103 STAT. 734 PUBLIC LAW 101-121—OCT. 23, 1989 facilities for Indians, as authorized by section 7 of the Act of August 5, 1954 (42 U.S.C. 2004a), the Indian Self-Determination Act and the Indian Health Care Improvement Act, $70,996,000, to remain avail- able until expended: Provided, That notwithstanding any other provision of law, funds appropriated for the planning, design, construction or renovation of health facilities for the benefit of an Indian tribe or tribes may be used to purchase land for sites to construct, improve, or enlarge health or related facilities. ADMINISTRATIVE PROVISIONS, INDIAN HEALTH SERVICE Appropriations in this Act to the Indian Health Service, available for salaries and expenses, shall be available for services as au- thorized by 5 U.S.C. 3109 but at rates not to exceed the per diem equivalent to the rate for GS-18, and for uniforms or allowances therefor as authorized by law (5 U.S.C. 5901-5902), and for expenses of attendance at meetings which are concerned with the functions or activities for which the appropriation is made or which will contrib- ute to improved conduct, supervision, or management of those functions or activities: Provided, That none of the funds appro- priated under this Act to the Indian Health Service shall be avail- able for the initial lease of permanent structures without advance provision therefor in appropriations Acts: Provided further. That non-Indian patients may be extended health care at all tribally administered or Indian Health Service facilities, if such care can be extended without impairing the ability of the facility to fulfill its responsibility to provide health care to Indians served by such facilities and subject to such reasonable charges as the Secretary of Health and Human Services shall prescribe, the proceeds of which, together with funds recovered under the Federal Medical Care Recovery Act (42 U.S.C. 2651-53), shall be deposited in the fund established by sections 401 and 402 of the Indian Health Care Improvement Act or in the case of tribally administered facilities, shall be retained by the tribal organization without fiscal year limitation: Provided further. That funds appropriated to the Indian Health Service in this Act, except those used for administrative and program direction purposes, shall not be subject to limitations di- rected at curtailing Federal travel and transportation: Provided 25 USC 1681. further. That with the exception of Indian Health Service units which currently have a billing policy, the Indian Health Service shall not initiate any further action to bill Indians in order to collect from third-party payers nor to charge those Indians who may have the economic means to pay unless and until such time as Congress has agreed upon a specific policy to do so and has directed the Indian Health Service to implement such a policy: Provided further. That personnel ceilings may not be imposed on the Indian Health Service nor may any action be taken to reduce the full-time equiva- lent level of the Indian Health Service by the elimination of tem- porary employees by reduction in force, hiring freeze or any other means without the review and approval of the Committees on Appropriations: Provided further, That none of the funds made available to the Indian Health Service in this Act shall be used to implement the final rule published in the Federal Register on September 16, 1987, by the Department of Health and Human Services, relating to eligibility for the health care services of the Indian Health Service until the Indian Health Service has submit- ted a budget request reflecting the increased costs associated with
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