The first section of the bill gives it a short title, allowing it to be referred to as the “Restoring Accountability in the Indian Health Service Act of 2024”.

The section provides an outline of the contents of the Act, which includes various titles such as improving the Indian Health Service, protections for employees, reporting requirements, and technical amendments. Each title contains specific provisions, for example, recruitment incentives, employee rights, and ensuring quality health care services.

The section adds incentives for recruiting and retaining healthcare professionals in the Indian Health Service by establishing a pay system comparable to that of similar federal healthcare roles and offering housing vouchers to critical employees working in under-staffed areas. The voucher program is intended to last three years, after which the Secretary must report its costs, employee participation, and impact on staffing needs.

The section discusses new measures to improve hiring and retention of healthcare workers in the Indian Health Service. It includes setting up a competitive pay system similar to other federal healthcare systems, providing temporary rental assistance to employees who work in areas with staff shortages, and requires full- or part-time employees to commit to working for a minimum period to receive these benefits.

The section establishes a new centralized medical credentialing system for health professionals in the Indian Health Service. It sets guidelines for implementation, consultation with Indian tribes, and exemptions for professionals already credentialed, while ensuring nondisruption of tribal rights in existing agreements.

The section outlines the creation of a centralized credentialing system by the Indian Health Service within one year to standardize the process for credentialing licensed health professionals across Service units. It mandates consultation with Indian tribes and other entities, exempts those already credentialed under previous policies until re-credentialing is needed, and requires a review of the system every five years to ensure compliance.

The section outlines that health professional volunteers at Indian Health Service units are to be treated as employees of the Public Health Service for liability protection purposes, under certain conditions such as not receiving compensation for their services. It explains the applicability of certain legal provisions, funding mechanisms, and the definition of a "Service unit," while ensuring it does not affect the rights of Indian tribes under existing laws.

The section updates the eligibility criteria for the Indian Health Service loan repayment program by specifying qualifications for health professionals and administrators. It also outlines details about the required service period and the payment amounts for fulfilling service obligations, allowing for up to $35,000 annually for full-time service or $17,500 for half-time service in designated health programs.

The section discusses improvements in hiring practices within the Indian Health Service by allowing the Secretary to directly appoint candidates and notifying local Indian tribes about certain hires. It also details conditions under which waivers of Indian preference laws can be requested and granted, particularly when there are staffing shortages or specific personnel issues.

The section allows the Secretary to hire candidates directly for certain positions without following standard federal hiring procedures, as long as the candidates meet the qualifications set by the Office of Personnel Management. Additionally, the Secretary must inform local Indian tribes about certain employment decisions and give them 10 days to provide comments.

The bill enhances the authority of the Secretary of Health and Human Services to hold senior executives and employees of the Indian Health Service accountable for misconduct or poor performance. It outlines clear definitions, procedures, and rights for reprimanding, suspending, demoting, or removing employees, as well as provides an internal grievance process and rules for judicial reviews.

The section gives the Secretary of the Indian Health Service authority to take disciplinary actions like reprimanding, suspending, or removing senior executives for misconduct or poor performance. It outlines the rights of the executives, timelines for decisions, grievance process, and options for judicial review, making sure any decision is fair, follows proper procedures, and is supported by evidence.

The section gives the Secretary of the Indian Health Service more power to hold employees accountable by allowing them to remove, demote, or suspend employees for poor performance or misconduct. It outlines the processes for taking such actions, the rights of employees during these procedures, the possible appeals, and conditions related to pay and benefits during appeals.

The amendment to Section 113 of the Indian Health Care Improvement Act requires that an annual mandatory training program be established for employees and providers at Service hospitals. This includes making it a condition of employment for employees and contractors to complete the training, starting from the enactment of the Restoring Accountability in the Indian Health Service Act of 2024.

The bill creates a demonstration program where the Indian Health Service (IHS) can provide extra staffing to certain health facilities that are self-funded by tribes, aiming for these resources to become self-sustaining. The program will last for four years, and a report evaluating its impact on staffing needs and potential for permanent implementation will be submitted afterward.

The bill establishes a demonstration program through the Indian Health Service to provide additional staffing resources to certain Service units, aiming to make these resources self-sustaining. The program will last for four years, after which a report will evaluate whether the staffing resources increased revenue and reduced unmet staffing needs, considering the potential for a permanent program deployment.

The section amends the Indian Health Care Improvement Act by adding a requirement for the Secretary to establish and update a Tribal consultation policy for engaging with Indian tribes in relation to health services. This policy must replace the existing policy, determine when and how tribes will be notified about consultations, specify what triggers such consultations, and define what meaningful consultation entails.

The section requires the Secretary to establish a Tribal consultation policy by December 31, 2023, and update it every five years, ensuring meaningful consultation with affected Indian tribes. The policy should include how the Service will notify tribes about consultations, identify which agency actions require consultation, and define what constitutes meaningful consultation.

