mmpc - National Indian Health Board

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Analysis of Tribal Consultation Policies For Health Insurance Exchanges b. Develop process to reimburse other QHP providers for waived cost sharing for AI/AN. C. Eligibility and Enrollment and Tribal Sponsorship 1. Eligibility a. Identification of individuals who are eligible for special protections and provisions as AI/AN in the eligibility process and at the provider level to assure that deductibles and co-pays are waived. b. Utilization of existing databases or development of new databases to expedite eligibility determinations. c. Deciding how additional documentation will be requested, submitted, reviewed, and stored and how eligibility determinations will be made when individuals are not included in approved data systems. d. Develop the system to assure waiver of penalties for AI/AN without Insurance and to communicate who is covered by this provision in the law. 2. Enrollment process a. Enrollment process must accommodate special provision for AI/ANs in Exchanges (monthly enrollment, waiver of cost sharing, exclusion of certain sources of income). b. As single point of enrollment, Exchanges must be able to identify AI/AN for benefits and protections in Medicaid, Medicaid Expansion, Child Health Insurance Programs, and Basic Health Plans, if there are any in the State. 3. Tribal Sponsorship 4. Website a. Allow tribes to decide which individuals they want to sponsor and provide opportunity for aggregate payment of premiums. b. Decide the terms and conditions of Tribal Sponsorship. c. Allow I/T/U clinic addresses to be used for QHP mailing to enrolled individuals. 16
D. FFE Data Analysis of Tribal Consultation Policies For Health Insurance Exchanges a. Design the website to include information specific to AI/ANs and the I/T/U. b. Test the website in Indian Country and in urban Indian clinics to make sure it is culturally appropriate, easy to navigate to Indian health information, and the information is presented in a way that is accurate and easy accessible to consumers, as well as those assisting with enrollment. 5. Enrollment Assistance a. Carve outs for navigator contracts for the I/T/Us, including an Indian Addendum. b. Provide other enrollment assistance funding, such as Medicaid Administrative Match (MAM). 6. Call Centers a. Decide whether it is most appropriate to have an Indian desk to handle questions and resolve problems regarding AI/AN and I/T/Us, or whether everyone who works at a call center should receive training about Tribes in the State, the Indian health care delivery system and special provisions in the law, regulations and systems for AI/AN. b. Review scripts that are used in call centers to assure their accuracy for AI/ANs and I/T/Us. c. Provide appropriate back up for call center employees who are unable to answer questions about AI/ANs and I/T/U and standards for timely response. d. Keep FAQs and review answers for accuracy. 1. Enrollment data 2. Federal data hub a.IHS registration data b. Other AI/AN data sets 3. Identifying AI/AN in FFE data and reports a. For benefits and protections for AI/AN b. For reimbursing cost sharing 17
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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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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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Draft Report: Currently being circu
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