[104th Congress Public Law 313]
[From the U.S. Government Printing Office]


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[DOCID: f:publ313.104]


[[Page 3819]]

    INDIAN HEALTH CARE IMPROVEMENT TECHNICAL CORRECTIONS ACT OF 1996

[[Page 110 STAT. 3820]]

Public Law 104-313
104th Congress

                                 An Act


 
     To amend the Indian Health Care Improvement Act to extend the 
  demonstration program for direct billing of Medicare, Medicaid, and 
    other third party payors. <<NOTE: Oct. 19, 1996 -  [H.R. 3378]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Indian Health 
Care Improvement Technical Corrections Act of 1996.>> 

SECTION 1. SHORT TITLE; REFERENCE.

<<NOTE: 25 USC 1601 note.>>     (a) Short Title.--This Act may be cited 
as the ``Indian Health Care Improvement Technical Corrections Act of 
1996''.

    (b) References.--Whenever in this Act an amendment or repeal is 
expressed in terms of an amendment to or repeal of a section or other 
provision, the reference shall be considered to be made to a section or 
other provision of the Indian Health Care Improvement Act.

SEC. 2. TECHNICAL CORRECTIONS IN THE INDIAN HEALTH CARE IMPROVEMENT ACT.

    (a) Definition of Health Profession.--Section 4(n) (25 U.S.C. 
1603(n)) is amended--
            (1) by inserting ``allopathic medicine,'' before ``family 
        medicine''; and
            (2) by striking ``and allied health professions'' and 
        inserting ``an allied health profession, or any other health 
        profession''.

    (b) Indian Health Professions Scholarships.--Section 104(b) of the 
Indian Health Care Improvement Act (25 U.S.C. 1613a(b)) is amended--
            (1) in paragraph (3)--
                    (A) in subparagraph (A)--
                          (i) by striking the matter preceding clause 
                      (i) and inserting the following:

    ``(3)(A) The active duty service obligation under a written contract 
with the Secretary under section 338A of the Public Health Service Act 
(42 U.S.C. 254l) that an individual has entered into under that section 
shall, if that individual is a recipient of an Indian Health 
Scholarship, be met in full-time practice, by 
service--'';
                          (ii) by striking ``or'' at the end of clause 
                      (iii); and
                          (iii) by striking the period at the end of 
                      clause (iv) and inserting ``; or'';
                    (B) by redesignating subparagraphs (B) and (C) as 
                subparagraphs (C) and (D), respectively;
                    (C) by inserting after subparagraph (A) the 
                following new subparagraph:

    ``(B) At the request of any individual who has entered into a 
contract referred to in subparagraph (A) and who receives a

[[Page 110 STAT. 3821]]

degree in medicine (including osteopathic or allopathic medicine), 
dentistry, optometry, podiatry, or pharmacy, the Secretary shall defer 
the active duty service obligation of that individual under that 
contract, in order that such individual may complete any internship, 
residency, or other advanced clinical training that is required for the 
practice of that health profession, for an appropriate period (in years, 
as determined by the Secretary), subject to the following conditions:
            ``(i) No period of internship, residency, or other advanced 
        clinical training shall be counted as satisfying any period of 
        obligated service that is required under this section.
            ``(ii) The active duty service obligation of that individual 
        shall commence not later than 90 days after the completion of 
        that advanced clinical training (or by a date specified by the 
        Secretary).
            ``(iii) The active duty service obligation will be served in 
        the health profession of that individual, in a manner consistent 
        with clauses (i) through (v) of subparagraph (A).'';
                    (D) in subparagraph (C), as so redesignated, by 
                striking ``prescribed under section 338C of the Public 
                Health Service Act (42 U.S.C. 254m) by service in a 
                program specified in subparagraph (A)'' and inserting 
                ``described in subparagraph (A) by service in a program 
                specified in that subparagraph''; and
                    (E) in subparagraph (D), as so redesignated--
                          (i) by striking ``Subject to subparagraph 
                      (B),'' and inserting ``Subject to subparagraph 
                      (C),''; and
                          (ii) by striking ``prescribed under section 
                      338C of the Public Health Service Act (42 U.S.C. 
                      254m)'' and inserting ``described in subparagraph 
                      (A)'';
            (2) in paragraph (4)--
                    (A) in subparagraph (B), by striking the matter 
                preceding clause (i) and inserting the following:
            ``(B) the period of obligated service described in paragraph 
        (3)(A) shall be equal to the greater of--''; and
                    (B) in subparagraph (C), by striking ``(42 U.S.C. 
                254m(g)(1)(B))'' and inserting ``(42 U.S.C. 
                254l(g)(1)(B))''; and
            (3) in paragraph (5), by adding at the end the following new 
        subparagraphs:

