On October 26th, National Indian Health Board (NIHB) Chairperson Cathy Abramson (Board Member, Treasurer, Sault Ste. Marie Tribe of Chippewa Indians) provided remarks and chaired the Health Subcommittee meeting at the 69th Annual National Congress of American Indians (NCAI) Convention & Marketplace in Sacramento, California. The focus of NIHB Chairperson Abramson’s remarks was to provide an update on NIHB’s efforts to secure the Special Diabetes Program for Indians (SDPI) reauthorized by Congress and the importance of protecting Indian programs from sequestration...
On Wednesday, November 14th - World Diabetes Day - please join NIHB and Tribal communities from across the country in asking your Senators and Representatives to support renewal of the Special Diabetes Program for Indians (SDPI) this year! Congress will be back in session and we need to make sure that they renew SDPI!
On October 16, the National Indian Health Board (NIHB) submitted a letter to the U.S. Department of Veterans Affairs (VA) and the Indian Health Service (IHS) recommending that Tribes receive the Medicaid All-Inclusive Reimbursement Rate rather than the Medicare Fee Schedule Reimbursement Rate. The Medicaid All-Inclusive Rate provides a fairer level of reimbursement that more adequately addresses the costs of providing services in small, often rural locations; assuring the availability of needed programs.
Earlier this year, Alaska Tribal Health programs executed reimbursement agreements with the VA under which the Medicaid All-Inclusive Rate would be paid for both inpatient and outpatient services. When Tribes outside of Alaska sought to negotiate a similar arrangement, VA indicated to Tribes that all reimbursement for Indian health outpatient services provided outside Alaska would be limited to the Medicare Fee Schedule Reimbursement Rate. In Tribal consultation sessions with VA, Tribes have objected this change in policy by VA.
This issue will play a critical role in allowing American Indians and Alaska Natives access to quality health care, especially as Tribes enter into negotiations with the VA on terms and conditions for reimbursement rates for direct services.
Letter to VA and IHS on All Inclusive Rate (PDF)
The Centers for Medicare & Medicaid Services (CMS) is pleased to share their draft for a revised American Indian and Alaska Native (AI/AN) Strategic Plan for CMS for the period 2013‐2018.
This is the third AI/AN Strategic Plan for CMS that the Tribal Technical Advisory Group (TTAG) has prepared. The previous plans were issued in 2004 and 2009. It is urgent that the plan is updated because there has been legislation that has resulted in policy and regulatory changes since the last plan was issued, which will significantly impact AI/ANs’ access to health care and the Indian health care delivery system. These changes include the American Recovery and Reinvestment Act of 2009 (ARRA) and the Patient Protection and Affordable Care Act (ACA) in 2010, which also permanently authorized the Indian Health Care Improvement Act (IHCIA).
The draft plan has goals, objectives, tasks, and budgets organized around the five themes of Tribal consultation, Policy Development, Long Term Care, Outreach and Enrollment, and Data. The Plan requests significant increases in CMS funding for AI/AN initiatives over the 5‐year period.
In addition to providing a roadmap for CMS, the plan is informative and useful, particularly Appendix B, which provides an updated summary of the "Legal Basis for Special CMS Provisions for American Indians and Alaska Natives."
The TTAG would like to hear from you about this plan before we finalize this draft and send it to CMS. Please send your comments to Elizabeth Heintzman via email lheintzman@nihb.org no later than October 30, 2012. Our intention is to complete the plan with your input by the end of the year.
A Word version of the Plan is available HERE, in which you can use to make red edits of your recommendations.
Also, visit the TTAG website HERE.
Washington, DC September 17, 2012 – The National Indian Health Board has completed Milestone 1 for Meaningful Use of Electronic Health Records as mandated by the Office of the National Coordinator for Health Information Technology.
August 23, 2012
Today, Health and Human Services (HHS) Secretary Kathleen Sebelius announced the next steps in the Obama administration’s work to help doctors and hospitals use electronic health records.
“The changes we’re announcing today will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests and greater patient engagement in their own care,” Secretary Sebelius said.
The final agenda for the IHS Tribal Consultation Summit being held in Denver, CO on August 7-8, 2012, can be located on the IHS Director’s Blog. Click here to for the final agenda.
