Audit of the Indian Health Services Internal Controls Over Monitoring of Recipients Compliance With Requirements of the Loan Repayment Program

摘要

The Indian Health Service (IHS), an agency in the U.S. Department of Health & Human Services, delivers clinical and preventive health services to American Indians and Alaska Natives. IHS provides care in more than 700 health care facilities, including hospitals and outpatient clinics. An IHS facility can be operated by IHS, an Indian tribe, or a tribal organization. Section 108 of the Indian Health Care Improvement Act (IHCIA) of 1976 (P.L. No. 94-437), as amended, requires IHS to administer the Loan Repayment Program. The purpose of the Loan Repayment Program is to ensure an adequate supply of trained health professionals to provide health care services to American Indians and Alaska Natives through Indian health programs. Under the program, IHS is authorized to pay directly to the recipient of a loan repayment award the principal, interest, and related expenses on government and commercial loans obtained for an education in the health professions. IHS awarded to recipients $38.5 million for loan repayments during the Federal fiscal years ended September 30, 2007, and September 30, 2008. The Indian Health Manual states that IHS is responsible for ensuring that recipients properly complete their applications for loan repayment funds. IHS Loan Repayment Program Procedures instruct IHS staff to verify that each application has documentation indicating that the recipient is employed at an IHS-approved site.