View all text of Subchapter II [§ 1621 - § 1623]
§ 1621j. California contract health services demonstration program
(a) Establishment
(b) Agreement with California Rural Indian Health Board
(1) In establishing such program, the Secretary shall enter into an agreement with the California Rural Indian Health Board to reimburse the Board for costs (including reasonable administrative costs) incurred, during the period of the demonstration program, in providing medical treatment under contract to California Indians described in section 1679(b) 1
1 See References in Text note below.
of this title throughout the California contract health services delivery area described in section 1680 of this title with respect to high-cost contract care cases.(2) Not more than 5 percent of the amounts provided to the Board under this section for any fiscal year may be for reimbursement for administrative expenses incurred by the Board during such fiscal year.
(3) No payment may be made for treatment provided under the demonstration program to the extent payment may be made for such treatment under the Catastrophic Health Emergency Fund described in section 1621a of this title or from amounts appropriated or otherwise made available to the California contract health service delivery area for a fiscal year.
(c) Advisory board
(d) Commencement and termination dates
(e) Report
Not later than July 1, 1998, the California Rural Indian Health Board shall submit to the Secretary a report on the demonstration program carried out under this section, including a statement of its findings regarding the impact of using a contract care intermediary on—
(1) access to needed health services;
(2) waiting periods for receiving such services; and
(3) the efficient management of high-cost contract care cases.
(f) “High-cost contract care cases” defined
For the purposes of this section, the term “high-cost contract care cases” means those cases in which the cost of the medical treatment provided to an individual—
(1) would otherwise be eligible for reimbursement from the Catastrophic Health Emergency Fund established under section 1621a of this title, except that the cost of such treatment does not meet the threshold cost requirement established pursuant to section 1621a(b)(2) 1 of this title; and
(2) exceeds $1,000.
(Pub. L. 94–437, title II, § 211, as added Pub. L. 102–573, title II, § 206(c), Oct. 29, 1992, 106 Stat. 4549; amended Pub. L. 104–313, § 2(c), Oct. 19, 1996, 110 Stat. 3822; Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.)