Purchased and Referred Care Improvement Act of 2025
Purchased and Referred Care Improvement Act of 2025
Plain Language Summary
# Purchased and Referred Care Improvement Act of 2025 Summary **What the Bill Does** This bill would require the Indian Health Service (IHS) to reimburse American Indian and Alaska Native patients for out-of-pocket medical expenses within 30 days. When the IHS cannot provide certain services directly, it authorizes patients to seek care from private providers. If patients pay for these authorized services upfront, the IHS would be required to reimburse them quickly—specifically within 30 days of receiving the patient's documentation.
The bill also directs the Department of Health and Human Services to update its policies and contracts to implement this faster reimbursement process. **Who It Affects** This bill primarily affects American Indian and Alaska Native patients who receive healthcare through the IHS system and have to pay out-of-pocket for referred care services that the IHS approves but doesn't provide directly. It would also impact IHS administrators and private healthcare providers who work with the IHS. **Current Status** The bill was introduced in the 119th Congress by Representative Dusty Johnson (R-South Dakota) and is currently in committee, meaning it has not yet been debated or voted on by the full House of Representatives.
CRS Official Summary
Purchased and Referred Care Improvement Act of 2025This 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.
Latest Action
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.