Also posted on the Director’s Blog were several new Dear Tribal Leader (DTL) letters providing updates on consultation activities that the DTL letters have initiated a few new consultations. IHS has also developed a summary of all consultation activities initiated since June 2009 with brief updates on their status and outcomes. Click here to view those updates.
Please note that if the letter does not state a deadline for comments, then IHS requests comments be submitted within 60 days from the date of the letter. Comments are should be addressed to Dr. Yvette Roubideaux at IHS Headquarters in Rockville, MD, or by email to consultation@ihs.gov.
The Centers for Disease Control and Prevention’s (CDC) Office for State, Tribal, Local and Territorial Support is pleased to inform you about the upcoming CDC Orientation for New Health Officials, October 15–17, 2012. The orientation will be held at CDC’s headquarters in Atlanta, Georgia.
July 3, 2012
The Special Diabetes Program for Indians (SDPI) is set to expire September 2013 unless Congress takes action to renew the program. And, as in past renewal campaigns, it is critical for Congress to renew the program as soon as possible to avoid disruption in programs and staff. That means we must all work together – in this difficult budget and political climate – to convince Congress to RENEW SDPI THIS YEAR. And it will take all of us working together and sharing information.
That is why NIHB has created a new resource to share information and new tools to make it easy for you and your communities to get involved. Today, we are happy to announce the launch of our new NIHB SDPI Resource Center! Click Here to visit this new site and to start using this valuable tool.
This website will contain up to date information on the status of the renewal campaign in Congress; materials created by grantees and tribes that showcase successes and personal stories, state specific information, and a new tool – a Congressional Tracker – that will give you current information on your Member of Congress relevant to the SDPI renewal campaign.
June 28, 2012
In today’s landmark decision of National Federation of Independent Business et al. vs. Sebelius, the Supreme Court upheld the Affordable Care Act (ACA) and affirms the permanent reauthorization of the Indian Health Care Improvement Act (IHCIA) included in the ACA. Now, with this important Supreme Court decision regarding the ACA with it permanent reauthorization of the IHCIA, the Indian health care system can begin a new chapter in the delivery of quality health care to American Indians and Alaska Natives. NIHB will continue to fight to protect the ACA and the continuous improvement of health care for American Indians and Alaska Natives...
On Monday, June 18th the U.S. Supreme Court ruled that the government must fully reimburse the Ramah Navajo Chapter and other Native American tribes for millions of dollars they spent on federal programs. The federal government had agreed to pay contract support costs to tribes that entered into agreements to manage federal programs, but Congress capped the amount of money earmarked for that reimbursement. The tribes sued, and the 10th U.S. Circuit Court of Appeals in Denver and said the money must be fully reimbursed. “Consistent with longstanding principles of government contracting law, we hold that the government must pay each tribe’s contract support costs in full,” Justice Sonia Sotomayor wrote for the majority. The U.S. Congress has long been keen to the funding issues that plague tribes, but it has never taken legislation actions for an appropriation solution. The high court now states that the executive branch must now make up the difference.
Attached below are both the April 18, 2012 Oral Argument transcript and the June 18, 2012 Decision of the Court.
Click here to view the Oral Argument.
Click here to view the Decision of the Court.
On May 16th, the Department of Health and Human Services (HHS) issued guidance documents to advance the implementation of Insurance Exchange under the Affordable Care Act. One of these documents addressed the federally facilitated exchange. If a state decides not to operate an exchange, HHS will operate a federally facilitated exchange (FFE) in that state. This guidance describes how HHS will consult with stakeholders to implement a federally facilitated exchange, how states can collaborate with HHS through a state partnership exchange to implement certain functions of this exchange, and key policies for the exchange. Through the work of the MMPC, NIHB submitted comments regarding the FFE to the Center for Consumer Information and Insurance Oversight (CCIIO) at Centers for Medicare & Medicaid Services (CMS) on Monday, June 18th.
Click here to read the comments.
On April 4, the National Indian Health Board (NIHB) submitted comments to the Indian Health Service (IHS) and the Department of Veterans Affairs (VA) regarding the agencies’ draft agreement for reimbursement for direct health care services.
Click here to read the comments
With 449 Tribes and Tribal organizations from across the nation, the National Indian Health Board (NIHB) filed an amicus brief to protect the permanent reauthorization of the Indian Health Care Improvement Act (IHCIA) and other Indian-specific provisions included in the ACA in the Affordable Care Act (ACA) case in the United States Supreme Court...
