INDIAN HEALTH SERVICE EMERGENCY CLAIMS PARITY ACT

On 2026-09-14, Representative Bruce Westerman (R-AR-4) delivered a floor speech titled "INDIAN HEALTH SERVICE EMERGENCY CLAIMS PARITY ACT" in the House.

INDIAN HEALTH SERVICE EMERGENCY CLAIMS PARITY ACT

Congressional Record, Volume 172 Issue 144 (Monday, September 14, 2026) [Congressional Record Volume 172, Number 144 (Monday, September 14, 2026)] [House] [Pages H5576-H5578] From the Congressional Record Online through the Government Publishing Office [ www.gpo.gov ] INDIAN HEALTH SERVICE EMERGENCY CLAIMS PARITY ACT Mr. WESTERMAN. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 8658) 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. The Clerk read the title of the bill. The text of the bill is as follows: H.R. 8658 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 not be less than 15 days.''. The SPEAKER pro tempore. Pursuant to the rule, the gentleman from Arkansas (Mr. Westerman) and the gentlewoman from Maryland (Ms. Elfreth) each will control 20 minutes. [[Page H5577]] The Chair recognizes the gentleman from Arkansas. General Leave Mr. WESTERMAN. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks and include extraneous material on H.R. 8658, the bill now under consideration. The SPEAKER pro tempore. Is there objection to the request of the gentleman from Arkansas? There was no objection. Mr. WESTERMAN. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, H.R. 8658, introduced by Congressman Mike Kennedy from Utah, would amend the Indian Health Care Improvement Act to require that non-elderly and nondisabled Indian patients have at least 15 days to notify the Indian Health Service when they receive emergency treatment or are admitted to a healthcare facility through the purchased/referred care program. The IHS uses the purchased/referred care program, or PRC, to pay outside providers when needed services are unavailable at an IHS or Tribal health facility. IHS approves a PRC payment if a patient meets specific requirements, including timely notification of IHS. The law currently provides elderly or disabled Indians a 30-day emergency notice window, while the rule for all other patients is 72 hours. During an emergency, 72 hours is a very short window. While extensions can be granted, the 72-hour window remains the standard. This timeframe is unrealistic for a patient dealing with a health crisis who may be transferred between facilities, recovering from surgery, or relying on assistance from someone unfamiliar with PRC notice rules. When the 72-hour deadline is missed, a claim that would otherwise be approved may be denied, and the patient is at risk of being billed or sent to collections for emergency care. This legislation would amend the Indian Health Care Improvement Act to provide at least 15 days to notify IHS of emergency treatment or admission for PRC purposes, while preserving the existing 30-day notification window for elderly or disabled Indians. Mr. Speaker, I thank Dr. Kennedy of Utah for championing this important legislation for Indian Country. I urge my colleagues to support the bill, and I reserve the balance of my time. House of Representatives, Committee on Energy and Commerce, Washington, DC, August 24, 2026. Hon. Bruce Westerman, Chairman, Committee on Natural Resources, Washington, DC. Dear Chairman Westerman: I write regarding H.R. 8658, the ``Indian Health Service Emergency Claims Parity Act.'' While there are provisions of the legislation that fall within the Rule X jurisdiction of the Committee on Energy and Commerce, I wanted to notify you that the Committee will forgo action on the bill so that it may proceed expeditiously to the House floor for consideration. This is done with the understanding that the Committee's jurisdictional interests over this and similar legislation are in no way diminished or altered. In addition, the Committee reserves the right to seek conferees on H.R. 8658 and requests your support when such a request is made. I would appreciate your response confirming this understanding with respect to H.R. 8658 and ask that a copy of our exchange of letters on this matter be included in the committee report on the bill or in the Congressional Record during consideration of the bill on the House floor. Thank you again for your assistance on this matter. Sincerely, Brett Guthrie, Chairman. ____ House of Representatives, Committee on Natural Resources, Washington, DC, August 24, 2026. Hon. Brett Guthrie, Chairman, Committee on Energy and Commerce, Washington, DC. Dear Chairman Guthrie: I write regarding H.R. 8658, the ``Indian