H.R. 1418: Purchased and Referred Care Improvement Act of 2025

This bill, titled the Purchased and Referred Care Improvement Act of 2025, proposes several changes to the existing Indian Health Care Improvement Act to clarify and modify how payment liabilities are handled for purchased or referred care services. Below are the main components of the bill:

Changes to Payment Liability

The bill seeks to amend Section 222 of the Indian Health Care Improvement Act, specifically regarding who is liable for payment of purchased/referred care services. Key modifications include:

• The language from "A patient" to a broader phrase that includes the situation of a patient notwithstanding any agreements, forms, or documents. This change emphasizes the patient's rights and obligations under the law.
• Replacing the term "contract health care" with "purchased/referred care" to provide clarity and consistency in terminology.
• Removing liability for payment from providers, debt collectors, or other persons in specific circumstances, reinforcing protections for individuals receiving care.

Reimbursement Procedures

The bill introduces procedures for patients who have paid out-of-pocket for authorized purchased/referred care. These procedures include:

• Establishment of a reimbursement process where patients can receive compensation for out-of-pocket costs within 30 days of submitting necessary documentation.
• Allowing documentation for reimbursement to be submitted electronically or in-person at service facilities.
• Clarifying that the reimbursement provisions do not apply to services provided under tribal compacts or contracts unless specifically agreed to by the tribe.

Update of Authorities

The Secretary of Health and Human Services is tasked with updating relevant guidelines and administrative documents to incorporate the changes made by this bill within a specified time frame (180 days after enactment). This includes:

• Revising the Indian Health Manual and other communication to reflect the terminology changes from "contract health service" to "purchased/referred care."
• Adjusting any contracts or agreements with providers to align with the new definitions and requirements.

Applicability

The amendments made by the bill are applicable to purchased/referred care services authorized and provided by the Indian Health Service, regardless of whether they were rendered before or after the enactment of this legislation.

Technical Amendments

Overall adjustments to definitions within the Indian Health Care Improvement Act aim for clearer communication regarding purchased and referred care. This includes:

• Revising the definition of "purchased/referred care" to ensure it reflects the current context.
• Updating all relevant guidance, manuals, and documents accordingly.

Relevant Companies

None found.