Tribal leaders, advocates and technical experts developed this fourth iteration of the American Indian and Alaska Native Strategic Plan to ensure that Tribal priorities shape federal health policy and programs impacting American Indian and Alaska Native (AI/AN) people across Indian Country. This strategic plan includes information and direction on a range of issues with a special and specific focus on the Centers for Medicare & Medicaid Service (CMS). Tribal stakeholders put forward this plan to advance the overarching goal of eliminating health disparities for AI/AN people and ensuring access to critical health services.