Posted - December 18, 2014
CMS Issues Proposed Rule Regarding Benefit and Payment Parameters for 2016
On November 26th, the Centers for Medicare and Medicaid Services, (CMS) issued a proposed rule, "Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2016," that announced a number of new benefits for American Indians and Alaska Natives (AI/AN). In the proposed rule, CMS is establishing a requirement for Qualified Health Plan (QHP) issuers to prepare a summary of Benefits and Coverage for each plan variation that they offered.
This is beneficial to AI/ANs who will be better able to compare plans and fully understand the type of coverage that is available to them. In addition the proposed rule will also urge QHPs to offer contracts to all Indian health care providers in their network and to include all the special terms and conditions under Federal law pertaining to Indian Health Care Providers, otherwise referred to as the "Indian Addendum." These proposed changes are a direct result of NIHB's advocacy efforts in these areas. NIHB applauds CMS for making these proposed changes but will continue to advocate that the inclusion of the "Indian Addendum" be a mandatory requirement.
Comments are due on December 22, 2014. NIHB and the Tribal Technical Advisory Group to CMS (TTAG) are in the process of constructing comments for this proposed rule. For more information or a copy of NIHB's comments, please contact Devin Delrow at 202-507-4072 or at [email protected].
Posted - December 18, 2014
Congress Passes FY 2015 Omnibus Appropriations Bill
On Saturday, December 13, the U.S. Senate cleared an omnibus appropriations package that will keep the majority of the federal government (including the Indian Health Service) funded through September 30, 2015. The final vote on the legislation was 56-40. In the Senate, 31 Democrats and 24 Republicans, majorities for both parties, supported it.
Specifically, the provisions for Indian Health Service Include:
- $4.6 billion in FY 2015. This is $208 million above the FY 2014 level.
- $4.2 billion is provided for services
- $460.2 million for facilities
- $914 million for Purchased/ Referred Care (formerly known as Contract Health Services) This is a $35 million increase from FY 2014.
- $663 million for Contract Support Costs (CSC). This amount includes increased CSC for FY 2015 but also funds to repay other budget line items which were reprogrammed to cover the FY 2014 CSC shortfall.
- Please stay tuned to NIHB in the coming days for specific details on the FY 2015 Indian Health Service budget.
Posted - December 17, 2014
Congress Repeals Section 910 of the Violence Against Women Act
On December 11, Congress passed S. 1474 which repeals Section 910 of the Violence Against Women Act (VAWA). This provision prohibited Alaska Tribes from exercising Special Domestic Violence Jurisdiction over non-Indian domestic violence offenders. This action is a major victory for Alaska Native Tribes.
Last year, the Indian Law and Order Commission, a bipartisan advisory board, called the Alaska exemption "unconscionable".
Posted - December 10, 2014
Congress Releases FY 2015 Spending Bill - IHS funded at $4.6 billion
Last night, Congress unveiled a $1.1 trillion spending bill that will keep most of the federal government funded through September 30, 2015. The Department of Homeland Security has funding only until February 27, 2015 so that action might be taken by the Republican Congress early next year to counter the President's recent actions on immigration.
The Indian Health Service (IHS) will receive a total of $4.6 billion in FY 2015. This is $208 million above the FY 2014 level. Within this, $4.2 billion is provided for services and $460.2 million for facilities...
Posted - December 10, 2014
HHS Releases a Proposed Rule for Medicare Like Rates for Purchased / Referred Care
On Friday, December 5, 2014, Department of Health and Human Services released a proposed rule on a Medicare Like Rate for non-hospital services. This proposed rule would amend Indian Health Service (IHS) Purchased and Referred Care (PRC), (formerly known as the Contract Health Services) regulations to apply Medicare payment methodologies to all physician and other health care professional services and non-hospital-based services. (IHS referrals currently use a Medicare Like Rate for hospital-based services.)
Specifically, it proposes that the health programs operated by IHS, Tribe, Tribal organization, or urban Indian organization (collectively, I/T/U programs) will pay the lowest of the amount provided for under the applicable Medicare fee schedule, prospective payment system, or Medicare waiver; the amount negotiated by a repricing agent, if available; or the usual and customary billing rate...
From NPR.org - November 18, 2014
Native Americans Urged To Sign Up For Private Insurance
The second round of buying health insurance on the Affordable Care Act exchanges has started. Health officials say Native Americans may have much to gain by buying insurance there.
Read Full Article at NPR.org
Posted - November 16, 2014
Post Election, Still Little Clarity on FY 2015 Appropriations
On Tuesday, November 4, the United States voters chose to make a change in who controls the US Senate and the margin by which the House of Representatives is controlled. In the Senate, Republicans gained several seats; they will now control the body by a 53 to 46 margin (In Louisiana, candidates will have a runoff election on December 6). In the House of Representatives, Republicans netted a gain of 13 seats; the breakdown of that Chamber is 244-184 with a few races still undecided. Click here for a full tally of election results by State and Congressional District.
