93.341: Analyses, Research and Studies to Address the Impact of CMS’ Programs on American Indian/Alaska Native (AI/AN) Beneficiaries and the Health Care System Serving these Beneficiaries

93.341

Active

Centers for Medicare and Medicaid Services (CMS) [HHS]

Aug. 23, 2022

Aug. 23, 2022

To further CMS’ mission and goals related to providing high quality health care to the American Indian/Alaska Native (AI/AN) community by providing research and analysis to increase the understanding of, access to, and impact of CMS’ programs in Indian Country. Congress authorized AI/ANs to have access to Medicare and Medicaid services when provided through Indian Health Service (IHS) facilities located in tribal communities and amended titles XVIII and XIX of the Social Security Act to permit IHS facilities to bill Medicare and Medicaid for services provided to eligible AI/ANs. This authority was later extended to tribal facilities. Congress has also provided authority for Indian health care programs and beneficiaries to participate in the Children’s Health Insurance program and the Health Insurance Marketplace. These changes have created a direct relationship between CMS and the Indian Health Service, The research conducted under this cooperative agreement is needed to help improve administration of CMS’ programs given that CMS and IHS programs operate under different and sometimes competing authorities for CMS’ programs, the Social Security Act and for IHS’ programs, the Indian Health Care Improvement Act and the Indian Self Determination Education and Assistance Act, P.L. 93-638. To make CMS’ programs work with Indian health program authorities, a crucial first is step is for CMS to understand the impact of its policies on Indian health care providers and tribal members so that the agency can provide the AI/AN community greater access to CMS’ programs in an effective and efficient manner. The authority at Section 1110 of the Social Security Act permits CMS to enter into grants andcooperative arrangements with organizations and certain other entities in order to aid in improving administration and effectiveness of programs administered by the agency. To this end, the work conducted under this cooperative agreement will address the potential and actual impacts of CMS’ programs on AI/ANs and the health care system serving these beneficiaries. CMS’ understanding of the impact of its policies is vital to improving greater AI/AN access to and participation in CMS’ programs; improving and ensuring that appropriate health care payments and resources are provided to IHS tribal, and urban Indian Health program providers; and contributing to overall improved health outcomes for Indian people. The information and activities produced or provided under the cooperative agreement will be used to develop culturally appropriate activities and strategies to improve how CMS’ program operate and are administered in Indian country.

B - Cooperative Agreements (Discretionary Grants)

Eligibility is limited to the National indian Health Board, and this single source award was approved by the Chief Grants Management Officer. NIHB meets the definition of “tribal organization”under the Indian Health Care Improvement Act (IHCIA) 25 USC Section 1603(26), with significant historical experience in providing outreach and education and the provision of health care information for Indian Tribes and Tribal Organizations. NIHB is a legally established organization controlled and governed by Indians and includes the maximum participation of Indians in all phases if its activities. NIHB has 100 percent appointed or elected officers that comprise the Board of Directors. NIHB acts in a supportive role to ensure the dissemination of health care education and information to tribes. NIHB must submit a copy of the 501(c) (3) Non-profit Certifion as proof of non-profit status. Applicant must have an Employer Identification Number (EIN), otherwise known as a Taxpayer Identification Number (TIN), to apply. Applicant must have a Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS) number. The DUNS number is a nine-digit identification number that uniquely identifies business entities. To obtain a DUNS number, access the following website: http://www.dnb.com/ or call -866-705-5711. This number should be entered in the block 8c (on the Form SF-424, Application for Federal Assistance). The organization name and addressed entered in block 8a and 8c should be exactly as given for the DUNS number. Applicant should obtain this DUNS number immediately to ensure all registration steps are completed in time. Applicant must also register in the Central Contractor Registration (CCR) database in order to be able to submit the application. Applicant should begin the CCR registration process immediately to ensure that it does not impair ability to meet required submission deadlines.

The primary beneficiaries of this effort are American Indians and Alaska Natives who are eligible for CMS’ programs to get them educated about and enrolled in CMS’ programs, as appropriate, ensure that Indian health care providers can participate and are enrolled in CMS programs ,and to reduce health disparities in tribal communities. By enrolling in CMS’ programs, AI/ANs benefit by having greater access to services that may not be provided by their local Indian health care providers, and tribal communities benefit through increased resources to their Indian health care programs. The Federal government will benefit by obtaining information to help make more informed policies which will improve administration of CMS’ programs in tribal communities and therereby provide AI/ANs access to quality health care. Federally Recognized Indian Tribal Governments and Native American Organizations would benefit because they can provide information and insight to help CMS understand the tribal provider and tribal beneficiary perspective so that CMS can make informed policies decisions that would permit CMS’ programs to be administered and operate effectively and efficiently in tribal communities and not conflict with legislative/regulatory authority under which the Indian Health Service programs operates.

93.621 - Affordable Care Act Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents

https://sam.gov/fal/2e7fdb9c5b8b4210a84cf4bdb87d6f99/view