Rounds Leads Legislation to Extend Reporting Deadline for Emergency Tribal Care

WASHINGTON – U.S. Senators Mike Rounds (R-S.D.) and Catherine Cortez Masto (D-Nev.), members of the Senate Committee on Indian Affairs, today reintroduced 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.

“Nobody in an emergency situation should have to have the bureaucratic paperwork process of the IHS at the top of their mind,” said Rounds. “In an emergency, patients need to be able to seek care at the closest facility that can adequately address their needs without worrying that the IHS won’t reimburse costs. 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.”

“Medical emergencies are emergencies – people can’t choose when and where they occur,” said Cortez Masto. “In a crisis, IHS patients should be able to seek care at the closest hospital without worrying about having to fill out burdensome paperwork after an emergency.”

“We thank Senator Rounds for his leadership to help improve Indian health care,” said Gay Kingman, Executive Director of the Great Plains Tribal Chairmen’s Association. “As he knows, many of our IHS patients have limited means and a clear avenue to secure assistance is critical to the provision of good health care and to improve health outcomes. These are life and death matters.”

“The last thing a medical patient should have to worry about is paperwork during a healthcare emergency,” said Frank Star Comes Out, President of Oglala Sioux Tribe. “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 ensure existing flexibilities are included in the bill and get it across the finish line.”

“Tribal members are already subject to a number of strict rules when accessing Purchased and Referred Care resources,” said Wayne Boyd, Treasurer of the Rosebud Sioux Tribe. “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.”

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 or disabled, which will stay at 30 days.

Click HERE for full bill text.

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