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Indian Health Service: Capping Payment Rates for Nonhospital Services Could Save Millions of Dollars for Contract Health Services
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Kathleen M. King (au)
The Indian Health Service (IHS) provides health care to American Indians and Alaska Natives. When care at an IHS-funded facility is unavailable, IHSäó»s federal contract health services (CHS) program pays for care from external providers. Hospitals are required to accept Medicare rates from federal and tribal CHS programs, while physicians and other nonhospital providers are paid at either billed charges or negotiated, reduced rates. This report compares CHS program payment rates with those of other public and private payers. It examines (1) how payments to physicians by IHSäó»s federal CHS programs compare with what Medicare and private health insurers would have paid for the same services; (2) physiciansäó» perspectives about how a cap on payment rates could affect them; (3) hospitalsäó» perspectives about how the MLR requirement affected them; and (4) IHS and tribal officialsäó» perspectives about the MLR requirement and a potential cap on nonhospital services. Table and figures. This is a print on demand report.
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