Murkowski, Tillis, Murray, and Cortez Masto Introduce Bipartisan Bill to Strengthen Urban Indian Organization Workforce

/in /by

U.S. Senators Lisa Murkowski (R-AK), Patty Murray (D-WA), Thom Tillis (R-NC), and Catherine Cortez Masto (D-NV) have introduced bipartisan legislation to allow U.S. Public Health Service Commissioned Corps officers (PHSCOs) to be detailed directly to Urban Indian Organizations (UIOs).

Recently, Secretary Kennedy assigned 70 officers to Indian Health Service facilities to help stabilize staffing needs. Allowing PHCSOs to be detailed directly to UIOs is a longstanding priority that would improve capacity to serve patients and families.

“UIOs provide far more than a place for an annual check-up; they deliver culturally grounded care that reflects the needs and values of the communities they serve,” said Senator Murkowski. “All Native people deserve access to quality health care, whether they live in a city or a rural community. Ensuring these facilities are adequately staffed will strengthen health outcomes for American Indian and Alaska Native communities nationwide and help fill a critical gap in care.”

“Nevada’s Urban Indian health facilities are chronically understaffed,” said Senator Cortez Masto. “Even the best doctors and nurses can’t provide patients with the quality of care that they need if there simply aren’t enough of them. This commonsense fix gives the Department of Health and Human Services the flexibility it needs to ensure that Tribal communities across the Silver State can get the health care they need.”

“We are grateful to Senators Murkowski, Murray, Tillis, and Cortez Masto for championing this bipartisan effort to allow U.S. Public Health Service Commissioned Officers to be detailed directly at urban Indian organizations. Due to limited funding, Urban Indian Organizations continue to face significant challenges in recruiting and retaining skilled health care professionals, and detailing Commissioned Officers help them address workforce shortages and increase collaboration across the federal health care system. We urge Congress to pass this legislation swiftly so that Urban Indian Organizations can benefit from this vital workforce support.” — Francys Crevier (Algonquin), CEO of NCUIH

Background

The Public Health Services for Advancing Care and Creating Efficient Support Systems in Underserved Communities Act, or the PHS ACCESS Act, would amend Section 214 of the Public Health Service Act to formally authorize the Health and Human Services (HHS) Secretary to detail PHCSOs to UIOs to perform work related to the functions of HHS. Detailing officers to UIOs would help address persistent workforce shortages at UIOs, bring skilled, federally-supported clinicians and public health professionals into urban Indian health settings, and strengthen coordination across the broader Indian health system.

Next Steps

The bill has been referred to the Senate Committee on Health, Education, Labor, and Pensions. The bill will need to be passed out of the Committee before receiving full consideration from the Senate.

NCUIH 2026-2027 Policy Priorities Released: Need for Full and Stable IHS Funding, Medicaid Parity for UIOs, and Investments in Native Behavioral Health Programs

/in /by

The National Council of Urban Indian Health (NCUIH) is pleased to announce the release of its 2026-2027 Policy Priorities document, which outlines a summary of urban Indian organization (UIO) priorities for the Executive and Legislative branches of the government. These priorities were informed by NCUIH’s 2025 Policy Assessment.

NCUIH hosted five focus groups and conducted a nationwide survey to identify and rank UIO policy priorities for 2026, as they relate to Indian Health Service (IHS)-designated facility types (full ambulatory, limited ambulatory, outreach and referral, and outpatient and residential). The result is a focused, member-driven agenda. NCUIH worked with UIOs to identify five top policy priorities for 2026-2027:

  • Increasing Funding for IHS and the Urban Indian Health Line Item
  • Establishing Permanent Full (100%) FMAP for Medicaid Services at UIOs
  • Increasing Behavioral Health Funding
  • Stability in Federal Grants
  • Health Information Technology and Electronic Health Record Improvement
Read the 2026-2027 Policy Priorities

2026-2027 Policy Priorities:

FULLY FUND THE INDIAN HEALTH SERVICE (IHS) & URBAN INDIAN HEALTH AT THE AMOUNTS REQUESTED BY TRIBES

Implement Tribal Funding Priorities for the Indian Health Service and Urban Indian Health

  • Support the Tribal Budget Formulation Work Group request of $73 billion for IHS and $1.09 billion for the Urban Indian Line Item for FY 2027.
  • Maintain Advance Appropriations for the Indian Health Service to Insulate the Indian Health System from Government Shutdowns and to Protect Patient Lives.
  • Reclassify Contract Support Costs and 105(l) Leases to Mandatory Appropriations.

