August 24, 2021 | Issue 21-28 |
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Senate Passes $3.5 Trillion Budget Reconciliation Resolution |
On Wednesday, August 11, the United States Senate passed a $3.5 trillion budget resolution on a vote of 50-49. The measure directs committees to craft a bill that would spend up to $3.5 trillion on climate initiatives, paid leave, child care, education and health care, as outlined Senate Budget Committee Chairman Bernie Sanders (I-VT) sent a Memorandum outlining the framework.
It highlights the major programs in the President’s agenda to receive increases, including programs under the Senate Committee on Indian Affairs such as the Indian Health Service (IHS). The Budget Resolution also authorized advanced appropriations for IHS, including health care facilities, at level funding provided for FY 2022 and FY 2023.
Both the Budget Resolution and the follow-up budget reconciliation bill require only a simple majority to pass in the Senate and is subject to limited debate. If passed this week, the committees of jurisdiction would have until approximately Sept. 15 to draft their pieces. Then, the separate legislative pieces would get packaged together into a single bill, debated, and voted on.
NIHB will continue to monitor and advocate for Indian health priorities during the negotiation period.
For any questions, contact NIHB Acting Director of Congressional Relations, Rhonda Harjo at rharjo@nihb.org. |
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UPDATES FROM THE FEDERAL & STATE ADMINISTRATIONS |
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New Emergency Use Authorization Codes from the FDA for the COVID-19 Vaccine |
On August 16, the Food and Drug Administration (FDA) released new emergency use authorizations for both the Pfizer and Moderna vaccine. The CPT code 0003A will now be used for the Pfizer vaccine and the CPT code 0013A for the Moderna vaccine. These new codes are effective August 12, 2021. CMS has authorized payment for administration of additional doses of the COVID-19 vaccine which has recently been cleared by the FDA for immunocompromised people. These additional doses will be reimbursed at $40. It is important for Tribal health care facilities that administer the COVID-19 vaccine to understand these new codes when billing Medicare.
For more information on Medicare COVID-19 codes click here.
For more information on Medicare COVID-19 payments click here.
For more information from the Centers for Disease Control (CDC) on additional doses click here.
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New Final Rule from CMS on the Medicare Program |
On August 13, the Centers for Medicare, and Medicaid Services (CMS) released a final rule on updates to the Medicare program hospital inpatient prospective payment system (PPS) for acute care hospitals and inpatient hospital services provided by long term care hospitals. This final rule also incorporates rural reclassification through the Medicare Geographic Classification Review Board. In addition, this rule also makes changes to the hospital value-based purchasing, hospital readmissions reduction, hospital inpatient quality reporting, hospital acquired condition reduction, the PPS-Exempt Cancer Hospital Reporting and the Long-Term Care Hospital Quality Reporting programs. These changes may be beneficial for Tribal inpatient hospital staff, Tribal acute care hospital staff, and Tribal long term care hospital staff. This final rule is effective October 1, 2021.
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New Funding from the USDA on Emergency Funds from the American Rescue Plan |
Proposed Rule from CMS on Updates to the Medicare Program |
On August 4, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule on the hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs. This rule also proposes new price transparency of hospital standard charges, radiation oncology model and requests for comments on the health and safety standards, quality, and reporting requirements for rural emergency hospitals. These regulatory changes may affect rural Tribal emergency hospital’s billing staff and other Tribal healthcare facilities billing staff who work with ambulatory, outpatient and other standard hospital charges. Comments on this proposed rule are due on September 17, 2021.
To learn more about the National Indian Health Board’s (NIHBs) previous comments to CMS on the Medicare program: hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs click here.
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CMS Virtual Workshop Registration |
The Centers for Medicare and Medicaid Services (CMS) released an announcement on new virtual workshops. These workshops rage from Medicare Benefits, Medicare rights and protections to Social Security Benefits. These workshops are being hosted through the CMS National Training Program virtual workshop webpage and intend to aid enrollment assisters and patient benefit coordinators in learning about the most relevant regulations and news regarding Medicare and Medicaid insurance. As a reminder the Medicare Open Enrollment Period begins on October 15, 2021 and ends December 7, 2021.
