Notice2022-19085
Analyses, Research, and Studies To Assess the Impact of Centers for Medicare & Medicaid Services Programs on American Indians/Alaska Natives and the Indian Health Care System Serving American Indians/Alaska Natives Beneficiaries
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Published
September 2, 2022
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
Through a Notice of Funding Opportunity, "Analyses, Research, and Studies to Assess the Impact of Centers for Medicare & Medicaid Services (CMS) Programs on American Indians/Alaska Natives (AI/ANs) and the Indian Health Care System Serving AI/AN Beneficiaries," CMS has sought an application from the National Indian Health Board (NIHB)for a single source cooperative agreement. The funding CMS anticipates awarding under this single source cooperative agreement will support research to assess the impact of CMS programs that affect AI/ANs and the Indian Health Care System.
Full Text
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<title>Federal Register, Volume 87 Issue 170 (Friday, September 2, 2022)</title>
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[Federal Register Volume 87, Number 170 (Friday, September 2, 2022)]
[Notices]
[Pages 54219-54220]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-19085]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
Analyses, Research, and Studies To Assess the Impact of Centers
for Medicare & Medicaid Services Programs on American Indians/Alaska
Natives and the Indian Health Care System Serving American Indians/
Alaska Natives Beneficiaries
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice of a single source award.
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SUMMARY: Through a Notice of Funding Opportunity, ``Analyses, Research,
and Studies to Assess the Impact of Centers for Medicare & Medicaid
Services (CMS) Programs on American Indians/Alaska Natives (AI/ANs) and
the Indian Health Care System Serving AI/AN Beneficiaries,'' CMS has
sought an application from the National Indian Health Board (NIHB)for a
single source cooperative agreement. The funding CMS anticipates
awarding under this single source cooperative agreement will support
research to assess the impact of CMS programs that affect AI/ANs and
the Indian Health Care System.
DATES: The NIHB's application is due on September 1, 2022, and if the
application is approved, CMS anticipates awarding a single source
cooperative agreement by September 28, 2022. The anticipated period of
performance for the cooperative agreement would be from September 29,
2022, through September 28, 2027, subject to the availability of funds
and satisfactory performance.
FOR FURTHER INFORMATION CONTACT: Rhonda Martinez-McFarland, Project
Officer (206) 615-2267.
SUPPLEMENTARY INFORMATION:
I. Background
Through a Notice of Funding Opportunity (NOFO), ``Analyses,
Research, and Studies to Assess the Impact of Centers for Medicare &
Medicaid Services (CMS) Programs on American Indians/Alaska Natives
(AI/ANs) and the Indian Health Care System Serving AI/AN
Beneficiaries,'' CMS has sought an application from the National Indian
Health Board (NIHB) for a single source cooperative agreement. The
funding CMS anticipates awarding under this single source cooperative
agreement will support research to assess the impact of CMS programs
that affect AI/ANs and the Indian Health Care System, composed of
Indian Health Service (IHS) providers, providers that are Tribally
operated under the Indian Self Determination and Education Assistance
Act (ISDEAA), and providers operated by Urban Indian organizations
(collectively referred to as ITU providers). This cooperative agreement
is authorized under Section 1110 of the Social Security Act, codified
at 42 U.S.C. 1310, which authorizes federal funding for analyses,
research, and studies which will help improve the administration and
effectiveness of programs carried on or assisted under the Social
Security Act and programs related thereto.
CMS anticipates that the research conducted under this award will
help CMS to develop more effective and efficient ways to increase
access to health services and coverage for the AI/AN population,
including by improving and increasing the enrollment of AI/AN
individuals and Indian Health Care System providers in Medicare,
Medicaid, the Children's Health Insurance Program (CHIP), and Health
Insurance Marketplace[supreg] \1\ coverage. CMS also anticipates that
the research conducted under this award might help CMS develop policies
to reduce health inequities experienced by AI/AN communities.
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\1\ Health Insurance Marketplace[supreg] is a registered service
mark of the U.S. Department of Health & Human Services.
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The scope of the work under the anticipated award builds on NIHB's
past experience and knowledge and is expected to help CMS better serve
AI/AN communities. NIHB was established by federally recognized Tribes
to advocate as their united voice. NIHB seeks to reinforce Tribal
sovereignty, strengthen Tribal health care systems, secure resources,
and build capacity to achieve the highest level of health and well-
being for AI/ANs. NIHB provides culturally appropriate outreach and
education to Tribal communities to encourage enrollment of AI/ANs in
CMS programs. Data analysis conducted by NIHB is shared with Tribal
leaders to increase their knowledge of the important role CMS plays in
providing greater access to health coverage in Tribal communities. In
the past, NIHB has conducted extensive analysis of AI/AN enrollment in
Medicare, which resulted in several data symposiums and reports. More
recently, NIHB analyzed data from the American Community Survey (ACS)
to demonstrate an increase in AI/AN enrollment in Medicare and
Medicaid. NIHB's initial analysis of Medicaid enrollment noted an
increase of AI/ANs enrolled in Medicaid from 1.4 million in 2012 to 1.7
million in 2016. Through the work of NIHB, Tribal leaders and Tribal
health directors have gained a better understanding of CMS policies and
programs and their impact on the Indian Health Care System and Tribal
communities.
II. Provisions of the Notice
CMS has solicited a proposal from the NIHB to undertake analysis,
research, and studies to assess the impact of CMS programs on AI/AN
beneficiaries and the Indian Health Care System serving those
beneficiaries. The project consists of five principal tasks:
<bullet> Research and analysis of impact of CMS Regulations/
Policies on AI/ANs and on the Indian Health Care System: Assess the
ongoing impact of CMS programs through an analysis of CMS regulations,
policies, and initiatives that have a potential impact or effect on the
Indian Health Care System and on AI/ANs. The objective is to determine
the level of Tribal input in the CMS regulatory and policy formulation
process and assess whether such input was effectively considered in the
final development of CMS regulations and policies that impact AI/ANs
and the Indian Health Care System.
