mmpc - National Indian Health Board
mmpc - National Indian Health Board mmpc - National Indian Health Board
Appendix A. I/T/U Programs in Each State 8/7/12 DRAFT COMPANION TO ADDENDUM – PAGE 7
1. Purpose of Addendum; Supersession. DRAFT Addendum for Indian Health Care Providers The purpose of this Addendum for Indian Health Care Providers is to apply special terms and conditions necessitated by Federal law and regulations to the agreement by and between ______________________ (herein "Qualified Health Plan") and ___________________________ (herein "Indian Health Care Provider"). To the extent that any provision of the Qualified Health Plan's network provider agreement or any other addendum thereto is inconsistent with any provision of this Addendum for Indian Health Care Providers, the provisions of this Addendum for Indian Health Care Providers shall supersede all such other provisions. 2. Definitions. (NOTE: NEED TO CHANGE THE ORDER TO BE ALPHABETICAL) For purposes of the Qualified Health Plan's agreement, any other addendum thereto, and this Addendum for Indian Health Care Providers, the following terms and definitions shall apply: (a) "Qualified Health Plan" has the meaning given in Sec. 1301 of the Patient Protection and Affordable Care Act (ACA), 42 U.S.C. §18021. (b) Indian Health Care Provider" means a health program administered by the Indian Health Service (IHS), a tribal health program, an Indian tribe or tribal organization to which funding is provided pursuant to section 23 of the Act of June 25, 1910 (25 U.S.C. § 47(commonly known as the “Buy Indian Act”)) or an urban Indian organization that receives funding from the IHS pursuant to Title V of the Indian Health Care Improvement Act, Pub. L. 94-437, as amended (IHCIA). (c) "Indian Health Service" means the agency of that name within the U.S. Department of Health and Human Services established by IHCIA Sec. 601, 25 USC §1661. (d) "Indian tribe" has the meaning given in IHCIA Sec. 4(14), 25 USC § 1603(14). (e) The term "tribal organization" has the meaning given in IHCIA Sec. 4(26), 25 USC §1603(26). (f) "Urban Indian organization" has the meaning given in IHCIA Sec. 4(29), 25 USC §1603(29). (g) The term "Indian," has the meaning given in 45 C.F.R. 155.300(a). (h) The term "contract health services" has the meaning given in IHCIA Sec. 4(5), 25 U.S.C. §1603(5). (i) The term “Tribal health program” has the meaning given in IHCIA Sec. 4(25), 25 U.S.C. § 1603(25). 3. Description of Indian Health Care Provider. The Provider identified in Section 1 of this Addendum for Indian Health Care Providers is (check appropriate box): /_/ The Indian Health Service (IHS). /_/ An Indian tribe that operates a health program under a contract or compact to carry out programs of the IHS pursuant to the Indian Self-Determination and Education Assistance Act (ISDEAA), 25 USC §450 et seq. /_/ A tribal organization that operates a health program under a contract or compact to carry out programs of the IHS pursuant to the ISDEAA, 25 USC §450 et seq. /_/ A tribe or tribal organization that operates a health program with funding provided in whole or part pursuant to section 23 of the Act of June 25, 1910 (25 U.S.C. § 47 (commonly known as the Buy 8/7/12 DRAFT Addendum – Page 1 Comment [A1]: While the QHP issuer might also be an MCO, the QHP is a commercial health insurance product that is not governed by medicaid requirements. The Medicaid definition is not applicable in this context.
- 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 and 24: Internal Revenue Service Meeting No
- 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: Under federal law, There are privac
- 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
- Page 75 and 76: Prepared by James Crouch MPH Chair,
- Page 77 and 78: Summary T he Indian Health Service
- Page 79 and 80: Summary providers that were either
- Page 81 and 82: Introduction Reliable determination
Appendix A. I/T/U Programs in Each State<br />
8/7/12 DRAFT COMPANION TO ADDENDUM – PAGE 7
Change language