Summary: H.R.5406 — 114th Congress (2015-2016)All Information (Except Text)

Bill summaries are authored by CRS.

Shown Here:
Reported to House amended, Part I (12/20/2016)

Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare Act or the HEALTTH Act


(Sec. 101) This bill amends the Indian Health Care Improvement Act by requiring the Indian Health Service (IHS) to implement a seven-year pilot program for testing the use of long-term contracts of at least five years for the operation of rural IHS hospitals with governance structures that include tribal input. The IHS must: (1) install a governing board at each participating hospital for overseeing the local operation of the hospital, and (2) consult with the primary Indian tribes served by the hospital when installing the boards. The boards must be comprised of representatives from the IHS, the hospital, primary Indian tribes served by the hospital, and experts in health care administration and delivery.

Hospitals may modify or terminate existing contracts so that they can enter into long-term contracts under the pilot program.

The IHS must report on the program results for each year of the pilot program.

(Sec. 102) The bill expands the IHS' hiring authority by allowing it to offer more benefits to recruit employees.

(Sec. 103) The bill allows the IHS to remove or demote an employee for performance or misconduct.

(Sec. 104) The IHS must: (1) establish standards to measure the timeliness of health care services in IHS facilities, and (2) develop a process for those facilities to report data to the IHS with respect to those standards.


(Sec. 201) The bill amends the Internal Revenue Code by excluding from gross income payments under the IHS loan repayment program.

(Sec. 202) The bill expands the repayment program by allowing loan repayment awards for: (1) health care management, health care administration, or hospital administration professions; and (2) individuals who work part time if they serve for at least four years.

(Sec. 203) The IHS must implement mandatory training programs for cultural competency for individuals who work at IHS facilities and whose employment requires regular direct patient access.

(Sec. 204) The IHS must offer relocation reimbursement to employees who relocate to serve in a different capacity or position if the position is: (1) in a rural area or medically underserved area and has not been filled by a full-time noncontractor for at least six months, or (2) for hospital management or administration.

(Sec. 205) The bill allows the IHS to waive the requirements of Indian preference laws for positions at an IHS facility if it has a vacancy rate of at least 20%. The IHS may also waive those laws in the case of an applicant who is a former IHS employee or formal tribal employee and who was removed from employment or demoted for misconduct in the last five years.

(Sec. 206) The IHS must centralize its credentials system for licensed health professionals who seek to volunteer at IHS facilities.


(Sec. 301) The bill establishes requirements for capping payments to certain non-IHS or non-tribal health care providers and suppliers.

(Sec. 302) The IHS must implement within three years a new revised distribution formula for the Purchased/Referred Care program, which was formerly referred to as the contract health services program.

(Sec. 303) The IHS must also implement a system to prioritize any backlog of unpaid balances under the program for each IHS area.

(Sec. 304) The Government Accountability Office must report on issues related to the financial stability of IHS' hospitals and facilities that have experienced sanction or threat of sanction by the Centers for Medicare & Medicaid Services.