Indian Health Care Improvement Technical Corrections Act of 1996
PL 104-313 (H.R.3378), enacted 10/19/1996

110 STAT. 3820 
PUBLIC LAW 104-313—OCT. 19, 1996 
Public L a w 104-313 
104th Congress 
Oct. 19, 1996 
[H.R. 3378] 
Indian Health 
Care 
Improvement 
Technical 
Corrections Act 
of 1996. 
25 use 1601 
note. 
An Act 
To amend the Indian Health Care Improvement Act to extend the demonstration 
program for direct billing of Medicare, Medicaid, find other third party payors. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; REFERENCE. 
(a) SHORT TITLE.—This Act may be cited as the "Indian Health 
Care Improvement Technical Corrections Act of 1996". 
(b) REFERENCES.—Whenever in this Act an amendment or 
repeal is expressed in terms of an simendment to or repeal of 
a section or other provision, the reference shall be considered to 
be made to a section or other provision of the Indian Health Care 
Improvement Act. 
SEC. 2. TECHNICAL CORRECTIONS IN THE INDIAN HEALTH CARE 
IMPROVEMENT ACT. 
(a) DEFINITION OF HEALTH PROFESSION,—Section 4(n) (25 
U.S.C. 1603(n)) is amended— 
(1) by inserting "allopathic medicine," before 
"family 
medicine"; and 
(2) by striking "and allied health professions" and inserting 
"an allied health profession, or any other health profession". 
(b) 
INDIAN 
HEALTH 
PROFESSIONS 
SCHOLARSHIPS.—Section 
104(b) of the Indian Health Care Improvement Act (25 U.S.C. 
1613a(b)) is amended— 
(1) in paragraph (3)— 
(A) in subparagraph (A)— 
(i) by striking the matter preceding clause (i) and 
inserting the following: 
"(3)(A) The active duty service obligation under a written con-
tract with the Secretary imder section 338A of the Public Hesilth 
Service Act (42 U.S.C. 2541) that an individual has entered into 
imder that section shall, if that individual is a recipient of an 
Indian Health Scholarship, be met in full-time practice, by 
service—"; 
(ii) by striking "or" at the end of clause (iii); and 
(iii) by striking the period at the end of clause 
(iv) and inserting "; or"; 
(B) by redesignating subparagraphs (B) and (C) as 
subparagraphs (C) and (D), respectively; 
(C) by inserting after subparagraph (A) the following 
new subparagraph: 
"(B) At the request of any individual who has entered into 
a contract referred to in subparagraph (A) and who receives a 
PUBLIC LAW 104-313—OCT. 19, 1996 
110 STAT. 3821 
degree in medicine (including osteopathic or allopathic medicine), 
dentistry, optometry, podiatry, or pheirmacy, the Secretary shall 
defer the active duty service obligation of that individual under 
that contract, in order that such individual may complete any 
internship, residency, or other advanced clinical training that is 
required for the practice of that health profession, for an appropriate 
period (in years, as determined by the Secretary), subject to the 
following conditions; 
"(i) No period of internship, residency, or other advsmced 
clinical training shall be counted as satisfying any period of 
obUgated service that is required under this section. 
"(ii) The active duty service obligation of that individual 
shall commence not later than 90 days after the completion 
of that advanced clinical training (or by a date specified by 
the Secretary). 
"(iii) The active duty service obhgation will be served in 
the health profession of tiiat individual, in a manner consistent 
with clauses (i) through (v) of subparagraph (A)."; 
(D) in subparagraph (C), as so redesignated, by striking 
"prescribed under section 3380 of the PubUc Healtii Service 
Act (42 U.S.C. 254m) by service in a program specified 
in subparagraph (A)" and inserting "described in subpara-
graph (A) by service in a program specified in that subpara-
graph"; and 
(E) in subparagraph (D), as so redesignated— 
(i) by striking "Subject to subparagraph (B)," gind 
inserting "Subject to subparagraph (C),"; and 
(ii) by striking "prescribed under section 338C of 
the PubUc Health Service Act (42 U.S.C. 254m)" and 
inserting "described in subparagraph (A)"; 
(2) in paragraph (4)— 
(A) in subparagraph (B), by striking the matter preced-
ing clause (i) and inserting the following: 
"(B) the period of obligated service described in paragraph 
(3XA) shall be equal to the greater of—"; and 
(B) in subparagraph (C), by striking "(42 U.S.C. 
