§1395qq Indian Health Service Facilities

Summary

Lets Indian Health Service hospitals and skilled nursing homes, whether run by the Service or by an Indian tribe or tribal organization, get payments under this part of the law if they meet the same rules that other hospitals and nursing homes must meet. If a facility did not meet the rules but filed an acceptable plan to meet them within six months after September 30, 1976, it is treated as meeting the rules and can get payments for the first 12 months after the month it files that plan. Payments owed under this authority must be put in a special fund held by the Secretary and used only (as money is provided by Congress) to make the improvements needed to meet the rules. That special‑fund rule ends when the Secretary certifies that substantially all IHS hospitals and facilities in the United States comply. The Secretary’s yearly report under section 1671 of title 25 must include a detailed update on how these hospitals and facilities are meeting the rules and on progress under any plans. The Secretary must also pay under Part B to an IHS or tribe‑run hospital or outpatient clinic (whether part of a hospital or independent) for certain services, and for all Part B payable items and services furnished on or after January 1, 2005, under the same terms that would apply if the facility were not run by the Service or a tribe. No Part B payment is made when that service is already paid under this subchapter. The listed services include those covered under section 1395w–4, services by practitioners described in section 1395u(b)(18)(C) paid under a fee schedule, and physical or occupational therapy services described in section 1395x(p) paid under a fee schedule. The special fund rule does not apply to these Part B payments. For rules about tribes or Alaska Native health organizations billing directly and getting paid, see section 1645 of title 25.