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- By Native News Online Staff
The newly approved amendments in Minnesota, New Mexico, Oregon, South Dakota, Washington, and Wyoming eliminate the longstanding "four walls" restriction that previously confined Medicaid clinic services to physical clinic 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," explained CMS Administrator Dr. Mehmet Oz. "These approvals help vulnerable Americans get care when and where they need it most."
The policy change addresses urgent healthcare needs within American Indian and Alaska Native populations, who experience some of the nation's highest rates of chronic illness, substance use disorders, and complex health conditions. The expanded service delivery model is particularly crucial for reaching patients in remote and hard-to-access areas where traditional clinic visits may pose significant challenges.
CMS developed these rule changes through extensive collaboration with Tribal governments, working closely with the CMS Tribal Technical Advisory Group and the Secretary of Health and Human Services' Tribal Advisory Committee. This partnership approach helped ensure the modifications directly addressed longstanding concerns raised by Tribal communities.
The approved State Plan Amendments cover a substantial number of Tribal communities across the six participating states:
- Minnesota: 11 Tribes
- New Mexico: 22 Tribes
- Oregon: 9 Tribes
- South Dakota: 9 Tribes
- Washington: 29 Tribes
- Wyoming: 9 Tribes
Each state formally attested to adopt the mandatory exception to Medicaid's clinic services location requirements, specifically for IHS and Tribal clinic providers.
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