II 

109TH CONGRESS 

1ST SESSION S. 1572 

To amend title XIX of the Social Security Act to clarify the application 

of the 100 percent Federal medical assistance percentage under the 

medicaid program for services provided by the Indian Health Service 

or an Indian tribe or tribal organization directly or through referral, 

contract, or other arrangement. 

IN THE SENATE OF THE UNITED STATES 

JULY 29, 2005 

Mr. JOHNSON (for himself and Mr. BINGAMAN) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to clarify 

the application of the 100 percent Federal medical assistance percentage under the medicaid program for services 

provided by the Indian Health Service or an Indian tribe 

or tribal organization directly or through referral, contract, or other arrangement. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicaid for American 

5 Indians and States Act of 2005’’. 
2 

•S 1572 IS

1 SEC. 2. CLARIFICATION OF APPLICATION OF 100 PERCENT 

2 FMAP. 

3 (a) IN GENERAL.—The third sentence of section 

4 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) 

5 is amended by striking ‘‘services which are received 

6 through’’ and inserting ‘‘any services provided under a 

7 State plan which are received at or by written medical re8 ferral from’’. 

9 (b) CONFORMING AMENDMENT.—Section 1911(c) of 

10 such Act (42 U.S.C. 1396j(c)) is amended by striking ‘‘in 

11 Indian Health Service facilities to Indians who are eligible 

12 for medical assistance under the State plan’’ and inserting 

13 ‘‘to Indians who are eligible for medical assistance under 

14 the State plan by the Indian Health Service or by an In15 dian tribe or tribal organization (as so defined) directly 

16 or through written medical referral to, or under contract 

17 or other arrangement with, another health care provider 

18 and the Indian Health Service or an Indian tribe or tribal 

19 organization, without regard to the location of service de20 livery or the entity submitting the claim for the service, 

21 or whether such provider would be considered an inde22 pendent contractor’’. 

23 (c) RETROACTIVE EFFECTIVE DATE.— 

24 (1) IN GENERAL.—The amendments made by 

25 subsections (a) and (b) shall apply to items and 

26 services furnished on or after January 1, 1997. 
3 

•S 1572 IS

1 (2) APPLICATION TO PREVIOUSLY DISALLOWED

2 PAYMENTS.— 

3 (A) REVIEW OF CLAIMS.—Not later than 

4 90 days after the date of enactment of this Act, 

5 the Secretary of Health and Human Services 

6 shall— 

7 (i) review any disallowed claim de8 scribed in subparagraph (B) to determine 

9 if the claim satisfies the requirements for 

10 the application of the 100 percent Federal 

11 medical assistance percentage under the 

12 third sentence of section 1905(b) of such 

13 Act (42 U.S.C. 1396d(b)), as amended by 

14 subsection (a); and 

15 (ii) if any such claim meets such re16 quirements, revoke the disallowance of the 

17 claim and adjust the payments made to the 

18 State accordingly. 

19 (B) CLAIM DESCRIBED.—For purposes of 

20 subparagraph (A), a claim described in this 

21 subparagraph is any claim submitted by a State 

22 for Federal financial participation for medical 

23 assistance provided under title XIX of the So24 cial Security Act which was disallowed during 

25 the period that begins on January 1, 1997, and 
4 

•S 1572 IS

1 ends on the date of enactment of this Act, on 

2 the basis that the claim was not for services re3 ceived through or provided by an Indian Health 

4 Service facility or did not otherwise satisfy the 

5 requirements for the application of the 100 per6 cent Federal medical assistance percentage 

7 under the third sentence of section 1905(b) of 

8 such Act (42 U.S.C. 1396d(b)). 

Æ