The Centers for Medicare & Medicaid Services (CMS) is expanding access to vital care for American Indian and Alaska Native communities by approving Medicaid State Plan Amendments (SPAs) in several states. Indian Health Service (IHS) and Tribal clinics in Minnesota, New Mexico, Oregon, South Dakota, Washington, and Wyoming are now authorized to provide Medicaid clinic services beyond the physical clinic site, including in homes, schools, and other appropriate community locations.
“Until last year, federal rules prevented IHS and Tribal Medicaid clinic services providers from delivering Medicaid clinic services to vulnerable Tribal patients outside the four walls of the clinic,” said CMS Administrator Dr. Mehmet Oz. “These approvals help vulnerable Americans get care when and where they need it most.”
CMS worked extensively with Tribal governments, the CMS Tribal Technical Advisory Group, and the Secretary of Health and Human Services’ Tribal Advisory Committee to help ensure the rule changes addressed longstanding tribal concerns.
American Indian and Alaska Native individuals face some of the highest rates of chronic illness, substance use disorders, and complex health needs nationwide. Today’s action gives IHS and Tribal Medicaid clinic service providers in several states greater flexibility to deliver care where their patients need it most, including in hard-to-reach and remote areas.
The approved SPAs reflect each state’s formal attestation to adopt the mandatory exception to the Medicaid clinic services “four walls” requirement for IHS and Tribal clinics. This change helps ensure that Medicaid funding can support the delivery of community-based clinic services delivery for eligible American Indian and Alaska Native populations in:
- Minnesota (11 Tribes)
- New Mexico (22 Tribes)
- Oregon (9 Tribes)
- South Dakota (9 Tribes)
- Washington (29 Tribes)
- Wyoming (9 Tribes)
CMS remains committed to strengthening Medicaid’s core mission—serving vulnerable populations, delivering value to taxpayers, and ensuring the program operates efficiently and with integrity.
For more information on each state’s SPA approval, visit Medicaid.gov:
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