§ 1645. Sharing arrangements with Federal agencies

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

1. 1988

   Indian Health Care Improvement Act

   Pub. L. 94–437 title IV § 405 · 90 Stat. 1400

   Enacted · 25 U.S.C. § 1645

   Pub. L. 94–437, title IV, § 405, as added Pub. L. 100–713, title IV, § 402, Nov. 23, 1988, 102 Stat. 4818

   Source evidence

   Code source credit
   Pub. L. 94–437, title IV, § 405, as added Pub. L. 100–713, title IV, § 402, Nov. 23, 1988, 102 Stat. 4818

2. 1992

   Indian Health Amendments of 1992

   Pub. L. 102–573 § 701(c)(3)(A) · 106 Stat. 4526

   Substituted · 25 U.S.C. § 1645(b)(1)

   Pub. L. 102–573, § 701(c)(3)(A), substituted “sections 1642(a)” for “sections 402(c)” and made technical amendment to reference to section 1680c(b)(2)(A) to reflect renumbering of corresponding section of original act

   Source evidence

   Code amendment note
   Subsec. (b)(1). Pub. L. 102–573, § 701(c)(3)(A), substituted “sections 1642(a)” for “sections 402(c)” and made technical amendment to reference to section 1680c(b)(2)(A) to reflect renumbering of corresponding section of original act.

   Enacted provision · exact public law section
   (A) in paragraph (1), by striking out “sections 402(c) and 713(b)(2)(A)” and inserting in lieu thereof “sections 402(a) and 813(b)(2)(A)”; and

3. 1992

   Indian Health Amendments of 1992

   Pub. L. 102–573 § 701(c)(3)(B) · 106 Stat. 4526

   Substituted · 25 U.S.C. § 1645(b)(4)

   Pub. L. 102–573, § 701(c)(3)(B), substituted “section 1642(a)” for “section 402(c)” in two places

   Source evidence

   Code amendment note
   Subsec. (b)(4). Pub. L. 102–573, § 701(c)(3)(B), substituted “section 1642(a)” for “section 402(c)” in two places.

   Enacted provision · exact public law section
   (B) in paragraph (4), by striking out “section 402(c)” each place it appears and inserting in lieu thereof “section 402(a)”.

4. 1992

   Indian Health Amendments of 1992

   Pub. L. 102–573 § 404(1) · 106 Stat. 4526

   Substituted · 25 U.S.C. § 1645(c)(2)

   Pub. L. 102–573, § 404(1), substituted “1996” for “1995”

   Source evidence

   Code amendment note
   Subsec. (c)(2). Pub. L. 102–573, § 404(1), substituted “1996” for “1995”.

   Enacted provision · exact public law section
   (1) in subsection (c)(2), by striking “1995” and inserting “1996”; and

5. 1992

   Indian Health Amendments of 1992

   Pub. L. 102–573 § 404(2) · 106 Stat. 4526

   Substituted · 25 U.S.C. § 1645(e)

   Pub. L. 102–573, § 404(2), substituted “1996” for “1995”

   Source evidence

   Code amendment note
   Subsec. (e). Pub. L. 102–573, § 404(2), substituted “1996” for “1995”.

   Enacted provision · exact public law section
   (2) in subsection (e), by striking “1995” and inserting “1996”.

6. 1996

   Indian Health Care Improvement Technical Corrections Act of 1996

   Pub. L. 104–313 § 2(d) · 110 Stat. 3820

   Substituted · 25 U.S.C. § 1645(c)(2)

   Pub. L. 104–313 substituted “1998” for “1996”

   Source evidence

   Code amendment note
   Subsec. (c)(2). Pub. L. 104–313 substituted “1998” for “1996”.

   Enacted provision · exact public law section
   (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”.

7. 1998

   Pub. L. 105–277 div. A § 101(e)(tIII)(s336) · 112 Stat. 2681

   Substituted · 25 U.S.C. § 1645(c)(2)

   Pub. L. 105–277 substituted “2000” for “1998”

   Source evidence

   Code amendment note
   Subsec. (c)(2). Pub. L. 105–277 substituted “2000” for “1998”.

