Current Hot Topics and TSGAC Issue Briefs

Indian Health Services

• TSGAC Issue Brief – IHS-OMB Payment Rates for CY 2024 – 2025-05-25a – Posted 6/11/2024
• TSGAC Issue Brief – Steps to Update or Add Entry on the HHS ECP List – 2024-05-26a – Posted 6/11/2024
• CCIIO Marketplace Matrix
  This CCIIO Marketplace Matrix tracks key provisions in the CMS/CCIIO regulations and Issuer Letters over the 2014 – 2021 plan years, such as those applying to Essential Community Providers, inclusive of Indian health care providers. – Posted 2/19/2020
• Tribal Best Practices: Use of OMB Encounter Rate for Outpatient Prescription Drugs (OPDs) for Indian Health Care Providers 2019-04-02 – Posted 4/2/2019
• TSGAC Brief – Outpatient Prescription Drugs Reimbursement – Use of OMB Encounter Rate 2018-12-17 – Posted 4/2/2019

Covid-19

• TSGAC Issue Brief_Medicare Telehealth Coverage – Medicare Telehealth Coverage Before, During, and After the COVID-19 Public Health Emergency 7/12/2021 – Posted 9/27/2021
• TSGAC Issue Brief_COVID Stimulus_1_13_2021 FINAL[2] – Posted 1/13/2021
• TSGAC Brief – COVID-19 Testing and Treatment Coverage Provisions – 2020-05-28c – Posted 5/29/2020
• Posted 4/23/2020 – Tribal Covid19 Funding Webinar – PPT & Support Documents
  • TSGAC PowerPoint – COVID-19 Health Services Funding Programs w-Attachments 2020-04-23j
  • NIHB_FINAL_CARES Act Health Provisions Analysis_for mmpc 2
  • CARES Act Provider Relief Fund _ All HHS Programs 2020-04-22
  • Sonosky COVID-19 Funding for Indian Country CHART 04.24.20
  • NY-HospAssoc-COVID_Funding_Sources
  • COVID Funding Summary no-source 4-2-2020
  • Hobbs-Straus-Guide to Federal Coronavirus Stimulus Funding and Tribal Health Programs 2020-04-23
  • Federal Coronavirus Assistance to Tribes 04 23 20_(PDF)
• TSGAC Brief – FAQs on COVID-19-Related Income and Marketplace-Medicaid Eligibility – 2020-04-13c – Posted 4/14/2020
• TSGAC Brief – Review of Medicaid Coverage Provisions in Two Recently Enacted Coronavirus (COVID‐19) Relief Bills – Posted 3/31/2020
• TSGAC Brief – CMS Restrictions on Billing Medicaid for Services Outside Four Walls 2020-03-24b – Posted 3/24/2020

