View Rule

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

HHS/IHS RIN: 0917-AA10 Publication ID: Spring 2023 
Title: Catastrophic Health Emergency Fund (CHEF) 

This proposed rule would promulgate regulations governing the administration of the Catastrophic Health Emergency Fund (CHEF). It would supersede and replace the notice of proposed rulemaking (NPRM) published on January 26, 2016, (81 FR 4239).  CHEF pays for extraordinary medical costs associated with treatment of victims of disasters or catastrophic illnesses by reimbursing Purchased/Referred Care (PRC) programs for high-cost cases (e.g., burn victims, motor vehicle accidents, high risk obstetrics, cardiology, etc.). The 2016 NPRM established conditions and procedures for payment from the fund.  However, during the public comment period, several Tribes and Tribal Organizations expressed concern about provisions 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 2016 NPRM pending the resolution of relevant litigation. On January 29, 2021, IHS issued a Dear Tribal Leader Letter to clarify that the 2016 NPRM should not be relied upon and that IHS intended to publish 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: Other Significant 
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), IHCIA, as amended by Pub. L. 111-148, sec. 10221   
Legal Deadline:  None
Action Date FR Cite
NPRM  01/26/2016  81 FR 4239   
NPRM Comment Period End  03/11/2016 
NPRM  06/00/2023 
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