NPAIHB Legislative & Policy Update
Tuesday November 03, 2020

COVID-19 Vaccination Distribution Deadline Extended 1 Week (DUE 11/6)
If your Tribe has decided to obtain the COVID-19 vaccination through the Indian Health Service, please contact CAPT Roney Won at

If your Tribe has decided to go through your State:  

HHS Provider Relief Fund Medicaid targeted funds and Medicare Phase 3 funds (APPLICATION DUE 11/6)
Announced 10/5/2020
Provides an opportunity for additional funding from the U.S. Department of Health and Human Services (HHS) Provider Relief Fund. Applications are currently open for Phase 3 General Distribution funding for Medicaid, Medicaid managed care, CHIP, dental providers, and certain Medicare providers. This extended relief to further expand the eligibility, seems to be designed in response to concerns of tribes. 
Providers that have already received funding from Phases 1 or 2, and previously ineligible providers, such as those who began practicing in 2020 are invited to apply.
All providers will receive funding of up to 2% of the reported total revenue from patient care. 

Contact information if you have questions about the Provider Relief Funds

DTLL Nov 02, 2020 Request for consultation re updates to the IHS contracting policy and procedures, implementing the Buy Indian Act of 1910 (COMMENT DUE 11/20)

Consultation dates are Nov 09, 2020 and Nov 16 2020. 3:00 - 4:30pm (EST)
  • CALL 888-391-3141, CODE: 8680097
  • Comments to (Subject Line: Buy Indian Act Consultation).


DTLL Oct 29, 2020 COVID-19 vaccinations for non-beneficiaries

DTLL Oct 23, 2020 FY 2021 short-term continuing appropriations
  • If a Tribal Health Programs (THP) performance period starts w/in Oct 01 - Dec 11, 2020 the THP will receive up to the full FY 2020 base Secretarial amount.
  • If THP funding is based on a formula (workload or need criteria), payments will be made after final FY 2021 appropriation
  • If the final FY 2021 appropriation differs from FY 2020 funding levels, adjustments will be made
  • Additional information within the DTLL.
DTLL Oct 14, 22020 FY 2020 Small Ambulatory Program (DUE 2/1)
DTLL Sep 21, 2020 CHAP Expansion consultation comments (DUE 11/23)


Federal Office of Rural Health Policy, Maternal and Child Health Bureau Strategic Plan Comments (DUE 11/18)


Center for Medicare and Medicaid Innovation (CMMI) released a FAQ on the Community Health Access and Rural Transformation (CHART) Model. 
CHART is a demonstration project that CMS is promoting in rural communities only. This will be for Medicare and Medicaid patients, commercial insurance participation is optional. Two payment options, capitated care or prospective payment. 
  • CHART is a demonstration project that will push primary care providers into relationship with their local hospitals as its design does not support fee-for-service payment systems.
  • Capitated care is a single payment for care, regardless of cost (grant based, initially)
  • Prospective payment is an advance payment that will establish or expand rural Accountable Care Organizations


Aug 28, 2020 Report Recent OIG Report contains findings that two tribal health programs operating under ISDEAA were not conducting required FBI fingerprint background checks for all employees. This is in the OIG Workplan below, and Tribal clinics should review their current background check procedures. 


Current OIG Workplan as it relates to IHS and Tribal Health:

  • Review of Indian Health Service Use of Critical Care Response Teams to Support Health Care Facilities During the COVID-19 Pandemic
  • Audits of IHS coverage of COVID-19 testing
  • Audits of SAMHSA Opioid Response Grants (State and Tribal)
  • Evaluation of the implementation of IHS Patient Protection Policies in Healthcare Facilities
  • Review of adverse events in IHS hospitals in 2017
  • Review background check processes at Tribally operated facilities
  • Analysis of state FMAP calculations for FY 2016 - 2018
  • Review of the quality of maternal healthcare at IHS hospitals
  • Review of opioid prescribing patterns, prevention and detection of opioid misuse, and opioid-related policy enforcement in IHS
  • Review tribally operated FQHC funded by IHS to ensure federal standards are being met



Senate and House have still not agreed on the next COVID-19 package. We anticipate there will be a package after the election. We will have more developments to share on the next COVID-19 package soon. 


The House passed 10 of the 12 FY 2021 appropriations bills over the summer. The Senate Appropriations Committee has not moved a single forward.  We are currently under a continuing resolution until December 11, 2020, which includes the Indian Health Service and the Special Diabetes Program for Indians. On or before this date, several scenarios possible:
  • Omni-bus FY 2021 package, combining all appropriations bills, plus COVID-19 assistance
  • Another FY 2021 continuing resolution, with COVID-19 assistance
  • Or a FY 2021 continuing resolution
We will continue to monitor activity on FY 2021 appropriations and keep you apprised of any developments.

For more information
 Laura Platero, Executive Director
Veronica Smith, Health Policy Consultant