mmpc - National Indian Health Board
mmpc - National Indian Health Board mmpc - National Indian Health Board
are eligible for the waiver (i.e., they would not have to go through the Exchange application process to determine their eligibility as AI/AN). i. NPRM on AI/AN cost sharing waiver and how providers/QHPs will be paid by Federal government for the amount of cost sharing they are not collecting from AI/AN will be issued in August. 3. New Issues that came up at FFE Tribal Consultation in DC, July 26 a. Partnerships - Administration is encouraging Partnership arrangements with states and it’s not clear whether Tribes need to be consulting with States or Feds, or both. More work for Tribes and very confusing. b. State Exchange Tribal Consultation Policies - States are not being required to have Tribal Consultation Policy for Exchanges until they submit the package to be certified (April 2013) – which means Tribes will not necessarily be consulted in the decisions about Exchanges. - Example: Essential Health Benefits c. Indian questions on application - Amy Erhardt is working on the applications and she said that waiver of cost sharing will only happen if applicant declares that they want to be considered for an “Insurance Accessibility Program”. i. The law says all AI are eligible for cost sharing waivers, even if they don’t want one of the Insurance Accessibility Programs (Medicaid, CHIP, Advanced Tax Credits). ii. This is important because we don’t want MAGI calculated for people who haven’t filed tax returns. iii. This approached was not challenged in the DC meeting. iv. New acronym: APTC/CSR (= Advanced Payment of Tax Credits and Cost Sharing Reductions) c. Navigators and In Person Assistance - (Holly Whalen is CCIIO point person on this) I. Looks like there will be competition for Navigator grants at federal level – no set aside for Tribes. ii. A second source of funding that can come from federal establish grants, but is not identified in the law is “in-person assistance.” 3
d. CCIIO Philosophy - CCIIO is taking the approach that “where we start is not where we finish”, in other words, they want to stand up the FFE as quickly as possible and go back and correct things that aren’t working. i. Tribes know from experience with CMS that it is better to get things right the first time rather than going back and trying to fix things that are in writing later. ii. Too many people in CMS/HHS are referring to Tribes as “Stakeholders” and not acknowledging the special legal/political status and governmentto-government relationship 4. Additional information provided during teleconference a. State Exchanges are expecting to decide on their QHP requirements for network adequacy in September or October and they are looking to CCIIO for guidance, including decisions about the FFE. b. State Exchange Tribal Consultation i. NM is moving forward on planning an exchange using a consultant, and the Exchange will be housed in the NM Health Alliance. Tribal input has been limited. ii. AZ is planning a State Exchange. c. Basic Health Programs i. Only 3 states are expected to have BHP: WA, VT, RI ii. CA has a BHP now, but they may drop it. 5. Next steps recommended in teleconference a. Alaska Consultation, August 7 i. Val should invite Pete and other federal officials to lunch at ANMC and include a tour of the facility and SCF outpatient services. ii. Comments in Alaska should focus on network adequacy, including both ANMC and village clinics. iii. Participants should tell Pete that they realize that not many federal officials could attend, but they are relying on him to communicate issues to others, particularly those whose decisions are outside his control. 4
- 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 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: edits on documents are due back fro
- 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
- Page 83 and 84: Analysis Groups IHS AIAN Methods Th
- Page 85 and 86: Methods group for the statistical m
- Page 87 and 88: Enrollees with no Payments Methods
- Page 89 and 90: Methods Table 5. Mean Medicaid and
d. CCIIO Philosophy - CCIIO is taking the approach that “where we start is not<br />
where we finish”, in other words, they want to stand up the FFE as quickly as<br />
possible and go back and correct things that aren’t working.<br />
i. Tribes know from experience with CMS that it is better to get things right<br />
the first time rather than going back and trying to fix things that are in<br />
writing later.<br />
ii. Too many people in CMS/HHS are referring to Tribes as “Stakeholders”<br />
and not acknowledging the special legal/political status and governmentto-government<br />
relationship<br />
4. Additional information provided during teleconference<br />
a. State Exchanges are expecting to decide on their QHP requirements for<br />
network adequacy in September or October and they are looking to CCIIO for<br />
guidance, including decisions about the FFE.<br />
b. State Exchange Tribal Consultation<br />
i. NM is moving forward on planning an exchange using a consultant, and<br />
the Exchange will be housed in the NM <strong>Health</strong> Alliance. Tribal input has<br />
been limited.<br />
ii. AZ is planning a State Exchange.<br />
c. Basic <strong>Health</strong> Programs<br />
i. Only 3 states are expected to have BHP: WA, VT, RI<br />
ii. CA has a BHP now, but they may drop it.<br />
5. Next steps recommended in teleconference<br />
a. Alaska Consultation, August 7<br />
i. Val should invite Pete and other federal officials to lunch at ANMC and<br />
include a tour of the facility and SCF outpatient services.<br />
ii. Comments in Alaska should focus on network adequacy, including both<br />
ANMC and village clinics.<br />
iii. Participants should tell Pete that they realize that not many federal<br />
officials could attend, but they are relying on him to communicate issues to<br />
others, particularly those whose decisions are outside his control.<br />
4
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