January 13, 2015 |  Issue 15-02





Tribal Leader Call with Vice President Biden on the Affordable Care Act

January 13, 2014


Affordable Care Act Mother's Tribal Day of Action 

January 13, 2015


IHS Tribal Self-Governance Advisory Committee 
January 27-28, 2015

Washington, DC


Affordable Care Act National Tribal Day of Action 

February 2, 2015


IHS FY 2017 National Budget Formulation Work Session

February 10-11, 2015

Washington, DC


Medicare, Medicaid Policy Committee Meeting

February 17, 2015

Washington, DC 


CMS Tribal Technical Advisory Group 

February 18-19, 2015

Washington, DC 


Direct Service Tribes Advisory Committee Meeting 

February 18-19, 2015

Nashville, TN


Secretary's Tribal Advisory Committee Meeting

March 17-18, 2015

Washington DC


NIHB Tribal Public Health Summit 

April 7-9, 2015

Palm Springs, CA


NIHB Annual Consumer Conference

September 21-24, 2015

Washington, DC

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In This Issue 

Capitol Hill Updates

Last week, the U.S. House of Representatives passed two measures that would affect employers under the Affordable Care Act (ACA).  The first bill, the "Hire more Heroes Act," would tweak the law so that veterans who are hired by businesses would not count toward the company's total number of employees under the ACA.  (Under the law, employers, including Tribal governments, with more than 50 employees must provide health insurance to their workers or face fines.)  This change would be premised mainly on the basis of Veterans already having health insurance coverage options through the Department of Defense or the Veterans' Administration.  This legislation passed with a wide majority and is expected to head to the Senate, but it is unclear if President Obama would sign the legislation into law.


The second piece of legislation that passed the House is H.R. 30, which passed the House last Thursday by a vote of 252-172.  It would adjust the ACA so that a "full-time" employee would be established at 40 hours per week, instead of 30 hours per week.  The law currently requires that employees who work more than 30 hours weekly to be considered full-time when employers are determining their size for coverage purposes - including the mandate requiring them to provide coverage.  Many small employers have argued that this threshold of 30 hours per week for full-time employees will discourage hiring and force them to cut hours.   Supporters of the law argue that the bill will do significant harm to workers across the country by limiting coverage options.  The President has indicated he would veto this legislation if it reaches his desk. 


You can read more about these two bills here

Administration Updates

Tribal Leader Call with Vice President Biden on the Affordable Care Act

You are invited to join a conference call on Tuesday, January 13th at 3:15 P.M. ET with Vice President Biden and other Administration Officials to discuss the benefits of the Affordable Care Act for Indian Country. Vice President Biden will also highlight the important work organizations are doing within Indian Country during this open enrollment period and the benefits of the Affordable Care Act for American Indians and Alaska Natives. We encourage you to circulate this invitation to all of your members or others who are engaged in enrollment efforts during this open enrollment period.  Please bring your questions as there will be Q&A at the end of the call.


Call Details



Last month, the Department of Health and Human Services released a proposed rule on Medicare Like Rates for non-hospital services.  This proposed rule would amend Indian Health Service (IHS) Purchased and Referred Care (PRC), (formerly known as the Contract Health Services) regulations to apply Medicare payment methodologies to all physician and other health care professional services and non-hospital-based services.  (IHS referrals currently use a Medicare Like Rate for hospital-based services.) 


Specifically, it proposes that the health programs operated by IHS, Tribes, Tribal organizations, or urban Indian organizations (collectively, I/T/U programs) will pay the lowest of the amount provided for under the applicable Medicare fee schedule, prospective payment system, or Medicare waiver; the amount negotiated by a repricing agent, if available; or the usual and customary billing rate.


The proposed rule states that enacting Medicare Like Rates for referred non-hospital services at IHS could save the agency millions per year for the purchased/referred care program.  IHS is seeking comments on the proposed rule and specifically the question: Should there be exceptions incorporated into the rule to permit an I/T/U to retain more flexibility over the payment rate? 


The rule follows a report released by the Government Accountability Office (GAO) in 2013 that recommended this important change.  You can view that report here. In June 2014, the Native CARE Act (H.R. 4843) was introduced by Congresswoman Betty McCollum (D-MN) and Congressman Tom Cole (R-OK) which would enact Medicare Like Rates for non-hospital services at IHS.  That legislation was not enacted by the end of the 113th Congress, so new legislation would need to be introduced for this change to occur legislatively.


Comments on the proposed rule are due by Tuesday, January 20, 2015.  NIHB will be creating a template comment for Tribes to send out.  Please contact Devin Delrow at ddelrow@nihb.org if you would like a copy of the template. 


You can read the entire proposed rule here


IHS All Tribes' Call - January 22 

Please join Dr. Yvette Roubideaux, the Acting Director for the Indian Health Service (IHS), for an IHS update by teleconference on Thursday, January 22 at 3:30 PM - 4:30 PM Eastern.














Note:  This call is off the record and not for press purposes.  Please dial in 5-10 minutes early to avoid any delays in joining the call. 

2015 White House Conference on Aging Webinar - January 29

Please click here for the invitation for the 2015 White House Conference on Aging's webinar on January 29th at 2:00 pm EST


The Nutrition = Solutions to Healthy Aging and Long-Term Services and Supports webinar will touch on two of the four priorities areas of this year's White House on Aging Conference and will outline the significance of nutrition interventions for older adults. 


You can register for the webinar by visiting: https://eatright.webex.com/eatright/j.php?RGID=rdaafb5b4c987c4ae1819f34083e84010 


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