MEETING THE TRUST OBLIGATION FOR IHS-MEDICAID BENEFICIARIES RECEIVING SERVICES AT URBAN INDIAN ORGANIZATIONS

Uphold the Trust Obligation for IHS-Medicaid Beneficiaries Receiving Services at Urban Indian Organizations

  • Provide 100% Federal Medical Assistance Percentage (FMAP) for Services at UIOs and Ensure Proper Implementation of Medicaid Obligations for Services Provided at Urban Indian Organizations under H.R. 1.
  • Pass the Urban Indian Health Parity Act to Ensure Permanent Full (100%) FMAP for Services Provided at UIOs.
  • Ensure that HHS and CMS Issue Binding Guidance to States to Automatically Exempt American Indian and Alaska Native Beneficiaries from H.R. 1 Work Requirements and Cost-Sharing.

IMPROVING BEHAVIORAL HEALTH FOR ALL AMERICAN INDIAN AND ALASKA NATIVE PEOPLE

Increase Funding for Behavioral Health and Substance Use Disorder Resources for American Indian and Alaska Native People

  • Appropriate $80 Million for Behavioral Health and Substance Use Disorder Resources for Native Americans.
  • Reintroduce and Co-Sponsor the Native Behavioral Health Access Improvement Act.
  • Protect Critical Programs Such as Native Connections from Any Funding Delays or Disruptions.

STABILIZE AND PROTECT FEDERAL GRANT FUNDING PATHWAYS

Stability in Federal Grants

  • Reduce Barriers to Access to Ensure Timely Distribution of Grant Funding.

HEALTH INFORMATION TECHNOLOGY AND ELECTRONIC HEALTH RECORD IMPROVEMENT

Bridging the Gap: Enhancing Patient Care by Advancing Health Information Technology

  • Appropriate Dedicated Funding for UIO and Tribal Health Care Providers to Offset HIT Modernization Costs, Including Costs Associated with Transitioning to or Achieving Interoperability with the New IHS Enterprise EHR System.
  • Ensure the PATH EHR is Fully Interoperable with the Diversity of COTS EHR Systems Currently in Use at UIOs and Tribal Facilities.
  • Develop a Pathway and Funding for UIOs Who Use COTS EHR Systems to Implement the PATH EHR If They Choose to Do So.

CMS Releases Guidance to States on Implementation of the One Big Beautiful Bill Act 6-Month Medicaid Redeterminations – Includes AI/AN Exemption

/in /by

The Centers for Medicare and Medicaid Services (CMS) recently released a State Medicaid Director letter (SMDL) on implementing the eligibility redeterminations in Section 71107 of the One Big Beautiful Bill Act, which is also known as the “Working Families Tax Cut Legislation.” The SMDL includes a summary of the exemptions for American Indian and Alaska Native people from the 6-month renewal requirement (see page 4). NCUIH continues to urge CMS to continue to consult with Tribes to ensure proper implementation of exemptions for American Indian and Alaska Native people.

Additional Information

On July 4, 2025, the President signed the One Big Beautiful Bill Act (OBBBA) into law. The OBBBA is a major bill that delivers many elements of President Trump’s legislative agenda, including new requirements for access to Medicaid and SNAP. Fortunately, Indians, Urban Indians, California Indians, and individuals determined eligible as an Indian for the Indian Health Service under regulations promulgated by the Secretary are exempted from the Medicaid requirements in the OBBBA and included in exemptions for the Supplemental Nutrition Assistance Program (SNAP) work requirements.

