II 

108TH CONGRESS 

1ST SESSION S. 1779

To amend title XVIII of the Social Security Act to provide for fairness 

in the provision of medicare services for Indians. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 23, 2003

Mr. BINGAMAN (for himself, Mr. INOUYE, Mr. DASCHLE, Mrs. MURRAY, Mr. 

DAYTON, Mr. JOHNSON, Ms. CANTWELL, and Ms. STABENOW) introduced the following bill; which was read twice and referred to the Committee on Finance 

A BILL

To amend title XVIII of the Social Security Act to provide 

for fairness in the provision of medicare services for Indians.

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 ‘‘Medicare Indian 

5 Health Fairness Act of 2003’’. 
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•S 1779 IS 

1 SEC. 2. AUTHORIZATION OF REIMBURSEMENT FOR ALL 

2 MEDICARE PART B SERVICES FURNISHED BY 

3 CERTAIN INDIAN HOSPITALS AND CLINICS. 

4 (a) IN GENERAL.—Section 1880(e) of the Social Se5 curity Act (42 U.S.C. 1395qq(e)) is amended—

6 (1) in paragraph (1)(A), by striking ‘‘for serv7 ices described in paragraph (2)’’ and inserting ‘‘for 

8 all items and services for which payment may be 

9 made under such part’’; 

10 (2) by striking paragraph (2); and 

11 (3) by redesignating paragraph (3) as para12 graph (2). 

13 (b) EFFECTIVE DATE.—The amendments made by 

14 this section shall apply to items and services furnished on 

15 or after the first day of the sixth month beginning after 

16 the date of enactment of this Act. 

17 SEC. 3. LIMITATION ON CHARGES FOR INPATIENT HOS18 PITAL CONTRACT HEALTH SERVICES PRO19 VIDED TO INDIANS BY MEDICARE PARTICI20 PATING HOSPITALS. 

21 (a) IN GENERAL.—Section 1866(a)(1) of the Social 

22 Security Act (42 U.S.C. 1395cc(a)(1)) is amended—

23 (1) in subparagraph (R), by striking ‘‘and’’ at 

24 the end; 

25 (2) in subparagraph (S), by striking the period 

26 and inserting ‘‘, and’’; and 
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•S 1779 IS 

1 (3) by adding at the end the following new sub2 paragraph: 

3 ‘‘(T) in the case of hospitals which furnish 

4 inpatient hospital services for which payment 

5 may be made under this title, to be a partici6 pating provider of medical care—

7 ‘‘(i) under the contract health services 

8 program funded by the Indian Health 

9 Service and operated by the Indian Health 

10 Service, an Indian tribe, or tribal organiza11 tion (as those terms are defined in section 

12 4 of the Indian Health Care Improvement 

13 Act), with respect to items and services 

14 that are covered under such program and 

15 furnished to an individual eligible for such 

16 items and services under such program; 

17 and 

18 ‘‘(ii) under a program funded by the 

19 Indian Health Service and operated by an 

20 urban Indian organization with respect to 

21 the purchase of items and services for an 

22 eligible urban Indian (as those terms are 

23 defined in such section 4), 

24 in accordance with regulations promulgated by 

25 the Secretary regarding admission practices, 
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•S 1779 IS 

1 payment methodology, and rates of payment 

2 (including the acceptance of no more than such 

3 payment rate as payment in full for such items 

4 and services).’’. 

5 (b) EFFECTIVE DATE.—The amendments made by 

6 this section shall apply as of a date specified by the Sec7 retary of Health and Human Services (but in no case later 

8 than 6 months after the date of enactment of this Act) 

9 to medicare participation agreements in effect (or entered 

10 into) on or after such date. 

11 SEC. 4. EQUAL PAYMENTS FOR CLINICS IN THE INDIAN 

12 HEALTH SERVICE SUPPORTED HEALTH CARE 

13 SYSTEM. 

14 (a) IN GENERAL.—Section 1880 of the Social Secu15 rity Act (42 U.S.C. 1395qq) is amended—

16 (1) by redesignating subsection (f) as sub17 section (g); and 

18 (2) by inserting after subsection (e) the fol19 lowing new subsection: 

20 ‘‘(f) Notwithstanding any other provision of law, for 

21 purposes of determining the rate of reimbursement for 

22 items and services under this title, any outpatient or am23 bulatory care clinic (whether freestanding or provider24 based) operated by the Indian Health Service, an Indian 

25 tribe, a tribal organization, or an urban Indian organiza-
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•S 1779 IS 

1 tion (as those terms are defined in section 4 of the Indian 

2 Health Care Improvement Act), shall, upon the election 

3 of such clinic, be reimbursed on the same basis as if such 

4 clinic were a hospital outpatient department of the Indian 

5 Health Service.’’. 

6 (b) EFFECTIVE DATE.—The amendments made by 

7 this section shall apply to items and services furnished on 

8 or after the first day of the sixth month beginning after 

9 the date of enactment of this Act.

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