National Council of Urban Indian Health Supports the Affordable Care Act in Light of the 2016 Presidential Elections

FOR IMMEDIATE RELEASE

November 16, 2016

Contact: Francys Crevier

NCUIH Policy Analyst and Congressional Relations Liaison
FCrevier@NCUIH.org

 

Washington, D.C.  – The 2016 Presidential election results have created panic among those in the healthcare industry, as the new administration states they will repeal all or much of the Patient Protection and Affordable Care Act (ACA). The National Council of Urban Indian Health (NCUIH) reaffirms its mission to fight for quality and access to healthcare for American Indians and Alaska Natives (AI/AN).

The National Council of Urban Indian Health was founded 18 years ago to represent the interests of Urban Indian Health Programs (UIHPs) before Congress and Federal agencies, and to influence policies impacting the health conditions experienced by urban American Indians and Alaska Natives (AI/AN).The National Council of Urban Indian Health is a 501(c)(3), membership-based organization devoted to support the development of quality, accessible, and culturally sensitive health care programs for AI/AN living in urban communities.  NCUIH fulfills its mission by serving as a resource center providing advocacy, education, training, and leadership for urban Indian health care providers.  NCUIH strives for healthy American Indians and Alaska Natives living in urban settings, which comprise over 70% of the AI/AN population, supported by quality, accessible health care centers and governed by leaders in the Indian community.

The National Council of Urban Indian Health stands firm in representing the health and welfare of American Indians and Alaska Natives (AI/AN) and recognizes the Indian Healthcare Improvement Act is at risk under the new administration, as well as the Affordable Care Act. NCUIH is working with our partners to ensure the protection of these laws that have not only permanently reauthorized the Indian Health Care Improvement Act, but also the AI/AN provisions that are included in them that aid in facilitating the trust responsibility.

NCUIH will be working side by side with our Tribal partners to protect the healthcare trust responsibility that AI/AN were promised. We are stronger together.  For questions, comments or concerns, feel free to contact NCUIH Policy Analyst and Congressional Relations Liaison Francys Crevier at FCrevier@NCUIH.org.

The U.S. Department of Veterans Affairs (VA) hosts Tribal Consultation at the National Museum of the American Indian

On September 28, 2016 the U.S. Department of Veterans Affairs (VA) held an in-person Tribal consultation session at the National Museum of the American Indian in Washington, DC to discuss amending the current VA Memorandum of Understanding (MOU) status to consolidate multiple community care programs, previously known as non-VA care, into one standard program with standard rates. The meeting was announced on September 12, 2016 through a Dear Tribal Leader Letter. NCUIH Board member Kerry Lessard and NCUIH Policy Analyst and Congressional Relations Liaison Francys Crevier emphasized the need to work with the VA to allow Urban Indian Health Programs the ability to have MOUs to better serve Native veterans. These MOUs would reimburse UIHPs for services provided to Native veterans who often prefer going to a UIHP for service rather than the VA because of shorter wait times and culturally competent care.

During the consultation, Tribal Leaders emphasized that the VA to fully implement the VA-IHS Memorandum of Understanding (MOU) that was implemented in 2012.  Many Tribal leaders expressed their disappointment of the MOU process taking over four years for approval, and others were concerned that VA’s consolidation plan would end  the current IHS/Tribal – VA MOU structure and would result a lengthier process and would most importantly infringe on the government-to-government relationship with the federal government.

At the National Indian Health Board’s conference in Scottsdale last month, the VA hosted a workshop on the MOU process. When the Ms. Crevier requested that the VA work with UIHPs as an integral part of the Indian Health system, the VA responded there was no need to work with UIHPs because there are VA offices in urban areas. NCUIH vehemently disagrees and strongly suggested that because of shorter wait times and cultural competency as well as the vital support UIHPs can bring to the VA, MOUs are necessary. A recent report from the Office of Inspector General showed that 215 VA patients died waiting for specialty care at the Phoenix VA, while Native Health, the Phoenix UIHP, resides in the same neighborhood and is willing to help alleviate that burden. Working together is the only way to make sure veterans do not fall through the cracks.

Tribal Consultation on the VA’s plan for consolidation is open until November 5, 2016. Click here to view the Federal Register Notice and submit comments.

100% FMAP State Health Official Announcement

On Friday, February 26, 2016 the Centers for Medicare & Medicaid Services (CMS) released the Dear State Health Official letter regarding 100% FMAP to inform state agencies and health officials about the update in payment policy affecting federal funding for services received by Medicaid-eligible individuals who are AI/ANs through facilities of the Indian Health Service (IHS), whether operated by IHS or Tribes. Through this letter, CMS is re-interpreting its payment policy with respect to services “received through” an IHS/Tribal facility, and is expanding the scope and nature of services that qualify for the matching rate.

This update to the national policy has Tribal implications for IHS and Tribal facilities as well as on Urban Indian Health Programs (UIHPs) that provide services to AI/AN Medicaid beneficiaries. CMS held several Tribal Consultations, participated in an Urban Conferring session between IHS and NCUIH, and solicited comments on the parameters of a reinterpretation of section 1905(b) of the Social Security Act as specified in CMS’ October 2015 Medicaid Services ‘Received Through’ and Indian Health Service/Tribal Facility: A Request for Comment.” They received comments from Tribes, Tribal organizations, urban Indian organizations, States, and other stakeholders in support of the proposed policy change.

The new policy is intended to help states, IHS, Tribes, and UIHPs improve the delivery of health to AI/AN Medicaid beneficiaries by increasing access to care and strengthening continuity of care. The letter outlining the new policy is attached and will be available online on Medicaid.gov here. CMS will be holding an All Tribes’ Call to walk through the policy and provide time for questions and answers.  They will send out a Save the Date notice for the All Tribes’ Call, and information about the All Tribes’ Call will be posted here. We will make sure that notice gets sent out to UIHP Directors.

NCUIH believes that the new policy marks progress for UIHPs at the regulatory level. The CMS announcement coupled with the 100% FMAP for All Indian Health Programs inclusion in the President’s FY2017 budget demonstrates a desire by the government to achieve parity for Urbans within the Indian healthcare system for Medicaid beneficiaries. There are still determinations to be made regarding technical eligibility issues and operationalizing the updated CMS regulation. Consultations with State Medicaid programs and conferring sessions between IHS and NCUIH’s FMAP Work Group will be sought to clarify outstanding issues and to figure out the best way advance the interests of UIHPs within the context of the new FMAP regulation. NCUIH still seeks the help of all UIHPs in reaching out to Members of Congress to request support for the 100% FMAP provision within the President’s budget. Lastly, NCUIH would like to express gratitude to the FMAP Work Group (Donna Keeler – South Dakota, Aren Spark – Seattle, Walter Murillo – Phoenix, and Ashley Tuomi – Detroit) as well as all of the UIHP Directors that have contributed time and effort over recent days, weeks, months, and years towards achieving 100% FMAP inclusion for Urbans. Should you have any questions regarding this announcement, please contact Rudy Soto, NCUIH Policy Analyst, at rsoto@ncuih.org.