Purchased and Referred Care Improvement Act of 2025
Senate Bill Would Shield Native Patients From Bills for Indian Health Service Referrals
Legislative Progress
Key Points
- Sends a clear message that patients are not responsible for unpaid bills tied to Indian Health Service-approved outside care, even if they signed forms.
- Requires the Health and Human Services Secretary to notify the outside provider and the patient within 5 business days that the patient can’t be billed for those costs.
- Creates a process for patients to get paid back when they already covered an approved referral out of pocket; the goal is reimbursement within 30 days after paperwork is submitted.
- Gives the agency 120 days to set up reimbursement procedures and 180 days to update manuals, provider contracts, and other paperwork to match the new rules.
- Applies these protections to Indian Health Service-authorized outside care provided on, before, or after the law takes effect, with limits for some tribal-run programs unless the tribe agrees.
Impact Analysis
Personal Impact
Life & Work
This bill directly protects Native Americans and Alaska Natives who receive medical care through the Indian Health Service's purchased/referred care program. When IHS sends a patient to an outside doctor or hospital, the patient would no longer be on the hook for any of those charges — even if they signed paperwork saying they'd pay. Patients who already paid out of pocket for IHS-approved outside care could also get reimbursed within 30 days of submitting their receipts. This is a meaningful protection against surprise medical debt for tribal members who rely on IHS referrals for specialty care not available at their local IHS facility.
Disabilities
State Impacts
Milestones
Committee on Indian Affairs. Hearings held.
Read twice and referred to the Committee on Indian Affairs.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in Senate
The bill was officially filed and given a number. It now enters the legislative queue.
Votes
No votes have been recorded for this legislation yet.
Related News
3 articles
Senate Committee on Indian Affairs hosts hearing for tribal health bills
The Senate Committee on Indian Affairs held a hearing on S. 699, the Purchased and Referred Care Improvement Act of 2025. The bill requires the IHS to reimburse tribal patients for care sought outside of IHS in a timely manner and clarifies that patients are not liable for authorized care costs.
BGOV Bill Analysis: H.R. 1418, Indian Health Service Payments
Analysis of H.R. 1418, which prohibits health-care providers and debt collectors from billing patients for care authorized by the IHS. It requires IHS to reimburse patients for out-of-pocket costs for authorized care and strengthens existing laws to prevent wrongful medical debt.
Patients Suffer When Indian Health Service Doesn't Pay for Outside Care
Investigation into the systemic failures of the IHS Purchased/Referred Care program. While the agency is supposed to cover outside referrals, administrative fumbles and funding shortages leave thousands of Native Americans with daunting medical bills or without necessary treatment.
Source Information
Document Type
Congressional Bill
Official Title
Purchased and Referred Care Improvement Act of 2025
Data Sources
Sponsor
Cosponsors
(4)Analysis generated by AI. Always verify with official sources.