Colorado Medicaid: Why is enrolling important?

Not only does Medicaid provide critical, often lifesaving health care, long term services and community support to children, adults and those living with disabilities, it also helps to stretch our tribal dollars so that funds can be utilized for other health-related care. Indian Health Service funding no longer meets the healthcare needs of our patients. Therefore Medicaid, as well as other resources, give patients more options for their care. Medicaid allows you to be seen locally rather than traveling to another Indian Health Facility. It will also pay for specialized care if needed at other healthcare providers or facilities.

During the years of 1975 and 1976 Congress reformed the Indian Health Service System by taking three major steps: passing the Indian Healthcare Improvement Act, Indian Self-Determination and Education Assistance Act and provided 638 Tribal Health Facilities with greater access to Medicare and Medicaid.

Under the Indian Healthcare Improvement Act of 1976, the IHS/MOA rate was established providing Tribal 638 health facilities, like SUHC, a higher reimbursement rate for each medical visit. This increased reimbursement rate provides Tribal Health Centers increased revenue, which translates to additional and more specialized health services.

Only Tribal Health Facilities can acquire this increased reimbursement rate on per patient visit.

Additionally, with the passing of Obama Care or the Patient Protection and Affordable Care Act in 2010, Tribal 638 Health Facilities were provided with an expansion of billable medical services through the State Medicaid system. This expansion of billable medical services allows 638 Tribal Health Facilities to reach a level of financial solvency and not to solely rely on IHS dollars.

As many of you are aware, Medicaid is jointly funded by state and the federal government. Each state designs their Medicaid program to provide federally mandated programs in addition to services for special populations that are a priority in the state. Federally mandated services are directed to both children and adults based on specific eligibility criteria and includes hospital services, home healthcare services, laboratory and x-ray services and Nursing Home Care.

States must also provide Early Periodic Screening, Diagnosis and Treatment services for eligible children. States may also offer optional services including prescription drugs, dental care, physical and other therapy services. Medicaid is also important for individuals with disabilities and chronic health conditions which may require long term care to maintain their health, independence and wellbeing.

The Southern Ute Health Center is growing, we have hired two additional fulltime medical providers, one who specializes in internal medicine and managing complex disease; the other is a well-respected primary care physician in the Durango area. We also are welcoming our first fulltime [in-house] physical therapist, who is board certified in orthopedic medicine.

When members of the Southern Ute Tribe utilize the services at the health center, we exercise the Tribe’s sovereignty and provide expanded healthcare services to our membership.

We are proud to serve the people of the Southern Ute Tribe, and welcome you to meet our staff and learn more about how we provide healthcare. This is the first article in a series of articles introducing our new providers and sharing our passion for good health.

If you are interested in enrolling in Medicaid, please contact Savannah Benally at 970-563-2204. Savannah can help you with the process including reviewing the exemptions in place for tribal members when it comes to qualifying for Medicaid. We encourage everyone to take advantage of this program to expand your options for care as well as stretch our funding for other healthcare options.

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