1 / 17

Legislative & Policy Update

Legislative & Policy Update. NW Portland Area Indian Health Board Quarterly Board Meeting April 23, 2014. Report Overview. SDPI Update Senate Committee on Indian Affairs Indian Bills FY 2014 & FY 2015 Budget Updates CSC Update DTLLs ACA Exemptions. SDPI Extended thru FY 2015.

miranda-gardner
Télécharger la présentation

Legislative & Policy Update

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Legislative & Policy Update NW Portland Area Indian Health Board Quarterly Board Meeting April 23, 2014

  2. Report Overview • SDPI Update • Senate Committee on Indian Affairs • Indian Bills • FY 2014 & FY 2015 Budget Updates • CSC Update • DTLLs • ACA Exemptions

  3. SDPI Extended thru FY 2015 • H.R. 4302 Protecting Access to Medicare Act • Commonly referred to as the Sustainable Growth Rate bill -- SGR fix • Sec. 204 Extends the Special Diabetes Program for Indians thru FY 2015 • Sec. 210 Delays implementation of ICD-10 to Oct. 1, 2015 • SDPI thru September 30, 2015 • Maintains $150 million per year less sequestered amount

  4. Senate Committee on Indian Affairs • New Chair: Sen. Jon Tester (MT) • Senators Cantwell and Crapo still on Committee • Legislation & Hearings • FY 2015 President’s Budget – March 26th • S. 1570 amend IHCIA for Advanced Appropriations • S. 919 amend ISDEAA to expand self-governance • Other Tribe specific and education, children related bills

  5. Indian Health Legislation • Advance Appropriations Bills • H.R. 3229: Don Young & Ray Lujan • S. 1570: Begich, Udall, Murkowski • Special Diabetes Program for Indians • House and Senate Sign-on letters • Indian Definition Fix • S. 1575: Senators: Mark Begich (D-AK), Max Baucus (D-MT), Tom Udall (D-NM), Brian Schatz (D-HI), Al Franken (D-MN) • Medicare-like Rates?

  6. FY 2014 Budget Highlights • FY 2014 budget $303 million increase over FY 2013 Operating Plan*** • ***Caution: Only $78 million over the FY 2014 Pre-Sequester Amount – Loss of $175 million • Program Increases for (Detail of changes): • $42.4 million for CHS • $24.9 million for facilities accounts • $71.9 million for staffing new facilities • $35 million for medical Inflation • $129.6 million for CSC

  7. FY 2014 & CSC Funding • IHS and BIA will fully fund CSC payments in FY 2014 and President’s FY 2015 budget proposes same • IHS estimated 2014 need: $587.4 million • FY 2013 Amt + 2014 Increase = $577.4 • IHS needed additional $10 million to cover CSC funding; consulted with Tribes about where to make the cuts • Reductions total $10 million made as follows: • $3 million IHS Directors Fund • $5 million from Indian Health Professions • $1 million from Self-Governance • $1 million from Tribal Management

  8. FY 2015 & CSC Funding • President’s Request includes $29.6 million CSC increase • IHS proposes to continue to fully fund CSC payments to tribes into the future • IHS Contract Support Cost Workgroup has reconvened to address substantive policy issues • Develop FY 2014 Payout Plan (Refer to Handout) • Develop Standard AFA language to deal with IHS Anti-Deficiency Act concerns • Develop two-year appropriation authority • Develop strategies to deal with new/expanded programs and changing IDC rates following payout • Analyze data to better estimate CSC need for appropriations • Develop process to better estiamate CSC need; pass-throughs and exclusions

  9. FY 2015 President’s Request • $4.634 billion for Indian Health Service • $199 million increase (4.5%) is respectable? • Staffing & New Tribes funding $78.8 million takes increase down to $120.9 million (2.7%) * • $29 million program increase for CSC * • $15.4 million program increase for CHS • Adjustments of $10 million to restore 2014 reductions (CSC) • Adjusting the increase for earmarks* leaves a balance of $91.9 million for current services (does not include CHS increase) • NPAIHB estimates at least $223 million is needed to maintain current services • President’s budget will be short by $131 million to fully fund inflation and population growth

  10. FY 2015 Detail of Changes – $199,662 mil. increase

  11. FY 2016 Budget Formulation • National IHS Budget Formulation - Feb. 26-27, 2014 in Washington DC • Representatives Andy Joseph & Steve Kutz • Recommended $779 million increase; 18% increase • $188 mil. for current services • $191 mil. for binding obligations (CSC, HFCPS, Staffing, New Tribes) • $337 mil. for program expansion (CHS, H&C, Mental Health, A/SA, Health Facilities other authorities) • $62 mil for other priorities (UIHP, facilities, dental, )

  12. Dear Tribal Leader Letters • April 2, 2014: DTLL on CSCs as it relates to the FY 2014 Consolidated Appropriations Act & Announcing on-going Consultation • March 6, 2014: DTLL IHS Director Listening Sessions • February 27, 2014: DTLL seeking input on MSPI& DVPI • February 18, 2014: DTLLupdate on the IHS Consultation & follow-up to the August 2, 2012 letter • February 12, 2014: DTLL Initiating consultation on CSC issues required in FY 2014 Consolidated Appropriations Act • January 13, 2014: DTLL changing Aberdeen Area IHS to the Great Plains Area

  13. TTAG/MMPC Updates • ACA Policy Subcommittee is very active • Tribal Exemption & I/T/U hardship exemption • Referrals and Cost Sharing Exemptions • CMS Final 2015 Letter to Issuers in FFM • and Proposed Rule including Minimum QHP Certification Standards • Revising the CMS Tribal Consultation Policy • Evaluation of CMS Strategic Plan & Updates • Alternatives for Medicaid Expansion: Arkansas Model and UCC Waivers • Indian definition issues • IRS/CMS Resource Exemptions • Extending Medicare Like Rates to non-hospital based services • ACA Educational materials • Data projects and studies

  14. Affordable Care Act Individual Mandate & Exemption • What is the ACA Tax Penalty? • What is the I/T/U Hardship Exemption and who is eligible? • How to apply for the Indian Exemption or I/T/U Hardship Exemption? • Additional Information related to exemptions and the application: • HHS instruction are forthcoming, tax filing information, • Do you need to reapply for the exemption? • What can you do to help Tribal members? • Education Tribal members and program beneficiaries • Make sure Tribal members understand the difference between Indian Exemption and the Hardship Exemption • Prepare to offer eligibility letters • Provide tax filing assistance • 2014 Penalty = 1% household income; $95/adult • 2015 Penalty = 2% household income; $325/adult • 2016 Penalty = 2.5% household income; $695/adult

  15. TTAG/MMPC Resources • https://www.dropbox.com/home/Delegates/Temp%20Folder%20created%20by%20Jim • MMPC Action Items and Tracking List • TTAG Roster of Pending Regulations and Assignments

  16. Discussion?

More Related