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CMS Division of Tribal Affairs 

Important Information for our Tribal partners



American Indian and Alaska Native Heritage Month

Honor Our Elders. Our past. Our Present. Our Future


The ACA Native American Week of Action blog is live.

In an effort to promote Affordable Care Act education, outreach, and enrollment, the Indian Health Service (IHS) has collaborated with the National Indian Health Outreach and Education (NIHOE) National Partners the National Indian Health Board, National Congress of American Indians and National Council of Urban Indian Health – to host national and urban Tribal Days of Action in certain cities and for specific populations across Indian Country. The Days of Actions are:

• November 3, 2015: ACA National Tribal Day of Action
• Week of November 16, 2015: ACA Native American Week of Action
• November 18, 2015: AIAN Benefits Fair, ACA Enrollment, PIMC, Phoenix, A
• December 3, 2015: ACA National Tribal Day of Action
• December 8, 2015: Urban Indian Outreach & Enrollment Event, Phoenix, AZ
• December 10, 2015: Tribal LGBT Two Spirit Day of Action
• December 14, 2015; Urban Indian Outreach & Enrollment Event, Dallas, TX

• January 7, 2016: Urban Indian Outreach & Enrollment Event, Rapid City, SD
• January 11, 2016: Urban Indian Outreach & Enrollment Event, Anchorage, AK
• January 20, 2016: Urban Indian Outreach & Enrollment Event, Tulsa, OK
• January 21, 2016: Urban Indian Outreach & Enrollment Event, Oklahoma City, OK

IHS Areas, Area Indian Health Boards, Tribes, and national and regional organizations are encouraged to participate. Recently at a national Tribal health conference, HHS Secretary Burwell challenged every Tribe to host an enrollment event. This open enrollment period is a great time to get involved in this important effort! You can volunteer to host an enrollment event, set up an information table at a community gathering or simply talk with your family and friends about the importance of being covered. Share the CMS AI/AN ACA materials with your community—you can download and print the materials, or order directly from CMS

To learn more visit:


Call for Applications: $32 Million Available to Help Get Eligible Children Enrolled in Medicaid and Children's Health Insurance Program (CHIP)

The Centers for Medicare & Medicaid Services is announcing a funding opportunity to support efforts to reach out to families with children eligible for Medicaid and CHIP, and help get them covered and stay covered for as long as they qualify.Awards will be in the form of cooperative agreements, ranging in size from $250,000 to $1 million over a two-year period.

About Connecting Kids to Coverage Outreach and Enrollment Funding

Connecting Kids to Coverage outreach and enrollment funding supports activities aimed at identifying children who are eligible for Medicaid and CHIP and helping their families enroll and renew their coverage. Along with the National Connecting Kids to Coverage Campaign, these activities have helped boost enrollment of eligible children in Medicaid and CHIP. They also have helped to engage a wide range of partners in taking steps to make health coverage outreach and enrollment a part of their routine efforts to ensure the health and security of the nation’s children and their families.

Who Can Apply: State and local governments, Indian tribes, certain health care provider organizations, nonprofit organizations including community and faith-based groups, and schools and school districts are eligible to apply. For more information on how to apply visit:


CMS will host two conference calls for prospective applicants:

Thursday, November 19, 3:00 pm to 4:00 pm EST
Call-in: 1-877-267-1577 Passcode: 992 099 111

Monday, November 30, 3:00 pm to 4:00 pm EST
Call-in: 1-877-267-1577 Passcode: 998 168 839 Password: Meeting1
(this teleconference will be using the new WebEx system and requires the addition of a password)

Please send questions regarding this information to:

Learn more about past outreach and enrollment funding awards and the History of Connecting Kids to Coverage Funding


CMS recently clarified its policy regarding zero and limited cost sharing plans:

Members of federally recognized tribes with incomes between 100% and 300% FPL can continue to enroll in a zero cost sharing plan, which means they won’t pay any out-of-pocket costs like co-payments, coinsurance, or deductibles for services covered by their Marketplace health plan.   CMS has clarified its policy to enable members of federally recognized tribes with incomes below 100% and above 300% FPL (regardless of income) to enroll in a limited cost sharing plan, which means  they won’t pay any out-of-pocket costs for services received from an Indian health care provider or from another provider if they have a referral from their Indian health care provider. 

CMS has created a bookmark (product #11816-N) that explains this policy clarification that can be distributed as part of your outreach and education efforts.

It is especially important to make sure you order this bookmark (product # 11816-N) when ordering the following materials:
•         Tribal Fact Sheets (product #11643-N)
•         Coverage to Care (product #11813-N)
•         Tribal Glossary (product #11900-N)
•         Health Insurance Marketplace: What is Means for American Indians & Alaska Natives (product #11732-N)


Native Art

Tribal Outreach in Ten Urban Areas

"Little Cheyenne Girl" is spreading the word about how health care coverage can improve Native health.

The CMS Division of Tribal Affairs is conducting tribal outreach in 10 urban areas with significant American Indian and Alaska Native (AI/AN) populations, but where no Indian health care providers are located. The goal is to raise awareness about the Affordable Care Act through Native art so AI/ANs in these communities know health care coverage is available and that they should sign up. The artwork is temporarily displayed on buildings similar to a light show. The outreach campaign builds anticipation of the art installation one week prior to display by posting a countdown message leading up to the unveiling of the art. The painting has been projected in Philadelphia, PA, and Atlanta, GA, with 8 more cities to go in the next few months.   

The artist and artwork that is on display is J. Nicole Nahmi-A-Piah's "Little Cheyenne Girl" and can be viewed at



CMS Tribal Affairs All Tribes Calls & Webinars

NEW All Tribes Calls & Webinar Schedule Coming Soon



NEW CMS Medicaid Estate Recovery Rules and Protections for Indians Brochure

CMS Tribal Affairs is pleased to announce the release of the Medicaid Estate Recovery Rules and Protections for Indians Brochure. Section 5006 of the American Recovery and Reinvestment Act (ARRA) exempts certain Indian income, resources, and property from being subject to Medicaid Estate Recovery. This brochure explains the Medicaid Estate Recovery rules and the exemptions and protections for American Indians and Alaska Natives (AI/ANs). The Medicaid Estate Recovery Rules and Protections for Indians Brochure is now available for downloading at

This brochure supports our outreach and education efforts to encourage AI/AN enrollment in CMS programs and was developed with input from the CMS Tribal Technical Advisory Group (TTAG) and our federal partners at Indian Health Service (IHS) and Health & Human Services Intergovernmental and External Affairs (HHS IEA).

For more outreach and education resources for AI/ANs and Indian health providers please visit the CMS AI/AN website:

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

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