123STA T .506PUBLIC LA W 111 – 5 —FE B.1 7, 200 9sharing,o rsi m i l ar c harg et hat w o u l db e due f rom the I ndian but for the o p eration of subparagraph (A).‘ ‘( 2 ) RULEOFC O NSTR UCT I ON. —N othing in this subsection shall be construed as restricting the application of an y other limitations on the imposition of premiums or cost sharing that may apply to an indi v idual receiving medical assistance under this title who is an Indian. ’ ’. (2) C ONFOR M IN GA MEN D MENT.— S ection 19 1 6 A(b)( 3 ) of such Act ( 4 2 U .S.C. 1396o – 1(b)(3)) is amended— (A) in subparagraph (A), by adding at the end the following new clause
‘‘(vii) An Indian who is furnished an item or service directly by the Indian H ealth Service, an Indian T ribe, Tribal O rgani z ation or Urban Indian Organization or through referral under contract health services.’’
and ( B ) in subparagraph (B), by adding at the end the following new clause: ‘‘( x ) Items and services furnished to an Indian directly by the Indian Health Service, an Indian Tribe, Tribal Organization or Urban Indian Organization or through referral under contract health services.’’. (b) TREATMENT OF CERTAIN P RO P ERT YF ROM RESOURCES FOR M EDICAID AND CHIP E LIGI B ILITY.— (1) MEDICAID.—Section 19 0 2 of the Social Security Act (42 U.S.C. 1396a), as amended by sections 203(c) and 211(a)(1)(A)(ii) of the Children’s Health Insurance Program Reauthorization Act of 2009 (Public L aw 111–3), is amended by adding at the end the following new subsection: ‘‘(ff) Notwithstanding any other re q uirement of this title or any other provision of Federal or State law, a State shall disregard the following property from resources for purposes of determining the eligibility of an individual who is an Indian for medical assist - ance under this title: ‘‘(1) Property, including real property and improvements, that is held in trust, sub j ect to Federal restrictions, or otherwise under the supervision of the Secretary of the Interior, located on a reservation, including any federally recognized Indian Tribe’s reservation, pueblo, or colony, including former reserva- tions in O k lahoma, Alaska Native regions established by the Alaska Native Claims Settlement Act, and Indian allotments on or near a reservation as designated and approved by the Bureau of Indian Affairs of the D epartment of the Interior. ‘‘(2) For any federally recognized Tribe not described in paragraph (1), property located within the most recent bound- aries of a prior Federal reservation. ‘‘(3) Ownership interests in rents, leases, royalties, or usage rights related to natural resources (including extraction of nat- ural resources or harvesting of timber, other plants and plant products, animals, fish, and shellfish) resulting from the exer- cise of federally protected rights. ‘‘(4) Ownership interests in or usage rights to items not covered by paragraphs (1) through (3) that have unique reli- gious, spiritual, traditional, or cultural significance or rights that support subsistence or a traditional lifestyle according to applicable tribal law or custom.’’. (2) APPLICATION TO C H IP.—Section 210 7 (e)(1) of such Act (42 U.S.C. 1397gg(e)(1)), as amended by sections 203(a)(2),
