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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:
https://www.ihs.gov/sites/newsroom/themes/responsive2017/display_objects/documents/2021_Letters/DTLL_01292021.pdf