 Native American Health Disparities November 18, 2003
Under the Indian Health Care Improvement Act (P.L. 94-437), or IHCIA, CMS (then HCFA) was tasked with paying the cost of important specialty care that is not available in Indian Health Service or tribally administered facilities. Since then, however, CMS has consistently decided to disregard the law, leading to a court challenge by the states of South Dakota and North Dakota. In both decisions the judges ruled that CMS' refusal to pay for vital referral care plays a part in perpetuating the health disparities that exist within the Native American community. "Twenty-seven years after the passage of IHCIA, Native Americans and Alaska Natives continue to experience significant health disparities," said Murkowski. "Compared to the general U.S. population, Native Americans and Alaska Natives have significantly higher rates of infant mortality, diabetes, heart disease, and traumatic injury. CMS' pattern of refusing to pay for specialty care only perpetuates the endemic health disparities," she said. Murkowski noted that the specific policy about paying for referral care, known as the 100 percent FMAP, has been a matter of debate between states, tribes, and the Department of Health and Human Services for years. The Secretary has 60 days to appeal the two rulings that found CMS responsible to pay for referral care. "We are urging the Secretary to not appeal the recent rulings, but rather acknowledge his agency's responsibility to provide American Indians and Alaska Natives full access to the benefits of our health care system. We hope the Secretary welcomes the rulings as an opportunity to show his commitment to reducing the long-standing health disparities faced by American Indians and Alaska Natives," said Murkowski.
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