21 Senators Request Protected Funding for IHS and Increased Resources for Urban Indian Health in FY 2027

/in /by

On April 15, 2026, 20 Senators joined Senator Tina Smith (D-MN) in her letter to Chair Lisa Murkowski (R-AK) and Ranking Member Jeff Merkley (D-OR) of the Senate Interior Appropriations Committee requesting funding for urban Indian health at the highest level possible—up to the Tribal Formulation Workgroup’s request of $1,093,999,000—and retaining advance appropriations for the Indian Health Service (IHS) in the Fiscal Year (FY) 2027 Interior, Environment, and Related Agencies Appropriations Act.

The 21 Senators requested full funding for urban Indian health as part of the Tribal Formulation Workgroup’s topline request of $73,007,281,000 for IHS in FY 2027, and that such an increase not be paid for by diminishing funding for already hard-pressed IHS and Tribal providers. The letter also requests the Appropriations Committee maintain advance appropriations for IHS for FY 2028.

The letter emphasizes the critical role that Urban Indian Organizations (UIOs) play in the health care delivery to American Indian and Alaska Native patients and the importance of providing UIOs with the necessary funding to continue to provide quality, culturally competent care to their communities.

The letter also notes that chronic underfunding of IHS and urban Indian health has contributed to the health disparities among American Indian and Alaska Native people living in urban areas that suffer greater rates of chronic disease, infant mortality, and suicide compared to other populations.

This letter sends a clear and powerful message to Chair Murkowski and Ranking Member Merkley and the members of the Senate that funding for urban Indian health must be significantly increased to fulfill the federal government’s trust responsibility to provide quality healthcare to all American Indian and Alaska Native people.

NCUIH is grateful for the support of the following Senators:

  1. Tina Smith (D-MN)
  2. Maria Cantwell (D-WA)
  3. Mark Kelly (D-AZ)
  4. Kirsten Gillibrand (D-NY)
  5. Ben Ray Luján (D-NM)
  6. Elissa Slotkin (D-MI)
  7. Catherine Cortez Masto (D-NV)
  8. Richard Blumenthal (D-CT)
  9. Tammy Duckworth (D-IL)
  10. Michael F. Bennet (D-CO)
  11. Ruben Gallego (D-AZ)
  12. Alex Padilla (D-CA)
  13. Andy Kim (D-NJ)
  14. Amy Klobuchar (D-MN)
  15. Ron Wyden (D-OR)
  16. Chris Van Hollen (D-MD)
  17. Edward J. Markey (D-MA)
  18. Richard J. Durbin (D-IL)
  19. Jacky Rosen (D-NV)
  20. Adam B. Schiff (D-CA)
  21. Angela D. Alsobrooks (D-MD)

Full Letter Text

Dear Chair Murkowski and Ranking Member Merkley,

We write to thank you for your proven commitment to the Indian health system, including Urban Indian Organizations (UIOs), and to request you continue your support by funding urban Indian health at the highest level possible, up to the demonstrated need of $1,093,999,000, and retaining advance appropriations for the Indian Health Service (IHS) in the Fiscal Year (FY) 2027 Interior, Environment, and Related Agencies Appropriations Act.

These requests reflect the full need for urban Indian health determined by the Tribal Budget Formulation Workgroup, which is comprised of Tribal leaders representing all twelve IHS service areas. The Workgroup recommended this funding amount for urban Indian health as a part of a $73,007,281,000 topline recommendation for the Indian Health Service. UIOs are an important part of the IHS, which oversees a three-prong system for the provision of health care: Indian Health Service, Tribal Programs, and Urban Indian Organizations (I/T/U).

UIOs are on the front lines in working to provide for the health and well-being of American Indians and Alaska Natives living outside of Tribal jurisdictions. They serve patients from over 500 federally-recognized Tribal Nations in 38 urban areas across the country. UIOs are not eligible for other federal line items that IHS and Tribal facilities are, like hospitals and health clinics money, purchase and referred care dollars, or IHS dental services dollars. Therefore, this funding request is essential to providing quality, culturally-competent health care to AI/AN people living in urban areas.

Chronic underfunding of IHS and urban Indian health has contributed to the health disparities among AI/AN people. Additionally, AI/AN people living in urban areas suffer greater rates of chronic disease, infant mortality, and suicide compared to all other populations. Urban Native populations are less likely to receive preventive care and are less likely to have health insurance. Additional funding is critical to addressing this disparity.

