Top Messages from Medicaid, Medicare Officials Focus on Telehealth, Expanded Eligibility
WASHINGTON, DC—Wednesday, October 6, 2021—Today at the National Indian Health Board (NIHB) National Tribal Health Conference (NTHC) the theme was “Fulfilling the Trust Responsibility: A Discussion of the Federal Government’s Role as a Funder of Indian Health Care” and topics and speakers came from the Centers for Medicaid and Medicare Services (CMS), an important agency that administers the Medicaid and Medicare programs in Indian Country. The Indian Health System is chronically underfunded, which enhances the importance of CMS to Indian Country. CMS programs are an integral third-party funder for the Indian health system, helping to fill gaps that would otherwise be filled by the full funding of the Indian Health Service. When Congress passed the Indian Health Care Improvement Act in 1976, they recognized their continued underfunding of Indian health care by allowing Indian health providers to bill third party insurers, including Medicare and Medicaid.
Leading today’s plenary session, NIHB Vice Chair Nickolaus Lewis said, “One of the most important factors in policymaking that the trust responsibility for American Indians and Alaska Natives health does not solely reside within the Indian Health Service (IHS). Rather, it is the responsibility of the entire federal government which includes the Centers for Medicaid and Medicare Services. In many ways, because of the poor funding levels for IHS, CMS has become an essential partner in getting healthcare services to our people. It’s important for Tribes to partner with CMS because they provide resources and implement policies that affect Indian healthcare funding and Tribal communities.”
CMS Administrator Chiquita Brooks-LaSure said the agency is dedicated to addressing the health disparities within the Indian healthcare system, like lower life expectancy rates, lack of access to quality care, discrimination and socio-economic disadvantages. Administrator Brooks-LaSure discussed her visit to Cherokee Nation in June 2021, following Oklahoma’s decision to expand Medicaid. She said that she was impressed by the impact of third-party reimbursements through Medicare and Medicaid.
“Building partnerships with underserved communities is a pillar of CMS’s work. We enjoy and are committed to continuing our work with the Tribal advisory committees and ensure that those committees will be fully staffed,” added Administrator Brooks-LaSure.
CMS Rural Health Council was created in 2016 to improve the healthcare access and delivery in rural and Tribal communities. The Council’s Co-Chair, Darci Graves, joined the session to share that health equity, telehealth flexibilities and long-term care and services are top priorities for the Rural Health Council and the Office of Minority Health. Rural health is of particular importance to Indian Country. American Indians and Alaska Natives are the most rural population in the country and issues that impact rural health have a disproportionate impact on Indian Country.
A panel discussion on pressing topics featured AI/AN health experts Dave Panana from the Kewa Pueblo Health Corporation; Jim Roberts from the Alaska Native Tribal Health Consortium; and John Stephens with the Swinomish Tribe Social Services. Speaker topics elevated issues like self-governance, Tribal consultation, and stronger Tribal-state relations. Given the chronic underfunding of the Indian Health Service, Tribes are often forced to work with states to be reimbursed for services such as telehealth through the Medicaid program. The reliance on Medicare also makes it essential that Tribes remain engaged and informed on changes through the federal Medicare program. Without these reimbursements, many Tribal health programs would have to ration health care. The necessity of these reimbursements elevates the importance of Tribal consultation and meaningful and thoughtful engagement with Indian Country, which was reinforced by the panelists.
Closing the second plenary session were remarks from Senator Lisa Murkowski (R-AK).
“The pandemic and related social and economic adversity certainly tested your communities over the last year and a half, but you all rose to the challenge. It is an honor to work in partnership with you to address Indian health issues as Vice Chairman of the Senate Committee on Indian Affairs and also as Ranking Member on the Interior Appropriations Subcommittee…Whether our work is building up infrastructure in Tribal communities, supporting the IHS budget, acknowledging and helping to heal the wounds of the policies of assimilation, or improving the delivery of services to Native children, I appreciate your partnership—working together to get it done,” said Sen. Murkowski.