Patient Care

By Elizabeth Franklin-Best, Esq., and Christopher Zoukis, JD, MBA

Program Statement 6031.06 at a glance

Field	Value
Program Statement	6031.06, Patient Care
Subject	The Bureau of Prisons’ national instruction on delivering health care to people in its custody — sick call, intake screening, comprehensive medical evaluations, chronic care clinics, emergency response, treatment refusal and informed consent
Effective / current edition date	June 22, 2026 (PDF header: “Number 6031.06 / Date June 22, 2026”), approved by Director William K. Marshall III; office of primary responsibility DPI HSD
Change notice	None. 6031.06 is a full reissue, not a change notice, and no CN has been issued to it
Supersedes / rescinds	“Program Statement Rescinded: 6031.05 CN-2 Patient Care (3/14/2025).” That change notice had itself amended PS 6031.05 (May 14, 2024), which rescinded PS 6031.04 (June 3, 2014)
Governing statute	The PS’s own REFERENCES block cites no statute. The constitutional floor is the Eighth Amendment as construed in Estelle v. Gamble, 429 U.S. 97 (1976)
Governing regulation (28 C.F.R.)	The PS’s own REFERENCES block cites no regulation. 28 C.F.R. part 549 is “Medical Services,” but it regulates only discrete subjects (subparts A–H) and contains no general right-to-treatment provision — see What changed
Related BP forms	BP-A0358, Medical Treatment Refusal; BP-A0408, Acknowledgment of Inmate, Part 3 & 4; BP-A0621, Authorization for Release of Medical Records; BP-A0770, Medical/Surgical and Psychiatric Referral Request. Non-BOP forms named: OF-522 (anesthesia and operations consent) and OSHA Form 300
Official PDF	PS 6031.06, Patient Care (June 22, 2026)

Checked against the BOP policy set · 2026-09-06.

Program Statement 6031.06 is the Bureau of Prisons’ national instruction on how health care is actually delivered inside a federal prison: how you get seen, how fast, by whom, and what happens when you say no. It was completely rewritten on June 22, 2026, and the rewrite removed structures that most published descriptions of BOP medical care still describe.

This is the “how it works” page. If your question is about the $2.00 charge for a sick-call visit and what is exempt from it, that is the Inmate Copayment Program (PS 6032.01). If it is about which prison someone is sent to for their medical needs — Care Levels 1 through 4, and how a transfer to a medical facility happens — that is medical designations and care levels (PS 6270.02). And if you have a live dispute about care your loved one is not receiving, start at medical care in federal prison, which covers what can actually be done about it.

The rule itself: every time frame and threshold in PS 6031.06

The most useful artifact in a 61-page policy is not its prose. It is its clocks. Below is every deadline, interval and numeric threshold PS 6031.06 sets, reproduced with the policy’s own language and pin-cited to the page it appears on. Nothing here is paraphrased into a number the Program Statement does not state.

