In this Edition:

• 💰 $5 Million Increase for Urban Indian Health in Fiscal Year 2027
• 📄 2025 Policy Assessment Released
• 🏥 Indian Health Service Realignment: Comments Due February 9
• ⚖ Court Grants Injunction on Health Resources and Services Administration 340B Rebate Pilot Program
• 💬 Medicare and Medicaid Billing Challenges Request for Information
• 💡 California Urban Indian Organization Social Determinants of Health Survey
• 📅 Upcoming Events and Key Dates

Fiscal Year 2026 Appropriations Enacted with Increase for Urban Indian Health

Congress enacted Fiscal Year 2026 appropriations, including increased investments across Indian Health Service and Tribal health programs.

• $95.42 million for Urban Indian Health, a $5 million increase over Fiscal Year 2025
• $5.31 billion in advance appropriations for Fiscal Year 2027
• Senate report language directing the Indian Health Service to explore an interagency working group to support Urban Indian Organizations

Additional provisions include:

• $5 million for generators at Indian Health Service, Tribal, and Urban Indian facilities
• $7 million for the Produce Prescription Pilot Program
• $39.43 million for Tribal Epidemiology Centers

2025 NCUIH Policy Assessment Released

The National Council of Urban Indian Health released its 2025 Policy Assessment, which will inform the development of the organization’s 2026 policy priorities.

Key focus areas include:

• Advance appropriations for the Indian Health Service
• Impacts of federal policy changes on Urban Indian Organization funding
• Executive orders affecting diversity, equity, inclusion, and accessibility programs
• Achieving full Medicaid parity for Urban Indian Organizations
• Strengthening the Urban Indian health workforce
• Food is Medicine initiatives addressing food insecurity and health

→ Go Deeper: Access the Policy Assessment via the NCUIH Policy Resource Center.

Rural Health Transformation Funding Update

Rural Health Transformation Funding Awards in States

Several states have received Rural Health Transformation funding and included Tribes or Tribal organizations as partners, subrecipients, or priority populations in their state plans.

• State awards range from approximately $160 million to $280 million
• Multiple states explicitly list Tribes or Tribal organizations as subrecipients, including Michigan, Montana, Nebraska, and Oregon
• Some states reference Tribal workforce development, training pipelines, and long-term retention strategies
• New Mexico’s plan allows Tribes to apply directly for a competitive grant program funded through the state’s allocation

Why it matters: These state plans may present opportunities for Urban Indian Organizations to engage in implementation, partnerships, and future funding discussions.

Federal Agency Updates

Indian Health Service Realignment: Comments Due February 9

The Indian Health Service is seeking Tribal and Urban Indian Organization input on its proposed agency realignment.

• Urban confer held January 15
• NCUIH hosted a preparation session for Urban Indian Organizations on January 14
• Written comments are due February 9, 2026 
• NCUIH will provide a comment template for Urban Indian Organizations

Federal Court Update

Court Grants Injunction on Health Resources and Services Administration 340B Rebate Pilot Program

A federal court granted an injunction halting implementation of the Health Resources and Services Administration’s proposed 340B Rebate Pilot Program.

Why it matters: 

• Prevents financial strain from paying full drug prices upfront
• Avoids administrative disruptions to reimbursement and claims processing
• Aligns with requests from the Secretary’s Tribal Advisory Committee and the Tribal Technical Advisory Group

NCUIH continues to advocate for exemptions for Indian health care providers.

Advocacy Highlights and Requests for Information

Medicare and Medicaid Billing and Claims Processing Challenges 

The National Indian Health Board’s Medicare, Medicaid, and Health Reform Policy Committee is collecting information on denied billing and claims processing challenges affecting Indian Health Service, Tribal, and Urban Indian providers.

• Goal: Identify consistent issues across Indian Health Service Areas
• Deadline: February 9, 2026 
• Submissions will be de-identified and elevated to the Centers for Medicare and Medicaid Services Tribal Technical Advisory Group

Indian Health Service Loan Scholarship Program Recipients at Urban Indian Organizations 

NCUIH is seeking input from Urban Indian Organizations on participation in the Indian Health Service Loan Scholarship Program.

• Does your organization currently employ any recipients of the Indian Health Service Loan Scholarship Program?
• If your organization previously employed recipients, did they remain at your Urban Indian Organization after completing their service obligation?

How to Respond: Please share your responses by emailing policy@ncuih.org.

New NCUIH Research Opportunity (California Urban Indian Organizations)

Earn $750+ for Your Organization

The National Council of Urban Indian Health launched a survey to collect insights from California Urban Indian Organizations on key Social Determinants of Health affecting urban American Indian and Alaska Native communities.

• Eligible organizations: California-based Urban Indian Organizations only
• Stipend: $750+ per completed response
• Limit: One response per Urban Indian Organization
• Survey closes: January 31, 2026 

Go Deeper: Access the survey via the National Council of Urban Indian Health website.
Contact: Sophie Chishty, NCUIH Research Associate, at schishty@ncuih.org.

Federal Budget Process

Fiscal Year 2028 Indian Health Service Budget Formulation

• Tribal request: $29.8 billion in full mandatory funding
• Indian Health Service Area budget consultations held October–December
• January 21–22: Area report presentation webinars
• January 22: NCUIH presents Urban Indian Health priorities
• February 10–11: National Tribal Budget Formulation Work Session

Upcoming Events and Important Dates

• February 9: State of Indian Nations Address (Washington, District of Columbia)
• February 10–12: National Congress of American Indians Executive Council Winter Session and Hill Day
• February 12: Indian Health Service Tribal Summit (70th Anniversary)
• February 18: National Council of Urban Indian Health Monthly Policy Workgroup (virtual)
• February 19: Department of Urban Indian Affairs Executive Directors and Chief Executive Officers Call

2026 NCUIH Annual Conference

2026 NCUIH Annual Conference Registration Open

Join us for our 2026 Annual Conference on April 27–30, 2026, at The Westin Downtown in Washington, D.C. The conference will bring together Urban Indian Organizations, health leaders, policymakers, and partners to share strategies, strengthen systems, and advance urban Indian health nationwide. Programming includes UIO board training, two full days of conference sessions, and a Hill Day for Urban Indian Organizations. Registration and hotel room block are open!

 

Recent NCUIH Policy Blogs

• 1/6/2026- Congressional Leaders Release Three Bill Minibus for FY 2027 with Increases for Urban Indian Health and Advance Appropriations for Indian Health Service
• 1/15/2026- Fresno American Indian Health Project Marks the Opening of Renewed Native Wellness and Youth Services Spaces
• 1/22/2026- CMS Announces Rural Health Transformation Program Awards in All 50 States, Including Tribal Set-Asides and Initiatives in Several States

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.