November 16, 2021

Dear Tribal Leader:

We would like to invite Tribal Leaders (or their representative designee), along with Tribal Health Program leadership, to two listening sessions regarding our collaborative efforts to administer VA’s Indian Health Service/Tribal Health Program (IHS/THP) Reimbursement Agreement Program (RAP) and implement Public Law 116-311, Proper and Reimbursed Care for Native Veterans Act. Inclusion of PRC into the program will require adopting a new agreement template. A tribal consultation will be held at a future date that incorporates information obtained from these sessions.

Public Law 116-311 amends Section 405(c) of the Indian Health Care Improvement Act (25 U.S.C. 1645) by clarifying the authority to reimburse for services regardless of whether they are provided directly by the Service, an Indian tribe, or tribal organization, through purchased/referred care, or through a contract for travel described in section 213(b).

VA is seeking feedback on the following points of discussion:

  1. Are there specific high-volume services that PRC is authorized for? How much is preauthorized versus unauthorized emergency care?
  2. What type of contracted travel is most prevalent and what is the historical volume?
  3. What should VA be aware of in the claim submission process?
  4. Are there other recommendations, concerns, or suggestions that VA should consider?
    When VA expands the agreements to include reimbursement of PRC, new agreements will be issued rather than further amend the current agreements. VA is hosting a listening session to obtain input from stakeholders to identify areas of concern, ambiguity, and suggested improvement to the agreement template in effort to enhance operations and the Veteran experience.

Two virtual listening sessions have been scheduled to address the above topics.

  1. Purchased Referred Care – Thursday, December 16th, 2021, 3:00-4:30 pm (Eastern Time).
  2. Updated Reimbursement Agreement Template – Thursday, January 13, 2:30-4:30 pm.

Written comments may also be submitted to before February 13, 2022. For questions regarding these efforts, please contact Kara Hawthorne at Program information can be found on the VA Office of Community Care, and the Office of Tribal Government Relations websites.

I look forward to working with Indian Health Services (IHS) and Tribal Health Programs (THPs) to enhance the Reimbursement Agreement Program and grow the unique relationship that IHS/THPs have with VA and the Veterans they serve. I appreciate your support as we move forward together.


/s/Julianne Flynn, MD Date
ADUSH for the Office of Community Care (13)

Share this story

Published on Nov. 16, 2021

Estimated reading time is 2 min.