Newhouse Tribal Healthcare Bill Receives Hearing

Today, Rep. Dan Newhouse (WA-04) delivered remarks at the House Natural Resources Indian and Insular Affairs Subcommittee hearing on his legislation, the Uniform Credentials for IHS Providers Act. This bill amends the Indian Health Care Improvement Act to create a centralized system to prevent malpractice, cut down on the onboarding backlog, establish a standard of care for tribes, and ensure the providers at IHS facilities are vetted in an efficient and proper manner.

Watch Rep. Newhouse's remarks here(link is external) or read remarks as written below:

"Before I discuss my legislation, I would like to introduce one of my constituents, Jarred Erickson, who is the Chairman of the Confederated Tribes of the Colville Reservation. As the Committee knows, the Colville Tribes have had many challenges with the Indian Health Service over the years. I also know that Chairman Erickson has been dealing with two wildfires burning on the Colville Reservation as we speak, and I appreciate him being here today to testify on these important bills.

I am here today to discuss the Uniform Credentials for IHS Providers Act, which I recently introduced with my colleague, Representative Dusty Johnson.

The Indian Health Service is responsible for providing direct medical and public health services to members of federally recognized Native American Tribes. This duty includes reviewing and verifying professional qualifications of clinicians through a process known as credentialing and privileging.

Currently, this process involves meeting credentialing requirements that are spread across multiple, and sometimes conflicting documents, making it challenging for officials to effectively and efficiently credential incoming medical providers.

This lack of a standardized credentialing system has led to issues for the IHS and for those who utilize its services.

In my district, constituents have reported instances in which the current IHS credentialing system has negatively impacted health provider recruitment and onboarding efforts, including one instance in which providers were interested in working for the local service unit only to pursue an opportunity elsewhere because of the slow pace of the credentialing process. Given the health disparities that exist in Tribal nations, recruitment of quality health personnel should be of the utmost priority.

Additionally, there have been reports of inconsistencies between facilities and their credentialing, privileging, and hiring processes in which hiring committees have prioritized filling vacant positions over thorough background and credentialing checks. Furthermore, it has been reported that a lack of shared information increased the practice of hiring individuals with otherwise questionable history and qualifications from one facility to another.

A recent GAO report described the effect of the lack of a centralized system. In one instance, the report found that at an IHS facility that was reviewed, 12 percent of clinician files that were analyzed did not meet IHS's requirement to verify all licenses held by the clinician, and in three of those files, the IHS had not verified any licenses.

My bill seeks to address such issues by requiring the Indian Health Service, in consultation with Tribes and stakeholders, to establish a uniformed and centralized IHS-wide credentialing system for individuals providing services at IHS facilities.

The development of such a system would ensure that IHS providers are equipped with the tools that they need to efficiently and effectively hire qualified personnel in their facilities and ensure that all of them are thoroughly vetted.

It is of the utmost importance that all patients receive the highest quality of care. I believe my legislation is a step in the right direction and urge the committee to support this important measure. Thank you."

Background:

To provide patients with the highest level of care at its federally operated facilities, the IHS, which is responsible for providing direct medical and public health services to members of federally recognized Native American Tribes, reviews and verifies professional qualifications of clinicians through a process known as credentialing and privileging. Currently, IHS requirements are spread across multiple, sometimes conflicting, documents, making it challenging for officials to know of and meet them.

Further, existing IHS oversight is concentrated at the local level and does not routinely include headquarters' reviews of clinicians' files for adherence with IHS requirements. Until it ensures clinicians are appropriately screened, IHS risks hiring or retaining clinicians with performance, health, or other issues, potentially affecting the quality of care provided to patients and putting them at risk.

The IHS has also documented various incidents in which health professionals with histories of malpractice claims have passed screenings that failed to identify performance, health, or other issues. The lack of a centralized, uniform, service-wide credentialing system has been identified as a cause. This bill would require the establishment of a standardized system to improve and maintain health professional quality and quality of care as well as ensure that health professionals at IHS facilities are vetted thoroughly.

Click here to read full bill text.

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Issues:Health Care