The "Purchased and Referred Care Improvement Act of 2025" ensures patients are not liable for payment of purchased/referred care, mandates reimbursements for out-of-pocket expenses, and updates terminology in the Indian Health Care Improvement Act.
Mike Rounds
Senator
SD
The Purchased and Referred Care Improvement Act of 2025 amends the Indian Health Care Improvement Act to ensure that Native American patients are not liable for payment for authorized purchased/referred care, regardless of any prior agreements. It mandates the Secretary to notify providers and patients about non-liability, establish reimbursement procedures for patients who paid out-of-pocket, and update relevant manuals and contracts to reflect these changes. The Act also updates terminology within the Indian Health Care Improvement Act, replacing "contract health service(s)" with "purchased/referred care" to modernize and clarify the language used. These amendments apply retroactively, covering care authorized both before and after the Act's enactment.
New Bill Shields Native Americans from Medical Bills for Referred Care: Reimbursements for Out-of-Pocket Costs Guaranteed
The "Purchased and Referred Care Improvement Act of 2025" is all about fixing a major headache for Native Americans getting healthcare through the Indian Health Service (IHS). Basically, it ensures that if the IHS refers you to an outside doctor or hospital, you're not on the hook for the bill – even if you signed something saying you might be.
No More Surprise Bills
The core of this bill is simple: If the IHS sends you to a specialist or facility outside their system (that's "purchased/referred care"), you won't be liable for the payment. The bill, in Section 2, explicitly states that patients are not responsible for these costs, regardless of any prior agreements. Think of it like this: if your car breaks down and your mechanic sends it to a specialist, you shouldn't get a surprise bill from both of them.
Getting Your Money Back
If you have paid out-of-pocket for authorized referred care, this bill has your back. The Secretary of Health and Human Services has to set up a system to reimburse you within 30 days of getting your paperwork (Section 2). And you can submit that paperwork electronically or in person – no more mailing forms and hoping for the best. For example, if a tribal member in a rural area had to travel for a specialist appointment and paid upfront, they can now get that money back quickly and easily.
Streamlining the System
Beyond the immediate financial impact, the bill also cleans up a lot of outdated language in the Indian Health Care Improvement Act. It replaces "contract health service(s)" with "purchased/referred care" throughout the law (Section 3). This might seem like a minor detail, but it helps modernize the system and makes things clearer for everyone involved. The Secretary has 180 days to update the Indian Health Manual and related contracts to reflect these changes, making the process more efficient and transparent (Sec. 2).
Real-World Impact
This change affects care authorized by the IHS before, on, or after this bill becomes law (Section 2). That's a big deal for anyone who's been stuck with past bills. It means less financial stress for families, and potentially better access to needed healthcare. While the bill does exclude some care under tribal contracts (unless the tribe agrees), the overall impact is a significant step towards fixing a broken system. It's about making sure that when the IHS says they'll cover your care, they actually cover it.