NPAIHB Legislative & Policy  Update
Thursday, May 23, 2019 

IMPORTANT DATES
May 29-30
IHS Direct Service Tribal Advisory Committee (DSTAC) Quarterly Meeting
Rapid City, SD

June 6
12:30PM PT: IHS June All Tribal and Urban Indian Organization Leaders Call
Conference Call: 800-857-5577; Passcode: 6703929 
Webinar:  https://ihs.cosocloud.com/r4k6jib09mj/; Password: ihs123

June 10-13
IHS 2019 Partnership Conference
Spokane, WA

IHS 2019 Dental Updates Continuing Dental Education Conference
Albuquerque, NM

June 11-13
NIHB Board Meeting
Washington, DC

June 19-20
IHS Tribal Leaders Diabetes Committee (TLDC) Meeting
Billings, MT

June 23-27
NCAI 2019 Mid-Year Conference & Marketplace
Sparks, NV

June 27-28
FY 2021 Evaluation/FY 2022 Planning Meeting National Tribal Budget Formulation Meeting
Reno, NV
ACTION ALERTS
CMS Medicaid and Medicare programs interoperability and patient access proposed rule (Comments Due 6/3)
3/4 Federal Register Notice
Proposes patient access through Application Programming Interfaces (APIs) by ensuring access and use of healthcare data to patients. Makes patient claims and other health information available to patients through third-party applications and developers.

HHS Office of the National Coordinator (ONC) 21st Century Cures Act interoperability, information blocking, and the ONC health IT certification program (Comments Due 6/3)
3/4 Federal Register Notice
Proposes for the adoption of standardized application programming interfaces (APIs) to allow patients to securely and easily access electronic health information.

HHS Request for Information (RFI)- Developing an STD Federal Action Plan ( Comments Due 6/3)
5/3 Federal Register Notice
Requests input on what strategies can be implemented by federal agencies to improve the impact of the national response to increasing rates of sexually transmitted diseases (STDs).

IHS DTLL- IHS initiates tribal consultation on draft National CHAP policy (Comments Due 6/7)
5/8 Issued
Requests  input and recommendations on a draft IHS policy to implement, outline, and define a National CHAP. It is extremely important for Northwest tribes to comment on the draft CHAP policy.

VA DTLL- AI/AN veterans healthcare needs in the MISSION Act Strategic Plan  (Comments Due 6/10)
5/16 Issued
Requests feedback on important healthcare needs of AI/AN veterans and healthcare system design needs.

ACF Adoption and foster care analysis and reporting system (AFCARS) amendment (Comments Due 6/18) 
4/19 Federal Register Notice
Amends the AFCARS regulations that require title IV-E agencies to collect and report data to ACF on children in out-of-home care, who exit out-of-home care to adoption or legal guardianship, and children who are covered by a title IV-E adoption or guardianship assistance agreement.

IHS DTLL- IHS is accepting applications for FY 2019 Small Ambulatory Program (Applications Due 6/28)
4/23 Issued
I ssues application cycle for FY 2019 Small Ambulatory Program. The FY 2019 budget includes $15 million.
 POLICY UPDATES
IHS DTLL: Results of tribal consultation on the Indian Health Manual, Part 2-Chapter 3 Purchased and Referred Care (PRC)
5/15 Issued
Updated the Indian Health Manual (IHM) Purchased and Referred Care (PRC) chapter on February 28 following consultation. IHS received 111 comments and the enclosure provides a summary of chapter changes. 

HHS Issue Brief: Special Diabetes Program for Indians (SDPI) estimates of Medicare savings 
5/10 Released 
Estimated the attribution of the reduction in ESRD-DM to SDPI accumulated Medicare savings from SDPI as high as $520.4 million.

GAO Report: Medicaid demonstrations approvals of major changes need increased transparency 
4/30 Released
Reported that GAO found weaknesses in CMS policies for ensuring transparency with Medicaid demonstration waiver changes to pending applications and amendments to existing demonstrations.
LEGISLATIVE UPDATES
House Appropriations Committee released draft FY 2020 legislation
4/14 Introduced
Proposes $6.3 billion to IHS, which is a $537 million increase over the 2019 enacted funding level. Includes $91 million to recruit and retain health professionals; $25 million for the electronic health record (EHR) system; and $20 million to expand the Community Health Aide Program (CHAP). 

Rep. O'Halleran (D-AZ) introduced bill to reauthorize SDPI (H.R. 2680)
5/10 Introduced
Proposes extension of the Special Diabetes Program for Indians (SDPI) for five years at $200 million per year ($50 million annual increase). Authorization of this program is set to expire September 30, 2019.

Rep. Diana DeGette (D-CO) introduced bill to reauthorized SDP (H.R. 2668)
5/10 Introduced
Proposes extension of the Special Diabetes Program (SDP), which funds programs researching Type 1 diabetes treatments. The bill increases SDP's funding to $200 million. Authorization of this program is set to expire September 30, 2019. 
Bill Information

WHAT WE'RE READING 
5/20 McConnell and Kaine unveil bill to raise tobacco age to 21

5/20 Surprise billing comparison: what you need to know

5/17 Seeking to contain drug costs, CMS may have 'killed' a PBM billing practice

5/16 House passes drug pricing bills paired with Obamacare fixes

5/13 Washingtonians to get public option on state's health-insurance exchange
5/9 Trump's talk on pre-existing conditions doesn't match his Administration's actions

5/5 White House issue proclamation for 'Missing and Murdered American Indians and Alaska Natives Awareness Day, 2019' 
For more information
  Laura Platero, Director of Government Affairs/Health Policy 
Sarah Sullivan, Health Policy Analyst
(503) 228-4185
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