Current Hot Topics & TSGAC Issue Briefs

Here you can find information regarding current hot topics and helpful TSGAC issue briefs covering Indian health services, Medicare, Medicaid, Marketplace, COVID-19, and other important healthcare issues affecting American Indian and Alaska Native communities. Explore the resources below for timely guidance, policy updates, reports, and practical information.

Indian Health Service

TSGAC Issue Brief – Update on Rule Regarding Health Reimbursement Arrangements (HRAs) and Other Account-Based Group Health Plans – Posted 6/15/26
TSGAC Issue Brief – TSGAC Brief – Applicable Percentages Thresholds and Payments for ACA Provisions – Posted 6/15/26
TSGAC Draft Issue Brief – AI/AN Marketplace Enrollment – Posted 6/15/26
TSGAC Issue Brief – IHS-OMB Payment Rates for CY 2024 – 2025-05-25a – Posted 6/11/2024
TSGAC Issue Brief – Steps to Update or Add Entry on the HHS ECP List – 2024-05-26a – Posted 6/11/2024
TSGAC Issue Brief – Community Health Aid Program (CHAP) & Indian Self-Determination and Education Assistance Act (ISDEAA) – Posted 9/27/2021
CCIIO Marketplace Matrix

Covid-19

TSGAC_Briefing Paper: Summary of How the End of the Public Health Emergency Affects Pandemic-Era Medicare and Medicaid Flexibilities – Posted 3/16/2023
TSGAC Issue Brief: CMS Encourages States to Address Health Related Social Needs through Section 1115 Waivers – Posted 3/16/2023
TSGAC Issue Brief_Medicare Telehealth Coverage – Medicare Telehealth Coverage Before, During, and After the COVID-19 Public Health Emergency 7/12/2021 – Posted 9/27/2021
TSGAC Issue Brief_COVID Stimulus_1_13_2021 FINAL[2] – Posted 1/13/2021

Medicare/Medicaid

TSGAC Brief – Guidance on Permanent Exception for Tribal Health Care Facilities Billing Medicaid for Clinic Services Provided Outside of Their “Four Walls” – Posted 3/23/26
TSGAC – Medicaid Pharmacy Reimbursement for Tribal Programs – 2025-03-16c – Posted 6/16/2025
TSGAC Brief – 2025 and 2026 FPL Handout – Medicaid and Marketplace 2025-03-31a – Posted 6/4/2025
Updated Medicaid Unwinding Survey_Executive Summary_FINAL dated April 10 2024 – Posted 4/10/2024
2023 TSGAC Increasing Medicare Medicaid and Other Revenue –Posted 7/24/2023
TSGAC Medicaid Unwinding Draft w YM_AP – Posted 7/24/2023
Tribal Sponsorship Flow Chart – Posted 7/24/2023

Marketplace

TSGAC Brief – Applicable Percentages Thresholds and Payments for ACA Provisions – 2025-03-25a – Posted 6/5/2025
TSGAC Memo -Tribal Sponsorship of Medicare Part B-D Premiums – 2054-03-27b – Posted 6/4/2025
TSGAC Update on ACA_IHCIA Project_June 21 2023 – Posted 7/24/2023
TSGAC Brief: American Indian and Alaska Native (AI/AN) Marketplace Enrollment, Including Access to Cost-Sharing Protections – Posted 3/16/2023
TSGAC Brief-Family Glitch Fix Rule – 2022-10-13a – Posted 10/18/2022
TSGAC Brief-AI-AN Marketplace Enroll-2021 – 2022_04_01 – Posted 5/3/2022
TSGAC Issue Brief No Surprises Act policy brief 4.27.2022 Final copy – Posted 5/3/2022

Other

Tribal Self-Governance Priorities Web Page – Posted 1/24/2017:
https://tribalselfgov.org/priorities/