Covering Indian Country – April 2023

April 2023

Spotlight: Navigating Medicaid and CHIP Eligibility Renewals

On March 31, the Medicaid continuous enrollment condition ended. This means state Medicaid and the Children's Health Insurance Program (CHIP) have resumed full Medicaid and CHIP eligibility renewals and begun terminating coverage for individuals who are no longer eligible.

Enrollment assisters and outreach workers play key roles in helping tribal Medicaid and CHIP beneficiaries through the unwinding process to make sure there are no gaps in health care coverage. Enrollment through Medicaid, CHIP, or the Marketplace provides greater access to services and results in more resources for tribal health programs by saving purchased and referred care dollars.

To better assist Medicaid and CHIP beneficiaries, CMS has created many resources, including the Anticipated 2023 State Timelines for Initiating Unwinding-Related Renewals as of February 24, 2023 (PDF, 93 KB, 2 pp).

For the most current information about Medicaid and CHIP renewal processes, we encourage all enrollment assisters and outreach workers to check state Medicaid websites and visit CMS's webpage on Medicaid and CHIP coverage renewals. Additionally, you can access tribal-specific resources and tools related to unwinding online.

When communicating with Medicaid and CHIP beneficiaries, please include the following three key messages:

• Update your contact information – Make sure the state Medicaid agency or CHIP program has your current mailing address, phone number, email address, or other contact information so they can contact you about your Medicaid or CHIP renewal
• Check your mail – State Medicaid agencies or CHIP programs will mail you a letter about your Medicaid or CHIP coverage
• Complete your renewal form (if you get one) – Fill out the form and return it to the state Medicaid agency or CHIP program right away to help avoid a gap in your Medicaid or CHIP coverage

Enrollment assisters and outreach workers play key roles in helping tribal Medicaid and CHIP beneficiaries navigate the unwinding process.

If you are or will be assisting Medicaid and CHIP beneficiaries with the continuous enrollment process, please review the updated communications toolkit, Medicaid and CHIP Continuous Enrollment Unwinding (PDF, 3.2 MB, 21 pp).

Additionally, check out the Medicaid Unwinding Toolkit Supporting Materials (ZIP, 47 MB). These materials include important information and resources to help inform people with Medicaid or CHIP about steps they must take to renew their coverage or, if they are no longer eligible for Medicaid or CHIP, to find other health care coverage through the Marketplace or Medicare.

People who no longer qualify for Medicaid or CHIP should be advised to visit HealthCare.gov to find out if they are eligible to enroll in a Marketplace plan. Let them know they may be able to purchase a health plan through the Marketplace while receiving help to pay for it. Four out of five enrollees can find plans that cost less than $10 a month and offer coverage for prescription drugs, visits with a health care provider, urgent care, and more.

Individuals whose Medicaid or CHIP eligibility has ended should be encouraged to enroll in a Marketplace plan as soon as possible to avoid a gap in their health care coverage. For more information, visit HealthCare.gov or contact the Marketplace at (800) 318–2596.

Special protections, such as zero or limited cost-sharing, apply to members of federally recognized tribes and Alaska Native Claims Settlement Act (ANCSA) corporation shareholders in the Marketplace. For more information about those special protections, please download Health Coverage Options for American Indians and Alaska Natives (PDF, 195 KB, 10 pp).

You may meet people who were covered by Medicaid until recently but did not enroll in Medicare when they first became Medicare-eligible. Please let them know about the six-month Medicare special enrollment period, which allows them to sign up for Medicare without paying a late enrollment penalty. More information on Medicare enrollment and coverage can be found at Medicare.gov.

Connecting Kids to Coverage HEALTHY KIDS

On March 30, CMS announced the Connecting Kids to Coverage (CKC) HEALTHY KIDS American Indian and Alaska Native (AI/AN) 2023 Outreach and Enrollment Cooperative Agreements grantees. Over $5.9 million in funding was awarded to the following tribal and urban Indian health programs in six states:

• All Nations Health Center in Montana
• The Chickasaw Nation in Oklahoma
• Choctaw Nation of Oklahoma
• Denver Indian Health and Family Services, Inc., in Colorado
• Fallon Paiute-Shoshone Tribe in Nevada
• Indian Health Board of Minneapolis, Inc., in Minnesota
• Indian Health Council, Inc., in California

The CKC outreach and enrollment grants provide funding to reduce the number of AI/AN children who are eligible for, but not enrolled in, Medicaid and the Children’s Health Insurance Program (CHIP), and to improve retention of eligible children who are enrolled in the programs.