<bullet> Data Research and Analysis: Analysis of AI/AN demographic,
enrollment, and utilization data by reviewing CMS, IHS, Social Security
Administration (SSA), United States Census, and other data resources in
order to develop strategies that make CMS data systems capable of
reporting on AI/AN enrollment. Determine service utilization, health
status, and payment data from Medicare, Medicaid, CHIP, and Health
Insurance Marketplace[supreg] coverage. The results of this data
analysis are expected to help facilitate CMS program planning,
evaluation, performance measurement, health status monitoring, and
targeted enrollment efforts. In addition, the data analysis will
include a review of data to help address health inequities experienced
by Tribal communities in a coordinated continuous effort with CMS and
Tribal partners.
<bullet> Research & Strategic Priority Planning: Review, revise,
and provide updates to the CMS Tribal Technical Advisory Group (TTAG)
strategic plan activities to reflect the views of all federally
recognized Tribal leaders on changes to Medicare, Medicaid, CHIP, and
Health Insurance Marketplace[supreg] coverage that impact AI/ANs and
the Indian Health Care System, including changes to CMS programs
resulting from legislation, regulations, policy guidance, and new
initiatives or priorities of the agency.
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<bullet> Consultation Policy: Provide research support on the use
and effectiveness of the CMS Tribal Consultation Policy, national
consultations and listening sessions with Tribes on CMS program issues,
and annual HHS National and Regional Consultation Sessions with Tribes.
Track issues raised at Tribal consultation/listening sessions and
develop an executive summary on key issues and recommended actions for
resolution and/or further analysis.
<bullet> Enrollment and Outreach: Evaluate the effectiveness of CMS
outreach and enrollment efforts to AI/ANs enrolled in CMS-regulated
programs by conducting quarterly trainings on these programs for Tribal
enrollment assisters, ITU providers, ITU third-party resource staff,
and AI/ANs. NIHB will complete an assessment and compile best practices
to increase AI/AN enrollment in Medicare, Medicaid, CHIP, and Health
Insurance Marketplace[supreg] coverage. In addition, NIHB, in
collaboration with CMS, will develop culturally appropriate Tribal
outreach materials. The information NIHB uses to evaluate CMS outreach
and enrollment efforts will be collected based on feedback from CMS
annual ITU trainings, AI/AN outreach events, and other data sources.
NIHB, in collaboration with Tribal leadership and CMS, will summarize
lessons learned and make recommendations on how CMS could improve AI/AN
outreach efforts in Indian Country.
Amount of the Award
The total amount of funding available over a 5-year period will be
up to $4,000,000 pending availability of funds and satisfactory
performance by the recipient. The cooperative agreement will be awarded
consistent with the overall quality of the proposal and the applicant's
ability to meet project goals. The amount of funding awarded will be no
more than $800,000 per 12-month budget period, subject to availability
of funds, and there will be five 12-month budget periods under this
award. Funding for budget periods 2-5 is non-competitive and is subject
to the availability of funds as well as satisfactory performance of the
recipient. The total award will not exceed $4,000,000.
Justification for Single Source Award
In 2012, CMS awarded a five-year single-source cooperative
agreement to NIHB under Section 1110 of the Social Security Act and in
2017, CMS awarded a second five-year single source cooperative
agreement to NIHB under the same authority. With this NOFO, CMS has
sought an application from NIHB for a third five-year single source
award, under the same authority.
Through its two previous cooperative agreements, since 2012, NIHB
has provided analysis and research on the potential and actual impact
of CMS policies and guidance on AI/ANs and the Indian Health Care
System. The work has included analysis and research on Medicare and
Medicaid enrollment of AI/ANs in order to gain a better understanding
of AI/AN utilization of CMS programs.
In addition, NIHB has been instrumental in tracking CMS regulation
and policy changes, and has provided a better understanding of the
implications that CMS regulations and guidance have had for Indian
Health Care System providers and AI/AN individuals. This includes
evaluating the impact of effective and meaningful Tribal consultation.
NIHB has a long history of providing unique forums for showcasing how
CMS works within Indian Country to promote enrollment of AI/ANs and
Indian Health Care System providers in CMS programs.
Based on this past experience, NIHB is the only entity capable of
carrying out the scope of activities in Fiscal Years (FY) 2022-2027
because the scope of the work that would be performed under this award
builds on past experience and knowledge. Any other source would not
have all of the knowledge and experience NIHB has gained in the last
ten years.
Project Period
The anticipated period of performance for this cooperative
agreement is September 29, 2022 through September 28, 2027 with funding
awarded in 12-month budget increments subject to the availability of
funds and satisfactory performance.
III. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting, recordkeeping, or third-party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995 (44 U.S.C. 3501 et seq.).
The Administrator of the Centers for Medicare & Medicaid Services
(CMS), Chiquita Brooks-LaSure, having reviewed and approved this
document, authorizes Evell Barco Holland, who is the Federal Register
Liaison, to electronically sign this document for purposes of
publication in the Federal Register.
Authority: Social Security Act section 1110.
Dated: August 30, 2022.
Evell Barco Holland,
Federal Register Liaison, Centers for Medicare & Medicaid Services.
[FR Doc. 2022-19085 Filed 9-1-22; 8:45 am]
BILLING CODE 4120-01-P
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