PRESS RELEASE: Senators Smith, Lankford, McSally and Udall Introduce Bill to Expand Resources for Urban Indian Organizations amid Pandemic


Contact: Meredith Raimondi, 202-932-6615,

The long-needed fix would allow urban Indian organizations to direct funds back to the patients who need it most.

Washington, DC (May 8, 2020) – Yesterday, Senators Tina Smith (D-MN) and James Lankford (R-OK) introduced bipartisan legislation with Senators Tom Udall (D-NM) and Martha McSally (R-AZ) to expand Federal Tort Claims Act (FTCA) coverage to urban Indian organizations, giving them a desperately needed boost in resources as many suffer critical supply shortages, closures, and financial hardship as a result of the COVID-19 pandemic. The Coverage for Urban Indian Health Providers Act (S.3650), would amend the Indian Health Care Improvement Act to create parity within the Indian Health System. This is a companion bill to H.R. 6535, introduced on April 17, 2020 by Rep. Ruben Gallego (D-AZ) and Rep. Markwayne Mullin (R-OK).

Urban Indian organizations (UIOs) are doing everything they can to keep their doors open during this pandemic while still dealing with paying for costly medical malpractice insurance. Unfortunately, urban Indian organizations may be forced to make extremely difficult choices – facing competing priorities and expenses like increased PPE prices, trying to pay for testing and supplies, in addition to very costly malpractice insurance. S. 3650 would create parity within the Indian Health Service health system by extending FTCA coverage to urban Indian organizations, who currently are forced to divert resources away from health care in order to foot exorbitant liability costs themselves.

“We are extremely grateful for the leadership of Senator Smith, Lankford, McSally and Udall in introducing this bipartisan legislation for a long-needed fix to the medical malpractice liability protection, which ensures parity for Urban Indian Organizations (UIOs). A single UIO can pay as much as $250,000 annually, funds that could be spent on PPE and testing kits for the American Indians and Alaska Natives they serve – made even more essential as our communities are hit by this pandemic. As all other Indian Health Care Providers are covered by FTCA and Community Health Centers employees as well as volunteers are also covered, this legislative fix is critical to ensure continuity of health care in a time when it’s needed most,” said Francys Crevier, Executive Director of the National Council of Urban Indian Health (NCUIH).

“Minnesota’s urban Indigenous community has been hit hard by the coronavirus pandemic, yet many urban Indian health organizations are often forced to spend hundreds of thousands of dollars on costly liability protection instead of being able to use those resources to provide health care to Native community members,” said Sen. Smith. “This is unacceptable. We need to make sure that urban Indian organizations can use every dollar they have to give urban Indigenous individuals the care they need. I’m glad to work in a bipartisan way to bring financial relief to these vital organizations.”

“There are two prominent UIOs in Oklahoma that faithfully serve our Tribal communities’ healthcare needs in addition to the other important Tribal health facilities around the state. I am glad our bill addresses this disparity in the law to help ensure equal access to medical malpractice liability coverage for the services they offer,” said Sen. Lankford. “Federal tort law currently omits coverage for UIOs, and especially during the coronavirus pandemic, UIOs, like other already covered Tribal health facilities, need to have the peace of mind that they can utilize their funds for care, not court cases.”

“Urban Indian health programs funded by the IHS are facing revenue shortfalls while ramping up services to combat the COVID-19 pandemic. And, as a result, many of these critical health care programs are struggling to keep the lights on and their doors open. They shouldn’t be the only branch of the IHS that has to divert resources away from health care services to cover exorbitant liability costs,” said Sen. Udall. “The federal government’s trust and treaty responsibilities to Native Americans do not stop at reservation boundaries. Nearly 70 percent of American Indians and Alaska Natives live in urban areas and Congress must ensure they have access to quality health care — especially during this public health crisis. This legislation is a common-sense measure to provide Urban Indian Health Programs with the same federal protections given to all other Indian Health Care Providers.”

