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Negotiations over Medicaid expansion in states heavily populated by Native Americans have prompted the CMS to propose fully funding medical services that are often not available at tribal healthcare facilities. The agency is looking to provide a 100% federal match rate for primary and specialty healthcare services that are purchased from private healthcare providers because they are not available at Indian Health Service or tribal healthcare facilities. This can include hospital and outpatient care, as well as physician, laboratory, dental, radiology, pharmacy and transportation services. (Dickson, 10/28)

Montana officials and health-care activists are hoping – and planning – that federal approval is imminent for the state’s Medicaid expansion, which will extend health coverage to thousands of low-income Montanans beginning in 2016. The state has asked federal health officials to approve Montana’s unique plan by Sunday. (Dennison, 10/28)

Sen. Kathy Campbell of Lincoln urged a Chamber of Commerce audience Wednesday to carefully consider the economic advantages that long-delayed Medicaid expansion would bring to the state. At stake are $2.3 billion in federal funding over the next five years and 10,000 potential new jobs, Campbell told a legislative breakfast gathering sponsored by the Lincoln Chamber of Commerce and the Nebraska Chamber of Commerce. Campbell said she and two legislative colleagues who are helping craft a new Medicaid expansion proposal -- Sens. John McCollister and Heath Mello, both of Omaha -- will meet with the Greater Omaha Chamber of Commerce next week to discuss the outlines of their plan. (Walton, 10/28)

In a letter to legislators, Gov. Asa Hutchinson said he agrees with a consultant that two of the seven points in his proposal to change the state's private-option Medicaid program should be scrapped. In the letter to members of the Health Reform Legislative Task Force dated Tuesday, Hutchinson said he no longer supports eliminating a nonemergency medical-transportation benefit for private-option enrollees or requiring that the poorest enrollees be served by the traditional fee-for-service Medicaid program instead of the private option. (Davis, 10/29)

The White House will not push back against states like Texas, whose leaders chose not to expand Medicaid to get health coverage to the poor, Health and Human Services Secretary Sylvia Burwell said during a brief stop Wednesday in Houston. "That is not something we will do," she said in response to questions about possible retaliation by withholding federal money that helps fund social and health care programs. Burwell met privately with community leaders and toured the Lois J. Moore Eligibility Center and adjoining El Franco Lee Community Health Center during the second leg of her Texas tour to help kick off enrollment in the 2016 Affordable Care Act's marketplace, which begins Sunday. President Barack Obama's administration has identified Texas as one of four states it will focus on in an effort to boost numbers in the federal exchange as it enters its third enrollment season. With more than 4 million still uninsured, Texas continues to lead the nation in the rate and number of uninsured. (Deam, 10/28)