Official Summaries

Indian Health Service Emergency Claims Parity Act

This 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.

Current Full Text

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1055 Introduced in Senate (IS)]

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119th CONGRESS
  1st Session
                                S. 1055

     To amend the Indian Health Care Improvement Act to modify the 
  notification requirement for emergency contract health services for 
             certain beneficiaries, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 13, 2025

Mr. Rounds (for himself and Ms. Cortez Masto) introduced the following 
  bill; which was read twice and referred to the Committee on Indian 
                                Affairs

_______________________________________________________________________

                                 A BILL


 
     To amend the Indian Health Care Improvement Act to modify the 
  notification requirement for emergency contract health services for 
             certain beneficiaries, and for other purposes.

    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 ``Indian Health Service Emergency 
Claims Parity Act''.

SEC. 2. AUTHORIZATION FOR EMERGENCY CONTRACT HEALTH SERVICES.

    Section 406 of the Indian Health Care Improvement Act (25 U.S.C. 
1646) is amended--
            (1) by striking ``With respect to'' and inserting the 
        following:
    ``(b) Elderly or Disabled Indians.--With respect to''; and
            (2) by inserting before subsection (b) (as so designated) 
        the following:
    ``(a) In General.--Except as provided in subsection (b), with 
respect to an Indian receiving emergency medical care or services from 
a non-Service provider or in a non-Service facility under the authority 
of this Act, the time limitation (as a condition of payment) for 
notifying the Service of such treatment or admission shall be 15 
days.''.
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