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Purchase Referred Care Program

Indian Health Services provides Federal health services to 2.2 million American Indians and Alaska Natives in 567 Federally recognized tribes. Indian Health Services can provide health care directly or may fund tribes to independently deliver health care. When an Indian Health Services 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 General Accountability Office that highlighted problems with the program. This audit will focus on Indian Health Services-administered PRC program services, which totaled $333.7 million in FY 2016. We will determine whether Indian Health Services PRC program services were provided in compliance with the purpose, time, and amount requirements specified in appropriation statutes and Indian Health Services requirements.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Nov-16 Indian Health Services Purchase Referred Care Program Office of Audit Services W-00-16-51004 2020