   Enacted provision · exact public law section
   Sec. 101. For programs, projects or activities in the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 1999, provided as follows, to be effective as if it had been enacted into law as the regular appropriations Act: AN ACT Making appropriations for Agriculture, Rural Development, Food and Drug Administration, and Related Agencies programs for the fiscal year ending September 30, 1999, and for other purposes. Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 1999.

8. 1998

   Federal Reports Elimination Act of 1998

   Pub. L. 105–362 title VI § 601(a)(2)(B) · 112 Stat. 3280

   Repealed · 25 U.S.C. § 1645

   Pub. L. 105–362 repealed section. Prior to repeal, section read as follows:

   Source evidence

   Code amendment note
   Pub. L. 105–362 repealed section. Prior to repeal, section read as follows:

   “§ 1645. Demonstration program for direct billing of medicare, medicaid, and other third party payors “(a) The Secretary shall establish a demonstration program under which Indian tribes, tribal organizations, and Alaska Native health organizations, which are contracting the entire operation of an entire hospital or clinic of the Service under the authority of the Indian Self-Determination Act, shall directly bill for, and receive payment for, health care services provided by such hospital or clinic for which payment is made under title XVIII of the Social Security Act (medicare), under a State plan for medical assistance approved under title XIX of the Social Security Act (medicaid), or from any other third-party payor. The last sentence of section 1905(b) of the Social Security Act shall apply for purposes of the demonstration program. “(b)(1) Each hospital or clinic participating in the demonstration program described in subsection (a) of this section shall be reimbursed directly under the medicare and medicaid programs for services furnished, without regard to the provisions of section 1880(c) of the Social Security Act and sections 1642(a) and 1680c(b)(2)(A) of this title, but all funds so reimbursed shall first be used by the hospital or clinic for the purpose of making any improvements in the hospital or clinic that may be necessary to achieve or maintain compliance with the conditions and requirements applicable generally to facilities of such type under the medicare or medicaid program. Any funds so reimbursed which are in excess of the amount necessary to achieve or maintain such conditions or requirements shall be used— “(A) solely for improving the health resources deficiency level of the Indian tribe, and “(B) in accordance with the regulations of the Service applicable to funds provided by the Service under any contract entered into under the Indian Self-Determination Act. “(2) The amounts paid to the hospitals and clinics participating in the demonstration program described in subsection (a) of this section shall be subject to all auditing requirements applicable to programs administered directly by the Service and to facilities participating in the medicare and medicaid programs. “(3) The Secretary shall monitor the performance of hospitals and clinics participating in the demonstration program described in subsection (a) of this section, and shall require such hospitals and clinics to submit reports on the program to the Secretary on a quarterly basis (or more frequently if the Secretary deems it to be necessary). “(4) Notwithstanding section 1880(c) of the Social Security Act or section 1642(a) of this title, no payment may be made out of the special fund described in section 1880(c) of the Social Security Act, or section 1642(a) of this title, for the benefit of any hospital or clinic participating in the demonstration program described in subsection (a) of this section during the period of such participation. “(c)(1) In order to be considered for participation in the demonstration program described in subsection (a) of this section, a hospital or clinic must submit an application to the Secretary which establishes to the satisfaction of the Secretary that— “(A) the Indian tribe, tribal organization, or Alaska Native health organization contracts the entire operation of the Service facility; “(B) the facility is eligible to participate in the medicare and medicaid programs under sections 1880 and 1911 of the Social Security Act; “(C) the facility meets any requirements which apply to programs operated directly by the Service; and “(D) the facility is accredited by the Joint Commission on Accreditation of Hospitals, or has submitted a plan, which has been approved by the Secretary, for achieving such accreditation prior to October 1, 1990. “(2) From among the qualified applicants, the Secretary shall, prior to October 1, 1989, select no more than 4 facilities to participate in the demonstration program described in subsection (a) of this section. The demonstration program described in subsection (a) of this section shall begin by no later than October 1, 1991, and end on September 30, 2000. “(d)(1) On November 23, 1988, the Secretary, acting through the Service, shall commence an examination of— “(A) any administrative changes which may be necessary to allow direct billing and reimbursement under the demonstration program described in subsection (a) of this section, including any agreements with States which may be necessary to provide for such direct billing under the medicaid program; and “(B) any changes which may be necessary to enable participants in such demonstration program to provide to the Service medical records information on patients served under such demonstration program which is consistent with the medical records information system of the Service. “(2) Prior to the commencement of the demonstration program described in subsection (a) of this section, the Secretary shall implement all changes required as a result of the examinations conducted under paragraph (1). “(3) Prior to October 1, 1990, the Secretary shall determine any accounting information which a participant in the demonstration program described in subsection (a) of this section would be required to report. “(e) The Secretary shall submit a final report at the end of fiscal year 1996, on the activities carried out under the demonstration program described in subsection (a) of this section which shall include an evaluation of whether such activities have fulfilled the objectives of such program. In such report the Secretary shall provide a recommendation, based upon the results of such demonstration program, as to whether direct billing of, and reimbursement by, the medicare and medicaid programs and other third-party payors should be authorized for all Indian tribes and Alaska Native health organizations which are contracting the entire operation of a facility of the Service. “(f) The Secretary shall provide for the retrocession of any contract entered into between a participant in the demonstration program described in subsection (a) of this section and the Service under the authority of the Indian Self-Determination Act. All cost accounting and billing authority shall be retroceded to the Secretary upon the Secretary’s acceptance of a retroceded contract.”

