§ 1680c. — Health services for ineligible persons.
[Laws in effect as of January 24, 2002]
[Document not affected by Public Laws enacted between
January 24, 2002 and December 19, 2002]
[CITE: 25USC1680c]
TITLE 25--INDIANS
CHAPTER 18--INDIAN HEALTH CARE
SUBCHAPTER VI--MISCELLANEOUS
Sec. 1680c. Health services for ineligible persons
(a) Individuals not otherwise eligible
(1) Any individual who--
(A) has not attained 19 years of age,
(B) is the natural or adopted child, step-child, foster-child,
legal ward, or orphan of an eligible Indian, and
(C) is not otherwise eligible for the health services provided
by the Service,
shall be eligible for all health services provided by the Service on the
same basis and subject to the same rules that apply to eligible Indians
until such individual attains 19 years of age. The existing and
potential health needs of all such individuals shall be taken into
consideration by the Service in determining the need for, or the
allocation of, the health resources of the Service. If such an
individual has been determined to be legally incompetent prior to
attaining 19 years of age, such individual shall remain eligible for
such services until one year after the date such disability has been
removed.
(2) Any spouse of an eligible Indian who is not an Indian, or who is
of Indian descent but not otherwise eligible for the health services
provided by the Service, shall be eligible for such health services if
all of such spouses are made eligible, as a class, by an appropriate
resolution of the governing body of the Indian tribe of the eligible
Indian. The health needs of persons made eligible under this paragraph
shall not be taken into consideration by the Service in determining the
need for, or allocation of, its health resources.
(b) Health facilities providing health service
(1)(A) The Secretary is authorized to provide health services under
this subsection through health facilities operated directly by the
Service to individuals who reside within the service area of a service
unit and who are not eligible for such health services under any other
subsection of this section or under any other provision of law if--
(i) the Indian tribe (or, in the case of a multi-tribal service
area, all the Indian tribes) served by such service unit requests
such provision of health services to such individuals, and
(ii) the Secretary and the Indian tribe or tribes have jointly
determined that--
(I) the provision of such health services will not result in
a denial or diminution of health services to eligible Indians,
and
(II) there is no reasonable alternative health facility or
services, within or without the service area of such service
unit, available to meet the health needs of such individuals.
(B) In the case of health facilities operated under a contract
entered into under the Indian Self-Determination Act [25 U.S.C. 450f et
seq.], the governing body of the Indian tribe or tribal organization
providing health services under such contract is authorized to determine
whether health services should be provided under such contract to
individuals who are not eligible for such health services under any
other subsection of this section or under any other provision of law. In
making such determinations, the governing body of the Indian tribe or
tribal organization shall take into account the considerations described
in subparagraph (A)(ii).
(2)(A) Persons receiving health services provided by the Service by
reason of this subsection shall be liable for payment of such health
services under a schedule of charges prescribed by the Secretary which,
in the judgment of the Secretary, results in reimbursement in an amount
not less than the actual cost of providing the health services.
Notwithstanding section 1880(c) of the Social Security Act [42 U.S.C.
1395qq(c)], section 1642(a) of this title, or any other provision of
law, amounts collected under this subsection, including medicare or
medicaid reimbursements under titles XVIII and XIX of the Social
Security Act [42 U.S.C. 1395 et seq., 1396 et seq.], shall be credited
to the account of the facility providing the service and shall be used
solely for the provision of health services within that facility.
Amounts collected under this subsection shall be available for
expenditure within such facility for not to exceed one fiscal year after
the fiscal year in which collected.
(B) Health services may be provided by the Secretary through the
Service under this subsection to an indigent person who would not be
eligible for such health services but for the provisions of paragraph
(1) only if an agreement has been entered into with a State or local
government under which the State or local government agrees to reimburse
the Service for the expenses incurred by the Service in providing such
health services to such indigent person.
(3)(A) In the case of a service area which serves only one Indian
tribe, the authority of the Secretary to provide health services under
paragraph (1)(A) shall terminate at the end of the fiscal year
succeeding the fiscal year in which the governing body of the Indian
tribe revokes its concurrence to the provision of such health services.
(B) In the case of a multi-tribal service area, the authority of the
Secretary to provide health services under paragraph (1)(A) shall
terminate at the end of the fiscal year succeeding the fiscal year in
which at least 51 percent of the number of Indian tribes in the service
area revoke their concurrence to the provision of such health services.
(c) Purposes served in providing health services to otherwise ineligible
individuals
The Service may provide health services under this subsection to
individuals who are not eligible for health services provided by the
Service under any other subsection of this section or under any other
provision of law in order to--
(1) achieve stability in a medical emergency,
(2) prevent the spread of a communicable disease or otherwise
deal with a public health hazard,
(3) provide care to non-Indian women pregnant with an eligible
Indian's child for the duration of the pregnancy through post
partum, or
(4) provide care to immediate family members of an eligible
person if such care is directly related to the treatment of the
eligible person.
(d) Extension of hospital privileges to non-Service health care
practitioners
Hospital privileges in health facilities operated and maintained by
the Service or operated under a contract entered into under the Indian
Self-Determination Act [25 U.S.C. 450f et seq.] may be extended to non-
Service health care practitioners who provide services to persons
described in subsection (a) or (b) of this section. Such non-Service
health care practitioners may be regarded as employees of the Federal
Government for purposes of section 1346(b) and chapter 171 of title 28
(relating to Federal tort claims) only with respect to acts or omissions
which occur in the course of providing services to eligible persons as a
part of the conditions under which such hospital privileges are
extended.
(e) ``Eligible Indian'' defined
For purposes of this section, the term ``eligible Indian'' means any
Indian who is eligible for health services provided by the Service
without regard to the provisions of this section.
(Pub. L. 94-437, title VIII, Sec. 813, formerly title VII, Sec. 713, as
added Pub. L. 100-713, title VII, Sec. 707(a), Nov. 23, 1988, 102 Stat.
4829; renumbered title VIII, Sec. 813, and amended Pub. L. 102-573,
title VII, Sec. 701(a), (b), title IX, Sec. 902(8), Oct. 29, 1992, 106
Stat. 4572, 4592.)
References in Text
The Indian Self-Determination Act, referred to in subsecs. (b)(1)(B)
and (d), is title I of Pub. L. 93-638, Jan. 4, 1975, 88 Stat. 2206, as
amended, which is classified principally to part A (Sec. 450f et seq.)
of subchapter II of chapter 14 of this title. For complete
classification of this Act to the Code, see Short Title note set out
under section 450 of this title and Tables.
The Social Security Act, referred to in subsec. (b)(2)(A), is act
Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles XIII and XIX of
the Social Security Act are classified generally to subchapters XVIII
(Sec. 1395 et seq.) and XIX (Sec. 1396 et seq.) of chapter 7 of Title
42, The Public Health and Welfare. For complete classification of this
Act to the Code, see section 1305 of Title 42 and Tables.
Amendments
1992--Subsec. (b)(2)(A). Pub. L. 102-573, Sec. 902(8), substituted
``section 1642(a) of this title'' for ``section 402(c) of this Act''.
Section Referred to in Other Sections
This section is referred to in sections 1621f, 1637, 1645 of this
title.
