U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Contract Health Services
Welcome to the Indian Health Services (IHS), Contract Health Service (CHS) website. This website was created to provide information to American Indian/Alaska Native (AI/AN) patients on the CHS program requirements for medical/dental care.

Medical/dental care provided at an IHS or tribal health care facility is called Direct Care. The CHS Program is for medical/dental care provided away from an IHS or tribal health care facility. CHS is not an entitlement program and an IHS referral does not imply the care will be paid. If IHS is requested to pay, then a patient must meet the residency requirements, notification requirements, medical priority, and use of alternate resources.

All AI/AN should be aware of the following requirements each time he/she is referred or requests IHS to pay for medical care away from an IHS or tribal health care facility.

  • Patient responsibility to comply with CHS requirements
  • Contract Health Service is not an entitlement program
  • CHS Eligibility Requirements
  • CHS Notification Requirements
  • CHS Patient Process for Authorization for Payment Diagram [PDF - 251KB]
  • Medical/Dental Priority of Care
  • Use of Alternate Resource
    (Medicare, Medicaid, VA, Private Insurance, charity, etc.)
  • Appeal Process for Denial of CHS care
  • Patient Rights & Responsibilities
  • Directory for an IHS or tribal health care facility near your location

The Frequently Asked Questions (FAQ) section gives answers to the most commonly asked questions regarding the CHS program.

The CHS program requirements are based on specific legislation, Federal regulations, policy, and guidelines to maintain the needs of AI/AN.

Read the Understanding the Contract Health Service Program: Parts 1-6 on the Director's Blog.
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