mmpc - National Indian Health Board
mmpc - National Indian Health Board mmpc - National Indian Health Board
Letter: Dr. Robert Petzel, Under Secretary, VA & Dr. Yvette Roubideaux, Director, IHS RE: Negotiation of Participating Tribal Health Program Agreements with Local VA Facilities: Need for Inclusion of Agreed Upon Payment Methodologies Page 4 of 4 October 5, 2012 forward to continuing to work with you. If you have any questions, you can reach me at (860) 862-6192; or via email: lmalerba@moheganmail.com. Sincerely, Chief Lynn Malerba, Mohegan Tribe Chairwoman, TSGAC cc: P. Benjamin Smith, Director, Office of Tribal Self-Governance, IHS Stephanie E. Birdwell, M.S.W. Director, Office of Tribal Government Relations, VA Stacy Bohlen, Executive Director, National Indian Health Board TSGAC Members TSGAC Technical Workgroup Members
October 17, 2012 Dr. Robert Petzel, M.D. Dr. Yvette Roubideaux, M.D., M.P.H., Director Under Secretary Indian Health Service Department of Veterans Affairs Room 448, The Reyes Building 810 Vermont Avenue 801 Thompson Avenue Washington, D.C. 20420 Rockville, MD 20852 RE: National All Inclusive Reimbursement Rate Agreement Dear. Dr. Petzel, and Dr. Roubideaux: On behalf of the National Indian Health Board (NIHB), I respectfully submit the following recommendation contained in this letter regarding the Department of Veterans Affairs’ (VA) implementation of the reimbursement requirements under Section 405(c) of the Indian Health Care Improvement Act (IHCIA). 1 Tribes see the implementation of reimbursement rates as a top priority that remains to be fulfilled. NIHB recommends that all Tribal facilities and Indian Health Service (IHS) operating programs receive reimbursement from the VA for services provided to our Native American Veterans based upon the Medicaid All-Inclusive rate rather than the Medicare Fee Schedule cost reimbursement rate that is applicable to a Federally Qualified Health Center (FQHC). This important issue will play a critical role in allowing AI/AN access to quality health care, especially as Tribes enter into negotiations with the VA for terms and conditions for reimbursement rates for ambulatory services. In the April 5, 2012, “Final Consultation Draft” of the “Draft Agreement between the VA and IHS for Reimbursement for Direct Health Care Services” (Draft National Reimbursement Agreement), additional detail on the agreed upon payment methodologies was included. Included was Section VII Reimbursement for Direct Care Services, which further articulated VA’s policy that reimbursement would be based at the Medicaid All-Inclusive Rate for outpatient hospital services. Initially, Tribes were pleased with the decision by VA to rely on the Medicaid All- Inclusive Rate approved by the IHS Director and published in the Federal Register as the basis of reimbursement. 1 Section 405(c) requires the VA to reimburse the IHS, an Indian Tribe or Tribal Organization “where services are provided through the Service, an Indian Tribe or a Tribal Organization to beneficiaries eligible for services from the [VA], notwithstanding any other provisions of law.”
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Letter: Dr. Robert Petzel, Under Secretary, VA & Dr. Yvette Roubideaux, Director, IHS<br />
RE: Negotiation of Participating Tribal <strong>Health</strong> Program Agreements with Local<br />
VA Facilities: Need for Inclusion of Agreed Upon Payment Methodologies<br />
Page 4 of 4 October 5, 2012<br />
forward to continuing to work with you. If you have any questions, you can reach me at (860)<br />
862-6192; or via email: lmalerba@moheganmail.com.<br />
Sincerely,<br />
Chief Lynn Malerba, Mohegan Tribe<br />
Chairwoman, TSGAC<br />
cc: P. Benjamin Smith, Director, Office of Tribal Self-Governance, IHS<br />
Stephanie E. Birdwell, M.S.W. Director, Office of Tribal Government Relations, VA<br />
Stacy Bohlen, Executive Director, <strong>National</strong> <strong>Indian</strong> <strong>Health</strong> <strong>Board</strong><br />
TSGAC Members<br />
TSGAC Technical Workgroup Members
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