254m(g)(lXB))" and inserting "(42 U.S.C. 2541(g)(1)(B))"; 
and 
(3) in paragraph (5), by adding at the end the following 
new subparagraphs: 
"(C) Upon the death of an individual who receives sm Indian 
Healtii Scholarship, any obligation of that individual for service 
or payment that relates to that scholarship shall be canceled. 
"(D) The Secretary shall provide for the partial or total waiver 
or suspension of any obligation of service or payment of a recipient 
of an Indian Health Scholarship if the Secretary determines that— 
"(i) it is not possible for the recipient to meet that obligation 
or make that payment; 
"(ii) requiring that recipient to meet that obhgation or 
meike that payment would result in extreme hardsMp to the 
recipient; or 
"(iii) the enforcement of the requirement to meet the obhga-
tion or make the payment would be unconscionable. 
"(E) Notwithstanding any other provision of law, in any case 
of extreme hardship or for other good cause shown, the Secretary 
may waive, in whole or in part, the right of the United States 
to recover funds made available under this section. 
110 STAT. 3822 
PUBLIC LAW 104-313—OCT. 19, 1996 
"(F) Notwithstanding any other provision of law, with respect 
to a recipient of an Indian Health Scholarship, no obligation for 
pa)anent may be released by a discharge in bankruptcy under 
title 11, United States Code, unless that discharge is granted sifter 
the expiration of the 5-yeeir period beginning on the initial date 
on which that payment is due, and only if the bankruptcy court 
finds that the nondischarge of the obligation would be unconscion-
able.". 
(c) CALIFORNIA CONTRACT HEALTH SERVICES DEMONSTRATION 
PROGRAM.—Section 211(g) (25 U.S.C. 1621j(g)) is amended by strik-
ing "1993, 1994, 1995, 1996, and 1997" and inserting "1996 through 
2000". 
(d) EXTENSION OF CERTAIN DEMONSTRATION PROGRAM.—Section 
405(c)(2) (25 U.S.C. 1645(c)(2)) is amended by striking "September 
30,1996" and inserting "September 30,1998". 
(e) 
GALLUP ALCOHOL AND SUBSTANCE 
ABUSE 
TREATMENT 
CENTER.—Section 706(d) (25 U.S.C. 1665e(d)) is amended to read 
as follows: 
"(d) AUTHORIZATION OF APPROPRL\TIONS.—^There are authorized 
to be appropriated, for each of fiscal years 1996 through 2000, 
such sums as may be necessary to carry out subsection (b).". 
(f) SUBSTANCE ABUSE COUNSELOR EDUCATION DEMONSTRATION 
PROGRAM.—Section 711(h) (25 U.S.C. 1665j(h)) is amended by strik-
ing "1993, 1994, 1995, 1996, and 1997" and inserting "1996 through 
2000". 
(g) 
HOME 
AND COMMUNITY-BASED 
CARE 
DEMONSTRATION 
PROGRAM.—Section 821(i) (25 U.S.C. 1680k(i)) is amended by strik-
ing "1993, 1994, 1995, 1996, and 1997" and inserting "1996 through 
2000". 
Approved October 19, 1996. 
LEGISLATIVE HISTORY—H.R. 3378 (S. 1869): 
HOUSE REPORTS: No. 104-742, Pt. 1 (Comm. on Resources). 
SENATE REPORTS: No. 104-346 accompanying S. 1869 (Comm. on Indian Affairs). 
CONGRESSIONAL RECORD, Vol. 142 (1996): 
Sept. 4, considered and passed House. 
Sept. 19, considered and passed Senate, amended. 
Sept. 27, House concurred in Senate amendment with an amendment. 
Oct. 3, Senate concurred in House amendment.