The President of the Navaho Nation http://www.navajo-nsn.gov Russell Begaye met with HHS https://www.hhs.gov directors during a Navajo Regional Tribal Consultation in June to present the tribe’s priority health concerns to HHS. President Begaye requested that a Navajo owned and operated “Managed Care Organization (MCO) is needed to expand the Navajo nation’s current health system.
President Begaye explained, “The level of healthcare services that the Navajo Nation needs to deliver is equivalent to the level provided by outside healthcare facilities. However, adequate specialty care isn’t available across the Navajo Nation. The Navajo Nation is working to expand specialty care services to include oncology, cardiology, 24/7 clinics and pediatrics.
In order to build these specialty facilities, the Navajo Nation is going to implement their own MCO, initially to the membership in New Mexico. By managing Medicaid coverage for Navajo tribal members in New Mexico, the Navajo Nation stands to capture millions in Medicaid reimbursements that currently go to outside healthcare facilities in New Mexico.
President Begaye reports, “The amount of revenue that this venture can produce for the Navajo nation will be reinvested in developing the programs needed to address the existing health disparities.”
Although there will be provisions for non-tribal members to opt into the Navajo MCO, these provisions will only accommodate non-tribal members who live on the Nation or in counties where Navajo health facilities exist. President Begaye is also requesting that HHS continue to support CMS in developing guidelines and regulations when implementing Indian Managed Care legislation.