This bill makes important changes to how Native Americans are protected when they receive medical care outside of Indian Health Service facilities. When the Indian Health Service refers a patient to an outside doctor or hospital for care they can't get at their own facility, that patient is now protected from being billed or sued for those costs. The federal government, not the patient, is responsible for paying those bills.

The bill also creates a new process for patients who already paid out of their own pocket for referred care. If they can show documentation of what they paid, the Indian Health Service must reimburse them within 30 days. Patients can submit this documentation either online or in person at a health facility. The only exception is for tribes that run their own health programs under special agreements—those tribes can choose whether to follow this reimbursement rule.

To make all this work, the bill gives the federal government 120 days to set up the reimbursement system and 180 days to update all the manuals, contracts, and policies that govern Indian health care. The bill also updates the official definition of what counts as 'referred care' and changes the terminology throughout Indian health law from 'contract health services' to 'purchased/referred care' to better reflect what's actually happening. This applies to all referred care, whether it was authorized before, on, or after this bill becomes law.