# Plain Language Summary: Purchased and Referred Care Improvement Act of 2025

When Native Americans need medical care that isn't available at their local Indian Health Service facility, the government arranges for them to get treatment at outside hospitals or clinics—this is called "purchased/referred care." The problem this bill addresses is that sometimes patients end up getting bills for these services and are held responsible for paying them, even though the government was supposed to cover the costs. This bill makes it clear that Native American patients cannot be held liable for these bills, and it prevents debt collectors from coming after them for payment.

The bill strengthens protections by stating that no contract, form, or agreement a patient signs can override this protection—patients simply cannot be forced to pay for authorized purchased/referred care services. It also applies this protection to debt collectors and any other third parties trying to collect payment. Additionally, the bill requires the Indian Health Service to set up a system where if a patient does end up paying out-of-pocket for an authorized service, they can get reimbursed within 30 days of submitting documentation. Patients can submit their paperwork either electronically or in person at a health facility, making the process more accessible.

The bill also updates the official terminology throughout Indian health law, replacing the older term "contract health service" with "purchased/referred care" to be more consistent and clear. The Secretary of Health and Human Services has 180 days to update all the relevant manuals, contracts, and administrative documents to reflect these changes. Importantly, if an Indian Tribe is running its own purchased/referred care program under a self-determination contract, these new rules don't automatically apply to them unless the Tribe agrees to adopt them—respecting tribal sovereignty and self-governance.

Purchased and Referred Care Improvement Act of 2025

Johnson, Dusty

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.&nbsp;Additionally, the bill requires HHS to&nbsp;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.