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CMS Division of Tribal Affairs 

Important Information for our Tribal partners 



CMS Tribal Affairs Webinars

Tribal Nursing Homes:
Best Practices and Challenges, Part I 

Date:   Wednesday, May 27   Time:  2:00pm ET

Conference number:  1-888-757-2790     Passcode: 177695

• 3 nursing home facilities in Alaska, Nebraska & Arizona 
• Exciting initiatives and challenges within tribal nursing homes
• Potential for a tribal nursing home collaborative


CMS Funding: Apply for Navigator Grants

A new funding opportunity is available from the Centers for Medicare & Medicaid Services (CMS) to support Navigators in Federally Facilitated Marketplaces (FFM), including State Partnership Marketplaces. Navigators provide objective information about health coverage to consumers to help them make the best possible choice.
The grant is open to eligible individuals, as well as private and public entities, applying to serve as Navigators in states with an FFM. Grantees will be selected for a 3-year project period. A total of up to $67 million is available for the first year of the award.

The deadline to apply is June 15, 2015.

Learn More and Apply for the Grant (Funding Opportunity Number: CA-NAV-15-001)
Read More About Navigators

Questions on the Indian Exemption for American Indians and Alaska Natives

Beginning in 2014, all individuals must have health care coverage, have a health care coverage exemption, or pay a fee (tax penalty) if you file a federal income tax return.  IRS Form 8965 is the form used to claim or report a health coverage exemption.   

Form IRS 8965 can be located at:


If the only health coverage you have is through the Indian Health Services (IHS) and you do not have other insurance, such as through your employer, or through a federal health program such as the Marketplace, Medicare, Medicaid or VA, you will need to file for an Indian Exemption to avoid paying any penalties.  An Indian Exemption is available to members of federally recognized Tribes, Alaska Native Claims Settlement Act Corporation shareholders, and individuals eligible to receive services from an Indian health care provider.

For more information about how to claim an Indian exemption, please go to: 

CMS has developed a more detailed list of Frequently Asked Questions (FAQs) that can be downloaded here: AI/AN Exemption Frequently Asked Questions 


NEW CMS Tribal Fact Sheets

Special Protections for AI ANs 

AI AN Trust Income and MAGI

CMS Tribal Affairs is pleased to announce the release of two new fact sheets. The first fact sheet explains the Protections for American Indians and Alaska Natives (AI ANs) in the Marketplace, Medicaid and CHIP. The second fact sheet describes Modified Adjusted Gross Income (MAGI) and what that means for AI AN Trust Income.  These fact sheets support our outreach and education efforts to encourage AI AN enrollment in CMS programs. The fact sheets were developed with input from the CMS Tribal Technical Advisory Group and our federal partners at IHS and HHS IEA.

Please feel free to distribute further. The fact sheets will be available for downloading on the CMS AI AN website at:


Click on our NEW 


A Roadmap
to Better
Care and a

CMS awards $3.9 million to improve access to quality health care services for American Indian and Alaska Native Children

The Centers for Medicare & Medicaid Services (CMS) awarded $3.9 million for outreach and enrollment efforts aimed at American Indian and Alaska Native children eligible for Medicaid and the Children’s Health Insurance Program (CHIP). The grant awards will fund activities to engage schools and tribal agencies in Medicaid and CHIP outreach and enrollment activities.

CMS awarded grant funds to health programs operated by the Indian Health Services, tribes, tribal organizations and urban Indian organizations located in seven states: Alaska, Arizona, California, Mississippi, Montana, New Mexico and Oklahoma.

“We are very pleased to support efforts that help eligible American Indian and Alaska Native children gain access to affordable health coverage,” said Director of the Center for Medicaid and CHIP Services Cindy Mann. “More people with health coverage also benefits local health care facilities, allowing them to offer more services and improve health care for the whole community.”

Several grantees will receive funds to conduct activities focused on helping eligible teens enroll in coverage. Grantees will work to ensure that eligible children retain coverage for as long as they qualify and will help guide families through the application process for Medicaid and CHIP.

Since 2009, the United States has made substantial progress toward reducing the number of children who remain uninsured, and toward providing health coverage to all children who are eligible for Medicaid and CHIP. Despite this significant progress, serious health coverage disparities persist, particularly for American Indian and Alaska Native children. Research shows that eligible American Indian and Alaska Native children are less likely to participate in Medicaid and CHIP and more likely to be uninsured compared with all children.

These awards, authorized under the Children’s Health Insurance Program Reauthorization Act of 2009 and extended by the Affordable Care Act, will help ensure American Indian and Alaska Native children have opportunities to get quality health care services which may not be available through their local Indian health care provider.

In states with expanded Medicaid, more parents and other adults in the family could be eligible for health coverage than in the past and can apply at any time.

For more information and a complete summary of the current American Indian and Alaska Native Connecting Kids to Coverage Outreach and Enrollment grants, visit

NEW Resource: Information and Tips for Assisters: Working with American Indians/Alaska Natives (AI/AN)

We posted a new resource to our Technical Assistance Resources pageInformation and Tips for Assisters: Working with American Indians/Alaska Natives provides background information about existing and new options for AI/ANs related to affordable health coverage. The Marketplace provides certain protections specifically for AI/ANs. The tip sheet highlights these protections, how assisters can help AI/ANs submit their documentation to support Marketplace applications, and other resources.

A new question and answer (Q&A) regarding the Special Enrollment Period for American Indian and Alaska Native families has been posted on

The Q&A explains that for those families that apply through the Federal-facilitated Marketplace, if one family member on the application is eligible for the Special Enrollment Period (SEP), all family members who apply on the same Marketplace application would be eligible for the SEP if otherwise eligible to enroll in a QHP.  The Q&A explains that for those who enroll in a state based marketplace, you will need to contact your state regarding whether this policy applies. 

To read the Q&A, please visit or