Catastrophic Health Emergency Fund (CHEF)

Purpose

Catastrophic Health Emergency Fund (CHEF) is 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. Currently the cost threshold requirement is $19,000 and must first be met before reimbursements can be expected from the CHEF.
  • PRC means 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 operations from financial disruption caused by the intensity of high cost illnesses and/or events.
• CHEF reimbursement cannot be made until all alternate resources the patient may be eligible for have been exhausted.
  • Alternate Resources are any Federal, i.e., Medicare/Medicaid, State, local, or private source of reimbursement for which the patient is eligible.
• CHEF appropriations cannot be used to offset or limit appropriations made to IHS.

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.

Electronic CHEF Application Webinars