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S 406106th CongressSigned into LawSenate

Alaska Native and American Indian Direct Reimbursement Act of 2000

Policy Area: Native Americans
View on Congress.gov
Origin Chamber
Senate
Last Updated
Jun 3, 2026
Latest Action Date
Nov 1, 2000

Latest Action

Became Public Law No: 106-417.

Official Summary

Alaska Native and American Indian Direct Reimbursement Act of 1999 - Amends the Indian Health Care Improvement Act to make permanent the demonstration program under which Indian tribes, tribal organizations, and Alaska Native health organizations that contract or compact for the operation of a hospital or clinic of the Indian Health Service may directly bill for, and receive payment for, health care services provided by such hospital or clinic for which payment is made under titles XVIII (Medicare) or XIX (Medicaid) of the Social Security Act or from any other third party payor.Requires participating hospitals and clinics to submit annual reports on the program to the Secretary of Health and Human Services.Provides for: (1) application to the Secretary by an Indian tribe, tribal organization, or Alaska Native health organization for participation of a Service facility in the program (the demonstration program was limited to four facilities); (2) the ongoing examination and implementation of necessary administrative changes to facilitate direct billing and reimbursement under the program; and (3) withdrawal from participation in the program.

GovScope Watchdog™

AI Government Intelligence™
Executive Summary

This bill makes permanent a demonstration program allowing Indian tribes, tribal organizations, and Alaska Native health organizations that operate Indian Health Service hospitals or clinics to directly bill and receive payments from Medicare, Medicaid, and other third-party payors. It requires participating facilities to submit annual reports to the Secretary of Health and Human Services and provides a process for application, administrative adjustments, and withdrawal from the program.

Bottom Line

The bill establishes a permanent framework for Alaska Native and American Indian health organizations to directly bill for healthcare services, potentially improving reimbursement processes for these entities.

Policy Risk Level
🟡 Medium
Neutral Risk Assessment
Key Points
  • Makes permanent the demonstration program enabling direct billing by Indian tribes and Alaska Native health organizations for Medicare, Medicaid, and other third-party payments.
  • Requires annual reporting by participating hospitals and clinics to the Secretary of Health and Human Services.
  • Provides procedures for application to participate, administrative adjustments, and withdrawal from the program.
Who Benefits?

Indian tribes, tribal organizations, and Alaska Native health organizations operating hospitals or clinics under the Indian Health Service may benefit by gaining direct reimbursement capabilities from Medicare, Medicaid, and other payors.

Potential Concerns

Implementation may require administrative adjustments and oversight to ensure compliance and effective billing processes. The bill does not specify funding for administrative costs or detail the impact on existing reimbursement systems.

Political Context

The bill, originating in the Senate during the 106th Congress, addresses Native American health policy and has been signed into law as Public Law No: 106-417 as of November 1, 2000.

Hidden Impact Review

No hidden impact flags detected

GovScope reviewed 11 policy-risk categories. Hover for a quick definition. Click detected flags for bill-specific details.

Clear Review
Categories Reviewed — Not Detected
Broad agency authority
New regulatory authority
Privacy concerns
Spending increases
Criminal penalties
Civil liability
Unfunded mandates
Executive discretion
Missing sunset provisions
Cross references
Hidden implementation costs
Indirect Effects

By enabling direct billing, the bill may streamline reimbursement processes for Indian health facilities, potentially improving financial stability and service delivery. It may also require adjustments in administrative systems and oversight.

GovScope Watchdog Notes

The full bill text is not provided, limiting detailed analysis. Citizens may want to review annual reports submitted under the program for transparency on implementation and outcomes. Monitoring administrative changes and their impact on billing efficiency could be important.

Passage Likelihood: UnknownConfidence: 75%Model: gpt-4.1-mini

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