Congress will return this week and begin considering the top leadership and committee positions for next Congress. They will also be looking at emergency funding for the Ebola crisis and continuing behind-the-scenes work on the FY 2015 spending package.
A path forward on FY 2015 Appropriations is still not clear. Many in Congressional Leadership on both sides of the aisle are arguing that FY 2015 appropriations should be completed in a single "omnibus" appropriations bill by December 11. This is the day when the current continuing resolution (CR) will expire. Others, however, are calling for Congress to put off this decision until January or early February and enact another CR. Still others, have said that Congress may choose to enact a full-year CR which would keep FY 2015 spending at FY 2014 levels.
Passing full-year appropriations would be more beneficial for the IHS/ Tribal and Urban health programs because they would be able to operate with knowledge of their budget for the remainder of the fiscal year. An omnibus would also ensure that current spending priorities are funded at needed amounts. One example of this is in Contract Support Costs (CSC) where IHS had to cut $25.1 million at the end of the year from other programs in order to fill unmet CSC need.
If you have any questions about the FY 2015 Budget, please contact NIHB's Director of Congressional Relations, Caitrin Shuy, at [email protected] or (202) 507-4085.
Posted - November 16, 2014
US Supreme Court to Hear Case on Affordable Care Act Tax Credits
On November 7, 2014, the United States Supreme Court agreed to hear the case, King v. Burwell, a case that could determine whether the Affordable Care Act (ACA) remains in its current form. The case centers on the question of whether premium tax credits should only be available in state-based marketplaces, and not federally-facilitated marketplace. Currently, they are available in both. This past July, the D.C. Circuit Court of Appeals had ruled that the tax credits only applied to state- based exchanges and not federally-facilitated marketplace. However, the D.C. Circuit agreed to rehear the same case en banc (reviewed by the entire panel of judges who sit on the D.C. Circuit) in December. It surprised many when the Supreme Court agreed to hear this case before the D.C. Circuit could issue a new opinion.
The ACA provides a federal tax credit to low and middle income Americans to offset the cost of insurance policies purchased through the marketplace. The marketplaces advance an individual's eligible tax credit dollars directly to health insurance providers as a means of reducing the upfront cost of plans to consumers. The ACA gives primary responsibility for establishing the marketplaces to individual states. If a state does not create its own marketplace, the federal government, through the Department of Health and Human Services (HHS), establishes and operates the marketplace within the state. The Supreme Court will now hear the issue to determine whether this is authorized under the law.
King v. Burwell does not threaten the Indian Health Care Improvement Act but it may mean significant changes to the other parts of the ACA, especially the premium tax credit. Given the fact that nearly 5 million people have already received subsidies through the federally-facilitated marketplace, the Court will likely defer to Congress to fix the error. Since the Court won't likely hear the case until sometime in the spring, there is time to strategize how we can best ensure the Indian-specific provisions are protected.
NIHB will keep you updated as this case develops. For further information or if you have any questions, please contact Devin Delrow at [email protected] or (202) 507-4072.
Posted - November 14, 2014
The National Indian Health Board has prepared an election results update with insight and analysis into the next Congress.
Please click here to view.
If you have any questions please contact NIHB's Director of Congressional Relations, Caitrin Shuy, at [email protected] or (202) 507-4085.
Posted - October 28, 2014
White House Announces 2014 Tribal Nations Conference
President Obama, the White House Office of Intergovernmental Affairs and the White House Domestic Policy Council cordially invitee you to join him and senior members of his Administration for the 2014 White House Tribal Nations Conference. The goal of this year's Conference is to bolster the meaningful discussion between Tribal leadership and the Administration, and further strengthen the Nation-to-Nation relationship between the United States and American Indian and Alaska Native Tribes.
The Conference will be held on Wednesday, December 3, 2014, at the Capital Hilton located at 1001 16th St NW, Washington, D.C. from 8:30 a.m. to 4:00 p.m. Supplementary programming will take place the afternoon of December 2nd (please click here for a draft agenda and FAQ).
One representative from each Federally recognized Tribe is invited to attend this event. Please RSVP here: http://www.whitehouse.gov/webform/rsvp-2014-white-house-tribal-nations-conference by 10 p.m. EST on Wednesday, November 12th, 2014.
Posted - October 28, 2014
Latest Ebola Update from the CDC
Centers for Disease Control and Prevention (CDC) continues to provide current information on the Ebola outbreak. The latest update (October 27, 2014), "Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure" is listed on the website.
The healthcare workers who take care of the patients with Ebola are not only helping those with the disease but also protecting the United States by helping to fight the outbreak at the source...
