NPAIHB Legislative & Policy  Update
Wednesday, December 4, 2019

December 4
12:00pm PST: IHS Health IT Modernization Project
Webinar: Passcode:  ihs123
Dial In:  (800) 832-0736; Participant Passcode:   3014886

December 5
12:30pm - 1:30pm PST: IHS All Tribes and Urban Indian Organization Leaders Call
Webinar:; Passcode: ihs123
Dial in:  800-857-5577; Passcode: 6703929
January 2, 2020
12:30pm - 1:30pm PST: IHS All Tribes and Urban Indian Organization Leaders Call
Webinar:;  Passcode:  ihs123
Dial in:  800-857-5577; Passcode: 6703929

January 14 - 16, 2020 
NPAIHB Quarterly Board Meeting
Tulalip, WA

January 21 - 24, 2020
SGAC: January 21 - January 22
TSAG: January 23 - January 24 
Washington, DC
IHS DTLL-Upcoming deadline to file a hardship exception application (Application Due 12/31/19)
Issued 12/2/19 
Informs that the IHS Resource Patient Management System (RPMS) will not meet the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) 2015 Edition certification requirements by 2019. Therefore, Eligible Clinicians and Eligible Hospitals that utilize RPMS and participate in various quality initiatives will not be able to attest using the certified health IT to qualify for incentives. The deadline to submit a hardship exception application to CMS for the QPP Promoting Interoperability Performance Category is Tuesday, December 31, 2019.

HHS proposes Stark law and anti-kickback statute reforms to support value-based and coordinated care (Comments Due 12/31/19)
Issued 10/9/19
Announces proposed changes to modernize and clarify the regulations that interpret the Physician Self-Referral Law (the "Stark Law") and the Federal Anti-Kickback Statute. 
The proposed rules provide greater certainty for healthcare providers participating in value-based arrangements and providing coordinated care for patients. The proposals would ease the compliance burden for healthcare providers across the industry, while maintaining strong safeguards to protect patients and programs from fraud and abuse. Tribes are requesting a safe harbor similar to the safe harbor for Federally Qualified Health Centers (FQHCs).                                                                                                 HHS Announcement.                                                                                                       HHS OIG Proposed Rule                                                                                                CMS Proposed Rule
IHS DTLL-Update on short-term continuing appropriations for fiscal year (FY) 2020 for tribal health programs   
Issued 11/27/19
Announces that IHS will pay Tribal Health Programs with performance periods starting within the continuing resolution (CR) period - October 1, 2019 through December 20, 2019 - up to the full FY 2019 base Secretarial amount.   Programs operated by the IHS, including contracts to Urban Indian Organizations, will continue to receive funding at the current CR funding level of 22.13 percent through December 20, 2019.

White House Executive Order on establishing the task force on missing and murdered American Indians and Alaska Natives
Issued 11/26/19
Establishes a Task Force on missing and murdered AI/AN, co-chaired by the Attorney General and Secretary of the Interior. The Department of Justice will provide funding and administrative support as necessary. The Task Force shall conduct appropriate consultations with tribal governments; develop model protocols and procedures to apply to new and unsolved cases; establish a multi-disciplinary, multi-jurisdictional team to review cold cases; and address the need for greater clarity concerning roles, authorities, and jurisdiction through cases. 

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.

IHS DTLL- Updates on modernizing Agency health information technology (IT)
Issued 11/15/19
Releases two reports on "Strategic Options for the Modernization of the Indian Health Service Health Information Technology Final Report" and "Strategic Options for the Modernization of the Indian Health Service Health Information Technology Roadmap Executive Summary."

CMS issues proposed rule on Medicaid fiscal responsibility
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.
Senate Committee on Indian Affairs (SCIA) Nomination Hearing on December 11, 2019 at 11:30am PST 
Nomination hearing to consider RADM Michael D. Weahkee, of New Mexico, to be Director of the Indian Health Service U.S. Department of Health and Human Services. 

H.R. 3055 - Further Continuing Appropriations Act, 2020, and Further Health Extenders Act of 2019 
Enacted 11/21/19
Provides continuing FY 2020 appropriations to federal agencies, including the Indian Health Service, through December 20, 2019, and extends several expiring health programs such as the Special Diabetes Program for Indians. 

FY 2020 Appropriations for IHS  
Lawmakers of the House and Senate Appropriations Committee have confirmed agreement on allocations for each of the 12 spending bills. However, the FY 2020 amount for the Interior, Environment and Related Agencies and IHS is still unknown. House and Senate funding bills for IHS differed by $300 million with House at $537 million above FY 2019 enacted level and Senate at $237 million above FY 2019 enacted level. 

S. 2891 - Indian Health Service Health Professions Tax Fairness Act of 2019
Introduced 11/14/19 by Senator Tom Udall (D-NM)
Amends the Internal Revenue Code of 1986 to exclude from gross income payments under the Indian Health Service Loan Repayment Program and certain amounts received under the Indian Health Professions Scholarship Program. 

All Other Pending Indian Health Bills

12/3  Key GOP senator: Spending 'understanding' needed within days to meet deadline
The Hill

12/3 HHS ready, set PrEp expands access to medication to prevent HIV

11/25 Medicare for all: The one state taking a big run at health reform 

11/25 Two M edicaid-related initiatives that help promote long-term care at home and in the community, rather than in institutions, are set to expire at the end of December

11/22 The U.S. gave troubled doctors a second chance. Patients paid the price. 

11/15 Trump administration announces historic price transparency requirements to increase competition and lower healthcare costs for all Americans

For more information
  Laura Platero, Director of Government Affairs/Health Policy 
Sarah Sullivan, Health Policy Analyst
(503) 228-4185