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CMS Division of Tribal Affairs 

Important Information for our Tribal partners

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SAVE THE DATE

WEBINAR

"A Tribal Sponsorship Analysis"

Thursday, February 11, 2016

1:00 -2:30 pm (Eastern)

 

This Webinar will review findings from an analysis of Tribal sponsorship conducted for one mid-sized Tribe as part of the Joint Initiative of Direct Service and Self-Governance Tribes. The process and analysis is being conducted with a select number of Tribes to assist in determining if Sponsorship of Tribal members in purchasing a QHP in the Marketplace is beneficial for the participating Tribe and Tribal members.  The analyses is being shared to help inform the decision-making process for other Tribes.

 

Presenters: 

Doneg McDonough leads the health care consulting firm Health System Analytics and advises clients on implementation of the Affordable Care Act. Doneg serves as a technical advisor to the Tribal Self-Governance Advisory Committee on work involving the Centers for Medicare and Medicaid Services (CMS) and its Tribal Technical Advisory Group (TTAG) as well as work involving the Indian Health Service. In addition, Doneg is under contract with the National Indian Health Board (NIHB), serving as a technical advisor to the Medicare, Medicaid and Health Reform Policy Committee (MMPC) on regulatory issues.

 

Laura Bird (Navajo) is an attorney and independent consultant who has interfaced with tribal, state and federal agencies to address Native issues. Ms. Bird currently serves as a technical advisor to the Tribal Self-Governance Advisory Committee on work involving the Centers for Medicare and Medicaid Services (CMS) and its Tribal Technical Advisory Group (TTAG). Ms. Bird served as Legislative Associate focusing on health policy issues for the National Congress of American Indians and also served as a trainer on the Affordable Care Act (ACA) through the Native Exchange, a project of the Tribal Education and Outreach Consortium (TEOC).

 

Registration URL: https://attendee.gotowebinar.com/register/4362944974254003969

 

United States (Toll-free): 1 877 309 2074 
United States: +1 (415) 930-5229 
Audio PIN:
Shown after joining the webinar

Attendee (muted) Access Code: 821-969-838

 

 

 

 

Revised CMS Tribal Consultation Policy

 

Download the tribal leader policyOn November 5, 2009, President Obama issued an executive order requiring all agencies to engage in regular and meaningful consultation and collaboration with Tribal officials. On November 17, 2011, the Centers for Medicare and Medicaid Services (CMS) finalized an agency specific Tribal Consultation Policy to establish a clear, concise and mutually acceptable process through which consultation can take place between CMS and Tribes.

 

As part of a periodic review of the Policy and through Tribal consultation, CMS issued a revised CMS Tribal Consultation Policy effective December 10, 2015. This revised policy includes a new section eight that incorporates the State/Tribal consultation requirements for State Medicaid agencies to obtain the advice and input from Indian health care providers and Tribes prior to changes in the Medicaid programs having Tribal implications.

 

For more information on the Tribal Consultation Policy and the process through which it was developed, download the Dear Tribal Leader letter(pdf).

 

 

 

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:

November
• 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
Z
December
• 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
• 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 http://go.cms.gov/CMS-Tribal-Products.

To learn more visit the IHS live blog:

https://www.ihs.gov/newsroom/index.cfm/ihs-blog/december2015/national-lgbt2s-tribal-day-of-action/

 https://www.ihs.gov/newsroom/index.cfm/ihs-blog/november2015/affordable-care-act-open-enrollment-period-november-1-2015-january-31-2016/

https://www.ihs.gov/newsroom/index.cfm/ihs-blog/december2015/phoenix-indian-medical-center-hosts-affordable-care-act-benefits-fair/

 

BOOKMARK

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
www.NativeArt4Health.org

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 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

Click on our NEW 

COVERAGE TO CARE TRIBAL BROCHURE

A Roadmap
to Better
Care and a
Healthier
You!