Federal Guidance on Tribal Consultation

The Federal Government has enacted numerous regulations and policies that establish and define a trust relationship with Indian Tribes. Federal departments, including the U.S. Department of Health and Human Services (DHHS), have tribal consultation policies in place to guide their work with federally-recognized tribes.

The Centers for Medicare and Medicaid Services (CMS) - the agency within DHHS that is responsible for the oversight of Medicare, Medicaid, and Children's Health Insurance Program (CHIP) - has developed a draft tribal consultation policy and works closely with the CMS Tribal Technical Advisory Group.


State Medicaid Director (SMDL) Letters

As a state agency responsible for administering a federal program, the AHCCCS Administration recognizes that these regulations and policies play a significant role in the AHCCCS Tribal Consultation Policy. CMS has issued State Medicaid Director Letters that provide guidance regarding instances when state Medicaid and CHIP programs must implement consultation with tribes in their states.

  • SMDL #10-001 - 1/22/10 [PDF] | [RTF]

    This letter addresses the protections for Indians in Medicaid and CHIP set forth by the American Recovery and Reinvestment Act (ARRA), including consultation with Indian health programs and urban Indian organizations.

  • SMDL #01-024 - 7/17/01 [PDF] | [RTF]

    This letter addresses the request of Tribes to more actively participate in the planning and development of Medicaid and SCHIP waiver proposals and waiver renewals.


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