Noem Leads Lawmakers in Introducing Comprehensive IHS Reform Bill

noem press header kristi noem headshot May 21 2014Noem Leads Lawmakers in Introducing
Comprehensive IHS Reform Bill

WASHINGTON, D.C. – Rep. Kristi Noem (R-SD) – along with Reps. Jeff Fortenberry (R-NE), Brad Ashford (D-NE), Adrian Smith (R-NE), and Kevin Cramer (R-ND) – today introduced the Helping Ensure Accountability, Leadership, and Transparency in Tribal Healthcare Act (HEALTTH Act), which offers comprehensive reforms to the crisis-stricken Indian Health Service (IHS).

“The government is required by treaty to provide healthcare to tribal communities. IHS has failed to uphold that duty,” said Rep. Kristi Noem.  “The problems are pervasive, but this legislation is comprehensive.  From care delivery to hospital administration, the bill aims to dramatically improve the quality of healthcare while making the system more efficient, cost-effective, and accountable.”

“We cannot sit idly by and watch an entire healthcare system remain, at best, inadequate—or worse harm persons and communities,” said Rep. Jeff Fortenberry. “This bill is another important step in addressing the health care needs of tribal members in Nebraska and throughout the nation.”

“Access to quality health facilities is an important factor in the growth of tribal communities in Nebraska and across the country. We have an obligation to improve care for Native Americans, and we cannot, in good conscious, stand by and do nothing. I am proud to cosponsor legislation that will support Nebraska tribal communities by investing in healthcare,” said Rep. Brad Ashford.

“While neighboring practitioners and hospitals are happy to assist when IHS facilities are unable to provide care, it also places serious strains on small, rural providers,” said Rep. Adrian Smith. “This legislation is an important first step in ensuring tribal communities can access the care they deserve while providing predictability for nearby rural communities.”

“No matter where you live, everyone deserves access to quality healthcare,” said Rep. Kevin Cramer. “The HEALTTH Act will make meaningful reforms at the Indian Health Service in order to support a better quality of life on our Indian reservations.”

The HEALTTH Act offers critical structural changes to how IHS operates, addressing both medical and administrative challenges.  More specifically, Noem’s legislation:

+ Improves IHS’s ability to secure long-term contracts for hospitals in emergency conditions by allowing for a partnership among IHS, tribal communities and healthcare stakeholders to collaborate throughout the contract negotiating process, rather than leaving those decisions solely to IHS.

+ Addresses the current recruitment problem – for both medical staff and hospital leadership – by putting provisions in place to:

  • Allow for faster hiring.
  • Make the existing student loan repayment program tax free, as an added incentive for high-quality employees.
  • Provide incentives to attract competent and well-trained hospital administrators as well as medical staff.

+ Reforms the Purchased/Referred Care (PRC) Program by, among other things:

  • Requiring IHS to develop a new formula for allocating PRC dollars. Under Noem’s bill, IHS would be required to develop a formula based on need, population size, and health status to ensure those areas that have the greatest need receive a greater portion of the funding.
  • Requiring IHS to negotiate Medicare-like rates for services it pays for with private providers.  IHS currently pays a premium for PRC services.  Noem’s proposal would bring payments in line with what Medicare pays to stretch every dollar further.
  • Requiring IHS to address the backlog of PRC payments to private providers.  Private hospitals in the Great Plains Area have long expressed concern because IHS has failed to pay their bills.  Noem would require IHS to put a strategy in place to get these hospitals paid what they are due.

+ Restores accountability through strategies, such as:

  • Require IHS to be accountable for providing timely care.
  • Require the Government Accountability Office to report on the financial stability of IHS hospitals that are threatened with sanction from the Centers for Medicare and Medicaid Services.

A section-by-section summary of the legislation can be found here or you can access the full text here.


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