In order to fulfill the federal government’s trust responsibility to all AI/AN people to provide quality healthcare, funding for urban Indian health must be significantly increased. It is also imperative that such an increase not be paid for by diminishing funding for already hard-pressed IHS and Tribal providers. The solution to address the unmet needs of urban Native and all AI/AN people is an increase in the overall IHS budget.

Thank you for your continued support of urban Indian health and your consideration of this important request.

NCUIH Honors Pfizer, Ishkode Fund, and Urban Indian Health Leaders

/in , /by

FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (May 11, 2026) – The National Council of Urban Indian Health (NCUIH) presented awards to partner organizations and Urban Indian Organization (UIO) leadership and staff for their work to advance urban Native health during our 2026 Annual Conference. NCUIH thanks the awardees for their dedication to urban Native health and their efforts to ensure that all Native people have access to high-quality health care services, no matter where they live.

Native Health Partnership Excellence Award: Presented to Pfizer and Accepted by Melissa Bishop-Murphy

Native Health Partnership Excellence Award: Presented to Pfizer and Accepted by Melissa Bishop-Murphy

The Native Health Partnership Excellence Award recognizes an individual or organization that has shown exceptional dedication and effectiveness in partnering with urban Native communities to improve health care outcomes. This year’s award was presented to Pfizer.

Over the past four years, Pfizer has invested more than $800,000 in NCUIH’s work, demonstrating a sustained and meaningful commitment to improving health outcomes for urban Native people. Pfizer’s partnership has helped advance NCUIH’s mission to ensure that American Indian and Alaska Native people living in urban areas have access to high quality, culturally grounded care.

Native Health Rising Ally Award: Presented to Ishkode Fund (Accepted by Kate Trujillo, Senior Programs Director)

Native Health Rising Ally Award: Presented to Ishkode Fund (Accepted by Kate Trujillo, Senior Programs Director)

The Native Health Rising Ally Award honors an emerging leader or organization who has demonstrated outstanding support, advocacy, and allyship in advancing urban Native American health initiatives. This year’s award was presented to the Ishkode Fund, accepted by Senior Programs Director Kate Trujillo.

The Ishkode Fund has demonstrated a growing and genuine commitment to health equity and allyship with Urban Indian Organizations. NCUIH is proud to recognize Ishkode’s investment in Native communities and looks forward to continuing to build this important partnership in the years ahead.

The Distinguished Service Award: Presented to Walter Murillo (Choctaw), Outgoing NCUIH Board President and CEO of Native Health

The Distinguished Service Award: Presented to Walter Murillo (Choctaw), Outgoing NCUIH Board President and CEO of Native Health

The Distinguished Service Award honors exceptional dedication and sustained commitment to NCUIH and to Native communities across the country. It recognizes individuals whose leadership, advocacy, and service have strengthened urban Indian health, advanced meaningful change, and helped elevate the voices and needs of Native people. This year’s award was presented to Walter Murillo (Choctaw), outgoing NCUIH Board President and Chief Executive Officer of Native Health in Phoenix, Arizona.

Walter’s leadership has embodied the compassion, integrity, and deep sense of responsibility to community that this award was created to honor. His contributions leave a lasting mark on NCUIH’s mission and reflect the spirit of service and solidarity that continues to move the organization forward.

Urban Indian Organization Visionary Award: Presented to LivA’ndrea Knoki, Board of Directors President, Native Americans for Community Action

Urban Indian Organization Visionary Award: Presented to LivA’ndrea Knoki, Board of Directors President, Native Americans for Community Action

The Urban Indian Organization Visionary Award celebrates an individual within an Urban Indian Organization who has demonstrated visionary leadership and innovation in addressing challenges and opportunities within urban Native communities. This year’s award was presented to LivA’ndrea Knoki, Board of Directors President of Native Americans for Community Action (NACA) in Flagstaff, Arizona.

