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119-s-699119th CongressWALLET

Purchased and Referred Care Improvement Act of 2025

Sponsored By: Senator Rounds, Mike [R-SD]

In Committee

Summary

This bill would make patients not liable for charges for purchased/referred care and shift payment responsibility toward the Indian Health Service (IHS). It would also require quick government notice to providers and patients and set a deadline for reimbursing patients who already paid out of pocket.

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  • Patients and families: Patients would not be responsible for paying providers, debt collectors, or other persons for purchased/referred care. If a patient already paid, they could submit documentation and be reimbursed within 30 days.
  • Providers and debt collectors: The Secretary would have to notify both the purchased/referred care provider and the patient within 5 business days after receiving a claim that the patient is not liable. The bill adds explicit language addressing debt collectors and other persons in provider communications.
  • Tribes and IHS operations: The Secretary would consult tribes and implement reimbursement procedures within 120 days and update the Indian Health Manual within 180 days. The changes would apply to care furnished on, before, or after enactment.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

No patient bills for Indian Health Service

If you received care the Indian Health Service authorized, you would not be responsible for paying those bills. That protection would apply to purchased/referred care furnished on, before, or after the date of enactment. If a provider files a claim, the Service would have to tell the provider and the patient within 5 business days that the patient is not liable. The Service would have to set rules within 120 days so patients who paid out-of-pocket can be reimbursed; after you submit proof, the Service would pay you within 30 days and must accept electronic or in-person documentation. The bill defines "purchased/referred care" as services referred by or paid for by an Indian health program and provided by a non‑IHS provider. The reimbursement rule would not apply to a tribe-run purchased/referred care program unless the tribe expressly agrees.

Indian Health Service manual updates

The bill would require the Secretary to update the Indian Health Manual, provider contracts, and guidance. The Secretary must consult tribes and replace the term "contract health service" with "purchased/referred care." Updates would have to be completed not later than 180 days after enactment.

Sponsors & CoSponsors

Sponsor

Rounds, Mike [R-SD]

SD • R

Cosponsors

  • Sen. Cantwell, Maria [D-WA]

    WA • D

    Sponsored 2/24/2025

  • Sen. Thune, John [R-SD]

    SD • R

    Sponsored 2/24/2025

  • Sen. Murray, Patty [D-WA]

    WA • D

    Sponsored 2/24/2025

  • Sen. Hoeven, John [R-ND]

    ND • R

    Sponsored 3/6/2025

  • Sen. Cortez Masto, Catherine [D-NV]

    NV • D

    Sponsored 4/28/2026

Roll Call Votes

No roll call votes available for this bill.

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