July 23, 2021 | Issue 21-24
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House of Representatives to Begin Consideration of Consolidated Appropriations Bill
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On Monday, July 26, 2021, at 2:00 pm EST, the House Rules Committee will hold a meeting to begin consideration of H.R. 4502, a “mini-bus” of 7 Appropriations bills for FY 2022. The Rules Committee typically determines the debate time and under what House rule the bills and approved amendments will be considered by the full House of Representatives. It is possible that the full House of Representatives could begin consideration of this consolidated bill as early as Tuesday or Wednesday.
The consolidated bill includes 1) Labor, Health and Human Services, and Education (Labor-HHS), 2) Agriculture and Rural Development, 3) Energy and Water Development, 4) Financial Services and General Government, 5) Interior and Environment (Interior), 6) Military Construction and Veterans Affairs, and 7) Transportation and Housing and Urban Development Appropriations bills.
The Rules Committee will also consider the 733 amendments filed to this bill. The most notable amendment relating to Indian health is Amendment 78 to Division E (Interior and Environment), filed by Representative McKinley (WV-R) which purports to transfer $8.804 million to the State and Tribal assistance grants under the Drinking Water State Revolving Fund.
NIHB reported earlier on Labor-HHS and Interior, Environment and Related Agencies, both of which contain Indian health-related funding provisions. It is also possible that three individual Appropriations bills might be considered next week as well: H.R. 4346 – Legislative Branch, H.R. 4373 – State and Foreign Operations, and H.R. – Commerce, Justice, and Science.
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Bipartisan Infrastructure Package Moves Closer to a Vote
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Senate negotiators remained busy this week to finalize the bipartisan $1.2 trillion physical infrastructure package. While the bill language has not been completely finalized, the legislation is intended to include significant funding for surface transportation and roads, drinking water, sanitation, water settlements, and broadband. The NIHB reported on the broad framework and purposes of the infrastructure legislation here.
It is expected that the bill text could be finalized as early as Monday, July 26, and then considered by the full Senate likewise as early as next week. Senate Majority Leader Schumer has signaled his intent to complete the package and send it to the House of Representatives before the August recess.
On June 21, NIHB submitted a letter to Congressional leadership outlining Tribal healthcare infrastructure requests, including $48 billion for full funding of the Indian Health Service (including Tribal health care systems), $21 billion for health care facilities construction, $3 billion for health IT modernization, and more.
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National Indian Health Board Pushes Forward on Advance Appropriations
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The National Indian Health Board continues moving forward on achieving advance appropriations for the Indian Health Service, including Tribal health programs. Background on the subject is available here. On March 11, 2020, the Congressional Research Service (CRS) issued a report on advance appropriations for the Indian Health Service (IHS).
This report identified several issues for Congress to consider as it weighs this authority. Some issues relate to implementation and others may be governed by Congressional budget process and rules. For example, the IHS must have “the capacity to estimate its budget in future years.”1 Unexpected costs may limit such capacity. The CRS specifically identified the Section 105(l) leases (whereby the IHS is required to pay full reasonable lease costs to tribes) as one such unexpected cost.
NIHB is coordinating with the Self-Governance Communication and Education Tribal Consortium to address these issues. The President has expressed support for advanced appropriations in his FY 2022 budget request for Indian Health Service as well as moving those “unexpected costs” of Section 105(l) leases and contract support costs to mandatory funding. In light of this support, the NIHB CEO will be connecting and working closely with the White House to continue moving this priority forward.
NIHB also anticipates including a panel on advance appropriations at the National Tribal Health Conference which will occur October 14-18, 2021. So please save the date and join in the discussion.
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UPDATES FROM THE FEDERAL & STATE ADMINISTRATIONS
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HRSA Waiver Training Program
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The Health Resources and Services Administration (HRSA) recently released a DATA 2000 Waiver Training Payment Program geared toward Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) that currently employ buprenorphine waivered providers. This program will provide FQHCs and RHCs with the opportunity to be awarded $3,000 in payment for each eligible provider who has a Drug Addiction Treatment Act of 2000 waiver on or after January 1, 2019. Funds will be paid on a first come first serve basis and FQHCs have been awarded $6 million in total while RHCs have been awarded $2 million. These funds may aid Tribal FQHCs and RHCs in attaining more revenue for their facility as well as incentivize providers into continuing to provide care in these settings.
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Emergency Tele-Critical Project Supported by HHS and the DOD
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The Department of Health and Human Services (HHS), in collaboration with the Department of Defense (DOD) announced a National Emergency Tele-Critical Care Network project that will provide virtual care with no cost to hospitals through “lightweight telemedicine platforms”. These lightweight telemedicine platforms include apps and a mobile device. This program is staffed by critical care experts from around the country and aims to aid hospitals who are caring for COVID-19 patients by providing physicians, nurses, respiratory therapists and other experts. Outcomes of this project implementation in Tribal hospitals could be beneficial for hospital staff in lessening the lode of work that has been exacerbated due to the COVID-19 pandemic.
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Interim Final Rule on Surprise Billing
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On July 13, the Personal Management Office at the Department of Health and Human Services (HHS) released interim final rule with a request for comment on requirements related to surprise billing. This is the first part in a series of rules that will set forth provisions for additions and revisions to the already existing Internal Revenue Code that protects participants, beneficiaries and those enrolled in group health plans from surprise medical bills. This may be beneficial for enrollment assisters of American Indian and Alaska Native (AI/AN) beneficiaries in Tribal communities to be used to better understand new provisions and that can ultimately relieve financial burdens. These regulations are effective September 13, 2021, and comments are due September 7, 2021.
