American Indian/Alaska Native

The Center for Medicare and Medicaid Services (CMS) Division of Tribal Affairs works closely with American Indian and Alaska Native (AIAN) communities and leaders to enable access to culturally competent healthcare to eligible to CMS beneficiaries in Indian Country. CMS collaborates with the Indian Health Service and other federal partners to facilitate access to high quality and timely healthcare.

Through Medicare, Medicaid and Children’s Health Insurance Program (CHIP) and the Health Insurance Marketplace, CMS contributes to the delivery of healthcare to AI/ANs. Funding from these program accounts for a significant portion of the Indian health care budget. Due to the special relationship between the federal government and Indian Tribes, CMS frequently has special rules when working with the Indian Health Service, Tribes and Urban Indian programs (I/T/Us).

CMS developed a video on The Role of CMS in Indian Health Care that highlights the history of Indian Health Care, CMS Tribal Consultation and the significant impact that CMS programs have in Indian Country.  

CMS established a Tribal Technical Advisory Group (TTAG) in 2004 to seek input and advice on policies and strategies to increase AI/AN access to CMS programs. TTAG adopted a 2010-2015 Strategic Plan that sets out three targets: (a) establishing and improving access to CMS funded long term care services; (b) implementing strategies to increase AI/AN enrollment in CMS programs; and (c) identifying current and future administrative, regulatory, and legislative policies that affect AI/AN beneficiaries and providers.

In 2009, the American Reinvestment and Recovery Act (ARRA) codified the TTAG/CMS relationship which strengthens the collaboration between CMS and I/T/Us. The Children’s Health Insurance Program Reauthorization Act (CHIPRA) added new provisions to eliminate barriers and fund innovative strategies to increase enrollment in Medicaid and CHIP, specifically for AI/AN beneficiaries. The Affordable Care Act of 2010 (ACA) expanded health coverage to millions of uninsured individuals, strengthened the coverage of those already insured, and expanded programs like Medicaid, CHIP, and Medicare. Within the vast reforms in the ACA, AI/AN populations will be affected not only by the general provisions but through specific, explicit provisions, including the permanent reauthorization of the Indian Health Care Improvement Act.

CMS has funded a number of initiatives to improve healthcare services to American Indian and Alaskan Native individuals who are eligible for CMS programs. This site provides background, practical tools and evidence-based strategies for AI/AN communities to navigate through federal and state requirements to provide for healthcare services. For more information about CMS initiatives in Indian Country, contact TribalAffairs@cms.hhs.gov or visit your CMS Native American Contact (NAC) (PDF).