Posted - September 9, 2014
HHS announces $60 million to help consumers navigate their health care coverage options in the Health Insurance Marketplace
The Affordable Care Act is working for millions of Americans who are able to access quality health coverage at a price they can afford, in large part because of the efforts of in-person assisters in local communities across the nation. People shopping for and enrolling in coverage through the Health Insurance Marketplace can get local help in a number of ways, including through Navigators.
Health and Human Services Secretary Sylvia M. Burwell today announced $60 million in Navigator grant awards to 90 organizations in states with federally-facilitated and state partnership Marketplaces. These awards support preparation and outreach activities in year two of Marketplace enrollment and build on lessons learned from last year...
Read Full Article on hhs.gov
Posted - August 19, 2014
The trouble with trying to sign people up for health insurance when care is already free
by Whitney Shefte - The Washington Post
It’s hard work trying to get people to sign up for health insurance when their care is mostly free to them. Andrea Thomas is working to get Alaska Natives in Sitka, Alaska, to do just that. She’s the outreach and enrollment manager at SouthEast Alaska Regional Health Consortium (SEARHC), and it’s her job to sign people up for health insurance coverage through exchanges created as a result of the Affordable Care Act...
Rwad Full Article
Posted - August 8, 2014
CDC Announces Upcoming Tribal Advisory Committee Meeting
The Centers for Disease Control and Prevention (CDC) have announced the next face-to-face meeting of the Tribal Advisory Committee (TAC). The meeting will be hosted by the Tribes of the Bemidji Area and will be held August 12-14, 2014 at the Grand Traverse Resort and Spa by Traverse City, Michigan. The CDC will be sending out a Dear Tribal Leader Letter soon. This is a good opportunity to consult with Tribal leaders about challenges and successes with health and public health systems and programming, funding, access to information and data, and other related topical areas in order to funnel this information to the official Area TAC representative. As the agenda has not been published yet, it is not known what portions of the meeting will be closed and what will be open, however, attendance is encouraged and a wonderful opportunity to provide live testimony and to listen to the testimony of others.
Posted - August 7, 2014
Maniilaq CEO reaches out for federal IHS funds up front
By Jillian Rogers - The Arctic Sounder
After a few months on the job, Maniilaq Association CEO Tim Schuerch said the organization is more financially stable now than it was when he started.
However, delays in federal funding are causing headaches when it comes to running the facilities and hiring healthcare workers.
Last week Schuerch took Maniilaq's plight to the House Natural Resources Subcommittee on Indian and Alaska Native Affairs, chaired by Congressman Don Young, to urge them to pass a bill that would provide Indian Health Service funding in advance...
Read Full Article
Related Article: "American Indians Look to Veterans’ Model for Stable Health Budgets"
Posted - July 1, 2014
SAMHSA Accepting Feedback on Tribal Consultation Policy
The Substance Abuse and Mental Health Services Administration has released a Dear Tribal Leader letter within the past month soliciting feedback on the latest revisions to their Tribal Consultation Policy (TCP). The policy can be read here, http://beta.samhsa.gov/sites/default/files/tribal-consultation.pdf. SAMHSA is requesting that all feedback on the revised policy be submitted via e-mail to [email protected] by August 29, 2014.
Posted - June 18, 2014
U.S. Patent and Trademark Office Cancels Six Federal Trademark Registrations for the Washington Redsk*ns
Today, the United States Patent and Trademark Office has canceled six federal trademark registrations for the name of the Washington Redsk*ns. As grounds for cancellation the Patent and Trademark Office ruled that the name is "disparaging to Native Americans" and cannot be trademarked under federal law that prohibits the protection of offensive or disparaging language. The plaintiff's lead counsel said in a press release that they "presented a wide variety of evidence - including dictionary definitions and other reference works, newspaper clippings, movie clips, scholarly articles, expert linguist testimony, and evidence of the historic opposition by Native American groups - to demonstrate that the word 'redsk*n' is an ethnic slur." The defendants in this case will most likely appeal the ruling and the trademark protection will continue through the appeals process.
For additional information see the links below:
Posted - June 12, 2014
NIHB Applauds Legislation Introduced to Provide Medicare Like Rates for All Care Purchased by the Indian Health Service
WASHINGTON, DC- June 12, 2014- Yesterday Congresswoman Betty McCollum (D-MN) and Congressman Tom Cole (R-OK), co-chairs of the Congressional Native American Caucus, introduced H.R. 4843, the "Native Contract and Rate Expenditure (CARE) Act." The bill would extend the Medicare-Like Rate cap on payments made by Purchased/Referred Care (PRC) (formerly Contract Health Services) programs at the Indian Health Service (IHS) and Tribal levels to all Medicare participating providers and suppliers. The National Indian Health Board (NIHB) worked closely with Congresswoman McCollum and Congressman Cole's offices to assist in the development of this legislation and is very pleased to see the bill introduced. The introduction of this legislation is an essential first step in allowing IHS and Tribal health facilities spend precious PRC resources most effectively and efficiently...