Getting seen: intake, evaluation and chronic care

Event	What the Program Statement directs	Pin-cite
Intake screening	“Qualified health care providers will conduct an intake screening assessment of each inmate within 24 hours of arrival to the facility, except where noted below, ideally while the inmate is still in Receiving and Discharge.”	PS 6031.06 § 10 at p. 18
Intake screening — cannot be waived	“This intake screen is mandatory and cannot be waived. If screening cannot be completed within 24 hours, it will be conducted at the earliest possible opportunity with a notation in the intake encounter explaining the delay.”	PS 6031.06 § 10 at p. 19
Intake refusal	“An inmate who refuses to participate in the intake will not be housed in the general population until screening is completed; applicable disciplinary action will be taken.”	PS 6031.06 § 10 at p. 19
Return from non-BOP custody	Inmates out of Bureau custody “for more than seven days will have an updated intake screening evaluation completed within 24 hours of their return to Bureau custody.”	PS 6031.06 § 10.d at p. 20
Comprehensive medical evaluation — no findings at intake	“If no history or active medical or mental health diagnosis are identified on intake screening – complete within 30 days.”	PS 6031.06 § 11 at p. 20
Comprehensive medical evaluation — chronic or new conditions	“For inmates with history or active chronic or new health concerns/conditions – complete within 14 days.”	PS 6031.06 § 11 at p. 20
Comprehensive medical evaluation — after time outside BOP custody	“A comprehensive medical evaluation will be required for inmates who are out of continuous custody for more than 30 days.”	PS 6031.06 § 11.c at p. 22
Chronic Care Clinic — everyone enrolled	“A physician will evaluate all inmates assigned to a CCC no less than once every 12 months.”	PS 6031.06 § 12 at p. 23
Chronic Care Clinic — Medical Care Level 4	“Must be seen by an APP or physician for CCC follow-up every three months, or more often as clinically indicated.”	PS 6031.06 § 12 at p. 23
Chronic Care Clinic — Medical Care Level 3	“Must be seen by an APP or physician for CCC follow-up every six months, or more often as clinically indicated.”	PS 6031.06 § 12 at p. 23
Intra-complex transfer for escalation of care	“[I]f the reason for the transfer is escalation in inmate care, then a CCC should be scheduled within 30 days of arrival.”	PS 6031.06 § 10.c at p. 20
Outside screening consultations	“Screening needs that require outside consultation (colonoscopy, lung CT, etc.) will have consultations placed no greater than 18 months prior to the target date of need.”	PS 6031.06 § 12.a at p. 24

Source: PS 6031.06 at pp. 18–24.

Emergencies, restrictions and restrictive housing

Event	What the Program Statement directs	Pin-cite
Emergency response	“All staff are trained to respond within four minutes when a medical emergency is identified. The four-minute response time begins when a medical emergency is identified, and it encompasses the time it takes for staff to be notified and arrive at the emergency scene.”	PS 6031.06 § 8.a at p. 16
Definition of a medical emergency	“A medical emergency is a life- or limb-threatening situation where immediate intervention is required.”	PS 6031.06 § 8.a at p. 16
Clinician coverage	“Except for MRCs, institutions will not have clinicians on site 24 hours. All institutions have clinicians on site 8–16 hours per day based on the needs of the inmate population.”	PS 6031.06 § 8.d at p. 17
Medical Idle	“Maximum of three calendar days for recuperation from an acute illness or injury. The inmate is restricted to their quarters except for meals, religious services, and medical call-outs or DOT (i.e., pill line).”	PS 6031.06 § 18 at p. 32
Medical Convalescence	“Maximum of 30 calendar days for extended recuperation from an illness, injury, or surgery.” A follow-up visit is scheduled “before the 30-day restriction expires,” and restrictions “may be renewed if clinically indicated.”	PS 6031.06 § 18 at p. 32
Medical Hold — surgery window	A Medical Hold is placed for any inmate “[a]pproved to undergo surgical or invasive diagnostic intervention within 60 days of the scheduled transfer date.”	PS 6031.06 § 7.f at p. 15
Medical Hold — review interval	The Medical Hold roster “will be reviewed and updated by the CD, ideally every two weeks but at a minimum monthly.”	PS 6031.06 § 7.f at p. 15
Restrictive housing — administrative rounds	“The HSA or designee will, at a minimum, make weekly administrative rounds. These rounds will be recorded using existing official monitoring systems.”	PS 6031.06 § 31 at p. 44
Restrictive housing — clinical rounds	“A credentialed health care provider (e.g., APP, RN, Paramedic) will conduct daily rounds to determine any sick call or urgent requests for care and arrange for timely evaluations as clinically indicated.”	PS 6031.06 § 31 at p. 45
Restrictive housing — routine care	The HSA and CD “will collaborate with the Captain to designate a weekly time frame for inmates in restrictive units/cells to access routine scheduled care, including chronic care clinics, non-urgent laboratory/radiologic testing, dental visits, etc.”	PS 6031.06 § 31 at p. 45
Injury reports	“A physician will review and co-sign all injury reports as soon as possible, ordinarily by the next working day.”	PS 6031.06 § 20 at p. 34
Medical reentry planning	Social Workers “provide release and treatment planning for all Care Level 3 and 4 medical and mental health care levels with serious/chronic medical and mental health issues at least 90 days prior to release.”	PS 6031.06 § 30 at p. 40

Source: PS 6031.06 at pp. 15–45.

