NCUIH September Policy Update: 2027 Policy Priorities, Appropriations Status, Medicaid Resources, and UIO Summit Preparation
In this Edition:
- Questions for UIOs: Request for Input and Feedback
- New and Forthcoming NCUIH Medicaid Resources
- New Maternal Health Resources
- Fiscal Year 2027 Appropriations Status
- NCUIH Regulation Tracker Updates
- Comment Opportunity: HRSA 340B Rebate Model Pilot Program
- Submitted Federal Comments
- NCUIH Participates in the National Tribal Health Conference
- NCUIH Participates in NCAI Tribal Impact Week
- Urban Indian Organization and Federal Partners Summit – NCUIH’s Preparation and Input Sessions
- Upcoming Events and Policy Dates
- 2027 NCUIH Annual Conference
- Current Funding Opportunities
Questions for UIOs: Request for Input and Feeback
Request for Information on H R 1 Medicaid Exclusions
As a member of the Centers for Medicare & Medicaid Services Tribal Technical Advisory Group (TTAG), NCUIH is working to support proper implementation of the exclusions for American Indian and Alaska Native (AI/AN) people under the new H.R. 1 Medicaid provisions.
- What definition is your state using for the exclusions for American Indian and Alaska Native people?
- Are you concerned that your state may not include everyone who should qualify for the American Indian and Alaska Native exclusion?
Responses can be sent to policy@ncuih.org.
New and Forthcoming NCUIH Medicaid Resources
Overview of the Impact of Medicaid on Health Care for American Indian and Alaska Native People
This updated resource explains why Medicaid matters for American Indian and Alaska Native people and UIOs. It provides data, background, and information that UIO staff and leaders can use for education and understanding Medicaid’s role in Native health care.
This quick-reference resource explains the new Medicaid work and renewal requirements, who may be protected by the American Indian and Alaska Native exemption, and the basic policy changes that staff, leaders, and patients should understand.
Forthcoming Medicaid Implementation Resources
NCUIH is developing two additional resources to help UIOs respond to the new Medicaid requirements:
- UIO Implementation Guide: Steps UIO staff should have in place and actions staff can take when applicable protections are not recognized correctly.
- Patient Handout: Steps patients should take after receiving a Medicaid work or renewal notice.
New Maternal Health Resources
NCUIH has released new resources highlighting best practices for improving American Indian and Alaska Native maternal health outcomes:
- When the Data Gets It Wrong: Racial Misclassification of American Indian and Alaska Native Pregnant People is a blog post on addressing racial misclassification to improve data accuracy, interventions, programming, and maternal health outcomes.
- American Indian and Alaska Native Led Maternal Mortality Review Committees is a one-page resource with recommendations to support the establishment of American Indian and Alaska Native-led Maternal Mortality Review Committees.
View the resources at ncuih.org/maternal-health.
Fiscal Year 2027 Appropriations Status
On September 2, 2026, the Continuing Appropriations and Extensions Act, 2027 (H.R.6500) was signed into law by the President. The Continuing Resolution (CR) funds the federal government through December 11, 2026 at Fiscal Year (FY) 2026 levels. The CR:
- Prevents the administration from implementing the Office of Management and Budget’s (OMB) proposed grants rule for the duration of the continuing resolution.
- OMB’s proposed Regulation for Federal Financial Assistance which will impact how nearly all grant awards are administered and overseen. NCUIH previously submitted comments on the proposal.
- Extends authorizations for important health, veterans, infrastructure, and other programs for the duration of the continuing resolution.
NCUIH Regulation Tracker Updates
NCUIH tracks regulations and other federal agency actions that affect UIOs and American Indian and Alaska Native people living in urban areas. Recent regulations NCUIH has tracked:
- Four letters from the Indian Health Service (IHS) addressing efforts to combat the syphilis epidemic, open positions at Tribal facilities and UIOs, the Continuing Appropriations and Extensions Act, 2027, and Director Mark Cruz’s dual role as IHS Director and U.S. Department of Health and Human Services Advisor.
- Two letters from the Health Resources and Services Administration (HRSA) initiating Tribal Consultation on the 340B Rebate Model Pilot Program.
Visit ncuih.org/policy/regulation-tracker to follow current agency actions.
Comment Opportunity HRSA 340B Rebate Model Pilot Program
On August 3, the Health Resources and Services Administration (HRSA) published a notice launching the 340B Rebate Model Pilot Program, which is scheduled to take effect January 1, 2027. Under the pilot, covered entities, including UIOs participating in the 340B Drug Pricing Program, would pay the full price upfront for a limited set of drugs and receive a manufacturer rebate within 10 days. HRSA held a Tribal Consultation on September 16, 2026 in response to requests from Tribal leaders and Tribal-serving organizations. Tribal stakeholders are encouraged to submit written testimony or comments directly to HRSA.
- Written comments are due Thursday, October 1, 2026.
- Submit comments to tribalconsultation@hrsa.gov.
Submitted Federal Comments
NCUIH Submits Comments to IHS on Health Information Technology Modernization
On September 4, NCUIH submitted comments to IHS on its Health Information Technology Modernization Roadmap to Cohorts following the August 6 Tribal Consultation and Urban Confer. NCUIH recommended that IHS clarify the criteria for Cohort One and continue engaging UIOs throughout implementation of Health Information Technology Modernization.
