02.26.25

Hoeven Helps Reintroduce Legislation to Protect Tribal Members from Medical Debt, Ensure Timely Reimbursement for Non-IHS Health Care

WASHINGTON – Senator John Hoeven this week helped reintroduce the Purchase and Referred Care (PRC) Improvement Act, bipartisan legislation sponsored by Senators Mike Rounds (R-S.D.) and Maria Cantwell (D-Wash.) to address delayed reimbursement claims at the Indian Health Service (IHS), benefitting both patients and providers. Specifically, the bill:

  • Requires the PRC program to provide, if approved, reimbursement of claims within 30 days of determination.
  • Allows claims to be submitted electronically or in person.
  • Strengthens liability protections for beneficiaries with approved PRC claims, protecting them from attempts to collect wrongfully-charged debt.   

“Artificial, bureaucratic hurdles at the Indian Health Service should not stand in the way of tribal members accessing the care they need and are entitled to,” said Senator Hoeven “This is about making the PRC program work better for patients and providers. Tribal members will be better able to utilize health care services outside of IHS facilities knowing they won’t go into debt, while providers can have confidence that they will receive the timely reimbursement they are owed for the critical services they provide.”

“The Indian Health Service has made a commitment to care for tribal members across the United States, and they need to honor that commitment,” said Senator Rounds. “Because of the strict standards for PRC claims, approved claims are few and far between. It’s crucial that IHS reimburses tribal members for outside care once it’s approved. I’m pleased to reintroduce this legislation, which would hold IHS accountable to make certain they get their work done and follow their mission of providing health care for tribal members.”

The legislation aligns with Hoeven’s work to leverage the PRC program to address unmet health care needs in tribal communities. Only 20 counties in North Dakota are approved as PRC care delivery areas, meaning that tribal members seeking outside care can only do so in less than half of our state’s 53 counties.

Accordingly, Hoeven and the congressional delegations from North Dakota and South Dakota have called on IHS to expand the PRC program to all counties within the two states. Doing so would help tribal members access the care they need, while giving health care providers, particularly in rural areas, an additional revenue stream to support and improve the services they provide.

The PRC Improvement Act is cosponsored in the Senate by Majority Leader John Thune (R-S.D.) and Senator Patty Murray (D-Wash.). Representatives Dusty Johnson (R-S.D.) and Kim Schrier (D-Wash.) are sponsoring a companion to the legislation in the House of Representatives. Click here for full bill text.

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