mmpc - National Indian Health Board

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The purpose of the Regulation Review and Impact Analysis Report (RRIAR) is to identify and summarize key regulations issued by the Centers for Medicare and Medicaid Services (CMS) pertaining to Medicare, Medicaid, CHIP, and health reform 1 that affect (a) American Indians and Alaska Natives and/or (b) Indian Health Service, Indian Tribe and tribal organization, and urban Indian organization providers. Furthermore, the RRIAR includes a summary of the regulatory analyses prepared by the National Indian Health Board (NIHB) 2 , if any, and indicates the extent to which the recommendations made by NIHB were incorporated into any subsequent CMS actions. In addition to this cover page, the report consists of three tables – - Table A provides a status report on the RRIAR itself, listing the regulations included in the RRIAR to date, and the components of the analysis provided under each. The regulations are organized in four sections: I. Medicaid; II. Medicare; III. Health Reform; and IV. Other. - Table B lists key regulations issued by CMS, due dates for comments, a synopsis of the CMS action, and a summary of the analysis, if any, prepared by NIHB. - Table C identifies the recommendations made by NIHB pertaining to each regulation, if any, and evaluates the extent to which the recommendations made by NIHB were incorporated into subsequent CMS actions. Regulations with pending due dates for public comments – 2.d. Medicare Advantage and Part D Plan Applications (CMS-10237 and CMS-10137; comments due 11/13/2012; under review) 11.e. Medicare Advantage Quality Bonus Payment Demonstration (CMS-10445; comments due 11/16/2012; comments drafted) 60.d. Medicare Electronic Data Interchange Form (CMS-10164; comments due 11/16/2012) 84. Monthly State File of Dual Eligible Enrollees (CMS-10143; comments due 11/16/2012) 49.b. Medicare Credit Balance Reporting Requirements (CMS-838; comments due 11/16/2012) 85. Minimum Data Set for Medicaid Incentives for Prevention of Chronic Diseases (CMS-10444; comments due 11/19/2012) 83. Medicaid Statistical Information System (CMS-R-284; comments due 11/19/2012) 3.c. DME Certificate of Medical Necessity (CMS-846-849, 10125, 0126; comments due 11/23/2012) 88. Early Retiree Reinsurance Program Survey (CMS-10408; comments due 11/27/2012) 95. Indian Health Service Forms to Implement Privacy Rule (IHS-810, etc.; comments due 11/30/2012 approx.) 11.d. Medicare Bid Pricing Tool (CMS-10142; comments due 12/4/2012) 11.f. Medicare PDP Benefit Package Formulary (CMS-R-262; comments due 12/4/2012) 11.c. Outcome Measures for Quality Assessment in Medicare Advantage and Special Needs Plans (CMS-10451; comments due 12/26/2012) 11.g. Medicare Advantage Reporting Requirements (CMS-10261; comments due 12/26/2012) 94. Methodology for Designation of Frontier and Remote Areas (HRSA/no ref. #; comments due 1/4/2013) 4.b. Hospital Outpatient and Ambulatory Service Center Payment Systems (CMS-1589-FC; comments due 1/12/2013 approx.) 70.a. Medicare Physician Fee Schedule Rule (CMS-1590-FC; comments due 1/13/2013 approx.) 96. IHS New System of Records (IHS/no ref. #; comments due 12/13/2012) Comments recently submitted by NIHB, TTAG and/or other tribal organizations– 80. Notice of Denial of Medical Coverage (or Payment) (CMS-10003: comments submitted 11/6/2012) 66. Requirements for Charitable Hospitals: Proposed Rule (IRS-130266-11; comments submitted 9/24/2012) 1 “Health reform” is inclusive of (1) the Patient Protection and Affordable Care Act (Pub. L. 111-148), incorporating by reference S. 1790 as reported by the Committee on Indian Affairs of the Senate in December 2009 (containing amendments to the Indian Health Care Improvement Act, IHCIA), and as amended by the Health Care and Education Reconciliation Act (HCERA; Public Law 111–152) (collectively referred to as “ACA”) and (2) the American Recovery and Reinvestment Act of 2009 (ARRA, Pub. L. 111-5) 2 The analyses and recommendations may include those made by the Tribal Technical Advisory Group to CMS (TTAG) and other tribal organizations. National Indian Health Board, Regulation Review and Impact Analysis Report Page 2 of 3 11/12/2012
64. Policy on Conferring with Urban Indian Organizations: Request for Comments (No ref #; comments submitted by ANTHC and NCUIH 9/23/2012) 65. Health Care Reform Insurance Web Portal Requirements (CMS-10320; submitted 9/13/2012) Regulations under OMB (Office of Management and Budget) review – 92. Insurance Market Rules (CMS-9972-P; sent to OMB 11/8/2012) 31.d. Standards Related to Health Benefits (CMS-9980-P; sent to OMB 11/8/2012) 81. Part II--Regulatory Provisions To Promote Program Efficiency, Transparency, and Burden Reduction (CMS-1367-P; sent to OMB 8/2/2012) Recent (final) rules issued – 71.a. Physician Fee Schedule, ESRD, Bad Debt, etc (CMS-1352-F; issued 11/9/2012) 52. Home Health Prospective Payment System Rate for CY2013 (CMS-1358;F; issued 11/8/2012) 44. Medicaid Payment for Primary Care Services and Charges for Vaccine Administration: Proposed Rule (CMS-2370-P; issued 11/6/2012) 1.b. MU EHR Incentive Payments--Stage 2 (CMS-0044-F; issued 9/4/2012; corrections issued 10/23/2012) Contacts: Jennifer Cooper (JCooper@nihb.org); Liz Heintzman (EHeintzman@nihb.org) National Indian Health Board, Regulation Review and Impact Analysis Report Page 3 of 3 11/12/2012
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MEDICARE, MEDICAID, & HEALTH REFORM
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GENERAL INFORMATION TABLE OF CONTEN
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Last Updated: November 12, 2012 2.
