CMS Division of Tribal Affairs Important information for our tribal partners



All Tribes Call Seeking Input on Proposed Distribution of Additional Graduate Medical Education (GME) Residency Positions for IHS and Tribal Hospitals

Date: Tuesday, September 28, 2021

2:00-3:30 PM Eastern Time

Please register at:

A conference line will be included in the email confirmation after registering. The Centers for Medicare & Medicaid Services (CMS) Division of Tribal Affairs, in collaboration with the CMS Division of Acute Care in the Hospital & Ambulatory Policy Group, will host an All Tribes Call to provide an overview of the FY 2022 Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2022 Rates (FY 2022 IPPS/LTCH PPS) proposed rule as it relates to the distribution of additional Graduate Medical Education (GME) residency positions under the provisions of section 126 of the Consolidated Appropriations Act (CAA).


Medicare makes two types of Graduate Medical Education (GME) payments to teaching hospitals. Direct GME payments compensate teaching hospitals for Medicare’s share of the costs directly related to educating residents.  Teaching hospitals paid under the hospital Inpatient Prospective Payment System also receive an additional Indirect Medical Education (IME) payment for each Medicare discharge to reflect the higher patient care costs of teaching hospitals relative to non-teaching hospitals. The Balanced Budget Act of 1997 placed a limit or “caps” on the number of allopathic and osteopathic full-time equivalent (FTE) residents that can be included as part of a hospital’s Direct GME and IME payments.

Section 126 of the Consolidated Appropriations Act, 2021

The Consolidated Appropriations Act (CAA), 2021, included a key provision affecting Medicare payments for GME. Section 126 of division CC of the CAA makes available 1,000 additional partially Medicare-funded FTE resident cap slots, phased in at a rate of no more than 200 slots per year beginning in FY 2023.

Please join this All Tribes Call to participate in a discussion about the proposed distribution of these additional residency positions. We are seeking input on any unique circumstances for Indian health care providers with respect to this provision, and other input on how teaching hospitals could collaborate with Indian health care providers.

As a reference, please review the FY 2022 IPPS/LTCH PPS proposed rule that includes more information about Medicare GME payments beginning on page 25083 of the Federal Register notice at:





“Getting Ready for the

Medicare Open Enrollment Period”

September 30, 2021

1:00 - 4:00 pm Eastern Time


Join us as we share Medicare Program updates and resources to help you assist people with Medicare make informed decisions about their 2022 health coverage.

Space is limited. To register for this webinar, go to:

After registration, you'll get an email with a calendar appointment. The event will be recorded for independent viewing later. You don’t need to register to access the recording.



Enhanced Federal Medical Assistance Percentage (FMAP)-State Health Official letter

On August 30th, CMS issued guidance that provides essential information to states as they navigate the options available to advance COVID-19 vaccination and testing, and the Medicaid program's broader aim of providing much-needed health coverage for millions of eligible individuals. For more information, see the press release here:

This guidance explains that under the ARP, states can receive a temporary increase in the Federal Medical Assistance Percentage (FMAP) if they newly extend Medicaid coverage to certain low-income adults. Additionally, the ARP temporarily makes 100% federal matching funds available for states' Medicaid and CHIP expenditures for COVID-19 vaccine administration. Also, state expenditures for Medicaid services received through Urban Indian Organizations and certain Native Hawaiian health care entities will receive a temporary match at 100% FMAP. To view the FMAP State Health Official letter, please visit: - PDF

Navigator Funding Awards

On August 27th, CMS Announced $80 million in grant awards to 60 Navigator organizations. The awardees will provide outreach to predominantly underserved communities, including people who identify as racial and ethnic minorities, rural communities, including American Indians and Alaska Natives, and many others.

The Great Plains Tribal Chairmen’s Health Board received a grant to help support American Indian and Alaska Native enrollment. See the press release and list of other recipients here:




Help spread the word to promote COVID-19 vaccination so we can reach community immunity.

We Can Do This. We’re working to promote COVID-19 vaccine confidence, encourage prevention, and support our partners’ efforts to reach their communities.

Through strong partnerships with tribes and urban Indian organizations across Indian Country, the Indian Health Service has administered more than 1 million COVID-19 vaccines in Native communities, but there is still more work to do to reach community immunity.

You can help by:


Flu Resources (Print Ads, Fillable Flyer, Bookmark)

Email Signature Blocks


Page Last Modified:
09/21/2021 04:04 PM