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Senators Urge Improvements to Indian Health Service

September 27, 2011
  • 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.

    In their letter, Senators Jeff Bingaman (NM), Lisa Murkowski (AK), Tim Johnson (SD), John Thune (SD), Daniel Akaka (HI), John Barrasso (WY) and Tom Udall (NM) acknowledge that IHS is working to correct some of the problems that have long plagued its programs, but they press Secretary Sebelius and Director Roubideaux to immediately step-up oversight of IHS's contract health services program (CHS).

    Excerpts of their letter follow:

    "The CHS can be a critical life-line for Native Americans throughout the nation. The CHS provides them with health services not available in IHS and tribal health facilities. As a result, CHS may provide for the most complex and life-sustaining care needed by Native Americans."

    "Given the important role of CHS and long standing problems with the program, we believe swift and comprehensive action by the IHS is required and insist that work to address the deficiencies identified by GAO begin immediately."

    "Specifically, we are requesting, within the next 60 days, a clear and comprehensive corrective action plan from IHS that documents how the agency will address each of the problems and recommendations made by the GAO in this Report. In addition, the plan should include a timeline for: (1) specific corrective actions, (2) a date when each action will be commenced, (3) a date when each action is expected to be completed, and (4) identifiable goals that, when reached, will lead to the completion of each corrective action."

    "We look forward to receiving the comprehensive corrective action plan and thank you for your continued dedication to providing high quality health care to Native Americans."

    This is the first in a series of GAO reports requested by a bipartisan group of senators, as well as those mandated by the Indian Health Care Improvement Act. The reports have been requested because of the long standing problems with the CHS. Forthcoming reports will examine other aspects of the Contract Health Service program including the allocation of funding, reimbursement issues, coordination of services, barriers to care, and claims administration. The next report is expected early in 2012.

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