Sen. Max Baucus demands investigation of IHS third-party collections
WASHINGTON – In an interview two months ago, former IHS Director Charles Grim, now an IHS policy adviser, noted that so-called third-party collections approximate $700,000,000 in the IHS budget. At $1 billion, they would represent almost one-fourth of the total IHS budget.
”That’s why so many people are paying attention,” Grim said.
Among them is Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee. On Feb. 12, alleging that hundreds of millions of dollars may have gone uncollected, he called on the Comptroller General of the United States to evaluate a slate of IHS third-party collection practices. ”It is my understanding that IHS has engaged in a practice of regularly writing off claims as uncollectible when claims are denied or when collection would involve considerable effort. … I am concerned that the IHS may be potentially under-collecting hundreds of millions of dollars from private sources and that taxpayers are picking up the tab for the difference.”
The under-funding of Indian health care has been a leading Native-specific issue on Capitol Hill throughout the past year, and in previous years for that matter. Baucus has been a principal figure in the effort to reauthorize the Indian Health Care Improvement Act, moving it through his committee, participating prominently in a Capitol Hill rally on its behalf, and issuing a strong statement of support when Sens. Byron Dorgan D-N.D., and Lisa Murkowski, R-Alaska, brought the bill to the Senate floor, where it still lingers.
Third-party obligations arise when the IHS provides care to American Indians enrolled in an independently insured, private sector health care plan, which must then reimburse IHS the cost of the plan’s benefits. But they don’t always, and IHS is authorized to write off debts it deems uncollectible. Baucus said it is giving up too easily. ”Officials at IHS should be bending over backwards to collect every cent that private insurance companies owe for the care provided to Native Americans. But it appears instead that the agency is writing off debt left and right without exhausting every effort to get those taxpayer dollars back. … We need these dollars to pay for the health care that Native Americans so desperately need and deserve.”
Tom Rodgers, a lobbyist with Carlyle Consulting who has aggressively monitored the issue, said the IHS has repeatedly stated that it does the best it can on collections, given limited resources. Rodgers shares Baucus’ conviction that it isn’t doing enough, given the deplorable health conditions in Indian country and the uncollected amount at issue.
Grim said IHS third-party collections increased in every year of his directorship.
