1.    As used in this section:

Terms Used In North Dakota Code 50-24.1-40

  • Organization: includes a foreign or domestic association, business trust, corporation, enterprise, estate, joint venture, limited liability company, limited liability partnership, limited partnership, partnership, trust, or any legal or commercial entity. See North Dakota Code 1-01-49
  • State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See North Dakota Code 1-01-49
  • year: means twelve consecutive months. See North Dakota Code 1-01-33

a. “Care coordination agreement” means an agreement between a health care provider and tribal health care organization which will result in one hundred percent federal funding for eligible medical assistance provided to an American Indian.

b.    “Tribal health care organization” means Indian health services or a tribal entity providing health care under the federal Indian Self-Determination and Education Assistance Act of 1975 [Pub. L. 93-638; 88 Stat. 2203; 25 U.S.C. § 5301 et seq.].

2.    The department shall facilitate care coordination agreements. Of any federal funding received in excess of the state‘s regular share of federal medical assistance funding which results from care coordination agreements, the department shall deposit eighty percent in the tribal health care coordination fund and twenty percent in the general fund.

3.    There is created in the state treasury a tribal health care coordination fund.

a.    Moneys in the fund are appropriated to the department on a continuing basis for distribution to a tribal government in accordance with an agreement between the department and a tribal government. The agreement between the department and a tribal government must require the tribe to:

(1) Use the money distributed under this section for purposes related to the ten essential services of public heath identified by the federal centers for disease control and prevention and the development or enhancement of community health representative programs or services; however, through June 30, 2025, no more than fifty percent, and thereafter, no more than thirty-five percent, may be used for capital construction.

(2) Submit to the department annual reports detailing the use of the money distributed under this section.

(3) Submit to the department every two years an audit report, conducted by an independent licensed certified public accountant, of the tribal government use of the money distributed under this section. A tribal government may use money distributed under this section to pay for this audit report. At the discretion of a tribal government, an audit may be conducted more often than every two years.

b.    The distribution of moneys from the fund to a tribal government must be in proportion to the federal funding received from care coordination agreement requests for services originating from within that tribal nation.

c.    At least annually, upon completion of any auditing and verification actions of the department, the department shall distribute moneys from the fund to the tribal government.

d.    If a tribal government fails to file with the department a timely annual report or audit report, the department shall withhold distribution of moneys from the fund to the tribal government until the report is filed.

e.    If an audit report or the department’s review of the annual report finds a tribal government used moneys distributed from the fund for a purpose inconsistent with this section, the department shall withhold future distributions to that tribal government in an amount equal to the money used improperly. The department shall distribute money withheld from a tribal government under this subdivision if a future audit report indicates moneys distributed from the fund are used for purposes consistent with this section.

4.    Before August of each even-numbered year, the department shall compile and summarize the annual reports and audit reports from the participating tribal governments data and provide the legislative management with a biennial report on the fund. Each participating tribe shall compile data and provide the legislative management with a biennial report on the tribe’s use of money distributed from the fund.