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

PRCDA Expansion

This webpage contains information on Re-Designation of a Purchased/Referred Care Delivery Area (PRCDA) also known as a PRCDA Expansion Request status and the most current official full PRCDA listings. With Medicaid Expansion and the implementation of PRC Rates (Medicare Like rates) many tribes are seeing their PRC dollars cover more services and would also like to cover more of their beneficiaries that are not currently covered under their existing PRCDA and are requesting PRCDA Re-designation or expansion. Details on how to re-designate or expand a Tribes PRCDA are located in the IHM Part 2 Chapter 3 Purchased/Referred Care, 2-3.4 REDESIGNATION OF A PRCDA.

The PRCDA Expansion Request Tracker is below.

PRC Expansion Progress Graph

The PRCDA listing is provided in the PDF link below. The list includes two recent expansions, the Spokane Tribe and the Mid-Atlantic Tribes.

PURCHASED/REFERRED CARE DELIVERY AREAS [PDF - 243 KB]

PRCDA vs Service Delivery Area
  • The Purchased/Referred Care Delivery Area (PRCDA) means the geographic area within which PRC services will be made available by the IHS to members of an identified Indian community who reside in the area, subject to the provisions of 42 C.F.R. Part 136 Subpart C.
  • A Service Delivery Area is a geographic area in which an IHS beneficiary must live in order to be counted in the user population of that ITU facility.

In most cases the PRCDA and Service Delivery Area are the same counties. However, in some cases they may differ. A Service Delivery Area must be requested by the IHS Area Office and is a different process from establishing a PRCDA. The OPHS Division of Program Statistics has templates for Area Office’s to use in development of the draft Service Delivery Area decision memo. If Service Delivery Areas overlap, there must be negotiations between Tribes and the Area on how user population will be divided. This agreement must be included in the decision memo.

If you have any questions regarding PRCDA Expansion requests, please contact Alison Sanders, Alison.Sanders@ihs.gov