§1621a — Title 25 Indians | U.S. Code

Summary

Creates the Indian Catastrophic Health Emergency Fund (CHEF) to pay very high medical bills for people who suffer disasters or catastrophic illnesses and who are the responsibility of the Indian Health Service. Money for CHEF comes from two places: amounts Congress appropriates and any reimbursements the Service gets (for example, insurance payments) for care that CHEF paid. The Secretary runs CHEF through the Indian Health Service headquarters and must use it only for those extraordinary medical costs. CHEF money cannot be given out as contracts or grants under any law (including the Indian Self-Determination and Education Assistance Act) and cannot be divided out to Area Offices, Service Units, or similar offices for their own use. The Secretary must make rules that say which disasters and illnesses qualify and how CHEF pays. A Service Unit cannot get CHEF money until its cost for a patient reaches a threshold. That threshold was $19,000 for the year 2000 and for each later year it must be at least the prior year’s threshold increased by the percentage change in the medical care part of the Consumer Price Index for All Urban Consumers (U.S. city average) for the 12 months ending in December of the prior year. The rules must explain how to reimburse Service Units and, when allowed, outside providers for costs above the threshold, how to pay when emergency treatment happens before formal approval, and how to avoid paying a provider from CHEF when other federal, state, local, or private sources can pay. CHEF funds must not be used to reduce other Indian Health Service funding, and any reimbursements the Service is entitled to for care paid by CHEF must be returned to CHEF.

Title 25, §1621a

Indians — Source: USLM XML via OLRC

(a)There is established an Indian Catastrophic Health Emergency Fund (hereafter in this section referred to as the “CHEF”) consisting of—

(1)the amounts deposited under subsection (f); and

(2)the amounts appropriated to CHEF under this section.

(b)CHEF shall be administered by the Secretary, acting through the headquarters of the Service, solely for the purpose of meeting the extraordinary medical costs associated with the treatment of victims of disasters or catastrophic illnesses who are within the responsibility of the Service.

(c)No part of CHEF or its administration shall be subject to contract or grant under any law, including the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.),11 See References in Text note below. nor shall CHEF funds be allocated, apportioned, or delegated on an Area Office, Service Unit, or other similar basis.

(d)The Secretary shall promulgate regulations consistent with the provisions of this section to—

(1)establish a definition of disasters and catastrophic illnesses for which the cost of the treatment provided under contract would qualify for payment from CHEF;

(2)provide that a Service Unit shall not be eligible for reimbursement for the cost of treatment from CHEF until its cost of treating any victim of such catastrophic illness or disaster has reached a certain threshold cost which the Secretary shall establish at—

(A)the 2000 level of $19,000; and

(B)for any subsequent year, not less than the threshold cost of the previous year increased by the percentage increase in the medical care expenditure category of the consumer price index for all urban consumers (United States city average) for the 12-month period ending with December of the previous year;

(3)establish a procedure for the reimbursement of the portion of the costs that exceeds such threshold cost incurred by—

(A)Service Units; or

(B)whenever otherwise authorized by the Service, non-Service facilities or providers;

(4)establish a procedure for payment from CHEF in cases in which the exigencies of the medical circumstances warrant treatment prior to the authorization of such treatment by the Service; and

(5)establish a procedure that will ensure that no payment shall be made from CHEF to any provider of treatment to the extent that such provider is eligible to receive payment for the treatment from any other Federal, State, local, or private source of reimbursement for which the patient is eligible.

(e)Amounts appropriated to CHEF under this section shall not be used to offset or limit appropriations made to the Service under the authority of section 13 of this title, or any other law.

(f)There shall be deposited into CHEF all reimbursements to which the Service is entitled from any Federal, State, local, or private source (including third party insurance) by reason of treatment rendered to any victim of a disaster or catastrophic illness the cost of which was paid from CHEF.

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.), referred to in subsec. (c), is Pub. L. 93–638, Jan. 4, 1975, 88 Stat. 2203, which was classified principally to subchapter II (§ 450 et seq.) of chapter 14 of this title prior to editorial reclassification as chapter 46 (§ 5301 et seq.) of this title. For complete classification of this Act to the Code, see

Short Title

note set out under section 5301 of this title and Tables. Codification Amendment by Pub. L. 111–148 is based on section 122 of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148.

Amendments

2010—Pub. L. 111–148 amended section generally. Prior to amendment, section related to establishment of Indian Catastrophic Health Emergency Fund with provisions for its administration, promulgation of

Regulations

, procedures for payment, effect of appropriated funds on other appropriations, and deposit of reimbursements. 1992—Subsec. (a)(1)(B). Pub. L. 102–573, § 202(a)(1), substituted “to the Fund under this section” for “under subsection (e) of this section”. Subsec. (b)(2). Pub. L. 102–573, § 202(a)(2), substituted “shall establish at—” and subpars. (A) and (B) for “shall establish at not less than $10,000 or not more than $20,000;”. Subsec. (c). Pub. L. 102–573, § 202(a)(3), substituted “Amounts appropriated to the Fund under this section” for “Funds appropriated under subsection (e) of this section”. Subsec. (e). Pub. L. 102–573, § 217(b)(2), struck out subsec. (e) which authorized appropriations for fiscal years 1989 to 1992.

Statutory Notes and Related Subsidiaries

Effective Date

of 1992 Amendment Pub. L. 102–573, title II, § 202(b), Oct. 29, 1992, 106 Stat. 4546, provided that: “The amendment made by subsection (a)(2) [amending this section] shall take effect January 1, 1993.”

§1621a Catastrophic Health Emergency Fund