IHS announces tribal consultation on draft policy regarding purchasing health coverage

Policy supports tribes, urban Indian organizations that buy qualified health plans for tribal members

The Indian Health Service will conduct a 30-day consultation with tribal leaders and confer with urban Indian organization representatives on a draft policy that provides guidance to tribes, tribal organizations and urban Indian health programs on purchasing health insurance for tribal members. The tribal consultation period is open from July 18 to August 17.

Under section 402 (25 U.S.C. § 1642) of the Indian Health Care Improvement Act (IHCIA), which was made permanent under the Affordable Care Act, tribes and tribal organizations may purchase health coverage, or “sponsor” premiums, for IHS beneficiaries using federal funding to the extent available under the law.

“This new draft policy on sponsoring health premiums is one important way IHS works with and supports tribes in their efforts to enhance access to care for their members, improve third-party collections, and achieve cost savings,” said Mary Smith, IHS principal deputy director. “By using their health care funds to purchase qualified health plans for their tribal members, tribes can maximize the benefits for their members.”

For IHS patients, having health care coverage means having more health care options. This draft policy also supports IHS facilities by increasing third-party billing revenue, which in turn increases resources available for IHS to spend on patient care.

The draft circular shared today includes information on determining eligible beneficiaries and funding sources, along with recommended language to be included in new or existing contracts, compacts or funding agreements between tribes and organizations and IHS. The draft circular also provides guidance on when a health plan self-funded in part or whole with ISDEAA funds will be considered eligible for reimbursement from the IHS Catastrophic Health Emergency Fund.

Smith also sent a letter to tribal and urban leaders informing them of the circular and consultation and confer. A telephone session is scheduled for July 25, 2016. Draft Circular 16-08 is available online.

According to the IHS Tribal Consultation Policy, tribal consultation occurs when there is a critical event that may impact Tribes, new or revised policies or programs are proposed or the IHS budget request and annual performance plan are being developed. Read more about IHS Tribal Consultation.

The IHS, an agency in the U.S. Department of Health and Human Services, provides a comprehensive health service delivery system for approximately 2.2 million American Indians and Alaska Natives.