As NACA’s first woman Board President, LivA’ndrea has served in this role for seven years, advancing the organization’s mission by strengthening governance, expanding strategic partnerships, and centering culturally grounded approaches in urban Indigenous health. She has helped reimagine access to care beyond traditional clinic-based models and has advanced culturally rooted practices — including traditional healing, conscious language, and ceremonial protocol — within urban systems. Her leadership has helped operationally define “Indigenous Values” to support services for youth, elders, LGBTQ2S+ relatives, and unhoused relatives, while reinforcing that Urban Indigenous Health requires models distinct from rural or reservation-based systems.

Urban Indian Organization Staff Member of the Year Award: Presented to Michael Duran, Director of Counseling, Indian Health Center of Santa Clara Valley

Urban Indian Organization Staff Member of the Year Award: Presented to Michael Duran, Director of Counseling, Indian Health Center of Santa Clara Valley

The Urban Indian Organization Staff Member of the Year Award recognizes a staff member of an Indian Health Service-funded Urban Indian Organization who demonstrates exceptional dedication, leadership, and service in advancing the organization’s mission and goals. This year’s award was presented to Michael Duran, Director of Counseling at the Indian Health Center of Santa Clara Valley.

Michael has demonstrated an unwavering commitment to advancing culturally grounded care, ensuring that Traditional Healing is not only recognized but integrated as a vital component of community wellness. His work has moved beyond theory to create tangible, positive outcomes for those he serves, making him an exceptional example of the dedication that drives urban Native health forward.

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.

###

NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

NCUIH Honors Chairman Tom Cole and Ranking Member Chellie Pingree with Urban Indian Health Champion Award

/in , /by

FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (April 29, 2026) – The National Council of Urban Indian Health (NCUIH) presented the Urban Indian Health Champion Award to Rep. Tom Cole (R-OK-04), Chairman of the House Committee on Appropriations, and Rep. Chellie Pingree (D-ME-01), Ranking Member of the House Appropriations Subcommittee on Interior, Environment, and Related Agencies, during NCUIH’s 2026 Annual Conference.

Chairman Cole and Ranking Member Pingree helped secure the continuation of critical HHS Native health set-asides and grants beyond IHS, including SAMHSA’s Native Connections and CDC’s Good Health and Wellness in Indian Country. These programs are integral to the holistic health care of Native communities and to fulfilling the federal trust responsibility.

Rep. Tom Cole (R-OK-04), Chairman, House Committee on Appropriations

An enrolled member of the Chickasaw Nation, Chairman Cole has been a steadfast advocate for Indian Country throughout his career, consistently using his position at the top of the House Appropriations Committee to ensure those obligations are met.

Rep. Tom Cole (R-OK-04), Chairman, House Committee on Appropriations

“We count on [your] Indian health care centers to discharge the federal trust responsibility in terms of health care, and you do a magnificent job of helping our folks, particularly in challenging moments in time.”

— Rep. Tom Cole, Chairman, House Committee on Appropriations

Rep. Chellie Pingree (D-ME-01), Ranking Member, House Appropriations Subcommittee on Interior, Environment, and Related Agencies

Rep. Pingree has been a consistent and powerful voice for Native health on the subcommittee that directly oversees IHS funding, and a driving force in maintaining bipartisan commitment to upholding treaty and trust obligations — even in difficult budget years.

“It is our deep responsibility to uphold our treaty and trust obligations, and we have to make sure we do that every year.”

— Rep. Chellie Pingree, Ranking Member, House Appropriations Subcommittee on Interior, Environment, and Related Agencies

The award recognizes members of Congress who have demonstrated outstanding commitment and leadership in advocating for issues vital to Native communities. Under their leadership, Congress enacted FY 2026 appropriations including $95.42 million for Urban Indian Health — a $5 million increase over FY 2025.

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.

###

NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

 

NCUIH Honors HHS Senior Advisor Mark Cruz with Excellence in Public Service Award

/in , /by

FOR IMMEDIATE RELEASE

WASHINGTON, D.C. (April 29, 2026) – The National Council of Urban Indian Health (NCUIH) presented the Excellence in Public Service to Advance Native Health Award to Mark Cruz, Senior Advisor to the Secretary at the Department of Health and Human Services, during NCUIH’s 2026 Annual Conference.

