Nez, Council duel over Navajo Medicaid, again

GALLUP

The battle between the president’s office and the Navajo Nation Council over the rollout of Naat’áanii Development Corp.-Molina Healthcare’s Indian Managed Care Entity continued this week as President Jonathan Nez and Speaker Seth Damon issued dueling news releases and accusations as the initiative was put on hold by the state of New Mexico.

“Governor (Michelle Lujan) Grisham, with the support of President Nez, has delayed implementation of the IMCE and is threatening to end the project,” stated a Jan. 11 news release from the speaker’s office. “Governor Grisham, at the request of the president’s office, is insisting the Navajo Nation waive its sovereign immunity in order for implementation to begin.”

Nez denied the accusation that he or members of his staff exerted influence over Grisham. “At no time did the Office of the President or the Navajo Nation Department of Justice request that Gov. Michelle Lujan Grisham insist on a waiver of sovereign immunity on the part of the Navajo Nation, a false allegation publicized in the Jan. 11, 2021 press release issued by the Office of the Speaker,” Nez stated in a Jan. 17 news release.

Nez said the fact that NDC would mislead the Health, Education, and Human Services Committee with “false information” is “deeply troubling” and casts further doubt on whether NDC truly intends to operate the IMCE with transparency.

Damon says Council provided all of “the necessary authorities” to engage with state and federal agencies to accomplish the full implementation of the NDC/Molina IMCE, established to provide Medicaid services for New Mexico Navajo citizens. Grisham did not respond to a request for comment on the matter.

‘Red flags’

In response to a request for clarification, Damon said that while no formal written notification has been received from the state regarding a cessation of the IMCE project, delegates received emails from the HSD cancelling IMCE work group meetings with a generic message stating: “As we continue to perform our due diligence in evaluating the programmatic and operational issues regarding the IMCE, HSD is pausing work on the IMCE until further notice.”

“State executive representatives, on bimonthly teleconference calls with the Navajo Nation, including HEHSC and OPVP, indicated their ‘preference’ or ‘position’ for the Navajo Nation being a signatory to the agreement,” said Damon.

“Governor Grisham, in a July 30th meeting, also made the same request when President Nez and Council leadership were present.”

Damon said that in the most recent calls in December and January, state representatives again informed Council leadership and NDC that they were requesting the Navajo Nation to be a signatory to the contract as requested by OPVP staffers with whom they were in communication.

“By definition, this means the Nation will have to waive its sovereignty because of how the contract is constructed for dispute resolution,” said Damon. “NDC and the Council believed this issue was laid to rest after discussion at the July 30th meeting, until the state revived it, apparently at OPVP’s request, in the past couple of months.”

Damon said after pushback from the Council and NDC on waiving the Nation’s sovereignty, the state made a different request for Navajo Nation attorney general to issue an opinion on the matter.0 In a Jan. 7 letter to New Mexico HSD Secretary David Scrase, the Navajo Department of Justice clarified that the Navajo Nation does not need to be a signatory to the IMCE contract.

“The Department of Justice agrees the Navajo Nation does not need to waive its sovereign immunity to stand up the IMCE,” said Damon. “There shouldn’t be any reason to further interfere with internal Navajo Nation matters and the Nation’s sovereignty.”

Scrase did not respond to a request for comment as of press time Wednesday.

“I am very concerned with how the Naat’áanii Development Corporation is working behind the scenes and giving false impressions to gain oversight to enormous amounts of Medicaid funds,” said Nez. “Their actions raise red flags and create grave concerns about how they will operate and who will truly benefit if the Naat’áanii Development Corporation, an entity with no prior health care experience or expertise, obtains approvals from the state of New Mexico to oversee Medicaid for our Navajo people,” he said.

Uncertainty prevails

On Jan. 23, 2020, the Naabik’iyati Committee passed a resolution that urged Grisham and the New Mexico HSD to collaborate with NDC to “expeditiously secure all necessary approvals, contracts and infrastructure for launching the NDC/Molina Healthcare IMCE in 2020.”

NDC was established in 2017 under former President Russell Begaye and then-Vice President Jonathan Nez as a Section 17 corporation to create economic opportunities and alternative revenue sources for the Nation.

“Since then, the Naat’áanii Development Corporation has operated mostly behind closed doors to lobby tribal and state officials to secure approvals and a contract with the state of New Mexico to manage the Medicaid funds,” stated the president’s office.

In March, Council took another step and approved another resolution formally requesting Grisham to “activate” the NDC/Molina IMCE due to the COVID-19 emergency with “passive” (automatic) enrollment. But this resolution was vetoed by Nez who expressed preference for “active” (voluntary) enrollment into the Medicaid plan.

At the time, Nez accused NDC/Molina and the Council of using the legislation to “capitalize” on the COVID-19 pandemic as way to fast-track the IMCE. In the spirit of compromise, NDC agreed to move forward with active enrollment per Nez’s wish, despite a Council veto overridethat made permanent the Nation’s position that the state should pursue passive enrollment.

“The Navajo Nation, including President Nez in public statements but not private actions, supports standing up the IMCE,” said HEHSC Vice Chairman Carl Slater. “We could get started on this, as a Nation, tomorrow, and that is what we ask the President Nez and Governor Grisham to support.”

However, now the president’s office is also claiming the final outcome of the Council’s attempt to override Nez’ veto remains in question due to a memo issued on April 7, 2020, by Delegate Charlaine Tso who stated that she inaccurately cast her vote in support of the override due to “unprecedented” telecommunication challenges, which could overturn the vote.

“In the memo, she requested that her vote be accurately recorded in opposition to the override, meaning that the override failed,” stated the president’s office. Tso confirmed that she submitted a request memo to have her vote changed from “yea” to “nay” on the override. “I have asked the speaker to update my vote and provide an update on two other occasions,” said Tso. “I have not received a response to this day.”

Nez once again expressed concerns over NDC’s ability to manage “hundreds of millions of dollars” in health care funding for Medicaid coverage for over 50,000 Navajo citizens in New Mexico.

He said the president’s office has “repeatedly” requested important financial information and detailed operating plans from NDC and Molina, as well as information on regulatory jurisdiction and oversight of the IMCE to ensure Navajo Nation sovereignty and regulatory authority would be recognized in the contract with the state.

“Unfortunately, the information provided to date has not provided clarity on how Navajo citizens’ health care would be improved, how the IMCE would contribute financially to the well-being of Navajo citizens, and how Navajo sovereignty would be protected and upheld,” said Nez.

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