Catastrophic Health Emergency Fund (CHEF)

Purpose

Catastrophic Health Emergency Fund (CHEF) was established to support and supplement Purchased/Referred Care (PRC) programs that experience extraordinary medical costs associated with the treatment of disasters and/or catastrophic illnesses that are within the responsibility of Indian Health Service (IHS) and Tribes.

What is the Catastrophic Health Emergency Fund (CHEF)?

• The fund was created by Congress to reimburse medical expenses incurred for catastrophic illnesses and events falling within the PRC payment responsibility of IHS after a threshold cost has been met. For FY 2025, the cost threshold requirement is $19,000 and must first be met before reimbursements can be requested from the CHEF. The CHEF threshold cost of $19,000, and for any subsequent year, not less than the threshold cost of the previous year, increased by the percentage increase in the medical care expenditures category of the consumer price index (CPI) for all urban consumers.
  • PRC is any health service that is delivered at the expense of, an Indian health program; and
  • provided by a public or private medical provider or hospital that is not a provider or hospital of the Indian health program.
• CHEF is intended to shield IHS and Tribal PRC programs from depletion of PRC funds caused by the high cost of catastrophic illnesses and/or events.
• CHEF reimbursement cannot be made until all alternate resources have been exhausted.
  • Alternate Resources are any Federal, State, local, or private source of health care resources for which the patient is eligible (i.e., Medicare/Medicaid/Private Insurance).

Electronic CHEF Application

The Electronic CHEF Application (ECA) is a fully automated paperless process for identifying, documenting, and submitting requests for reimbursement from the CHEF. The ECA uses current technology to streamline both the workflow and the documentation required for a CHEF case to be considered complete for reimbursement.

All sites are highly encouraged to use this desktop application that is available to both RPMS and Non-RPMS programs. ECA is user-friendly, efficient and will result in fewer errors and rejections. ECA allows cases to be in one coordinated location providing self-service tracking and report generation.

For additional information regarding ECA implementation, training and support email the ECA support team at hq_orapchefonlinesupport@ihs.gov

Electronic CHEF Application Webinars