GAO: Indian Health Service needs increased oversight

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The Government Accountability Office has found deficiencies in Indian Health Service’s (IHS) data collection on unfunded services, leading GAO to conclude that increased oversight is needed.

Part of the Department of Health and Human Services, IHS provides care to American Indians and Alaska Natives. When care at an IHS-funded facility is unavailable, IHS’s contract health services (CHS) program pays for care from external providers under certain conditions. The GAO study, required under the Patient Protection and Affordable Care Act, recommended the HHS direct IHS to ensure unfunded services data are accurately recorded, CHS program funds management improved and provider communication enhanced.

“Due to deficiencies in IHS’s oversight of data collection, the data on unfunded services that IHS uses to estimate CHS program need were not accurate,” the study stated. “Specifically, the data that IHS collected from CHS programs were incomplete and inconsistent.”

Five of the 66 federal and 30 of the 103 tribal CHS programs that responded to the GAO’s survey reported that they did not submit these data to IHS in 2009. Individual CHS programs reported inconsistencies in how they recorded information about a specific type of unfunded service that IHS uses in its assessment of need.

In November 2010, an IHS workgroup was established to examine weaknesses in its data, and will make a recommendation to the IHS director by the end of 2011 to adopt a new method to assess need.

“Sixty of the 66 federal and 73 of the 103 tribal CHS programs that responded to GAO’s survey reported that in fiscal year 2009 they did not have CHS funds available to pay for all services for which patients otherwise met requirements,” the report stated. “Some federal CHS programs reported continuing to approve services for patients when sufficient funds were not available; IHS officials told us they were unaware this practice was occurring.”