Title 42 — The Public Health and WelfareRelease 119-73
§1320b–9 Improved access to, and delivery of, health care for Indians under subchapters XIX and XXI
Title 42 › Chapter CHAPTER 7— - SOCIAL SECURITY › Subchapter SUBCHAPTER XI— - GENERAL PROVISIONS, PEER REVIEW, AND ADMINISTRATIVE SIMPLIFICATION › Part Part A— - General Provisions › § 1320b–9
Summary
Require the Secretary to urge states to make it easier for Indians who live on or near reservations to sign up for Medicaid and the State children’s health insurance program near where they live. The Secretary must promote steps like placing eligibility workers near reservations and making agreements with the Indian Health Service, Indian Tribes, Tribal Organizations, or Urban Indian Organizations so those groups can do outreach, explain benefits, help people enroll, and provide translation when needed. This does not change any existing agreements that let those groups do administrative work now. The words "Indian", "Indian Tribe", "Indian Health Program", "Tribal Organization", and "Urban Indian Organization" use the meanings given in section 1603 of title 25.
Full Legal Text
Title 42, §1320b–9
The Public Health and Welfare — Source: USLM XML via OLRC
(a)(1)In order to improve the access of Indians residing on or near a reservation to obtain benefits under the Medicaid and State children’s health insurance programs established under subchapters XIX and XXI, the Secretary shall encourage the State to take steps to provide for enrollment on or near the reservation. Such steps may include outreach efforts such as the outstationing of eligibility workers, entering into agreements with the Indian Health Service, Indian Tribes, Tribal Organizations, and Urban Indian Organizations to provide outreach, education regarding eligibility and benefits, enrollment, and translation services when such services are appropriate.
(2)Nothing in paragraph (1) shall be construed as affecting arrangements entered into between States and the Indian Health Service, Indian Tribes, Tribal Organizations, or Urban Indian Organizations for such Service, Tribes, or Organizations to conduct administrative activities under such subchapters.
(b)The Secretary, acting through the Centers for Medicare & Medicaid Services, shall take such steps as are necessary to facilitate cooperation with, and agreements between, States and the Indian Health Service, Indian Tribes, Tribal Organizations, or Urban Indian Organizations with respect to the provision of health care items and services to Indians under the programs established under subchapter XIX or XXI.
(c)For purposes of this section, subchapter XIX, and subchapter XXI, the terms “Indian”, “Indian Tribe”, “Indian Health Program”, “Tribal Organization”, and “Urban Indian Organization” have the meanings given those terms in section 1603 of title 25.
Legislative History
Notes & Related Subsidiaries
Editorial Notes
Amendments
2010—Subsec. (c). Pub. L. 111–148 substituted “For purposes of this section, subchapter XIX, and subchapter XXI” for “In this section”. 2009—Pub. L. 111–3 amended section generally. Prior to amendment, section related to the National Commission on Children. 1994—Subsec. (d). Pub. L. 103–432, § 264(d), repealed Pub. L. 101–508, § 5057. See 1990 Amendment note below. 1990—Subsec. (d). Pub. L. 101–508, § 5057, which directed amendment of subsec. (d) by substituting “an interim report no later than
September 30, 1990, and a final report no later than
March 31, 1991” for “an interim report no later than
March 31, 1991, and a final report no later than
September 30, 1990”, and could not be executed, was repealed by Pub. L. 103–432, § 264(d). See
Construction
of 1990 Amendment note below. Pub. L. 101–508, § 4207(k)(6), formerly § 4027(k)(6), as renumbered by Pub. L. 103–432, § 160(d)(4), substituted “interim report no later than
March 31, 1990, and a final report no later than
March 31, 1991, setting forth” for “interim report no later than
March 31, 1991, and a final report no later than
September 30, 1990, setting forth”. 1989—Subsec. (d). Pub. L. 101–239, § 6221(1), which directed the substitution of “
March 31, 1990” for “
September 30, 1988” and “
March 31, 1991” for “
March 31, 1990 [1989]”, could only be executed in part by substituting “
March 31, 1991” for “
March 30, 1990” in view of amendment by Pub. L. 100–647. See 1990 Amendment note above. Subsec. (e)(1)(A), (4)(B). Pub. L. 101–239, § 6221(2), substituted “
March 31, 1991” for “
September 30, 1990”. Subsec. (f). Pub. L. 101–45 amended subsec. (f) generally. Prior to amendment, subsec. (f) read as follows: “(1) The Commission shall appoint an Executive Director of the Commission who shall be compensated at a rate fixed by the Commission, but which shall not exceed the rate established for level V of the Executive Schedule under title 5. “(2) In addition to the Executive Director, the Commission may appoint and fix the compensation of such personnel as it deems advisable, in accordance with the provisions of title 5 governing appointments to the competitive service, and the provisions of chapter 51 and subchapter III of chapter 53 of such title, relating to classification and General Schedule pay rates.” Subsec. (j). Pub. L. 101–239, § 6221(3), substituted “through fiscal year 1991, such sums” for “such sums”. Subsecs. (k), (l). Pub. L. 101–239, § 6221(4), added subsecs. (k) and (l). 1988—Subsec. (d). Pub. L. 100–647, § 8201(1), (2), substituted “
March 31, 1990” for “
September 30, 1988” and “
September 30, 1990” for “
March 31, 1989” in introductory provisions. Subsec. (e)(1)(A), (4)(B). Pub. L. 100–647, § 8201(3), (4), substituted “
September 30, 1990” for “
March 31, 1989”. Subsec. (j). Pub. L. 100–647, § 8201(5), inserted “for each of fiscal years 1989 and 1990” before period at end.
Statutory Notes and Related Subsidiaries
Effective Date
of 2009 AmendmentAmendment by Pub. L. 111–3 effective Apr. 1, 2009, and applicable to child health assistance and medical assistance provided on or after that date, with certain exceptions, see section 3 of Pub. L. 111–3, set out as an
Effective Date
note under section 1396 of this title.
Effective Date
of 1994 Amendment Pub. L. 103–432, title II, § 264(h), Oct. 31, 1994, 108 Stat. 4469, provided that: “Each amendment made by this section [amending this section and section 602, 1382a, and 1383 of this title] shall take effect as if included in the provision of OBRA–1990 [Pub. L. 101–508] to which the amendment relates at the time such provision became law.”
Construction
of 1990 Amendment Pub. L. 103–432, title II, § 264(d), Oct. 31, 1994, 108 Stat. 4468, provided that: “section 5057 of OBRA–1990 [Pub. L. 101–508, amending this section], and the amendment made by such section, are hereby repealed, and section 1139(d) of the Social Security Act [42 U.S.C. 1320b–9(d)] shall be applied and administered as if such section 5057 had never been enacted.”
Reference
Citations & Metadata
Citation
42 U.S.C. § 1320b–9
Title 42 — The Public Health and Welfare
Last Updated
Apr 6, 2026
Release point: 119-73