[Congressional Record Volume 166, Number 194 (Monday, November 16, 2020)]
[House]
[Page H5738]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           PROPER AND REIMBURSED CARE FOR NATIVE VETERANS ACT

  Mr. HUFFMAN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 6237) to amend the Indian Health Care Improvement Act to 
clarify the requirement of the Department of Veterans Affairs and the 
Department of Defense to reimburse the Indian Health Service for 
certain health care services, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 6237

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Proper and Reimbursed Care 
     for Native Veterans Act'' or the ``PRC for Native Veterans 
     Act''.

     SEC. 2. CLARIFICATION OF REQUIREMENT OF DEPARTMENT OF 
                   VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE TO 
                   REIMBURSE INDIAN HEALTH SERVICE FOR CERTAIN 
                   HEALTH CARE SERVICES.

       Section 405(c) of the Indian Health Care Improvement Act 
     (25 U.S.C. 1645) is amended by inserting before the period at 
     the end the following: ``, regardless of whether such 
     services are provided directly by the Service, an Indian 
     tribe, or tribal organization, through purchased/referred 
     care, or through a contract for travel described in section 
     213(b)''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Huffman) and the gentleman from Utah (Mr. Bishop) each 
will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. HUFFMAN. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
to include any extraneous material on the measure under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. HUFFMAN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, the bill before us, H.R. 6237, is the PRC for Native 
Veterans Act, introduced by our colleague from Arizona, Representative 
Gallego. This bill will ensure that Native veterans can access high-
quality healthcare regardless of the system where they choose to seek 
it.
  Providing for the healthcare of our veterans should be one of our top 
priorities, including the care of approximately 150,000 Native veterans 
who have served our country.
  By law, a Native veteran is eligible to receive services under both 
the VA and Indian Health Service. They can choose which one of those to 
use at any given time.
  In instances where a Native veteran is eligible for a particular 
healthcare service from both the VA and IHS, the VA is considered the 
primary payer. As such, the VA reimburses IHS and Tribal facilities for 
any direct care they provide.
  Here is the problem that sometimes arises: It is with the Purchased/
Referred Care Program, known as PRC. IHS and Tribal facilities are not 
always able to directly provide all of the necessary health services a 
Tribal member may need, and in order to bridge that gap, the PRC 
program was created. It authorizes the purchase of services from a 
network of private providers when care is not available at IHS or 
Tribal facilities.
  During the permanent reauthorization of the Indian Health Care 
Improvement Act, Congress amended section 405(c) of that law to require 
the VA to reimburse IHS and Tribes for health services provided under 
that PRC program.
  But the VA now claims that this language does not statutorily require 
them to reimburse specialty and referral services through IHS or Tribal 
facilities. The VA, instead, insists that the referral must come from 
them.
  That creates problems. It means that the Native veterans who arrive 
at IHS or Tribal facilities needing specialty care are often forced to 
travel extreme distances to the nearest VA just to get a redundant 
primary care visit and a referral.
  These extra steps cause significant hardship for many Native veterans 
and can delay critical care. The result is that many IHS and Tribal 
facilities are referring Native veterans out for specialty care and 
then just paying for it themselves with their already meager PRC fund 
so that the patient can be treated in a timely and competent manner.
  This bill clarifies that the VA is responsible for reimbursing IHS 
and Tribes for any specialty care provided through a referral by an IHS 
or Tribal facility.
  I think we can all agree our Native veterans should have timely 
access to the quality of care they need no matter where they choose to 
access it.
  I want to thank Representative Gallego for championing this 
bipartisan legislation on behalf of all Native veterans, and I urge its 
quick adoption.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BISHOP of Utah. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I, too, wish to support H.R. 6237, which is officially 
the Proper and Reimbursed Care for Native Americans Act. Over the last 
century, Native Americans have served in the U.S. armed services at a 
higher per capita rate than any other ethnicity, and with Veterans Day 
occurring last week at the same time as the opening of the Native 
American Veterans Memorial, I thank those who have served and continue 
to serve in this capacity.
  Under current law, the Department of Veterans Affairs or the 
Department of Defense reimburses the Indian Health Services for any 
health-related services provided to Native Americans.
  Unfortunately, not all Indian Health Services or Tribally operated 
facilities can provide every level of care, and some patients must be 
referred. For these situations, the VA or the DOD cannot reimburse the 
Indian Health Service or Tribal facility for certain services.
  H.R. 6237 would amend the Indian Health Care Improvement Act to fix 
this problem and ensure that the Veterans Administration or the 
Department of Defense has authority to pay for the care Native veterans 
receive regardless of where those services are provided.
  So I have to thank subcommittee Chairman Gallego, who is, himself, a 
marine veteran, for his service and ensuring that Native Americans 
receive proper care.
  I urge adoption of this measure, and I yield back the balance of my 
time.
  Mr. HUFFMAN. Mr. Speaker, I request an ``aye'' vote, and I yield back 
the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Huffman) that the House suspend the 
rules and pass the bill, H.R. 6237, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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