---
kind: "section"
citation: "25 U.S.C. § 1621r"
title: "25"
title_heading: "Indians"
number: "1621r"
heading: "Contract health services payment study"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/25/1621r"
units:
  - "Chapter 18 — Indian Health Care"
  - "Subchapter II — Health Services"
---

# §1621r. Contract health services payment study

- (a) **Duty of Secretary—** The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18) and in consultation with representatives of [Indian tribes](/usc/25/1603.md?p=14) and [tribal organizations](/usc/25/1603.md?p=26) operating contract health care programs under the [Indian](/usc/25/1603.md?p=13) Self-Determination Act ([25 U.S.C. 450f](/usc/25/450f.md) et seq.)[^1] or under self-governance compacts, [Service](/usc/25/1603.md?p=18) personnel, private [contract health services](/usc/25/1603.md?p=5) providers, the [Indian](/usc/25/1603.md?p=13) Health [Service](/usc/25/1603.md?p=18) Fiscal Intermediary, and other appropriate experts, shall conduct a study—
  - (1) to assess and identify administrative barriers that hinder the timely payment for [services](/usc/25/1603.md?p=18) delivered by private [contract health services](/usc/25/1603.md?p=5) providers to individual [Indians](/usc/25/1603.md?p=13) by the [Service](/usc/25/1603.md?p=18) and the [Indian](/usc/25/1603.md?p=13) Health [Service](/usc/25/1603.md?p=18) Fiscal Intermediary;
  - (2) to assess and identify the impact of such delayed payments upon the personal credit histories of individual [Indians](/usc/25/1603.md?p=13) who have been treated by such providers; and
  - (3) to determine the most efficient and effective means of improving the [Service](/usc/25/1603.md?p=18)’s [contract health services](/usc/25/1603.md?p=5) payment system and ensuring the development of appropriate consumer protection policies to protect individual [Indians](/usc/25/1603.md?p=13) who receive authorized [services](/usc/25/1603.md?p=18) from private [contract health services](/usc/25/1603.md?p=5) providers from billing and collection practices, including the development of materials and programs explaining patients’ rights and responsibilities.
- (b) **Functions of study—** The study required by [subsection (a)](#a) shall—
  - (1) assess the impact of the existing [contract health services](/usc/25/1603.md?p=5) regulations and policies upon the ability of the [Service](/usc/25/1603.md?p=18) and the [Indian](/usc/25/1603.md?p=13) Health [Service](/usc/25/1603.md?p=18) Fiscal Intermediary to process, on a timely and efficient basis, the payment of bills submitted by private [contract health services](/usc/25/1603.md?p=5) providers;
  - (2) assess the financial and any other burdens imposed upon individual [Indians](/usc/25/1603.md?p=13) and private [contract health services](/usc/25/1603.md?p=5) providers by delayed payments;
  - (3) survey the policies and practices of collection agencies used by [contract health services](/usc/25/1603.md?p=5) providers to collect payments for [services](/usc/25/1603.md?p=18) rendered to individual [Indians](/usc/25/1603.md?p=13);
  - (4) identify appropriate changes in Federal policies, administrative procedures, and regulations, to eliminate the problems experienced by private [contract health services](/usc/25/1603.md?p=5) providers and individual [Indians](/usc/25/1603.md?p=13) as a result of delayed payments; and
  - (5) compare the [Service](/usc/25/1603.md?p=18)’s payment processing requirements with private insurance claims processing requirements to evaluate the systemic differences or similarities employed by the [Service](/usc/25/1603.md?p=18) and private insurers.
- (c) **Report to Congress—** Not later than 12 months after October 29, 1992, the [Secretary](/usc/25/1603.md?p=17) shall transmit to the Congress a report that includes—
  - (1) a detailed description of the study conducted pursuant to this section; and
  - (2) a discussion of the findings and conclusions of such study.

## Footnotes

[^1]: See References in Text note below.

## Source credit

(Pub. L. 94–437, title II, § 219, as added Pub. L. 102–573, title II, § 215, Oct. 29, 1992, 106 Stat. 4557.)

## Notes

### Editorial Notes

### References in Text

The Indian Self-Determination Act (25 U.S.C. 450f et seq.), referred to in subsec. (a), is title I of Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2206, which was classified principally to part A (§ 450f et seq.) of subchapter II of chapter 14 of this title prior to editorial reclassification as subchapter I (§ 5321 et seq.) of chapter 46 of this title. For complete classification of this Act to the Code, see Short Title note set out under section 5301 of this title and Tables.