Senator John Hoeven has played a role in reintroducing the Purchase and Referred Care (PRC) Improvement Act. This bipartisan legislation, sponsored by Senators Mike Rounds and Maria Cantwell, aims to address delays in reimbursement claims at the Indian Health Service (IHS), which affects both patients and providers.
The bill outlines several key provisions: it mandates that the PRC program must reimburse approved claims within 30 days of determination, allows for electronic or in-person submission of claims, and strengthens liability protections for beneficiaries with approved PRC claims to protect them from wrongful debt collection attempts.
Senator Hoeven emphasized the importance of removing bureaucratic barriers at IHS that hinder tribal members from accessing necessary care. “This is about making the PRC program work better for patients and providers,” he stated. He added that tribal members would be more likely to use health care services outside IHS facilities without fearing debt, while providers could trust they would receive timely reimbursements.
Senator Rounds highlighted the commitment of IHS to care for tribal members across the United States. He noted that due to strict standards, approved PRC claims are rare. “It’s crucial that IHS reimburses tribal members for outside care once it’s approved,” Rounds said.
The legislation supports Hoeven’s efforts to utilize the PRC program to meet unmet health care needs in tribal communities. Currently, only 20 counties in North Dakota are designated as PRC care delivery areas, limiting access for tribal members seeking outside care. Hoeven and congressional delegations from North Dakota and South Dakota have urged IHS to expand the PRC program statewide.
The PRC Improvement Act is cosponsored by Senate Majority Leader John Thune and Senator Patty Murray. In the House of Representatives, Representatives Dusty Johnson and Kim Schrier are sponsoring a companion bill.
