NCUIH March Policy Update: Congressional Testimony, Medicaid Guidance, and IHS Policy Developments
In this Edition:
- š NCUIH Testified Before Congress on Urban Indian Health
- š„Ā HHS Secretary Kennedy Jr.Ā Announced $1 Billion for IHS Infrastructure
- š¤Ā NCUIH in Action: Recent Policy Engagement with IHS and HHS leaders
- š Medicaid Redetermination Guidance Included an AI/AN Exemption
- šĀ Bipartisan Bill Would Elevate Indian Health Service Leadership Within HHS
- š»Ā IHS Requested Feedback on Health IT Modernization PATH Activities
- š¾ NCUIH Requested Input on Rural Health Transformation Fund Awards
- š Upcoming Policy Events, Deadlines, and Opportunities
- š Join Us in April for the 2026 NCUIH Annual Conference
NCUIH Testifies Before Congress on Urban Indian Health
On March 17, 2026,Ā NCUIHĀ CEO Francys Crevier, testified before the House Appropriations Subcommittee on Interior, Environment, and Related Agencies during the American Indian and Alaska Native Public Witness hearing. Testifying on behalf of the National Council of Urban Indian Health (NCUIH) and the 41 Urban Indian Organizations (UIOs) it represents,Ā sheĀ elevated the role of UIOs in the Indian health system and urged Congress to protect funding for the Indian Health Service, provide $106 million for Urban Indian Health in FY27, maintain advance appropriations, and include UIOs in the Behavioral Health Pilot Program.
Her testimony underscored that Urban Indian OrganizationsĀ remainĀ an essential part of the Indian health system and continue to meet growing need in Native communities across the country.Ā AsĀ statedĀ in her testimony, āThe three requests before you today are targeted and achievable: fund Urban Indian Health at $106 million, maintain advance appropriations, and include UIOs in the Behavioral Health Pilot Program.ā
SheĀ also emphasized that these requests are grounded in the federal governmentās trust responsibility to provide health care for American Indian and Alaska Native people, including those living in urban areas. Her testimony reinforced that sustained investment in urban Indian health is necessary to protect services, strengthen care delivery, and ensure Native communities are not left behind.
NCUIH alsoĀ submittedĀ written testimony.
Read more about the hearing on NCUIHāsĀ blog.
Interior SubcommitteeĀ ChairmanĀ Mike Simpson (ID-02-R) and Appropriations CommitteeĀ ChairmanĀ Tom Cole (OK-04-R)Ā both reaffirmed the committeeās commitment to advancing progress in Indian health care and protecting andĀ maintainingĀ stable funding forĀ IHS.
U.S. Department of Health and Human Services Secretary Kennedy Jr. Announces $1 Billion in Infrastructure Investment for IHS
HHS Secretary Kennedy Jr. announced aĀ $1 billionĀ investmentĀ toward priority Indian Health Service facilities infrastructure projects beginning inĀ FY 2027.
- Funding is from existing departmental resources drawn from the HHS Nonrecurring Expenses Fund.
- Announcement was made at the February 12 IHS Tribal Summit.
Read more onĀ ourĀ blog.
NCUIH in Action: Recent Policy Engagement
NCUIH engaged in several recent convenings, including:
- IHS Tribal Self-Governance Advisory Committee (TSGAC) Meeting
February 24ā25, 2026 | Washington, D.C.
Discussion included the recently announcedĀ $1 billionĀ IHS infrastructure initiative. - Native American Coalition for Economic Prosperity (NACEP) Fourth Convening of the Government-to-Government Roundtable Series
February 25,Ā 2026Ā | Washington, D.C.
Discussion also included the $1 billion IHS infrastructure initiative.
CMS Guidance to States on Implementation of One Big Beautiful Bill Act 6-Month Medicaid Redeterminations – includes AI/AN Exemption
The Centers for Medicare & Medicaid Services (CMS)Ā issued guidance to states on implementation of 6-month Medicaid redeterminations, and theĀ guidance included an American Indian and Alaska Native exemption that also applies to Urban Indians.
NCUIH-Endorsed Bipartisan Bill to Elevate Indian Health Service Leadership Within HHS Introduced in Senate
TheĀ Stronger Engagement for Indian Health Needs ActĀ is a bipartisan bill supported by NCUIH that would elevate theĀ IHS Director to Assistant Secretary for Indian Health within HHS.
Why it matters:
- This would strengthen Tribal representation in federal health decision-making and reinforce the federal governmentās trust responsibility to provide health care to American Indian and Alaska Native people.
