August 14, 2020 |  Issue 20-27 Missed Last Week's Washington Report? Click Here to Visit our Archives!

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

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TribalDataBipartisan House Coalition Releases Tribal Health Data Improvement Act
On Friday August 7, 2020, multiple members of the House Energy and Commerce Committee (E&C) introduced pivotal new legislation to address chronic challenges faced by Tribal Nations and Tribal Epidemiology Centers (TECs) in accessing federal healthcare and public health surveillance data systems. Led by Representative Gianforte (R-MT) and Representative Lujan (D-NM), and joined by Representative Mullin (R-OK), Representative O'Halleran (D-AZ), Representative McMorris Rodgers (R-WA), and Representative Ruiz (D-CA), the Tribal Health Data Improvement Act would do the following:

  • Require the Department of Health and Human Services (HHS), within 30 days of the Tribal Health Data Improvement Act becoming law, to give direct access to all data related to health care and public health surveillance programs and services to Tribal Nations, Indian Health Service, and Tribal Epidemiology Centers

  • Require the Centers for Disease Control and Prevention (CDC) to give technical aid to Tribes and Tribal Epidemiology Centers for improving health statistics

  • Require CDC to engage in consultation with Tribes, Tribal organizations, the Centers for Medicare and Medicaid Services (CMS) Tribal Technical Advisory Group (TTAG), and the CDC/ATSDR Tribal Advisory Committee (TAC) and then develop guidelines for States and local health agencies on improving the quality and accuracy of birth and death record data for American Indians and Alaska Natives

  • Require CDC to enter into cooperative agreements with Tribes, Tribal organizations, urban Indian organizations, and Tribal Epidemiology Centers to address misclassification and undersampling of American Indians/Alaska Natives on birth/death records and in health care/public health surveillance systems

  • Encourage states to enter into data sharing agreements with Tribes and Tribal Epidemiology Centers 

To access bill text for the Tribal Health Data Improvement Act, click here.
To access a press release from the Committee, click here.
In This Issue:

NIHB Leads Efforts on Joint Letter to Congress Opposing Policy Changes to Medicaid FMAP
On July 27, the National Indian Health Board (NIHB) sent a joint letter to Congress firmly opposing any policy that would undo decades of precedent in federal Medicaid policy towards Tribal Nations by extending 100% Federal Medical Assistance Percentage (FMAP) to States for Medicaid services rendered by providers outside the Indian health system to American Indians/Alaska Natives. This policy would seek to stabilize state Medicaid programs at the direct expense of the Indian health system, and runs contrary to federal trust and treaty obligations.
NIHB was joined by Tribal Nations, National Congress of American Indians, National Council of Urban Indian Health, and multiple regional Tribal organizations in this important advocacy. NIHB encourages all Tribal Nations and organizations to join us in showing that Indian Country is uniformly opposed to this provision by sending similar letters. 

