Removal of Obsolete Portion of Regulation Relating to Care and Treatment of Ineligible Individuals

Can someone who is not eligible for Indian Health Service care still be treated at an IHS hospital? In an emergency, yes — and a final rule published October 8 keeps that promise in place while cleaning up old wording around it.

The rule edits 42 CFR 136.14(b). The old text said ineligible patients should be charged rates approved by the Assistant Secretary for Health and the Surgeon General and published in the Federal Register. Those officials no longer approve or publish such rates, so the language is being removed. IHS says its practices and authorities do not change.

After the edit, the section will say two things. In an emergency, as an act of humanity, people not otherwise eligible may get temporary care in IHS facilities. And if the Service Unit Director decides an ineligible patient can pay, the patient will be charged; insurance or other third-party payment can be arranged by the patient or by IHS.

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The change takes effect December 7, 2026. HHS first proposed it in June 2020 and received no public comments. The same day, IHS published a companion rule (FR 2026-20684) removing a separate set of 1987 regulations, 42 CFR part 136a, that were never put into use.

Background papers are at www.regulations.gov under Docket ID IHS-FRDOC-0001. The contact is Carl Mitchell, IHS Division of Regulatory and Policy Coordination, at 301-651-0489.

Federal Register filing: https://www.federalregister.gov/documents/2026/10/08/2026-20685/removal-of-obsolete-portion-of-regulation-relating-to-care-and-treatment-of-ineligible-individuals

This is a Notice Nearby publisher-desk Federal brief — a short in-house summary of a public federal filing. It is not official agency minutes, not a newspaper story, and not Legal Publication. It does not satisfy a statutory notice requirement.