Sponsors (8)
Want to know what is actually in this bill?
This is not an official government website.
Copyright © 2026 PLEJ LC. All rights reserved.
Replaces instances of the term "contract health care" with "purchased/referred care", inserts a prefatory "Notwithstanding any other provision of law..." clause into subsection (a), and adds new subsections establishing reimbursement procedures and administrative update requirements (new subsections (d) and (e)).
Amends section 4(5) of the Indian Health Care Improvement Act by striking the paragraph designation and heading and all that follows through and inserting a new subsection (5) defining 'Purchased/referred care'.
Amends the Indian Health Care Improvement Act by striking each place the Act is referenced (regardless of casing and typeface and including in headings) and inserting revised text with appropriate casing and typeface.
Changes wording in the Indian Health Care Improvement Act from “contract health care” to “purchased/referred care” and requires HHS and the Indian Health Service (IHS) to create a fast reimbursement process for patients who paid out-of-pocket for purchased/referred care. The agencies must issue procedural rules within 120 days and reimburse patients within 30 days of receiving documentation; paperwork may be submitted electronically or in person. Tribal-run purchased/referred care programs under ISDEAA are not subject to the reimbursement rules unless the Tribe agrees. The bill also directs technical/terminology updates across statute text, manuals, contracts, and other materials and requires agency updates within set time frames.
Amends Section 222 of the Indian Health Care Improvement Act (25 U.S.C. 1621u).
In subsection (a): replace the phrase "A patient" with the longer phrase beginning "Notwithstanding any other provision of law or any agreement, form, or other written or electronic document signed by a patient, a patient" (modifies the introductory language that applies to patients).
In subsection (a): strike the term "contract health care" and insert "purchased/referred care."
In subsection (b): replace occurrences (each place it appears) with the term "purchased/referred care" and specifically strike "contract health care" and insert "purchased/referred care."
In subsection (c): an insertion is made (text inserted after specified punctuation in subsection (c) as indicated in the amendment).
Who is affected and how:
American Indian and Alaska Native patients who use Purchased/Referred Care (PRC): They gain a clear statutory path to seek reimbursement if they pay out-of-pocket for PRC services. The 30-day target for reimbursement and acceptance of electronic documentation should speed payments and reduce paperwork delays. Because the rule applies to services furnished before enactment as well, some past-payments may be eligible for reimbursement.
Indian Health Service (IHS) and HHS program and claims staff: Agencies must develop procedures, update manuals and contracts, and implement claims-processing changes within short deadlines (procedures in 120 days; manual updates within 180 days). This will require administrative work to update systems, train staff, and handle reimbursement claims promptly.
Tribal health programs operating PRC under ISDEAA compacts/contracts: These programs are not automatically bound by the new reimbursement rules; Tribes retain sovereign control and must choose to adopt the new reimbursement regime if they wish. That preserves tribal self-determination but may lead to different rules depending on Tribe decisions.
Health care providers and third-party clinics that furnish PRC services: They may see increased direct reimbursement claims routed through IHS/HHS or patient-submitted documentation for reimbursement. Providers may need to assist patients with receipts or records to support claims.
Patients and advocates: Faster and clearer reimbursement timelines reduce financial burden and uncertainty after paying for care out-of-pocket; advocates may use the statutory deadlines to press for timely agency action.
Net effect: The change is primarily administrative and patient-protective, improving reimbursement speed and clarifying terminology. Implementation will require operational work at HHS/IHS and local support for patients seeking reimbursement; tribal programs remain under tribal control unless they opt in.
Expand sections to see detailed analysis
Referred to the Committee on Natural Resources, and in addition to the Committee on Energy and Commerce, 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.
Introduced February 18, 2025 by Dustin Johnson · Last progress February 18, 2025
Referred to the Committee on Natural Resources, and in addition to the Committee on Energy and Commerce, 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.
Introduced in House