mmpc - National Indian Health Board

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Draft Report: Currently being circulated for Tribal leader and health director review and comment. Please provide comments by October 30, 2012 to Liz Heintzman at the National Indian Health Board at EHeintzman@nihb.org. Task 2: Adopt network adequacy standards to include I/T/U for managed care organizations funded through CMS programs. Task 3: Review programs, policies, payment mechanisms and provide training and technical assistance to assure that the I/T/U can be the medical home for AI/AN who use their services. Task 4: Assure that AI/AN who are enrolled in managed care organization through CMS programs can be referred to specialty care by I/T/U providers and that the laws and protections regarding deductibles and co-pays for AI/AN are followed. Objective 2c – CMS will assure that the I/T/U is paid for all services provided that are covered by CMS programs for all AI/AN who are enrolled in Medicaid, Medicaid Expansion, Basic Health Plans, Medicare, and Health Insurance Exchanges. Task 1: CMS enforces the law that assures that the I/T/U is paid for off-plan services by managed care organizations with CMS funding. Task 2: CMS will sponsor a conference to engage Tribal technical advisors and others on emerging payment approaches, analyze how those approaches may affect I/T/U, and share that information. Task 3: All CMS programs will review their payment policies to assure that the I/T/U can be paid for telehealth services delivered to AI/AN. Task 4: CMS will pay for Medicaid serves for AI/AN youth who are receiving treatment and/or enrolled in boarding schools in a different state from their parents (A/K/A Across State Borders). Task 5: CMS will create a workgroup across all agencies and with the TTAG to develop criteria for I/T/U providers as distinct provider types for enrollment in Medicare and Medicaid. 120,000 0 0 0 0 0 31
Draft Report: Currently being circulated for Tribal leader and health director review and comment. Please provide comments by October 30, 2012 to Liz Heintzman at the National Indian Health Board at EHeintzman@nihb.org. Objective 2d – The Office for Dual Eligibles will work with a subcommittee of the TTAG to assure that there is integration of the Indian health system in new approaches for coordinating services and payments for people who are eligible for Medicaid and Medicare, and in some cases also eligible for services from the VA. Task 1: Workgroup on policy and data to implement AI/AN provisions of ARRA and ACA on eligibility and enrollment, federal data hub, and computer systems used by providers to flag AI/AN cost sharing protections, and performance metrics. Objective 2e – CMS and the TTAG will work together to assure that AI/AN continue to receive needed services and the I/T/U continues to receive payment for those services In the context of States reforming their Medicaid programs, creating new types of waivers, choosing whether to implement Medicaid Expansion, and eliminating CHIP programs. Task 1: Information and technical assistance to Tribes and States to adopt principles and approaches used in Arizona Medicaid waiver to preserve services for AI/AN. Task 2: Notify Tribes about State Medicaid reforms and consult with them. Task 3: State Medicaid reform proposals approval contingent on continued services for AI/AN from I/T/U, and payment for those services. 120,000 0 0 0 0 0 Objective 2f – Offices within CMS that are responsible for enforcement and compliance will work with the TTAG to develop reasonable approaches for assuring that I/T/U adheres to laws and regulations. Task 1: Training on Indian health care delivery systems to CMS offices responsible for enforcement. Task 2: Expedite consideration of recommendations regarding Safe Harbors submitted by Tribes and Tribal Organizations. Task 3: Develop appropriate policies for compliance with tiered standards that consider the budgets, size, location and staffing of I/T/U facilities. 32
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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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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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