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Catastrophic Health Emergency Fund (CHEF)


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 $25,000 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

  • October 23, 2018 - Training for PRC Staff:
    • Adobe connect presentation
    • Audio recording

Transcription for the audio recording [PDF - 127 KB]

  • March 19, 2019 - Training for Information Technology Managers/Staff:
    • Adobe connect presentation
    • Audio recording

Transcription for the audio recording [PDF - 284 KB]