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Best practices within the ihs system itself and shared those and incense vized the ability to move that kind of activity that is providing highquality care for individuals in that system, in certain areas, and making certain that were able to extend that across the country in the ihs. Okay. We look forward to working with you on that. I think Best Practices is a good place to start. Obviously, those have not been employed in a lot of facilities in our state. In 2009, cms issued a final rule that required all Outpatient Therapeutic Services to be provided under direct supervision every year since then. The rule has been delayed. Either administratively or legislatively in small and rural hospitals. I shared this with you as well. In my statement we have a lot of critical access hospitals, rural areas, big geography to cover, and sometimes difficult to get providers out to these areas. So, the question is, if confirmed, will you work to charge of some of these issues in a way that remove

Medicaid systemCommunity based careBest practicesIhs systemIndian health serviceRural areasOne waySenator caseyWashington dcHealth careHasn tUrban institute reportUrban instituteApril 2016Page 3Coverage provisions