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About Smoke signals. (Grand Ronde, Or.) 19??-current | View Entire Issue (Dec. 15, 2017)
S moke S ignals DECEMBER 15, 2017 3 Pharmacy switching to all- inclusive medication rate State amendment could potentially save Oregon Tribes millions By Danielle Frost December • Monday, Dec. 25 – Christmas Day. Tribal offices closed. • Wednesday, Dec. 27 – Tribal Council meeting, 4 p.m., Tribal Council Chambers, 9615 Grand Ronde Road. 503-879-2301. • Sunday, Dec. 31 – New Year’s Eve Sobriety Event, 3 p.m., Northern Lights Theatre, 3893 Commercial St. S.E., Salem. 503-879-1489. January • Monday, Jan. 1 – New Year’s Day. Tribal offices closed. • Sunday, Jan. 7 – General Council meeting, 11 a.m., Tribal Community Center, 9615 Grand Ronde Road. 503-879-2301. • Wednesday, Jan. 10 – Tribal Council meeting, 4 p.m., Tribal Council Chambers, 9615 Grand Ronde Road. 503-879-2301. • Monday, Jan. 15 – Martln Luther King Jr. Day. Tribal offices closed. • Wednesday, Jan. 24 – Tribal Council meeting, 4 p.m., Tribal Council Chambers, 9615 Grand Ronde Road. 503-879-2301. February • Sunday, Feb. 4 – General Council meeting, 11 a.m., Portland site to be determined. 503-879-2301. • Wednesday, Feb. 7 – Tribal Council meeting, 4 p.m., Tribal Council Chambers, 9615 Grand Ronde Road. 503-879-2301. • Monday, Feb. 19 –Tribal Chiefs’ Day. Tribal offices closed. • Wednesday, Feb. 21 – Tribal Council meeting, 4 p.m., Tribal Council Chambers, 9615 Grand Ronde Road. 503-879-2301. Official Tribal Facebook pages • Confederated Tribes of Grand Ronde: www.facebook.com/CTGRgov • Grand Ronde Tribal Council: www.facebook.com/TheConfederatedTribesOfGrandRondeTribalCouncil • Grand Ronde Higher Education: www.facebook.com/grand.r.ed • Grand Ronde Youth Education: www.facebook.com/CTGRYouthEducation • Spirit Mountain Community Fund: www.facebook.com/SpiritMountainCommunityFund • Grand Ronde Station: www.facebook.com/GrandRondeStation • Grand Ronde Royalty: www.facebook.com/CTGRRoyalty • Veterans Special Event Board: www.facebook.com/pages/Veterans-Board-of-the-Confederated-Tribes-of- the-Grand-Ronde-Community • Community Garden: www.facebook.com/GrandRondeCommunityGarden • Grand Ronde Food Bank: www.facebook.com/GrandRondeFoodBank • Grand Ronde Youth Council: www.facebook.com/CTGRYouthCouncil • Grand Ronde Tribal Police Department: www.facebook.com/grandrondepolice/ • Children & Family Services: www.facebook.com/CTGRCFS/ • Social Services Department: www.facebook.com/CTGRSocialservices/ Ad created by George Valdez Smoke Signals staff writer A new state amendment will change how all nine Oregon Tribes are reimbursed for medications covered by Medicare and Medicaid, a move that could potentially mean $500,000 to $5 million in increased annual revenue. Currently, Tribal pharmacies in Oregon are reimbursed at cost per medication. The state amendment allows for an opt-in, all-inclusive rate of $392 that has no per-day cap. This will encourage 90-day fills and medication coordination, Grand Ronde Pharmacy Director Leatha Lynch said. She said that most states cap all-inclusive rates at one to two pre- scriptions per patient per day, but the Oregon Health Plan amendment will allow the pharmacy unlimited prescriptions per day, per patient. Additionally, any cost exceeding $500 can be billed under a separate billing number, at cost, to prevent Tribes from losing money on some of the high-usage and more expen- sive medications, such as those for hepatitis, HIV, cancer and diabetes. “This is so exciting and will change the way that Medicare and Medicaid pay Tribes for all phar- maceuticals for our Native brothers and sisters in Oregon,” Lynch said. Oregon Health Authority repre- sentatives discussed the changes during a cluster meeting held at the Tribal Community Center on Wednesday, Nov. 29. The amendment will be backdat- ed to Oct. 1, 2017, for any Tribes that choose to participate. It is not required and Tribes can change opt- in status up to four times per year. Billing practices are not expected to change for Tribal pharmacies. “We are pretty excited about this and how it does not place additional burdens (on pharmacies),” Oregon Health Authority Alternative Pay- ment Methodoligies Analyst Jamal Furqan said. “Our plan is for it to become an automated process, with no changes to billing.” Health & Wellness Center Di- rector Kelly Rowe said the Tribal clinic would participate in the new plan, and was awaiting further in- struction from the Oregon Health Authority. NOTICE TO ALL TRIBAL MEMBERS ON THE SSI/SSD SUPPLEMENTAL INCOME PROGRAM Attention Tribal members on SSI or SSD Programs: Fall is here and it is that time of year again: Time to remember to send us a copy of your upcoming benefit statement for the year 2018 from the Social Security Administration so that we can update your file. This is a requirement for Tribal members between the ages of 18-54 who are wanting to re-qualify for this supplemental program. The SSA benefit statements should start to come out to Tribal members who qualify starting around the month of November with most receiving these statements in December. If you do not receive your current benefit statement, you may order one by calling the Social Security Administration at 800-772-1213 or go online @ www. ssa.gov. Your current benefit statement must reach our office by Jan. 15, 2018, to avoid any delays in your benefits. For Elders age 55 and older, it is a requirement that we have an updated Social Security Administration (SSA) letter of eligibility once every two years. Please note: We will be con- tacting every Elder on the supplemental program (SSI) to verify that we get a copy of your SSA statement. Failure to provide this document may result in your Elder tax status being changed from non-taxable Elder pension to taxable Elder pension. We will need a copy of that document (SSA award letter) to update your file. Please mail copies of your benefit statement and the application to: CTGR Member Services Attn: Jolanda Catabay 9615 Grand Ronde Road Grand Ronde, OR 97347 You may also e-mail or fax a copy to the following: Fax: 503 879-2480; e-mail: Jolanda.Catabay@grandronde.org Note: It is the responsibility of the Tribal member to notify the Tribe of any changes in your benefits from the Social Security Administra- tion SSI/SSD program. Failure to notify the Tribe may result in an obligation to repay ineligible benefits received, or interrupt or delay your Tribal Supplemental Security Income and Disability payments. Feel free to contact me if you have further questions or concerns. My contact number(s): 503-879-2253 or toll-free 800- 422-0232, ext. 2253. Respectfully, Jolanda Catabay Enrollment Member Services specialist Confederated Tribes of Grand Ronde