Mark Cruz, Senior Advisor to the Secretary, HHS and and Walter Murillo, CEO of NATIVE HEALTH, and NCUIH Vice-President

Mark Cruz, Senior Advisor to the Secretary, HHS and and Walter Murillo, CEO of NATIVE HEALTH, and NCUIH Vice-President

“My commitment to you all is to always engage, to always show up.”

— Mark Cruz, Senior Advisor to the Secretary, HHS, April 28, 2026

The Excellence in Public Service to Advance Native Health Award recognizes a federal public servant whose work has meaningfully advanced health care access for Native people, including those living in urban areas. Mark Cruz was appointed in June 2025 as the first-ever Senior Advisor to the HHS Secretary, a position created to ensure Native health priorities are represented at the highest levels of the Department. Since taking office, Mark has delivered — proposing advanced appropriations for IHS in the President’s FY 2027 budget request and helping drive Secretary Kennedy’s $1 billion commitment to IHS construction. He has also logged thousands of miles visiting Urban Indian Organizations across the country — a reflection of his belief that showing up is part of the job. NCUIH is grateful for his partnership and dedication to advancing Native health.

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.

###

NCUIH Contact: Meredith Raimondi, Vice President of Policy and Communications, mraimondi@ncuih.org

NCUIH April Policy Update: 2026-27 Policy Priorities, FY 2027 President’s Budget Update, Medicaid and 340B, and IHS Policy Developments

/in /by

In this Edition:

  • 📋 NCUIH Released 2026-2027 Policy Priorities
  • 📊 FY 2027 President’s Budget: Proposes Increase for Indian Health Service, Advance Appropriations for FY 2028
  • 🤝 60 Bipartisan Representatives Sign Letter Supporting IHS and Urban Indian Health Funding
  • 💰 HRSA 340B Rebate Pilot Program: NCUIH and TTAG Support for IHCP Exemption
  • 📋 FMAP Updates for Urban Indian Organizations
  • 💻 NCUIH Comments on IHS Health IT Modernization PATH Activities
  • 🌾 Rural Health Transformation Fund: NCUIH Requests UIO Input
  • 📅 Upcoming Policy Events, Deadlines, and Opportunities
  • 🎉 Join Us April 27–30 for the 2026 NCUIH Annual Conference

NCUIH Released 2026-2027 Policy Priorities

NCUIH has released its 2026-2027 Policy Priorities, which outlines a summary of urban Indian organization (UIO) federal priorities:

  • Increasing Funding for IHS and the Urban Indian Health Line Item
  • Establishing Permanent Full (100%) Federal Medical Assistance Percentage (FMAP) for Medicaid Services at UIOs
  • Increasing Behavioral Health Funding
  • Stability in Federal Grants
  • Health Information Technology and Electronic Health Record Improvement

Read the full priorities.

President Releases FY 2027 Budget with Proposed Increase for IHS, Congress Requests Protection of IHS Funding

On April 3, 2026, the President released the full Fiscal Year (FY) 2027 Department of Health and Human Services Budget In Brief and the Indian Health Service (IHS) Congressional Justification. The budget prioritizes funding for IHS by proposing $9.1 billion for the Indian Health Service — an increase of more than $1 billion above FY 2026 enacted levels. It also includes:

  • Advance Appropriations for IHS for FY 2028: $5.6B
  • Read more on NCUIH’s blog.

60 Bipartisan Representatives Sign Letter Supporting IHS and Urban Indian Health Funding

In a significant show of bipartisan support, 60 Members of Congress signed a dear-colleague letter urging the protection of IHS funding and increased resources for Urban Indian Health. NCUIH supporting this effort which included requests for $106 million for Urban Indian Health, maintaining Advance Appropriations for IHS, and protecting IHS from sequestration.

Read more on NCUIH’s blog.

Health Resources and Services Administration 340B Rebate Pilot Program Updates – NCUIH Support for Indian Health Care Provider Exemption

The Health Resources & Services Administration (HRSA) is seeking information on potential implementation of a 340B Rebate Model Pilot Program rebate pilot program, which poses administrative and financial burdens for Indian Health Care Providers (IHCPs), including Urban Indian Organizations.