ACA Medicare/Medicaid

• TSGAC Memo -Tribal Sponsorship of Medicare Part B-D Premiums – 2024-06-11b – Posted 6/11/2024
• TSGAC Issue Brief – 2024 and 2025 FPL Handout – Medicaid and Marketplace 2024-05-27a – Posted 6/11/2024
• Updated Medicaid Unwinding Survey_Executive Summary_FINAL dated April 10 2024 – Posted 4/10/2024
• 2023 TSGAC Increasing Medicare Medicaid and Other Revenue –Posted 7/24/2023
• TSGAC Medicaid Unwinding Draft w YM_AP – Posted 7/24/2023
• Tribal Sponsorship Flow Chart– Posted 7/24/2023
• TSGAC Issue Brief: CMS Encourages States to Address Health Related Social Needs through Section 1115 Waivers – Posted 3/16/2023
• TSGAC_Briefing Paper: Summary of How the End of the Public Health Emergency Affects Pandemic-Era Medicare and Medicaid Flexibilities –Posted 3/16/2023
• Jan. 18, 2023 – ACA/IHCIA Broadcast: Medicaid Unwinding & Other Updates –Posted 1/24/2023
• TSGAC Brief – 2022 and 2023 FPL Handout – Medicaid-Marketplace-Medicare 2022-11-17c –Posted 11/22/2022
• TSGAC Brief – ACA-Medicare Provisions in Inflation Reduction Act – 2022-08-17 –Posted 8/17/2022
• TSGAC Issue Brief on Medicaid Unwinding FINAL 4.26.2022 – Posted 5/3/2022
• TSGAC Issue Brief on Medicaid Unwinding FINAL 4.26.2022 – Posted 4/26/2022
• TSGAC Issue Brief – Interaction of Eligibility for Medicare, Medicaid, and Marketplace Financial Assistance for AI/ANs – Posted 3/2/2022
• TSGAC Brief – 2021 and 2022 FPL Handout – Medicaid and Marketplace 2021-10-06a (jk) – Posted 10/7/2021
• TSGAC Issue Brief – Community Health Aid Program (CHAP) & Indian Self-Determination and Education Assistance Act (ISDEAA) – Posted 9/27/2021
• TSGAC Issue Brief – AI-AN Marketplace-Medicaid Enrollment Including Access to Cost Sharing Protections-2019-2020 dated 2021-06-15 – Posted 9/27/2021
• TSGAC – Medicaid Pharmacy Reimbursement for Tribal Programs – 2020-02-10b – Posted 2/10/2020
• TSGAC Brief – Update on State Efforts to Impose Individual Mandates after Effective Repeal of Federal Individual Mandate to Secure Health Insurance – December 11, 2019 – Posted 12/16/2019
• TSGAC Brief – Tribal Sponsorship of Medicare Part B and Part D Premiums – December 10, 2019 – REVISED –Posted 12/10/2019
• TSGAC Brief – Treatment of Indian Health Benefits, including Tribal Sponsorship Payments, as Non-Taxable Income – December 6, 2019 –Posted 12/10/2019
• TSGAC Brief – Steps to Update (or Add) Entry on the HHS Essential Community Provider List – December 6, 2019 –Posted 12/10/2019
• Posted 7/10/2019:  Oklahoma Medicaid expansion report; Webinar presentation; and 100% FMAP Claiming related documents.
  • Oklahoma Medicaid Expansion Option – TSGAC Analysis – 2019-06-30a
  • 1-Oklahoma MedExpanAnalysis-PP Presentation-TSGAC 2019-07-09h-DIST
  • 2-CMA SHO Letter 022616
  • 3-FMAP Preface
  • 4-FMAP Addendum
  • 5-CMS FAQ Services Received Through IHS or Tribal Facility
  • 6-CMS Presentation on 100% FMAP
• TSGAC Brief – 2019 and 2020 FPL Handout – Medicaid and Marketplace 2019-02-11c REV –Posted 2/12/2019
• TSGAC Brief – 2019 and 2020 FPL Handout – Medicaid and Marketplace 2019-01-27a – Posted 1/28/2019
• TSGAC Brief – 2018 and 2019 FPL Handout – Medicaid and Marketplace 2018-11-28b – Posted 11/28/2018
• TSGAC Brief – 2018 and 2019 Federal Poverty Level Handout – Medicaid, Marketplace and MSP Programs (October 31, 2018) – Posted 10/31/2018
• TSGAC-Memo-Tribal-Sponsorship-of-Medicare-Part-B-D-Premiums-2018-08-31a.pdf –Posted 8/31/2018 (REVISED)
• Update on Federal Regulations Regarding Use of Special Enrollment Periods for Lower-Income American Indians and Alaska Natives Enrolled in Medicare Part D – Posted 5/7/2018
• TSGAC – Medicaid Pharmacy Reimbursement for Tribal Programs – 2018-03-02c – Posted 3/2/2018 (*UPDATED)
• TSGAC Brief on Federal Poverty Level Thresholds – 2018 and 2019 FPL Handout – Medicaid and Marketplace 2018-02-08a –Posted 2/8/2018
• Substantial Increases in AI/AN Enrollment in Medicaid Expansion States and Ongoing Potential for Additional Increases in AI/AN Enrollment, Particularly in Non-Medicaid Expansion States (This Tribal Self-Governance Advisory Committee (TSGAC) brief seeks to provide information to Tribes on the number of American Indians and Alaska Natives (AI/ANs) gaining Medicaid coverage, by state…..) – Posted 11/9/2017
• TSGAC Memo – AI-AN Medicaid Eligibility and Enrollment – 2017-04-10c –Posted 6/28/2017
• Substantial Increases in AI/AN Enrollment in Medicaid Expansion States and On-going Potential for Additional Increases in AI/AN Enrollment, Particularly in Non-Medicaid Expansion States (Updated April 10, 2017) –Posted 4/7/2017

