mmpc - National Indian Health Board

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-Request Schedule and Process for dealing with open issues on Single Enrollment Form for Exchanges and Medicaid (including how CMS is dealing with process for vetting with other groups) -Status of letter to Tribes (development of CMS Template) for outlining process at state level for those Tribes not moving forward with Medicaid Expansion-Jim Roberts TTAG November Face-to Face Meeting -Invite Gary Cohen -Invite OIG to report and present on Safe Harbors and Medicaid Collections -Take final action and approval of Strategic Plan -Discussion on working with states on exchanges and Medicaid expansion MMPC November Face-to-Face Meeting: -Request Data Report from Jim Crouch/Carol Korenbrot and review/discuss findings -Invite OPM (coordinate with Elliott)
Internal Revenue Service Meeting Notes Denver, Colorado Meeting September 25, 2012 Participants: Christie Jacobs, Jonathon Damm, IRS Jim Roberts, Ed Fox, Jessica Imotochi, Gerald Moses, Dee Sabattus, Diddy Nelson, Valerie Davidson, Doneg McDonough, Sam Ennis, Myra Munson, D’Shane Barnett, Mim Dixon, John Stephens, Jim Crouch 1. Health Insurance Penalty Exemption Discussion a. We covered definition issue and strategy to align. IRS not much to do here aligning ACA with Medicaid. This is HHS. o IRS seemed agree that the three statutory references to def. of Indian under ACA are the same, including under IRC § 45(A)(c)(6). o For IRS, their primary concern seemed to be, after comparing the ACA-referenced definitions to the Medicaid reg., is that non-Federally recognized tribes would be included under the Medicaid reg., if used. b. Tax Penalty o There may be administrative authority by Treasury Secretary and HHS Secretary to grant IHS coverage as meeting “essential coverage” pursuant to Treasury regulation. But it will take collaboration and agreement of both Secretaries. Doneg had citation in Treasury reg....Section 5000(A)(f)(1)???? o This request would apply only to the tax penalty and not eligibility for the APTC. o TTAG should draft a letter to this effect requesting that Secretaries act on this. 2. Identification of Indians: IHS data base of users a. It was mentioned to IRS staff that the HIS-maintained database for users is an important mechanism to more easily identify AI/AN b. The fact that not all IHS eligibles are captured in the database should not mean that the HIS database not be used. c. Christy stated that “discussions are just starting on how this [identification of AI/AN] is going to work.” 3. MAGI a. Chart that IRS and CMS are working on this. They have created a chart with the Indian exemptions for each of the programs. There are only one or two items that are not on the IRS exemption list. Aside these, most exempt items for IRS & CMS are the same. If IRS exempts Indian income, it will not collect information about the income that is exempt. The two items still under discussion are: i. Education costs and the BIA ii. Per capita distributions b. These items are also under discussion with regard to the General Welfare guidance that Treasury is preparing with regard to Tribes and tribal members. c. Follow up item: Can we get a copy of the chart? 4. Tribal Sponsorship/APTC items
Page 1 and 2: MEDICARE, MEDICAID, & HEALTH REFORM
Page 3 and 4: GENERAL INFORMATION TABLE OF CONTEN
Page 5 and 6: Last Updated: November 12, 2012 2.
Page 7 and 8: Ref. # 2. Task/Issue Person(s) CMS
Page 9 and 10: Ref. # II. POLICY Task/Issue Person
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Page 13 and 14: Ref. # Task/Issue Person(s) 15. Eva
Page 15 and 16: IV. OUTREACH AND EDUCATION MMPC: SU
Page 17 and 18: Ref. # Task/Issue Person(s) 25. Med
Page 19 and 20: MMPC October 9, 2012 Teleconference
Page 21: To do List: -Myra will have draft b
Page 25 and 26: with a “interim/acting”. Can al
Page 27 and 28: 8/7/12 DRAFT COMPANION TO ADDENDUM
Page 29 and 30: Indian Self-Determination and Educa
Page 31 and 32: Under federal law, There are privac
Page 33 and 34: 1. Purpose of Addendum; Supersessio
Page 35 and 36: (1) ISDEAA, 25 USC §450 et seq.; (
Page 37 and 38: 13. Medical Quality Assurance Requi
Page 39 and 40: edits on documents are due back fro
Page 41 and 42: d. CCIIO Philosophy - CCIIO is taki
Page 43 and 44: - I/T/U provider receives their all
Page 45 and 46: i. CMS rep. commented that an analy
Page 47 and 48: IHS TRIBAL SELF-GOVERNANCE ADVISORY
Page 49 and 50: Letter: Dr. Robert Petzel, Under Se
Page 51 and 52: October 17, 2012 Dr. Robert Petzel,
Page 53 and 54: A BILL To correct inconsistencies i
Page 55 and 56: California Rural Indian Health Boar
Page 57 and 58: As people have changes in employmen
Page 59 and 60: Indian eligibility determinations,
Page 61 and 62: v.7, 2012‐09‐23a ACA, (2) the s
Page 63 and 64: Indian tribe means any Indian tribe
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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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2. Office of Intergovernmental Affa
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will give equal consideration to th
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provide Indian Tribes with a region
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4. Each Operating Division Head/Dep
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Department’s ability to address i
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17. Sovereignty - The ultimate sour
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1. Selection of workgroup co-chairs
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It is unclear if this was just an o
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November 14 -15, 2012 TTAG FACE TO
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AGENDA: Day 2 Thursday - Nov. 15, 2
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Subpart G--Social Services Block Gr
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organization applying for or receiv
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members of a tribe receiving direct
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is at or below the poverty line. (d
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under this part. Grantees that rece
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income home energy assistance progr
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Need for Uniform Operational Guidan
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Dear Tribal Representatives, Octobe
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There is a strong correlation betwe
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Wed. Nov 14 th : SDPI National Call
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Future MMPC Meetings & Conference C
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Regulation Review and Impact Analys
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64. Policy on Conferring with Urban
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RRIAR Ref. # 1.c. 8. 9. 13. Short T
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RRIAR Ref. # 20. 23. 26. 28.a. Shor
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RRIAR Ref. # 43. 44. 46. 61. Short
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RRIAR Ref. # 83. 84. 85. 86. Short
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RRIAR Ref. # 2.c. 2.d. 3.a. Short T
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RRIAR Ref. # 4.b. 5. 10.a. 10.b. Sh
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RRIAR Ref. # 11.e. 11.f. 11.g. Shor
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RRIAR Ref. # 22. 24. 25.a. Short Ti
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RRIAR Ref. # 52.a. 52.b. 52.c. 57.
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RRIAR Ref. # 60.b. 60.c. 60.d. Shor
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RRIAR Ref. # 71.b. 72. 73. Short Ti
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RRIAR Ref. # 6.b. 6.c. 7.a. Short T
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RRIAR Ref. # 7.e. 7.f. 7.g. 12.a. S
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RRIAR Ref. # 29. 31.a. 31.b. 31.c.
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RRIAR Ref. # 39. 42. 45. 47. Short
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premium tax credit assistance and c
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Access to this benefit is criticall
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community providers for purposes of
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November 12, 2012 Centers for Medic
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_________ American Indian or Alaska
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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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mmpc - National Indian Health Board

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