CMS Division of Tribal Affairs
Important Information for our Tribal partners
Dear Tribal Leader letter on Medicaid Managed Care Final Rule
On April 25, 2016, CMS published a final rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP), which incorporates the Indian protections in section 5006 of the American Recovery and Reinvestment Act (ARRA). CMS engaged with Tribes throughout the rulemaking process to ensure that the final rule is consistent with the ARRA protections for American Indians and Alaska Natives.
CMS will be hosting an All Tribes' Call to provide an overview of final rules and address any questions you may have. At that time, we will walk through the tribal specific provisions in more detail. The All Tribes' Call will be held:
Monday, May 23, 2016
12:30 – 2:00 pm
Conference call #: 1-866-901-6455
Participant Code: 361-333-070
Please register at: https://attendee.gotowebinar.com/register/3741894629588526337. After registering, you will receive a confirmation email containing information about joining the call.
The final rule is available at https://www.federalregister.gov/articles/2016/05/06/2016-09581/medicaid-and-childrens-health-insurance-program-chip-programs-medicaid-managed-care-chip-delivered and can be viewed at https://www.federalregister.gov starting April 25, 2016.
For more information about the proposed rule, please visit https://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/managed-care/managed-care-site.html.
Please contact Kitty Marx, Director, Division of Tribal Affairs, Intergovernmental and External Affairs Group, Centers for Medicaid and CHIP Services, with any questions or concerns by phone, (410) 786-8619, or via e-mail, email@example.com.
TRIBAL DAYS OF ACTION
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:
• 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
• 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
• 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, AZ
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 http://go.cms.gov/CMS-Tribal-Products.
To learn more visit the IHS live blog:
(National LGBT2S Day of Action) https://www.ihs.gov/newsroom/index.cfm/ihs-blog/december2015/national-lgbt2s-tribal-day-of-action/
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)
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 www.NativeArt4Health.org
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 http://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/Downloads/MedicaidEstateRecoveryBrochure.pdf
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: http://go.cms.gov/AIAN-OutreachEducationResources
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:
- IRS Form 8965 Instructions- http://www.irs.gov/pub/irs-pdf/i8965.pdf
- IRS Form 8965- http://www.irs.gov/pub/irs-pdf/f8965.pdf
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: https://www.healthcare.gov/american-indians-alaska-natives/exemptions/
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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