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CMS Updates Medicaid Payment Policy for Indian Health Services

The Indian Health Service (IHS) and tribal health facilities now can enter into care coordination agreements with non-IHS/tribal providers to furnish certain services for Medicaid-eligible American Indian (AI) and Alaska Native (AN) individuals, the Centers for Medicare & Medicaid Services (CMS) said in a Feb. 26 letter to state health officials.

Under such agreements, services for AI/AN Medicaid beneficiaries would be eligible for an enhanced federal matching rate of 100 percent.

In the letter, CMS also updated the variety of services considered to be “received through” an IHS or tribal facility to include any service that such a facility is authorized to provide that also is covered under the Medicaid state plan, including long-term services and support. This payment update is for fee-for-service, but allows for AI/AN beneficiaries to be enrolled in risk-based Medicaid managed care organizations. CMS plans to release additional guidance and will work with states to implement this policy change.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Gontscharow is a senior policy analyst for America's Essential Hospitals.

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