This funding will support innovative outreach strategies aimed at:

• Increasing the enrollment and retention of eligible AI/AN children, parents, and pregnant individuals in Medicaid and CHIP
• Educating families about the availability of free or low-cost health coverage under Medicaid and CHIP
• Identifying children likely to be eligible for these programs
• Assisting families with the application and renewal process during the COVID-19 public health emergency unwinding period

Grantees will provide outreach by:

• Partnering with tribal programs that work with children and families
• Engaging schools and other programs serving young people in outreach, enrollment, and retention activities
• Establishing and developing application assistance resources to provide high quality, reliable Medicaid/CHIP enrollment and renewal services in local communities
• Using social media to conduct virtual outreach and enrollment assistance
• Using parent mentors and community outreach workers to assist families with enrolling in Medicaid and CHIP, retaining coverage, and finding resources for addressing social determinants of health

April: Injury prevention

Share this ad in your newsletter or on your website. For more information, please visit CMS’s Outreach and Education Resources page.

Health observances

April is National Minority Health Month

This year, the theme of National Minority Health Month is Better Health Through Better Understanding, which highlights the importance of health literacy. The U.S. Department of Health and Human Services is committed to the long-term goal of eliminating health disparities, achieving health equity, and attaining health literacy. One way to promote health literacy is to help patients feel more comfortable about asking questions and talking openly. To that end, the IHS Health Literacy Workgroup recommends health care providers use the Let's TALK approach during every patient encounter. The approach sets the stage for patients to: Tell providers what is going on Ask what can be done about it Learn from providers about where to get more information Act on this information to Keep healthy

National Infant Immunization Week: April 24–30

Routine vaccinations during the first year of life offer protection from diseases such as hepatitis B, polio, and whooping cough.

In observance of National Infant Immunization Week, please remind families that vaccinations are covered as preventive care benefits.

Also, share the link to CDC's parent-friendly immunization schedule for children age 6 years and younger.

Additional resources

Online suicide prevention training for rural communities

SafeSide Prevention has partnered with the University of Rochester Medicine Recovery Center of Excellence to offer online suicide prevention training for service providers in rural communities. The training includes a half-day interactive workshop, followed by one year of ongoing support in the form of: A weekly newsletter Monthly Q&A video calls An online discussion forum Service providers may opt to attend the May 23 or July 25 workshop. Both workshops will begin at 12 p.m. Eastern. Workshop content will highlight issues specific to youth, substance use, and tribal communities.

Funding opportunities

Targeted violence and terrorism prevention

Deadline: April 25
View the targeted violence and terrorism prevention funding opportunity

Department of Homeland Security funds are available to support online, in-person, and hybrid programs that address the threat of violence in virtual and or physical spaces.

Approximately 35–38 grants will be awarded for a two-year performance period. Tribes are encouraged to apply.

Tribal home visiting program cooperative agreements

The Administration for Children and Families, Office of Early Childhood Development, is offering two types of cooperative agreements to fund evidence-based home visiting programs for expectant families and families with young children.

• The development/implementation cooperative agreements are intended for tribes, tribal organizations, and urban Indian organizations (UIOs) that do not have prior experience implementing evidence-based home visiting programs and are not currently implementing such a program.
• Approximately 16 development/implementation cooperative agreements will be awarded for a 63-month performance period. The deadline to apply is May 1.
• The implementation/expansion cooperative agreements are intended for tribes, tribal organizations, and UIOs that currently operate evidence-based home visiting programs.
• Approximately 28 implementation/expansion cooperative agreements will be awarded for a five-year performance period. The deadline to apply is May 31.

USDA grants to increase access to fresh local food

Deadline: May 2

Two U.S. Department of Agriculture (USDA) programs are offering grants for projects to help increase consumer access to fresh local food and develop new market opportunities for farmers and other agricultural businesses.

• The Farmers Market Promotion Program supports efforts to expand and improve the operation of farmers markets and roadside stands.
• The Local Food Promotion Program supports food hubs, community-supported agriculture, and other intermediaries that connect food producers and consumers.

Tribal governments are eligible to apply.

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