104TH CONGRESS

2D SESSION H. R. 3378

HOUSE AMENDMENT

TO SENATE

AMENDMENT
In the House of Representatives, U.S.,

September 27, 1996.

Resolved, That the House agree to the amendment of the

Senate to the bill (H.R. 3378) entitled ‘‘An Act to amend the

Indian Health Care Improvement Act to extend the demonstration program for direct billing of Medicare, Medicaid,

and for other purposes’’, with the following

HOUSE AMENDMENT TO

SENATE AMENDMENT:

In lieu of the matter proposed to be inserted by the Senate amendment to the text of the bill, insert:
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1 SECTION 1. SHORT TITLE; REFERENCE.

2 (a) SHORT TITLE.—This Act may be cited as the ‘‘In3 dian Health Care Improvement Technical Corrections Act

4 of 1996’’.

5 (b) REFERENCES.—Whenever in this Act an amend6 ment or repeal is expressed in terms of an amendment to

7 or repeal of a section or other provision, the reference shall

8 be considered to be made to a section or other provision

9 of the Indian Health Care Improvement Act.

10 SEC. 2. TECHNICAL CORRECTIONS IN THE INDIAN HEALTH

11 CARE IMPROVEMENT ACT.

12 (a) DEFINITION OF HEALTH PROFESSION.—Section

13 4(n) (25 U.S.C. 1603(n)) is amended—

14 (1) by inserting ‘‘allopathic medicine,’’ before

15 ‘‘family medicine’’; and

16 (2) by striking ‘‘and allied health professions’’

17 and inserting ‘‘an allied health profession, or any

18 other health profession’’.

19 (b) INDIAN HEALTH PROFESSIONS SCHOLARSHIPS.—

20 Section 104(b) of the Indian Health Care Improvement Act

21 (25 U.S.C. 1613a(b)) is amended—

22 (1) in paragraph (3)—

23 (A) in subparagraph (A)—

24 (i) by striking the matter preceding

25 clause (i) and inserting the following:
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1 ‘‘(3)(A) The active duty service obligation under a

2 written contract with the Secretary under section 338A of

3 the Public Health Service Act (42 U.S.C. 254l) that an in4 dividual has entered into under that section shall, if that

5 individual is a recipient of an Indian Health Scholarship,

6 be met in full-time practice, by service—’’;

7 (ii) by striking ‘‘or’’ at the end of

8 clause (iii); and

9 (iii) by striking the period at the end

10 of clause (iv) and inserting ‘‘; or’’;

11 (B) by redesignating subparagraphs (B)

12 and (C) as subparagraphs (C) and (D), respec13 tively;

14 (C) by inserting after subparagraph (A) the

15 following new subparagraph:

16 ‘‘(B) At the request of any individual who has entered

17 into a contract referred to in subparagraph (A) and who

18 receives a degree in medicine (including osteopathic or

19 allopathic medicine), dentistry, optometry, podiatry, or

20 pharmacy, the Secretary shall defer the active duty service

21 obligation of that individual under that contract, in order

22 that such individual may complete any internship, resi23 dency, or other advanced clinical training that is required

24 for the practice of that health profession, for an appropriate
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1 period (in years, as determined by the Secretary), subject

2 to the following conditions:

3 ‘‘(i) No period of internship, residency, or other

4 advanced clinical training shall be counted as satisfy5 ing any period of obligated service that is required

6 under this section.

7 ‘‘(ii) The active duty service obligation of that

8 individual shall commence not later than 90 days

9 after the completion of that advanced clinical train10 ing (or by a date specified by the Secretary).

