NPAIHB Legislative & Policy  Update
Thursday, August 15, 2019 

August 24-30
2019 IHS Clinical and Community-Based Conference
Tigard, OR

September 5
12:30PM PT: IHS All Tribal and Urban Indian Organization Leaders Call
Dial-In: 800-857-5577; Passcode: 6703929

September 10-11
NCAI Tribal Unity Impact Days
Washington, D.C.

IHS Tribal Self Governance Advisory Committee (TSGAC) Strategy Session
Maricopa, AZ

September 12-13
HHS Secretary's Tribal Advisory Committee (STAC) Meeting
Washington, D.C.

September 16-19
NIHB National Tribal Health Conference
Temecula, CA

September 19
NIHB Tribal Diabetes Summit
Temecula, CA
NIH DTLLs: All of Us program, data sharing, and intellectual property (Comments Due 8/22)
5/24 Issued
Seeks comments on 1) inclusion of AI/ANs in the All of Us program for precision medicine; 2) acceptable requirements when proposing research with tribes; and 3) how intellectual property policies impact biomedical research with tribal communities.
NIH DTLL: All of Us Program

HRSA DTLL: Annual Tribal consultation (Comments Due 8/23)
Requests testimony on health care issues that affect Indian Country or questions for the September 16 consultation at the NIHB National Tribal Health Conference

HHS request for information: ensuring patient access and effective drug enforcement ( Comments Due 8/29)
7/30 Issued
Requests comments on ensuring legitimate access to controlled substances, while preventing abuse, as well as how federal, state, local and tribal entities can collaborate to address these issues
Request for Information

IHS DTLL: IHS extends comment period on development of an FY 2019 opioid grant program (Comments Due 9/3)
7/26 Issued
Requests feedback on developing an IHS Opioid Grant Program to distribute the $10 million FY 2019 funding. Program is proposed to be modeled after SDPI.

CMS Proposed Rule: Methods for assuring access to covered Medicaid services rescission (Comments Due 9/13)
7/15 Issued
Removes regulatory text that sets forth the current required process for states to document whether Medicaid payments in fee-for-service systems are sufficient to enlist enough providers to assure beneficiary access to covered care services consistent with the Medicaid statute.

CMS Medicare Program: CY 2020 revisions to payment policies under the Physician Fee Schedule; Medicaid promoting interoperability program requirements for eligible professionals; establishment of an ambulance data collection system; updates to the QPP; Medicare enrollment of opioid treatment programs and enhancements to provider enrollment regulations concerning improper prescribing; and amendments to physician self-referral law advisory opinion regulations (Comments due 9/27)
8/14 Issued
Rewards clinicians for time spent with patients, removing unnecessary measures they have to report. Updates payment policies for clinicians paid for the services they provide to Medicare beneficiaries under the Physician Fee Schedule (PFS) and Quality Payment Program (QPP). 

Support needed for Advanced Appropriations for the Indian Health Service and Bureau of Indians Affairs - S.229, H.R. 1128, and H.R. 1135
IHS DTLL: FY 2020 IHS Joint Venture Construction Program (JVCP) Pre-Application (Application Due 10/11)
8/17 Issued
Requests for applications for  a federally recognized tribe  for  construction of a health care facility that meets the IHS planning, environmental review, sustainability, design, and construction requirements. In exchange, the IHS will request that Congress fund the staffing and operations of the health care facility under a no-cost, 20-year lease.

IHS DTLL: IHS releases updated Indian Health Manual (IHM) section 6-3.2(E) of the Contract Support Costs (CSC) policy
8/6 Issued
Updates the IHM section 6-3.2(E) following Tribal consultation. Cl arifies  language, provides technical corrections,  and ensured that the CSC policy is consistent with ISDEAA.
Enclosure: Updated CSC section 6-3.2(E)
Enclosure: Tribal Consultation summary Report

CMS announces new standards for Medicaid DUR programs to combat opioid misuse and abuse 
8/5 Issued
Updates standard requirements for the Medicaid Drug Utilization Review (DUR) in order to promote proper use of prescription opioids. 
I HS DTLL: IHS seeks comments on NTAC Behavioral Health initiative funding recommendations (Comments Due 10/1)
8/2 Issued
Seeks input on recommendations made by NTAC to address the explanatory statement in the Consolidated Appropriations Act of 2018 which encourages IHS to transfer behavioral health initiative funding through ISDEAA compacts and contracts instead of grants.
Enclosure: NTAC recommendations
Senator Udall introduced a bill to improve access to health care for urban Native veterans (S.2365)
Introduced 7/31 
Allows the VA to reimburse urban Indian health centers for services they provide to Native veterans.

Senator Booker introduced the Environmental Justice Act of 2019 (S.2236)
Introduced 7/23
Requires federal agencies to address environmental justices including the disproportionate health impacts on communities of color, indigenous communities, and low-income communities.

Senator Casey and Senator Murkowski introduced the Family Violence Prevention and Services Improvement Act of 2019 (S.2259)
Introduced 7/7
Sources federal funding for domestic violence shelters and would raise authorization levels for certain programs and includes a tribal set aside and enhancements for Indian Country. Sets funding for an AI/AN Tribal Resource Center on domestic violence and the National Indian Domestic Violence hotline. 
8/12 Indian Child Welfare Act survives legal attack 

8/12 Surprise bills surge in ER, inpatient settings, JAMA finds

8/10 Native candidates advance in Washington state primary

8/7 NCAI to co-host first-ever Presidential candidate forum focused on Native American concerns

8/6 VA inappropriately processed one-third of non-VA emergency claims

7/31 Jamestown S'Klallam Tribe dispels rumors about treatment facility

7/23 Senate Finance pushes ahead on plan to address high drug prices

7/18 Medication assisted treatment - closing the treatment gap. A prescriber's journey

7/17 After 90 years, Idaho high school retires its controversial Native American mascot
For more information
  Laura Platero, Director of Government Affairs/Health Policy 
Sarah Sullivan, Health Policy Analyst
(503) 228-4185