Sec. 2. Changes to liability for payment
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Section 222 of the Indian Health Care Improvement Act ( 25 U.S.C. 1621u ) is amended— in subsection (a)— by striking A patient who receives contract health care services and inserting Notwithstanding any other provision of law or any agreement, form, or other written or electronic document signed by a patient, a patient who receives purchased/referred care ; and by striking such services and inserting the purchased/referred care ; by striking subsection
(b)and inserting the following: The Secretary shall notify a purchased/referred care provider and any patient who receives purchased/referred care authorized by the Service that, notwithstanding any other provision of law or any agreement, form, or other written or electronic document signed by the patient, the patient is not liable to any provider, debt collector, or any other person for the payment of any charges or costs associated with the provision of the purchased/referred care not later than 5 business days after receipt of a notification of a claim by a provider of the purchased/referred care. ; in subsection (c)— by inserting , debt collector, or any other person, as applicable, after the provider ; and by striking the services and inserting the purchased/referred care ; and by adding at the end the following: Not later than 120 days after the date of enactment of the Purchased and Referred Care Improvement Act of 2025 , in consultation with Indian tribes, and except as provided in paragraph (2), the Secretary shall establish and implement procedures to allow a patient that paid out-of-pocket for purchased/referred care authorized by the Service under this Act to be reimbursed by the Service for that payment not later than 30 days after the date on which the patient submits documentation to the Service in accordance with subparagraph (B). The Secretary shall accept documentation from a patient seeking reimbursement under paragraph
(1)that was submitted— electronically; or in-person at a Service facility. Paragraph
(1)shall not apply to purchased/referred care furnished under a purchased/referred care services program operated by an Indian tribe under a contract or compact entered into under the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5301 et seq. ) unless expressly agreed to by the Indian tribe. Not later than 180 days after the date of enactment of the Purchased and Referred Care Improvement Act of 2025 , the Secretary, in consultation with Indian tribes, shall update applicable provisions of and exhibits to the Indian Health Manual, contracts with providers, and other relevant documents and administrative authorities to incorporate the provisions of this section. . The amendments made by subsection
(a)shall apply to purchased/referred care (as defined in section 4 of the Indian Health Care Improvement Act ( 25 U.S.C. 1603 )) authorized by the Indian Health Service furnished on, before, or after the date of enactment of this Act.
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