the expiration of the term for which the 
member’s predecessor was appointed shall 
be appointed only for the remainder of that 
term. A vacancy in the Commission shall 
be filled in the manner in which the origi-
nal appointment was made. 
‘‘(C) PAY.—Members of the Panel shall 
serve without pay. 
‘‘(D) 
CHAIRPERSON; 
VICE
CHAIR-
PERSON.— 
‘‘(i) CHAIRPERSON.—The Secretary of 
Health and Human Services, or a designee 
of the Secretary, shall serve on the Panel 
as the Chairperson of the Panel. 
‘‘(ii) VICE
CHAIRPERSON.—The Ad-
ministrator of the Federal Emergency 
Management Agency, or a designee of the 
Administrator, shall serve on the Panel as 
the Vice Chairperson of the Panel. 
‘‘(5) STAFF, EXPERTS, AND CONSULTANTS.— 
The Panel may— 
‘‘(A) appoint such staff as the Panel con-
siders to be appropriate, without regard to the 
provisions of title 5, United States Code, gov-
erning appointments in the competitive service; 
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‘‘(B) fix the pay of such staff, without re-
gard to the provisions of chapter 51 and sub-
chapter III of chapter 53 of such title relating 
to classification and General Schedule pay 
rates; and 
‘‘(C) procure the services of experts and 
consultants in accordance with the provisions of 
section 3109(b) of such title. 
‘‘(6) DETAIL OF FEDERAL PERSONNEL.—Upon 
request of the Panel, the head of any Federal agency 
may detail, on a reimbursable basis, any of the per-
sonnel of the agency to the Panel to assist it in car-
rying out the duties under paragraph (3). 
‘‘(7) FEDERAL
ADVISORY
COMMITTEE
ACT.— 
The Federal Advisory Committee Act (5 U.S.C. 
App.) shall apply to the Panel. 
‘‘(8) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated such sums as 
may be necessary to the Panel for carrying out the 
duties of the panel for each of fiscal years 2024 
through 2029. 
‘‘(h) GUIDANCE RELATING TO AMERICAN INDIANS 
AND ALASKA NATIVES.— 
‘‘(1) IN GENERAL.—The Secretary shall issue 
guidance with respect to applying the provisions of 
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this section in a manner consistent with the fol-
lowing: 
‘‘(A) To further the goal that Federal 
health services to maintain and improve the 
health of Indians are consonant with and re-
quired by the Federal Government’s historical 
and unique legal relationship with, and result-
ing responsibility to, Indians. 
‘‘(B) No enrollment fee, premium, or simi-
lar charge, and no deduction, copayment, cost 
sharing, or similar charge, is to be imposed 
against an Indian who is furnished an item or 
service through a waiver under this section. All 
costs incurred in waiving such charges shall be 
borne by the Federal Government in fulfillment 
of the trust responsibility. 
‘‘(C) A State may not require the enroll-
ment of an individual who is an Indian in 
health insurance offered through a waiver under 
this section. 
‘‘(D) Health insurance issuers offering cov-
erage pursuant to a waiver under this section 
must make good faith efforts to contract with 
Indian health care providers operating within 
the area served by the issuers. 
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‘‘(E) Health insurance issuers offering cov-
erage pursuant to a waiver under this section 
shall pay Indian health care providers, whether 
such providers are participating or nonpartici-
pating providers with respect to the coverage, 
for covered services provided to those Indian 
enrollees who are eligible to receive services 
from such providers at a rate equal to the rate 
negotiated between such entity and the provider 
involved or, if such a rate has not been nego-
tiated, at a rate that is not less than the level 
and amount of payment which the entity would 
make for the services if the services were fur-
nished by a participating provider which is not 
an Indian health care provider. 
‘‘(F) Health insurance issuers offering cov-
erage pursuant to a waiver under this section 
will include a standard contract addendum 
when contracting with Indian health care pro-
viders. The contract addendum will be devel-
oped in consultation with Tribes and in con-
ference with urban Indian health programs op-
erating within the service area of the State. 
‘‘(G) The treatment of Indians under this 
section does not constitute invidious racial dis-
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crimination in violation of the due process 
clause of the Fifth or Fourteenth Amendments, 
but is reasonable and rationally designed to fur-
ther the health of Indians. 
‘‘(H) In the case of any State in which 1 
or more Indian health care programs furnishes 
health care services, the State will provide for 
a process under which the State seeks advice on 
a regular, ongoing basis from designees of such 
Indian health care programs and urban Indian 
organizations on matters relating to the appli-
cation of a waiver under this section that are 
likely to have a direct effect on such Indian 
health programs and that— 
‘‘(i) shall include solicitation of advice 
prior to submission of any plan amend-
ments, waiver requests, and proposals for 
demonstration projects likely to have a di-
rect effect on Indians or Indian health care 
programs; and 
‘‘(ii) may include appointment of an 
advisory committee and of a designee of 
such Indian health care programs to the 
medical care advisory committee advising 
the State on its waiver under this section. 
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‘‘(2) DEFINITIONS.—For purposes of this sub-
section: 
‘‘(A) The term ‘Indian’ has the meaning 
given such term in section 447.50 of title 42, 
Code of Federal Regulations (as in effect on 
July 1, 2010). 
‘‘(B) The term ‘Indian health care pro-
vider’ has the meaning given such term in sec-
tion 438.14(a) of title 42, Code of Federal Reg-
ulations. 
‘‘(i) DEFINITIONS.—In this section: 
‘‘(1) HEALTH BENEFITS COVERAGE.—The term 
‘health benefits coverage’— 
‘‘(A) means— 
‘‘(i) health insurance coverage, as 
such term is defined in section 2791(b) of 
the Public Health Service Act (42 U.S.C. 
300gg–(b)); and 
‘‘(ii) coverage under a group health 
plan, as such term is defined in section 
2791(a) of the Public Health Service Act 
(42 U.S.C. 300gg–(a)); and 
‘‘(B) includes any medical coverage or 
health benefits provided under one or more of 
the specified Federal health program described 
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