S. 460 would require the Department of Health and Human Services (HHS) to confer with urban Indian organizations regrading matters pertaining to the Indian Health Care Improvement Act and other provisions of law relating to Indian health care. According to the Indian Health Service (IHS), there are 41 urban Indian organizations that provide primary care services to urban Indian populations and others in 22 states nationwide. The urban Indian organizations are not part of the IHS service delivery network but receive grant funding from IHS. Current law only requires IHS to confer with urban Indian organizations and the bill would require other agencies within HHS to confer with them as well. CBO estimates that enacting S. 460 would not affect direct spending or revenues and would have an insignificant effect on spending subject to appropriation for HHS staff to confer periodically with urban Indian organizations.