Download
legislative policy update n.
Skip this Video
Loading SlideShow in 5 Seconds..
Legislative & Policy Update PowerPoint Presentation
Download Presentation
Legislative & Policy Update

Legislative & Policy Update

90 Views Download Presentation
Download Presentation

Legislative & Policy Update

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. Legislative & Policy Update NW Portland Area Indian Health Board Quarterly Board Meeting June 20, 2014

  2. Report Overview • SDPIExtended • GAO Report on Veterans Health • FY 2015 Appropriations Update • Dental Health Aide Therapists • Health IT Updates • Contract Support Cost Update • Navajo Nation Medicaid Study

  3. GAO Native American Veterans Report • HEALTH CARE ACCESS: Improved Oversight, Accountability, and Prioritization Can Improve Access for Native American Veterans • Reviewed IHS & VA actions under required MOU • Report found agencies face substantial implementation challenges • Oversight is inconsistent: In 2013, the officials tasked with oversight of the implementation of the MOU did not meet and did not systematically evaluate the progress of MOU implementation. • Written policies and guidance are lacking on implementation • Prioritization of MOU implementation is lacking: Leadership of VA and IHS have not made MOU implementation a priority, which threatens the ability of agencies to move forward

  4. DHAT Preparation • If legislation in WA State is to be successful, WA Tribes must weigh in • Cody, Appleton, McCoy will not rely on tribal organizations to carry support – AIHC, ATNI, NPAIHB • Board Proposal under consideration with Kellogg, Pew, and NW Washington Foundation • Two state and national strategy to address mid-levels

  5. SDPI Extended thru FY 2015 • H.R. 4302 Protecting Access to Medicare Act • Sustainable Growth Rate bill (Sec. 204) Extends the Special Diabetes Program for Indians thru FY 2015 • SDPIthru September 30, 2015 • Maintains $150 million per year less sequestered amount • April TLDC meeting to discuss recommendations on distribution • NPAIHB comment letter provide recommendations • Concerns related to user pop calculations

  6. Senate Committee on Indian Affairs • New Chair: Sen. Jon Tester (MT) • Senators Cantwell and Crapo still on Committee • Legislation & Hearings • FY 2015 President’s Budget – March 26th • S. 1570 amend IHCIA for Advanced Appropriations • S. 919 amend ISDEAA to expand self-governance

  7. Indian Health Legislation • Advance Appropriations Bills • H.R. 3229: Don Young & Ray Lujan • S. 1570: Begich, Udall, Murkowski • Special Diabetes Program for Indians • House and Senate Sign-on letters • Indian Definition Fix • S. 1575: Senators: Mark Begich (D-AK), Max Baucus (D-MT), Tom Udall (D-NM), Brian Schatz (D-HI), Al Franken (D-MN) • Medicare-like Rates (Contract Rate Expenditure)- H.R. 4843 Rep. Betty McCollum (D-MN) and Rep. Tom Cole (R-OK)

  8. FY 2015 President’s Request • $4.634 billion for Indian Health Service • $199 million increase (4.5%) is respectable? • Staffing & New Tribes funding $78.8 million takes increase down to $120.9 million (2.7%) * • $29 million program increase for CSC * • $15.4 million program increase for CHS • Adjustments of $10 million to restore 2014 reductions (CSC) • Adjusting the increase for earmarks* leaves a balance of $91.9 million for current services (does not include CHS increase) • NPAIHB estimates at least $223 million is needed to maintain current services • President’s budget will be short by $131 million to fully fund inflation and population growth

  9. FY 2015 Appropriations Update • Full Congress not agreed on budget resolution • House Resolution: “Path to Prosperity” • Senate agreed to use framework Budget Control Act • Murray/Ryan deal set spending caps in FY 2015 for discretionary spending • April 7-8th House Public Witness Hearings; April 30th Senate Hearing • Senate considering “mini-bus” bill for some Departments • Sign that headed for a long haul

  10. TTAG/MMPC Updates • ACA Policy Subcommittee is very active • Tribal Exemption & I/T/U hardship exemption • Referrals and Cost Sharing Exemptions • CMS Final 2015 Letter to Issuers in FFM and Guidance FAQs • Revising the CMS Tribal Consultation Policy • Evaluation of CMS Strategic Plan & Updates • Alternatives for Medicaid Expansion: Arkansas Model and UCC Waivers • IRS/CMS Resource Exemptions • Extending Medicare Like Rates to non-hospital based services • ACA Educational materials • Data projects and studies

  11. TTAG/MMPC Resources • https://www.dropbox.com/home/Delegates/Temp%20Folder%20created%20by%20Jim • MMPC Action Items and Tracking List • TTAG Roster of Pending Regulations and Assignments

  12. Navajo State Medicaid Agency Study • CMS release Navajo Medicaid Study – 51st state concept for Medicaid • Report Concludes it is feasible for Navajo to administer a Medicaid Agency but many challenges: • Start-up costs $134 - $243 million • Operational budget $360 - $526 million • State & Federal concerns related to costs • CMS does not see Navajo serving non-Indians • FMAP at 100% and Medicaid maximum of 83% for non-Indians – Report estimates Navajo could generate required 17% for non-federal share • May be statutory barriers and legislative action needed

  13. Discussion?