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U.S. Department of Health and Human Services
Purchased/Referred Care (PRC)

Program Staff

This page contains information regarding program functions and funding; it is intended for use primarily by PRC program staff.

The PRC program responsibility is to administer and manage the contracting of health care services with non-IHS providers for services of Indian people residing on or near reservations. The PRC funds are used to supplement and complement other health care resources available to eligible Indian people. This responsibility is accomplished through the staff located at the IHS Headquarters in Rockville, Maryland and at each of the twelve Area Offices located across the nation. PRC staff can also be found at IHS and Tribal facilities. The program directory on this website provides the twelve Areas and the contact numbers for each of these PRC program locations.

The PRC funds are utilized in situations where: (1) no IHS direct care facility exists, (2) the direct care element is incapable of providing required emergency and/or specialty care, (3) the direct care element has an overflow of medical care workload, and (4) supplementation of alternate resources (i.e., Medicare, private insurance) is required to provide comprehensive care to eligible Indian people.

The program accomplishes the responsibilities or functions with dedicated PRC program staff. The staff or Full time Equivalent (FTE) provide comprehensive administrative management functions using a Headquarters criteria and the staffing module to estimate the requirements to perform the functions. The standards are derived from the IHS Resource.

Requirements Methodology (RRM) identifies the workload and related functions:

  1. Patient eligibility for Purchased/Referred Care.
  2. Processing procurement orders for requested contract health services.
  3. Assistance to patients with alternate resources compliance.
  4. Correspondence related to PRC authorizations for payment or non-payment.
  5. Tracking allocation of PRC funds to assure the program stays within budget.
  6. Coordination of activities associated with Purchased/Referred Care.

The Program Staff section will continue to be developed for program-related information.