Justia Native American Law Opinion Summaries

Articles Posted in Health Law
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The Washington State Health Care Authority (“HCA”) and the Swinomish Indian Tribal Community petition for review of a Center for Medicare and Medicaid Services (“CMS”) decision denying Washington’s request to amend Apple Health, the Washington State Medicaid plan (the “State Plan”). HCA petitioned CMS to amend the State Plan to include dental health aide therapists (“DHATs”) on the list of licensed providers who can be reimbursed through Medicaid. CMS rejected the Amended State Plan on the basis that it violates the Medicaid free choice of providers statute and regulation guaranteeing all Medicaid beneficiaries equal access to qualified healthcare professionals willing to treat them. Petitioners challenged this denial.   The Ninth Circuit granted the petition of review. The panel rejected CMS’s reasoning on the ground that the underlying Washington statute—Wash. Rev. Code Section 70.350.020—did not violate Section 1396(a)(23) because it merely authorized where and how DHATs can practice and did not in any way restrict Medicaid recipients’ ability to obtain service from DHATs relative to non-Medicaid recipients. CMS’s rejection of the Amended State Plan was “not in accordance with law.” 5 U.S.C. Section 706(2)(A). Accordingly, the panel granted the petition for review and remanded to the agency with instructions to approve the Amended State Plan. View "WASHINGTON STATE HEALTH CARE A, ET AL V. CENTERS FOR MEDICARE & MEDICAI, ET AL" on Justia Law

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Indian Health Services (IHS) previously provided health care to the federally recognized Tribe through a clinic in McDermitt, Nevada, and an emergency medical services program. Federal law entitles members of other tribes also to receive care at the clinic. In 2016, the Tribe notified IHS of its intent to assume responsibility for the clinic and part of the EMS program. The Tribe requested about $603,000 annually to provide medical care at the clinic. IHS awarded only about $53,000. The parties disputed whether the Tribe was entitled to all the funds that IHS previously had spent on the clinic or whether the agency could withhold the portion of those funds to benefit members of another tribe. IHS allocates generally funding among health care programs according to the number of eligible users living in the tribe's assigned. IHS funded the clinic to benefit the Tribe and the nearby Winnemucca Tribe. IHS argued that it could not include Winnemucca’s “tribal share” of clinic funding without that tribe’s consent. The parties disputed the treatment of third-party income from Medicare and Medicaid, which the Tribe now collects directly. The Tribe assumed full control of the clinic, filed suit, and obtained summary judgment.The D.C. Circuit reversed. The Indian Self-Determination and Education Assistance Act, 25 U.S.C. 5321(a), did not permit withholding of the amount budgeted as benefitting members of the second tribe but did permit withholding an amount equal to the Medicare and Medicaid reimbursements. View "Fort McDermitt Paiute and Shoshone Tribe v. Becerra" on Justia Law

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After the Indian Health Service agreed to pay the Swinomish Indian Tribal Community to run a health program on the Swinomish Reservation, Swinomish filed suit under the Contract Disputes Act and Declaratory Judgment Act, claiming that it was owed additional sums in direct and indirect contract support for costs calculated as percentages of the money it received from insurers and spent on health services. The DC Circuit affirmed the district court's grant of the government's motion for summary judgment, holding that the Indian Self-Determination and Education Assistance Act does not require Indian Health Service to pay for contract support costs on insurance money received by Swinomish. Neither does Swinomish's contract with Indian Health Service. View "Swinomish Indian Tribal Community v. Becerra" on Justia Law

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The Ninth Circuit reversed the district court's dismissal for lack of standing of a tribal health organization's action seeking declaratory relief regarding alleged violations of a federal law concerning the provision of health services to Alaska Natives. The panel held that SCF alleges an injury in fact sufficient to confer Article III standing in two distinct ways: first, that ANTHC infringed SCF's governance and participation rights under Section 325 of the Department of the Interior and Related Agencies Appropriations Act of 1998 by delegating the full authority of the fifteen-member Board to the five-person Executive Committee; and second, that ANTHC erected informational barriers in the Code of Conduct and Disclosure Policy that deprived SCF of its ability to exercise effectively its governance and participation rights. The panel remanded for further proceedings. View "Southcentral Foundation v. Alaska Native Tribal Health Consortium" on Justia Law