193 
and Indian Tribes, Tribal Organizations, and Urban In-
dian Organizations for the collection, preparation, and sub-
mission of applications by Indians for assistance under the 
Medicaid and State children’s health insurance programs 
established under titles XIX and XXI of the Social Security 
Act, and benefits under the Medicare program established 
under title XVIII of such Act, see subsections (a) and (b) 
of section 1139 of the Social Security Act. 
‘‘(f) DEFINITION OF PREMIUMS AND COST SHARING.— 
In this section: 
‘‘(1) PREMIUM.—The term ‘premium’ includes 
any enrollment fee or similar charge. 
‘‘(2) COST
SHARING.—The term ‘cost sharing’ 
includes any deduction, deductible, copayment, coin-
surance, or similar charge. 
‘‘SEC. 403. REIMBURSEMENT FROM CERTAIN THIRD PAR-
TIES OF COSTS OF HEALTH SERVICES. 
‘‘(a) RIGHT OF RECOVERY.—Except as provided in 
subsection (f), the United States, an Indian Tribe, or Tribal 
Organization shall have the right to recover from an insur-
ance company, health maintenance organization, employee 
benefit plan, third-party tortfeasor, or any other responsible 
or liable third party (including a political subdivision or 
local governmental entity of a State) the reasonable charges 
billed by the Secretary, an Indian Tribe, or Tribal Organi-
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zation in providing health services through the Service, an 
Indian Tribe, or Tribal Organization to any individual to 
the same extent that such individual, or any nongovern-
mental provider of such services, would be eligible to receive 
damages, reimbursement, or indemnification for such 
charges or expenses if— 
‘‘(1) such services had been provided by a non-
governmental provider; and 
‘‘(2) such individual had been required to pay 
such charges or expenses and did pay such charges or 
expenses. 
‘‘(b) LIMITATIONS ON RECOVERIES FROM STATES.— 
Subsection (a) shall provide a right of recovery against any 
State, only if the injury, illness, or disability for which 
health services were provided is covered under— 
‘‘(1) workers’ compensation laws; or 
‘‘(2) a no-fault automobile accident insurance 
plan or program. 
‘‘(c) NONAPPLICATION OF OTHER LAWS.—No law of 
any State, or of any political subdivision of a State and 
no provision of any contract, insurance or health mainte-
nance organization policy, employee benefit plan, self-in-
surance plan, managed care plan, or other health care plan 
or program entered into or renewed after the date of the 
enactment of the Indian Health Care Amendments of 1988, 
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shall prevent or hinder the right of recovery of the United 
States, an Indian Tribe, or Tribal Organization under sub-
section (a). 
‘‘(d) NO EFFECT ON PRIVATE RIGHTS OF ACTION.— 
No action taken by the United States, an Indian Tribe, or 
Tribal Organization to enforce the right of recovery pro-
vided under this section shall operate to deny to the injured 
person the recovery for that portion of the person’s damage 
not covered hereunder. 
‘‘(e) ENFORCEMENT.— 
‘‘(1) IN GENERAL.—The United States, an In-
dian Tribe, or Tribal Organization may enforce the 
right of recovery provided under subsection (a) by— 
‘‘(A) intervening or joining in any civil ac-
tion or proceeding brought— 
‘‘(i) by the individual for whom health 
services were provided by the Secretary, an 
Indian Tribe, or Tribal Organization; or 
‘‘(ii) by any representative or heirs of 
such individual, or 
‘‘(B) instituting a civil action, including a 
civil action for injunctive relief and other relief 
and including, with respect to a political sub-
division or local governmental entity of a State, 
such an action against an official thereof. 
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196 
‘‘(2) NOTICE.—All reasonable efforts shall be 
made to provide notice of action instituted under 
paragraph (1)(B) to the individual to whom health 
services were provided, either before or during the 
pendency of such action. 
‘‘(3) RECOVERY FROM TORTFEASORS.— 
‘‘(A) IN GENERAL.—In any case in which 
an Indian Tribe or Tribal Organization that is 
authorized or required under a compact or con-
tract issued pursuant to the Indian Self-Deter-
mination and Education Assistance Act (25 
U.S.C. 450 et seq.) to furnish or pay for health 
services to a person who is injured or suffers a 
disease on or after the date of enactment of the 
Indian Health Care Improvement Act Amend-
ments of 2007 under circumstances that establish 
grounds for a claim of liability against the 
tortfeasor with respect to the injury or disease, 
the Indian Tribe or Tribal Organization shall 
have a right to recover from the tortfeasor (or an 
insurer of the tortfeasor) the reasonable value of 
the health services so furnished, paid for, or to 
be paid for, in accordance with the Federal Med-
ical Care Recovery Act (42 U.S.C. 2651 et seq.), 
to the same extent and under the same cir-
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197 
cumstances as the United States may recover 
under that Act. 
‘‘(B) TREATMENT.—The right of an Indian 
Tribe or Tribal Organization to recover under 
subparagraph (A) shall be independent of the 
rights of the injured or diseased person served by 
the Indian Tribe or Tribal Organization. 
‘‘(f) LIMITATION.—Absent specific written authoriza-
tion by the governing body of an Indian Tribe for the period 
of such authorization (which may not be for a period of 
more than 1 year and which may be revoked at any time 
upon written notice by the governing body to the Service), 
the United States shall not have a right of recovery under 
this section if the injury, illness, or disability for which 
health services were provided is covered under a self-insur-
ance plan funded by an Indian Tribe, Tribal Organization, 
or Urban Indian Organization. Where such authorization 
is provided, the Service may receive and expend such 
amounts for the provision of additional health services con-
sistent with such authorization. 
‘‘(g) COSTS AND ATTORNEYS’ FEES.—In any action 
brought to enforce the provisions of this section, a prevailing 
plaintiff shall be awarded its reasonable attorneys’ fees and 
costs of litigation. 
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