Before 1990 the legal position of a Native American burial excavated by an archaeologist was, in most American jurisdictions, that of an artefact. It belonged to the landowner or to the institution that took it, and the ordinary law protecting graves and the dead did not reach it. Museums, universities and federal agencies held very large collections assembled on that footing, some of them gathered from battlefields and from cemeteries within living memory of the communities concerned.
The Act changes the starting point. Every federal agency and every museum receiving federal funds must compile an inventory of the Native American human remains and associated funerary objects it holds, must determine as far as possible the lineal descendants or the culturally affiliated tribe or Native Hawaiian organisation, and must notify them. On request, the remains and objects are to be returned. The same duty covers unassociated funerary objects, sacred objects needed by traditional religious leaders for the practice of a religion, and objects of cultural patrimony, defined as having ongoing communal importance and therefore not alienable by any individual.
For material found after 1990 on federal or tribal land, ownership vests in the descendants or the affiliated nation, and excavation requires consultation and consent. Trafficking in Native American human remains or cultural items obtained in violation of the Act is a federal crime.