Indian Health Service Emergency Claims Parity Act
S. 1055, the Indian Health Service Emergency Claims Parity Act, introduces a small amendment to the Indian Health Care Improvement Act (IHCIA) focused on how quickly the Indian Health Service (IHS) must be notified about emergency medical care received from non-IHS providers or in non-IHS facilities under contract health services. The bill restructures Section 406 to create a general 15-day notification deadline for most Indians, while preserving a separate provision for elderly or disabled Indians. The aim is to standardize and speed up the notification process to support timely payment of emergency claims, thereby improving parity in how emergency services are billed and reimbursed when care is sought outside IHS facilities. In short, the bill seeks to ensure a clear, 15-day window to notify IHS about emergency care from non-service providers, while maintaining a distinct rule for elderly or disabled beneficiaries. This could reduce claim denial risk due to late notice and streamline the contracting health services process for emergency care.
Key Points
- 1The bill amends Section 406 of the Indian Health Care Improvement Act to modify the notification requirement for emergency contract health services.
- 2It creates a general subsection (a) establishing a 15-day deadline to notify the Service (IHS) about emergency treatment or admission when care is received from a non-Service provider or in a non-Service facility.
- 3It re-designates the existing provision for elderly or disabled Indians as subsection (b), preserving a separate notification framework for that group.
- 4The change is described as promoting “parity” in how emergency claims are notified and paid, by standardizing the notification timeline.
- 5The bill’s effect is limited to the notification deadline and does not, on its face, change other aspects of eligibility or payment, aside from the timing requirement.