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42 USC § 238m - Use of fiscal agents

---
identifier: "/us/usc/t42/s238m"
source: "usc"
legal_status: "official_prima_facie"
title: "42 USC § 238m - Use of fiscal agents"
title_number: 42
title_name: "THE PUBLIC HEALTH AND WELFARE"
section_number: "238m"
section_name: "Use of fiscal agents"
chapter_number: 6
chapter_name: "PUBLIC HEALTH SERVICE"
subchapter_number: "I"
subchapter_name: "ADMINISTRATION AND MISCELLANEOUS PROVISIONS"
part_number: "B"
part_name: "Miscellaneous Provisions"
positive_law: false
currency: "119-84"
last_updated: "2026-04-17"
format_version: "1.1.0"
generator: "[email protected]"
source_credit: "(July 1, 1944, ch. 373, title II, § 244, formerly title XXI, § 2116, as added Pub. L. 99–272, title XVII, § 17003, Apr. 7, 1986, 100 Stat. 359; renumbered title XXIII, § 2316, Pub. L. 99–660, title III, § 311(a), Nov. 14, 1986, 100 Stat. 3755; renumbered title XXV, § 2514, Pub. L. 100–607, title II, § 201(1), (3), Nov. 4, 1988, 102 Stat. 3062, 3063; renumbered title XXVI, § 2614, Pub. L. 100–690, title II, § 2620(a), Nov. 18, 1988, 102 Stat. 4244; renumbered title XXVII, § 2714, Pub. L. 101–381, title I, § 101(1), (2), Aug. 18, 1990, 104 Stat. 576; renumbered title II, § 244, Pub. L. 103–43, title XX, § 2010(a)(1)–(3), June 10, 1993, 107 Stat. 213.)"
---

# § 238m. Use of fiscal agents

**(a)** **Contracting authority** The Secretary may enter into contracts with fiscal agents—

**(1)**

**(A)** to determine the amounts payable to persons who, on behalf of the Indian Health Service, furnish health services to eligible Indians,

**(B)** to determine the amounts payable to persons who, on behalf of the Public Health Service, furnish health services to individuals pursuant to section 247d or 249 of this title,

**(2)** to receive, disburse, and account for funds in making payments described in paragraph (1),

**(3)** to make such audits of records as may be necessary to assure that these payments are proper, and

**(4)** to perform such additional functions as may be necessary to carry out the functions described in paragraphs (1) through (3).

**(b)** **Contracting prerequisites**

**(1)** Contracts under subsection (a) may be entered into without regard to section 6101 of title 41 or any other provision of law requiring competition.

**(2)** No such contract shall be entered into with an entity unless the Secretary finds that the entity will perform its obligations under the contract efficiently and effectively and will meet such requirements as to financial responsibility, legal authority, and other matters as he finds pertinent.

**(c)** **Advances under contracts** A contract under subsection (a) may provide for advances of funds to enable entities to make payments under the contract.

**1** **Applicable statutory provisions** [^1]section 1395u of this title

Subsections (d) and (e)  of  shall apply to contracts with entities under subsection (a) in the same manner as they apply to contracts with carriers under that section.

See References in Text note below.

**(e)** **“Fiscal agent” defined** <sup>1</sup>Public Law 93–63825 U.S.C. 5321

In this section, the term “fiscal agent” means a carrier described in section 1395u(f)(1)  of this title and includes, with respect to contracts under subsection (a)(1)(A), an Indian tribe or tribal organization acting under contract with the Secretary under the Indian Self-Determination Act () [ et seq.].

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**Source Credit**: (July 1, 1944, ch. 373, title II, § 244, formerly title XXI, § 2116, as added Pub. L. 99–272, title XVII, § 17003, Apr. 7, 1986, 100 Stat. 359; renumbered title XXIII, § 2316, Pub. L. 99–660, title III, § 311(a), Nov. 14, 1986, 100 Stat. 3755; renumbered title XXV, § 2514, Pub. L. 100–607, title II, § 201(1), (3), Nov. 4, 1988, 102 Stat. 3062, 3063; renumbered title XXVI, § 2614, Pub. L. 100–690, title II, § 2620(a), Nov. 18, 1988, 102 Stat. 4244; renumbered title XXVII, § 2714, Pub. L. 101–381, title I, § 101(1), (2), Aug. 18, 1990, 104 Stat. 576; renumbered title II, § 244, Pub. L. 103–43, title XX, § 2010(a)(1)–(3), June 10, 1993, 107 Stat. 213.)

## Editorial Notes

### References in Text

Subsections (d), (e), and (f) of , referred to in subsecs. (d) and (e), were repealed by , , .

The Indian Self-Determination Act, referred to in subsec. (e), is title I of , , , which is classified principally to subchapter I (§ 5321 et seq.) of chapter 46 of Title 25, Indians. For complete classification of this Act to the Code, see Short Title note set out under  and Tables.

### Codification

In subsec. (b)(1), “” substituted for “section 3709 of the Revised Statutes ()” on authority of , , , which Act enacted Title 41, Public Contracts.

Section was classified to  prior to renumbering by , to  prior to renumbering by , and to  prior to renumbering by .