Patient Referred Care

Formerly known as Contract Health, Patient Referred Care is a federally funded program created to assist in payment for healthcare services received by Tribal members that are not available at Elbowoods Memorial Health Center. 

How does Patient Referred Care Operate?

The funding received each year is not based on each enrolled tribal member of that reservation but by the number of patients who have received care at the Elbowoods Memorial Health Center within the last three years. This decision is made by Congress and the lump-sum allocated is then divided up by each Indian Health Service and tribally contracted health facility. Due to the federal government unable to fully fund this program, we have federal guidelines to follow that are strictly enforced. 

How do you as a patient access these funds?

You will need to schedule an appointment with an Elbowoods Memorial Health provider or any of the field clinic providers and they will issue a referral for your medical care to an outside non-IHS facility. This referral is then reviewed by the PRC committee which consists of:

  • Medical Provider - To review medical notes and the referral to make a decision on the medical priority.
  • Eligibility Specialist - To determine whether or not the patient may be eligible for an alternate resource or to verify if the patient has active insurance coverage.
  • CEO - To make a decision to approve or deny the use of PRC funds.
  • PRC Staff - To process the referral once it has been approved or denied. 

In cases of an emergency, a 72-hour notification to the PRC department must be submitted by the individual, provider, hospital, or someone on behalf of the individual. For elderly or disabled, it is 30 days.  

Who is eligible for PRC coverage and EMHC and field clinics?

  • Enrolled members of the MHA Nation that reside on the Fort Berthold Reservation or reside in a county bordering the Fort Berthold Reservation.
  • Enrolled members of a federally recognized tribe residing on the Fort Berthold Reservation.
  • Students who meet the eligibility guidelines at their permanent residence prior to leaving for school. Students must submit a PRC service application with a copy of full-time student status each semester.
  • Non-Indian women pregnant with an eligible Native American child.


  • Provide proof of tribal affiliation. Acceptable forms of tribal affiliation include:
    • Tribal identification cards
  • Apply for alternate resources for care. Examples of alternate resources include:
    • Medicare
    • Medicaid
    • Disability
    • Express enrollment for pregnant women and children
  • Failure to apply for alternate resources may result in a denial for PRC coverage and you will be financially responsible for the entire bill.
  • Proof of residency that you live within the Elbowoods PRC coverage area. 

Please remember to make sure that all your information is current within our system. Your mailing address, phone number, and insurance, are all pertinent data to receiving your referral and getting it processed in a timely manner.