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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 1: CMS will work with the TTAG and its Sub Committees, Tribal Epidemiology Centers, and the DHHS Health Research Advisory Committee for AI/AN (HRAC) to update the plan to identify additional data development and analysis work. Task 2: Carry out additional data development and analysis activities that are of high impact or of a time sensitive nature. TOTAL S 75,000 75,000 75,000 75,000 75,000 75,000 575,000 525,000 525,000 525,000 525,000 525,000 TOTALS 5,540,000 7,275,000 7,385,000 4,460,000 4,460,000 4,460,000 39
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. Appendix B: Legal Basis for Special CMS Provisions for American Indians and Alaska Natives I. Introduction Carol Barbero, Esq. 5 Elliott Milhollin, Esq. Hobbs, Straus, Dean and Walker, LLP November 2012 There is a special relationship between the United States and Indian Tribes that creates a trust responsibility toward Indian people regarding health care. The existence of this truly unique obligation supplies the legal justification and moral foundation for health policy making specific to American Indians and Alaska Natives (AI/ANs) – with the objectives of enhancing their access to health care and overcoming the chronic health status disparities of this segment of the American population. It is beyond question that the obligation to carry out the trust responsibility to Indians applies to all agencies of the federal government – including the Centers for Medicare & Medicaid Services (CMS) – as evidenced by Presidential Executive Orders and Special Memoranda. 6 Furthermore, with regard to health care for AI/ANs, federal law assigns comprehensive duties to the Secretary of the Department of Health and Human Services (HHS) in order to achieve the goals and objectives established by Congress for Indian health. The trust responsibility, and laws enacted pursuant thereto, provides ample authority for the Secretary – whether acting through the Indian Health Service (IHS), CMS, or other agency of HHS – to take pro-active efforts to achieve the Indian health objectives Congress has articulated. 5 The initial version of this Appendix D appeared in the first Strategic Plan submitted to CMS in 2005 by the CMS Tribal Technical Advisory Group. In that submission, the author acknowledged the Northwest Portland Area Indian Health Board (NPAIHB) and its member tribes for their generous support of the author’s earlier work which provided foundation for that paper. That earlier paper, titled "The Federal Trust Responsibility: Justification for Indian-Specific Health Policy," was presented at the National Roundtable on the Indian Health System and Medicaid Reform sponsored by the NPAIHB at the Urban Institute on August 31, 2005. This Appendix D has been updated to reflect significant Indian-specific health policy legislative and administrative actions that have occurred since it was originally drafted. The authors would like to thank the United South and Eastern Tribes, Inc. for its generous support in updating this Appendix D. 6 See, e.g., Exec. Order No. 13175, 65 Fed. Reg. 67249 (Nov. 6, 2000) reprinted in 2000 U.S.C.C.A.N. at B77; White House Memorandum for Heads of Executive Departments and Agencies, Nov. 5, 2009; Dep't of Health and Human Services Tribal Consultation Policy (Dec. 14, 2010); Centers for Medicare and Medicaid Services Tribal Consultation Policy (Nov. 17, 2011); Cramer v. United States, 261 U.S. 219 (1923). 40
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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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Background Analysis of Tribal Consu
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Analysis of Tribal Consultation Pol
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