Medical Review of Purchased/Referred Care (PRC) Appeals
See attached solicitation for details, 75H70423Q00034.
The Purchased/Referred Care (PRC) Program, in the IHS Office of Resources, Access, and Partnerships (ORAP) is integral to providing comprehensive health care services to American Indians and Alaska Natives (AI/AN). The Indian Health Service (IHS) health system delivers care through direct care services provided in IHS, Tribal, and urban (I/T/U) health facilities (e.g., hospitals, clinics) and through PRC services provided by non-IHS providers. The general purpose of PRC is for IHS and Tribal facilities to purchase services from private health care providers in situations where: 1) no IHS or Tribal direct care facility exists; 2) the existing direct care element is incapable of providing required emergency and/or specialty care; 3) utilization in the direct care element exceeds existing staffing; and 4) supplementation of alternate resources (e.g., Medicare, Medicaid, or private insurance) is required to provide comprehensive health care to eligible AI/AN).
This is a request for quote using the procedures located under FAR Part 12 and 13. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular (FAC) 2023-01. The North American Industry Classification System (NAICS) code for the proposed acquisition is 541990, All Other Professional, Scientific, and Technical Services.