Sick call — the four things a sick call must be

Sick call is the walk-in route. PS 6031.06 § 19 defines it as “the process that allows inmates access to health care providers for acute issues (e.g., a ‘walk-in’ inmate-initiated visit),” conducted “ordinarily … on weekdays, except on federal holidays, during HSU’s operating hours.” The policy then sets four mandatory elements. Verbatim, “[s]ick call concerns must be”:

1. “made by the inmate in person.”
2. “assessed and triaged by a qualified health care provider (Paramedic, Registered Nurse (RN), APP). Licensed Practical Nurses (LPN)/Licensed Vocational Nurses (LVN)/Medical Assistants cannot triage an inmate independently but can help in the triage process (e.g., take vital signs, gather basic medical history/chief complaint, and perform tasks per protocol or at RN/APP direction).”
3. “documented as a clinical encounter in the EHR and include history of concern, vital signs, triage exam, and disposition.”
4. “tracked by the HSA to ensure appropriate timeliness of care and to identify trends and risks.”

Two further sentences in § 19 do more work than anything else on the page. The first is the escalation rule: “Inmates who are evaluated on multiple, distinct occasions for the same, unresolved complaint without a definite diagnosis or fail to respond to treatment will be referred to the CD or physician during the third such encounter. The physician will evaluate the inmate within a reasonable time frame based on the severity of the medical condition.” The second is the triage split: “Inmates presenting with urgent conditions will be assessed and treated by an appropriate provider expeditiously. Inmates presenting with non-urgent complaints will be assessed to determine stability, reassured, and scheduled for follow-up according to clinical indication or wait until the next scheduled CCC.”

And the policy states the cost consequence in one line: “Co-pays are applicable for sick calls per the Program Statement Inmate Copayment Program.”

Source: PS 6031.06 at pp. 32–33.

The three settings of care

The June 2026 rewrite replaced the old five-category “levels of care” scheme with three defined settings of care. These are the terms staff now use, and they are defined in § 2:

Setting	Definition as printed in PS 6031.06
Ambulatory Care (Outpatient Care)	“Ambulatory Care refers to health care services provided to inmates who are housed in the general population or other routine housing settings and who present to a medical or dental treatment area to receive scheduled or unscheduled services. … Inmates who receive ambulatory care return to their housing unit after the medical service has been provided.”
Enhanced-Ambulatory Care (Intermediate Care)	“Enhanced-Ambulatory Care (EAC) refers to health care or observation services provided to inmates who require increased monitoring, temporary separation from the general population, or accommodation for medical, mental health, infection control, or operational reasons, but who do not require infirmary-level care or continuous on-unit nursing presence. … Inmates who receive enhanced-ambulatory care are not housed in general population and require overnight stays to receive the intended service.”
Infirmary Care (Inpatient Care)	“Refers to inpatient-level health care services provided to inmates whose medical, surgical, psychiatric, palliative, rehabilitative, or functional care needs cannot be safely managed in an ambulatory or enhanced-ambulatory setting and who require ongoing skilled nursing care, daily clinical monitoring, or assistance with activities of daily living for a period generally exceeding 24 hours. Infirmary-level care is defined by the scope and intensity of services provided rather than by a specific physical location.”

Source: PS 6031.06 § 2 at pp. 2–5.

The Enhanced-Ambulatory definition is the one to read twice. Its named examples include “Special Housing Unit (SHU) for Medical Purposes — SHU placement utilized for medical isolation, trip preparation, clinical monitoring, or other medically indicated purposes,” alongside airborne isolation and quarantine settings, medical observation beds, suicide watch and restraint cells, stepdown units and specialized housing units (PS 6031.06 at pp. 3–4). In plain terms: the policy expressly contemplates that a person can be placed in the SHU for a medical reason. Families who hear “he’s in the SHU” and assume discipline are sometimes hearing about this instead.

