Indian Health Amendments to the Social Security Act
Department & Agency:
Department of Health and Human Services
Administering Agency:
Centers for Medicare & Medicaid Services (CMS)
Stimulus Provisions:
Division B of the stimulus bill contains some significant Indian health provisions. Several of these provisions, now enacted, have long been sought by tribal advocates in their efforts to have the Indian Health Care Improvement Act reauthorized.
Section 5006 makes the following important amendments to the Social Security Act concerning Indian health:
Subsection (a) explicitly prohibits the imposition of enrollment fees, premiums and cost-sharing on Indians served by the Indian Health Service, a tribe or tribal organization, or an Urban Indian Organization or through the referrals to contract health, and prohibits the reduction of the reimbursement to the IHS, Tribal or Urban Indian Organization for the fees or cost-sharing.
Subsection (b) exempts certain Indian property, such as trust land, from being included as a resource or asset in determining eligibility of an individual who is an Indian for medical assistance under Medicaid and the Children’s Health Insurance Program (CHIP).
Subsection (c) continues protections currently offered by CMS to exempt certain Indian income, resources and property from Medicaid estate recovery for a deceased beneficiary for the cost of certain services provided by Medicaid to that beneficiary.
Subsection (d) requires Medicaid managed care entities (MCEs) and Primary Care Case Management companies to meet certain conditions regarding access for Indian Medicaid beneficiaries to receive Medicaid payments, including agreeing to make prompt payment to participating Indian health care providers. This section would also apply special payment provisions to certain Indian health providers that are Federally-Qualified Health Centers.
Subsection (e) would codify in statute the Tribal Technical Advisory Group, established to provide technical assistance or advice to the Centers for Medicaid & Medicare Services. This section also requires the states in which one or more Indian Health Program or Urban Indian Organization provides health services to establish a process for consultation with the Indian Health Program or Urban Indian Organizations on matters relating to Medicaid which are likely to have a direct effect on Indians or Indian health programs.
Finally, subsection (f) provides that the provisions of this entire section will take effect on July 1, 2009.
