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[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1572 Introduced in Senate (IS)]

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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicaid for American Indians and 
States Act of 2005''.

SEC. 2. CLARIFICATION OF APPLICATION OF 100 PERCENT FMAP.

    (a) In General.--The third sentence of section 1905(b) of the 
Social Security Act (42 U.S.C. 1396d(b)) is amended by striking 
``services which are received through'' and inserting ``any services 
provided under a State plan which are received at or by written medical 
referral from''.
    (b) Conforming Amendment.--Section 1911(c) of such Act (42 U.S.C. 
1396j(c)) is amended by striking ``in Indian Health Service facilities 
to Indians who are eligible for medical assistance under the State 
plan'' and inserting ``to Indians who are eligible for medical 
assistance under the State plan by the Indian Health Service or by an 
Indian tribe or tribal organization (as so defined) directly or through 
written medical referral to, or under contract or other arrangement 
with, another health care provider and the Indian Health Service or an 
Indian tribe or tribal organization, without regard to the location of 
service delivery or the entity submitting the claim for the service, or 
whether such provider would be considered an independent contractor''.
    (c) Retroactive Effective Date.--
            (1) In general.--The amendments made by subsections (a) and 
        (b) shall apply to items and services furnished on or after 
        January 1, 1997.
            (2) Application to previously disallowed payments.--
                    (A) Review of claims.--Not later than 90 days after 
                the date of enactment of this Act, the Secretary of 
                Health and Human Services shall--
                            (i) review any disallowed claim described 
                        in subparagraph (B) to determine if the claim 
                        satisfies the requirements for the application 
                        of the 100 percent Federal medical assistance 
                        percentage under the third sentence of section 
                        1905(b) of such Act (42 U.S.C. 1396d(b)), as 
                        amended by subsection (a); and
                            (ii) if any such claim meets such 
                        requirements, revoke the disallowance of the 
                        claim and adjust the payments made to the State 
                        accordingly.
                    (B) Claim described.--For purposes of subparagraph 
                (A), a claim described in this subparagraph is any 
                claim submitted by a State for Federal financial 
                participation for medical assistance provided under 
                title XIX of the Social Security Act which was 
                disallowed during the period that begins on January 1, 
                1997, and ends on the date of enactment of this Act, on 
                the basis that the claim was not for services received 
                through or provided by an Indian Health Service 
                facility or did not otherwise satisfy the requirements 
                for the application of the 100 percent Federal medical 
                assistance percentage under the third sentence of 
                section 1905(b) of such Act (42 U.S.C. 1396d(b)).
                                 <all>
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