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CMS Division of Tribal Affairs 

Important Information for our Tribal partners

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SAVE THE DATE
Centers for Medicare & Medicaid Services
Tribal Consultation
Date: Monday September 21, 2015
Time: 1:30 - 4:30 PM Eastern Time (ET)

Location: Jefferson Room at the Washington Hilton
1919 Connecticut Ave., NW
Washington, DC 20009

The Centers for Medicare & Medicaid Services (CMS) will be holding a Tribal Consultation session prior to the beginning of the National Indian Health Board’s Annual Consumer Conference in the Jefferson Room at the Washington Hilton on Connecticut Ave., NW, Washington, DC.

CMS will use this opportunity to consult with Tribal leaders on a wide- range of CMS policy matters impacting Indian Country, including those related to the Health Insurance Marketplace and the Medicaid program. Consistent with the CMS Tribal Consultation Policy, CMS leadership and subject matter experts will be available to provide programs updates and receive comments and answer questions from Tribal Leaders and/or their designees.

AGENDA:
1:30 pm: Welcoming Remarks and Opening Prayer
• Health Insurance Marketplace Issues
• Medicaid Issues
• Other CMS related Issues

4:30 pm: Closing Remarks

We look forward to seeing you at the Tribal Consultation. Please contact Kitty Marx, Director of the Division of Tribal Affairs, Intergovernmental and External Affairs Group, Center for Medicaid and CHIP Services, CMS, with any comments or questions. She can be reached by email at Kitty.Marx@cms.hhs.gov or phone at 410.786.8619.

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SAVE THE DATE

CMS Tribal Affairs All Tribes Calls & Webinars

All Tribes Call

 

 

All Tribes Call


Date:

Wednesday,
August 19, 2015

 

Time:

3-4:00 ET 

 

Conference number:

1-866-431-5314 

 

Passcode: 

979015

The Centers for Medicare & Medicaid Services (CMS) is strongly committed to honoring the special relationship between Tribal governments and the Federal government. Through our partnership, we share the goal of implementing CMS programs in a way that is both effective for Tribes and provides American Indians and Alaska Natives (AI/ANs) all of the protections to which they are entitled.

 

Under the Affordable Care Act, there are special cost sharing protections for Tribal members depending on their income. Those Tribal members who have household income below 100% of the Federal poverty level (FPL) and those who have household income above 300% of the FPL and who are enrolled in a qualified health plan (QHP) can select a limited cost sharing plan variation. Tribal members in these plans do not pay any cost sharing (co-pays, deductibles or co-insurance) when receiving care through an Indian health care provider or from other providers when receiving essential health benefits (EHBs) that have been referred from an Indian health care provider. However, to avoid paying cost sharing when receiving EHBs from providers other than Indian health care providers, tribal members need to present a referral from an Indian health care provider.

 

The referral has been the topic of much discussion between CMS, Tribes, and Tribal leaders. Therefore, in response to concerns expressed by Tribes, Tribal Leaders, and issuers, we are seeking Tribal consultation regarding the information that is needed in the referrals so all AI/ANs will not be charged cost sharing when they seek EHBs from their enrolled QHP through referrals under contract health services (now called Purchased/Referred Care).

 

CMS seeks consultation on the scope of information that should be included in the referral. We wish to address concerns around the possibility of "blanket" or "comprehensive" referrals while being cognizant of the need to provide sufficient flexibility to Indian health care providers. For instance, should a referral include the length of time the referral should be effective, how or if the referral should define an episode of care, or any other parameters that are not listed that should be included or not included on a referral?

 

In the spirit of true consultation, CMS is seeking Tribal input on the parameters above without having prepared definitive guidance prior to consultation. Following this Tribal consultation, CMS may establish a model referral, potentially subject to certain modifications by Indian Health care providers to suit their needs.

 

CMS will be hosting an All Tribes' Call to hear comments on this subject, and to respond to comments and questions. There will be an additional opportunity to provide comments at the National Indian Health Board Annual Consumer Conference Consultation Session on Monday, September 21, 2015 between1:30 and 2:30 p.m. at the Washington Hilton, Washington, DC. Please submit any written comments to Jeff Wu, Deputy Director of Policy, Center for Consumer Information and Insurance Oversight, by 5 p.m. (EDT) September 30, 2015 at jeff.wu@cms.hhs.gov.

 

Please contact Kitty Marx, Director, Division of Tribal Affairs, Intergovernmental External Affairs Group, Centers for Medicaid and CHIP Services, with any questions or concerns by phone, (410) 786-8619, or via e-mail, kitty.marx@cms.hhs.gov.

 

We look forward to obtaining your input on referrals. Please feel free to reach out to me if you have any questions.

 

Kevin J. Counihan

Chief Executive Officer, Health Insurance Marketplace

Director, Center for Consumer Information & Insurance Oversight

 

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WEBINARS

Scenarios: American Indians/Alaska Natives and Special Tribal Provisions in the Marketplace webinar

Thursday, August 27, 2015

Time: 2:00 - 3:30 PM ET
Call-in Number: (855) 897-8197
Webinar link: http://www.cmsitutrainings.net

The Centers for Medicare & Medicaid Services (CMS) is pleased to host a webinar entitled Scenarios: American Indians/Alaska Natives and Special Tribal Provisions in the Marketplace.

American Indians and Alaska Natives are granted special provisions under the Affordable Care Act.  Tribal members and Alaska Native shareholders can enroll in Qualified Health Plans (QHP) in the Marketplace that can help reduce out of pocket costs.  If you, or your family, have income between 100 to 300 percent of the Federal Poverty Level (FPL) and are eligible for the premium tax credits, you can enroll in a zero cost sharing plans and have NO out of pocket costs for services received from an Indian health provider or a QHP.  If your income is below 100 percent FPL or above 300 percent FPL, you can enroll in a limited cost sharing plan (regardless of income).  Under a limited cost sharing plan, you will have NO out of pocket expenses for services received from an Indian health provider or through a referral to a QHP.  For those individuals, with incomes below 100 percent FPL (less than $12,000 for an individual), and who reside in states that have not expanded Medicaid, limited cost sharing plans are an important option to receive low cost health care coverage.

This webinar presentation will review some of the special provisions and using scenario-based examples, we will review cases to clarify enrollment eligibility. This webinar was held previously in May 2015 and has been updated to reflect the changes in policy for American Indians and Alaska Natives eligible to enroll in limited cost sharing plans.

At the end of the presentation there will be time for questions.

Presenter:
Cynthia Gillaspie
Consortium for Medicaid and Children’s Health Operations
Centers for Medicare & Medicaid Services

NEW BROCHURE

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:

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

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: http://go.cms.gov/AIAN-OutreachEducationResources

Click on our NEW 

COVERAGE TO CARE TRIBAL BROCHURE

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