Legislators introduce bill to extend Tribal Emergency Care reporting deadline
WASHINGTON – U.S. Senator Mike Rounds (R-S.D.) and Catherine Cortez Masto (D-Nev.) introduced legislation to extend the reporting deadline for Indian Health Service (IHS) patients who seek emergency care outside of IHS facilities. The IHS Emergency Claims Parity Act would extend the emergency notification requirements of IHS’s Purchased and Referred Care (PRC) program from within 72 hours to 15 days.
“When IHS patients are in an emergency situation, the last thing they should be worried about is whether IHS is going to cover the cost of care at an outside facility,” said Rounds. “In an emergency, patients need to be able to seek care at the closest facility that can adequately address their needs. Asking them to report this care within 72 hours after a medical emergency is unrealistic and has contributed to significant medical debt in tribal communities. Currently, IHS offers one of the shortest windows to submit emergency claims out of any government-run health care system. This legislation would fix that.”
“Tribal families deserve access to lifesaving emergency care without additional barriers like strict reporting deadlines,” said Cortez Masto. “Our bipartisan legislation gives Tribal patients more time to report emergency care, whether they received health care services at an IHS facility or not.”
“I support the IHSECPA legislation to extend the timeline for emergency reporting due to the many factors and obstacles our people face trying to navigate the current healthcare system and especially the patient rights that must be better explained to all patients who need guidance on making such critical decisions regarding their health care and benefit,” said Clyde Estes, Chairman of the Lower Brule Sioux Tribe.
“Unexpected emergency medical situations can happen at any time. When tribal patients are required to access outside emergency care, they deserve a fair reporting timeline. I would like to thank Senator Rounds for taking up this effort,” said Christian Skunk, Lower Brule Sioux Tribe Councilman.
“The last thing a medical patient should have to worry about is paperwork during a healthcare emergency. The Indian Health Service’s current 72-hour emergency PRC reporting window places an undue burden on tribal members. We thank Senator Rounds for consulting with tribal leaders on this issue and working to find potential solutions. The restrictive rules of the PRC program need to be addressed. We look forward to working with the Senator to get this across the finish line,” said Frank Star Comes Out, President of Oglala Sioux Tribe.
“Tribal members are already subject to a number of strict rules when accessing Purchased and Referred Care resources. It is unrealistic for IHS to expect patients to report PRC claims when dealing with life threatening injuries or illness. I thank Senator Rounds for working with tribal leaders and taking a common-sense approach to address this issue,” said Rosebud Sioux Tribe Treasurer Wayne Boyd.
IHS beneficiaries are subject to a number of restrictive rules when seeking outside care; however, few of these rules are as problematic as the emergency reporting deadline. Currently, in emergency cases, the patient must notify the PRC office within 72 hours of receiving outside care. Native American patients determined to be elderly or disabled are given 30 days to notify the IHS of emergency medical care received from non-IHS medical providers or at non-IHS medical facilities.
The IHS Emergency Claims Parity Act would increase the window for timely consideration of emergency care payments to 15 days for all IHS beneficiaries. This excludes reporting requirements for patients considered to be elderly/disabled, which will stay at 30 days.
This bill is endorsed by the Great Plains Tribal Chairmen’s Association.
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August 22, 2024