mmpc - National Indian Health Board

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a b c d e IHS & Medicaid Align IHS Eligibility for AI/ANs Chart of Indian-specific Health Care Provisions with Different Citations in Federal Law for Defining "Indian" Medicaid: Protections and Benefits for AI/ANs Monthly Enrollment Periods for AI/AN's Sec. 4 IHCIA Affordable Care Act-related Provisions Health Insurance Exchange-related Provisions Cost-Sharing Protections for AI/AN's Sec. 4(d) ISDEAA No cost-sharing for AI/ANs under 300% FPL (at all providers) No cost-sharing for AI/ANs served by I/T/U; payment of full amount due to I/T/U (without cost-sharing reductions) CMS stated in regulations these definitions "operationally mean the same thing." Exemption from IRC tax penalties for AI/ANs not having "minimum essential coverage" IRC 45A(c)(6) IRS stated informally in meetings these definitions are the same. NPAIHB / TSGAC v. 1.1
California Rural Indian Health Board September 21, 2012 Valerie B. Jarrett, Senior Advisor The White House 1600 Pennsylvania Avenue N.W. Washington, DC 20500 Dear Ms. Jarrett and Ms. Gillette: Jodi Gillette, Senior Policy Advisor Native American Affairs 1600 Pennsylvania Avenue N.W. Washington, DC 20500 Northwest Portland Area Indian Health Board The California Rural Indian Health Board (CRIHB) and the Northwest Portland Area Indian Health Board (NPAIHB) are Tribal organizations organized under the Indian Self-Determination and Education Assistance Act. 1 Our organizations represent health care issues of 63 federally-recognized Tribes in California, Idaho, Oregon, and Washington. We are writing to you about a very important Affordable Care Act matter. In just three months, States will be applying to the federal government for certification of their Health Insurance Exchanges under the Affordable Care Act. One of the current activities for both State Exchanges and the Federally-Facilitated Exchange is to create a single streamlined application for Medicaid, Child Health Insurance Programs, and the individual Exchanges. The Administration’s goal of a short and simple application that uses electronic data bases is at odds with regulatory guidance regarding identifying American Indians and Alaska Natives (AI/AN) for the purposes of cost sharing waivers, special enrollment periods, and other protections in Medicaid, CHIP and the Exchanges. It is imperative that the White House provide guidance on this issue so that AI/AN who were intended to benefit from ACA are not left out. Here is a short list of potential problems that could occur if the definition of Indian used by Exchanges is different from the one used by Medicaid and CHIP: An AI/AN child who is not allowed to enroll as tribal members until her 18 th birthday will not be considered as AI/AN by Exchanges, although she would be considered AI/AN by Medicaid and CHIP. An Alaska Native adult will not be considered AI/AN by Exchanges until his parent dies and he inherits stock in an Alaska Native corporation. And his children will not be considered AI/AN by Exchanges until he dies and his stock in an Alaska Native corporation is passed along to his children, even though they qualify as AI/AN under Medicaid and CHIP. 1 As defined in the Indian Self-Determination and Education Assistance Act, P.L. 93-638, 25 U.S.C., Section 450(b) a Tribal organization is a legally established governing body of any Indian tribe(s) that is controlled, sanctioned, or chartered by such Indian Tribe(s) and designated to act on their behalf.
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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
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Page 15 and 16: IV. OUTREACH AND EDUCATION MMPC: SU
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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 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
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Page 49 and 50: Letter: Dr. Robert Petzel, Under Se
Page 51 and 52: October 17, 2012 Dr. Robert Petzel,
Page 53: A BILL To correct inconsistencies i
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Page 61 and 62: v.7, 2012‐09‐23a ACA, (2) the s
Page 63 and 64: Indian tribe means any Indian tribe
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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
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Page 97 and 98: Methods Map 1. 12 IHS Areas: Contra
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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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RRIAR Ref. # 20. 23. 26. 28.a. Shor
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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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D. FFE Data Analysis of Tribal Cons
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John O'Brien Director, Healthcare &
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Draft Report: Currently being circu
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