View Rule

View EO 12866 Meetings Printer-Friendly Version     Download RIN Data in XML

HHS/IHS RIN: 0917-AA10 Publication ID: Spring 2021 
Title: Catastrophic Health Emergency Fund (CHEF) 

CHEF pays for extraordinary medical costs associated with treatment of victims of disasters or catastrophic illnesses. CHEF is used to reimburse PRC programs for high cost cases (e.g., burn victims, motor vehicle accidents, high risk obstetrics, cardiology, etc.). The proposed rule establishes conditions and procedures for payment from the fund.  During the comment period for the NPRM, several Tribes and Tribal Organizations expressed concern about provisions in the NRPM related to coordination with Tribal self-insurance as an alternate resource.  In response to those concerns, the IHS engaged in additional Tribal consultation and decided to delay moving forward with the NPRM pending the resolution of relevant litigation.  IHS intends to proceed with developing the NPRM consistent with how Tribal self-insurance is currently recognized in agency policy at On January 29, 2021, IHS issued a Dear Tribal Leader Letter to clarify that the proposed rule should not be relied upon and that IHS will be moving forward by publishing a new proposed rule in the near future. A copy of the Dear Tribal Leader Letter concerning next steps for the CHEF regulations is available on the IHS website at:

Agency: Department of Health and Human Services(HHS)  Priority: Info./Admin./Other 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: Not Yet Determined     (To search for a specific CFR, visit the Code of Federal Regulations.)
Legal Authority: Pub. L. 94-437, sec. 202(d), IHCI Act, as amended by Pub. L. 111-148, sec. 10221   
Legal Deadline:  None
Action Date FR Cite
NPRM  01/26/2016  81 FR 4339   
NPRM Comment Period End  03/11/2016 
NPRM  12/00/2021 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: Undetermined 
Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
CAPT John E. Rael
Director, Office of Resource Access and Partnerships
Department of Health and Human Services
Indian Health Service
5600 Fishers Lane, Suite 10E73,
Rockville, MD 20857
Phone:301 443-0969