Central ND News

Senator John Hoeven has joined efforts to reintroduce the Purchase and Referred Care (PRC) Improvement Act, a bipartisan initiative aimed at addressing delayed reimbursement claims at the Indian Health Service (IHS). The legislation is sponsored by Senators Mike Rounds and Maria Cantwell. It aims to benefit both patients and providers by requiring the PRC program to reimburse approved claims within 30 days of determination. Additionally, it allows for electronic or in-person claim submissions and strengthens liability protections for beneficiaries with approved PRC claims.

Senator Hoeven emphasized the importance of removing "artificial, bureaucratic hurdles" that hinder tribal members from accessing necessary health care. He stated, "This is about making the PRC program work better for patients and providers." According to Hoeven, the legislation would enable tribal members to access non-IHS health services without incurring debt while ensuring providers receive timely reimbursements.

Senator Rounds highlighted the commitment of IHS to care for tribal members across the United States, stressing that they need to honor this commitment. He remarked on the stringent standards for PRC claims, noting that approved claims are rare. "It’s crucial that IHS reimburses tribal members for outside care once it’s approved," he said.

The legislation supports Hoeven's ongoing efforts to use 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 Senate cosponsors of the PRC Improvement Act include Majority Leader John Thune and Senator Patty Murray. In the House of Representatives, Representatives Dusty Johnson and Kim Schrier are sponsoring a companion bill.