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IHS considers stopping funds for tribes requesting patient copays
Posted: June 20, 2008
by: Rob Capriccioso
In each of IHS' 12 area offices, agency officials have been busily explaining to tribal officials that treaty rights calling for federal trust responsibility are upended when copays are required of tribal members. Tribal officials have also been told that tribes that require copays could end up seeing a large number of their clients choose to go to other IHS clinics that don't require copays, and thus risk losing already-limited funds.
But one of the most important issues at hand, according to Demaray, is the fact that Congress could view widespread tribal copay collection as a big reason to further limit the agency's budget.
''We see this as kind of a slippery slope,'' Demaray said. Some Congress members, he noted, would like to see Indians paying for all of their health care needs out of their own pockets, despite treaty rights and federal trust responsibility.
The Senate's passed version of the Indian Health Care Improvement Act already contains language that would make tribal beneficiary copays lawful nationwide. IHS is opposed to the provision.
Some tribal health officials noted that tribes that don't require copays might be happy to go along with IHS' position since, if monies were limited to other tribes, more funds would theoretically be available to tribes that have followed the rules.