S. 699 — Purchased and Referred Care Improvement Act of 2025

This section revises patient liability protections under Section 222 of the Indian Health Care Improvement Act (25 U.S.C. 1621u) for purchased/referred care (i.e., health services delivered by non-Service providers based on a referral by, or at the expense of, an Indian health program), as follows: (1) specifies that authorized patients are not liable for payment notwithstanding any other law or signed agreement, form, or document; (2) requires the Secretary of Health and Human Services (HHS) to notify providers, patients, debt collectors, and others of non-liability within 5 business days of a claim; (3) establishes reimbursement procedures, to be implemented within 120 days of enactment in consultation with tribes, under which HHS must reimburse patient out-of-pocket payments for authorized care within 30 days of electronic or in-person documentation submission (except for tribally operated programs unless agreed); and (4) directs HHS to update relevant manuals, contracts, and authorities within 180 days of enactment. The amendments apply to all purchased/referred care furnished on, before, or after enactment.

This section revises the definitions section of the Indian Health Care Improvement Act (25 U.S.C. 1603) by striking the definition of "contract health service," redesignating subsequent paragraphs, and adding an identical definition for "purchased/referred care" (i.e., any health service delivered based on a referral by, or at the expense of, an Indian health program and provided by a non-Indian health program provider or hospital). It further replaces all instances of "contract health service," "contract health services," "Contract Health Service," "Contract Health Services," and "contract care" with "purchased/referred care" throughout the Act (including in multiple section headings and references such as §§211, 219, 406, 815, and 830); updates cross-references and citations; and directs the Secretary of Health and Human Services to revise the Indian Health Manual and related materials accordingly. (Thus, the amendment makes no substantive changes to program operations or eligibility.)