Summary
Incorporates and enacts the Indian Health Care Improvement Act (IHCIA) (S.1790), with some amendments, as reported by the Committee on Indian Affairs in December 2009.
Implementation Status
Upon the ACA’s immediate enactment in the spring 2010, the President hailed the reauthorization of the Indian Health Care Improvement Act (IHCIA) included in the ACA.
On September 5, 2013, GAO issued a new report in which it found that most American Indians and Alaska Natives will likely be eligible for new ACA coverage options, but that further actions are necessary to ensure their enrollment. Also, in a September 12, 2013 HHS HIV/AIDS blog post, IHS Director, Dr. Yvette Roubideaux highlighted the role of the ACA and American Indians and Alaska Natives.
On Nov. 12, CMS announced the award of $3.9M to support Medicaid and CHIP outreach and enrollment efforts targeting American Indian and Alaska Native (AI/AN) children.
2015
Of note, in a Feb. 3 blog post, SAMHSA leaders detail the role of the ACA in enhancing access to behavioral health services to the American Indian/Alaska Native (AI/AN) community.
On June 19, IHS issued a notice announcing a new limited competition to “encourage national Indian organizations, IHS, and Tribal partners to work together to conduct ACA/IHCIA training and technical assistance throughout Indian Country.” Eligible applicants are national Indian organizations. Applications are due Aug. 16.
2016
On a related note, on Feb. 26, CMS issued a SHO letter regarding payment policy updates pertaining to services “received through” an IHS/Tribal facility and furnished to Medicaid-eligible American Indians and Alaskan Natives.
On a related note, in December 2016, CMS issued an informational bulletin summarizing the Indian provisions of the final Medicaid and CHIP managed care regulation, the latter of which was published in April 2016. Also on a related note, in January 2017, CMS issued a FAQs addressing federal funding or services “received through” an IHS/tribal facility and furnished to Medicaid-eligible American Indians and Alaska Natives.
Statutory Text
SEC. 10221. INDIAN HEALTH CARE IMPROVEMENT. (a) IN GENERAL.—Except as provided in subsection (b), S. 1790 entitled ‘‘A bill to amend the Indian Health Care Improvement Act to revise and extend that Act, and for other purposes.’’, as reported by the Committee on Indian Affairs of the Senate in December 2009, is enacted into law. [The bill, as enacted and amended by subsection (b), is shown in a separate compiled document.] (b) AMENDMENTS.—[Amendments below are incorporated into the separate compiled document.] (1) Section 119 of the Indian Health Care Improvement Act (as amended by section 111 of the bill referred to in subsection (a)) is amended— (A) in subsection (d)— (i) in paragraph (2), by striking ‘‘In establishing’’ and inserting ‘‘Subject to paragraphs (3) and (4), in establishing’’; and (ii) by adding at the end the following: ‘‘(3) ELECTION OF INDIAN TRIBE OR TRIBAL ORGANIZATION.— ‘‘(A) IN GENERAL.—Subparagraph (B) of paragraph (2) shall not apply in the case of an election made by an Indian tribe or tribal organization located in a State (other than Alaska) in which the use of dental health aide therapist services or mid-level dental health provider services is authorized under State law to supply such services in accordance with State law. ‘‘(B) ACTION BY SECRETARY.—On an election by an Indian tribe or tribal organization under subparagraph (A), the Secretary, acting through the Service, shall facilitate implementation of the services elected. ‘‘(4) VACANCIES.—The Secretary shall not fill any vacancy for a certified dentist in a program operated by the Service with a dental health aide therapist.’’; and (B) by adding at the end the following: ‘‘(e) EFFECT OF SECTION.—Nothing in this section shall restrict the ability of the Service, an Indian tribe, or a tribal organization to participate in any program or to provide any service authorized by any other Federal law.’’. (2) The Indian Health Care Improvement Act (as amended by section 134(b) of the bill referred to in subsection (a)) is amended by striking section 125 (relating to treatment of scholarships for certain purposes). (3) Section 806 of the Indian Health Care Improvement Act (25 U.S.C. 1676) is amended— (A) by striking ‘‘Any limitation’’ and inserting the following: ‘‘(a) HHS APPROPRIATIONS.—Any limitation’’; and (B) by adding at the end the following: ‘‘(b) LIMITATIONS PURSUANT TO OTHER FEDERAL LAW.—Any limitation pursuant to other Federal laws on the use of Federal funds appropriated to the Service shall apply with respect to the performance or coverage of abortions.’’. (4) The bill referred to in subsection (a) is amended by striking section 201.