Purchased and Referred Care Improvement Act of 2025

Purchased and Referred Care Improvement Act of 2025

This 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.