The section explains that the rule applied to hospitals operated by the Indian Health Services (IHS) or a Tribe allows these hospitals to receive a specific payment adjustment for low-volume operations. This rule or adjustment has been applicable since the fiscal year 2011 and continues for each year after.

The section outlines efforts to improve care quality in the Indian Health Service by establishing best practices for governing boards and area offices, reviewing quality measures, and creating a compliance assistance program for underperforming facilities. It also involves collaboration with various stakeholders, setting reporting requirements, and implementing a termination period for the program.

The new section added to the Indian Health Care Improvement Act requires that if the Service starts an investigation into a licensed professional's conduct, they must inform the relevant State medical board within 14 days. Additionally, any records related to the investigation must also be submitted to the State medical board within the same timeframe.

The section requires that when a federal service begins investigating the professional behavior of a state license holder, the Secretary must inform the state's medical board within 14 days. Additionally, any records produced from this investigation must also be sent to the state's medical board within the same time frame.

The bill requires the Indian Health Service to check with state medical boards about any past violations or settlements involving health care providers before hiring them. It also mandates that detailed information about any violations by current providers be shared with relevant state medical boards. Additionally, the Indian Health Service must report on its process of reviewing providers who leave or transfer within the system to ensure there are no unresolved issues.

The section mandates that for hiring new health care providers, the Director of the Service must obtain details from state medical boards about any violations or disciplinary settlements regarding the provider's medical license over the past 20 years. Additionally, the Director must send detailed information about any license violations by current providers to the respective state medical boards, even if the boards haven't asked for it.

The bill amends the Indian Health Care Improvement Act to require the Secretary to set up regulations for measuring how quickly health care services are provided at Service facilities. It also mandates that each area's office report these metrics annually, which will be made publicly available online.

The section requires the Secretary to create standards to measure how quickly health care services are provided at Service facilities and collect data on these standards. It also mandates that each Area office submits an annual report on these metrics, which will then be published online.

The section outlines protections for whistleblowers within the Indian Health Service, defining key terms like "whistleblower" and "retaliation," and establishing an official to handle reports of retaliation. It empowers the Secretary to remove employees who retaliate against whistleblowers and mandates actions to enhance whistleblower protection.

The section outlines rules to protect employees, called whistleblowers, who report illegal or dangerous actions. It explains what counts as retaliation and requires officials to investigate and act within a few days if a report is made. It also allows for the removal of employees found guilty of retaliation and requires measures to strengthen whistleblower protections.

The section amends the law to clarify that federal employees have the right to contact Congress without needing prior approval, and specifies consequences for those who violate this right. It also outlines a process for ensuring all employees of the Indian Health Service are informed electronically about these rights, including creating a memorandum that needs approval from the Inspector General and ensuring it is accessible to employees.

The new section added to the Indian Health Care Improvement Act outlines rules for fiscal accountability in the Indian Health Service. It prevents salary increases for certain individuals until required plans are submitted, prioritizes patient care funding, restricts the use of funds for remodeling and pay increases, and mandates spending and status reports for better transparency.

The section outlines that if the Secretary of the Indian Health Service does not submit required plans on time, they cannot receive certain financial benefits. It also mandates that unused funds be prioritized for patient care, restricts their use for office upgrades, and requires annual reports on services' financial and operational statuses, without affecting tribal rights to self-management contracts.

The section defines several terms related to health services: "Secretary" refers to the Secretary of Health and Human Services, "Service" refers to the Indian Health Service, "Service unit" and "tribal health program" have the meanings given in the Indian Health Care Improvement Act.

The Secretary of Health and Human Services must create and share plans addressing housing and staffing needs for the Indian Health Service (IHS) and tribal health programs. These plans will follow recommendations from the Government Accountability Office and include projections for 1, 5, and 10-year periods.

The section requires the Comptroller General to submit three reports to Congress: one on the housing needs of Indian Health Service (IHS) employees, another on IHS staffing needs, and a third on whistleblower protections within the IHS. Each report must assess plans, discuss needs, and potentially offer recommendations, focusing on accurate reflection of needs, staffing methodologies, and the efficacy of protections against retaliation.

The bill requires the Inspector General of the Department of Health and Human Services to create and submit a report to Congress every three years on patient harm and deaths in Service units, the denial and deferral of care, and the quality and timeliness of care standards. The report should evaluate and recommend ways to reduce patient deaths and improve tracking systems. Additionally, an audit of current reporting systems is to be carried out, along with recommendations and technical assistance for improvements.

The section amends the Social Security Act to require the Centers for Medicare & Medicaid Services to conduct surveys at least every two years of Indian Health Service hospitals and nursing facilities to ensure they follow certain regulations. Survey results must be posted online, adhering to privacy rules set by the Health Insurance Portability and Accountability Act.

The section updates the Indian Health Care Improvement Act by defining the term "purchased/referred care" and replacing the term "contract health service" with "purchased/referred care" throughout the document to ensure consistency. It also rearranges and renumbers some definitions for clarity.