NPAIHB Legislative & Policy  Update
Tuesday, January 28, 2020

IMPORTANT DATES
January 27 - 30, 2020
Affiliated Tribe of Northwest Indians (ATNI)

January 29, 2020
11:30pm - 1:00pm PST: IHS FY 2022 Area Report Webinar #1
Webinar:  https://ihs.cosocloud.com/rm2o6bauqok6/ Passcode: ihs123
Dial-In:  18008320736;  4242095

January 30, 2020
11:30pm - 1:00pm PST: IHS FY 2022 Area Report Webinar #2
Passcode: ihs123  Dial-In:  +18008320736; Passc ode: 4242095

February 6, 2020
12:30pm - 1:30pm PST: IHS All Tribes and Urban Indian Organization Leaders
Webinar:  https://ihs.cosocloud.com/r4k6jib09mj/;  Passcode:  ihs123
Dial in:  800-857-5577; Passcode: 6703929

February 6-7, 2020
HHS Secretary's Tribal Advisory Committee Meeting
Washington, DC

February 11-12, 2020
IHS DSTAC Quarterly Meeting
Washington, DC

House Interior Appropriations Subcommittee on American Indian and Alaska Native Public Witness Hearings
Washington, DC

February 13-14, 2020
FY 2022 National Tribal Budget Formulation Work Session
Washington, DC

February 25-26, 2020
NIHB Quarterly Meeting
Washington, DC
ACTION ALERTS
CMS issues proposed rule on Medicaid fiscal responsibility (Comments Due 2/1/20)
Issued 11/12/19
Proposes to create new reporting requirements for states to provide CMS with certain information on supplemental payments to Medicaid providers, including supplemental payments approved under either Medicaid state plan or demonstration authority, and applicable upper payment limits (UPL). The proposed rule focuses on the following areas: Medicaid fee-for-service (FFS) provider payments; disproportionate share hospital (DSH) payments; Medicaid program financing; supplemental payments, and health care-related taxes and provider-related donations.
 POLICY UPDATES
Smoking cessation: a report of the Surgeon General
Issued 1/23/20
Reports that  more than two-thirds of U.S. adult cigarette smokers report interest in quitting cigarette smoking; and the majority of adult cigarette smokers in the United States have tried to quit during the past year. The prevalence of smoking is concentrated in populations that may face barriers to quitting, including persons with behavioral conditions; persons of low socio-economic status; persons who are lesbian, gay, bisexual, or transgender, AI/ANs; recent immigrants; residents of the South and Midwest; and persons with a disability.
Surgeon General Report and Executive Summary

I HS DTLL- Decision to reprogram FY 2019 for ISDEAA Section 105(l) lease cost agreements
Issued 1/22/20
Announces IHS decision to reprogram approximately $72 million within the IHS's FY 2019 Services appropriation account to pay for the 105( l ) lease cost agreements. The $72 million reprogramming includes $25 million from across multiple budget lines that follows the reprogramming allocation from FY 2018, and $47 million from funds identified for staffing of newly constructed health care facilities, which was available due to construction delays. These construction delays meant the full amount of funds projected for staffing two newly constructed health care facilities was not required in FY 2019. 

CMS releases decision memo for acupuncture for chronic low back pain (CAG-00452N)
Issued 1/21/20
Finalizes  a CMS decision to cover acupuncture  for Medicare patients with chronic low back pain.  CMS recognizes the importance of having treatment options which allow for an integrated approach that is tailored to the needs and preferences of Medicare patients. Medicare will cover up to 12 sessions in 90 days with an additional 8 sessions for those patients with chronic low back pain who demonstrate improvement.

GAO Report - Veterans health care: services for substance use disorders (SUD) and efforts to address access issues in rural areas
Issued 12/2/19
Concludes that the VA treated 518,570 veterans diagnosed with a SUD in FY 2018, a 9.5% increase since FY 2016. Of these, 152,482 veterans received specialty SUD services in FY 2018, which remained relatively unchanged since FY 2014. Expenditures for VA's specialty SUD services increase from about $552 million in FY 2014 to more than $600 million in FY 2018.

GAO Report - Tribal programs: resource constraints and management weaknesses can limit federal program delivery to tribes
Issued 11/19/19
Highlights that the federal government inadequately supports Native Americans' physical, social, and economic well-being. Includes inefficient delivery of federal services as a factor that limits effective delivery of some federal programs and activities serving tribes. GAO found: high staff vacancies and insufficient staff capacity; inadequate funding; and effects of budget uncertainty.

All Other Pending Indian Health Policies
LEGISLATIVE UPDATES
H.R.1865 - Further Consolidated Appropriations Act, 2020
Became law 12/20/19
Funds IHS at $6.04 billion, a 4% increase above FY 2019 enacted level. IHS funding included $125 million for Section 105(l) leases; $5 million for CHAP expansion; $10 million for opioid grants; $65.3 million for Indian health professions; and $8 million for EHR modernization. 

S.3126 - Native Behavioral Health Access Improvement Act of 2019
Introduced 12/19/19
Amends the Public Health Service Act to authorize a special behavioral health program for Indians and establishes a technical assistance center
H.R. 5323 - Tribal Elder Care Improvement Act of 2019
Introduced 12/5/19
Amends the Older Americans Act of 1965 to expand supportive services and enhance training capacity for Native American aging programs.
H.R. 4957 - Native American Child Protection Act
Introduced 12/5/19
Amends the Indian Child Protection and Family Violence Prevention Act and in awarding grants encourages the use of culturally appropriate treatment services and programs that respond to the unique cultural values, customs, and traditions of applicant Indian tribes.

H.Res 735 - Recognizing the maternal health crisis among indigenous women in the United States
Introduced 12/2/19
Recognizes the maternal health crisis among indigenous women in the U.S., which includes American Indian, Alaska Native, and Native Hawaiian women, recognizing the importance of reducing mortality and morbidity among indigenous women, and calling for urgent Federal funding changes to ensure comprehensive, high-quality, and culturally competent maternal health and family planning services are available.

Sen. Udall highlights 2019 legislative accomplishments for Indian Country
Issued 1/17/20
Released a summary of 2019 legislative accomplishment from the Senate Committee on Indian Affairs, including 12 Indian Affairs Committee bills passing the Senate and 6 becoming law.

Other Pending Indian Health Bills  Indian Health Legislation 1-8-20
WHAT WE'RE READING 
1/23 Trump administration finalizing Medicaid block grant plan targeting Obamacare

1/21 Feds allow use of opioid funds to stem meth, cocaine surge

1/15 ONC's federal IT roadmap continues app, API push

1/15 Health insurers urge Supreme Court to take ObamaCare case, uphold health law

1/13 Hoyer: House priorities for 2020 include health care, infrastructure, climate, redistricting

12/31 Rx for ailing Indian Health Service: Changes in spending, recruitment
For more information
  Laura Platero, Executive Director
Sarah Sullivan, Health Policy Analyst
(503) 228-4185
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