Pueblo of Zia
Talking Points
Medicaid Modernization Tribal
Consultation
March 20, 2012
·
The
Pueblo of Zia is looking forward to full implementation in the Affordable Care Act.
Specifically we support the full implementation of Medicaid Expansion,
the Health Insurance Exchange Plan, and the entire Indian Health Care
Improvement Act which is permanently reauthorized through the Affordable Care
Act.
·
Cost
Cutting Issues
o
From 2014 to 2019, the Federal government will pay
between 100% and 93% of the cost of covering these newly-eligible individuals.
After 2019, the Federal Medical Assistance Percentage (FMAP) will be 90 percent
for these Medicaid health service costs, with States contributing 10%.
o
The FMAP for AI/AN served by the Indian Health
Service (IHS) and Indian tribes and tribal organizations will remain at 100
percent.
·
The Medicaid expansion under the ACA is
projected to generate new funding to serve AI/AN. A portion of the new Medicaid
revenues will flow to Indian health programs and a portion will offset Contract
Health Service expenditures.
·
These provisions along with the creation of a
Health Insurance Exchange Plan in New Mexico will greatly expand the number of
constituents that the State will be responsible for.
·
The Pueblo of Zia agrees with the State that
this is a great opportunity to look at enhancing the health service delivery
system for American Indians in New Mexico. This includes the modernization of
the Medicaid Program.
·
Centennial Care is meant to be the States
attempt at Modernization. The Pueblo of Zia shares the concerns of the other
Tribes in this room.
·
The Pueblo of Zia is a direct service tribe.
Meaning we receive our services directly from the IHS. We are concerned about
the impact of the new program on the IHS.
·
We heard that the HSD will require the MCO to
develop contracts with the IHS and Tribally run facilities, but we need more
participation in that process. We need to be assured that the contracts are in
place prior to Centennial Care going live. The IHS is highly dependent on the
Medicaid reimbursements and therefore the Pueblo of Zia is dependent on these
reimbursements.
·
The Pueblo of Zia does not support any
mandatory requirement that puts the responsibility of health services in the
hands of the state. We have a direct relationship with the Federal Government
and resist any attempt of the state to insert itself in to that relationship.
·
The Plan must be conducive to the needs of American
Indians on and off the reservation. And work efficiently with the Indian Health
Service and tribally run programs.
·
The Pueblo of Zia feels the Plan would be most
effective if the pieces of medical, behavioral and long-term care services are
consolidated. In the past, the separation of services has created the effect of
splitting the patient.
·
Finally, The Pueblo of Zia wants to ensure that
existing Medicaid protections for American Indians remain in place and that the
IHS, tribally run facilities and urban Indian organizations are included in
health plan provider networks under Medicaid and HIE plans.
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