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WASHINGTON – U.S. Senators John Barrasso (R-WY), John Thune (R-SD) and John Hoeven (R-ND) today introduced the Restoring Accountability in the Indian Health Service Act of 2017, legislation to improve the quality and delivery of patient care throughout Indian Country.

A lack of oversight, financial integrity and employee accountability at the Indian Health Service (IHS) has led to the delivery of substandard health care services for patients, families and communities. The bill will increase transparency and accountability at the IHS to ensure Native Americans have access to reliable, quality health care.

“For years, the Indian Health Service (IHS) has fallen short in providing high quality medical care throughout Indian Country. The long history of failures at IHS are unacceptable and will not be tolerated,” said Barrasso. “Our bill will ensure tribal members get the medical care they desperately need and deserve. Our legislation also increases transparency and accountability in Washington. This will go a long way in changing the culture at IHS to one that finally puts patients first.”

“It would be a significant understatement to say tribal members deserve better health care than what they’re accustomed to receiving from IHS,” said Thune. “After hearing about one heartbreaking story after another from tribal members in South Dakota and throughout the Great Plains area, it’s time to move away from talking about reforming IHS and begin making positive and systemic changes that lead to better care and greater oversight. For years, IHS has made hollow commitments to me and my colleagues in Congress to correct many of the problems that are ultimately addressed in this bill, which was formed with significant tribal member input. The bill would make several critical improvements to the delivery of care at IHS facilities, and it would hold IHS accountable to Congress and the community members they serve, more importantly. I look forward to continuing to work with members of the South Dakota tribes and with Sens. Barrasso and Hoeven in doing everything we can to fix the broken IHS system once and for all.”

“The documented shortcomings over the last decade at the Indian Health Service show the agency must improve,” said Senate Committee on Indian Affairs Chairman Hoeven. “Our bill is the necessary first step towards restoring accountability at the IHS and ultimately reforming a broken Indian health care system. I look forward to working with Senator Barrasso and Senator Thune to improve patient care for tribal citizens and get this legislation passed and signed into law.”

The bill will improve transparency and accountability at the IHS by:

• expanding removal and discipline authorities for problem employees at the agency;
• commissioning Government Accountability Office reports on housing and staffing needs, whistleblower protections, and patient care and harm occurring at the IHS, among other reports;
• providing requirements for the Secretary of HHS to issue standards to measure the timeliness of health care services provided at IHS facilities; and
• requiring the IHS to develop and implement a service-wide centralized credentialing system for licensed health professionals seeking to provide health care services at multiple facilities.

The bill also strengthens staff recruitment and retention at the IHS by:

• providing the Secretary of the U.S. Department of Health and Human Services (HHS) with direct hiring and other authorities to avoid long delays in the traditional hiring process;
• providing authority for health professionals to volunteer their health care services and be provided liability protections when working at an IHS service unit;
• addressing gaps in IHS personnel by giving the Secretary of HHS flexibility to create competitive pay scales and provide temporary housing assistance for medical professionals; and
• expanding the eligibility for certain IHS employees to participate in the loan repayment program by including degrees in business administration with an emphasis in health care management, health administration, hospital administration, or public health.

U.S. Representative Kristi Noem (R-SD), along with Reps. Rob Bishop (R-UT), Cathy McMorris-Rodgers (R-WA), Tom Cole (R-OK), and Markwayne Mullin (R-OK), have also introduced an identical bill in the House.


The Restoring Accountability in the Indian Health Service Act of 2017 is based on extensive feedback and information gathered by the Senate Committee on Indian Affairs (SCIA) since 2010.

In 2016, the SCIA held multiple oversight hearings and a field hearing, listening session and town hall meeting to examine the quality of care delivered by the IHS. Senator Barrasso (R-WY) and Senator Thune (R-SD) introduced a similar bill, which passed the SCIA, in the 114th Congress.