Purchased and Referred Care Improvement Act of 2025
This bill specifies that the Indian Health Service (IHS) must reimburse patients for their out-of-pocket costs for authorized purchased/referred care services within 30 days. (The IHS provides medical and dental services directly to American Indian and Alaska Native patients whenever possible. However, when services are not available, IHS beneficiaries may be referred to private providers. This is called purchased/referred care.)
Specifically, the bill requires the Department of Health and Human Services (HHS) to establish and implement procedures to allow a patient who paid out of pocket for purchased/referred care services authorized by the IHS to be reimbursed by the IHS for that payment no later than 30 days after the patient submits required documentation.
Additionally, the bill requires HHS to update applicable provisions of and exhibits to the Indian Health Manual, contracts with providers, and other relevant documents and administrative authorities to incorporate the provisions of the bill.
The bill also replaces statutory references to contract health service with purchased/referred care.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1418 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 1418
To amend the Indian Health Care Improvement Act to address liability
for payment of charges or costs associated with provision of purchased/
referred care services, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 18, 2025
Mr. Johnson of South Dakota (for himself and Ms. Schrier) introduced
the following bill; which was referred to the Committee on Natural
Resources, and in addition to the Committee on Energy and Commerce, for
a period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To amend the Indian Health Care Improvement Act to address liability
for payment of charges or costs associated with provision of purchased/
referred care services, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Purchased and Referred Care
Improvement Act of 2025''.
SEC. 2. CHANGES TO LIABILITY FOR PAYMENT.
(a) In General.--Section 222 of the Indian Health Care Improvement
Act (25 U.S.C. 1621u) is amended--
(1) in subsection (a)--
(A) by striking ``A patient'' and inserting
``Notwithstanding any other provision of law or any
agreement, form, or other written or electronic
document signed by a patient, a patient''; and
(B) by striking ``contract health care'' and
inserting ``purchased/referred care'';
(2) in subsection (b)--
(A) by striking ``contract care'' each place it
appears and inserting ``purchased/referred care'';
(B) by striking ``contract health care'' and
inserting ``purchased/referred care'';
(C) by inserting ``, notwithstanding any other
provision of law or any agreement, form, or other
written or electronic document signed by a patient,''
after ``by the Service that''; and
(D) by inserting ``to any provider, debt collector,
or any other person'' after ``is not liable'';
(3) in subsection (c), by inserting ``, the debt collector,
or any other person, as applicable'' after ``the provider'';
and
(4) by adding at the end the following:
``(d) Reimbursement.--
``(1) In general.--Not later than 120 days after the date
of the enactment of this subsection and in consultation with
Indian Tribes, the Secretary shall establish and implement
procedures to allow a patient that paid out-of-pocket for
purchased/referred care services authorized by the Service
under this Act to be reimbursed by the Service for that payment
not later than 30 days after the patient submits documentation
to the Service pursuant to paragraph (2).
``(2) Submitting documentation.--The Secretary shall accept
documentation from a patient seeking reimbursement under
paragraph (1) that was submitted--
``(A) electronically; or
``(B) in-person at a Service facility.
``(3) Effect.--The preceding provisions of this subsection
shall not apply to purchased/referred care service furnished
under a purchased/referred care services program operated by an
Indian Tribe under an Indian Self-Determination and Education
Assistance Act (25 U.S.C. 5301 et seq.) compact or contract
unless expressly agreed to by the Indian Tribe.
``(e) Updating Authorities.--Not later than 180 days of the
enactment of this subsection and in consultation with Indian Tribes,
the Secretary shall update applicable provisions of and exhibits to the
Indian Health Manual, contracts with providers, and other relevant
documents and administrative authorities to incorporate the provisions
of this section.''.
(b) Application.--The amendments made by this section shall apply
to purchased/referred care services authorized by the Indian Health
Service furnished on, before, or after the date of the enactment of
this Act.
SEC. 3. TECHNICAL AMENDMENTS.
(a) Definitions.--Section 4(5) of the Indian Health Care
Improvement Act (25 U.S.C. 1603) is amended by striking the paragraph
designation and heading and all that follows through ``means'' and
inserting the following:
``(5) Purchased/referred care.--The term `purchased/
referred care' means''.
(b) Technical Amendments.--The Indian Health Care Improvement Act
(25 U.S.C. 1601 et seq.) is amended by striking ``contract health
service'' each place it appears (regardless of casing and typeface and
including in the headings) and inserting ``purchased/referred care''
(with appropriate casing and typeface).
(c) Updating Authorities.--The Secretary of Health and Human
Services is directed to ensure that the Indian Health Manual and all
other relevant rules, guidance, manuals, and other materials are
revised such that ``contract health service'', each place it appears
(regardless of casing and typeface and including in the headings) is
revised to read ``purchased/referred care'' (with appropriate casing
and typeface).
<all>
Introduced in House
Introduced in House
Referred to the Committee on Natural Resources, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Natural Resources, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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