IHS provides Federal health services to 2.2 million American Indians and Alaska Natives in 567 Federally recognized tribes. IHS can provide health care directly or may fund tribes to independently deliver health care. When an IHS or tribal facility is not available, or does not provide the required care, patients are referred to the purchased/referred care (PRC) program, which coordinates needed services through private health care providers. PRC program funds grew 17.2 percent from $779.9 million in FY 2011 to $914.1 million in FY 2016. We are initiating this audit because of the significant magnitude and growth of PRC program funds and previous reports by GAO that highlighted problems with the program. This audit will focus on IHS-administered PRC program services, which totaled $333.7 million in FY 2016. We will determine whether IHS PRC program services were provided in compliance with the purpose, time, and amount requirements specified in appropriation statutes and IHS requirements. Read the Work Plan Summary