Legislative updates include:
- Senate billĀ introduced February 5,Ā 2026Ā by Senators Catherine Cortez Masto (D-NV) and Mike Rounds (R-SD)
- House billĀ introduced January 28,Ā 2026Ā by Representatives Greg Stanton (D-AZ-04) and David Joyce (R-OH-14)
Read more onĀ ourĀ blog.
NCUIH Provided Comments to IHS on Proposed Realignment following Second Round of Urban Confer
Following IHSā January 15 virtual Urban Confer session on the IHS Strategic Realignment, NCUIH submitted written comments to IHS emphasizing the importance of protecting UIO contracts, maintaining Area offices and strengthening partnerships, addressing IHS staffing needs, and ensuring continued engagement with UIOs, while also highlighting the importance of 100% Federal Medical Assistance Percentage (FMAP) for UIOs.
IHSā Realignment plans (communicated during the January 15 Urban Confer):
- April 1: Federal Register Comment Period (30 days)
- May 22: Federal Register Notice
- May-June: Transition to Future State
IHS Requested Feedback on Health IT Modernization PATH Activities
On March 5, IHS held aĀ Health IT Modernization Information SessionĀ on Patients at the Heart (PATH) electronic health record (EHR) activities. Planned go-live for the pilot site for implementing PATH EHR is the beginning of August 2026.
During the session, IHS shared consultation and confer questions for Tribes and UIOs, including:
- What clarifications are neededĀ regardingĀ the PATH EHR activities?
- WhatĀ additionalĀ information or content would help sites better understand PATH EHR implementation?
- What additional information or content would be helpful to better understand PATH EHR implementation at your site?
ā¢What potential opportunities do you foresee for staff or patients in implementing PATH EHR?
Written comments are due by Saturday, April 4, 2026,Ā to urbanconfer@ihs.gov with the subject line: Health IT Modernization CY 03-5-2026.
NCUIH is Requesting UIO Input on Rural Health Transformation Fund Awards
On December 29, 2025, The Centers for Medicare & Medicaid Services (CMS) awarded all 50 states funding through the Rural Health Transformation Fund (RHTF). Read more about this funding on NCUIHāsĀ blog.
NCUIH is asking Urban Indian Organizations to share whether they receive this funding.
Request for UIOs:Ā
- Let NCUIH know if your UIO receives RHTF funding.Ā Contact: policy@ncuih.org
Upcoming Events and Key DatesĀ Requests for Information
- March 25ā26, 2026Ā āĀ CMS Tribal Technical Advisory Group Quarterly Meeting (Washington, D.C.)
- April 4, 2026Ā āĀ Written comments due for IHS Health IT Modernization PATH activities
- April 6ā9, 2026Ā āĀ Tribal Self-Governance Conference (Phoenix, Arizona).Ā RegisterĀ here.
- April 15, 2026Ā āĀ NCUIH Monthly Policy Workgroup (Virtual)
- April 27ā30, 2026āĀ 2026 NCUIH Annual Conference (Washington, D.C.)
2026 NCUIH Annual Conference
Join usĀ April 27ā30, 2026, inĀ Washington, D.C., as NCUIH marks theĀ 50th anniversary of the Indian Health Care Improvement Act (IHCIA)āa landmark commitment to the health and wellābeing of American Indians and Alaska Nativesāand reflects on five decades of progress, collaboration, and continued commitment to Native health.
Register to attend:Ā https://ncuih.org/conference/
Recent NCUIH Policy Blogs
- 1.Ā Serving Native Community Across New York City: The Work of the New York Indian Council
March 3, 2026/inĀ Policy Blog/byĀ River Carroll - HHS Secretary Kennedy Jr. Announces $1 Billion in Infrastructure Investment for IHS
March 4, 2026/inĀ Policy Blog/byĀ Jeremy Grabiner - NCUIH Submits Written Testimony Urging House to Protect Funding of Indian Health ServiceāÆand Urban Indian Health
March 13, 2026/inĀ Policy Blog/byĀ Jeremy Grabiner - NCUIH Testifies Before Congress on Native Health Priorities
March 17, 2026/inĀ Policy Blog/byĀ NCUIH
About NCUIH
The National Council of Urban Indian Health (NCUIH) is a national representative for the 41 Urban Indian Organizations contracting with the Indian Health Service under theĀ Indian Health Care Improvement Act. NCUIH is devoted to the support and development of high quality and accessible health and public health services for American IndianĀ and Alaska Native people living in urban areas.
NCUIH respects and supports Tribal sovereignty and the unique government-to-government relationship between our Tribal Nations and the United States. NCUIH works to support those federal laws,Ā policies, and procedures that respect and uplift Tribal sovereignty and the government-to-government relationship. NCUIH does not support any federal law,Ā policy, or procedure that infringes upon or in any way diminishes Tribal sovereignty or the government-to-government relationship.
