IHS Implements New Regulation for Tribes to Negotiate Medicare-Like Rates


The Indian Health Service (IHS) is implementing a new regulation that gives the IHS, Tribal and urban Indian health programs the ability to cap payment rates at a “Medicare-like rate” to physician and other non-hospital providers and suppliers who provide services through the Purchased/Referred Care program.These rates will be known as Purchased/Referred Care rates.

“For years Indian health programs have been paying higher rates than private health insurers and other federal programs. This new regulation offers Tribes the option to negotiate reasonable rates for nonhospital based services, as long as they are in the best interest of the program,” said IHS Principal Deputy Director Mary Smith. “Tribes are not required to take action based on this new regulation. It’s an opt-in rule, which allows flexibility for Tribes and exercises sovereignty and self-determination.”



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