The "Purchased and Referred Care Improvement Act of 2025" seeks to amend the Indian Health Care Improvement Act, primarily by clarifying patient financial liability for services authorized by the Indian Health Service (IHS). It explicitly states that a patient receiving purchased/referred care is not liable for any associated charges or costs, regardless of any agreements or forms they may have signed. This provision is designed to protect patients from unexpected medical bills for services approved by IHS. Furthermore, the bill mandates that the Secretary of Health and Human Services notify both the provider and the patient of this non-liability within five business days of a claim. For patients who have already paid out-of-pocket for authorized care, the bill establishes procedures for them to be reimbursed by the Service within 30 days of submitting documentation, which can be done electronically or in-person. However, this reimbursement mechanism does not apply to care under tribal self-determination contracts unless the tribe explicitly agrees. The legislation also includes extensive technical and conforming amendments, replacing the term "contract health service" with "purchased/referred care" throughout the Indian Health Care Improvement Act and related documents. It defines "purchased/referred care" as health services delivered based on an Indian health program's referral or expense, provided by a non-Indian health program provider. These changes, including the patient liability provisions, apply to authorized care furnished on, before, or after the bill's enactment.