June 26, 2020 |  Issue 20-20  Missed Last Week's Washington Report? Click Here to Visit our Archives!

National Clinical Care Commission
June 26, 2020

Community Health Aide Program (CHAP) TAG Vacancies
 In February 2018, with the announcement of CHAP expansion to Tribes beyond Alaska, IHS created a CHAP Tribal Advisory Group.

 Information on CHAP and CHAP TAG, including vacant  positions, is available on the CHAP
website .

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Top Story
HVACTestimonyNIHB Testifies Virtually Before House VA Technology Modernization and Health Subcommittees on VA Use of Telehealth During COVID-19 Urges Committee to Invest in Native Veterans' Care 
  On June 23, the National Indian Health Board (NIHB) Vice Chair Chief Bill Smith from the Valdez Tribe of Alaska testified before the House Committee on Veterans Affairs , Subcommittee on Health and Subcommittee on Technology Modernization on VA's use of telehealth during the COVID-19 pandemic. The hearing titled, "VA Telehealth During the COVID-19 Pandemic: Expansion and Impact," provided an opportunity for NIHB to share its priorities for the Veterans Health Administration (VHA) , including significant investments in Health Information Technology (HIT) and Electronic Health Records (EHR).

In his testimony, Chief Smith urged the House VA Committee to implement specific policy recommendations to improve healthcare within the VHA for AI/AN Veterans:
  • Pass the bipartisan H.R. 4908 - Native American PACT Act that would exempt Native Veterans from paying copays and deductibles into the VA health system on the base of federal treaty obligations for healthcare that exist in perpetuity.
  • Ensure parity in legislation and funding between the VHA and IHS, especially for HIT modernization and telehealth infrastructure, which can lead to greater quality and access to care for thousands of AI/AN Veterans across the country.
  • Pass the bipartisan H.R. 2791 - Department of Veterans Affairs Tribal Advisory Committee Act of 2019 which would establish a committee essential to strengthening the government-to-government relations between Tribes and the VA and improving VA accountability to AI/AN veteran health needs.
Find the full NIHB testimony at www.nihb.org/covid-19/advocacy-tools. For more information or questions about Native Veterans healthcare, please contact Shervin Aazami at saazami@nihb.org. 
In This Issue:



ECTestimonyNIHB Submits Written Testimony to House Energy and Commerce Subcommittee on Health Care Inequality and the COVID-19 Pandemic
In response to a June 17 House Energy and Commerce Subcommittee on Health hearing titled "Health Care Inequality: Confronting Racial and Ethnic Disparities in COVID-19 and the Health Care System", the National Indian Health Board (NIHB) submitted written testimony highlighting and examining how already existing inequities put Indian Country at greater risk of COVID-19. NIHB outlined specific priorities that fall within the Comittee's jurisidction including: 
  • Eliminate the sunset provisions under Section 30106 of HEROES so that removal of the "four walls" Medicaid billing restriction and extension of 100% FMAP to urban Indian organizations are made permanent
  • Authorize Indian Health Care Providers (IHCPs) to receive Medicaid reimbursement for all medical services authorized under the Indian Health Care Improvement Act (IHCIA) - called "Qualified Indian Provider Services" - when delivered to Medicaid-eligible American Indians and Alaska Natives
  • Enact Certain Sections of the CONNECT to Health Act
  • Pass the bipartisan H.R. 2680 - Special Diabetes Program for Indians Reauthorization Act - with new authority to allow Tribes and Tribal organizations to receive awards through P.L. 93-638 self-determination and self-governance contracts and compacts
  • Pass the bipartisan H.R. 7056 to fund critical water sanitation projects in Indian Country
NIHB's full testimony may be read here
TelehealthTestimonyNIHB Submits Written Testimony to Senate Health, Labor, Education, and Pensions Committee on Telehealth Priorities for Indian Country

In response to a June 17 Senate Health, Labor, Education, and Pensions Committee hearing titled "Telehealth: Lessons from the COVID-19 Pandemic", the National Indian Health Board (NIHB) submitted written testimony highlighting and examining how already telehealth measures and policies enacted during the COVID-19 public health emergency have served Indian Country in response to the pandemic. To continue the progress of telehealth in the Indian health care system. NIHB outlined specific priorities that fall within the Comittee's jurisidction including: 
  • Provide meaningful increases to the IHS budget for telehealth, electronic health records and health information technology (IT) infrastructure development
  • Permanently Extend Waivers under Medicare for Use of Telehealth
  • Enact Certain Sections of the CONNECT to Health Act
  • Ensure that Medicare reimburses IHS and Tribal providers for telehealth services at the IHS All-Inclusive Rate or "OMB Rate" 

NIHB's full testimony may be read here

FederalFailureA Summary of "The COVID-19 Response in Indian Country; A Federal Failure"
The Center for American Progress published an article about the federal government's response to the COVID-19 pandemic for American Indians and Alaska Natives (AI/AN). The article details the federal government's neglect in relation to upholding its trust responsibility to Tribes.  It also provides historical context of the centuries of disease outbreaks and draws parallels to the lack of support from the current administration. Seven suggestions are highlighted on how the government should now take action.  These suggestions are: including American Indians and Alaska Natives into COVID-19 data, addressing the bureaucratic barriers, supporting Tribal economic development, addressing the underfunded Indian Health Services (IHS), supporting Indian Country's changing infrastructure, funding Tribal public safety needs, and supporting the restoration and ecocultural resource management of Tribal homelands. For the full article please click here. 
NHSCThe National Health Service Corps (NHSC) Scholarship Program, the NHSC Students to Service Loan Repayment Program and the Native Hawaiian Health Scholarship notice from The Health Resources and Services Administration (HRSA)
On June 15, 2020 HRSA released a notice on the application and other forms used by the NHSC Scholarship Program, the NHSC Students to Service Loan Repayment Program, and the Native Hawaiian Health Scholarship Program. These scholarships are designed to provide funding to students who are pursuing primary health care education and training, who in return provide health care to underserved communities. This notice details a requests for comments on the application forms and supporting documents used to collect the needed information of applicants for these programs. These comments will allow for HRSA to make determinations for the awards as well as, monitor compliance with program requirements. 

