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The IHS is the principal federal health care provider and health advocate for Indian people. It has hospitals, health centers , school health centers , and 46 . The mission for the Centers for American Indian and Alaska Native Health ( CAIANH) is to promote the health and well-being of American Indians and Alaska. Indian Health Service programs, tribes, tribal organizations, and urban Indian . The VHA Office of Community Care, Office of Tribal Government Relations, and VA medical centers work together to implement the Tribal Reimbursement . Inspectors from the Centers for Medicare and Medicaid Services have . AI/AN population including limited access to specialty services and a chronic understaffing of physicians.