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VATestimoyNational Indian Health Board Supports House Bill to Require Veterans Health Administration to Reimburse Indian Health Providers
On July 22, NIHB Acting Chairman William Smith testified before the Subcommittee for Indigenous Peoples of the United States (SCIP) for a legislative hearing on the "PRC for Native Veterans Act" ( H.R. 6237 ). This critical bill would amend the Indian Health Care Improvement Act to clarify that the Veterans Health Administration (VHA) and the Department of Defense are required to reimburse the Indian Health Service (IHS) and Tribal health programs for healthcare services provided to Native veterans through an authorized referral. Acting Chairman Smith, who is a Vietnam veteran, stressed that third-party reimbursement adds funds to the IHS Purchase/Referred Care (PRC) system so specialty services can be purchased and reiterated that the government has a dual responsibility to Native veterans. 
"Congressman Gallego's bill would guarantee that IHS and Tribes receive that third-party reimbursement from the VHA and finally settle the Veterans Affairs claims that they have no statutory obligation to pay IHS or Tribal health providers for specialty and referral services, despite repeated requests from Tribes," said NIHB Acting Chairman Smith. "If a veteran wants to get care from an Indian health provider then that program should be reimbursed for the services even if the same service could have been done at a nearby VA facility. Native veterans should have the freedom to get care from either the VA or an Indian health program. This failure in the system creates greater care coordination issues and burdensome requirements for Native veterans."

Read the complete testimony at www.nihb.org/covid-19/advocacy-tools. 
In This Issue:

TribalLetterNational Indian Health Board joins National Congress of American Indians and Tribal Organizations Send Tribal Priorities to Congressional Leadership for Upcoming COVID-19 Relief Package
On July 20, the National Indian Health Board (NIHB) joined the National Congress of American Indians and a and a consortium of national and regional Tribal and Native organizations sent a letter to Senate Majority Leader McConnell, Speaker of the House Pelosi, Senator Minority Leader Schumer, and House Minority Leader McCarthy outlining Tribal priorities to Congress for the upcoming and likely final COVID-19 pandemic relief package before the November election. The letter encompasses a broad scope of Tribal priorities including in health, education, housing, public safety, Tribal governance, and economies. 

As the COVID-19 infection rate, and death toll intensifies in Indian Country, the Indian Health Services, tribal health programs, and Urban Indian Organizations (UIOs) need significantly more resources to protect and preserve human life. 

Health priorities addressed include: 
  • Emergency funding in the amount of at least $2 billion for Indian Health Service, and at least $1 billion for critical health infrastructure like sanitation;
  • Technical amendments to Medicaid, Medicare, and other programs to address disparate
  • Enact certain sections of the bipartisan CONNECT to Health Act (S.2741 & H.R.4932), to address telehealth needs in Indian Country;
  • Parity for UIOs, including for Federal Tort Claim coverage;
  • Pass the bipartisan Special Diabetes Program for Indians Reauthorization Act of 2019 (S. 3937), with slight changes to the new "Delivery of Funds" language to ensure tribal nations and tribal organizations are able to receive awards through P.L. 93-638 self-determination and self-governance contracts and compacts. 
  • Increased funding for the Temporary Assistance for Needy Families (TANF) program;
  • Increased funding for AI/AN veteran health;
  • Additional support for Indian Child Welfare Services; and
  • Increased emergency funding for tribal roads, housing, health and education facilities, water and sewer systems, energy; and broadband.
To read the full list of priorities for Indian Country, the letter may be read here

Learn more about NIHB's advocacy at www.nihb.org or visit the NIHB COVID-19 Tribal Resource Center at www.nihb.org/covid-19/advocacy-tools to read the full testimony.
VAHearingNational Indian Health Board Submits Written Testimony to House Veterans Affairs Committee Full Legislative Hearing
On July 23, the full House Veterans Affairs Committee held a legislative hearing on several bills including the Department of Veterans Affairs Tribal Advisory Committee Act of 2019 (H.R. 2791) and the Native American PACT Act (H.R. 4908). 

