2018- TSGAC Issue Area Summary – Reimbursement for Purchased and Referred Care (PRC)


“Recommendation: THPs, in particular, work hard to provide a seamless health care experience. Lack of coordination of care for specialty care and other medically necessary care paid by PRC will only create more barriers for our veterans. We recommend that the VA include PRC in the IHS/THP reimbursement agreements so that there is no further rationing of health care provided by IHS and THPs to Native veterans and other eligible AI/ANs in the system. The aim of this initiative is to ensure the IHCIA is fully implemented and ensure the VA fully reimburses for services provided by IHS/THPs as required in Section 405(c) of the IHCIA.”