  1. NCUIH and the Centers for Medicare and Medicaid Services (CMS) Tribal Technical Advisory Group (TTAG) are supporting an exemption for IHCPs from the 340B rebate pilot program and requesting tribal consultation and urban confer.

Comments to HRSA are due April 20, 2026. Submission information can be found here.

HRSA Visit to NATIVE HEALTH in Arizona

NCUIH’s CEO participated in a HRSA visit to NATIVE HEALTH on April 9, providing an opportunity to highlight the impact of 340B on Urban Indian clinics directly to HRSA leadership. The visit included Tom Engels, HRSA Administrator; Mark Cruz, Senior Advisor to U.S. Department of Health and Human Services Secretary Kennedy; Francys Crevier, NCUIH CEO, as well as Jack Ganter, HRSA Director of Legislation and Devin Delrow, Principal Advisor for Tribal Affairs, U.S. Department of Health and Human Services.

Federal Updates: 100% FMAP for UIOs and Traditional Healing Reimbursement

FMAP Support at CMS TTAG Meeting 

Federal Medical Assistance Percentage (FMAP) policy continues to be a critical issue for UIOs. Updates include:

  • NCUIH Board President Walter Murillo, who serves as the NCUIH representative on the CMS TTAG, raised the need of 100% Federal Medical Assistance Percentage for UIOs, specifically for Traditional Healing services reimbursement, to CMS leadership during the the March 24-25 CMS TTAG quarterly meeting.

Read more on NCUIH’s Policy Resource Center.

NCUIH Submitted Comments on IHS Health IT Modernization PATH Activities

On April 4, 2026, NCUIH submitted written comments to IHS in response to the March 5 Health IT Modernization Tribal Consultation/Urban Confer on Patients at the Heart (PATH) Electronic Health Record (EHR) activities.

  • NCUIH recommended that IHS ensure cohort selection equally prioritizes all facility types and provide UIOs with clear guidance on PATH EHR implementation.

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 NCUIH’s blog.

  Request for UIOs:

2026 NCUIH Annual Conference

April 27–30, 2026, in Washington, D.C., as NCUIH marks the 50th anniversary of the Indian Health Care Improvement Act (IHCIA)—a landmark commitment to the health and well-being of American Indians and Alaska Natives—and reflects on five decades of progress, collaboration, and continued commitment to Native health.

  • Registration has closed.

Notable sessions include:

  1. IHS Listening Session — An opportunity for UIOs to engage directly with IHS leadership on policy priorities.
NCUIH Annual Conference 2026 Website

Upcoming Events and Policy Dates

April 21-22 — HHS Annual Tribal Budget Consultation (Washington, DC)
April 27–30, 2026 — 2026 NCUIH Annual Conference (Washington, D.C.)
May 20 — NCUIH Monthly Policy Workgroup (virtual)

Recent NCUIH Policy Blogs

  1. President’s Budget Proposes Increase for Indian Health Service, Advance Appropriations for FY 2028
    April 3, 2026/in /by 
  2. NCUIH Recognized at IHS 70th Anniversary Tribal Summit for Exceptional Partnership
    March 28, 2026/in /by 
  3. Tribal Leaders Recommend Increased Urban Indian Health Funding for Fiscal Year 2028
    March 25, 2026/in /by 
NCUIH Policy Blog

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.

NCUIH Requests the Indian Health Service Strengthen Relationships with Area Offices Under the Proposed Realignment

/in /by

On February 27, 2026, the National Council of Urban Indian Health (NCUIH) submitted written comments to the Indian Health Service (IHS) Chief of Staff, Clayton Fulton, regarding IHS’ November 13, 2025, and December 5, 2025, Dear Tribal Leader and Urban Indian Organization (UIO) Leader letters (DTLLs/DULLs) and January 15, 2026, virtual Urban Confer on the IHS Proposed Realignment.  

In the written comments, NCUIH recommended IHS strengthen UIOs’ relationships with Area Offices as part of the Proposed Realignment, and emphasized the importance of protecting UIO contracts, addressing IHS staffing needs, and ensuring continued engagement with UIOs, while also highlighting the importance of 100% Federal Medical Assistance Percentage (FMAP) for UIOs. 

