[Congressional Record Volume 142, Number 58 (Wednesday, May 1, 1996)]
[Extensions of Remarks]
[Pages E694-E695]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            TO AMEND THE INDIAN HEALTH CARE IMPROVEMENT ACT

                                 ______


                             HON. DON YOUNG

                               of alaska

                    in the house of representatives

                         Wednesday, May 1, 1996

  Mr. YOUNG of Alaska. Mr. Speaker, I am pleased to introduce a bill to 
amend the Indian Health Care Improvement Act to extend the 
demonstration program for direct billing for Medicare, Medicaid, and 
other third-party payors to September 30, 1998.
  Section 405 of the Indian Health Care Improvement Act established a 
demonstration program to authorize up to four tribally-operated Indian 
Health Service [IHS] hospitals or clinics to test methods for direct 
billing for and receipt of payment for heath services provided to 
Medicare- and Medicaid-eligible patients. This program was established 
to determine whether these collections could be increased through 
direct involvement of the tribal health provider as compared with the 
current practice which required such billings and collections to be 
channeled through the IHS.
  Currently, there are four tribal health care providers participating 
in this demonstration project, the Bristol Bay Area Health Corp. of 
Dillingham, AK; the Southeast Alaska Regional Health Consortium of 
Sitka, AK; the

[[Page E695]]

Mississippi, Choctaw Health Center of Philadelphia, MI, and the Choctaw 
Tribe of Oklahoma of Durant, OK. All participants have unanimously 
expressed success and satisfaction with the demonstration program and 
report that dramatically increased collections for Medicare and 
Medicaid services, thereby providing additional revenues for Indian 
health programs at these facilities; significant reduction in the turn-
around time between billing and receipt of payment; and increased 
efficiency by being able to track down their own billings and 
collections and thereby act quickly to resolve questions and problems.
  The IHS is required to monitor participation and receive quarterly 
reports from the four participants. The law also requires the IHS to 
report to Congress on the demonstration program on September 30, 1996, 
the end of fiscal year 1996. This report is to evaluate whether the 
objective have been fulfilled, and whether direct billing should be 
allowed for other tribal providers who operate an entire IHS facility.
  All four participants seek to extend the demonstration program 
authority for 2 more years to give Congress time to review the report 
IHS must submit on September 30, 1996, and determine the future of the 
program.
  Without the extension, the four participants would have to close down 
their direct billing-collection departments and return to the old 
system of IHS-managed collections. This would mean the dismantling of 
highly specialized administrative staff and would have an immediate 
negative impact on revenue collection.
  This is a technical amendment to extend the program in 2 more years 
so that the existing participants can continue their direct billing 
collection efforts while the required report from the IHS is reviewed.

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