Posted - June 4, 2014
CMS SUBMITS NAVAJO NATION MEDICAID AGENCY FEASIBILITY REPORT TO CONGRESS ON JUNE 3, 2014
The Indian Health Care Improvement Act, as reauthorized by the Affordable Care Act, required the Secretary of the Department of Health and Human Services to conduct a study and report to the Congress on the feasibility of establishing a Navajo Nation Medicaid Agency. A copy of the report was submitted to Congress by the Centers for Medicare & Medicaid Services. The report was prepared in consultation with the Navajo Nation.
CLICK HERE to access the report.
Posted - May 11, 2014
Dear Tribal Leader Letters from IHS Acting Director Dr. Yvette Roubideaux
IHS Acting Director Dr. Yvette Roubideaux wrote to Tribal Leaders on May 9, 2014 to provide an update on the Special Diabetes Program for Indians (SDPI). The letter notes that that the SDPI program has been renewed by Congress for 1 year and that the Tribal Leaders Diabetes Committee (TLDC) recommended that IHS continue the same funding distribution in FY 2015. The TLDC also recommended that IHS continue discussions on recommendations for any future extension that might be for multiple years, and encouraged IHS to request a waiver to allow for a continuation application rather than a competitive application.
View Letter (PDF)
On May 12, 2014, IHS Acting Director Dr. Yvette Roubideaux wrote to Tribal Leaders to provide an update on Contract Support Costs (CSC). The letter addresses: 1) the Indian Health Service’s (IHS) progress on resolving past CSC claims; 2) consultation activities on a long-term solution for CSC as requested by Congress; 3) CSC appropriations and payments in fiscal year (FY) 2014; and 4) CSC in the FY 2015 President’s Budget Request.
View Letter (PDF)
Posted - April 2, 2014
Native American Leaders Promote Affordable Care Act in National Indian Health Board Video
BILLINGS, Mont.--April 3, 2014--During its full day of free Affordable Care Act training for Tribes, today in Billings, MT, the National Indian Health Board (NIHB) launched a media campaign featuring American Indian elders. The launch was marked by the national debut of a public service announcement (PSA) for American Indian and Alaska Native elders highlighting how the Affordable Care Act (ACA) improves the health care for Native elders.
Read Full Article
Posted - March 4, 2014
President releases the FY 2015 Budget request to Congress
Today the President released the FY 2015 Budget request to Congress. This officially kicks off the appropriation season. In the coming months, Congress will use this request as a baseline as it develops the FY 2015 budget.
Overall, the FY 2015 budget request totals $3.901 trillion and would increase taxes on the wealthy (by formalizing the “Buffet Rule”), cut the size and pay of the military and expand social programs. Most of the proposal will not be enacted by Congress, but will still serve as a benchmark as FY 2015 spending is finalized. You may also find this infographic from the Washington Post interesting:
For the Indian Health Service the President requested $6 billion, and increase of $228 million or 4 percent over FY 2014. The budget fully funds contract support costs and provides increases for Purchased/referred care (aka contract health service) for medial inflation (5%); and clinical services. The budget also restores the cuts that were made to the Indian Health professions; tribal management and self-governance accounts in the FY 2014 operating plan in order to fully fund contract support costs.
The Administration has released a brief (attached) today but more details will be shared in the coming days. Please stay tuned for a more detailed analysis from NIHB. You can view the whole Health and Human Services Department brief here: http://www.hhs.gov/budget/#brief
IHS FY 2015 Budget in Brief (PDF)
Posted - February 20, 2014
Indian Health Service releases its FY 2014 operating plan
On February 18, 2014, the Indian Health Service released its FY 2014 operating plan. As you may recall, on January 17, 2014, Congress passed an appropriations bill to fund the Federal government for the remainder of Fiscal Year 2014 (FY 2014). The law removed caps on Contract Support Costs (CSC) and created a way for the Indian Health Service (IHS) and Bureau of Indian Affairs (BIA) to fully fund CSC in 2014. Given the parameters of the legislative language, the “way” to fully fund CSC was by moving money from other IHS and BIA line items into CSC.
Today, IHS released their FY 2014 operating plan which details the funding for each spending account for the remainder of the fiscal year. The plan funds Contract Support Costs and made reductions in other areas from FY 2013. Accounts receiving those reductions for FY 2014 include Self-governance ($1 million), Tribal Management ($1 million) and Indian Health Professions ($5 million).
IHS Budget Review FY2012-2014: Click Here (PDF)
IHS Budget FY2014: Click Here (PDF)
BIA Budget FY2014: Click Here (PDF)
Please contact Caitrin Shuy at [email protected] with any questions on the FY 2014 budget.
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