Utah legislature advances bill to cover traditional Native healing through Medicaid


Maddie McCarthy


A bill that would require the Utah Department of Health and Human Services (DHHS) to submit a 1115 waiver to the Centers for Medicare and Medicaid Services (CMS) to provide Medicaid reimbursement for traditional healing services for the state’s Native population has crossed over into the opposite chamber.

Senate Bill 181, sponsored by Sen. Luz Escamilla (D – Salt Lake County), unanimously passed its third reading in the Senate on Tuesday.

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The bill was previously approved as proposed legislation by the Native American Legislative Liaison Committee in November.

“An opportunity to add and incorporate traditional medicine healing services to our Utah American Indian [and] Alaska Native residents in our state … will increase and better their wellbeing,” Escamilla said at a committee hearing last week.

Traditional healing incorporates spirituality and culture into the healing process and is often blended with Western medicine. While the definition of traditional healing varies by tribe, some traditional healing practices include sweat lodge ceremonies, talking circles, and more.

Due to the tribal differences in traditional healing practices, Escamilla said the traditional healers will be approved by tribal governments and councils.

“The goal is that we will be focusing on traditional healers per the definition of the tribes, and their governments defining them.”

— Escamilla

Rachel Craig, government affairs manager for the Association for Utah Community Health (AUCH), spoke to the needs and specifics of the bill at the Native American Legislative Liaison Committee meeting in November before Escamilla became the bill sponsor. 

Craig said many tribal health facilities are unable to keep traditional healers on site because either the patient or the clinic has to pay for the healer out of pocket, which can be too expensive for many people or facilities.

She also noted that the benefit would require the traditional healing services to be integrated with Western medicine.

“We do want to note that this benefit would have to be part of a comprehensive health plan,” Craig said. “… It would kind of have to be integrated with Western health as well so it wouldn’t just be a Medicaid member just using it for [traditional healing]. It would be part of a comprehensive health plan. That is pretty true of all Medicaid services requested under 1115 waivers.”

She clarified that this is not a new program or an eligibility expansion. All the waiver would do would be to help provide more services for the Native population delivered at Indian Health Service and Tribal health facilities. 

If the bill passes and CMS approves the waiver, Utah will be one of the only states offering reimbursement for traditional healing services

The Arizona Health Care Cost Containment System (AHCCCS) previously submitted a 1115 waiver seeking Medicaid reimbursement for traditional healing services. They were the first state to do so. 

Almost a decade after submitting the first waiver, Escamilla said AHCCCS is in the final negotiation stage to implement reimbursement for these services.

Craig said AUCH has spoken with AHCCCS to learn about what CMS may request in terms of changes to the waiver. 

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