Read More
Click Here for more information (PDF)
On February 3, 2012, a Tribal and State Health Collaborative Roundtable was hosted by ASTHO, the National Indian Health Board, the Northwest Portland Area Indian Health Board, and the Centers for Disease Control at the Marriott Century Center in Atlanta, GA. The meeting began with dinner at 6pm on Thursday, February 2nd and ended at 3pm on Friday, February 3rd. The purpose of this meeting was to assemble state and tribal health leaders to identify opportunities to improve state health and Medicaid agencies’ collaboration with tribal health leaders and to discuss pertinent issues in regard to public health programming, federal funding, and strategic relationships. Preliminary steps were taken to develop an action plan for on-going work among states, tribes, CDC and Center for Medicare and Medicaid. Based on discussions and work at this meeting, a primer will be developed to promote enhanced communication between new State Health Officers and Tribal Leaders and enhance collective understanding of their roles and responsibilities.
NIHB participated in the ASTHO Community Benefits Consensus Statement Meeting on February 6, 2012. The purpose of this meeting was to convene stakeholders to create a consensus statement to inform the Internal Revenue Service (IRS) and non-profit hospitals on specific state and local public health expertise and inputs for community health needs assessments. NIHB attended the meeting on behalf of all federally recognized Tribes who may be running 501(c)(3) hospitals in Indian Country to ensure that AI/AN input was provided.
Meeting objectives included:NIHB has since sent out information on the pending policy changes to Tribal leaders and health organizations potentially impacted. Please contact Paul Allis, Senior Public Health Manager at pallis@nihb.org for any questions or comments. The deadline for comments included in the draft consensus statement are due to ASTHO on February 9, 2012.
On January 11th, the Department of Health and Human Services released a “Dear Tribal Leader Letter” inviting Tribes to the 14th Annual U.S. Department of Health and Human Services (HHS) Tribal Budget Consultation (ATBC) which will take place from March 7- 9, 2012, in the Great Hall of the Hubert H. Humphrey Building at 200 Independence Avenue, SW, Washington, DC as well as to its 2012 Annual Regional Tribal Consultations held across the country.
The National Indian Health Board has submitted comments to the Indian Health Service (IHS) in response to a November 9th “Dear Tribal Leader Letter” regarding the Federal Advisory Committee Act (FACA) and IHS Advisory Groups.
Click here to read NIHB’s comments.
Click here to read the “Dear Tribal Leader Letter”
Although Fiscal Year (FY) 2012 officially began on October 1st, Congress has yet to pass nine of the twelve appropriations bills for this year. This includes the Interior, Environment, and Related Agencies Appropriations bill, which contains funding for the Indian Health Service (IHS)...
The Indian Health Services Budget and Sequestration (PDF)
Affordable Care Act and Indian Health Care improvement Act Implementation (PDF)
The Special Diabetes Program for Indians (PDF)
Suicide and Substance Abuse Prevention (PDF)
On November 21st, the Joint Select Committee on Deficit Reduction aka Supercommittee officially admitted defeat in the quest to find $1.2 trillion in federal deficit reduction over the next 10 years.
Click here for more information on what this means for federal spending and the Indian Health Service.
On November 14th, the Supreme Court announced announced that it will hear arguments regarding the constitutionality of various provisions of the Patient Protection and Affordable Care Act (ACA), including the controversial individual mandate, this March.
Click here for an NIHB update.
The National Congress of American Indians (NCAI), the National Indian Health Board (NIHB), and the National Council of Urban Indian Health (NCUIH) have been jointly awarded a grant from the Indian Health Service (IHS) to collaborate on the National Indian Health Education and Outreach initiative.
Through this partnership, our organizations are working together to develop the necessary tools and resources to assist Tribal nations and their communities in making more informed decisions about their new health care options under the Patient Protection and Affordable Care Act (ACA).
In order to have a better understanding of what resources and tools Tribal nations and their communities might need regarding health care delivery and options, we are encouraging Tribal leaders, American Indian and Alaska Native community members, Tribal employers, and health directors to complete a survey on the ACA.
Click here to take the survey!
