Traditional Indian Medicine Reimbursement Advocacy Program

Grantee: Seattle Indian Health Board
Timeframe: July 2025 – June 2026 | Amount: $200,000

Traditional Indian Medicine has long been essential to American Indian and Alaska Native (AI/AN) health, but colonization and exclusion from modern healthcare systems have contributed to severe health disparities. While preliminary data shows significant mental health and substance use improvements among those accessing Traditional Indian Medicine, lack of insurance reimbursement limits availability.

A historic policy shift in 2024 allowed Medicaid and the Children’s Health Insurance Program (CHIP) coverage for Traditional Indian Medicine in four states, setting a precedent for nationwide access. Washington State must now amend its Section 1115 Medicaid waiver to secure reimbursement, but budget constraints may restrict coverage to Tribal health facilities, excluding Urban Indian Organizations (UIOs), where 81% of AI/AN individuals receive care.

Seattle Indian Health Board (SIHB) is leading advocacy efforts to ensure equitable access across the entire Indian Health Service (IHS), Tribal health facilities, and UIO system (I/T/U). With previous support from PHPDA, SIHB has pioneered policy and billing infrastructure advancements, positioning Washington State to expand Traditional Indian Medicine services statewide.

SIHB will address health disparities among American Indians and Alaska Natives by expanding advocacy efforts to make Traditional Indian Medicine a reimbursable service through a Section 1115 Medicaid Demonstration Waiver. With PHPDA funding, SIHB aims to advance reimbursement and access through four key activities: amending Washington State’s Section 1115 Medicaid waiver to include Traditional Indian Medicine, advocating at the federal level to secure approval of the waiver amendment, establishing a credentialing framework that meets state requirements for Traditional Indian Medicine providers, and developing billing procedures with Medicaid Managed Care Organizations (MCOs) for reimbursement.

In Year 1, SIHB will focus on designing the waiver amendment and initiating federal advocacy efforts. SIHB will work with state policy groups, tribal leaders, and stakeholders to propose an amendment ensuring access to Traditional Indian Medicine across Indian Health Service (IHS), Tribal health facilities, and Urban Indian Organizations (UIOs). Advocacy will emphasize the long-term cost benefits of Traditional Indian Medicine, which has demonstrated improved mental health, increased patient engagement, and better treatment adherence.

Once Washington State legislators approve the waiver amendment, the request will advance to the Centers for Medicare & Medicaid Services (CMS) for federal review. SIHB will advocate for a comprehensive implementation plan, ensuring a structured rollout that meets CMS standards for provider credentialing and billing procedures. SIHB will support state agencies in defining credentialing standards for Traditional Indian Medicine providers. SIHB’s experience with pilot projects positions it as a key advisor in navigating complexities such as service coding, billing integration, and Medicaid compliance.

ABOUT OUR GRANTEE

Seattle Indian Health Board

“Seattle Indian Health Board is a community health center that provides health and human services to its patients, while specializing in the care of Native people. We are recognized as a leader in the promotion of health improvement for urban American Indians and Alaska Natives, locally and nationally.”