facility managed, operated, or otherwise supported 
by the Service. 
‘‘(2) UPDATES.—With respect to any change of 
a status described in paragraph (1), the Secretary 
shall immediately provide to each entity described in 
paragraphs (1) through (3) of subsection (c) an up-
date describing such change. 
‘‘(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion may be construed— 
‘‘(1) to negatively impact the right of an Indian 
Tribe to enter into a compact or contract under the 
Indian Self-Determination and Education Assistance 
Act (25 U.S.C. 5304 et seq.); and 
‘‘(2) to apply to such a compact or contract un-
less expressly agreed to by the Indian Tribe.’’. 
TITLE III—REPORTS 
SEC. 301. DEFINITIONS. 
In this title: 
(1) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(2) SERVICE.—The term ‘‘Service’’ means the 
Indian Health Service. 
(3) SERVICE UNIT.—The term ‘‘Service unit’’ 
has the meaning given the term in section 4 of the 
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Indian Health Care Improvement Act (25 U.S.C. 
1603). 
SEC. 302. REPORTS BY THE SECRETARY OF HEALTH AND 
HUMAN SERVICES. 
(a) IHS PROFESSIONAL HOUSING PLAN.—Not later 
than 1 year after the date the Government Accountability 
Office releases their ongoing report about Indian Health 
Service housing needs, the Secretary shall develop, make 
publicly available, and submit to Congress and the Comp-
troller General of the United States a written plan to ad-
dress the professional housing needs of employees of the 
Service that comports with the practices and recommenda-
tions of the Government Accountability Office relating to 
professional housing. 
(b) PLAN RELATING TO IHS STAFFING NEEDS.— 
Not later than 1 year after the date the Government Ac-
countability Office releases their ongoing report about In-
dian Health Service housing needs, the Secretary shall de-
velop, make publicly available, and submit to Congress and 
the Comptroller General of the United States a written 
plan to address staffing needs in the Service that comports 
with the practices of the Government Accountability Office 
relating to workforce planning. 
(c) INDIAN HEALTH CARE IMPROVEMENT ACT RE-
PORT.—Not later than 1 year after the date of enactment 
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of this Act, and each year thereafter for a period of 5 
years, the Secretary shall develop, make publicly available, 
and submit to Congress a report on the data submitted 
under section 412(b) of the Indian Health Care Improve-
ment Act, as amended by section 107. 
(d) QUALITY OF CARE AND STAFFING REPORT.— 
Not later than 1 year after the date of enactment of this 
Act, and each year thereafter, the Secretary shall develop 
and submit to Congress a report on the data obtained 
under section 108, with an emphasis on quality of care 
and access to care. 
SEC. 303. REPORTS BY THE COMPTROLLER GENERAL. 
(a) IHS HOUSING NEEDS REPORT.— 
(1) IN GENERAL.—Not later than 5 years after 
the date on which the Comptroller General of the 
United States receives the professional housing plan 
under section 302(a), the Comptroller General shall 
develop and submit to Congress a report. 
(2) CONTENTS.—The report required under 
paragraph (1) shall include the following: 
(A) An evaluation of any existing, as of the 
date of the report, assessments and projections 
for the professional housing needs of employees 
of the Service, including discussion and conclu-
sion as to whether existing assessments and 
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projections accurately reflect the professional 
housing needs of employees of the Service. 
(B) An assessment of the professional 
housing needs of employees of the Service for 
each Service area (as defined in section 4 of the 
Indian Health Care Improvement Act (25 
U.S.C. 1603)). 
(C) An assessment of the professional 
housing plan developed by the Secretary under 
section 302(a). 
(b) IHS STAFFING NEEDS REPORT.— 
(1) IN GENERAL.—Not later than 5 years after 
the date on which the Comptroller General receives 
the report under section 302(b), the Comptroller 
General shall prepare and submit to Congress a re-
port on the staffing needs of the Service. 
(2) CONTENTS.—The report required under 
paragraph (1) shall include the following: 
(A) A description of the number and type 
of full-time positions needed at each facility of 
the Service and the amount of funds necessary 
to maintain such positions. 
