C.F.R. » Title 42 » CHAPTER I—PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER M—INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES › PART 136—INDIAN HEALTH › Subpart D—Limitation on Charges for Services Furnished by Medicare-Participating Hospitals to Indians

42 C.F.R. § 136.31

Authorization by urban Indian organization

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An urban Indian organization may authorize for purchase items and services for an eligible urban Indian (as those terms are defined in 25 U.S.C. 1603(f) and (h)) according to section 503 of the IHCIA and applicable regulations. Services and items furnished by Medicare-participating inpatient hospitals shall be subject to the payment methodology set forth in § 136.30.

Notes of Decisions
Cited in 1 case, 2020–2020 · leading case: Saginaw Chippewa Indian Tribe of Michigan v. Blue Cross Blue Shield of Michigan
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Saginaw Chippewa Indian Tribe of Michigan v. Blue Cross Blue Shield of Michigan (2020) mied “Plaintiffs’ response brief provides: Because Medicare-participating hospitals are legally required to accept MLR pricing as “payment in full” for services authorized by a tribal CHS program under 42 C.F.R. § 136.31 (j), in circumstances where the MLR price was lower than BCBSM’s…”
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