291 
‘‘(10) A report on environmental and nuclear 
health hazards as required by section 215. 
‘‘(11) An annual report on the status of all 
health care facilities needs as required by section 
301(c)(2)(B) and 301(d). 
‘‘(12) Reports on safe water and sanitary waste 
disposal facilities as required by section 302(h). 
‘‘(13) An annual report on the expenditure of 
non-Service funds for renovation as required by sec-
tions 304(b)(2). 
‘‘(14) A report identifying the backlog of mainte-
nance and repair required at Service and tribal fa-
cilities required by section 313(a). 
‘‘(15) A report providing an accounting of reim-
bursement funds made available to the Secretary 
under titles XVIII, XIX, and XXI of the Social Secu-
rity Act. 
‘‘(16) A report on any arrangements for the 
sharing of medical facilities or services, as authorized 
by section 406. 
‘‘(17) A report on evaluation and renewal of 
Urban Indian programs under section 505. 
‘‘(18) A report on the evaluation of programs as 
required by section 513(d). 
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‘‘(19) A report on alcohol and substance abuse as 
required by section 701(f). 
‘‘(20) A report on Indian youth mental health 
services as required by section 707(h). 
‘‘(21) A report on the reallocation of base re-
sources if required by section 808. 
‘‘(22) REPORT
REGARDING
PATIENT
MOVE-
MENT.—A report on the movement of patients between 
Service Units, including— 
‘‘(A) a list of those Service Units that have 
a net increase and those that have a net decrease 
of patients due to patients assigned to one Serv-
ice Unit voluntarily choosing to receive service at 
another Service Unit; 
‘‘(B) an analysis of the effect of patient 
movement on the quality of services for those 
Service Units experiencing an increase in the 
number of patients served; and 
‘‘(C) what funding changes are necessary to 
maintain a consistent quality of service at Serv-
ice Units that have an increase in the number of 
patients served. 
‘‘SEC. 802. REGULATIONS. 
‘‘(a) DEADLINES.— 
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‘‘(1) PROCEDURES.—Not later than 90 days 
after the date of enactment of the Indian Health Care 
Improvement Act Amendments of 2007, the Secretary 
shall initiate procedures under subchapter III of 
chapter 5 of title 5, United States Code, to negotiate 
and promulgate such regulations or amendments 
thereto that are necessary to carry out titles II (except 
section 202) and VII, the sections of title III for 
which negotiated rulemaking is specifically required, 
and section 807. Unless otherwise required, the Sec-
retary may promulgate regulations to carry out titles 
I, III, IV, and V, and section 202, using the proce-
dures required by chapter V of title 5, United States 
Code (commonly known as the ‘Administrative Proce-
dure Act’). 
‘‘(2) PROPOSED REGULATIONS.—Proposed regu-
lations to implement this Act shall be published in the 
Federal Register by the Secretary no later than 2 
years after the date of enactment of the Indian Health 
Care Improvement Act Amendments of 2007 and shall 
have no less than a 120-day comment period. 
‘‘(3) FINAL REGULATIONS.—The Secretary shall 
publish in the Federal Register final regulations to 
implement this Act by not later than 3 years after the 
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date of enactment of the Indian Health Care Improve-
ment Act Amendments of 2007. 
‘‘(b) COMMITTEE.—A negotiated rulemaking com-
mittee established pursuant to section 565 of title 5, United 
States Code, to carry out this section shall have as its mem-
bers only representatives of the Federal Government and 
representatives of Indian Tribes, and Tribal Organizations, 
a majority of whom shall be nominated by and be represent-
atives of Indian Tribes and Tribal Organizations from each 
Service Area. 
‘‘(c) ADAPTATION OF PROCEDURES.—The Secretary 
shall adapt the negotiated rulemaking procedures to the 
unique context of self-governance and the government-to- 
government relationship between the United States and In-
dian Tribes. 
‘‘(d) LACK OF REGULATIONS.—The lack of promul-
gated regulations shall not limit the effect of this Act. 
‘‘(e) INCONSISTENT REGULATIONS.—The provisions of 
this Act shall supersede any conflicting provisions of law 
in effect on the day before the date of enactment of the In-
dian Health Care Improvement Act Amendments of 2007, 
and the Secretary is authorized to repeal any regulation 
inconsistent with the provisions of this Act. 
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