Refusing treatment — and the four exceptions

PS 6031.06 § 40.e states the baseline: “As a general rule, medical and dental treatment, including medication, are only given when the inmate consents to treatment.” It then names four exceptions, verbatim, where “[e]xceptions may be made when a Bureau physician determines”:

• “There is a danger to life or of serious permanent injury to the inmate (e.g., refusal of insulin by an inmate with Type I Diabetes).”
• “The inmate poses a risk to others by refusing treatment (e.g., infectious tuberculosis).”
• “There is a court order for evaluation or treatment to be provided.”
• “There exists a mental health emergency, as defined by the Program Statement Psychiatric Evaluation and Treatment.”

A refusal is papered on a named form: “clinicians document the refusal in the EHR, complete a BP-A0358, Medical Treatment Refusal form,” signed by the inmate and the witnessing staff and scanned into the record. “If the inmate refuses to sign, two staff witnesses will sign the BP-A0358 … attesting to their observation that the clinician explained the consequences of refusing the proposed care in a language the inmate understood.” Refusing is not permanent — “[a]n inmate’s refusal of treatment will not preclude the inmate from reconsidering their decision and accepting care in the future” — but the policy adds a warning that belongs in front of anyone considering it: if delay has “compromised” the benefit of the treatment, “the inmate will be reevaluated to determine what treatment is clinically indicated,” and the clinician documents that.

Separately, some diagnostic procedures are not optional at all: “Diagnostic procedures related to potentially communicable disease may be mandatory,” including “[t]uberculin screening tests,” “[c]hest x-rays,” and “[b]lood specimens for hepatitis or HIV (post-exposure incidents),” and “[r]efusal of these procedures will require an incident report.” The section closes with the rule that governs the whole subject: “The inmate’s right to refuse medical treatment is not absolute and, in all cases, will be weighed against legitimate government interests, including the security and orderly operation of correctional institutions.”

Source: PS 6031.06 § 40.e at pp. 58–59.

What the patient care policy means for you

If you are the person inside: how sick call works

Sick call is in person and it is a weekday process. Section 19 says a sick-call concern must be “made by the inmate in person,” and that clinicians “will ordinarily conduct sick call and schedule appointments on weekdays, except on federal holidays, during HSU’s operating hours.” A cop-out into a box is not sick call. If the problem cannot wait for the next weekday and is not life- or limb-threatening, that is “urgent care” under § 8.c — “for minor illnesses or injuries that are not life-threatening but should not be deferred until normal business hours” — and where clinical staff are not available, “custody staff should contact the on-call provider to determine the next steps.” If it is life- or limb-threatening, say those words: it is an emergency, and the policy trains all staff to respond within four minutes.

Count your visits for the same problem. The third distinct encounter for the same unresolved complaint without a diagnosis is the one where § 19 directs a referral “to the CD or physician.” If you are on your third or fourth visit for the same pain and have still only seen a nurse or a paramedic, ask, in a written BP-A0148 cop-out, for the physician referral the policy describes — and keep the copy.

Two more practical things. First, results: § 11 directs that providers “review all laboratory or other diagnostic testing and ensure the inmate is informed of results.” If nobody told you what the labs showed, that is a specific, answerable request. Second, medication stopped without explanation: § 12.b is unusually strong here, and it is new. A provider discontinuing a chronic-care medication must document that “the patient was notified of the discontinuation and received appropriate patient education regarding the rationale, potential risks, expected symptoms, available treatment alternatives, and how to request reevaluation,” must document “a revised or new plan of care,” and — verbatim — “[d]iscontinuation of medication shall not occur solely through administrative note documentation without direct patient notification and clinical reassessment.”

If you are a family member: why the institution will not tell you

You will not get medical information by calling the institution. Federal medical privacy applies inside prison, and the Bureau releases records on the incarcerated person’s authorization — the policy names the form: BP-A0621, Authorization for Release of Medical Records. Ask your loved one to execute it naming you (and, if there is counsel, naming counsel). That single piece of paper is the difference between guessing and knowing.

