Indian Health Service Emergency Claims Parity Act
Indian Health Service Emergency Claims Parity Act
Plain Language Summary
# Indian Health Service Emergency Claims Parity Act Summary **What the Bill Would Do** This bill would give American Indian and Alaska Native patients more time to notify the Indian Health Service (IHS) about emergency medical care they received at non-IHS hospitals or providers. Currently, patients have 72 hours to report emergency care so the IHS can authorize payment through its Purchased/Referred Care (PRC) program. The bill would extend this deadline to 15 days, making it easier for patients to get their emergency medical bills covered. However, the bill does not change the rules for elderly or disabled patients, who would continue to have 30 days to report emergency care. **Who It Affects and Current Status** This bill directly affects American Indian and Alaska Native patients who rely on IHS services and sometimes need emergency care at hospitals outside the IHS system.
The PRC program reimburses these outside medical providers when IHS facilities aren't available. The bill is currently in committee in the Senate and has not yet been voted on. Sponsor Senator Mike Rounds (R-SD) introduced it to address the challenge patients face when dealing with emergencies—situations where a 72-hour notification window may be too tight given the chaos of medical crises and varying notification procedures across providers.
CRS Official Summary
Indian Health Service Emergency Claims Parity ActThis bill extends from 72 hours to 15 days the time period to notify the Purchased/Referred Care (PRC) program of emergency medical care received from a non-Indian Health Service (IHS) medical provider or at a non-IHS medical facility. This bill does not apply to individuals who are elderly or disabled, who continue to have a 30-day notification requirement for emergency services.The IHS provides medical and dental services directly to American Indian and Alaska Native patients whenever possible. The PRC program pays for medical or dental care that is provided away from an IHS or tribal health care facility. The PRC program must be notified of requests for authorization of payment for health care services from a non-IHS provider.Currently in emergency cases, the patient, an individual on behalf of the patient, or the medical care provider must, within 72 hours after the beginning of treatment for the condition or after admission to a health care facility, notify a PRC authorizing official of the need for the emergency medical care. This bill instead allows the patient, other individual, or provider to notify PRC within 15 days of the treatment or admission.
Latest Action
Committee on Indian Affairs. Hearings held.