“Arizona is home to four Urban Indian Organizations, all of which are forced to spend hundreds of thousands of dollars annually on liability insurance that could otherwise be spent on patients,” said Sen. McSally. “Our legislation will fix this inequity by extending federal liability coverage to our urban Indian health groups, dramatically decreasing the cost of malpractice insurance while freeing up more money for patient care. Bringing parity to Urban Indian Health is an important step to improving Native American health care across the board.”

“On behalf of the NCUIH and NATIVE Health in Phoenix, we appreciate the strong commitment from Arizona Senator McSally in ensuring parity for urban Indian health care providers. In addition to stretching already limited resources more thin, especially during this time of crisis, we are unable to share providers across our clinics. We are hopeful that Congress will act quickly to enact this bipartisan fix to allow our programs to have more resources to put directly back into patient care during this this pandemic,” said Walter Murillo, President of NCUIH, CEO of NATIVE Health.

“Oklahoma City Indian Clinic has been operating on the front lines of this crisis with limited resources. We spend hundreds of thousands of dollars each year on liability insurance for our providers. With parity in FTCA, we would put every cent back into services which will allow us to fulfill our mission of providing excellent health care to American Indians.  Increasing access to quality health care and preventive wellness services and producing positive health outcomes for urban American Indians living in central Oklahoma is the business we are in.  We applaud the leadership of Senator Smith and Senator Lankford on helping redirect resources back to patients and families who rely on our services,” said Robyn Sunday Allen, NCUIH Vice-President and CEO of Oklahoma City Indian Clinic.

“We are grateful to our Senator Tina Smith as well as Senators Udall, McSally and Lankford for introducing this important legislation to help Urban Indian Organizations like Indian Health Board of Minneapolis. Despite the coronavirus pandemic and its implication and impact that is has on our clinic as well as our community, IHB continues to provide health care services that are vital to the ongoing needs of the community we serve. We are hopeful for FTCA coverage to allow us to redirect those resources back to our patients during this pandemic,” said Dr. Patrick Rock, CEO of the Indian Health Board of Minneapolis.



The National Council of Urban Indian Health (NCUIH) is the national non-profit organization devoted to the support and development of quality, accessible, and culturally-competent health and public health services for American Indians and Alaska Natives (AI/ANs) living in urban areas. NCUIH is the only national representative of the 41 Title V Urban Indian Organizations (UIOs) under the Indian Health Service (IHS) in the Indian Health Care Improvement Act (IHCIA). NCUIH strives to improve the health of the over 70% of the AI/AN population that lives in urban areas, supported by quality, accessible health care centers.

OPM Announces Nationwide Special Solicitation for Combined Federal Campaigns – Pledge to NCUIH by June 30

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The U.S. Office of Personnel Management (OPM) announced that the Combined Federal Campaign (CFC) will conduct a nationwide special solicitation to support charities serving and affected by COVID-19. This special solicitation will run through June 30.

Under this solicitation, the CFC giving platform will reopen for federal employees, military employees, and retirees who may want to make supplemental pledges to charities hard hit by the COVID-19 emergency, as well as to charities providing emergency services to Americans and global citizens affected by this pandemic. One hundred percent of the donations received will go directly to the over 6,000 local, national, and international health and human welfare charities who are struggling to keep up with the increased demand posed by COVID-19.

“By participating in this special solicitation, federal employees can contribute to charities that provide support to people impacted during this critical time. Americans are coming together to support one another, and the Combined Federal Campaign is a great opportunity for federal employees to continue in the long tradition we have of supporting our fellow Americans in need,” said Acting Director Michael Rigas.

All COVID-19 guidance issued by OPM is available at

The CFC online giving portal can be accessed at

Trump and CMS Issue Second Round of Changes to Healthcare Regulations

On April 30, 2020, at President Trump’s direction, the Centers for Medicare & Medicaid Services (CMS) issued a second round of regulatory waivers and rule changes “to deliver expanded care to the nation’s seniors and provide flexibility to the healthcare system as America reopens. These changes include making it easier for Medicare and Medicaid beneficiaries to get tested for COVID-19 and continuing CMS’s efforts to further expand beneficiaries’ access to telehealth services.”