Links to register for upcoming workshops can be found here:
August 2021
September 2021
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Consultation on Improving the Consistent and Transparent Process of Paying 105(l) Leases |
On July 27, the Indian Health Service (IHS) and the Office of the Assistant Secretary on Indian Affairs (IA) signed a joint Dear Tribal Leader Letter (DTLL) seeking feedback on the 105(l) lease requirements and payments. A 105(l) lease is a provision of the Indian Self-Determination and Education Assistance Act that allows Tribes and Tribal organizations to administer Federal functions on their own by entering into a lease agreement with the IA or IHS. Functions associated with 105(l) leases can either be carried out through a self-determination contract or a self-governance compact. In the most recent fiscal year 2021 Omnibus appropriation general provision language for the Department of the Interior (DOI) and the Department of Health and Human Services (HHS), the administration of 105(l) leases was addressed with the intent to include a consistent and transparent process for payment of these leases. The IA and IHS is requesting input from Tribal facilities and Tribal leaders on how to improve the processing of 105(l) leases, what the definition of “lease proposal” is, what should be added to the IHS guidelines, input on a possible facility-size guideline document for a wide variety of programs, what criteria should be used to determine a square footage guidelines, what criteria should be used for reasonable lease compensation, and how can guidelines be better written to address facility-type, capacity and sovereignty
For more information on 105(l) lease agreements from the National Indian Health Board (NIHB) please click here.
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September Tribal Self-Governance Conference |
From September 14-16, 2021, the Tribal Self-Governance will be holding a conference to discuss recent issues within Indian Country. Topics at the meeting will include a session on sustainable energy for Tribal communities, public safety within Tribal communities, roundtable discussions from the Department of Health and Human Services, expanding health care infrastructure and other important topics for Tribal communities.
To view a draft agenda of the conference, click here.
To sign up for the conference click here.
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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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New Funding Opportunity from NIH for a Resource Center to Serve American Indian and Alaska Native Populations |
On August 9, the National Institutes of Health’s (NIH) National Institute of Minority Health and Health Disparities released a funding opportunity for a selected resource center to provide both support and technical assistance for Tribal Epidemiology centers. This funding is being awarded to aid in research and data science capacity relating to American Indian and Alaska Native populations. If awarded this funding, the center would begin work in July of 2022. If you or an organization within your Tribal community is interested in receiving these funds, please submit a letter of intent by October 30, 2021. To apply online click here.
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New Applicants Eligible for the CMS CDO Program |
On June 3, the Center for Medicare and Medicaid Services (CMS) announced the ability for new organizations to join the Certified Application Counselor Designated Organization (CDO) Program. This opportunity will be available for organizations operating in a Federally facilitated Marketplace state and who are interested in providing certified application counselor enrollment assistance to new consumers in their community. Organizations that wish to apply for the 2022 Plan Year must do by August 31, 2021, and by doing so will enter into an agreement with CMS in order to implement the CDO program. This program could be helpful for Tribal health care organizations wishing to include Certified Application Counselors in their facilities to aid in the Marketplace enrollment process for members in their communities. CMS has also published a FAQ sheet which can also be of use when deciding if the CDO program would be beneficial for your community.
For questions and concerns related to Tribal engagement with this program please email KBitsuie@nihb.org.
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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, 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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New Grant Applications for the IHS TPI Community Health Aid Program |
On July 30, the Indian Health Service (IHS) released a notice on Tribal Planning and Implementation (TPI) of the Community Health Aid Program (CHAP). The IHS is looking for applicants to this grant program in an effort to support the addition of new CHAP programs in Indian Country. The CHAP program provides Tribal communities with a network of health aids who provide disease prevention, health promotion and direct health care while also increasing health services like inpatient and outpatient visits. The TPI program plans to provide resources to support the planning and implementation of CHAP to Tribal communities and organizations in the lower 48. The deadline to submit an application is September 1, 2021.
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New Grant Applications for the IHS TAP Community Health Aid Program |
On July 30, the Indian Health Service (IHS) released a notice on Tribal Assessment and Planning (TAP) Program in collaboration with the Community Health Aide Program (CHAP). Specifically, the IHS is accepting grant applications for the CHAP TAP program. The CHAP program provides Tribal communities with a network of health aids who provide disease prevention, health promotion and direct health care while also increasing health services like inpatient and outpatient visits. The TAP program is designed to assist Tribal communities and organizations in understanding their ability to implement CHAP in their respective communities. The application deadline for this program is September 6, 2021.
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Visit the NIHB COVID-19 Tribal Resource Center at:
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