“The United States federal government has a dual obligation to Native veterans – one obligation specific to the treaties and the other obligation specific to their service in our collective national defense,” said NIHB Acting Chairman Smith, who is a member of the Valdez Native Tribe of Alaska.
“One way that Congress can close the gap between the Veterans Health Administration and the Indian Health Service is by passing H.R. 6237, that will ensure the VHA fully reimburses IHS and Tribes for healthcare services through Purchased/Referred Care. The chronic underfunding of the IHS and the strain of the COVID-19 pandemic makes those PRC dollars critical to the overall stability of the Indian health system.”
The PRC system is designed for IHS and Tribes to purchase care from outside providers to help make up for the lack of primary and specialty care providers within the Indian health system. However, the system is limited to only circumstances where the patient has first exhausted all other available forms of health coverage including private insurance, Medicare and Medicaid. Essentially, the PRC program is the payer of last resort. The “PRC for Native Veterans Act,” sponsored by Subcommittee Chair Congressman Ruben Gallego (D-AZ) emphasizes that IHS is indeed the payor of last resort, and the VHA must reimburse for services.
Tribal governments rely on third-party reimbursements from federal programs like Medicare, Medicaid and private insurance to supplement the underfunding from IHS and extend care to critical patients. For many self-governance Tribes, third-party collections make up nearly 60% of their healthcare operating budgets. Many Tribes have experienced third-party reimbursement shortfalls ranging from $800,000 to $5 million due to COVID-19 cancellations of non-emergent care. These funding shortfalls have forced Tribes across the country and Alaska to furlough hundreds of workers, curtail available healthcare services or close clinics entirely.