The question families ask most is whether an outside doctor can see their person. Section 5 answers it, and the answer is narrow. “Inmates are not generally permitted to use non-contracted physicians or other providers from the community, including those with whom they had a prior relationship, whether on a reimbursable or non-reimbursable basis.” There is an exception, and it is exactly one sentence wide: if a community physician was treating the person before incarceration and follow-up is clinically appropriate, “[t]he Warden, upon consultation with the Regional Director and Bureau Medical Director, may permit such a visit for examination only at the inmate’s expense.” The policy then adds: “Such action will not be routine and should be infrequent.” And crucially: “The Bureau physician will review any recommendations and documentation provided by the visiting physician but is under no obligation to carry out the visitor’s recommendations.” An outside opinion can enter the record. It cannot order treatment.

What you can do that helps: get pre-incarceration records to Health Services early, keep a dated log of what your loved one reports about visits and medications, and note the specific words used — “sick call,” “urgent,” “emergency,” “chronic care clinic” — because those words map to different obligations in this policy.

If you are counsel: patient care

Three features of the 2026 edition change how a medical record request should be framed.

First, the comprehensive medical evaluation (CME) is now a single defined artifact that absorbs what used to be three separate encounters. Section 2.e defines it as “a thorough history, physical examination, review of diagnostic reports, formulation of an active problem list, and development of a treatment plan,” and says it “can be captured in the electronic health record through a History & Physical (H&P) encounter, a 14- or 30-day encounter, or a Chronic Care Clinic encounter.” So a request for “the H&P” now under-captures the file. Ask for CMEs by all three encounter types.

Second, § 12.a converts the annual CME into a checklist that is discoverable as a set of yes/no facts. At each annual comprehensive evaluation, physicians are expected at a minimum to “[r]eview and revise current medical care level or screening medical care level assignments at each encounter”; “[r]eview MDS accommodations, issued DME, and Medical Holds for appropriateness”; and — the item that matters most for post-conviction work — “[r]eview whether Reduction in Sentence (RIS) is appropriate. See clinical guidance Compassionate Release Criteria for Requests Based on Medical Circumstances.” Whether that review occurred, and what it concluded, is a fact in the record. See Compassionate Release / Reduction in Sentence (PS 5050.51).

Third, the constitutional frame has not moved, and it is worth stating precisely to clients. Estelle v. Gamble, 429 U.S. 97 (1976), held that “deliberate indifference to serious medical needs of prisoners constitutes the ‘unnecessary and wanton infliction of pain’ … proscribed by the Eighth Amendment,” whether shown “by prison doctors in their response to the prisoner’s needs or by prison guards in intentionally denying or delaying access to medical care or intentionally interfering with the treatment once prescribed.” The Court was equally explicit about what does not qualify: “a complaint that a physician has been negligent in diagnosing or treating a medical condition does not state a valid claim of medical mistreatment under the Eighth Amendment,” and “the question whether an X-ray — or additional diagnostic techniques or forms of treatment — is indicated is a classic example of a matter for medical judgment.” Farmer v. Brennan, 511 U.S. 825 (1994), added the mental-state test: liability requires that “the official knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference,” though “a factfinder may conclude that a prison official knew of a substantial risk from the very fact that the risk was obvious.” Both were retrieved and read this session: Estelle and Farmer.

And the distinction that governs every one of these pages: a Program Statement is the Bureau’s internal instruction to its own staff. It is not a regulation and not a statute, and a departure from it is not by itself a legal violation. Its value is evidentiary — it establishes what the Bureau told its own people to do, which is often the cleanest way to show what a defendant knew.

What changed in the June 2026 patient care rewrite

The June 22, 2026 reissue is a rewrite, not a touch-up, and its own Summary of Changes says so. Verbatim, PS 6031.06 rescinded “6031.05 CN-2 Patient Care (3/14/2025)” and made these changes:

• “Revised organization of the program statement for ease of navigation.”
• “Removed Utilization Review section.”
• “Changed requirements for both a history and physical and a 14- or 30-day chronic care clinic, combining these assessments into a comprehensive medical evaluation.”
• “Added ability to declare an inmate death in certain circumstances.”
• “Removed Radiology section.”

