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HHS/IHS RIN: 0917-AA12 Publication ID: Spring 2014 
Title: ●Medicare-Like Rate for Non-Hospital Services 
Abstract: Section 506 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173) authorized the Secretary to establish a payment methodology, payment rates, and admissions practices for Medicare-participating hospitals that furnish inpatient services applicable when such hospitals provide medical care to an eligible American Indian/Alaskan Native beneficiary that has been authorized by an IHS, tribal or urban program (I/T/U). The MLR methodology established by 42 CFR part 136 subpart D does not apply to non-hospital services, including physician and other health professional services, and non-provider-based items and services. Rather, I/T/Us reimburse for authorized services at the rates provided by contracts negotiated locally with providers or according to provider's billed charges. 
Agency: Department of Health and Human Services(HHS)  Priority: Substantive, Nonsignificant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: None     (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: PL 108-173   
Legal Deadline:  None
Action Date FR Cite
NPRM  01/00/2015 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Carl Harper
Director, Office of Resource Access and Partnerships
Department of Health and Human Services
Indian Health Service
801 Thompson Avenue, TMP Suite 360,
Rockville, MD 20852
Phone:301 443-1016

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