May 21, 2021 | Issue 21-17 |
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Senate Finance Committee holds Hearing on COVID-19 Medicare and Medicaid Flexibilities |
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Jessica Farb, Director, Health Care, United States Government Accountability Office
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Kisha Davis, M.D., MPH, Member, Commission On Federal And State Policy, American Academy of Family Physicians
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Linda V. DeCherrie, M.D., Clinical Director, Mount Sinai Health System
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Narayana Murali, M.D., Executive Director And Board Member Of America’s Physician Groups, Marshfield Clinic
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Robert A. Berenson, M.D., Institute Fellow, Urban Institute
The hearing focused on the Medicare and Medicaid flexibilities instituted in response to the COVID-19. The questions from the committee focused on the expansion of telehealth, home care, and behavioral health flexibilities for Medicare and Medicaid created during the public health emergency. The witnesses recommended expanding and making permeant many of these flexibilities and offered feedback on the payment structure for these programs, especially telehealth.
Telehealth during the pandemic has been especially important for Indian Country and a top advocacy priority at NIHB. Most recently, NIHB submitted written testimony to the House Energy and Commerce Subcommittee on Health outlining the needs of Indian Country as it pertains to telehealth. This includes fixes to Medicare and Medicaid and the expansion of access throughout the Indian Health System. Read NIHB’s full testimony to the House Energy and Commerce Subcommittee on Health here.
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UPDATES FROM THE FEDERAL & STATE ADMINISTRATIONS |
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Annual Regional Tribal Consultations from HHS |
On May 19, the Department of Health and Human Services (HHS) will be hosting three 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.
- May 25, 2021, 12:00PM EDT: Regions 7 and 8 sessions
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The region 7 (Missouri, Iowa, Nebraska, and Kansas) the HHS Tribal contact is Kit Wagar; Kit.Wagar@hhs.gov
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The region 8 (Montana, Wyoming, North Dakota, South Dakota, Utah, and Colorado), the HHS Tribal contact is Dylan Kintish; Dylan.Kintish@hhs.gov
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May 26, 2021, 12:00PM EDT: Regions 6,7 and 8 sessions.
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The HHS Tribal contact for region 6 (New Mexico, Texas, Oklahoma, Arkansas, and Louisiana) is Julia Lothrop; Julia.Lothrop@hhs.gov.
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May 27, 2021, 12:00PM EDT: Region 6.
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Dear Tribal Leader Letter from HHS Office of Minority Health |
On May 19, the Department of Health and Human Services (HHS) Office of Minority Health (OMH) published a Dear Tribal Leader Letter, detailing a way for Tribal leaders to provide feedback to OMH on establishing a Tribal Advisory Committee (TAC). During the three Regional Tribal Consultation meetings, HHS has set aside a time for Tribal leaders to advise OMH on the TAC and the structure and function of a Center for Indigenous Innovation and Health Equity (CIIHE). In addition to these three regional sessions, Tribal members can also submit comments and suggestions to CAPT Damion Killsback, OMH Senior Advisor for Tribal Affairs at Damion.Killsback@hhs.gov. Comments are due Friday, August 20, 2021.
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Dear Tribal Leader Letter from IHS on the Electronic Health Record |
On May 14, the Indian Health Service (IHS) distributed a Dear Tribal Leader Letter on a request for information on which Tribes currently use their own RPMS Electronic Health Record (EHR) system and the amount it costs those Tribes to maintain that system with periodic updates. This information is intended to aid IHS in responding to the Congressional mandate to improve their understanding of the Tribal and Urban Indian Organization investment in Health Information Technology. To submit information, the department asks that you complete an “EHR Data Call Template”. These templates are due June 4, 2021, and can be emailed to ihsmodernization@mitre.org.
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State Medicaid Director Letter from CMS on a Temporary FMAP Increase |
On May 13, the Centers for Medicare, and Medicaid Services (CMS) released a Dear State Medicaid Director Letter on the temporary 10 percentage point increase to the Federal Medical Assistance Percentage (FMAP) for Medicaid home and community-based services (HCBS) through the American Rescue Plan Act of 2021. This letter details guidance on how to implement this temporary increase as well as guidance on best practices states can use to support, strengthen and enhance their HCBS. It is important for Tribal facility staff and Indian Health Service facility billing staff to know that through this letter, the 10 percent FMAP increase is not applicable for Medicaid expenditures “‘received through’ an Indian Health Service (IHS) facility.”
