Detailed Summary

<b>(This measure has not been amended since it was introduced. The summary has been expanded because action occurred on the measure.)</b>

Medicare, Medicaid, and SCHIP Indian Health Care Improvement Act of 2007 - (Sec. 2) Amends titles XVIII (Medicare), XIX (Medicaid), and XXI (State Children's Health Insurance) (SCHIP) of the Social Security Act (SSA) to extend the eligibility of the Indian Health Service (IHS) for payments under such programs to Indian Tribes, Tribal Organizations, and Urban Indian Organizations (Indian health programs).

(Sec. 3) Amends SSA title XI to: (1) eliminate the National Commission on Children; and (2) require the Secretary of Health and Human Services to encourage states to take steps to provide for enrollment in Medicaid and SCHIP programs on or near Indian reservations.

Directs the Secretary, acting through the Centers for Medicare and Medicaid Services (CMMS), to take steps necessary to facilitate cooperation with, and agreements between, states and the IHS and other Indian health programs for the provision of health care items and services to Indians under the Medicare, Medicaid, and SCHIP programs.

(Sec. 4) Exempts from the 10% limit on child health assistance expenditures not used for Medicaid or health insurance assistance any expenditures for outreach activities to families of Indian children likely to be eligible for SCHIP or Medicaid.

Allows use of a document issued by a federally-recognized Indian tribe evidencing membership or enrollment in, or affiliation with, such tribe as a document evidencing U.S. citizenship or nationality for Medicaid eligibility purposes.

(Sec. 5) Amends SSA title XIX to: (1) prohibit premiums or cost sharing for Indians furnished items of services directly by Indian health programs or through referral under the contract health service; and (2) require a state to disregard certain property for purposes of determining eligibility for Medicaid or SCHIP assistance.

(Sec. 6) Amends SSA title XI to require nondiscrimination in qualifications for services provided by an Indian health program under a federal health care program.

Prohibits federal payments to entities or individuals excluded from participation in federal health care programs or whose state licenses are under suspension or have been revoked.

(Sec. 7) Amends SSA title XI to require the Secretary to maintain within the CMMS a Tribal Technical Advisory Group, including a representative of the Urban Indian Organizations and the IHS.

Amends SSA title XIX to require the Medicaid plan, for any state in which the IHS operates or funds health care programs, or in which one or more Indian health programs provide health care for which Medicaid is available, to provide for a process under which the state seeks advice on a regular, ongoing basis from designees of such programs on matters (including plan amendments, waiver requests, and proposals for demonstration projects) likely to have a direct effect on them.

(Sec. 8) Grants the Secretary additional authority to waive the exclusion of certain individuals and entities from participation in affected Indian health programs.

Deems to be in safe harbors any transfers of anything of value, meeting certain criteria, between or among Indian health programs made to provide necessary health care items and services to any patient relating to: (1) diagnostic specimens or test data; (2) inventory or supplies; (3) staff; or (4) a waiver of all or part of premiums or cost sharing.

(Sec. 9) Sets forth rules applicable under Medicaid and SCHIP to managed care entities with respect to Indian enrollees, Indian health care providers, and Indian managed care entities.

Requires a non-Indian Medicaid managed care entity to allow an Indian enrollee to choose an Indian health care provider as the Indian's primary care provider.

Prescribes requirements for payment by a managed care entity of participating and non-particiting Indian health care providers.

Applies such requirements to the SCHIP program.

(Sec. 10) Amends SSA title XI to require the Secretary, acting through the CMMS Administrator and the IHS Director, to report annually to Congress on the enrollment and health status of Indians served by SSA health benefit programs.

Status of the Legislation

Latest Major Action: 1/8/2008: Placed on Senate Legislative Calendar under General Orders. Calendar No. 555.

Points in Favor

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Points Against

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