   Enacted provision · exact public law section
   (B) Section 405 of the Indian Health Care Improvement Act (25 U.S.C. 1645) (relating to the tribal organization demonstration program for direct billing of medicare, medicaid, and other third party payors) is repealed.

9. 2000

   Alaska Native and American Indian Direct Reimbursement Act of 2000

   Pub. L. 106–417 § 4(a) · 114 Stat. 1812

   Changed · 25 U.S.C. § 1645

   Pub. L. 106–417, § 4(a), reenacted section as in effect on Nov. 9, 1998. For text of section as reenacted, see 1998 Amendment note below

   Source evidence

   Code amendment note
   Pub. L. 106–417, § 4(a), reenacted section as in effect on Nov. 9, 1998. For text of section as reenacted, see 1998 Amendment note below.

   Enacted provision · exact public law section
   (a) In General.— Effective November 9, 1998, section 405 of the Indian Health Care Improvement Act (25 U.S.C. 1645(e)) is reenacted as in effect on that date.

   Effective date note
   Pub. L. 106–417, § 3(c), Nov. 1, 2000, 114 Stat. 1816, provided that: “The amendments made by this section [amending this section and sections 1395qq and 1396j of Title 42, The Public Health and Welfare] shall take effect on October 1, 2000.” Pub. L. 106–417, § 4(a), Nov. 1, 2000, 114 Stat. 1816, provided that the reenactment of this section by section 4(a) is effective Nov. 9, 1998. Pub. L. 106–417, § 4(b), Nov. 1, 2000, 114 Stat. 1816, provided that the amendment made by section 4(b) is effective Nov. 10, 1998.

10. 2000

    Alaska Native and American Indian Direct Reimbursement Act of 2000

    Pub. L. 106–417 § 3(a) · 114 Stat. 1812

    Amended · 25 U.S.C. § 1645

    Pub. L. 106–417, § 3(a), amended section generally. For text of section prior to amendment, see subsecs. (a) to (d) of section as set out in 1998 Amendment note below

    Target inherited from the preceding amendment note.

    Source evidence

    Code amendment note
    Pub. L. 106–417, § 3(a), amended section generally. For text of section prior to amendment, see subsecs. (a) to (d) of section as set out in 1998 Amendment note below.

