42 U.S.C. § 1395qq : US Code - Section 1395QQ: Indian health service facilities

Search 42 U.S.C. § 1395qq : US Code - Section 1395QQ: Indian health service facilities

(a) Eligibility for payments; conditions and requirements
A hospital or skilled nursing facility of the Indian Health
Service, whether operated by such Service or by an Indian tribe or
tribal organization (as those terms are defined in section 1603 of
title 25), shall be eligible for payments under this subchapter,
notwithstanding sections 1395f(c) and 1395n(d) of this title, if
and for so long as it meets all of the conditions and requirements
for such payments which are applicable generally to hospitals or
skilled nursing facilities (as the case may be) under this
subchapter.
(b) Eligibility based on submission of plan to achieve compliance
with conditions and requirements; twelve-month period
Notwithstanding subsection (a) of this section, a hospital or
skilled nursing facility of the Indian Health Service which does
not meet all of the conditions and requirements of this subchapter
which are applicable generally to hospitals or skilled nursing
facilities (as the case may be), but which submits to the Secretary
within six months after September 30, 1976, an acceptable plan for
achieving compliance with such conditions and requirements, shall
be deemed to meet such conditions and requirements (and to be
eligible for payments under this subchapter), without regard to the
extent of its actual compliance with such conditions and
requirements, during the first 12 months after the month in which
such plan is submitted.
(c) Payments into special fund for improvements to achieve
compliance with conditions and requirements; certification of
compliance by Secretary
Notwithstanding any other provision of this subchapter, payments
to which any hospital or skilled nursing facility of the Indian
Health Service is entitled by reason of this section shall be
placed in a special fund to be held by the Secretary and used by
him (to such extent or in such amounts as are provided in
appropriation Acts) exclusively for the purpose of making any
improvements in the hospitals and skilled nursing facilities of
such Service which may be necessary to achieve compliance with the
applicable conditions and requirements of this subchapter. The
preceding sentence shall cease to apply when the Secretary
determines and certifies that substantially all of the hospitals
and skilled nursing facilities of such Service in the United States
are in compliance with such conditions and requirements.
(d) Report by Secretary; status of facilities in complying with
conditions and requirements
The annual report of the Secretary which is required by section
1671 of title 25 shall include (along with the matters specified in
section 1643 of title 25) a detailed statement of the status of the
hospitals and skilled nursing facilities of the Service in terms of
their compliance with the applicable conditions and requirements of
this subchapter and of the progress being made by such hospitals
and facilities (under plans submitted under subsection (b) of this
section and otherwise) toward the achievement of such compliance.
(e) Services provided by Indian Health Service, Indian tribe, or
tribal organization
(1)(A) Notwithstanding section 1395n(d) of this title, subject to
subparagraph (B), the Secretary shall make payment under part B of
this subchapter to a hospital or an ambulatory care clinic (whether
provider-based or freestanding) that is operated by the Indian
Health Service or by an Indian tribe or tribal organization (as
defined for purposes of subsection (a) of this section) for
services described in paragraph (2) (and for items and services
furnished during the 5-year period beginning on January 1, 2005,
all items and services for which payment may be made under part B
of this subchapter) furnished in or at the direction of the
hospital or clinic under the same situations, terms, and conditions
as would apply if the services were furnished in or at the
direction of such a hospital or clinic that was not operated by
such Service, tribe, or organization.
(B) Payment shall not be made for services under subparagraph (A)
to the extent that payment is otherwise made for such services
under this subchapter.
(2) The services described in this paragraph are the following:
(A) Services for which payment is made under section 1395w-4 of
this title.
(B) Services furnished by a practitioner described in section
1395u(b)(18)(C) of this title for which payment under part B of
this subchapter is made under a fee schedule.
(C) Services furnished by a physical therapist or occupational
therapist as described in section 1395x(p) of this title for
which payment under part B of this subchapter is made under a fee
schedule.
(3) Subsection (c) of this section shall not apply to payments
made under this subsection.
(f) Cross reference
For provisions relating to the authority of certain Indian
tribes, tribal organizations, and Alaska Native health
organizations to elect to directly bill for, and receive payment
for, health care services provided by a hospital or clinic of such
tribes or organizations and for which payment may be made under
this subchapter, see section 1645 of title 25.