June 2, 2015 |  Issue 15-16




Secretary's Tribal Advisory Committee Meeting

June 2-3, 2015

Washington, DC


Medicare, Medicaid Policy Committee Retreat (MMPC)

June 16-17, 2016

San Diego, CA


Great Plains Tribal Chairman's Health Board 5th Annual Health Summit

July 8-9, 2015

Spearfish, SD


Tribal Self Governance Advisory Committee Quarterly Meeting

July 21-23, 2015

Washington, DC


Direct Service Tribes National Meeting

August 26-27, 2015

Flagstaff, AZ


NIHB Annual Consumer Conference

September 21-24, 2015

Washington, DC

Follow NIHB on Twitter
Like National Indian Health Board on Facebook!


In This Issue 


NIHB Updates

On June 16 and June 17, the Medicare, Medicaid and Health Reform Policy Committee (MMPC) will conduct its annual retreat in San Diego, California The MMPC is a standing committee of the National Indian Health Board (NIHB) and provides technical support to the Tribal Technical Advisory Group to the Centers for Medicare and Medicaid Services (TTAG).  MMPC continues work on the Affordable Care Act (ACA) and Indian Health Care Improvement Act (IHCIA) health policy issues, regulation review and the development of draft positions with the greatest opportunities for the Indian Health System. Membership in MMPC is open to individuals authorized to represent:  a Tribe; Tribal Organization; Urban Indian Program; or Indian Health Service (IHS).


The Retreat is held annually and its purpose is to set the path of MMPC going forward and strategize priorities for the rest of the year.  This year, topics include: Estate Recovery under the Long Term Care and Services, Medicaid Waivers Review, Arizona's State Bill 1092 AHCCCS Waiver, the Office of Personnel Managements Plans, and more.


For further information or a copy of the draft agenda, please contact Richard Litsey, Director of Policy and Advocacy at rlitsey@nihb.orgor Devin Delrow, Program Manager for Medicare and Medicaid Policy, at ddelrow@nihb.org or  call 202-507-4070. 

Budget Update

Tribes Finalize FY 2017 Budget Recommendations and Present to HHS


Tribal leaders present FY 2017 budget priorities to officials at the Department of Health and Human Services.

Last month, Tribal Budget Formulation Workgroup Co-Chairs presented the FY 2017 Tribal Budget Recommendations to the Department of Health and Human Services. Co-Chairs Andy Joseph (NIHB At-Large Board Member) and Gary Hayes, presented the Workgroup's FY 2017 Tribal Budget Request for the Indian Health Service (IHS) to top Budget Officials at the Department of Health and Human Services.  NIHB Great Plains Area Board Member Patrick Marcellais was also at the meeting.   



The top recommendations for FY 2017 for IHS are:

  • Fully fund IHS at $29.96 Billion Phased in over 12 Years
  • Increase FY 2016 President's IHS Budget by a minimum 22% ($6.2 billion) in FY 2017:
    • $157.4 million for full funding of current services
    • $325 million for binding fiscal obligations (includes placeholder estimates for CSC, Staffing for new facilities & new Tribes)
    • $591.7 million for program expansion increases 
  • Request a higher percentage budget increase in Hospitals & Clinics budget line to provide additional flexible "Services" budget line item funding which will be used by the IHS Areas to fund local budget priorities 
  • Provide an additional $300 million in the "Services" budget line to implement the provisions authorized in the Indian Health Care Improvement Act (IHCIA) 
  • Advocate that Tribes and Tribal programs be permanently exempted from sequestration

Other key priorities identified by the Tribes include Hospitals and Clinics; Purchased/Referred Care; Dental Services; Mental Health; Alcohol and Substance Abuse Services. 


You can view a summary document and the full FY 2017 Recommendations on NIHB's website.

Administration Updates

IHS Releases "Dear Tribal Leader Letters" on Contract Support Costs and Employee Union Settlements

The Indian Health Service (IHS) has released two "Dear Tribal Leader Letters" (DTLLs) providing updates to Tribes on two key issues.  The first letter, provides an update on Contract Support Costs (CSC). In the letter, IHS Acting Director Robert McSwain provides information on 1) status of resolving past year claims for unpaid CSC; 2) fiscal years (FY) 2014 and 2015 CSC payment and reconciliation activities; 3) implementation of an Annual CSC Calculation (ACC) Estimation Tool; 4) negotiation of direct CSC; 5) the FY 2016 President's Budget proposal to make CSC a mandatory appropriation beginning in FY 2017; and 6) IHS CSC Workgroup activities.  The agency notes that it has settled 947 past CSC claims in the amount of approximately $705.5 million.  They have also worked with the CSC workgroup to develop systems for better estimating CSC need each year in order to avoid any shortfalls.


In the second letter, Acting Director McSwain provides information on a settlement that IHS has reached with employee unions.  The settlement resolves claims by IHS employees for overtime compensation for work that they performed in or for federally-operated IHS hospitals, clinics, or facilities and for which they were not adequately paid.  The total amount of the settlement totals $80 million.  Of that $80 million, $20 million will come FY 2015 funding that was originally designated for staffing at the Kayenta Health Center in Arizona.  That facility will not open as early as planned, and IHS says that only $4 million (out of the original appropriation of $24 million) will be needed for that staffing package.  The remainder of the settlement ($60 million) will come from past year's appropriations and third party collections.  Tribes have already expressed concerns about this settlement to IHS due to its high price tag and reprogramming of IHS funds.


You can read both of the DTLLs on IHS' website here.


Recently, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule regarding Medicaid and Children's Health Insurance Program (CHIP) managed care regulations, the first update in more than a decade.  The proposed rule can be found in the Federal Register as of June 1, 2015.  Summaries of key provisions can be found on CMS' website


CMS also issued a Dear Tribal Leader Letter (DTLL) on May 28, 2015 informing Tribal leaders of the proposed rule.  The DTLL recognizes that Tribes and Tribal health programs have expressed interest in improving American Indians and Alaska Natives' access to services from Medicaid managed care entities while preserving Tribes' ability to continue to receive services from their Indian health care providers and services provided through a referral to a specialty provider.  CMS is also seeking comment on barriers to contracting with managed care plans.  


CMS will be hosting an All Tribes' Call to provide an overview of the proposed rules on Thursday, 3:00 - 4:00 p.m., EDT, June 25, 2015. 

  • Call in:  1-888-339-3507 /Passcode, 583 583.

The proposed rule is the first update in over 10 years.  NIHB will be submitting comments to the proposed rule prior to the July 27, 2015 deadline.  


SAVE THE DATE: Direct Service Tribes National Meeting August 26-27

The Indian Health Service's 12th Annual Direct Service Tribes (DST) National Meeting will be held on August 26-27, 2015 in Flagstaff, Arizona. 

The meeting will take place at the High Country Conference Center at Northern Arizona University. 

For additional conference information, including registration info please click here.

Click here to view 2015 DST Awards Information.

926 Pennsylvania Avenue, SE
Washington, DC 20003
Main Phone: 202-507-4070
Fax: 202-507-4071
Thank you for visiting the Washington Report!