Aberdeen Area ND and SD Findings

1. Aberdeen AreaND and SD Findings December 11 – 15, 2006Facility visits Centers for Medicare & Medicaid Services (CMS) Tribal Affairs Group

2. Who is CMS? • Centers for Medicare & Medicaid Services (CMS) • Sister Agency to IHS – HHS • Administer the Medicareprogram directly • Participate financially and establish broad parameters for States in the administration of Medicaid and SCHIP • Exceptions within regulations respective to IHS and Tribal 638 programs.

3. Meet with Tribal leaders & administrators Why? Operating Income Tribal members hesitant to enroll in Medicare and Medicaid Belief health care is a federal trust responsibility Tribal members should not have to: fill out applications, pay cost sharing, divulge personal information Facility visits

4. Aberdeen Area • Issues consistent • Mix of IHS and CMS responsibility • General lack of understanding as to CMS

5. Findings: • Lack of understanding of • Medicare and Medicaid • State Medicaid Plans/services • Need access to mental health services • Payment for CHR services • Long Term Care options • Rx Script refill limited - 30 days

6. Findings con’t: • Medicaid payments per day • DME – Tribes unaware that IHS can be a DME supplier • Lack of understanding of EMTALA • Poor working relationships with State Medicaid Agencies • Contract Health Services referrals and payments to private hospitals.

7. Goals: • Provide information in follow-up meeting • Encourage partnerships • Highlight best practices • Foster better: • Working relationships • Understanding of Medicare, Medicaid & SCHIP • Increase Enrollment and Income