ACA Marketplace

• TSGAC – Medicaid Pharmacy Reimbursement for Tribal Programs – 2024-05-28e – Posted 6/11/2024
• TSGAC Brief – Applicable Percentages Thresholds and Payments for ACA Provisions – 2024-02-26a – Posted 3/4/2024
• TSGAC Update on ACA_IHCIA Project_June 21 2023 –Posted 7/24/2023
• TSGAC Brief: American Indian and Alaska Native (AI/AN) Marketplace Enrollment, Including Access to Cost-Sharing Protections –Posted 3/16/2023
• TSGAC Brief – Applicable Percentages Thresholds and Payments for ACA Provisions – 202-12-08e –Posted 12/13/2022
• TSGAC Brief-Family Glitch Fix Rule – 2022-10-13a –Posted 10/18/2022
• TSGAC Brief-AI-AN Marketplace Enroll-2021 – 2022_04_01 – Posted 5/3/2022
• TSGAC Issue Brief No Surprises Act policy brief 4.27.2022 Final copy – Posted 5/3/2022
• TSGAC Brief – American Indian and Alaska Native (AI/AN) Marketplace Enrollment,Including Access to Cost-Sharing Protections, and Medicaid Enrollment – December 20, 2019 – Posted 1/2/2020
• TSGAC Re-Review of Summary of Benefits and Coverage Docs, 2019/03/31 –Posted 3/31/2019
• TSGAC Brief – AI-AN Marketplace Medicaid Enrol-2018 – 2019-03-21a –Posted 3/31/2019
• TSGAC PP – ACA Marketplace Enrollment 2019-03-20a REV –Posted 3/31/2019
• TSGAC Letter to TTAG on Review of SBCs, 2018-03-01d –Posted 3/31/2019
• TTAG Request to CCIIO for Enforcement Action on SBCs, 2018-03-26 –Posted 3/31/2019
• TSGAC – TTAG Review of CCIIO Training Materials on Indian-Specific Cost-Sharing Protections 2018-11-01 –Posted 3/31/2019
• CCIIO Marketplace Matrix (This CCIIO Marketplace Matrix tracks key provisions in the CMS/CCIIO regulations and Issuer Letters over the 2014 – 2018 plan years, such as those applying to Essential Community Providers, inclusive of Indian health care providers.) – Posted 11/9/2017
• TSGAC Memo – Cumulative Financial Impact of the Senate Health Plan vs. the Affordable Care Act over the Family Cycle of an AI/AN Family (June 30, 2017) (This TSGAC brief examines the cumulative financial impact that health insurance legislation recently introduced in the Senate (Senate bill) would have over a “family cycle” on American Indians and Alaska Natives (AI/ANs) who meet the definition of Indian under the Affordable Care Act (ACA), as compared with current law, including the ACA) – Posted 7/3/2017
• TSGAC Memo- FAMILY CYCLE ANALYSIS: Financial Impact of the Senate Health Plan vs. the Affordable Care Act on AI/AN and Other Families (June 29, 2017) (This TSGAC brief examines the financial impact the health insurance legislation recently introduced in the Senate (Senate bill) would have on American Indians and Alaska Natives (AI/ANs) who meet the definition of Indian under the Affordable Care Act (ACA), as compared to coverage under current law, including the ACA.1 In addition, this brief provides a similar set of analyses of the impact of the Senate bill versus the ACA for others who do not meet the definition of Indian. As such, this brief provides two sets of analyses, and within each set of analyses, health insurance-related costs are presented for families with varying household income levels at different points along a continuum of “family cycle stages.”) – Posted 7/3/2017
• TSGAC – Timeline of Key ACA-Related Congressional Activities 2017-06-22d –Posted 6/28/2017
• TSGAC Matrix-Senate-House-ACA-House w-Attach as of 2017-06-28a –Posted 6/28/2017
• TSGAC Memo-FamilyCycle-Senate-MT w-Attach- 2017-06-27p –Posted 6/28/2017
• TSGAC – Timeline of Potential Administration and Congressional Action on ACA Repeal/Replace Legislation; Other Key Dates; and Activities of Tribes – Posted 6/23/2017
• Matrix of Key Elements of the House of Representatives Health Plan, Passed on May 4, 2017, With Tracking of a Series of Amendments –Posted 5/7/2017
• Analysis of Affordable Care Act (ACA) Market Stabilization Final Rule – Posted 4/20/2017
• Next on the Affordable Care Act: Funding for Cost-Sharing Protections and Marketplace Stability Programs –Posted 4/7/2017
• TSGAC Memo – AI-AN Marketplace Enrollment CSRs -2016 – 2017-03-20b – Posted 3/24/2017
• TSGAC Memo – Life Cycle analysis w-Attach -House Hlth Plan- MT – 2017-03…– Posted 3/24/2017
• TSGAC memo – Review of Amends to House Hlth Plan-w-Attach- as of 2017-03… –Posted 3/24/2017
• (UPDATED 3/13/17) TSGAC – Timeline of Key ACA-Related Congressional Activities 2017-03-13c… –Posted 3/13/2017
• (UPDATED 3/13/17) TSGAC Brief – CMS Restrictions on Billing Medicaid for Services Outside …–Posted 3/13/2017
• TSGAC – Status of Individual Mandate 2017-02-27a –Posted 3/1/2017
• TSGAC Brief – No Repeal without Replacement 2017-03-02a –Posted 3/1/2017
• Despite Large Increases in Marketplace Premiums in 2017, Net Health Insurance Costs Fall for Low- to Moderate-Income Families in Many States – PDF – Posted 1/23/2017
• tsgac-status-of-csr-payments-2017-1-6a –Posted 1/13/2017
• tsgac-memo-aca-in-2017-and-trump-ryan-health-care-plans-2017-01-06a – UPDATED 1/13/2017

Other:

• Tribal Self-Governance Priorities Web Page – Posted 1/24/2017:
  http://www.tribalselfgov.org/priorities/