NCUIH will continue to closely follow the development and implementation of IHS’ Proposed Realignment. 

Background on the IHS Proposed Realignment 

On June 13, 2025, IHS published a DTLL/DULL announcing IHS was initiating Tribal Consultation and Urban Confer to receive comments and recommendations regarding IHS’ Proposed Realignment.​ IHS described the goal of the Proposed Realignment as creating a “more accountable, efficient, and responsive IHS that maximizes resources and improves outcomes while simultaneously strengthening intergovernmental relationships for better service coordination and funding access.” ​​During the Urban Confer session on the Proposed Realignment, IHS shared the agency is still in the development phase. As part of the development phase, IHS was seeking feedback from relevant stakeholders, including Tribes and UIOs. 

On November 13, 2025, IHS’ then-Acting Director, Ben Smith, published a DTLL/DULL announcing the next phase in the Agency’s proposed realignment which would include four in-person Tribal Consultation sessions and one virtual Urban Confer session. On December 5, 2025, the IHS Chief of Staff released a DTLL/DULL in response to requests for additional opportunities and added more in-person sessions and a virtual Tribal Consultation. IHS also released a realignment narrative, a draft re-organization chart, and a frequently asked questions document. During the second Urban Confer on the Proposed Realignment, IHS reiterated that no decisions had been made by IHS regarding the Proposed Realignment.  

IHS also created a webpage on IHS’ website on the Proposed Realignment. 

Next Steps 

While the path forward is subject to change, IHS shared the Agency plans to have a Federal Register comment period (30 days) followed by a Federal Register notice with a “Transition to Future State” occurring between May and June of 2026. IHS stated that the Agency plans to continue to use Tribal Consultation and Urban Confer to keep Tribes and UIOs up to date on the Proposed Realignment. 

NCUIH Engages Federal Leaders on Urban Indian Health at NATIVE HEALTH Site Visit in Arizona

/in /by

On April 9, 2026, Walter Murillo (Choctaw), Board President of National Council of Urban Indian Health and CEO of NATIVE HEALTH, welcomed a distinguished group of federal leaders to NATIVE HEALTH’s Arizona facility for a site visit showcasing the important role of Urban Indian Organizations (UIOs) in delivering care to Native communities. NATIVE Health is one of 11 HRSA-funded UIOs serving Native communities across the country. 

The delegation included Tom Engels, Health Resources and Services Administration (HRSA) Administrator; Mark Cruz, Senior Advisor to HHS Secretary Kennedy; Jack Ganter, HRSA Director of Legislation; and Devin Delrow, Principal Advisor for Tribal Affairs, U.S. Department of Health and Human Services. NCUIH CEO, Francys Crevier (Algonquin), joined the visit, ensuring NCUIH had a direct voice in conversations with federal decision-makers.

During the visit, leaders toured the facility, engaged with staff, and witnessed firsthand how UIOs provide culturally responsive care in urban settings. NCUIH used the occasion to elevate a top priority: securing an exemption for Tribal and Urban Indian facilities from HRSA’s 340B Rebate Model Pilot. The 340B drug pricing program is essential to UIO operations, enabling facilities like NATIVE HEALTH to extend limited resources and broaden access to care for American Indian and Alaska Native patients.

NCUIH also reinforced the distinct legal and operational framework within which UIOs function — a framework that federal policy must account for. Engagements like this are critical to ensuring Native voices are part of federal decision-making and that agency leadership understands the on-the-ground realities of urban Indian health programs.

NCUIH will continue pursuing direct engagement with HRSA and HHS leadership to protect and advance UIO priorities.  

Background 

The 340B Drug Pricing Program allows qualifying safety-net providers, including UIOs, to purchase outpatient drugs at significantly reduced costs. These savings are reinvested to expand services and improve health outcomes for underserved populations. HRSA’s proposed 340B Rebate Model Pilot has raised concerns across the UIO community, as it could undermine the financial sustainability of programs that American Indian and Alaska Native communities in urban areas depend on. NCUIH has consistently worked to protect Tribal and Urban Indian facilities from harmful changes to the 340B program.