Please find this template letter on NIHB's Tribal COVID-19 Resource Center. 
Read the joint letter here
CorpsRevisionRevision to the Commissioned Corps of the U.S. Public Health Service Application
On August 3, 2020 HHS issued an information collection request for a revision to the Commissioned Corps of the U.S. Public Health Service Application. This application seeks to collect information needed to determine eligibility of applicants for the Regular Corps and Ready Reserve. Topics of comments could include ways to enhance the quality, unity and clarity of the collected information on the application or the use of automated collection techniques to eliminate information collection burden. Comments are due October 2, 2020. 
OGCNotice from HHS on changes to the Statement of Organization, Functions and Delegations of Authority for the Office of the General Counsel
On August 4, 2020 HHS released a notice on significant changes to the Statement of Organization, Functions and Delegations of Authority for the Office of the General Counsel. This notice highlights changes to the General Counsel and Immediate Office of the General Council, the Division in the Office of the General Counsel and the Ten Regional Offices. These changes intend to take into account the last compiled issuances of the Statement of Organization to incorporate all amendments, changes in the law and changes in titles or order of succession.
ControlledSubstancesA Proposed Rule from CMS on Electronic Prescribing of Controlled Substances
On August 4, 2020 a proposed rule was published by CMS on the "Medicare Program: Electronic Prescribing of Controlled Substances (EPCS)". This rule specifies the agency's request for information on whether or not CMS should include certain exceptions to the EPCS. EPCS stems from the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) where prescriptions for controlled substances are covered under the Medicare Part D prescription drug plan. This also includes whether or not CMS should create penalties for noncompliance and what those penalties should be. Comments are due October 5, 2020.
PaymentSystemA Final Rule from CMS on the 2021 Inpatient Psychiatric Facilities Prospective Payment System
On August 4, 2020 a final rule from CMS was released on the "FY 2021 Inpatient Psychiatric Facilities Prospective Payment System and special requirements for Psychiatric Hospitals". This final rule includes several changes, one of which updates the prospective payment rates and other specifics associated with Medicare inpatient hospital services provided by inpatient psychiatric facilities. Other changes include the adoption of recent Office of Management and Budget statistical area delineations. This rule is effective October 1, 2020.
HospiceWageA Final Rule from CMS on the 2021 Hospice Wage Index, Payment Rates and Cap Amount
On August 4, 2020 CMS issued a final rule on the hospice wage index, payment rates, and cap amount for FY 2021. This rule includes information on hospice care, services covered by the Medicare hospice benefit, and Medicare payment specifics for hospice care. Highlighted topics from this final rule include the revision of the hospice wage index as it references the current Office of Management and Budget area delineations with a 5 percent cap on wage index decreases and amends previous comments on the Hospice Center webpage designed to help hospices understand the content requirements finalized in the FW 2020 Hospice Wage Index and Payment Rate Update final rule. This final rule is effective October 1, 2020.
SkilledNursingA Final Rule from CMS with changes to the Medicare Prospective Payment System for Skilled Nursing Facilities
On August 5, 2020 CMS published a final rule titled "Medicare Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities." This rule makes updates to the value based purchasing program for FY 2021, the case-mix classification code for mappings used for the skilled nursing facilities through the prospective payment system and adopts the new revisions of the Office of Management and Budget statistical area delineations. The rule also makes changes to the Skilled Nursing Facility Value Based Purchasing Program. This final rule is effective October 1, 2020.
Please see below for call information to the IHS' All Tribes Call on Thursday, August 20th 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, August 20th
Time:  4:00 PM - 5:30 PM (Eastern)
Conference Call:  800-857-5577 | Participant Passcode:  6703929
Webinar Adobe Connect: | Participant Password:  ihs123
HardshipMedicare Eligible Hospitals: Hardship Exception Application
Application Deadline: Sept. 1, 2020

The Centers for Medicare and Medicaid Services (CMS) opened the hardship exception application submission period for Medicare's Eligible Hospital (EH) Hardship Exception to avoid the 2021 payment adjustment. EHs that utilized 2014 Certified Resource and Patient Management System (RPMS) Electronic Health Record (EHR) and were unable to demonstrate Promoting Interoperability (formerly known as Meaningful Use) in CY 2019 may need to apply for a hardship. Read the full memo here.

The deadline to apply for an EH Hardship Exceptions is Tuesday, September 1, 2020. Please note: This deadline has been extended from the original date of July 1, 2020 due to COVID-19. Direct all inquiries to Drew Morgan related to hardship exceptions. For IHS Specific questions related to the hardship exception, please direct all inquiries to IHS's Promoting Interoperability Team at
FCCFCC 2.5 GHz Rural Tribal Window
DEADLINE EXTENDED! Applications Now due Wednesday, September 2, 2020 at 6:00 PM ET
In light of the COVID-19 pandemic, there is a greater need for high-speed internet connections as communities turn to telemedicine. The Federal Communications Commission (FCC) 2.5 GHz Rural Tribal Window is unique opportunity for Tribes in rural areas to directly access unassigned spectrum over their Tribal lands, subject to buildout requirements. Read more here.
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