To amend title XVIII of the Social Security Act to provide for a limitation on the charges for contract health services provided to Indians by Medicare providers.

SA 3894. Mr. BINGAMAN (for himself and Mr. Thune) proposed an
amendment to amendment SA 3899 proposed by Mr. Dorgan (for himself, Ms.
Murkowski, Mr. Baucus, Mr. Kennedy, Mr. Smith, Mr. Nelson of Nebraska,
and Mr. Salazar) to the bill S. 1200, to amend the Indian Health Care
Improvement Act to revise and extend the Act; as follows:

At the end of title II, add the following:

SEC. ____. LIMITATION ON CHARGES FOR CONTRACT HEALTH SERVICES
PROVIDED TO INDIANS BY MEDICARE PROVIDERS.

(a) All Providers of Services.--
(1) In general.--Section 1866(a)(1)(U) of the Social
Security Act (42 U.S.C. 1395cc(a)(1)(U)) is amended by
striking ``in the case of hospitals which furnish inpatient
hospital services for which payment may be made under this
title,'' in the matter preceding clause (i).
(2) Effective date.--The amendment made by paragraph (1)
shall apply to Medicare participation agreements in effect
(or entered into) on or after the date that is 1 year after
the date of enactment of this Act.
(b) All Suppliers.--
(1) In general.--Section 1834 of the Social Security Act
(42 U.S.C. 1395m) is amended by adding at the end the
following new subsection:
``(n) Limitation on Charges for Contract Health Services
Provided to Indians by Suppliers.--No payment may be made
under this title for an item or service furnished by a
supplier (as defined in section 1861(d)) unless the supplier
agrees (pursuant to a process established by the Secretary)
to be a participating provider of medical care both--
``(1) under the contract health services program funded by
the Indian Health Service and operated by the Indian Health
Service, an Indian Tribe, or Tribal Organization (as those
terms are defined in section 4 of the Indian Health Care
Improvement Act), with respect to items and services that are
covered under such program and furnished to an individual
eligible for such items and services under such program; and
``(2) under any program funded by the Indian Health Service
and operated by an urban Indian Organization with respect to
the purchase of items and services for an eligible Urban
Indian (as those terms are defined in such section 4),

in accordance with regulations promulgated by the Secretary
regarding payment methodology and rates of payment (including
the acceptance of no more than such payment rate as payment
in full for such items and services.''.
(2) Effective date.--The amendment made by paragraph (1)
shall apply to items and services furnished on or after the
date that is 1 year after the date of enactment of this Act.
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