Many of CMS’s temporary changes will apply immediately for the duration of the Public Health Emergency declaration. The changes build on an array of temporary regulatory waivers and new rules CMS announced on March 30 and April 10. Providers and states do not need to apply for the blanket waivers and can begin using the flexibilities immediately. CMS also is requiring nursing homes to inform residents, their families, and representatives of COVID-19 outbreaks in their facilities. Below are the blanket waivers issued separated into categories:

  • New rules to support and expand COVID-19 diagnostic testing for Medicare and Medicaid beneficiaries:
    • Under the new waivers and rule changes, Medicare will no longer require an order from the treating physician or other practitioner for beneficiaries to get COVID-19 tests and certain laboratory tests required as part of a COVID-19 diagnosis. During the Public Health Emergency, COVID-19 tests may be covered when ordered by any healthcare professional authorized to do so under state law. A written practitioner’s order is no longer required for the COVID-19 test for Medicare payment purposes.
    • Pharmacists can work with a physician or other practitioner to provide assessment and specimen collection services, and the physician or other practitioner can bill Medicare for the services. Pharmacists also can perform certain COVID-19 tests if they are enrolled in Medicare as a laboratory, in accordance with a pharmacist’s scope of practice and state law. With these changes, beneficiaries can get tested at “parking lot” test sites operated by pharmacies and other entities consistent with state requirements.
    • CMS will pay hospitals and practitioners to assess beneficiaries and collect laboratory samples for COVID-19 testing, and make separate payment when that is the only service the patient receives.
    • CMS is announcing that Medicare and Medicaid are covering certain serology (antibody) tests. Medicare and Medicaid will cover laboratory processing of certain FDA-authorized tests that beneficiaries self-collect at home.
  • Additional highlights of the waivers and rule changes announced today:
    • CMS is giving providers flexibility during the pandemic to increase the number of beds for COVID-19 patients while receiving stable, predictable Medicare payments. For example, teaching hospitals can increase the number of temporary beds without facing reduced payments for indirect medical education. Inpatient psychiatric facilities and inpatient rehabilitation facilities can admit more patients to alleviate pressure on acute-care hospital bed capacity without facing reduced teaching status payments. Similarly, hospital systems that include rural health clinics can increase their bed capacity without affecting the rural health clinic’s payments.
    • Under current law, most provider-based hospital outpatient departments that relocate off-campus are paid at lower rates under the Physician Fee Schedule, rather than the Outpatient Prospective Payment System (OPPS). CMS will allow certain provider-based hospital outpatient departments that relocate off-campus to obtain a temporary exception and continue to be paid under the OPPS.
    • Long-term acute-care hospitals can now accept any acute-care hospital patients and be paid at a higher Medicare payment rate, as mandated by the CARES Act.
  • Healthcare Workforce Augmentation:
    • Beneficiaries may need in-home services during the COVID-19 pandemic, nurse practitioners, clinical nurse specialists, and physician assistants can now provide home health services, as mandated by the CARES Act. These practitioners can now (1) order home health services; (2) establish and periodically review a plan of care for home health patients; and (3) certify and re-certify that the patient is eligible for home health services
    • CMS is allowing physical and occupational therapists to delegate maintenance therapy services to physical and occupational therapy assistants in outpatient settings.
    • CMS is waiving a requirement for ambulatory surgery centers to periodically reappraise medical staff privileges during the COVID-19 emergency declaration
  • Prioritizing Hospitalization Services:
    • CMS is allowing payment for certain partial hospitalization services – that is, individual psychotherapy, patient education, and group psychotherapy – that are delivered in temporary expansion locations, including patients’ homes.
    • CMS is temporarily allowing Community Mental Health Centers to offer partial hospitalization and other mental health services to clients in the safety of their homes. Previously, clients had to travel to a clinic to get these intensive services.
  • Expansion of Telehealth in Medicare:
    • CMS is waiving limitations on the types of clinical practitioners that can furnish Medicare telehealth services. Prior to this change, only doctors, nurse practitioners, physician assistants, and certain others could deliver telehealth services. Now, other practitioners are able to provide telehealth services, including physical therapists, occupational therapists, and speech language pathologists.
    • Hospitals may bill for services furnished remotely by hospital-based practitioners to Medicare patients registered as hospital outpatients, including when the patient is at home when the home is serving as a temporary provider based department of the hospital.
    • Hospitals may bill as the originating site for telehealth services furnished by hospital-based practitioners to Medicare patients registered as hospital outpatients, including when the patient is located at home.
    • CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians. CMS is broadening that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of $14-$41 to $46-$110. The payments are retroactive to March 1, 2020.
    • As mandated by the CARES Act, CMS is paying for Medicare telehealth services provided by rural health clinics and federally qualified health clinics.
    • CMS is waiving the video requirement for certain telephone evaluation and management services, and adding them to the list of Medicare telehealth services. As a result, Medicare beneficiaries will be able to use an audio-only telephone to get these services.
  • In addition, CMS is making changes to the Medicare Shared Savings Program to give the 517 accountable care organizations (ACOs):
    • ACOs are groups of doctors, hospitals, and other healthcare providers, that come together voluntarily to give coordinated high-quality care to their Medicare patients. CMS is making adjustments to the financial methodology to account for COVID-19 costs so that ACOs will be treated equitably regardless of the extent to which their patient populations are affected by the pandemic. CMS is also forgoing the annual application cycle for 2021 and giving ACOs whose participation is set to end this year the option to extend for another year. ACOs that are required to increase their financial risk over the course of their current agreement period in the program will have the option to maintain their current risk level for next year, instead of being advanced automatically to the next risk level.
    • CMS is permitting states operating a Basic Health Program (BHP) to submit revised BHP Blueprints for temporary changes tied to the COVID-19 public health emergency that are not restrictive and could be effective retroactive to the first day of the COVID-19 public health emergency declaration.

