102 STAT. 4818
PUBLIC LAW 100-713—NOV. 23, 1988
"(d)(1) The real property referred to in subsection (a) is United States Survey Numbered 4000, other than the lands described in paragraph (2). "(2) The lands referred to in subsection 0)X1) are the lands identified as tracts A and B in the determination AA-18959 of the Bureau of Land Management issued on September 30, 1983, pursuant to the Alaska Native Claims Settlement Act.". TITLE IV—ACCESS TO HEALTH SERVICES MEDICAID PROVISIONS
42 USC 1396J note. 42 USC 1396J note.
SEC. 401. (a) Subsection (c) of section 402 (42 U.S.C. 1396j, note) is amended— (1) by striking out "or skilled nuraing facility" and inserting in lieu thereof "skilled nursing facility, or any other t3T)e of facility which provides services of a type otherwise covered under a State plan for medical assistance approved under title XIX of the Social Security Act", (2) by striking out "a State plan approved under title XIX of the Social Security Act" and inserting in lieu thereof "such a State plan", and (3) by striking out "The preceding sentence shall" and inserting in lieu thereof "In making payments from such fund, the S e c r e t a ^ shall ensure that each service unit of the Indian Health Service receives at least 50 percent of the amounts to which the facilities of the Indian Health Service, for which such service unit makes collections, are entitled by reason of section 1911 of the Social Security Act, if such amount is necessary for the purpose of making improvements in such facilities in order to achieve compliance with the conditions and requirements of title XIX of the Social Security Act. This subsection shall". (b) Subsection (b) of section 402 (42 U.S.C. 1396j, note) is repealed. (c) The amendments made by this section shall applv to services performed on or after the date of the enactment of this Act. DEMONSTRATION PROGRAM
SEC. 402. Title IV is amended by adding at the end thereof the following new section: " D E M O N S T R A T I O N P R O G R A M FOR DIRECT BIIXING OF MEDICARE, MEDICAID, AND OTHER THIRD PARTY PAYORS Health care facilities. 42 USC 1395qq note.
"SEC. 405. (a) The Secretary shall establish a demonstration program under which Indian tribes, tribal organizations, and Alaska Native health organizations, which are contracting the entire operation of an entire hospital or clinic of the Service under the authority of the Indian Self-Determination Act, shall directly bill for, and receive payment for, health care services provided by such hospital or clinic for which payment is made under title XVIII of the Social Security Act (medicare), under a State plan for medical assistance approved under title XIX of the Social Security Act (medicaid), or from any other third-party payor. The last sentence of section 1905(b) of the Social Security Act shall apply for purposes of the demonstration program. "(b)(1) Each hospital or clinic participating in the demonstration program described in subsection (a) shall be reimbursed directly
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