Source: PS 6031.06 at p. 1.

The most consequential change is one the Summary states only obliquely. The five “levels of care” categories are gone. Under the prior edition, PS 6031.05 defined a five-tier taxonomy that determined whether a treatment would be approved at all: “Medically Necessary – Emergency”; “Medically Necessary – Non-emergency”; “Medically Acceptable – Not Always Necessary” (the elective tier, with joint replacement, septoplasty, ACL reconstruction and carpal tunnel release given as the examples); “Limited Medical Value” (interventions “that provide little or no medical value” and are “usually excluded from the scope of services,” with cosmetic repair and excision of non-cancerous skin lesions as examples); and “Extraordinary” (interventions that “affect the life of another individual, such as in some organ transplantation,” requiring the Medical Director’s approval). That scheme, and the Utilization Management section that ran on it, do not appear in 6031.06.

This matters for two practical reasons. First, virtually every published third-party description of BOP medical care — including our own prior page on the 6031.05 edition — still describes the five levels of care as current. As of June 22, 2026 they are not in the Patient Care Program Statement. Second, the utilization-review machinery did not disappear; it moved. PS 6031.06 now cross-references a separate Program Statement, Healthcare Utilization Management, and § 3.a assigns the Medical Director responsibility to “[a]pprove categories of care reserved for the Bureau Medical Director (e.g., organ transplant approval, organ donor approval, etc.).” One residual use of the old vocabulary survives in the new text, at § 21.b: when a mastectomy is performed to treat cancer, “breast reconstruction is categorized as Medically Necessary, Not Emergent, and is processed through the institution URC” (PS 6031.06 at p. 35). So the categories still exist somewhere in the Bureau’s system — just not in this document.

Three other structural changes are worth naming. The old edition required both a history-and-physical and a separate 14- or 30-day chronic care clinic encounter; 6031.06 combines them into the single comprehensive medical evaluation described above. The Radiology section is gone. And the medication-discontinuation protections in § 12.b — direct patient notification, documented education on risks and alternatives, a revised plan of care, a medically indicated taper, and the express statement that “patient health and safety shall take precedence over operational or custody considerations, including concerns related to diversion” — are new and considerably stronger than anything in the prior edition.

One thing that did not change: the regulation. PS 6031.06’s REFERENCES block cites no C.F.R. section at all. The Bureau’s medical regulations live at 28 C.F.R. part 549, “Medical Services”, but that part is not a general right-to-care rule. It has eight subparts, each aimed at a discrete subject: A, Infectious Disease Management; B, Over-The-Counter (OTC) Medications; C, Psychiatric Evaluation and Treatment; D, Plastic Surgery; E, Hunger Strikes, Inmate; F, Fees for Health Care Services; G, Authority To Conduct Autopsies; and H, Civil Commitment of a Sexually Dangerous Person. Verified against the current C.F.R. There is no binding regulation that codifies sick-call intervals, chronic-care frequencies, or the four-minute response time. Those live only in the Program Statement — which is why the distinction between policy and law is not academic here.

Where people get stuck when sick call produces nothing

“I keep going to sick call and nothing happens”

This is the single most common medical complaint from federal prisons, and PS 6031.06 gives it a specific answer: the third distinct encounter for the same unresolved complaint is supposed to trigger a physician referral. The route is to make the ask in writing before escalating. File a BP-A0148 Inmate Request to Staff to the Health Services Administrator identifying the dates of the prior sick-call encounters, the unchanged complaint, and the § 19 third-encounter referral — then, if that produces nothing, move into the Administrative Remedy Program. Informal resolution first; a formal BP-9 is due within 20 calendar days of the event; a BP-10 within 20 calendar days of the Warden’s signed response, and a BP-11 within 30 calendar days of the Regional Director’s. Where health is genuinely at stake, cite the emergency provision: 28 C.F.R. § 542.18 requires that “[i]f the Request is determined to be of an emergency nature which threatens the inmate’s immediate health or welfare, the Warden shall respond not later than the third calendar day after filing.” And if no response arrives within the time allowed, § 542.18 lets you treat “the absence of a response to be a denial at that level” and appeal up.

