Urban Natives could be left behind despite budget seeking millions to cover traditional healing

This month, Medicaid and CHIP have expanded coverage of traditional healing practices, like sweat lodges and musical therapy, for tribal members across four Western states, including Arizona. But the state is responsible for the upfront costs of the two-year pilot program and still has to figure out how to pay for it.

The state budget, in part, “recognizes the importance of culturally responsive services to address the physical, mental, and emotional health of members, using methods developed and practiced by generations of Tribal healers.”

That's why Democratic Gov. Katie Hobbs is asking for $1.3 million from the general fund, and another nearly $222 million, with the latter getting reimbursed by the federal government.

But even if her proposal is approved, many urban Natives could be left behind.

“If we end up treating people referred to us by the IHS or tribes, then that would be a covered service,” according to NATIVE HEALTH of Phoenix CEO Walter Murillo. “But those who we serve directly, we wouldn’t be able to bill.”

Murillo, who sits on the Tribal Technical Advisory Group for the Centers for Medicare and Medicaid Services, or CMS, shared that California, Oregon and New Mexico have agreed to help fund their share for urban Indian organizations, but Arizona hasn’t.

“It does actually create an administrative barrier to the large population that lives in cities,” he added. “When you tie it to the recent trauma from the rehab home crisis, I think it would be a misstep to not include urbans.”

The Tucson Indian Center, NATIVE HEALTH of Phoenix, NACA in Flagstaff and Valley-based Native American Connections are currently excluded from participating in this pilot program — unless a patient is referred to them. Meaning, an enrolled tribal member cannot seek out such services from these providers on their own.

Murillo explained this bureaucratic problem could still be undone by amending Arizona's 1115 waiver with CMS to include them, but more buy-in would be needed from lawmakers at the state Capitol.

“So both are needed, and it doesn't matter who goes first,” Murillo elaborated. “If AHCCCS wants to wait for the Legislature to move, then this is that time to give the nod to CMS that Arizona is serious about providing this care.”

At the same time, AHCCCS submitted the nation’s first request for traditional healing to be reimbursed through Medicaid in 2015, and it wouldn't be until a decade later when these services would be finally eligible for coverage by health plans.

The Biden administration made the October decision allowing the program to begin at the start of this year, but now, it’s unclear how celebrity physician Dr. Mehmet Oz, who President Donald Trump tapped to oversee CMS, may tip the scale in settling this matter for Arizona's urban Indigenous population.