354 
(A) by redesignating subparagraphs (B) 
through (E), as subparagraphs (C) through (F), 
respectively; and 
(B) by inserting after subparagraph (A), 
the following new subparagraph: 
‘‘(B) Section 1902(e)(13) (relating to dis-
regard of certain property for purposes of mak-
ing eligibility determinations).’’. 
(c) CONTINUATION OF CURRENT LAW PROTECTIONS OF 
CERTAIN INDIAN PROPERTY FROM MEDICAID ESTATE RE-
COVERY.—Section 1917(b)(3) of the Social Security Act (42 
U.S.C. 1396p(b)(3)) is amended— 
(1) by inserting ‘‘(A)’’ after ‘‘(3)’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(B) The standards specified by the Secretary under 
subparagraph (A) shall require that the procedures estab-
lished by the State agency under subparagraph (A) exempt 
income, resources, and property that are exempt from the 
application of this subsection as of April 1, 2003, under 
manual instructions issued to carry out this subsection (as 
in effect on such date) because of the Federal responsibility 
for Indian Tribes and Alaska Native Villages. Nothing in 
this subparagraph shall be construed as preventing the Sec-
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355 
retary from providing additional estate recovery exemp-
tions under this title for Indians.’’. 
SEC. 205. NONDISCRIMINATION IN QUALIFICATIONS FOR 
PAYMENT FOR SERVICES UNDER FEDERAL 
HEALTH CARE PROGRAMS. 
Section 1139 of the Social Security Act (42 U.S.C. 
1320b–9), as amended by section 202, is amended by redes-
ignating subsection (c) as subsection (d), and inserting after 
subsection (b) the following new subsection: 
‘‘(c) NONDISCRIMINATION
IN QUALIFICATIONS
FOR 
PAYMENT FOR SERVICES UNDER FEDERAL HEALTH CARE 
PROGRAMS.— 
‘‘(1) REQUIREMENT TO SATISFY GENERALLY AP-
PLICABLE PARTICIPATION REQUIREMENTS.— 
‘‘(A) IN GENERAL.—A Federal health care 
program must accept an entity that is operated 
by the Indian Health Service, an Indian Tribe, 
Tribal Organization, or Urban Indian Organi-
zation as a provider eligible to receive payment 
under the program for health care services fur-
nished to an Indian on the same basis as any 
other provider qualified to participate as a pro-
vider of health care services under the program 
if the entity meets generally applicable State or 
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356 
other requirements for participation as a pro-
vider of health care services under the program. 
‘‘(B) SATISFACTION OF STATE OR LOCAL LI-
CENSURE
OR
RECOGNITION
REQUIREMENTS.— 
Any requirement for participation as a provider 
of health care services under a Federal health 
care program that an entity be licensed or recog-
nized under the State or local law where the en-
tity is located to furnish health care services 
shall be deemed to have been met in the case of 
an entity operated by the Indian Health Service, 
an Indian Tribe, Tribal Organization, or Urban 
Indian Organization if the entity meets all the 
applicable standards for such licensure or rec-
ognition, regardless of whether the entity obtains 
a license or other documentation under such 
State or local law. In accordance with section 
221 of the Indian Health Care Improvement Act, 
the absence of the licensure of a health care pro-
fessional employed by such an entity under the 
State or local law where the entity is located 
shall not be taken into account for purposes of 
determining whether the entity meets such stand-
ards, if the professional is licensed in another 
State. 
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357 
‘‘(2) PROHIBITION ON FEDERAL PAYMENTS TO 
ENTITIES OR INDIVIDUALS EXCLUDED FROM PARTICI-
PATION
IN
FEDERAL
HEALTH
CARE
PROGRAMS
OR 
WHOSE STATE LICENSES ARE UNDER SUSPENSION OR 
HAVE BEEN REVOKED.— 
‘‘(A) EXCLUDED ENTITIES.—No entity op-
erated by the Indian Health Service, an Indian 
Tribe, Tribal Organization, or Urban Indian 
Organization that has been excluded from par-
ticipation in any Federal health care program 
or for which a license is under suspension or has 
been revoked by the State where the entity is lo-
cated shall be eligible to receive payment under 
any such program for health care services fur-
nished to an Indian. 
