April 11, 2023

In This Week's Washington Report

• Special Diabetes Program for Indians: Congressional Diabetes Caucus Issues Sign on Letters for Special Diabetes Program for Indians Renewal – Contact your member of Congress TODAY!  

• Medicaid Unwinding: What you need to know and what you can do to retain coverage 

• Veterans' Affairs: VA Issues Final Rule on Copayment Exemption for Indian Veterans 

• HHS Budget Consultation: On April 18-19, 2023, HHS will host this year's budget consultation on the Fiscal Year 2025 Budget Request. 

• Upcoming Events: Tribal Advisory Committees & Tribal Consultations

• Notice of Funding Opportunities: (3) opportunities from the Maternal and Child Health Bureau

News from Across Indian Country

Congressional Diabetes Caucus Issues Sign on Letters for Special Diabetes Program for Indians Renewal – Contact your member of Congress TODAY! 

Every year the Special Diabetes Program for Indians (SDPI) serves approximately 780,000 American Indians and Alaska Natives. The program has become the nation’s most effective federal initiative to combat diabetes and serves as a useful model both for diabetes programs nationwide and public health programs in Indian Country. SDPI expires this year on September 30th. Congress must act now to reauthorize this invaluable program.  

Currently, the House and Senate sign-on letter is being circulated to members requesting their commitment to reauthorize the program. To succeed, it is imperative that members of Congress hear directly from their constituents. Please join NIHB in urging members to sign the letter of commitment to reauthorize. You can find your member of Congress and how to contact them HERE. 

To view the Congressional sign on letter for the Senate, click here. 

To view the Congressional sign on letter for the House, click here. 

For more information and additional resources on the Special Diabetes Program for

Indians, please visit NIHB’s SDPI webpage. If you have any questions or need assistance

contacting your member, please contact NIHB’s Congressional Relations Coordinator, Taylor Barrett at [email protected] or 202-507-4070.  

Medicaid Eligibility Redeterminations are Happening NOW – What you need to know and what you can do to retain coverage 

Up to 236,000 American Indians and Alaska Natives are expected to lose Medicaid coverage after a provision that allowed for continuous enrollment in the program ended Saturday. The provision was enacted in 2020 to help individuals who were losing their jobs retain health insurance during the beginning of the COVID-19 pandemic. Now, the continuous enrollment provision has ended, and state Medicaid programs have returned to normal eligibility redetermination activities, meaning individuals can be disenrolled if they are deemed ineligible for coverage.  

All Medicaid enrollees will be reviewed for eligibility over the next 12-14 months, so the disenrollments will be staggered across the country depending on each state program’s timeline and available resources, so some individuals will be disenrolled before others. The most important thing to pay attention to is your mail. Be on the lookout for mail coming from your state Medicaid program! They should be contacting you to update or verify your income, contact information, and more. If you have moved over the past three years, contact your state’s Medicaid office, and provide them your new information as soon as possible so you don’t miss anything that could impact your eligibility.  

If you have questions about your coverage, please contact your local Indian Health Service (IHS),

Tribal, or Urban health facility so that a Tribal Enrollment Assister or Patient Benefit Coordinator can help you. You can also find out how to renew your Medicaid or CHIP coverage, how to find coverage through the Health Insurance Marketplace if you no longer qualify for Medicaid, and how to contact your state’s Medicaid office through the Centers for Medicare and Medicaid (CMS) Division of Tribal Affairs HERE. 

For more information and additional resources on Medicaid unwinding process, please visit NIHB’s Medicaid Unwinding webpage. For questions about how to effectively educate and inform your community on the unwinding, please contact NIHB’s Tribal Health Care Outreach and Education Policy Coordinator, Kristen Bitsuie at [email protected] or 202-507-4084. 

Veterans Administration Issues Final Rule on Copayment Exemption for Indian Veterans 



On Tuesday, April 4, 2023, the U.S. Department of Veterans Affairs (VA) adopted a final rule to exempt American Indian and Alaska Native (AI/AN) veterans from copayment requirements for some health care received at VA facilities. The final rule will reimburse eligible AI/AN veterans for copayments made from January 1, 2022 through April 3, 2023. Exempting Indian veterans from paying copays for VA health services is important to address inequities in health care access, create parity across federal sources of health care, and live up to the federal trust responsibility. Beginning April 4, AI/AN Veterans can submit documentation to qualify for the copayment exemption. Eligible Veterans include any Veteran who meets the definitions of “Indian” or “urban Indian” under the Indian Health Care Improvement Act – including Veterans who are members of an American Indian Tribe, certain Veterans who are descendants of Tribe members, Alaska Native Veterans, and more.  

Services Included in the Exemption:

The final rule will exempt AI/AN veteran copayment requirements for most hospital care and medical services, including all urgent care visits. In our submitted comments, NIHB emphasized the importance of including copayment exemptions for all urgent care visits. 

Next Steps for Eligible Veterans: The VA will begin identifying eligible AI/AN veterans and start outreach and education efforts about the benefit. As NIHB staff learn more about this process, we will continue to keep you informed on developments.   

HHS To Host Annual Tribal Budget Consultation – April 18-19 in Washington, DC 

On April 18-19, 2023, the U.S. Department of Health and Human Services (HHS) will host its 25^th Annual Tribal Budget Consultation (ATBC) at the Hubert H. Humphrey Building at 200 Independence

Avenue, SW, Washington, D.C. This year’s budget consultation is to collaborate on the Fiscal Year 2025 Budget Request.

The ATBC is a powerful tool to influence the operational goals of the administration and sets the stage for Congressional action. The ATBC provides Tribes and Tribal organizations an opportunity to provide input on the President’s Budget Request to Congress. The President’s Budget describes how the administration plans to operate, how much money is needed to accomplish that mission, and any changes in law that are necessary to achieve that mission.  

More information regarding the ATBC can be found in the Dear Tribal Leader Letter.  

Upcoming Tribal Advisory Committees & Tribal Consultations 

Notice of Funding Opportunities

The Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration (HRSA) is pleased to announce three open funding opportunities focused on improving maternal health outcomes. Tribes and Tribal organizations are eligible to apply to these opportunities. You can find more details at grants.gov and on our webpage, as well as summary information below. 

Alliance for Innovation on Maternal Health (AIM) Capacity (closes May 9)  

The purpose is to support state and regional capacity to implement AIM patient safety bundles and expand the reach, depth, and quality of AIM implementation throughout the United States.  

AIM Technical Assistance (TA) Center (closes May 9)  

The purpose of this program is to expand implementation and reach of AIM program activities by funding the AIM TA Center to support all 50 states, D.C., jurisdictions, U.S. territories, tribal communities, and birthing facilities that are participating in the AIM program.  

Integrated Maternal Health Services (IMHS) (closes May 24)  

The purpose of the IMHS initiative is to improve maternal health outcomes in the U.S. by increasing access to quality, equitable, comprehensive care for pregnant and postpartum people.

National Indian Health Board | www.nihb.org | 202-507-4070

Visit the NIHB COVID-19 Tribal Resource Center at www.nihb.org/covid-19