The Centers for Medicare & Medicaid Services (CMS) has extended the grace period previously granted to Indian Health Service (IHS) facilities, and facilities operated by Tribes and Tribal organizations, to claim Medicaid reimbursement for services provided outside of the “four walls” of the facility to October 31, 2021. This bulletin also explains the steps Tribal facilities and states will need to take before the extended grace period expires in order to continue to be reimbursed for services provided outside the four walls of the facility after October 31st.