‘‘(B) EXCLUDED
INDIVIDUALS.—No indi-
vidual who has been excluded from participation 
in any Federal health care program or whose 
State license is under suspension or has been re-
voked shall be eligible to receive payment under 
any such program for health care services fur-
nished by that individual, directly or through an 
entity that is otherwise eligible to receive pay-
ment for health care services, to an Indian. 
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358 
‘‘(C) FEDERAL HEALTH CARE PROGRAM DE-
FINED.—In this subsection, the term, ‘Federal 
health care program’ has the meaning given that 
term in section 1128B(f), except that, for pur-
poses of this subsection, such term shall include 
the health insurance program under chapter 89 
of title 5, United States Code.’’. 
SEC. 206. CONSULTATION ON MEDICAID, SCHIP, AND 
OTHER HEALTH CARE PROGRAMS FUNDED 
UNDER THE SOCIAL SECURITY ACT INVOLV-
ING INDIAN HEALTH PROGRAMS AND URBAN 
INDIAN ORGANIZATIONS. 
(a) IN GENERAL.—Section 1139 of the Social Security 
Act (42 U.S.C. 1320b–9), as amended by sections 202 and 
205, is amended by redesignating subsection (d) as sub-
section (e), and inserting after subsection (c) the following 
new subsection: 
‘‘(d) CONSULTATION WITH TRIBAL TECHNICAL ADVI-
SORY GROUP (TTAG).—The Secretary shall maintain 
within the Centers for Medicaid & Medicare Services (CMS) 
a Tribal Technical Advisory Group, established in accord-
ance with requirements of the charter dated September 30, 
2003, and in such group shall include a representative of 
the Urban Indian Organizations and the Service. The rep-
resentative of the Urban Indian Organization shall be 
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359 
deemed to be an elected officer of a tribal government for 
purposes of applying section 204(b) of the Unfunded Man-
dates Reform Act of 1995 (2 U.S.C. 1534(b)).’’. 
(b) SOLICITATION OF ADVICE UNDER MEDICAID AND 
SCHIP.— 
(1) MEDICAID STATE PLAN AMENDMENT.—Sec-
tion 1902(a) of the Social Security Act (42 U.S.C. 
1396a(a)) is amended— 
(A) in paragraph (69), by striking ‘‘and’’ 
at the end; 
(B) in paragraph (70)(B)(iv), by striking 
the period at the end and inserting ‘‘; and’’; and 
(C) 
by 
inserting 
after 
paragraph 
(70)(B)(iv), the following new paragraph: 
‘‘(71) in the case of any State in which the In-
dian Health Service operates or funds health care 
programs, or in which 1 or more Indian Health Pro-
grams or Urban Indian Organizations (as such terms 
are defined in section 4 of the Indian Health Care 
Improvement Act) provide health care in the State for 
which medical assistance is available under such title, 
provide for a process under which the State seeks ad-
vice on a regular, ongoing basis from designees of 
such Indian Health Programs and Urban Indian Or-
ganizations on matters relating to the application of 
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360 
this title that are likely to have a direct effect on such 
Indian Health Programs and Urban Indian Organi-
zations and that— 
‘‘(A) shall include solicitation of advice 
prior to submission of any plan amendments, 
waiver requests, and proposals for demonstration 
projects likely to have a direct effect on Indians, 
Indian Health Programs, or Urban Indian Or-
ganizations; and 
‘‘(B) may include appointment of an advi-
sory committee and of a designee of such Indian 
Health Programs and Urban Indian Organiza-
tions to the medical care advisory committee ad-
vising the State on its State plan under this 
title.’’. 
(2) APPLICATION TO SCHIP.—Section 2107(e)(1) 
of such Act (42 U.S.C. 1397gg(e)(1)), as amended by 
section 204(b)(2), is amended— 
(A) by redesignating subparagraphs (B) 
through (F) as subparagraphs (C) through (G), 
respectively; and 
(B) by inserting after subparagraph (A), 
the following new subparagraph: 
‘‘(B) Section 1902(a)(71) (relating to the 
option of certain States to seek advice from des-
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