Congressional members reintroduce bill to ease Tribal Health care regulations

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WASHINGTON – U.S. Senators Mike Rounds (R-S.D.) and Maria Cantwell (D-Wash.), members of the Senate Committee on Indian Affairs, along with Representatives Dusty Johnson (R-S.D.) and Kim Schrier (D-Wash.), today reintroduced the Purchased and Referred Care Improvement Act. This legislation mandates the Indian Health Service (IHS) to provide timely reimbursement for tribal members seeking care outside of IHS facilities.

The Purchased and Referred Care (PRC) program supplements health care resources for eligible tribal members when IHS facilities cannot provide necessary services, including emergency and specialty care. Despite being an essential resource, many beneficiaries face significant barriers in accessing this care due to stringent residency, notification, and eligibility requirements.

Although IHS is expected to process approved PRC claims within 30 days, a Department of Health and Human Services analysis revealed that around 32,000 claims over two years were not reimbursed in that period. This delay can lead to financial burdens, including wrongful medical debt for tribal members.

“The Indian Health Service has a duty to care for tribal members nationwide, and it is time they fulfill that responsibility,” stated Rounds. “The strict PRC claim requirements have resulted in limited approvals. It is vital that IHS promptly reimburses tribal members for approved outside care. I am proud to reintroduce this legislation to ensure accountability and support our mission of health care for tribal members.”

Cantwell added, “This bill aims to eliminate delays in medical reimbursements that have caused substantial financial strains for tribal members. I have heard from the Confederated Tribes of the Colville Reservation about the issues they face regarding reimbursements from IHS for non-Tribal care. This legislation will alleviate their concerns about potential debt collection and credit score impacts while awaiting reimbursements.”

The bill is co-sponsored in the Senate by Majority Leader John Thune (R-S.D.) and Senator Patty Murray (D-Wash.).

Johnson remarked, “The IHS is failing to meet its obligations to Native American patients in the PRC program, resulting in patients facing debts for which they are not liable. This legislation will correct this injustice and ensure IHS fulfills its payment responsibilities.”

Schrier stated, “Unpaid claims can have a devastating impact on tribal community members, affecting their financial well-being and credit status. I am committed to introducing bipartisan reforms that safeguard tribal citizens, allowing them to access the health care they require without financial stress.”

1. Garret Renville, President of the Coalition of Large Tribes and Chairman of the Sisseton-Wahpeton Oyate, emphasized, “The U.S. has a treaty obligation to provide health care, yet there are significant failures, particularly in timely payments for PRC services, leading to unjust medical debt. This legislation will alleviate such issues and protect access to care in line with our treaty rights.”

Frank Star Comes Out, President of the Oglala Sioux Tribe, noted, “Senator Rounds’ initiative addresses an ongoing problem for tribal health care—delayed reimbursements for PRC services. We appreciate his leadership and commitment to enacting reform to ensure Native individuals are not burdened with costs for approved PRC claims.”

Jarred-Michael Erickson, Chairman of the Confederated Tribes of the Colville Reservation, stated, “Years of mismanagement by IHS have led to severe challenges in accessing essential health care. This legislation will clarify IHS obligations, ensuring that tribal members are not unfairly pursued for unpaid medical bills.”

The Purchased and Referred Care Improvement Act includes provisions to:

• Require IHS to establish procedures for reimbursing beneficiaries within 30 days for out-of-pocket approved PRC services.
• Allow beneficiaries to submit documentation as evidence when requesting reimbursement.
• Strengthen liability provisions to prohibit outside providers from collecting debt from beneficiaries for approved PRC claims.

 

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