The United States federal government has a dual obligation to AI/AN Veterans - one obligation specific to their political status as citizens of sovereign Tribal Nations, and one obligation specific to their courageous service in our Armed Forces. By current estimates, there are over 140,000 Native Veterans, with AI/ANs enlisting to serve at nearly five times the national average, and at higher rates per capita than any other ethnicity. Yet despite the bravery, sacrifice, and steadfast commitment to protecting the sovereignty of Tribal Nations and the entire United States, Native Veterans continue to experience among the worst health outcomes, and among the greatest challenges in receiving quality health services, among all Americans. These enduring challenges have left Native Veterans at significantly higher risk of COVID-19 due to disparities

Read the complete testimony here. 
PowerMobilityMedicaid Program Collection Request on Conditions for Payment of Power Mobility Devices
On July 8, 2020 CMS released a collection request on their Medicaid Program: conditions for payment of power mobility devices, including power wheelchairs and power operated vehicles. Specifically this request asks for comments on an April 5, 2006 final rule that requires a face-to-face examination of the beneficiary by the physician or treating practitioner, a written prescription, and a receipt of pertinent parts of the medical record by the supplier in order to keep in their records for later review from CMS agents. 

Comments are due September 8, 2020.
PRCA Notice from IHS on Purchased/Referred Care Delivery Area Designation
On July 10, 2020 IHS released a notice on the intent to expand geographic boundaries of the Purchased/Referred Care Delivery Area for the Northwestern Band of the Shoshone Nation. This expansion would include the Utah counties of Box Elder, Davis, Salt Lame and Weber. With this expansion Tribal members would now be eligible to receive Purchased Referred Care services and are now expected to serve an additional 171 individuals.

Comments are due August 10, 2020
CMSLetterCMS Dear State Medicaid Director Letter
On July 14, 2020 CMS released a Dear State Medicaid Director Letter that described new guidance for the home and community-based services (HCBS) Settings Rule. Due to the response of the COVID-19 pandemic from states, CMS is now changing their HCBS settings criteria with the understanding that it is now difficult for states to comply. CMS's specific concern is with the elderly where social distancing has made it hard for those individuals to participate in their communities. In addition, other concerns have also been brought to the attention of CMS by states on how the setting criteria cannot easily be achieved due to the pandemic. CMS has decided to extend the deadline for ensuring compliance with the Home and Community-Based Settings Regulation. The new deadline is now for March 17, 2023.
DTLLDear Tribal Leader Letter from the Indian Health Service (IHS)
On July 2, 2020 the IHS released a Dear Tribal Leader letter on initiating Tribal consultation on the use of $30 million in funding from the Special Diabetes Program for Indians (SDPI). This funding is an offset from previous year funds due to an accumulation of prior SDPI grants. Due to an added sixth year to the current grant cycle for SDPI, a new plan is needed for FY 2020 offset funds. Both offset funds and carry over funds could be used for different purposes. These purposes could include "new grant funding for $10 million per year for 3 years for eligible entities that do not currently have a SDPI grant, or one open to all eligible entities to apply to address diabetes related risk factors." This letter concludes with an invitation for all Tribal leaders to provide feedback to IHS on how this $30 million might be spent. 

The deadline to comment is August 28, 2020.
Please see below for call information to the  IHS' All Tribes Call on Thursday, July 30th 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 30th
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
EnrollmentWebinarNIHB Webinar: Health Insurance Enrollment During COVID-19
The National Indian Health Board (NIHB) is hosting a webinar on Health Insurance Enrollment During COVID-19 on Thursday, July 30 from 2:00 - 3:30 pm Eastern Time. This webinar is for enrollment assisters, patient registration and benefits coordinators.  The onset of the COVID-19 pandemic made it critical for enrollment assisters across Indian Country to stay informed on the special protections and benefits that health insurance coverage offers to the safety of American Indians and Alaska Natives (AI/ANs). The webinar is intended to help educate enrollment assisters about available health insurance coverage options, benefits and special federal protections exclusively for AI/ANs. The webinar will cover Special Enrollment Period eligibility for AI/ANs who have experienced lifetime events, such as losing a job or having a baby. Webinar participants will hear from BeWellNM and an Indian Health Service Patient Benefits Coordinator about their outreach and education strategies.

Date: Thursday, July 30, 2020
Time: 2:00 PM - 3:30 PM Eastern Time
MinigrantsNIHB Offering Tribal Telehealth Capacity Mini-grants
Applications due Tuesday, July 21, 2020 at 11:59 PM ET
With funding from the Johns Hopkins University Center for American Indian Health, as part of the national Nick Kristof's C-19 Impact Initiative, the National Indian Health Board (NIHB) is offering 18 COVID-19 Tribal Telehealth Mini-grants to Tribes, Tribal organizations or inter-Tribal consortia in amounts up to $10,000 each to assist with building capacity and responding to telehealth services and needs. The project period will run from approximately August 1 through December 31, 2020. To download the application, click here. Download the application here.
Additionally, a preapplication webinar was held Monday, July 13, 2020. The preapplication webinar slides and recording can be found here under the NIHB COVID-19 Tribal Telehealth Mini-Grant banner.
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