1976, 90 Stat. 1409; amended Pub. L. 
100-203, title IV, Secs. 4118(f)(1), 4211(h)(8), Dec. 22, 1987, 101 
Stat. 1330-155, 1330-206; Pub. L. 100-360, title IV, Sec. 411(k)(10)(E), 
July 1, 1988, 102 Stat. 796.)


                               Amendments

    1988--Subsecs. (a), (b). Pub. L. 100-360, Sec. 411(k)(10)(E), made 
technical correction to directory language of Pub. L. 100-203, 
Sec. 4118(f)(1)(A), see 1987 Amendment note below.
    1987--Subsecs. (a), (b). Pub. L. 100-203, Sec. 4118(f)(1)(A), as 
amended by Pub. L. 100-360, Sec. 411(k)(10)(E), substituted ``, nursing 
facility, or any other type of facility which provides services of a 
type otherwise covered under the State plan'' for ``or nursing 
facility''.
    Pub. L. 100-203, Sec. 4211(h)(8), substituted ``or nursing 
facility'' for ``, intermediate care facility, or skilled nursing 
facility'' wherever appearing.
    Subsec. (c). Pub. L. 100-203, Sec. 4118(f)(1)(B), added subsec. (c).


                    Effective Date of 1988 Amendment

    Except as specifically provided in section 411 of Pub. L. 100-360, 
amendment by Pub. L. 100-360, as it relates to a provision in the 
Omnibus Budget Reconciliation Act of 1987, Pub. L. 100-203, effective as 
if included in the enactment of that provision in Pub. L. 100-203, see 
section 411(a) of Pub. L. 100-360, set out as a Reference to OBRA; 
Effective Date note under section 106 of Title 1, General Provisions.


                    Effective Date of 1987 Amendment

    Section 4118(f)(2) of Pub. L. 100-203 provided that: ``The 
amendments made by paragraph (1) [amending this section] shall apply to 
health care services performed on or after the date of the enactment of 
this Act [Dec. 22, 1987].''
    Amendment by section 4211(h)(8) of Pub. L. 100-203 applicable to 
nursing facility services furnished on or after Oct. 1, 1990, without 
regard to whether regulations implementing such amendment are 
promulgated by such date, except as otherwise specifically provided in 
section 1396r of this title, with transitional rule, see section 
4214(a), (b)(2) of Pub. L. 100-203, as amended, set out as an Effective 
Date note under section 1396r of this title.


   Agreements To Reimburse State Agency for Health Care and Services 
                      Provided by Agency to Indians

    Pub. L. 94-437, title IV, Sec. 402(b), Sept. 30, 1976, 90 Stat. 
1409, which authorized Secretary to enter into agreements to reimburse 
State agencies for health care and services provided in Service 
facilities to Indians eligible for medical assistance under this 
subchapter, was repealed by Pub. L. 100-713, title IV, Sec. 401(b), Nov. 
23, 1988, 102 Stat. 4818, applicable to services performed on or after 
the Nov. 23, 1988.


 Payments Into Special Fund To Improve Indian Health Service Facilities 
To Achieve Compliance With Conditions and Requirements; Certification of 
                         Compliance by Secretary

    Section 402(c) of Pub. L. 94-437, as amended by Pub. L. 100-713, 
title IV, Sec. 401(a), Nov. 23, 1988, 102 Stat. 4818, provided that 
payments to which any Indian Health Service facility was entitled by 
reason of this section were to be placed in a special fund of the 
Secretary for improvements of facilities of the Service to comply with 
requirements of this subchapter, required minimum funding for each 
service unit making collections for such facilities, and provided for 
section 402(c) of Pub. L. 94-437 to cease to apply when Secretary 
determined that substantially all such facilities complied with 
requirements of this subchapter, prior to the general amendment of 
section 402 of Pub. L. 94-437 by Pub. L. 102-573, title IV, 
Sec. 401(b)(1), Oct. 29, 1992, 106 Stat. 4565. Similar provisions are 
contained in section 402(a) of Pub. L. 94-437 which is classified to 
section 1642(a) of Title 25, Indians.


   Medicaid Payments Not Considered in Determining Appropriations for 
                           Indian Health Care

    Section 402(d) of Pub. L. 94-437 provided that any payments received 
for services provided recipients under this section were not to be 
considered in determining appropriations for the provision of health 
care and services to Indians, prior to the general amendment of section 
402 of Pub. L. 94-437 by Pub. L. 102-573, title IV, Sec. 401(b)(1), Oct. 
29, 1992, 106 Stat. 4565. Similar provisions are contained in section 
402(b) of Pub. L. 94-437 which is classified to section 1642(b) of Title 
25, Indians.

                  Section Referred to in Other Sections

    This section is referred to in section 290ff of this title; title 25 
section 1642.
