Key Takeaways:
– Native American patients are being wrongfully billed for healthcare services covered by federal programs.
– These financial impositions disrupt lives, affecting credit scores and loan availability.
– Delays and errors in the Indian Health Service’s payment process contribute to the issue.
– Legislation is proposed to rectify these unfair practices and establish a patient reimbursement system.
– However, tribal leaders highlight that underfunding and inefficiencies within the federal healthcare program persist.
The Struggles of Native American Patients
In a twisted encounter with bureaucracy, Tescha Hawley, a resident of the Fort Belknap Indian Reservation, discovered that her credit score had been hit by hospital bills from her son’s birth. Quite surprisingly, these bills had been forwarded to debt collectors, disrupting her plans to purchase a house.
Hawley is among many Native American citizens who are victims of a flawed healthcare system. She, and others like her, frequents a local Indian Health Service (IHS) hospital, a federal agency responsible for providing healthcare free of charge to Native Americans. However, due to acute funding and staffing shortages, IHS facilities are under-equipped and routinely refer patients to privately-owned health facilities.
Unlawful Debt Collections
This referral scenario stems from the Purchased/Referred Care program, a federal setup designed to cover healthcare services that IHS-funded clinics or hospitals cannot provide. According to federal law, patients referred under this program should bear no costs.
Despite these protections, tribal leaders, health officials, and recent federal reports suggest that patients are frequently billed due to delays, oversights, or errors by various parties involved, from the IHS to the private healthcare providers. This overwhelming financial burden can linger for years, damaging credit scores, impeding access to loans, and escalating interest rates.
Damaged Credit; Damaged Lives
A study by the federal Consumer Financial Protection Bureau (CFPB) revealed that these systemic problems disproportionally affect Native American communities. They are nearly twice as likely to accumulate medical debt in collections than the national average, with their total medical debt significantly higher.
For Hawley, the repercussions of these wrongful charges are all too real. Her journey towards homeownership was delayed by a year, and it took another seven years for the debt to leave her credit report. She still struggles with navigating the referral program, receiving notifications about overdue bills from clinics.
Federal Response and Reforms
In response to these ongoing issues health officials are working on two federal bills: The Purchased and Referred Care Improvement Act and the Protecting Native Americans’ Credit Act.
The first act aims to oblige the IHS to establish a wrongful billing reimbursement process. The second act intends to safeguard patents’ credit scores from debts resulting from such wrongful bills.
However, determining the precise number of wrongfully billed patients remains challenging. While the IHS acknowledges the need for improvement, the agency is also developing a tracking and quick bill processing tool as well as looking to fill vacancies in referred-care staff.
Despite these initiatives, Melanie Egorin, an assistant secretary at the U.S. Department of Health and Human Services, warns against the proposed legislation’s lack of punitive measures for health facilities that repeatedly wrongfully bill patients.
Tribal Reservations and Federal Aid
Many tribal leaders view the monetary and administrative problems with the referred-care program as examples of the U.S federal government breaching treaties that promised quality healthcare in exchange for their land.
While the Indian Health Service aims to overcome these challenges, the larger problem of limited program accessibility due to underfunding persists. The program currently operates on a $1 billion budget, with an estimated shortfall of $9 billion. These figures underline the need for broader systemic changes beyond legislative stopgaps.
Despite this bleak landscape, Native American patients, including Hawley, persist. However, as Hawley notes, each new bill meant to be covered by the referral program becomes another tiresome battle against an untrustworthy system. The hope is that with combined legislative and administrative reform, the financial burdens unjustly borne by Native American communities will become a thing of the past.