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Vaccine Requirements from CMS |
On May 13, the Centers for Medicare, and Medicaid Services (CMS) released an interim final rule on their COVID-19 vaccine requirements for Long-Term Care (LTC) facilities and Intermediate Care facilities for beneficiaries with intellectual disabilities. This rule revises the infection control requirements for LTCs and Intermediate Care Facilities. Specifically, language in this rule encourages vaccine uptake by LTC staff members and residents, including those located in Tribal LTC facilities, by requiring that residents be educated about COVID-19 vaccines and requiring that a vaccine be offered to all residents, clients, and staff. It also requires that the vaccination status of residents be reported to the Center for Disease Control and Prevention (CDC). This rule is effective May 21, 2021, and comments are due on July 12, 2021.
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CMS Medicare Promoting Interoperability Program |
On May 17, the Centers for Medicare, and Medicaid Services (CMS) released an application for their Medicare Promoting Interoperability Program Hardship Exception. This application is for CMS eligible hospitals and critical access hospitals who may be exempt from the Medicare promoting interoperability payment adjustment if they can prove that “compliance with the [Medicare Promoting Interoperability Program] requirement for being a meaningful Electronic Health Record (EHR) user would result in a significant hardship.” This application may be of interest to Tribal facilities and Tribal hospitals whose EHR has become severely burdensome due to decertified EHR technology, insufficient internet connectivity, or recurring difficulties with the availability of certified electronic health record technology. This exemption would give Tribal health care facilities an exemption from complying with the Medicare Promoting Interoperability payment adjustment. Applications are due on September 1, 2021.
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GRANTS, RESOURCES AND EVENTS |
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National Council of Urban Indian Health Annual Conference |
If you would like to register for the conference, click here.
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Tribal Navigation for the American Rescue Plan Act |
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NIHB Brain Health Learning Community Informational Webinar |
To create a learning community that works best for its participants, NIHB is hosting an informational webinar that will provide a brief overview of the Brain Health Learning Community meetings and provide time for discussion and recommendations from participants. The informational webinar will be:
Wednesday, May 26, 2021
2:00 PM – 2:45 PM EDT
For more information about NIHB's Brain Health Learning Community, contact Sara Zdunek at szdunek@nihb.org or 202-507-4077.
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Department of Veterans Affairs Consultation on American Indian and Alaska Natives Veteran’s Documentation – Written Comments Due |
On March 29, the Department of Veterans Affairs (VA) released a Dear Tribal Leader Letter on a request for Tribal leaders to participate in a discussion on the documentation for veterans who are Tribal members and are entitled to accessing care from the VA health care system. The VA is seeking input from Tribal governments, American Indians and Alaska Natives (AI/AN), and Urban Indians on a form of official documentation that can be used to identify Veterans who are also AI/ANs. This official documentation will aid health care facilities in distinguishing Veteran AI/ANs to ensure no collection of copayments are necessary for their receipt of medical services.
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Administration for Children and Families Seeking Nominations for Tribal Advisory Committee |
- 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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VA Seeking Nominations for a New Tribal Advisory Committee |
On May 5, the Department of Veterans Affairs (VA) released a notice on a solicitation for nominations to their Advisory Committee on Tribal and Indian affairs. Individuals interested in applying should be able to identify specific issues for Indian Tribes and Tribal organizations related to Native American Veterans and the Department. Individuals should also be able to propose solutions to issues raised regarding Tribal consultation reports and additionally provide clarification on such issues to the department. Nominations are due on June 1, 2021. The National Indian Health Board (NIHB) has commented on the department's plan for a Tribal Advisory Committee in the past in a January 8, 2021 article by the United States Senate Committee of Veteran Affairs. This committee is the result of a tireless effort by NIHB in 2020 to codify this committee in law. Read more here.
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HRSA Seeking Nominations for a Tribal Advisory Council |
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, Pheonix 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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IHS Virtual Tribal Consultation on IHS Tribal Consultation Policy and Process |
On Tuesday, June 8, 2021, the Indian Health Service is hosting a virtual Tribal Consultation session to seek Tribal input on how to improve the Tribal Consultation Policy and process.
Written comments and recommendations on the IHS consultation policy are due by Tuesday, June 15, 2021 and can be submitted to consultation@ihs.gov with the subject line “IHS Tribal Consultation Policy and Process.”
Time 1:00pm – 2:30 pm EDT
Phone: (833) 568-8864, Meeting ID: 161 5609 4640, Passcode: 571603
Zoom information can be found on the event page here.
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NCAI Mid-Year Conference Registration Open |
Registration for the National Congress for American Indians Mid-Year Conference is now open. The conference will occur virtually this year and provide tribal leaders and partners an opportunity to discuss work on issues facing Tribal Nations. The virtual conference will be held:
June 20-24, 2021
Early Bird Registration Deadline: May 30, 2021
The conference agenda can be found on NCAI’s website here.
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CMS Extends Healthcare.gov Marketplace Special Enrollment Period |
For more information on the special enrollment period, visit the CMS website here.
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Visit the NIHB COVID-19 Tribal Resource Center at:
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