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




   ALASKA NATIVE AND AMERICAN INDIAN DIRECT REIMBURSEMENT ACT OF 1998

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                          HON. DALE E. KILDEE

                              of michigan

                    in the house of representatives

                        Thursday, June 18, 1998

  Mr. KILDEE. Mr. Speaker, I rise to urge my colleagues to support 
legislation I am introducing today with Resources Committee Chairman 
Young that would permanently authorize and expand the Medicare and 
Medicaid direct collections demonstration program under section 405 of 
the Indian Health Care Improvement Act.
  The Medicare and Medicaid direct collections demonstration program 
currently allows four tribal health care operators who operate an 
entire Indian Health Service hospital or clinic to bill directly and 
collect Medicare and Medicaid reimbursements instead of having to deal 
with the bureaucracy at the Indian Health Service. The current 
participants are the Bristol Bay Health Corporation and the Southeast 
Regional Health Corporation in Alaska, the Mississippi Choctaw Health 
Center, and the Choctaw Tribe of Oklahoma.
  The demonstration program has been fully tested over the past decade. 
All of the participants--and the Department of Health and Human 
Services--report that the program is a great success. In fact, the 
program has: Significantly reduced the turnaround time between billing 
and the receipt of payment for Medicare and Medicaid services; 
increased the administrative efficiency of the participating facilities 
by empowering them to track their own Medicare and Medicaid billings 
and collections; and improved collections for Medicare and Medicaid 
services, which in turn have provided badly-needed revenues for Indian 
and Alaska Native health care.
  In 1996, when the demonstration program was about to expire, Congress 
extended it through fiscal year 1998. This extension has allowed the 
participants to continue their direct billing and collection efforts 
and has given Congress additional time to consider whether to authorize 
the program permanently.
  Because the demonstration program is again set to expire on September 
30, Congress must act quickly to recognize the benefits of the 
demonstration program by enacting legislation that simply would 
permanently authorize it and expand it to other eligible tribal 
participants.
  The Alaska Native and American Indian Direct Reimbursement Act of 
1998 is an identical companion bill to legislation introduced in the 
Senate on April 29 and sponsored by Senators Murkowski, Lott, Baucus, 
and Inhofe. The Indian Health Service and the Health Care Financing 
Administration support it.
  I hope that my colleagues also will support this important 
legislation and that the Resources Committee and this House will 
favorably consider it as soon as possible so this successful program 
can continue to increase the administrative efficiency of participating 
Alaska native and American Indian health care facilities.

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