mmpc - National Indian Health Board

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a. RE: premium subsidies and applying full APTC for purpose of Tribal sponsorship. Up to individual and IRS may not impose any requirements on how individual uses. b. When asked whether APTC could be split between a medical plan and a dental plan, Christy said she didn’t know. Doneg noted that HHS is responsible for issuing guidance re APTC for pediatric dental plans. c. Myra asked whether IRS could enter into assignment agreements whereby people who accept tribal sponsorship for payment of health insurance premiums can have any underpayment of premium tax credits paid to the sponsoring organization. IRS was not enthusiastic about the chances of this happening because IRS only uses this for limited situations and Christy thought the Tribe might not be the right kind of entity to qualify for assignment of tax refunds. d. John Stephens asked whether over or under recovery of APTC at the end of the year could be moved to the following year’s taxes. Christie responded that they couldn’t let it ride to the next year without interest. John was very effective in making the point that it will only take one tax bill for one person to end tribal sponsorship. Jim Roberts commented that Washington State was working with tribes on an aggregator model for tribal sponsorship, but it may not work due to assignment of tax credits. He asked if IRS was working with states on this. Christy said IRS isnot working with States. e. f. Follow up item: IRS is to send us the section of the tax code that applies to similar assignment so that Tribal policy wonks can determine if there is some application here that can be used for Tribal sponsorship. 5. IRS Form 1040 a. Christy indicated that IRS will want to consult with tribes on the question(s) put on Form 1040 b. We mentioned that TTAG submitted recommendations on a “single question” to ask c. It seems we should resend the old TTAG recommendations to Christy/IRS, or send a revised recommendation if preferred. 6. IRS Outreach & Education a. IRS does plan to have special outreach to AI/AN, with an increase in outreach activities in 2013. IRS is tied into the overall O&E campaign of HHS. IRS not in position to conduct outreach until final rules & decisions are in place. b. Voluntary tax assistance centers. There are tribal sponsors for these centers now and IRS expects to use them for ACA. i. Follow-up Item: How can Tribes become Voluntary Tax Assistance centers if they are not? Can IHS/Tribal benefits coordinators be trained to provide this assistance? Non-tribal sites will need special training about tribal benefits and sponsorship; how will this happen? c. In IRS all training is now electronic. Christie recognizes the need for face-t0-face, small group training for Tribes, but she says that the IRS needs to hear this from Tribes. d. Follow-up item: Tribes should send letter to IRS Commissioner and Sec of Treasury with cc to Christy. e. Christie recommended that we stay in touch with her about such issues as they become more clear in the coming months. f. Who do we direct our advocacy to? Normally the Deputy Secretary is responsible for Tribal issues however position is vacant (Aaron Kline left, but someone else checks in mailbox)
with a “interim/acting”. Can always direct information to IRS Commissioner, with copy to Christie Jacobs. g. John Stephens asked whether a person had to file taxes previously in order to apply for APTC through the Exchange. Christy said she didn’t know the answer to that question. 7. Recommendation to form IRS-Tribal Workgroup a. The Department of Treasury Tribal Consultation Policy is on their website on a Tribal page. The Department of Treasury does not seem willing to have IRS Advisory Groups. b. Christie will check with Pete Nakata to see if they can combine this effort. She didn’t seem willing to do something different than the ACA Policy Subcommittee meetings that we have with CCIIO. Christie preferred to site in on the CCIIO meetings and use that venue if she needs to engage on Tribal issues. She will get back to us.
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
Page 11 and 12: Ref. # Task/Issue Person(s) 9. Stra
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 and 22: To do List: -Myra will have draft b
Page 23: Internal Revenue Service Meeting No
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
Page 65 and 66: v.7, 2012‐09‐23a In issuing thi
Page 67 and 68: (1) to ensure the highest possible
Page 69 and 70: v.7, 2012‐09‐23a Delays in acc
Page 71 and 72: v.7, 2012‐09‐23a 1997. The prov
Page 73 and 74: 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. # 69. 77. 88. Short Titl
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RRIAR Ref. # 92. 35. 36. 74. Short
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RRIAR Ref. # 94. 95. 96. 97. 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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