[Congressional Record Volume 144, Number 80 (Thursday, June 18, 1998)]
[Extensions of Remarks]
[Pages E1164-E1165]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         A BILL TO AMEND THE INDIAN HEALTH CARE IMPROVEMENT ACT

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                             HON. DON YOUNG

                               of alaska

                    in the house of representatives

                        Thursday, June 18, 1998

  Mr. YOUNG of Alaska. Mr. Speaker, I am pleased to introduce 
legislation with my distinguished colleague, Mr. Dale Kildee of 
Michigan, to amend the Indian Health Care Improvement Act (IHCIA). In 
1988, pursuant to Section 405 of the IHCIA, the Indian Health Service 
(IHS) was directed to select up to four tribally-operated IHS hospitals 
to participate in a demonstration program to test methods for the 
direct billing for and receipt of payment for health services provided 
to Medicare and Medicaid eligible patients. This was established to 
determine whether collections would be increased through direct 
involvement of tribal health care providers versus the current practice 
which required billings and collections be routed through the IHS.
  In 1996, Congress extended this demonstration program until 1998. 
This extension allowed Congress additional time with which to consider 
whether to permanently authorize the collection program. The law also 
required the IHS to submit a report to Congress on the demonstration 
program on September 30, 1996, the same day the program was originally 
to expire. The report was to evaluate whether the objectives were 
fulfilled and whether direct billing should be allowed for other tribal 
providers who operate an IHS facility. This report is still undergoing 
Departmental review, however, it is our understanding that the 
Secretary of Health and Human Services and the Indian Health Service 
are very pleased with the success of the demonstration program.

[[Page E1165]]

  All four participants have reported a dramatic increase of 
collections for Medicare and Medicaid services, which provided 
additional revenues for IHS programs at these facilities. In addition, 
there has been a significant reduction in the turn-around time between 
billing and receipt of payment and an increase in efficiency by being 
able to track their own billings and collections in order to act 
quickly to resolve questions and problems.
  On behalf of my constituents, the Bristol Bay Area Health Corporation 
and the South East Area Regional Health Corporation, I am introducing 
this legislation to provide permanent status for the demonstration 
program established by Section 405 of the Indian Health Care 
Improvement Act, to provide a ``grandfather'' clause for the current 
four demonstration participants to enable them to continue their 
programs without interruption, and to expand eligibility for the 
program to tribes or tribal organizations who operated or are served by 
an IHS hospital or clinic.

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