In response to these changes Seema Verma, CMS Administrator, stated that “CMS’s changes will make getting tested easier” and the health care system “more accessible for Medicare and Medicaid beneficiaries.”

NCUIH Youth Council Highlight: YC Megan McDermott Launches Virtual Storefront

NCUIH congratulates member 2019-20 Megan McDermott (Descendant Piegan Blackfeet & Plains Cree) as she takes big steps in establishing an entrepreneurial presence as an Indigenous artist throughout Indian Country. YC Megan launched her own Indigenous virtual storefront that has many amazing Native art pieces, prints, handcrafted Native jewelry, greetings cards for purchase. YC Megan also provides a free coloring page for download.

As an Indigenous artist, YC Megan continues to leave a positive impact on AI/AN communities both locally and nationally. She has collaborated and led various native art therapy events and programs for AI/AN youth for the greater Seattle Washington area. She also completed a prestigious art residency program with the YÉ™haw’ show and the Seattle Office of Arts and Culture. YC Megan also participated in various art competitions in Washington State and throughout Indian Country- most notably the #HealthyNativeLoveis Photo Contest!, the ‘Art Battle Seattle ‘contest in May of 2019, NCUIH’s National Call for Artwork Contest.

YC Megan’s latest endeavor includes supplying the Chief Seattle Club with 7 coloring page files as part of their Native Care art packages for their members and working with other Native organizations in providing coloring pages to their AI/AN communities. Megan also did a weeklong Twitter takeover for IndigenousBeads with the intention to spread positivity during these challenging times.

YC Megan’s artwork has been sold in many state-wide art festivals and events, including- the 2019 Seattle Indigenous Peoples Festival and the 2019 Black Friday weekend Duwamish Longhouse Holiday Market. Megan appeared on King5 New Day Northwest TV station to talk about her artwork, beading, and briefly demonstrate how to bead.

To learn more about YC Megan McDermott and to support an inspiring Indigenous artist- please visit her virtual storefront at