PUBLIC LAW 102-573—OCT. 29, 1992 106 STAT. 4549 "(4) identify and evaluate various means for providing hospice care, including— "(A) the provision of such care by the personnel of a Service hospital pursuant to a hospice program established by the Secretary at such hospital; and "(B) the provision of such care by a community-based hospice program under contract to the Service; and "(5) identify and assess any difficulties in furnishing such care and the actions needed to resolve such difficulties. "(c) Not later than the date which is 12 months after the Reports, date of the enactment of this section, the Secretary shall transmit to the Congress a report containing- "(1) a detailed description of the study conducted pursuant to this section; and "(2) a discussion of the findings and conclusions of such study. "(d) For the purposes of this section— "(1) the term 'terminally ill' means any Indian who has a medical prognosis (as certified by a physician) of a life expectancy of six months or less; and "(2) the term 'hospice program' means any program which satisfies the requirements of section 1861(dd)(2) of the Socied Security Act (42 U.S.C. 1395x(dd)(2)); and "(3) the term 'hospice care' means the items and services specified in subparagraphs (A) through (H) of section 1861(dd)(l) of the Social Security Act (42 U.S.C. 1395x(dd)(l)).". (b) MANAGED CARE. —Title II of the Act is amended by adding at the end the following new section: "MANAGED CARE FEASIBILITY STUDY "SEC. 210. (a) The Secretary, acting through the Service, shall 25 USC 16211. conduct a study to assess the feasibility of allowing an Indian tribe to purchase, directly or through the Service, managed care coverage for all members of the tribe from— "(1) a tribally owned and operated managed care plan; or "(2) a State licensed managed care plan. "(b) Not later than the date which is 12 months after the Reports, date of the enactment of this section, the Secretary shall transmit to the Congress a report containing— "(1) a detailed description of the study conducted pursuant to this section; and "(2) a discussion of the findings and conclusions of such study.". (c) CONTRACT CARE. —Title II of the Act (as amended by subsection (b) of this Act) is amended by adding at the end the following new section: "CALIFORNIA CONTRACT HEALTH SERVICES DEMONSTRATION PROGRAM "SEC. 211. (a) The Secretary shall estabhsh a demonstration 25 USC l62lj. program to evaluate the use of a contract care intermediary to improve the accessibility of health services to Cahfomia Indians. "(b)(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 pro-
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