A medication was stopped and nobody explained why

Under the prior edition this was a hard complaint to frame. Under § 12.b of the 2026 edition it is a checklist. The provider is directed to document notification, patient education covering “the rationale, potential risks, expected symptoms, available treatment alternatives, and how to request reevaluation,” and a revised plan of care; to use “a medically indicated tapering schedule” where clinically appropriate; and, where the discontinuation follows non-adherence or refusal, to “obtain and document a signed refusal form.” The record either contains those entries or it does not. A cop-out asking for the documented rationale and the revised plan of care, followed by a BP-9 if the answer is silence, is a much stronger filing than a general complaint about being taken off a medication.

The transfer that interrupts treatment

Section 7.f exists precisely for this and is worth quoting to a unit team. A Medical Hold “will be placed for any inmate meeting the following criteria,” which include being “[a]pproved to undergo surgical or invasive diagnostic intervention within 60 days of the scheduled transfer date,” having “[r]ecently underwent a surgical or invasive diagnostic procedure requiring follow-up care with the consultant who completed the procedure,” being “[c]urrently undergoing treatment, which needs to be completed prior to transfer, to include transfer to a Residential Reentry Center (RRC) or placement in home confinement,” and having “[r]ecently … discharged from a community hospital.” The policy also states that “[o]nly the CD or designee can authorize removal of a Medical Hold.” A pending surgery or an active cancer, hepatitis C or tuberculosis course is a Medical Hold question, and it should be raised with Health Services — not only with the unit team — before the transfer list goes out.

The problem is the prison, not the provider

Sometimes the clinic is doing what it can and the institution simply does not have the resource. That is a designation question, and it runs on a different track with different decision-makers: the Office of Medical Designations and Transportation, using the Care Level system. PS 6031.06 § 12.a directs that care levels be reviewed at every comprehensive medical evaluation and “after each major change in the inmate’s health status (e.g., recent hospitalization, development of complications related to disease progression, etc.).” If dialysis, oncology, skilled nursing or a dementia setting is what is actually needed, the argument is a care-level argument. See medical designations and care levels (PS 6270.02), and consider a consultation rather than a cop-out — designation disputes reward being framed correctly the first time.

Related BOP policy on medical care

Page	What it covers
Medical care in federal prison	The practical overview: getting seen, disputing a decision, and what a family can do
Inmate Copayment Program (PS 6032.01)	The $2.00 fee, when it applies, and the eight exempt categories
Medical designations and care levels (PS 6270.02)	Care Levels 1–4, OMDT, and transfer to a medical facility
Management of Aging Offenders (PS 5241.01)	Age thresholds, accommodations, and the annual RIS evaluation after 65
Treatment and Care of Inmates with Mental Illness (PS 5310.16)	Mental health care levels and psychiatric treatment
Medical records access (PS 6090.04)	Health Information Management and how records are obtained
Special Housing Units (PS 5270.12)	The housing side of the restrictive-housing rounds described above
Compassionate Release / Reduction in Sentence (PS 5050.51)	The Bureau’s medical criteria and internal review path
Administrative Remedy Program (PS 1330.18)	BP-8 through BP-11, deadlines, emergency response, constructive denial
Inmate Request to Staff (PS 5511.08)	The BP-A0148 cop-out
Federal Tort Claims Act (PS 1320.07)	The separate route for negligence claims, which is not the administrative remedy process
Dental Services (PS 6400.03)	Dental care, which 6031.06 routes to its own Program Statement

Frequently Asked Questions About BOP Patient Care

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Full text of the Program Statement

The Bureau’s own text of Program Statement 6031.06, Patient Care — together with Program Statement 6370.02, Laboratory Services, issued the same day — is reproduced in full, with page markers for pin-citing, on a companion page: Program Statements 6031.06 Patient Care and 6370.02 Laboratory Services (full text).

Reviewed for legal accuracy by Elizabeth Franklin-Best, Esq., Principal Attorney·September 2026