NCUIH Submits Comments to CMS on Current Procedural Terminology
On September 14, NCUIH submitted comments to the Centers for Medicare & Medicaid Services in response to its Current Procedural Terminology Request for Information – potential updates to health care coding policies. NCUIH emphasized the need to minimize administrative burden on Indian Health Care Providers – including UIOs, ensure a smooth implementation process for any future changes, and protect reliable reimbursement for services.
NCUIH Joins Indian Country Partners at the National Indian Health Board’s National Tribal Health Conference
From August 17-20, NCUIH participated in the National Indian Health Board’s National Tribal Health Conference in Phoenix, Arizona, where NCUIH and UIO leaders connected with newly confirmed IHS Director, Mark Cruz. NATIVE Health CEO, Walter Murillo (Choctaw), moderated a panel with Kelly Rowe (Grand Ronde) and Angie Wilson (Klamath) to discuss A New Era for Traditional Healing: Celebrating Progress and Shaping the Future, highlighting traditional healing practices and on-the-ground implementation experience.
NCUIH Submits Comments to Arizona Medicaid Program on Traditional Healing Demonstration
On September 6, NCUIH submitted comments on an Arizona Medicaid amendment for UIOs seeking to participate in the Traditional Healing program. NCUIH asked Arizona to ensure timely implementation of Traditional Healing reimbursement at UIOs and to identify and secure the non-federal share needed to reimburse UIOs, which do not currently receive 100% FMAP.
NCUIH Participates in NCAI Tribal Impact Days
NCUIH joined the National Congress of American Indians (NCAI) for Tribal Impact Days in Washington, D.C. During a session in the Senate Committee on Indian Affairs Hearing Room, NCUIH heard from Senators Tina Smith (D-MN), Lisa Murkowski (R-AK), and other members of Congress about their work on behalf of Indian Country. NCUIH also connected with NCAI Executive Director Larry Wright, Jr., Tribal leaders, and Native organizations working on federal policy priorities. The week concluded at the National Museum of the American Indian with a reception celebrating the Tribal Supreme Court Project’s 25 years of coordinating Supreme Court strategy on cases affecting Tribal Nations.
SAVE THE DATE: UIO and Federal Partners Summit Preparation and Input Sessions
NCUIH is preparing UIOs for the upcoming Urban Indian Organization and Federal Partners Summit in Washington, D.C. set to be held on November 19, 2026, in Washington D.C. NCUIH will host two virtual sessions to gather input, share available information, and help UIOs prepare for the Summit.
October 21: UIO Summit Preparation and Input Session. This virtual session will gather UIO input and support early preparation for the Summit. Invite forthcoming.
November 10: UIO Summit Preparation Session. This virtual session will go over general Summit prep and logistics for UIOs. Invite forthcoming.
- NCUIH also plans to host an in-person gathering for UIOs in Washington, D.C. RSVP required. Details to follow.
Upcoming Events and Policy Dates
- September 22-24: U.S. Department of Health and Human Services Secretary’s Tribal Advisory Committee Meeting, San Diego, California.
- September 30: NCUIH 2027 Policy Priorities Survey deadline.
- October 1: Written comments due to HRSA on the 340B Rebate Model Pilot Program.
- October 13: National Indian Health Board Medicare Medicaid and Health Reform Policy Committee Face-to-Face Meeting, Washington, D.C.
- October 14-15: Centers for Medicare & Medicaid Services Tribal Technical Advisory Group Face-to-Face Meeting, Washington, D.C.
- October 15: IHS Division of Urban Indian Affairs UIO Chief Executive Officer Monthly Conference Call, virtual.
- October 21: NCUIH Monthly Policy Work Group and UIO Summit Preparation and Input Session, virtual.
- November 10: UIO Summit Preparation Session, virtual, pending IHS approval.
2027 NCUIH Annual Conference
The 2027 NCUIH Annual Conference will be held May 3-6, 2027, at Westin Washington, D.C. Downtown.
We are excited to welcome Urban Indian Organizations, health care professionals, policymakers, community leaders, advocates, and partners from across the country. Through educational sessions, networking opportunities, and advocacy-focused discussions, attendees will connect, share best practices, strengthen partnerships, and explore solutions to critical issues impacting urban Indian health. Together, we will advance efforts to improve the health and well-being of urban Indian communities.
Conference Agenda:
- May 3: Board Training – Board Training is free and does not require conference registration. Select the “IHS and NCUIH-Sponsored Events” ticket and choose “Yes, register me” for Board Training.
- May 4-5: Conference Programming
- May 6: Hill Day – Participation is limited to staff and leadership of IHS-funded UIOs. Pre-registration is required and will be sent out in March 2027.
Important Deadlines:
- Early Bird Registration Deadline: December 18, 2026
- Call for Proposals Submission Deadline: November 3, 2026
- Award Nominations Open: October 5, 2026
Learn more at ncuih.org/conference.
Current Funding Opportunities
Indian Health Service Fiscal Year 2026 Urban Emergency Fund
- Purpose: To help UIOs address costs associated with one-time, non-recurring emergencies and disaster relief efforts.
- Award: A limited discretionary fund with up to $250,000 available.
- Application deadline: As soon as reasonably practicable after the emergency occurs.
Visit the NCUIH website to explore the full list of funding opportunities.
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 the 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 Indian 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, policies, and procedures that respect and uplift Tribal sovereignty and the government-to-government relationship. NCUIH does not support any federal law, policy, or procedure that infringes upon or in any way diminishes Tribal sovereignty or the government-to-government relationship.
