of the employee. A Federal employee found to have 
interfered with or denied the right of another Fed-
eral employee under such section shall be subject to 
an adverse action described in paragraphs (1) 
through (5) of section 7512 of title 5, United States 
Code, including a suspension for more than 14 days 
without pay.’’. 
(3) SUBMISSION.—Not later than 30 days after 
the date of enactment of this Act, the Secretary 
shall submit the memorandum described in para-
graph (1) to the Inspector General of the Depart-
ment of Health and Human Services (referred to in 
this subsection as the ‘‘Inspector General’’) for ap-
proval. 
(4) APPROVAL
OR
DISAPPROVAL.—Not later 
than 30 days after the submission of the memo-
randum under paragraph (3), or a revised memo-
randum under paragraph (6), the Inspector General 
shall approve or disapprove the memorandum or re-
vised memorandum, as the case may be. 
(5) NOTICE.—In the case of an approval under 
paragraph (4), not later than 30 days after such ap-
proval, the Secretary shall— 
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(A) provide to each employee of the Indian 
Health Service an electronic copy of the ap-
proved memorandum; and 
(B) post such memorandum in a clear and 
conspicuous place on the website of the Indian 
Health Service for a period not less than 120 
days. 
(6) REVISED MEMORANDUM.—In the case of a 
disapproval under paragraph (4), not later than 15 
days after such disapproval, the Secretary shall sub-
mit a revised memorandum to the Inspector General 
for approval under paragraph (4). 
SEC. 203. FISCAL ACCOUNTABILITY. 
Title VI of the Indian Health Care Improvement Act 
(25 U.S.C. 1661 et seq.), as amended by sections 105, 
106, and 201, is further amended by adding at the end 
the following: 
‘‘SEC. 609. FISCAL ACCOUNTABILITY. 
‘‘(a) MANAGEMENT OF FUNDS.— 
‘‘(1) IN
GENERAL.—If the Secretary fails to 
submit the professional housing plan under section 
301(a) of the Restoring Accountability in the Indian 
Health Service Act of 2018 or the staffing plan 
under section 301(b) of that Act, the Secretary may 
not receive, obligate, transfer, or expend any 
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amounts for a salary increase or bonus of an indi-
vidual described in paragraph (2) until the profes-
sional housing plan or staffing plan, as the case may 
be, is submitted. 
‘‘(2) INDIVIDUAL
DESCRIBED.—An individual 
described in this paragraph is an individual em-
ployed in a position in the Service that is a posi-
tion— 
‘‘(A) 
described 
under 
sections 
5312 
through 5316 of title 5, United States Code; 
‘‘(B) placed in level IV or V of the Execu-
tive Schedule under section 5317 of title 5, 
United States Code; 
‘‘(C) as a limited term appointee, limited 
emergency appointee, or noncareer appointee in 
the Senior Executive Service, as defined under 
paragraphs (5), (6), and (7), respectively, of 
section 3132(a) of title 5, United States Code; 
or 
‘‘(D) under section 213.3301 or 213.3302 
of title 5, Code of Federal Regulations. 
‘‘(b) PRIORITIZATION OF PATIENT CARE.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of law, the Secretary shall use amounts 
available to the Indian Health Service that are not 
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obligated or expended, including base budget fund-
ing and third party collections, during the fiscal year 
for which the amounts are made available, and that 
remain available, only to support patient care by 
using such funds for the costs of— 
‘‘(A) essential medical equipment; 
‘‘(B) purchased or referred care; or 
‘‘(C) staffing. 
‘‘(2) SPECIAL RULE.—In using amounts under 
paragraph (1), the Secretary shall ensure that, in 
any case where the amounts were originally made 
available for a particular Service unit, such amounts 
are used to benefit Indians served by that Service 
unit. 
‘‘(3) RESTRICTIONS.—The Secretary may not 
use amounts described in paragraph (1)— 
‘‘(A) to remodel or interior decorate any 
Area office; or 
‘‘(B) to increase the rate of pay of any em-
ployee of an Area office. 
‘‘(c) SPENDING REPORTS.—Not later than 90 days 
after the end of each quarter of a fiscal year, the Secretary 
shall submit a report describing the authorizations, ex-
penditures, outlays, transfers, reprogramming, and obliga-
tions of each level of the Service, including the head-
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quarters, each Area office, each Service unit, and each 
health clinic or facility, to— 
‘‘(1) each Indian Tribe; 
‘‘(2) in the Senate— 
‘‘(A) the Committee on Indian Affairs; 
‘‘(B) the Committee on Health, Education, 
Labor, and Pensions; 
‘‘(C) the Committee on Appropriations; 
and 
‘‘(D) the Committee on the Budget; and 
‘‘(3) in the House of Representatives— 
‘‘(A) the Committee on Natural Resources; 
‘‘(B) the Committee on Energy and Com-
merce; 
‘‘(C) the Committee on Appropriations; 
and 
‘‘(D) the Committee on the Budget. 
‘‘(d) STATUS REPORTS.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
not later than 180 days after the end of each fiscal 
year, the Secretary shall provide to each entity de-
scribed in paragraphs (1) through (3) of subsection 
(c) a report describing the safety, billing, certifi-
cation, credential, and compliance statuses of each 
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