Tuesday, May 15, 2012

Zia Pueblo talking points on Medicaid Modernization


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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