Comments on this notice are due July 15, 2020. 
Collection Request for the Medicare Program: Procedures for Making National Coverage Decisions
On June 6, 2020, CMS released a notice on an information collection request asking for assistance on making national coverage decisions (NCD) on whether or not medical procedures, supplies, or diagnostic services are covered nationally by the Medicare program. Third parties should submit a formal request for new or reconstructed national coverage decision. This collection will help the Medicare program ensure it continues to meet the needs of its beneficiaries. 

Comments on this collection request are due July 8, 2020.
HPSAHRSA seeks input on HPSA Scoring criteria and on establishing criteria for a new Maternity Care Health Professional Target Area
HRSA is seeking public input and feedback on two pending issues. First, the agency is looking for input on changes to the Health Professional Shortage Area Scoring Criteria (HPSA). Indian health facilities are currently automatically designated as HPSAs. They are also seeking input on the establishment for criteria for Maternity Care Health Professional Target Areas.
IneligibilityThe Indian Health Service (IHS) and Regulations on the Care and Treatment of Ineligible Individuals
On June 15, 2020 IHS released a notice of proposed rulemaking on removal of obsolete language appearing in the Code of Federal Regulations, regarding the rates charged for the provision of IHS services to ineligible individuals The notice highlights that "in cases of emergency...individuals not eligible...may be provided temporary care and treatment in Service facilities...charging ineligible individuals." This notice also highlights several other executive orders that were issued in relation to this change. Comments on this notice are due August 14, 2020.
PACECenters for Medicare and Medicaid Services (CMS) and the Programs of All-inclusive Care for Elderly (PACE)
On June 17, CMS released a notice on a collection request for quality data monitoring and reporting on the PACE. The PACE is a form of managed care service for the frail elderly, who are mostly both eligible for Medicare and Medicaid. To be eligible for PACE, an individual must be 55 years or older and live in the service area of a PACE organization, need nursing home-level care or rely on the assistance of PACE to live safely. Comments on this collection request are due August 17, 2020.
NondiscriminationCenters for Medicare and Medicaid Service's (CMS) Final Rule on Nondiscrimination in Health and Health Education Programs
On June 19, CMS released a final rule on Nondiscrimination in Health and Health Education Programs. The rule specifically prohibits the discrimination on the basis of race, color, national origin, sex, age and disability. The rule also amends several other rules for nondiscrimination provisions within various CMS regulations. This final rule is effective August 18, 2020.
DrugRebateCenters for Medicare and Medicaid Services (CMS) and the Minimum Standards in Medicaid State Drug Utilization Review with Supporting Value-Based purchasing for Drugs Covered in Medicaid, Drug Rebate and Third Party Liability Requirements
On June 19, 2020, CMS released a proposed rule on their establishment of minimum standards in Medicaid state drug utilization review and supporting value based purchasing for drugs covered in Medicaid, revising Medicaid drug rebate and third party liability. Along with other changes, this rule is specifically designed to support state flexibilities for new value-based purchasing arrangements (VBPs) with drug manufacturers and to support those manufacturers with regulatory support to enter into VBPs with payers, such as Medicaid. This rule is also proposing new regulatory policies to clarify these goals.

Comments on this proposed rule are due July 20, 2020.
Please see below for call information to the  IHS' All Tribes Call on Thursday, July 2nd at 4:00 PM Eastern . This call is intended to update Tribes on the Coronavirus Disease 2019 (COVID-19). Tribal Leaders will have an opportunity to provide comments and ask questions to federal officials. IHS has also scheduled a COVID-19 call for the following week at the same time-call info is the same for both calls.

Date:   Thursday, July 2nd 
Time:  4 :00 PM - 5:30 PM (Eastern)
Conference Call:   800-857-5577 | Participant Passcode:  6703929
Webinar Adobe Connect:   https://ihs.cosocloud.com/r4k6jib09mj/ | Participant Password:  ihs123
The target audience for CMS ITU Trainings includes:
  • Business Office staff
  • Benefits Coordinators
  • Patient Registration staff
  • Medical Records staff
  • Purchased/Referred Care staff
Please click here to access the schedule of virtual CMS ITU trainings. 
DTFundingFunding Opportunity: Dental Therapy in Indian Country
Applications due Monday, July 20, 2020 at 11:59 PM ET
The National Indian Health Board (NIHB) is pleased to announce it is accepting applications for three funding opportunities related to dental therapy in Indian Country. These announcements are part of NIHB's Tribal Oral Health Initiative.
  • Tribal Colleges/Universities to conduct activities to develop dental therapy education programs
  • Tribes and Tribal Organizations to conduct activities to implement dental therapy in health settings
  • Tribes and Tribal Organizations to conduct outreach and education activities in support of dental therapy
Completed applications should be submitted to Brett Weber at bweber@nihb.org and should reference the grant code in the subject line. Read more and download the applications here.  
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