((a)) ** Coordination of services**

((1)) ** Study and evaluation** The Comptroller General of the United States shall conduct a study, and evaluate the effectiveness, of coordination of health care services provided to Indians—

((A)) through Medicare, Medicaid, or SCHIP;

((B)) by the Service; or

((C)) using funds provided by—

((i)) State or local governments; or

((ii)) Indian tribes.

((2)) ** Report** Not later than 18 months after , the Comptroller General shall submit to Congress a report—

((A)) describing the results of the evaluation under paragraph (1); and

((B)) containing recommendations of the Comptroller General regarding measures to support and increase coordination of the provision of health care services to Indians as described in paragraph (1).

((b)) ** Payments for contract health services**

((1)) ** In general** The Comptroller General shall conduct a study on the use of health care furnished by health care providers under the contract health services program funded by the Service and operated by the Service, an Indian tribe, or a tribal organization.

((2)) ** Analysis** The study conducted under paragraph (1) shall include an analysis of—

((A)) the amounts reimbursed under the contract health services program described in paragraph (1) for health care furnished by entities, individual providers, and suppliers, including a comparison of reimbursement for that health care through other public programs and in the private sector;

((B)) barriers to accessing care under such contract health services program, including barriers relating to travel distances, cultural differences, and public and private sector reluctance to furnish care to patients under the program;

((C)) the adequacy of existing Federal funding for health care under the contract health services program;

((D)) the administration of the contract health service program, including the distribution of funds to Indian health programs pursuant to the program; and

((E)) any other items determined appropriate by the Comptroller General.

((3)) ** Report** Not later than 18 months after , the Comptroller General shall submit to Congress a report on the study conducted under paragraph (1), together with recommendations regarding—

((A)) the appropriate level of Federal funding that should be established for health care under the contract health services program described in paragraph (1);

((B)) how to most efficiently use that funding; and

((C)) the identification of any inequities in the current distribution formula or inequitable results for any Indian tribe under the funding level, and any recommendations for addressing any inequities or inequitable results identified.

((4)) ** Consultation** In conducting the study under paragraph (1) and preparing the report under paragraph (3), the Comptroller General shall consult with the Service, Indian tribes, and tribal organizations.