WASHINGTON (AP) — The Supreme Court on Thursday sided with Native American tribes in a battle against the federal government…
WASHINGTON (AP) — The U.S. Supreme Court on Thursday sided with Native American tribes in a battle with the federal government over health care fees when tribes run health care programs in their own communities.
The 5-4 decision means the government will have to cover millions of dollars in overhead costs incurred when the two tribes took over running health-care programs under a law aimed at giving Native Americans more regional autonomy.
The Department of Health and Human Services had argued that it wasn’t responsible for the potentially high overhead costs of billing insurance companies, Medicare and Medicaid.
The federal Indian Health Service has provided health care to tribes since the 1800s under treaty obligations, but facilities are often inadequate and understaffed, the San Carlos Apache tribe of Arizona said in court documents.
In court documents, the Northern Arapaho Tribe of Wyoming said IHS costs per person $100,000 to care for, and the average life expectancy of Native American tribal populations is about 65 years, nearly 11 years lower than the U.S. as a whole.
Tribes contracted with IHS to run their own programs, from emergency services to substance abuse treatment. The agency paid the tribes money it would have spent to run those services, but the contracts didn’t include the overhead of billing insurance companies, Medicare, or Medicaid, because other agencies would cover those costs while the government runs the programs.
But the tribes had to foot the bill themselves: The San Carlos Apaches paid about $3 million over three years, the Northern Arapaho $1.5 million over two years, the tribes said. Two lower courts ruled in their favor.
The Department of Health and Human Services appealed the decision to the Supreme Court, arguing that while tribes get some money for overhead, the government isn’t responsible for costs associated with third-party revenue. Most federally recognized tribes currently contract with IHS to run at least some of their own health care programs, and reimbursing claims costs for all those programs could amount to between $800 million and $2 billion a year, the Department of Health and Human Services said.
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