,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #hief  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #i1 #bjbd,mr4   
,ne:\se 7= himself & ,mr4 ,johnson (    
,s\? ,dakota7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,natural
 ,res\rces1 & 9 addition to ! ,committee
 on ,en]gy & ,comm]ce1 = a p]iod to be  
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d ! ,indian  
,heal? ,c>e ,improvem5t ,act = !        
developm5t & implem5tation ( a c5traliz$
 sy/em to cr$5tial lic5s$ heal?         
pr(essionals :o seek to provide heal?   
c>e s]vices at any ,indian ,heal?       
,s]vice unit4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,uni=m ,cr$5tials =    
,,ihs ,provid]s ,act ( #bjbd4  #b4      
,m$ical cr$5tial+ sy/em ,title ,i ( !   
,indian ,heal? ,c>e ,improvem5t ,act    
7#be ,u4,s4,c4 #afaa et seq47 is am5d$  
by add+ at ! end ! foll[+3  #abe4       
,m$ical cr$5tial+ sy/em  7a7 ,9 g5]al   

7#a7 ,developm5t & implem5tation timel9e
 ,n lat] ?an #a ye> aft] ! date (       
enactm5t ( ! ,uni=m ,cr$5tials = ,,ihs  
,provid]s ,act ( #bjbd1 ! ,secret>y1    
act+ ?r\gh ! ,s]vice 7ref]r$ to 9 ?is   
section z ! ,secret>y71 9 accordance )  
subsection 7b71 %all develop & implem5t 
a ,s]vice-wide c5traliz$ cr$5tial+ sy/em
 7ref]r$ to 9 ?is section z ! cr$5tial+ 
sy/em7 to cr$5tial lic5s$ heal?         
pr(essionals :o seek to provide heal?   
c>e s]vices at any ,s]vice unit4  7#b7  
,implem5tation ,9 implem5t+ ! cr$5tial+ 
sy/em1 ! ,secret>y-- 7,a7 %all n require
 re-cr$5tial+ ( lic5s$ heal?            
pr(essionals :o 7 cr$5tial$ us+ exi/+   
,s]vice policy prior to ! date (        
enactm5t ( ! ,uni=m ,cr$5tials = ,,ihs  
,provid]s ,act ( #bjbd2 &  7,b7 %all--  
7i7 use ! cr$5tial+ sy/em =-- 7,i7 all  
applications = cr$5tial+ or re-cr$5tial+
 ( lic5s$ heal? pr(essionals submitt$ on
 or aft] ! date ( enactm5t ( ! ,uni=m   
,cr$5tials = ,,ihs ,provid]s ,act (     
#bjbd2 &  7,,ii7 ! migration into !     

cr$5tial+ sy/em ( cr$5tials data t exi/$
 prior to implem5tation ( ! cr$5tial+   
sy/em2 &  7ii7 ma9ta9 ! e/abli%$ timel9e
 = re-cr$5tial+ ( lic5s$ heal?          
pr(essionals :o 7 cr$5tial$ prior to    
implem5tation ( ! cr$5tial+ sy/em1 z    
def9$ by ,s]vice policy4  7b7           
,requirem5ts  7#a7 ,9 g5]al ,9 develop+ 
! cr$5tial+ sy/em "u subsection 7a71 !  
,secret>y %all ensure t-- 7,a7 cr$5tial+
 proc$ures %all be uni=m ?r\gh\t !      
,s]vice2 &  7,b7 ) respect to ea* lic5s$
 heal? pr(essional :o successfully      
completes ! cr$5tial+ proc$ures ( !     
cr$5tial+ sy/em1 ! ,secret>y may        
au?orize ! lic5s$ heal? pr(essional to  
provide heal? c>e s]vices at any ,s]vice
 unit4  7#b7 ,exemption ,! requirem5ts  
describ$ 9 p>agraph 7#a7 %all n apply to
 lic5s$ heal? pr(essionals :o 7         
cr$5tial$ us+ exi/+ ,s]vice policy prior
 to ! date ( enactm5t ( ! ,uni=m        
,cr$5tials = ,,ihs ,provid]s ,act (     
#bjbd until ! date on :i* ^? lic5s$     
heal? pr(essionals are requir$ to be    

re-cr$5tial$ 9 accordance ) ! cr$5tial+ 
sy/em develop$ & implem5t$ "u subsection
 7a74  7c7 ,consultation ,9 develop+ !  
cr$5tial+ sy/em "u subsection 7a71 !    
,secret>y-- 7#a7 %all consult ) ,indian 
tribes2 &  7#b7 may consult )-- 7,a7 any
 public or private association ( m$ical 
provid]s2  7,b7 any gov]nm5t ag5cy2 or  
7,c7 any o!r relevant exp]t1 z det]m9$  
by ! ,secret>y4  7d7 ,application  7#a7 
,9 g5]al ,subject to p>agraph 7#b71 a   
lic5s$ heal? c>e pr(essional may n      
provide heal? c>e s]vices at any ,s]vice
 unit1 unless ! lic5s$ heal? c>e        
pr(essional successfully completes !    
cr$5tial+ proc$ures ( ! cr$5tial+ sy/em 
develop$ & implem5t$ "u subsection 7a74 
7#b7 ,exemption ,p>agraph 7#a7 %all n   
apply to lic5s$ heal? pr(essionals :o 7 
cr$5tial$ us+ exi/+ ,s]vice policy prior
 to ! date ( enactm5t ( ! ,uni=m        
,cr$5tials = ,,ihs ,provid]s ,act (     
#bjbd until ! date on :i* ^? lic5s$     
heal? pr(essionals are requir$ to be    
re-cr$5tial$ 9 accordance ) ! cr$5tial+ 

sy/em develop$ & implem5t$ "u subsection
 7a74  7e7 ,nonduplication ( ef=ts  7#a7
 ,9 g5]al ,to ! ext5t t prior to !      
deadl9e describ$ 9 subsection 7a77#a71 !
 ,s]vice has begun implem5t+ or has     
complet$ implem5tation ( a m$ical       
cr$5tial+ sy/em t o!rwise meets !       
requirem5ts ( ?is section1 ! ,s]vice    
%all n be requir$ to e/abli% a new      
cr$5tial+ sy/em "u ?is section4  7#b7   
,au?ority ,! ,s]vice may exp& or enhance
 an exi/+ cr$5tial+ sy/em to meet !     
requirem5ts ( ?is section4  7#c7 ,review
  7,a7 ,9 g5]al ,n less frequ5tly ?an   
once e #e ye>s1 ! ,s]vice %all-- 7i7    
und]take a =mal review ( ! cr$5tial+    
sy/em 9 effect on ! date ( ! review2 &  
7ii7 if necess>y1 take action to br+ !  
cr$5tial+ sy/em into compliance ) !     
requirem5ts ( ?is section4  7,b7        
,consultation ,ea* =mal review conduct$ 
"u subp>agraph 7,a7 %all be subject to !
 consultation requirem5ts "u subsection 
7c74  7f7 ,effect ,no?+ 9 ?is section-- 
7#a7 negatively impacts ! "r ( an       

,indian tribe to ent] into a compact or 
contract "u ! ,indian ,self-,det]m9ation
 & ,education ,assi/ance ,act 7#be      
,u4,s4,c4 #ecja et seq472 or  7#b7      
applies to su* a compact or contract    
unless expressly agre$ to by ! ,indian  
tribe4  4