NPAIHB Legislative & Policy Update
Tuesday December 15, 2020

ACTION ALERTS

National Indian Health Board

The NIHB is hosting a virtual 2021 White House Transition Tribal Nations Summit on Dec 16, 2020 from 10am - 3pm Pacific Time. Registration Link is active.

Special Diabetes Program for Indians

SDPI Grant Continuation Applications are due Dec 15, 2020. SDPI Programs were given two options for application submission due to the COVID-19 pandemic:
Indian Health Service

IHS issued a DTLL on Dec 10, 2020, to update the I/T/U system on next steps related to Information Technology (IT) modernization. RADM Weahkee's recommendation is a full replacement of the RPMS system. Written consultation comments are due Jan 24, 2021 to consultation@ihs.gov. IHS is hosting two Health IT Modernization listening sessions:
  • Dec 17, 2020 from 11am - 12:30pm (Pacific Time)  REGISTRATION LINK
    • Meeting ID: 996 3952 6346    Passcode: 461608
  • Jan 14, 2021 from 11am - 12:30apm (Pacific Time) REGISTRATION LINK
    • Meeting ID: 939 813 1199  Passcode: 026367
 POLICY UPDATES
Center for Medicare and Medicaid Services
On Dec 10, 2020 CMS announced proposed changes that will require state Medicaid and CHIP programs to improve the prior authorization process and improve Health Information Exchanges. The proposed rule would require payers in Medicaid and CHIP to build electronic interfaces (HL7) for data exchange and prior authorizations.  The proposed rule does not cover Medicare or Medicare Advantage plans at this time.  
 
Health Resources and Services Administration
 
HRSA Published its Final Rule on the 340b Drug Pricing Program, Administrative Dispute Resolution Regulation on Dec 10, 2020. This establishes an Alternative Dispute Resolution (ADR) process for the 340b Drug Pricing Program, the ADR process will resolve:
  • Claims by covered entities that they have been overcharged for covered outpatient drugs by manufacturers, and
  • Claims by manufacturers
Based on analysis from Hobbs, Straus, Dean, and Walker LLP, (memo circulated electronically by NPAIHB on Dec 14, 2020) the ADR provides a pathway to resolve recent challenges tribally operated facilities have had with manufacturers restricting access to the 340b program.
 
The FAQ for Provider Relief Funds was updated as of Dec 04, 2020.
Indian Health Service
 
The IHS and the U.S. Department of Veterans Affairs issued a joint DTLL on Dec 02, 2020 regarding an upcoming joint consultation on the DRAFT revised Memorandum of Understanding (MOU) between the two agencies.
Office of Minority Health
 
Department of Health and Human Services (HHS), Office of Minority Health (OMH) is seeking nominations of qualified candidates to be considered for appointment as a member of the Advisory Committee on Minority Health. The Committee provides advice to the Deputy Assistant Secretary for Minority Health on the development of goals and specific program activities for improving the health and the quality of healthcare minorities receive and eliminating racial and ethnic health disparities consistent with the Public Health Service Act. There are three vacancies representing American Indian/Alaska Native people on this Committee.
  • Committee and qualification information is found here.
  • Deadline for nominations is Mar 04, 2021. 
LEGISLATIVE UPDATES
Continuing Resolution (CR) 

A one-week CR was signed by the President on Dec 11, 2020. This CR includes funding for the Special Diabetes Program for Indians and Tribal-TANF program.
 
COVID-19 Relief

COVID-19 Relief has been split into two bills by the bi-partisan group negotiating the package. The two items that Democrats and Republicans disagree over, $160b in relief for tribal, state, and local governments and liability protections for businesses will move into a separate piece of legislation, and the remaining COVID-19 relief package ($748b) contains relief provisions that both sides of the aisle agree upon.Tribal specific provisions include:
  • $160b for tribal state, local governments (separate legislation)
  • Possible extension for the use of CARES Act Funding
  • $1b in Provider Relief Funds for tribes, tribal organizations, urban Indian organizations, and health service providers to tribes
  • $3.42b from the Center for Disease Control (CDC) in direct grants to tribal, state, local and territorial governments
  • $129m from the CDC for vaccination distribution and infrastructure for tribes, tribal organizations, urban Indian organizations, and health service providers to tribes
  • $350m in direct grants for tribes, tribal organizations and urban Indian health organizations for COVID-19 testing and tracing
  • $25b in rental assistance to states and local governments, and Native American tribes
  • Funding for the Food Distribution Program on Indian Reservations (FDPIR)
  • $3.15b to SAHMSA block grant programs 
Veterans Health Care and Benefits Improvement Act of 2020

The Veterans Health Care and Benefits Improvement Act of 2020 passed the senate on Dec 09, 2020. This package of bills will improve access to care and reduce costs for all veterans, and includes the following re. American Indian/Alaska Native (AI/AN) veterans:
  • An amendment to statute (38 U.S.C ยง 1730A) that prohibits the collection of co-pays from AI/AN veterans by the Veterans Administration. 
  • The formation of a Department of Veterans Affairs Advisory Committee on Tribal and Indian Affairs that will advise the VA Secretary on matters related to Indian tribes, tribal organizations, and Native veterans.
  • A provision that allows IHS to enter into a memorandum of understanding with the Secretary of HHS that will allow IHS case managers to provide case management assistance to veterans who receive housing vouchers under the Tribal Housing and Urban Development-Veterans Affairs Supportive Housing program (Tribal HUD-VASH)
For more information
 Laura Platero, Executive Director
Veronica Smith, Health Policy Consultant
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