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New Physician Payment Rule to Improve Health Equity and Patient Access from CMS
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On July 13, the Centers for Medicare and Medicaid Services (CMS) announced a proposal for the Physician Payment Rule to Improve Health Equity and Patient Access. This rule aims to expand patient access to care in underserved populations where CMS is seeking feedback on health equity data collection to better analyze health disparities. This rule also aims to expand telehealth and other telecommunication technologies for behavioral health with an advancement of the Quality Payment Program and an update to vaccine payment rates. This rule could potentially affect American Indian and Alaska Native (AI/AN) communities. The comments on this rule are due September 13, 2021.
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Notice with Request for Nominations for the IHS Contract Support Cost Advisory Group
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CMS Announcement on the “Summer Sprint to Coverage Initiative”
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On July 15, the Centers for Medicare, and Medicaid Services (CMS) released an announcement on the launch of a “Summer Sprint to Coverage” campaign initiated by the Biden-Harris Administration. This initiative aims to vamp up the amount of enrollees into health insurance during the final 30 days of the Special Enrollment Period. During this initiative CMS will release education material and other forms of outreach events to populations with high uninsured rates. This announcement may be beneficial for patient benefit coordinators and enrollment assisters working with American Indian and Alaska Native (AI/AN) populations who have historically been predominantly uninsured.
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GRANTS, RESOURCES AND EVENTS
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Additional Funding from the American Rescue Plan to HRSA “look-alike” Health Centers
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Upcoming Meeting of the COVID-19 Health Equity Task Force
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On July 12, the Department of Health and Human Services (HHS) released a notice of meeting of the COVID-19 Health Equity Task Force. This meeting will be held on July 30, 2021. Topics at this meeting will include recommendations from members on how to address future pandemic preparedness, mitigation and resilience for minority communities of color and underserved populations. This meeting provides a forum for American Indian and Alaska Native (AI/ANs) communities to express hardships they experienced with health equity during the COVID-19 pandemic and may benefit Tribal communities when responding to future health emergency crisis.
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New Funding from HHS from the American Rescue Plan to Help Mitigate Burnout in the Health Workforce
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Annual Regional Tribal Consultations from HHS
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The Department of Health and Human Services (HHS) will be hosting four HHS Regional Tribal Consultation Sessions to collaborate with Tribes on regional specific issues related to HHS policies and programs. These sessions will also provide Tribal leaders with a means to consult with leadership within HHS on national-level issues.
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July 27, 2021: Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont).Register here Contact: Paul Jacobsen; Paul.Jacobsen@hhs.gov
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August 9 – 12, 2021: Region 9 (Arizona, California, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federal States of Micronesia, Guam, Marshall Islands, and Republic of Palau). Register here. Contact: Schuyler Hall; Schuyler.Hall@hhs.gov
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Administration for Children and Families Seeking Nominations for Tribal Advisory Committee
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- Albuquerque Primary and Alternate
- Billings Alternate
- California Alternate
- Oklahoma Primary and Alternate
- Phoenix Primary and Alternate
Vacancies will be filled on a rolling basis. Click here to learn more.
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HRSA Seeking Nominations for a Tribal Advisory Council
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The Health Resources and Services Administration (HRSA) is seeking nominations for their Tribal Advisory Council (TAC). These individuals are required to be Tribal officials who have the authority within their Tribe to act on behalf of their communities and who represent the collective views of the Tribes in the area from which they were nominated. These individuals when nominated will serve a length of two years before new nominations will take place. Currently, the areas open for nomination include the Albuquerque Area, California Area, Phoenix Area, and the Tucson Area. To see the work the National Indian Health Board (NIHB) has done on Tribal Advisory Committees please click here. Eligibility criteria for those interested in applying can be found here.
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CMS Extends Healthcare.gov Marketplace Special Enrollment Period
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For more information on the special enrollment period, visit the CMS website here.
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Call for Proposal for 2021 National Tribal Health Conference
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The National Indian Health Board will be hosting its upcoming National Tribal Health Conference (NTHC) from October 4-8, 2021. The theme of this year's conference is, "The Future of Native Health in Our Changing World" NIHB is now accepting proposals for ALL workshop sessions until August 6, 2021. Workshops are excellent opportunities to share best or promising practices, recent research or program outcomes, and provide an in-depth exploration of new or arising issues or policies. Submit a workshop proposal for a 75-minute presentation relevant to one of the following daily topics.
2021 NTHC Daily Topics:
- Health Equity and the Trust Responsibility: Be Heard, Make Change
- Disruption, Governance, Politics in the Tribal Health Space
- Transformational Approaches to Financing our Health Systems
- Resilience During Periods of Sustained Crisis
- The Rise of Technology to Revolutionize AI/AN Health
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NIHB Accepting Nominations for Outstanding Service Awards
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The National Indian Health Board (NIHB) is now accepting nominations for the 2021 Outstanding Service Awards. Each year, the NIHB invites nominations for awards that recognize excellence, achievement and contributions that go "above and beyond" the call of service and honors efforts made by individuals, organizations and programs that have enriched and improved American Indian and Alaska Native health, health systems or policy at the local, regional, and national level. All nominations must be received through the online form by 11:59 PM ET on Wednesday, July 28, 2021.
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Visit the NIHB COVID-19 Tribal Resource Center at:
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