The National Indian Health Board commented on six proposed federal rules related to the implementation of the Affordable Care Act on October 31st. Five of the proposed rules were issued by the Centers for Medicare and Medicaid Services (CMS), regarding eligibility for federal health coverage and the establishment of new state-run health insurance exchanges (online marketplaces where consumers can compare pricing and services to choose the best health insurance option for themselves and their families):
In 2010, the Department of Health and Human Services (HHS) created a Secretary’s Tribal Advisory Committee (STAC) and has successfully been meeting for nearly a year. The STAC was one of the first Cabinet Level Tribal Advisory Committee to any Secretary in the Administration...
On October 26th, 2011, the United States Government Accountability Office (GAO) released a report entitled, "Indian Health Service: Continued Efforts Needed to Help Strengthen Response to Sexual Assaults and Domestic Violence."...
On October 22, 2011, NIHB Board Member and Alaska Area Representative, H. Sally Smith, testified at a Senate Committee on Indian Affairs Oversight Field Hearing at the Dena’ina Civic and Convention Center in Anchorage, Alaska. Entitled, “H.O.P.E. for the Future: Helping Our People Engage to Protect Our Youth,” the hearing centered on root causes of the youth suicide epidemic currently plaguing Indian Country and featured witnesses from the federal government, as well as Alaska Native witnesses. Ms. Smith’s testimony on behalf of NIHB focused on adverse childhood experiences (ACEs) as a major cause of suicide and called for greater funding for the Indian Health Service, mental health studies, and suicide prevention grant programs.
Click here to read the testimony
On September 27th, seven senators from the Senate Committee on Indian Affairs sent a letter to HHS Secretary Sebelius and IHS Director, Dr. Yvette Roubideaux, urging the Secretary and other top administration officials to act quickly to improve health care delivery to American Indians and Alaska Natives. The Senators pointed to a U.S. Government Accountability Office (GAO) report issued September 23rd that highlights billing and other problems in the IHS system that make it difficult for American Indians and Alaska Natives to receive care from health providers and makes it difficult for health care providers offering the services to get reimbursed.
The senators requested that IHS submit a comprehensive corrective action plan to address each of the problems and recommendations made in the GAO report, including a timeline for (1) corrective actions, (2) a date when each action will be commenced, (3) a date when each action is expected to be completed, and (4) identifiable goals that will lead to completion of each corrective action.
To view the letter, please visit: http://bingaman.senate.gov/policy/gao_ihs.pdf
The report is available at http://www.gao.gov/new.items/d11767.pdf
Purpose of the Study: The Patient Protection and Affordable Care Act requires GAO to study the adequacy of federal funding for IHS’s CHS program. To examine program funding needs, IHS collects data on unfunded services—services for which funding was not available—from the federal and tribal CHS programs. GAO examined (1) the extent to which IHS ensures the data it collects on unfunded services are accurate to determine a reliable estimate of CHS program need, (2) the extent to which federal and tribal CHS programs report having funds available to pay for contract health services, and (3) the experiences of external providers in obtaining payment from the CHS program. GAO surveyed 66 federal and 177 tribal CHS programs and spoke to IHS officials and 23 providers.
What GAO Recommends: GAO recommends that HHS direct IHS to ensure unfunded services data are accurately recorded, CHS program funds management is improved, and provider communication is enhanced. HHS noted how IHS would address the recommendations; describing the proposed new method to estimate need. IHS’s steps will address some recommendations, but immediate steps are needed to improve the collection of unfunded services data to determine program need.
Since the 1970s, the rate of childhood obesity in our country has tripled, and today a third of American children are overweight or obese. This dramatic rise threatens to have far‑reaching, long-term effects on our children's health, livelihoods, and futures. Without major changes, a third of children born in the year 2000 will develop Type 2 diabetes during their lifetimes, and many others will face obesity‑related problems like heart disease, high blood pressure, cancer, and asthma...Read Full Article
The President’s Plan for Economic Growth and Deficit Reduction lives up to a simple idea: as a Nation, we can live within our means while still making the investments we need to prosper – from a jobs bill that is needed right now to long-term investments in education, innovation, and infrastructure. It follows a balanced approach: asking everyone to do their part, so no one has to bear a disproportionate share of the burden. And it says that everyone – including millionaires and billionaires – must pay their fair share. Pursuing a balanced approach to deficit reduction is critical to being able to keep our promises made to all Americans...Read Full Article
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