Indian Health Service Emergency Claims Parity Act

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Bruce Westerman, AR

Republican
“Let's pass this bill. I have no other reason to say here.”
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Official Congressional Record

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 8658) to amend the Indian Health Care Improvement Act to modify the notification requirement for emergency contract health services for certain beneficiaries, and for other purposes. The Clerk read the title of the bill. The text of the bill is as follows:

Bruce Westerman, AR

Republican

Linked statement

“People in health emergencies are too busy. They can't notify the government program fast enough. That deadline is too strict. This bill fixes that. More time for patients to tell the program about their care. I want the bill to pass.”
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Official Congressional Record

Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, H.R. 8658, introduced by Congressman Mike Kennedy from Utah, would amend the Indian Health Care Improvement Act to require that non-elderly and nondisabled Indian patients have at least 15 days to notify the Indian Health Service when they receive emergency treatment or are admitted to a healthcare facility through the purchased/referred care program. The IHS uses the purchased/referred care program, or PRC, to pay outside providers when needed services are unavailable at an IHS or Tribal health facility. IHS approves a PRC payment if a patient meets specific requirements, including timely notification of IHS. The law currently provides elderly or disabled Indians a 30-day emergency notice window, while the rule for all other patients is 72 hours. During an emergency, 72 hours is a very short window. While extensions can be granted, the 72-hour window remains the standard. This timeframe is unrealistic for a patient dealing with a health crisis who may be transferred between facilities, recovering from surgery, or relying on assistance from someone unfamiliar with PRC notice rules. When the 72-hour deadline is missed, a claim that would otherwise be approved may be denied, and the patient is at risk of being billed or sent to collections for emergency care. This legislation would amend the Indian Health Care Improvement Act to provide at least 15 days to notify IHS of emergency treatment or admission for PRC purposes, while preserving the existing 30-day notification window for elderly or disabled Indians. Mr. Speaker, I thank Dr. Kennedy of Utah for championing this important legislation for Indian Country. I urge my colleagues to support the bill, and I reserve the balance of my time.

Sarah Elfreth, MD

Democrat
“The IHS has problems. They don't have enough money or staff. They can't help everyone. So patients go outside for care. The notification time is too short. People can't do paperwork during an emergency. They need more time. This bill gives them 15 days. That's better. I want this bill to pass.”
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Mr. Speaker, the Indian Health Service, or IHS, is the primary agency responsible for providing healthcare to American Indians and Alaska Natives. However, the agency is chronically underfunded and understaffed, resulting in limited care at IHS and Tribal facilities. When these facilities cannot offer care, Tribal patients may receive services from outside providers under the Purchased and Referred Care, or PRC, program. As the chairman pointed out, in an emergency, most Tribal patients only have 3 days, or 72 hours, to notify the agency that they received care under the PRC program. This is, as the chairman said, completely unrealistic for too many Americans. It places an unfair burden on patients and their families to navigate paperwork and deadlines during medical emergencies, when they should be focused on receiving care. H.R. 8658 would extend the notification period from 3 days to 15 days. This simple extension would gave patients and their families the time to complete the necessary requirements and allow them to focus on their recovery in the event of an emergency. This small change is a meaningful step in supporting healthcare for Indian country because Tribal patients should not have to worry about balancing paperwork and going into medical debt while recovering and receiving the care they are entitled to. Mr. Speaker, I urge my colleagues to support this legislation, and I reserve the balance of my time.

Mike Kennedy, UT

Republican
“I sponsored this bill. I want to talk about it. I'm a doctor. I see how paperwork can get in the way. Patients need care. Not paperwork. The current 72-hour rule is bad. It was written by bureaucrats. They don't know what it's like in a hospital. Families are focused on a loved one. They shouldn't worry about paperwork. This bill extends the time to 15 days. That's better. I want the government to be smarter. I want it to be more responsive. This bill is a common-sense fix. There are many more needed. I want my colleagues to vote for this bill.”
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Official Congressional Record

Mr. Speaker, I thank Mr. Westerman for the time to speak. Our constituents know there is too often a gap between the rules Washington writes and the realities Americans face. Nowhere is that gap more apparent than in our healthcare system. I know that reality well. I have been a doctor for 25 years and continue to see patients. I sit with families during some of the most difficult moments of their lives, and I see firsthand how frustrating paperwork and red tape can be when what matters most is getting someone the care that they need. That experience is why I rise today in support of my bill, H.R. 8658, the Indian Health Service Emergency Claims Parity Act. This bill is simple: Put patients before paperwork. Today, when an American Indian or Alaska Native patient receives emergency care outside the Indian Health Service, the IHS must be notified within 72 hours. When missed, a family can be left with the bill for care that should have been covered. Mr. Speaker, that rule was written from behind a desk, not beside a hospital bed. Anyone who has worked in healthcare knows that 72 hours can pass in what feels like an instant. Families should be focused on their loved one's recovery, not on whether they met a Federal notification deadline. H.R. 8658 extends that window to 15 days so families can take care of their loved ones first and the paperwork second. This is what good government should look like. When a rule does not reflect the reality people face, we should fix it. When government bureaucracy gets in the way of common sense, we should cut through it. My congressional colleagues and I understand that. We need a government that is smarter, quicker, and more responsive to the people it serves. We need a government that is streamlined and close to home, not bloated and distant. This is one practical, commonsense fix, and there are many more like it across our government and throughout our healthcare system. I thank Chairman Westerman, my colleagues on the Natural Resources Committee, our outstanding staff on the Committee as well as my staff, and my bipartisan colleagues for their work on this fix and their commitment to making government work for the people. Mr. Speaker, I urge my colleagues to support H.R. 8658.

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