(B) An explanation of the various meth-
odologies that the Service utilizes and has pre-
viously utilized to determine the number and 
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type of full-time positions needed at federally 
managed Service units. 
(C) An assessment of the use of inde-
pendent contractors, including the number of 
independent contractors hired to fill vacant full- 
time positions and amounts spent on inde-
pendent contractors who provide health care 
services. 
(D) An assessment of the staffing plan de-
veloped by the Secretary under section 302(b). 
(c) WHISTLEBLOWER PROTECTIONS REPORT.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, the Comptroller 
General shall develop and submit to Congress a re-
port on the efficacy of existing protections for whis-
tleblowers in the Service. 
(2) CONTENTS.—The report required under 
paragraph (1) shall include the following: 
(A) A discussion and conclusion as to 
whether the Service has taken proper steps to 
prevent retaliation against whistleblowers. 
(B) If applicable, any recommendations for 
changes to the policy of the Service with respect 
to whistleblowers. 
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(C) A discussion and conclusion as to 
whether the official email accounts of employees 
of the Service are appropriately monitored. 
SEC. 304. INSPECTOR GENERAL REPORTS. 
(a) PATIENT CARE REPORTS.— 
(1) IN GENERAL.—Not later than 2 years after 
the date of enactment of this Act, and not less than 
every 3 years thereafter, the Inspector General of 
the Department of Health and Human Services shall 
develop and submit to Congress and the Service a 
report on patient harm events occurring in Service 
units and deferrals and denials of care of patients of 
the Service. 
(2) CONTENTS.—The report required under 
paragraph (1) shall include the following: 
(A) An evaluation of the number and kind 
of events that contribute to patient deaths in a 
Service unit and recommendations regarding re-
ducing the number of patient deaths. 
(B) An evaluation of the Service’s tracking 
and reporting of, and response to, patient harm 
events and recommendations regarding how to 
improve such tracking, reporting, and response. 
(C) The effects of deferrals and denials of 
care on patients of the Service, including pa-
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tient outcomes, and recommendations regarding 
how to reduce deferrals and denials of care. 
(b) REPORTING SYSTEMS AUDIT.—Not later than 2 
years after the date of enactment of this Act, the Inspector 
General shall— 
(1) conduct an audit of reporting systems of the 
Service, as of the date of enactment of this Act; and 
(2) provide to the Service recommendations and 
technical assistance regarding implementation of im-
proved reporting systems, procedures, standards, 
and protocols. 
SEC. 305. TRANSPARENCY IN CMS SURVEYS. 
Section 1880 of the Social Security Act (42 U.S.C. 
1395qq) is amended by adding at the end the following: 
‘‘(g)(1) Not less frequently than once every 2 years, 
the Administrator of the Centers for Medicare & Medicaid 
Services shall conduct surveys of participating Indian 
Health Service facilities to assess the compliance of each 
hospital or skilled nursing facility of the Indian Health 
Service with— 
‘‘(A) section 1867; and 
‘‘(B) conditions of participation in the program 
under this title. 
‘‘(2) Each survey completed under this subsection 
shall be posted on the Internet website of the Centers for 
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Medicare & Medicaid Services. Such posting shall comply 
with the Federal regulations concerning the privacy of in-
dividually identifiable health information promulgated 
under section 264(c) of the Health Insurance Portability 
and Accountability Act of 1996.’’. 
TITLE IV—TECHNICAL 
AMENDMENTS 
SEC. 401. TECHNICAL AMENDMENTS. 
The Indian Health Care Improvement Act (25 U.S.C. 
1601 et seq.) is amended— 
(1) by striking ‘‘contract health service’’ each 
place such term appears (regardless of casing and 
typeface and including in the headings) and insert-
ing ‘‘purchased/referred care’’ (with appropriate cas-
ing and typeface); and 
(2) by striking ‘‘contract health services’’ each 
place such term appears (regardless of casing and 
typeface and including in the headings) and insert-
ing ‘‘purchased/referred care’’ (with appropriate cas-
ing and typeface). 
Æ 
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