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Ref. # 2. Task/Issue Person(s) CMS
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Ref. # II. POLICY Task/Issue Person
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Ref. # Task/Issue Person(s) 9. Stra
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Ref. # Task/Issue Person(s) 15. Eva
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IV. OUTREACH AND EDUCATION MMPC: SU
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Ref. # Task/Issue Person(s) 25. Med
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MMPC October 9, 2012 Teleconference
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To do List: -Myra will have draft b
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Internal Revenue Service Meeting No
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with a “interim/acting”. Can al
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8/7/12 DRAFT COMPANION TO ADDENDUM
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Indian Self-Determination and Educa
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Under federal law, There are privac
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1. Purpose of Addendum; Supersessio
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(1) ISDEAA, 25 USC §450 et seq.; (
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13. Medical Quality Assurance Requi
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edits on documents are due back fro
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d. CCIIO Philosophy - CCIIO is taki
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- I/T/U provider receives their all
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i. CMS rep. commented that an analy
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IHS TRIBAL SELF-GOVERNANCE ADVISORY
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Letter: Dr. Robert Petzel, Under Se
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October 17, 2012 Dr. Robert Petzel,
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A BILL To correct inconsistencies i
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California Rural Indian Health Boar
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As people have changes in employmen
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Indian eligibility determinations,
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v.7, 2012‐09‐23a ACA, (2) the s
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Indian tribe means any Indian tribe
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v.7, 2012‐09‐23a In issuing thi
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(1) to ensure the highest possible
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v.7, 2012‐09‐23a Delays in acc
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v.7, 2012‐09‐23a 1997. The prov
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v.7, 2012‐09‐23a 48 Enacted thr
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Prepared by James Crouch MPH Chair,
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Summary T he Indian Health Service
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Summary providers that were either
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Introduction Reliable determination
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Analysis Groups IHS AIAN Methods Th
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Methods group for the statistical m
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Enrollees with no Payments Methods
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Methods Table 5. Mean Medicaid and
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Restricted Benefits Methods Enrolle
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Age and Sex Methods Medical care pa
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Methods Table 9. Findings for all s
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Methods Map 1. 12 IHS Areas: Contra
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Findings Figure 1. Adjustment of Me
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Findings Payments are Higher for IH
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Findings for Group 3 was $600 and W
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Findings Unadjusted mean payments f
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Findings Table 10. Unadjusted Mean
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Findings Figure 13. Adjusted Mean T
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Analysis Group Compiled Findings fo
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Findings Adjusted Mean Payments for
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Findings Figure 18. Percent differe
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Findings providers for services nee
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Findings Figure 21. Medicaid Altern
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Conclusions and Recommendations pro
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Indian Health Service, 2012. Federa
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Tribal Consultation Policy HHS 1. P
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defined in Sections 8 and 9 of this
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Page 139 and 140: 17. Sovereignty - The ultimate sour
Page 141 and 142: 1. Selection of workgroup co-chairs
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Page 155 and 156: organization applying for or receiv
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Page 159 and 160: is at or below the poverty line. (d
Page 161 and 162: under this part. Grantees that rece
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Page 171 and 172: Dear Tribal Representatives, Octobe
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Page 177 and 178: Future MMPC Meetings & Conference C
Page 179: Regulation Review and Impact Analys
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November 9, 2012 Page 2 We are comm
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Tribal Consultation for Health Insu
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Background Analysis of Tribal Consu
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Analysis of Tribal Consultation Pol
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D. FFE Data Analysis of Tribal Cons
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John O'Brien Director, Healthcare &
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Draft Report: Currently being circu
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