    Enacted provision · exact public law section
    (a) Permanent Authorization.— Section 405 of the Indian Health Care Improvement Act (25 U.S.C. 1645) is amended to read as follows: “(a) Establishment of Direct Billing Program.— “(1) In general.— The Secretary shall establish a program under which Indian tribes, tribal organizations, and Alaska Native health organizations that contract or compact for the operation of a hospital or clinic of the Service under the Indian Self-Determination and Education Assistance Act may elect to directly bill for, and receive payment for, health care services provided by such hospital or clinic for which payment is made under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) (in this section referred to as the ‘medicare program’), under a State plan for medical assistance approved under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) (in this section referred to as the ‘medicaid program’), or from any other third party payor. “(2) Application of 100 percent fmap.— The third sentence of section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) shall apply for purposes of reimbursement under the medicaid program for health care services directly billed under the program established under this section. “(b) Direct Reimbursement.— “(1) Use of funds.— Each hospital or clinic participating in the program described in subsection (a) of this section shall be reimbursed directly under the medicare and medicaid programs for services furnished, without regard to the provisions of section 1880(c) of the Social Security Act (42 U.S.C. 1395qq(c)) and sections 402(a) and 813(b)(2)(A), but all funds so reimbursed shall first be used by the hospital or clinic for the purpose of making any improvements in the hospital or clinic that may be necessary to achieve or maintain compliance with the conditions and requirements applicable generally to facilities of such type under the medicare or medicaid programs. Any funds so reimbursed which are in excess of the amount necessary to achieve or maintain such conditions shall be used— “(A) solely for improving the health resources deficiency level of the Indian tribe; and “(B) in accordance with the regulations of the Service applicable to funds provided by the Service under any contract entered into under the Indian Self-Determination Act (25 U.S.C. 450f et seq.). “(2) Audits.— The amounts paid to the hospitals and clinics participating in the program established under this section shall be subject to all auditing requirements applicable to programs administered directly by the Service and to facilities participating in the medicare and medicaid programs. “(3) Secretarial oversight.— The Secretary shall monitor the performance of hospitals and clinics participating in the program established under this section, and shall require such hospitals and clinics to submit reports on the program to the Secretary on an annual basis. “(4) No payments from special funds.— Notwithstanding section 1880(c) of the Social Security Act (42 U.S.C. 1395qq(c)) or section 402(a), no payment may be made out of the special funds described in such sections for the benefit of any hospital or clinic during the period that the hospital or clinic participates in the program established under this section. “(c) Requirements for Participation.— “(1) Application.— Except as provided in paragraph (2)(B), in order to be eligible for participation in the program established under this section, an Indian tribe, tribal organization, or Alaska Native health organization shall submit an application to the Secretary that establishes to the satisfaction of the Secretary that— “(A) the Indian tribe, tribal organization, or Alaska Native health organization contracts or compacts for the operation of a facility of the Service; “(B) the facility is eligible to participate in the medicare or medicaid programs under section 1880 or 1911 of the Social Security Act (42 U.S.C. 1395qq; 1396j); “(C) the facility meets the requirements that apply to programs operated directly by the Service; and “(D) the facility— “(i) is accredited by an accrediting body as eligible for reimbursement under the medicare or medicaid programs; or “(ii) has submitted a plan, which has been approved by the Secretary, for achieving such accreditation. “(2) Approval.— “(A) In general.— The Secretary shall review and approve a qualified application not later than 90 days after the date the application is submitted to the Secretary unless the Secretary determines that any of the criteria set forth in paragraph (1) are not met. “(B) Grandfather of demonstration program participants.— Any participant in the demonstration program authorized under this section as in effect on the day before the date of enactment of the Alaska Native and American Indian Direct Reimbursement Act of 1999 shall be deemed approved for participation in the program established under this section and shall not be required to submit an application in order to participate in the program. “(C) Duration.— An approval by the Secretary of a qualified application under subparagraph (A), or a deemed approval of a demonstration program under subparagraph (B), shall continue in effect as long as the approved applicant or the deemed approved demonstration program meets the requirements of this section. “(d) Examination and Implementation of Changes.— “(1) In general.— The Secretary, acting through the Service, and with the assistance of the Administrator of the Health Care Financing Administration, shall examine on an ongoing basis and implement— “(A) any administrative changes that may be necessary to facilitate direct billing and reimbursement under the program established under this section, including any agreements with States that may be necessary to provide for direct billing under the medicaid program; and “(B) any changes that may be necessary to enable participants in the program established under this section to provide to the Service medical records information on patients served under the program that is consistent with the medical records information system of the Service. “(2) Accounting information.— The accounting information that a participant in the program established under this section shall be required to report shall be the same as the information required to be reported by participants in the demonstration program authorized under this section as in effect on the day before the date of enactment of the Alaska Native and American Indian Direct Reimbursement Act of 1999. The Secretary may from time to time, after consultation with the program participants, change the accounting information submission requirements. “(e) Withdrawal From Program.— A participant in the program established under this section may withdraw from participation in the same manner and under the same conditions that a tribe or tribal organization may retrocede a contracted program to the Secretary under authority of the Indian Self-Determination Act (25 U.S.C. 450 et seq.). All cost accounting and billing authority under the program established under this section shall be returned to the Secretary upon the Secretary’s acceptance of the withdrawal of participation in this program.”.

