§ 1621e TITLE 25—INDIANS Page 446

(b) Functions of study

Such study shall—

(1) assess the impact of Indian culture and

beliefs concerning death and dying on the provision of hospice care to Indians;

(2) estimate the number of Indians for whom

hospice care may be appropriate and determine the geographic distribution of such individuals;

(3) determine the most appropriate means to

facilitate the participation of Indian tribes

and tribal organizations in providing hospice

care;

(4) identify and evaluate various means for

providing hospice care, including—

(A) the provision of such care by the personnel of a Service hospital pursuant to a

hospice program established by the Secretary at such hospital; and

(B) the provision of such care by a community-based hospice program under contract

to the Service; and

(5) identify and assess any difficulties in furnishing such care and the actions needed to resolve such difficulties.

(c) Report to Congress

Not later than the date which is 12 months

after October 29, 1992, the Secretary shall transmit to the Congress a report containing—

(1) a detailed description of the study conducted pursuant to this section; and

(2) a discussion of the findings and conclusions of such study.

(d) Definitions

For the purposes of this section—

(1) the term ‘‘terminally ill’’ means any Indian who has a medical prognosis (as certified

by a physician) of a life expectancy of six

months or less; and

(2) the term ‘‘hospice program’’ means any

program which satisfies the requirements of

section 1395x(dd)((2) of title 42; and

(3) the term ‘‘hospice care’’ means the items

and services specified in subparagraphs (A)

through (H) of section 1395x(dd)(1) of title 42.

(Pub. L. 94–437, title II, §205, as added Pub. L.

102–573, title II, §206(a), Oct. 29, 1992, 106 Stat.

4548.)

PRIOR PROVISIONS

A prior section 1621d, Pub. L. 94–437, title II, §205, as

added Pub. L. 100–713, title II, §203(c), Nov. 23, 1988, 102

Stat. 4807, related to Native Hawaiian health promotion and disease prevention, prior to repeal by Pub.

L. 100–579, §14, formerly §10, Oct. 31, 1988, 102 Stat. 2923;

Pub. L. 100–690, title II, §2310, Nov. 18, 1988, 102 Stat.

4229; renumbered §14, Pub. L. 102–396, title IX, §9168,

Oct. 6, 1992, 106 Stat. 1948. See section 11701 et seq. of

Title 42, The Public Health and Welfare.

§ 1621e. Reimbursement from certain third parties of costs of health services

(a) Right of recovery

Except as provided in subsection (f) of this section, the United States, an Indian tribe, or a

tribal organization shall have the right to recover the reasonable expenses incurred by the

Secretary, an Indian tribe, or a tribal organization in providing health services, through the

Service, an Indian tribe, or a tribal organization, to any individual to the same extent that

such individual, or any nongovernmental provider of such services, would be eligible to receive reimbursement or indemnification for

such expenses if—

(1) such services had been provided by a nongovernmental provider, and

(2) such individual had been required to pay

such expenses and did pay such expenses.

(b) Recovery against State with workers’ compensation laws or no-fault automobile accident insurance program

Subsection (a) of this section shall provide a

right of recovery against any State only if the

injury, illness, or disability for which health

services were provided is covered under—

(1) workers’ compensation laws, or

(2) a no-fault automobile accident insurance

plan or program.

(c) Prohibition of State law or contract provision

impeding right of recovery

No law of any State, or of any political subdivision of a State, and no provision of any contract entered into or renewed after November 23,

1988, shall prevent or hinder the right of recovery of the United States, an Indian tribe, or a

tribal organization under subsection (a) of this

section.

(d) Right to damages

No action taken by the United States, an Indian tribe, or a tribal organization to enforce

the right of recovery provided under subsection

(a) of this section shall affect the right of any

person to any damages (other than damages for

the cost of health services provided by the Secretary through the Service).

(e) Intervention or separate civil action

The United States, an Indian tribe, or a tribal

organization may enforce the right of recovery

provided under subsection (a) of this section

by—

(1) intervening or joining in any civil action

or proceeding brought—

(A) by the individual for whom health

services were provided by the Secretary, an

Indian tribe, or a tribal organization, or

(B) by any representative or heirs of such

individual, or

(2) instituting a separate civil action, after

providing to such individual, or to the representative or heirs of such individual, notice

of the intention of the United States, an Indian tribe, or a tribal organization to institute

a separate civil action.

(f) Right of recovery for services when self-insurance plan provides coverage

The United States shall not have a right of recovery under this section if the injury, illness,

or disability for which health services were provided is covered under a self-insurance plan

funded by an Indian tribe or tribal organization.

(Pub. L. 94–437, title II, §206, as added Pub. L.

100–713, title II, §204, Nov. 23, 1988, 102 Stat. 4811;

amended Pub. L. 102–573, title II, §209, Oct. 29,

1992, 106 Stat. 4551.)
Page 447 TITLE 25—INDIANS § 1621h

AMENDMENTS

1992—Subsec. (a). Pub. L. 102–573, §209(b)(1), substituted ‘‘Except as provided in subsection (f) of this

section, the’’ for ‘‘The’’.

Pub. L. 102–573, §209(a)(1)–(3), inserted ‘‘, an Indian

tribe, or a tribal organization’’ after ‘‘United States’’,

after ‘‘Service’’, and after ‘‘Secretary’’.

