If you would like a DVD copy of the video please provide e-mail your name and mailing address to tribalhealthcareweb@gmail.com.  The videos and shipping are free of charge while supplies last.

Tribes are encouraged to check the list to review the list to ensure their facilities are listed, because this is the list provided to issuers in the Federal Marketplace looking to become Qualified Health Plans.

With a few goals in mind including, providing greater access to health care for American Indians and Alaskan Natives and maximizing opportunities for tribal communities, we have developed the information below for tribal leaders to consider before 2014.

Increase enrollment in federal health insurance programs: 
The ACA allows states to expand the eligibility for Medicaid services up to 133% of the poverty line for individuals.  This provision not only allows for greater access for American Indians and Alaska Natives, but should encourage IHS, tribal, and urban Indian facilities to streamline enrollment, business, and billing processes to ensure that the health facilities maximize their third party billing reimbursements.

Prepare an insurance purchasing plan:
Tribal governments and enterprises are responsible for purchasing insurance as employers.  Tribal entities with more than fifty fulltime employees must provide insurance that meets the minimum essential coverage required by the law. These entities can either, self-insure, join the Federal Employees Health Benefits (FEHB) program or purchase insurance through an insurance agent.

 Adopt streamlined business practices:
There are number of new and expanded revenue streams under the ACA and IHCIA, including additional Medicaid enrollees, third party billing, and the dual eligible veterans.  Tribal leaders should work with health directors to prepare business processes that will ensure streamlined billing practices and enrollment in federal health insurance programs.

Explore opportunities for citizen insurance:
Under the new law tribal governments can pay insurance premiums for members.  Although some tribes do this now, there may be greater opportunity as health insurance marketplaces launch.  Tribal leaders considering this option should conduct a cost benefit analysis, especially in communities where health facilities are tribally operated.  More citizens with coverage means more revenue flowing to health clinics in your area.

Develop and adopt a plan to assist consumers:
The new law is very confusing.  There are exemptions and requirements for individual consumers and even small businesses.  Tribal leaders should consider hiring or appointing a person or team to conduct outreach, education, and when possible, enrollment.  Open enrollment begins October 1, 2013 and it is important that every individual know his/her rights and duties as a citizen.  There are a number of resources and trainings available in your area.

Download this information in a printable flyer here.

A Family of Three Using the Online Single Streamlined Application

An Individual Using the Online Single Streamlined Application

Check out the new tables here.

On February 4, 2013, the Tribal Health Care Reform Initiative presented at the United South & Eastern Tribes (USET) Impact Week in Arlington, VA to provide an update on this year’s campaign in Indian Country to deliver community outreach and education for tribal consumers about the Affordable Care Act (ACA).  National partners, the National Indian Health Board (NIHB) and National Congress of American Indians (NCAI), will travel to three Indian Health Service (IHS) areas and provide local ACA trainings on all stages of implementation.  Health care reform materials and tools will be shared on such topics as: cost-benefit analysis tool use, IRS and tax implications, Medicaid Expansion and Children Health Insurance Program (CHIP) and more.

Are you interested in learning more about this outreach and education initiative?  Do you have an idea of what training materials or tools your community needs now?  Contact us and share your suggestions – We want to hear from you!

The Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Treasury (Treasury) are committed to engaging in meaningful consultation with Tribes on matters that have tribal implications.  To that end, we are writing to request your advice and input on these separate Notices of Proposed Rulemaking (NPRMs) published by CMS and Treasury.  We encourage you to submit written comments during the comment period as outlined in the Federal Register notices.  Written comments that are submitted during the comment period will become part of the official rulemaking record.

In addition, a Tribal consultation session will be held in Washington, D.C. on February 21 at the conclusion of the CMS Tribal Technical Advisory Group (TTAG) meeting.  A call-in line will be available for Tribal leaders who are not able to attend in person.  The details for the meeting are as follows:

Date: Thursday, February 21, 2013

Time: 12:30 p.m. to 2:00 p.m., ET

HHS Hubert Humphrey Building, Room 505A

Call-In number: 877-267-1577

Passcode: 2579

Webinar Link: https://webinar.cms.hhs.gov/r11342460/

(Note: Presentation slides will only be available during the call. To access the slides, please login to the website as a Guest.)

Please contact Kitty Marx, Director of CMS Tribal Affairs Group, with any questions or concerns regarding this tribal consultation session by phone, (410) 786-8619, or via-email, kitty.marx@cms.hhs.gov.

The CMS rule can be found here.

The IRS rule can be found here.

To find a fact sheet about these rules, click here.

Health and Human Services (HHS) Secretary Kathleen Sebelius  announced yesterday that more states are on track to implement the health care law and establish health insurance marketplaces, or Exchanges, in their states.

California, Hawaii, Idaho, Nevada, New Mexico, Vermont and Utah are conditionally approved today to operate a State-based Exchange, and Arkansas is conditionally approved to operate a State Partnership Exchange.

HHS is also providing more guidance to states today on marketplaces that will be operated in partnership with the federal government.

“States across the country are working to implement the health care law and build a marketplace that works for their residents,” said Secretary Sebelius. “In ten months, consumers in all fifty states will have access to a new marketplace where they will be able to easily purchase affordable, high quality health insurance plans, and today’s guidance will provide the information states need to guide their continued work.”

Thursday’s conditional approvals follow those issued previously granted to Colorado, Connecticut, the District of Columbia, Kentucky, Massachusetts, Maryland, Minnesota, New York, Oregon, Rhode Island and Washington to operate State-based Exchanges and to Delaware to operate a State Partnership Exchange.

To date, 20 states including DC have been conditionally approved to partially or fully run their marketplaces – with the remaining states having until February 15, 2013 to apply for a State Partnership Exchange.

Because of the Affordable Care Act, consumers and small businesses will have access to a new marketplace starting in 2014 where they can access quality, affordable private health insurance.  These are similar to those choices that will be offered to members of Congress.

Consumers in every state will be able to buy insurance from qualified health plans directly through these marketplaces and may be eligible for tax credits to help pay for their health insurance.

To learn more about Exchange conditional approvals, visit:  http://www.cciio.cms.gov/resources/factsheets/state-marketplaces.html

For more information on Exchanges, visit: http://www.healthcare.gov/exchanges

After five years of implementation, health reform will continue to improve patient care and access by incentivizing quality care through payment system reforms.