    Effective date note
    Pub. L. 106–417, § 3(c), Nov. 1, 2000, 114 Stat. 1816, provided that: “The amendments made by this section [amending this section and sections 1395qq and 1396j of Title 42, The Public Health and Welfare] shall take effect on October 1, 2000.” Pub. L. 106–417, § 4(a), Nov. 1, 2000, 114 Stat. 1816, provided that the reenactment of this section by section 4(a) is effective Nov. 9, 1998. Pub. L. 106–417, § 4(b), Nov. 1, 2000, 114 Stat. 1816, provided that the amendment made by section 4(b) is effective Nov. 10, 1998.

11. 2000

    Alaska Native and American Indian Direct Reimbursement Act of 2000

    Pub. L. 106–417 § 4(b) · 114 Stat. 1812

    Struck · 25 U.S.C. § 1645(e)

    Pub. L. 106–417, § 4(b), struck out subsec. (e). For text of subsec. (e) prior to amendment, see subsec. (e) of section as set out in 1998 Amendment note below

    Source evidence

    Code amendment note
    Subsec. (e). Pub. L. 106–417, § 4(b), struck out subsec. (e). For text of subsec. (e) prior to amendment, see subsec. (e) of section as set out in 1998 Amendment note below.

    Enacted provision · exact public law section
    (b) Reports.— Effective November 10, 1998, section 405 of the Indian Health Care Improvement Act is amended by striking subsection (e).

    Effective date note
    Pub. L. 106–417, § 3(c), Nov. 1, 2000, 114 Stat. 1816, provided that: “The amendments made by this section [amending this section and sections 1395qq and 1396j of Title 42, The Public Health and Welfare] shall take effect on October 1, 2000.” Pub. L. 106–417, § 4(a), Nov. 1, 2000, 114 Stat. 1816, provided that the reenactment of this section by section 4(a) is effective Nov. 9, 1998. Pub. L. 106–417, § 4(b), Nov. 1, 2000, 114 Stat. 1816, provided that the amendment made by section 4(b) is effective Nov. 10, 1998.

12. 2003

    Medicare Prescription Drug, Improvement, and Modernization Act of 2003

    Pub. L. 108–173 title IX § 900(e)(6)(B) · 117 Stat. 2066

    Substituted · 25 U.S.C. § 1645(d)(1)

    Pub. L. 108–173 substituted “Centers for Medicare & Medicaid Services” for “Health Care Financing Administration” in introductory provisions

    Source evidence

    Code amendment note
    Subsec. (d)(1). Pub. L. 108–173 substituted “Centers for Medicare & Medicaid Services” for “Health Care Financing Administration” in introductory provisions.

