Medicare - Like Rates
The Department of Health and Human Services published regulations effective July 5, 2007, to implement Section 506 of the Medicare Modernization Act (MMA), which will require hospitals that participate in the Medicare program to accept Medicare-like rates as payment in full when providing services to Indian patients. The rules place a cap on the amount hospitals may charge for patients referred by the IHS, tribal and urban Indian organization Contract Health Service (CHS) programs. The new law will provide IHS and Tribally-operated CHS programs with similar benefits to those enjoyed by of other Federal purchasers of health care.
Additional Information
- More about Medicare - Like Rate on the Indian Health Service Website
- Centers for Medicare and Medicaid Services-Strategic Plan 2010 - 2015 (PDF)
- Final Rule - Section 506 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 - Limitation on Charges for Services Furnished by Medicare Participating Inpatient Hospitals to Individuals Eligible for Care Purchased by Indian Health Programs
Documents from the September 12th Portland Area Training
- Medicare Like Rates Overview - Kris Locke, American Indian Health Commission
- Medicare Claims Forms - Igna Zamora, Blue Cross/Blue Shield
- Medicare Payment Methodologies - Will Fox, Milliman Consultants & Actuaries
- IHS Fiscal Intermediary Contract