11 ‘‘(iii) The active duty service obligation will be

12 served in the health profession of that individual, in

13 a manner consistent with clauses (i) through (v) of

14 subparagraph (A).’’;

15 (D) in subparagraph (C), as so redesig16 nated, by striking ‘‘prescribed under section

17 338C of the Public Health Service Act (42

18 U.S.C. 254m) by service in a program specified

19 in subparagraph (A)’’ and inserting ‘‘described

20 in subparagraph (A) by service in a program

21 specified in that subparagraph’’; and

22 (E) in subparagraph (D), as so redesig23 nated—
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1 (i) by striking ‘‘Subject to subpara2 graph (B),’’ and inserting ‘‘Subject to sub3 paragraph (C),’’; and

4 (ii) by striking ‘‘prescribed under sec5 tion 338C of the Public Health Service Act

6 (42 U.S.C. 254m)’’ and inserting ‘‘described

7 in subparagraph (A)’’;

8 (2) in paragraph (4)—

9 (A) in subparagraph (B), by striking the

10 matter preceding clause (i) and inserting the fol11 lowing:

12 ‘‘(B) the period of obligated service described in

13 paragraph (3)(A) shall be equal to the greater of—’’;

14 and

15 (B) in subparagraph (C), by striking ‘‘(42

16 U.S.C. 254m(g)(1)(B))’’ and inserting ‘‘(42

17 U.S.C. 254l(g)(1)(B))’’; and

18 (3) in paragraph (5), by adding at the end the

19 following new subparagraphs:

20 ‘‘(C) Upon the death of an individual who receives an

21 Indian Health Scholarship, any obligation of that individ22 ual for service or payment that relates to that scholarship

23 shall be canceled.

24 ‘‘(D) The Secretary shall provide for the partial or

25 total waiver or suspension of any obligation of service or
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1 payment of a recipient of an Indian Health Scholarship

2 if the Secretary determines that—

3 ‘‘(i) it is not possible for the recipient to meet

4 that obligation or make that payment;

5 ‘‘(ii) requiring that recipient to meet that obliga6 tion or make that payment would result in extreme

7 hardship to the recipient; or

8 ‘‘(iii) the enforcement of the requirement to meet

9 the obligation or make the payment would be uncon10 scionable.

11 ‘‘(E) Notwithstanding any other provision of law, in

12 any case of extreme hardship or for other good cause shown,

13 the Secretary may waive, in whole or in part, the right

14 of the United States to recover funds made available under

15 this section.

16 ‘‘(F) Notwithstanding any other provision of law, with

17 respect to a recipient of an Indian Health Scholarship, no

18 obligation for payment may be released by a discharge in

19 bankruptcy under title 11, United States Code, unless that

20 discharge is granted after the expiration of the 5-year pe21 riod beginning on the initial date on which that payment

22 is due, and only if the bankruptcy court finds that the non23 discharge of the obligation would be unconscionable.’’.

24 (c) CALIFORNIA CONTRACT HEALTH SERVICES DEM25 ONSTRATION PROGRAM.—Section 211(g) (25 U.S.C.
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1 1621j(g)) is amended by striking ‘‘1993, 1994, 1995, 1996,

2 and 1997’’ and inserting ‘‘1996 through 2000’’.

3 (d) EXTENSION OF CERTAIN DEMONSTRATION PRO4 GRAM.—Section 405(c)(2) (25 U.S.C. 1645(c)(2)) is amend5 ed by striking ‘‘September 30, 1996’’ and inserting ‘‘Sep6 tember 30, 1998’’.

7 (e) GALLUP ALCOHOL AND SUBSTANCE ABUSE TREAT8 MENT CENTER.—Section 706(d) (25 U.S.C. 1665e(d)) is

9 amended to read as follows:

10 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There

11 are authorized to be appropriated, for each of fiscal years

12 1996 through 2000, such sums as may be necessary to carry

13 out subsection (b).’’.

14 (f) SUBSTANCE ABUSE COUNSELOR EDUCATION DEM15 ONSTRATION PROGRAM.—Section 711(h) (25 U.S.C.

16 1665j(h)) is amended by striking ‘‘1993, 1994, 1995, 1996,

17 and 1997’’ and inserting ‘‘1996 through 2000’’.

18 (g) HOME AND COMMUNITY-BASED CARE DEMONSTRA19 TION PROGRAM.—Section 821(i) (25 U.S.C. 1680k(i)) is

20 amended by striking ‘‘1993, 1994, 1995, 1996, and 1997’’

21 and inserting ‘‘1996 through 2000’’.

Attest:

Clerk.