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Special General Memorandum 2011-01


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DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service
     Indian Health Service
 Rockville MD 20852

SGM 2011-01

July 11, 2011

TO: Area Directors

FROM: Director

SUBJECT: Crediting Third-Party Reimbursements Documentation - Indian Health Care Improvement Act, Section 207

The purpose of this Special General Memorandum (SGM) is to clarify the instructions in Part 5, Chapter 1, Indian Health Manual, Manual Exhibit 5-1-A, "Accounts Receivable Posting and Reconciliation Instructions," and establish a procedure to ensure that:

  1. all third-party reimbursements are returned to the Service Unit or entity where the health care service was provided, and

  2. the Agency will not offset or limit any funds obligated to the Service Unit or entity because they received third-party reimbursements.

The Headquarters Office of Finance and Accounting (OFA) produces a weekly collections report and issues reimbursable allotments to the Area Financial Management Officers (FMO).  The report contains the record of revenues available for distribution to the Service Unit or health care entity that generated the revenue.  Each Area Office FMO is provided an allowance budget upload (the Open Interface Worksheet) to enter the allowances into the Unified Financial Management System (UFMS).  The Area Office or Service Unit staff shall record the collections data into UFMS without modifications to ensure funds are issued to the correct location.  These funds are not authorized for any method of re-distribution outside of the Service Unit or entity where the revenue was generated and the health care service provided.

Each Service Unit Chief Executive Officer (CEO) or the health care entity CEO will conduct an annual review to confirm that reimbursements were credited properly.  The CEO's will randomly select eight weekly collections reports for the annual review.

If you have questions about this SGM, please contact Ms. Elizabeth Fowler, Chief Financial Officer and Director, OFA, at
(301) 443-1270.

/Yvette Roubideaux, M.D./
Yvette Roubideaux, M.D., M.P.H.


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