Subsec. (b). Pub. L. 102–573, §209(a)(4), struck out

‘‘, or any political subdivision of a State,’’ after

‘‘against any State’’.

Subsecs. (c), (d). Pub. L. 102–573, §209(a)(1), inserted

‘‘, an Indian tribe, or a tribal organization’’ after

‘‘United States’’.

Subsec. (e). Pub. L. 102–573, §209(a)(1), (3), inserted

‘‘, an Indian tribe, or a tribal organization’’ after

‘‘United States’’ in two places and after ‘‘Secretary’’.

Subsec. (f). Pub. L. 102–573, §209(b)(2), added subsec.

(f).

§ 1621f. Crediting of reimbursements

(a) Except as provided in section 1621a(d) of

this title, subchapter III–A of this chapter, and

section 1680c of this title, all reimbursements received or recovered, under authority of this

chapter, Public Law 87–693 (42 U.S.C. 2651, et

seq.), or any other provision of law, by reason of

the provision of health services by the Service

or by a tribe or tribal organization under a contract pursuant to the Indian Self-Determination

Act [25 U.S.C. 450f et seq.] shall be retained by

the Service or that tribe or tribal organization

and shall be available for the facilities, and to

carry out the programs, of the Service or that

tribe or tribal organization to provide health

care services to Indians.

(b) The Service may not offset or limit the

amount of funds obligated to any service unit or

any entity under contract with the Service because of the receipt of reimbursements under

subsection (a) of this section.

(Pub. L. 94–437, title II, §207, as added Pub. L.

100–713, title II, §204, Nov. 23, 1988, 102 Stat. 4812;

amended Pub. L. 102–573, title VII, §701(c)(1),

Oct. 29, 1992, 106 Stat. 4572.)

REFERENCES IN TEXT

Public Law 87–693, referred to in subsec. (a), is Pub. L.

87–693, Sept. 25, 1962, 76 Stat. 593, which is classified

generally to chapter 32 (§2651 et seq.) of Title 42, The

Public Health and Welfare. For complete classification

of this Act to the Code, see Tables.

The Indian Self-Determination Act, referred to in

subsec. (a), is title I of Pub. L. 93–638, Jan. 4, 1975, 88

Stat. 2206, as amended, which is classified principally

to part A (§450f et seq.) of subchapter II of chapter 14

of this title. For complete classification of this Act to

the Code, see Short Title note set out under section 450

of this title and Tables.

AMENDMENTS

1992—Subsec. (a). Pub. L. 102–573 made technical

amendment to reference to section 1680c of this title to

reflect renumbering of corresponding section of original act.

§ 1621g. Health services research

Of the amounts appropriated for the Service in

any fiscal year, other than amounts made available for the Indian Health Care Improvement

Fund, not less than $200,000 shall be available

only for research to further the performance of

the health service responsibilities of the Service. Indian tribes and tribal organizations contracting with the Service under the authority of

the Indian Self-Determination Act [25 U.S.C.

450f et seq.] shall be given an equal opportunity

to compete for, and receive, research funds

under this section.

(Pub. L. 94–437, title II, §208, as added Pub. L.

100–713, title II, §204, Nov. 23, 1988, 102 Stat. 4812.)

REFERENCES IN TEXT

The Indian Self-Determination Act, referred to in

text, is title I of Pub. L. 93–638, Jan. 4, 1975, 88 Stat.

2206, as amended, which is classified principally to part

A (§450f et seq.) of subchapter II of chapter 14 of this

title. For complete classification of this Act to the

Code, see Short Title note set out under section 450 of

this title and Tables.

§ 1621h. Mental health prevention and treatment

services

(a) National plan for Indian Mental Health Services

(1) Not later than 120 days after November 28,

1990, the Secretary, acting through the Service,

shall develop and publish in the Federal Register a final national plan for Indian Mental

Health Services. The plan shall include—

(A) an assessment of the scope of the problem of mental illness and dysfunctional and

self-destructive behavior, including child

abuse and family violence, among Indians, including—

(i) the number of Indians served by the

Service who are directly or indirectly affected by such illness or behavior, and

(ii) an estimate of the financial and human

cost attributable to such illness or behavior;

(B) an assessment of the existing and additional resources necessary for the prevention

and treatment of such illness and behavior;

and

(C) an estimate of the additional funding

needed by the Service to meet its responsibilities under the plan.

(2) The Secretary shall submit a copy of the

national plan to the Congress.

(b) Memorandum of agreement

Not later than 180 days after November 28,

1990, the Secretary and the Secretary of the Interior shall develop and enter into a memorandum of agreement under which the Secretaries

shall, among other things—

(1) determine and define the scope and nature of mental illness and dysfunctional and

self-destructive behavior, including child

abuse and family violence, among Indians;

(2) make an assessment of the existing Federal, tribal, State, local, and private services,

resources, and programs available to provide

mental health services for Indians;

(3) make an initial determination of the

unmet need for additional services, resources,

and programs necessary to meet the needs

identified pursuant to paragraph (1);

(4)(A) ensure that Indians, as citizens of the

United States and of the States in which they

reside, have access to mental health services

to which all citizens have access;

(B) determine the right of Indians to participate in, and receive the benefit of, such services; and