    ``(C) Upon the death of an individual who receives an Indian Health 
Scholarship, any obligation of that individual for service or payment 
that relates to that scholarship shall be canceled.
    ``(D) The Secretary shall provide for the partial or total waiver or 
suspension of any obligation of service or payment of a recipient of an 
Indian Health Scholarship if the Secretary determines that--
            ``(i) it is not possible for the recipient to meet that 
        obligation or make that payment;
            ``(ii) requiring that recipient to meet that obligation or 
        make that payment would result in extreme hardship to the 
        recipient; or
            ``(iii) the enforcement of the requirement to meet the 
        obligation or make the payment would be unconscionable.

    ``(E) Notwithstanding any other provision of law, in any case of 
extreme hardship or for other good cause shown, the Secretary may waive, 
in whole or in part, the right of the United States to recover funds 
made available under this section.

[[Page 110 STAT. 3822]]

    ``(F) Notwithstanding any other provision of law, with respect to a 
recipient of an Indian Health Scholarship, no obligation for payment may 
be released by a discharge in bankruptcy under title 11, United States 
Code, unless that discharge is granted after the expiration of the 5-
year period beginning on the initial date on which that payment is due, 
and only if the bankruptcy court finds that the nondischarge of the 
obligation would be unconscionable.''.
    (c) California Contract Health Services Demonstration Program.--
Section 211(g) (25 U.S.C. 1621j(g)) is amended by striking ``1993, 1994, 
1995, 1996, and 1997'' and inserting ``1996 through 2000''.
    (d) Extension of Certain Demonstration Program.--Section 405(c)(2) 
(25 U.S.C. 1645(c)(2)) is amended by striking ``September 30, 1996'' and 
inserting ``September 30, 1998''.
    (e) Gallup Alcohol and Substance Abuse Treatment 
Center.--Section 706(d) (25 U.S.C. 1665e(d)) is amended to read as 
follows:
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated, for each of fiscal years 1996 through 2000, such sums as 
may be necessary to carry out subsection (b).''.
    (f) Substance Abuse Counselor Education Demonstration Program.--
Section 711(h) (25 U.S.C. 1665j(h)) is amended by striking ``1993, 1994, 
1995, 1996, and 1997'' and inserting ``1996 through 2000''.
    (g) Home and Community-Based Care Demonstration 
Program.--Section 821(i) (25 U.S.C. 1680k(i)) is amended by striking 
``1993, 1994, 1995, 1996, and 1997'' and inserting ``1996 through 
2000''.

    Approved October 19, 1996.

LEGISLATIVE HISTORY--H.R. 3378 (S. 1869):
---------------------------------------------------------------------------

HOUSE REPORTS: No. 104-742, Pt. 1 (Comm. on Resources).
SENATE REPORTS: No. 104-346 accompanying S. 1869 (Comm. on Indian 
Affairs).
CONGRESSIONAL RECORD, Vol. 142 (1996):
            Sept. 4, considered and passed House.
            Sept. 19, considered and passed Senate, amended.
            Sept. 27, House concurred in Senate amendment with an 
                amendment.
            Oct. 3, Senate concurred in House amendment.

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