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
