SCIA Press Release on GAO Report on IHS Billing

SENATORS URGE IMPROVEMENTS TO INDIAN HEALTH SERVICE

WASHINGTON – A bipartisan group of senators is urging Health and Human Services Secretary Kathleen Sebelius and other top administration officials to act quickly to improve health care delivery to American Indians and Alaska Natives.

In a letter to Secretary Sebelius and Indian Health Service Director Dr. Yvette Roubideaux, the senators pointed to a U.S. Government Accountability Office report issued Friday, September 23, that highlights billing and other problems in the IHS system that make it difficult for American Indians and Alaska natives to receive care from health providers and makes it difficult for health care providers offering the services to get reimbursed.

The GAO report, called “Indian Health Service: Increased Oversight Needed to Ensure Accuracy of Data Used for Estimating Contract Health Service Need,” states that due to inadequate and inconsistent data collection by IHS, it has been very difficult for health care providers who contract with IHS to quickly determine a patient’s eligibility for services.  Poor data collection also makes it difficult for IHS to know what contractual services are needed by American Indians and Native Alaskans and whether it has adequate funds to pay for such services.

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New General Accounting Office Report on IHS

Here. H/t Pechanga.

Here is the GAO summary:

The Indian Health Service (IHS), an agency in the Department of Health and Human Services (HHS), provides health care to American Indians and Alaska Natives. When care at an IHS-funded facility is unavailable, IHS’s contract health services (CHS) program pays for care from external providers if the patient meets certain requirements and funding is available. The Patient Protection and Affordable Care Act requires GAO to study the adequacy of federal funding for IHS’s CHS program. To examine program funding needs, IHS collects data on unfunded services–services for which funding was not available–from the federal and tribal CHS programs. GAO examined (1) the extent to which IHS ensures the data it collects on unfunded services are accurate to determine a reliable estimate of CHS program need, (2) the extent to which federal and tribal CHS programs report having funds available to pay for contract health services, and (3) the experiences of external providers in obtaining payment from the CHS program. GAO surveyed 66 federal and 177 tribal CHS programs and spoke to IHS officials and 23 providers.

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