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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

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     Indian Health Manual

Part 2, Chapter 3:  Manual Exhibit 2-3-F

Notice to Contract Health Providers Concerning all Patients being Referred by the Indian Health Service

A patient may be referred by an authorizing official of the Indian Health Service (IHS) when the medical care required cannot be provided at the IHS facility.  The referral is not an implication that the IHS will authorize payment for the cost of the care to be provided.  The IHS will assume financial responsibility for referrals if the patient is eligible within a Contract Health Service Delivery Area under the Contract Health Service (CHS) regulations and is not eligible for or does not have an alternate resource.  Patients who are ineligible under the CHS regulations will be financially responsible for the medical costs incurred for a referral made by the IHS.

The basic criterion for determination of an Indian person’s eligibility for the CHS program is contained in the CHS regulations 42 Code of Federal Regulations.  An Indian person is deemed eligible for CHS when his/she resides on a Federally-recognized Indian reservation or resides near the reservation of which he/she is a member or is determined to have close social and economic ties with the Tribes located on the reservation.

Further clarification and/or additional information concerning CHS may be obtained from the Chief Executive Officer and/or the Supervisory Health Systems Specialist, CHS.

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