PRIA, Government Policy, Made Personal

Summary

Indians with income at or below 300% of the poverty level who sign up for a qualified health plan through a State Exchange must not be charged cost-sharing for that coverage. Health programs run by the Indian Health Service, tribes, tribal organizations, and Urban Indian organizations must act as the payer of last resort for services they give to people who are eligible for those programs. That means those Indian health programs pay only after any other available sources have paid, and this rule applies even if other federal, state, or local laws say otherwise.

Title 25, §1623

Indians, Source: USLM XML via OLRC

(a)No Cost-sharing for Indians with income at or below 300 percent of poverty enrolled in coverage through a State Exchange

For provisions prohibiting cost sharing for Indians enrolled in any qualified health plan in the individual market through an Exchange, see section 18071(d) of title 42.

(b)Payer of last resort

Health programs operated by the Indian Health Service, Indian tribes, tribal organizations, and Urban Indian organizations (as those terms are defined in section 1603 of this title) shall be the payer of last resort for services provided by such Service, tribes, or organizations to individuals eligible for services through such programs, notwithstanding any Federal, State, or local law to the contrary.

Notes & Related Subsidiaries

Editorial Notes

Codification Section is comprised of subsecs. (a) and (b) of section 2901 of Pub. L. 111–148. Subsections (c) and (d) of section 2901 amended section 1396a and 1320b–9, respectively, of Title 42, The Public Health and Welfare. Section was enacted as part of the Patient Protection and Affordable Care Act, and not as part of the Indian Health Care Improvement Act which comprises this chapter.

§1623 Special Rules Relating to Indians

Summary

Title 25, §1623

Notes & Related Subsidiaries

Editorial Notes

Citations & Metadata