Health Service Emergency Claims Parity Act,'' which was ordered reported by the Committee on Natural Resources on July 15, 2026. I recognize that the bill contains provisions that fall within the jurisdiction of the Committee on Energy and Commerce and appreciate your willingness to forgo further consideration of the bill. I acknowledge that the Committee on Energy and Commerce will not formally consider H.R. 8658 and agree that the inaction of your Committee with respect to the bill does not waive any jurisdiction over the subject matter contained therein. I am pleased to support your request to name members of the Committee on Energy and Commerce to any conference committee to consider such provisions. I will ensure that our exchange of letters is included in the Congressional Record during floor consideration of the bill and will include such letters in the committee report on H.R. 8658. 1 appreciate your cooperation regarding this legislation. Sincerely, Bruce Westerman, Chairman, Committee on Natural Resources. {time} 1710 Ms. ELFRETH. Mr. Speaker, the Indian Health Service, or IHS, is the primary agency responsible for providing healthcare to American Indians and Alaska Natives. However, the agency is chronically underfunded and understaffed, resulting in limited care at IHS and Tribal facilities. When these facilities cannot offer care, Tribal patients may receive services from outside providers under the Purchased and Referred Care, or PRC, program. As the chairman pointed out, in an emergency, most Tribal patients only have 3 days, or 72 hours, to notify the agency that they received care under the PRC program. This is, as the chairman said, completely unrealistic for too many Americans. It places an unfair burden on patients and their families to navigate paperwork and deadlines during medical emergencies, when they should be focused on receiving care. H.R. 8658 would extend the notification period from 3 days to 15 days. This simple extension would gave patients and their families the time to complete the necessary requirements and allow them to focus on their recovery in the event of an emergency. This small change is a meaningful step in supporting healthcare for Indian country because Tribal patients should not have to worry about balancing paperwork and going into medical debt while recovering and receiving the care they are entitled to. Mr. Speaker, I urge my colleagues to support this legislation, and I reserve the balance of my time. Mr. WESTERMAN. Mr. Speaker, I yield 4 minutes to the gentleman from Utah (Mr. Kennedy), the lead sponsor of this bill. Mr. KENNEDY of Utah. Mr. Speaker, I thank Mr. Westerman for the time to speak. Our constituents know there is too often a gap between the rules Washington writes and the realities Americans face. Nowhere is that gap more apparent than in our healthcare system. I know that reality well. I have been a doctor for 25 years and continue to see patients. I sit with families during some of the most difficult moments of their lives, and I see firsthand how frustrating paperwork and red tape can be when what matters most is getting someone the care that they need. That experience is why I rise today in support of my bill, H.R. 8658, the Indian Health Service Emergency Claims Parity Act. This bill is simple: Put patients before paperwork. Today, when an American Indian or Alaska Native patient receives emergency care outside the Indian Health Service, the IHS must be notified within 72 hours. When missed, a family can be left with the bill for care that should have been covered. Mr. Speaker, that rule was written from behind a desk, not beside a hospital bed. Anyone who has worked in healthcare knows that 72 hours can pass in what feels like an instant. Families should be focused on their loved one's recovery, not on whether they met a Federal notification deadline. H.R. 8658 extends that window to 15 days so families can take care of their loved ones first and the paperwork second. This is what good government should look like. When a rule does not reflect the reality people face, we should fix it. When government bureaucracy gets in the way of common sense, we should cut through it. My congressional colleagues and I understand that. We need a government that is smarter, quicker, and more responsive to the people it serves. We need a government that is streamlined and close to home, not bloated and distant. This is one practical, commonsense fix, and there are many more like it across our government and throughout our healthcare system. I t

Referenced legislation: HR8658, HR8658