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<bill bill-stage="Introduced-in-House" dms-id="H03B3021F71F24200824BFC26A3F0BD8E" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>119 HR 1418 IH: Purchased and Referred Care Improvement Act of 2025</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2025-02-18</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 1418</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20250218">February 18, 2025</action-date><action-desc><sponsor name-id="J000301">Mr. Johnson of South Dakota</sponsor> (for himself and <cosponsor name-id="S001216">Ms. Schrier</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HII00">Committee on Natural Resources</committee-name>, and in addition to the Committee on <committee-name committee-id="HIF00">Energy and Commerce</committee-name>, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend the Indian Health Care Improvement Act to address liability for payment of charges or costs associated with provision of purchased/referred care services, and for other purposes.</official-title></form><legis-body id="H6C8237E4CADD4CC5804DE38F1971A798" style="OLC"> 
<section id="H3187F57EFB774FBFB957487F98F11393" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Purchased and Referred Care Improvement Act of 2025</short-title></quote>.</text></section> <section id="H0BF27D4BED714AFAAC7F9CA7AA753FD0" section-type="subsequent-section"><enum>2.</enum><header>Changes to liability for payment</header> <subsection id="HB276C7BC638C46E5ABB00BCC1276F385"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 222 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1621u">25 U.S.C. 1621u</external-xref>) is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="HEFFC37658AA740078AEF151E4AC52A5B"><enum>(1)</enum><text>in subsection (a)—</text> <subparagraph commented="no" display-inline="no-display-inline" id="HD34101BE8C0048D4A5616C62D409BF9C"><enum>(A)</enum><text>by striking <quote>A patient</quote> and inserting <quote>Notwithstanding any other provision of law or any agreement, form, or other written or electronic document signed by a patient, a patient</quote>; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H6CEC7CF20D99433786D9DCF0691DE862"><enum>(B)</enum><text>by striking <quote>contract health care</quote> and inserting <quote>purchased/referred care</quote>;</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HF989A152A18446B097182319E860E226"><enum>(2)</enum><text>in subsection (b)—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HA8EDF748DF864FA7BC54CFBCE8F26B8D"><enum>(A)</enum><text>by striking <quote>contract care</quote> each place it appears and inserting <quote>purchased/referred care</quote>; </text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HC4D7269C5BC449A6BEE571195C7B3023"><enum>(B)</enum><text>by striking <quote>contract health care</quote> and inserting <quote>purchased/referred care</quote>;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H5941F7F75C7840249982E7B6BD33339F"><enum>(C)</enum><text>by inserting <quote>, notwithstanding any other provision of law or any agreement, form, or other written or electronic document signed by a patient,</quote> after <quote>by the Service that</quote>; and</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HC020D4D1DB8F48BEB861369DE3E57253"><enum>(D)</enum><text>by inserting <quote>to any provider, debt collector, or any other person</quote> after <quote>is not liable</quote>;</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H5EAC2EF2D1124C32973E4E17131A1A80"><enum>(3)</enum><text>in subsection (c), by inserting <quote>, the debt collector, or any other person, as applicable</quote> after <quote>the provider</quote>; and</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H582A630246A347FA834DFBBB58D9514C"><enum>(4)</enum><text>by adding at the end the following:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HD498030487C84C28BF06A5F47A7C19EC">
<subsection id="H3145768B75A04391B311AA2E442BE6EA"><enum>(d)</enum><header>Reimbursement</header>
<paragraph commented="no" display-inline="no-display-inline" id="H31D31FA6F5B340D4B9DF6C3AADE25A80"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Not later than 120 days after the date of the enactment of this subsection and in consultation with Indian Tribes, the Secretary shall establish and implement procedures to allow a patient that paid out-of-pocket for purchased/referred care services authorized by the Service under this Act to be reimbursed by the Service for that payment not later than 30 days after the patient submits documentation to the Service pursuant to paragraph (2).</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HF9331F57D0FB41D9B0C827F461CFBF65"><enum>(2)</enum><header>Submitting documentation</header><text>The Secretary shall accept documentation from a patient seeking reimbursement under paragraph (1) that was submitted—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HFD5709C6542C4713A82925C734217CEC"><enum>(A)</enum><text display-inline="yes-display-inline">electronically; or </text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H66FA8B0394834D96AAC3AB2F06C51DA5"><enum>(B)</enum><text display-inline="yes-display-inline">in-person at a Service facility.</text></subparagraph></paragraph>
<paragraph id="H071A33038D1A4465915104240C5E7234"><enum>(3)</enum><header>Effect</header><text>The preceding provisions of this subsection shall not apply to purchased/referred care service furnished under a purchased/referred care services program operated by an Indian Tribe under an Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5301">25 U.S.C. 5301 et seq.</external-xref>) compact or contract unless expressly agreed to by the Indian Tribe.</text></paragraph></subsection> <subsection id="HFD282E15D81E42B5BE0EE0D755341D71"><enum>(e)</enum><header>Updating authorities</header><text>Not later than 180 days of the enactment of this subsection and in consultation with Indian Tribes, the Secretary shall 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 this section.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H87B539F0918D4F8199BBB58E6E51B664"><enum>(b)</enum><header>Application</header><text display-inline="yes-display-inline">The amendments made by this section shall apply to purchased/referred care services authorized by the Indian Health Service furnished on, before, or after the date of the enactment of this Act.</text></subsection></section> <section id="HEE242F6D67CD4CB3869C469CB21BD133"><enum>3.</enum><header>Technical amendments</header> <subsection id="H845AE2AD29254F0A9C15876EA73137C5"><enum>(a)</enum><header>Definitions</header><text>Section 4(5) of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>) is amended by striking the paragraph designation and heading and all that follows through <quote>means</quote> and inserting the following:</text>
<quoted-block id="H55955AD3EE7646CFBAF9B32271206480" style="OLC">
<paragraph id="HAC936AA9C8174C4187895B26899CDC28"><enum>(5)</enum><header>Purchased/referred care</header><text>The term <quote>purchased/referred care</quote> means</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H2CD8CB14DC37405E8A973A0A0FC87B72"><enum>(b)</enum><header>Technical amendments</header><text>The Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1601">25 U.S.C. 1601 et seq.</external-xref>) is amended by striking <quote>contract health service</quote> each place it appears (regardless of casing and typeface and including in the headings) and inserting <quote>purchased/referred care</quote> (with appropriate casing and typeface).</text></subsection>
<subsection id="HF3168875571743B19538D4347FBEE441"><enum>(c)</enum><header>Updating authorities</header><text>The Secretary of Health and Human Services is directed to ensure that the Indian Health Manual and all other relevant rules, guidance, manuals, and other materials are revised such that <quote>contract health service</quote>, each place it appears (regardless of casing and typeface and including in the headings) is revised to read <quote>purchased/referred care</quote> (with appropriate casing and typeface).</text></subsection></section> </legis-body></bill>

