Introduction

The Tribal Technical Advisory Group (TTAG) is a group of elected tribal leaders, or an appointed representative from their Area, who are nominated from the twelve areas of the Indian Health Service (IHS) delivery System. The TTAG serves as an advisory committee to the Centers for Medicare & Medicaid Services (CMS) on important health care matters associated with the Medicare, Medicaid, and State Children Health Insurance Programs. There is a Principal Member and an Alternate from each of the twelve service areas. These areas are: Alaska, Aberdeen, Albuquerque, Bemidji, Billings, California, Nashville, Navajo, Oklahoma, Phoenix, Portland, and Tucson. In addition to these twelve areas, there is representation from the three Washington, DC based advocacy organizations: Tribal Self Governance Advisory Committee, National Indian Health Board, and National Congress of American Indians.

Recently the TTAG has divided into smaller subcommittees (Adobe Acrobat PDF) to analyze major Medicare and Medicaid topics effecting AI/ANs in greater detail. Individual TTAG and MMPC members along with employees from the CMS and IHS are subcommittee members. These subcommittees include, but are not limited to: Across State Borders, Durable Medical Equipment, Federal Supply Schedule, Medicare Administrative Match, Outreach and Education and the Strategic Plan, Medicare Part B, Equitable Relief, and Tribal Consultation subcommittees.

For more information about the TTAG and the MMPC Technical Advisors, please refer to the document Tribal Technical Advisory Group Membership (WORD DOC).

 

CMS Issues Final Rule for Meaningful Use of Electronic Health Records

On July 13, 2010, the Centers for Medicare and Medicaid Services issued the final rule “Medicare and Medicaid Programs; Electronic Health Record Incentive Program.” The Health Information Technology for Economic and Clinical Health (HITECH) Act created incentive payments for medical providers to convert to electronic health systems, if they achieve meaningful use of the systems. The rule provides the basis for what constitutes “meaningful use.” The Notice of Proposed Rule Making prompted more than 2,000 comments, according to the Department of Health and Human Services (HHS). Key changes made in the final rule according to the agency include:

• Greater flexibility with respect to eligible professionals and hospitals in meeting and reporting certain objectives for demonstrating meaningful use. The final rule divides the objectives into a “core” group of required objectives and a “menu set” of procedures from which providers may choose any five to defer in 2011-2012. This gives providers latitude to pick their own path toward full EHR implementation and meaningful use.
• An objective of providing condition-specific patient education resources for both EPs and eligible hospitals and the objective of recording advance directives for eligible hospitals, in line with recommendations from the Health Information Technology Policy Committee.
• A definition of a hospital-based EP as one who performs substantially all of his or her services in an inpatient hospital setting or emergency room only, which conforms to the Continuing Extension Act of 2010
• CAHs within the definition of acute care hospital for the purpose of incentive program eligibility under Medicaid.

Resources for Meaningful Use Rule

• HHS Press Release
• Final Rule
• Standards and Certification Final Rule Fact Sheet

For more information about the final rule, including background information and fact sheets on incentives for Medicare and Medicaid, click here.

 

CMS Letter regarding Medicaid Changes in PPACA 2010

CMS is pleased to announce the release of the first letter in a series of guidance regarding the Medicaid changes and improvements that are included in the Patient Protection and Affordable Care Act of 2010 (the Affordable Care Act) as amended by the Health Care and Education Reconciliation Act of 2010.  
 
Specifically, this letter provides initial guidance on section 2001 of the Affordable Care Act, Medicaid Coverage for the Lowest Income Populations, which establishes a new Medicaid eligibility group and the option for States to begin providing medical assistance to individuals eligible under this new group as of April 1, 2010.  For the first time since the Medicaid program was established, States will be able to receive Federal Medicaid funding to provide coverage under their State Medicaid plan for the lowest income adults, without regard to disability, parental status or most other categorical limitations.
 
States may elect to phase-in coverage for this new eligibility group at any time, but for an effective date of April 1, 2010, States need to submit amendments to their State plans by June 30, 2010.  We are looking forward to working closely with States as they consider implementing this important new option.  
 
Click here to download a copy of the CMS Letter.

 

CHIPRA Guidance on Express Lane Eligibility and Prospective Payment for FQHCs

Today Center for Medicaid and State Operations (CMSO) announces the release of two (2) letters to State Health Officials as part of our series that provides guidance on implementation of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). CHIPRA includes many provisions designed to give States the tools they need to effectively enroll eligible children in Medicaid and Children’s Health Insurance Program (CHIP) coverage.

• One of the key tools that CHIPRA offers is the Express Lane Eligibility option. Section 203 of CHIPRA permits States to rely on findings from an Express Lane agency to conduct simplified eligibility determinations and facilitate enrollment in Medicaid and CHIP. This provision was effective upon enactment of CHIPRA, February 4, 2009. This letter and enclosures provide guidance on Express Lane eligibility option to enable States to effectively pursue this strategy. To download a copy of the letter click here.
• Section 503 of CHIPRA, which makes section 1902(bb) of the Act, the provision that governs payment for federally qualified health centers (FQHCs) and rural health clinics (RHCs), applicable to CHIP in the same manner as it applies to Medicaid. Medicaid programs make payments for FQHC/RHC services in an amount calculated on a per-visit basis that is equal to the reasonable cost of such services documented for a baseline period, with certain adjustments, or to use an alternative payment methodology to pay for FQHC and RHC services. Section 503 of CHIPRA also authorizes $5 million in transition grants to assist States in meeting the requirements of this provision, which will be announced later this month. To download a copy of the letter click here.

We look forward to our continuing work with States in implementing these and other provisions of CHIPRA. If you have questions regarding this guidance, please contact Ms. Vikki Wachino, Director of the Family and Children’s Health Programs Group at 410-786-5647.