    Enacted provision · exact public law section
    (B) Indian health care improvement act.— Section 405(d)(1) of the Indian Health Care Improvement Act (25 U.S.C. 1645(d)(1)) is amended by striking “Health Care Financing Administration” in the matter preceding subparagraph (A) and inserting “Centers for Medicare & Medicaid Services”.

13. 2010

    Patient Protection and Affordable Care Act

    Pub. L. 111–148 title X § 10221(a) · 124 Stat. 119

    Amended · 25 U.S.C. § 1645

    Pub. L. 111–148 amended section generally. Prior to amendment, section related to establishment of program for direct billing of medicare, medicaid, and other third party payors by Indian tribes, tribal organizations, and Alaska Native health organizations

    Source evidence

    Code amendment note
    Pub. L. 111–148 amended section generally. Prior to amendment, section related to establishment of program for direct billing of medicare, medicaid, and other third party payors by Indian tribes, tribal organizations, and Alaska Native health organizations.

    Enacted provision · exact public law section
    (a) In General.— Except as provided in subsection (b), S. 1790 entitled “A bill to amend the Indian Health Care Improvement Act to revise and extend that Act, and for other purposes.”, as reported by the Committee on Indian Affairs of the Senate in December 2009, is enacted into law.

14. 2020

    Consolidated Appropriations Act, 2021

    Pub. L. 116–260 § 1113(1) · 134 Stat. 1182

    Inserted · 25 U.S.C. § 1645(a)(1)

    Pub. L. 116–260, § 1113(1), inserted “urban Indian organizations,” before “and tribal organizations”

    Source evidence

    Code amendment note
    Subsec. (a)(1). Pub. L. 116–260, § 1113(1), inserted “urban Indian organizations,” before “and tribal organizations”.

    Enacted provision · exact public law section
    (1) in subsection (a)(1), by inserting “urban Indian organizations,” before “and tribal organizations”; and

15. 2020

    Consolidated Appropriations Act, 2021

    Pub. L. 116–260 § 1113(2) · 134 Stat. 1182

    Inserted · 25 U.S.C. § 1645(c)

    Pub. L. 116–260, § 1113(2), inserted “urban Indian organization,” before “or tribal organization” and “an urban Indian organization,” before “or a tribal organization”

    Source evidence

    Code amendment note
    Subsec. (c). Pub. L. 116–260, § 1113(2), inserted “urban Indian organization,” before “or tribal organization” and “an urban Indian organization,” before “or a tribal organization”.

    Enacted provision · exact public law section
    (2) in subsection (c)— (A) by inserting “urban Indian organization,” before “or tribal organization”; and (B) by inserting “an urban Indian organization,” before “or a tribal organization”.

16. 2021

    Proper and Reimbursed Care for Native Veterans Act

    Pub. L. 116–311 § 2 · 134 Stat. 4927

    Inserted · 25 U.S.C. § 1645(c)

    Pub. L. 116–311 inserted “, regardless of whether such services are provided directly by the Service, an Indian tribe, or tribal organization, through purchased/referred care, or through a contract for travel described in section 1621l(b) of this title” before period at end

    Source evidence

    Code amendment note
    Subsec. (c). Pub. L. 116–311 inserted “, regardless of whether such services are provided directly by the Service, an Indian tribe, or tribal organization, through purchased/referred care, or through a contract for travel described in section 1621l(b) of this title” before period at end.

    Enacted provision · exact public law section
    SEC. 2. CLARIFICATION OF REQUIREMENT OF DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE TO REIMBURSE INDIAN HEALTH SERVICE FOR CERTAIN HEALTH CARE SERVICES.   Section 405(c) of the Indian Health Care Improvement Act (25 U.S.C. 1645) is amended by inserting before the period at the end the following: “, regardless of whether such services are provided directly by the Service, an Indian tribe, or tribal organization, through purchased/referred care, or through a contract for travel described in section 213(b)”.

15 of 16 references resolved to an enrolled provision · 1 partial