NCUIH October Policy Update: Traditional Healing Waivers in Utah and Maine, $1.86 Billion for IHS, 2030 Census Proposal, and UIO Summit Preparation
In this Edition:
- IHS Releases Updated Medicare Part D Creditable Coverage Letter
- Traditional Healing Waivers Approved in Utah and Maine
- $1.86 Billion Planned for IHS Information Technology and Facilities
- 340B Rebate Model Pilot Program Update
- Bipartisan Bill to Elevate Indian Health Service Leadership Within HHS Passed House
- New Medicaid Implementation Resources
- Comment Opportunity: 2030 Census Proposed Rule
- IHS Produce Prescription Pilot Program Awards
- HHS Secretary’s Tribal Advisory Committee Meeting – HHS Visits San Diego UIO
- NCUIH at the NCAI Annual Convention
- UIO Summit Preparation
- Upcoming Events and Policy Dates
- 2027 NCUIH Annual Conference
- Current Funding Opportunities
IHS Releases Updated Medicare Part D Creditable Coverage Letter
On October 15, 2026, the Indian Health Service (IHS) released an updated Medicare Part D Creditable Coverage Letter confirming that prescription drug coverage provided through IHS, Tribal Health Programs, and Urban Indian Organizations is creditable coverage for Medicare Part D purposes. The letter provides American Indian and Alaska Native Medicare beneficiaries with documentation of their creditable prescription drug coverage, which can help prevent or challenge Medicare Part D late-enrollment penalties.
The release follows sustained work by Tribal leaders and Indian health partners through the Centers for Medicare & Medicaid Services Tribal Technical Advisory Group (TTAG) and the National Indian Health Board’s Medicare, Medicaid and Health Reform Policy Committee (MMPC) IHS-Tribal Workgroup. The issue has been a TTAG priority since at least July 2025, with continued work among Tribal representatives, IHS, and CMS to address outstanding questions and finalize an updated letter. NCUIH is honored to participate in TTAG alongside Tribal leaders to ensure the perspectives of Urban Indian Organizations and the people they serve are represented in CMS policy discussions.
IHS encourages I/T/U Registration, Benefits Coordination, Business Office, and Pharmacy staff to inform Medicare-eligible beneficiaries about the letter and assist them in obtaining a copy when needed. Tribes and Urban Indian Organizations may use the IHS template as provided or adapt it to their local letterhead and operational practices.
Read the IHS Dear Tribal Leader and Urban Indian Organization Leader Letter and Creditable Coverage Letter template
Traditional Healing Waivers Approved in Utah and Maine
CMS has approved section 1115 applications from Utah and Maine to provide reimbursement for Traditional Healing for eligible beneficiaries. The Utah approval includes UIOs. The Utah waiver was approved on September 24, 2026 and took effect on October 1, 2026.
CMS determined that covering traditional health care practices is expected to be budget neutral, so neither waiver requires a specific budget neutrality expenditure limit.
$1.86 Billion Planned for IHS Information Technology and Facilities
On October 5, 2026, HHS Secretary Robert F. Kennedy Jr. notified Congress of plans to invest $1.86 billion in the Indian Health Service (IHS) for critical information technology and facilities projects, including backlog items within the IHS Health Care Facility Construction Program.
NCUIH will monitor implementation, including how these investments reach Indian Health Care Providers across the Indian health system.
340B Rebate Model Pilot Program Update
The Health Resources and Services Administration’s (HRSA) 340B Rebate Model Pilot Program is scheduled to take effect January 1, 2027. At HRSA’s Tribal Consultation on September 16, 2026, Tribal and Urban leaders opposed the pilot, citing financial and administrative burden and its inconsistency with the federal trust responsibility.
On October 1, 2026, NCUIH submitted comments to HRSA requesting an exemption for Indian health care providers.
NCUIH-Endorsed Bipartisan Bill to Elevate Indian Health Service Leadership Within HHS Passed House
On September 15, 2026, the House unanimously passed the bipartisan Stronger Engagement for Indian Health Needs Act of 2025 (H.R.741). The bill, which was introduced in the House of Representatives by Congressmen Greg Stanton (D-AZ-04) and David Joyce (R-OH-14), would formally elevate the IHS Director’s position within the federal government, strengthening Tribal representation in federal health decision-making and reinforcing the federal government’s trust responsibility to provide health care to American Indian and Alaska Native people.
Next Steps: The bill will now need to be passed by the Senate. The Senate currently has companion legislation which was introduced by U.S. Senators Catherine Cortez Masto (D-NV) and Mike Rounds (R-SD).
New Medicaid Implementation Resources
NCUIH has developed 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.
