The Government Accountability Office office released a report today that said the Indian Health Service may not have adequate procedures in place to maximize collections from private insurers.

The Indian Health Care Improvement Act authorizes IHS to collect reimbursement for services provided at IHS facilities from third-party insurers, including Medicare, Medicaid, and private companies. The report recommends the agency update its billing and collection activities to ensure it receives all the money it is owed.

"While the design of IHS’s policies and procedures relating to its billings and collections from private insurers is consistent with federal standards, to remain useful these policies and procedures must be periodically evaluated to ensure that they are still relevant and up to date," the report said.

Sen. Max Baucus (D-Montana), the chairman of the Senate Finance Committee, requested the report. He said IHS Director Yvette Roubideaux has promised to make improvements to the system.

“Right now, American Indians and Alaskan Natives are suffering because IHS lacks adequate resources to provide the quality care they need, but these improvements will provide more dollars to deliver that care," Baucus said in a press release. "These lapses are unacceptable. I will be tracking the improvement effort carefully and will demand a follow-up report by GAO.”

According to the GAO, IHS collected $795 million from third-party insurers in fiscal year 2008. Of the amount, about $94 million, or 12 percent, was collected from private insurers, while the remaining 88 percent was collected from Medicare and Medicaid.

"Indian Health Service: Updated Policies and Procedures and Increased Oversight Needed for Billings and Collections from Private Insurers":
Summary | Full Report