View the resources at https://ncuih.org/medicaid-changes/
Comment Opportunity: 2030 Census Proposed Rule
The U.S. Census Bureau has issued a proposed rule that would make significant changes to the 2030 Census, including the proposed removal of race and ethnicity questions. If finalized, the changes could significantly affect annual federal appropriations in Indian Country, since federal agencies use Census data to determine funding levels, program eligibility, and allocations for Tribal communities.
A Tribal consultation was held on October 2. Written comments are due on November 2, 2026.
IHS Produce Prescription Pilot Program Awards
On September 22, 2026, IHS announced $3.5 million in funding through Phase 2 of the Produce Prescription Pilot Program (P4), supporting 14 Tribal and urban Indian recipients. NCUIH congratulates the recipients.
HHS Secretary’s Tribal Advisory Committee Meeting – HHS Visits San Diego UIO
From September 22-24, 2026, NCUIH attended the Department of Health and Human Services (HHS) Secretary’s Tribal Advisory Committee (STAC) in Jamul, California. The STAC’s primary purpose is to seek consensus, exchange views, share information, provide advice and/or recommendations; or facilitate any other interaction related to intergovernmental responsibilities or administration of HHS programs.
As part of the HHS STAC site visits, San Diego Community Health Center welcomed Tribal leaders, federal officials, and health partners for a firsthand look at the vital work of UIOs.
NCUIH was honored to attend the swearing-in ceremony for Mark Cruz as Director of IHS during the meeting and looks forward to continuing our work together to strengthen the Indian health system and advance the health of AI/AN people, including those served by UIOs.
NCUIH at the NCAI Annual Convention
NCUIH participated in the National Congress of American Indians (NCAI) 83rd Annual Convention and Marketplace in Palm Springs, California, engaging with Tribal leaders, federal officials, and national partners to advance priorities across the Indian health system.
NCUIH Board President Robyn Sunday-Allen served as Co-Chair of NCAI’s Health Subcommittee alongside the National Indian Health Board, helping lead discussions on critical health policy resolutions. NCUIH Board Vice-President Walter Murillo sponsored a resolution urging HRSA to exempt Indian health care providers from the 340B Rebate Model Pilot Program. NCUIH also worked with Tribal partners to strengthen a resolution on Indian-specific Medicaid Section 1115 demonstration waivers and proposed budget neutrality changes, including an amendment explicitly recognizing urban Indian communities. Both resolutions advanced through NCAI’s Human Resources Committee.
NCUIH leadership also met with Indian Health Service Director Mark Cruz to discuss longstanding priorities, including permanent 100% federal medical assistance percentage (FMAP) for Urban Indian Organizations and reimbursement policies that support access to care. NCUIH also engaged with Congressman Raul Ruiz (D-CA) on Indian health priorities during the convention.
Through these discussions, NCUIH continued its work alongside Tribal leaders and federal partners to strengthen the Indian health system, uphold Tribal sovereignty, and improve access to quality health care for American Indian and Alaska Native communities.
SAVE THE DATE: November 10 – UIO and Federal Partners Summit Preparation Session
NCUIH is preparing UIOs for the Urban Indian Organization and Federal Partners Summit, which will be held on November 19, 2026, in Washington, D.C. On October 21, NCUIH held a virtual UIO Summit Preparation and Input Session to gather UIO input and support early preparation for the Summit.
UPCOMING – November 10: UIO Summit Preparation Session (virtual). This session will go over general Summit preparation and logistics for UIOs. No RSVP required.
Upcoming Events and Policy Dates
- November 3-4: IHS Tribal Self-Governance Advisory Committee Meeting (Washington, D.C.)
- November 10: UIO Summit Preparation Session (virtual)
- November 19: Urban Indian Organization and Federal Partners Summit (Washington, D.C.)
- December 15: Tribal Leaders Diabetes Committee Quarterly Meeting (virtual)
- January 20-21, 2027: FY 2029 Area Report Presentations Webinar (virtual)
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 Submission Deadline: February 5, 2027
- Learn more at ncuih.org/conference.
Current Funding Opportunities
FY 2027 Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program: Development and Implementation Grants
- Purpose: Five-year cooperative agreements to support federally recognized Tribes, Tribal organizations, and urban Indian organizations in developing and implementing evidence-based home visiting programs for expectant families and young children.
- Source: HHS, Administration for Children and Families, Office of Early Childhood Development. UIOs are eligible.
- Award: Funding amount not yet specified.
- Timeline: Forecasted opportunity. Expected to open December 1, 2026; estimated due date March 2, 2027.
View the forecasted opportunity.
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.
