your internet resource on facebook on twitter on Google+ on soundcloud
phone: 202 630 8439
Dynamic Homes
Advertise on Indianz.Com
Home > News > Headlines
Print   Subscribe
State loses case over Indian Health Care Improvement Act
Tuesday, December 4, 2007
Filed Under: Health | Law

The state of Arizona is not entitled to recover all of its Medicaid costs under the Indian Health Care Improvement Act, a federal appeals court ruled on Monday.

The state billed over $36 million to the Health Care Financing Administration, the federal agency that administers Medicaid. The state said it was entitled to recover 100 percent of its costs for providing health care to Medicaid-eligible Indian patients.

But the 9th Circuit Court of Appeals disagreed. In a unanimous decision, a three-judge panel said the IHCIA provision at issue was ambiguous so it deferred to the government's interpretation of the law.

The ruling means the only providers that are entitled to 100 percent reimbursement for Medicaid costs are the Indian Health Service and tribes that administer care at IHS facilities.

Otherwise, states like Arizona can recover just a percentage of their Medicaid costs for Indian patients. For the coming fiscal year, the rates -- known as federal Medicaid Assistance Percentages (FMAP) -- range from 50 percent to 74 percent, depending on the state.

The ruling also means urban Indian health care providers cannot receive 100 percent of their Medicaid costs. They are reimbursed at the same rate as their respective state.

Quoting the IHCIA, the 9th Circuit said "the costs eligible for a FMAP reimbursement rate of 100 percent are 'limited to those 'received through' an IHS facility which offers, is responsible for and bills Medicaid for the services provided.'"

Even though the IHCIA has been on the books since 1976, the issue has only come up three times in the courts. The first two cases were from North Dakota and South Dakota and the states ended up losing both times.

The 9th Circuit arrived at the same outcome as the 8th Circuit in those cases. But the circuits disagreed on whether the IHCIA provision regarding Medicaid was ambiguous.

In a 2005 decision, the 8th Circuit said the legislative history for the IHCIA was "clear and consistent" with regard to the providers that are entitled to recover 100 percent of Medicaid services to Indian patients. "Nowhere does it suggest that the 100 percent FMAP applies to services provided outside of IHS facilities, such as the referrals at issue in this case," the court said.

The 9th Circuit, however, said the legislative history was not clear. So the court deferred to the Department of Health and Human Services' interpretation of which providers receive 100 percent reimbursement.

Congress is currently considering a reauthorization of the IHCIA. Tribal advocates have called for a provision to reimburse urban Indian health care providers 100 percent of their Medicaid costs.

The bill, however, has failed to pass for the last seven years due to objections from the Bush administration and Republican lawmakers. Last year, Senate Republicans blocked passage on the eve of consideration after the Department of Justice released an anonymous "white paper" objecting to numerous provisions.

This year, the Bush administration objected to extending health care benefits to urban Indians, certain Alaska Natives and lineal Indian descendants. The administration suggested that such programs might violate the U.S. Constitution because they are based on race.

9th Circuit Decision:
Arizona Health Care Cost Containment System v. McClellan (December 3, 2007) | Audio: Oral Arguments (May 15, 2007)

8th Circuit Decision:
North Dakota, South Dakota v. Centers for Medicare and Medicaid (April 6, 2005)

Department of Health and Human Services Appeals Board Decisions:
Arizona | North Dakota | South Dakota

House Energy and Commerce Committee Documents:
Summary | Manager's Amendment | Press Release | Webcast

Indian Health Care Improvement Act Amendments:
S.1200 | H.R.1328

Relevant Documents:
Letter to President Bush | Letter to Alberto Gonzales | DOJ White Paper

Relevant Links:
Arizona Health Care Cost Containment System -
Centers for Medicare & Medicaid Services -
Indian Health Service -
National Indian Health Board -

Related Stories:
House subcommittee approves Indian health care bill (11/08)
IHCIA delayed but could come up next week (10/26)
Long-delayed IHCIA set for vote in Senate (10/22)
Indian health care leaders win prestigious award (10/04)
Indian Country rallies for health care in U.S. Capitol (09/13)
Indian health care markup, rally in Washington (9/12)
Senate markup on Indian Health Care Act (9/10)
IHCIA pushed as Congress returns from break (9/5)
Rally for Indian health set in DC for September 12 (9/4)
Wild horses get more money than IHS hospital (08/16)
Senate field hearing on Indian health in Montana (8/15)
Senate field hearing on health this Wednesday (8/13)
IHCIA reauthorization exchange on Senate floor (8/2)
Editorial: Indian health care a trust responsibility (7/31)
IHS suffers from long waits, inadequate funding (7/30)
White House changed testimony on trust (7/27)
IHS slow to resolve problems under Grim (7/26)
Senate confirmation hearing for Dr. Grim of IHS (7/26)
Pill 'epidemic' strikes reservations in Montana (7/23)
Senate Indian Affairs Committee renews focus (7/20)
Direct Service Tribes discuss IHS in Denver (06/27)
Emergency room at IHS facility fails inspection (05/09)
Indian Health Care Act introduced in Senate (05/02)
California tribes seek bigger share of health funding (5/1)
Belcourt: Indian Country takes path of healthy living (4/30)
House committee approves Indian health care bill (4/26)
Montana and Wyoming tribes host health conference (04/06)
Montana lawmaker presses for health care funding (4/5)
Opinion: U.S. failing to provide Indian health care (3/22)
Kara Briggs: The fight to reauthorize IHCIA (3/21)
Urban Indians hurt by IHS policy in Montana (3/20)
Health care push continues at House hearing (3/19)
DOJ's Indian white paper a political whodunit (3/14)
House hearing on Indian Health Care Improvement (3/14)
Urban Indians under attack over health care (3/12)
Fireworks at Indian health care hearing (3/9)
Senate hearing on Indian Health reauthorization (3/8)
Urban Indians in New Mexico feel left out on health (3/8)
Some urban Indians denied care at request of IHS (3/8)
Indian Health Care Act introduced in House (3/7)
Hearings on Indian Health Care Improvement Act (3/5)
Democrats promise action at USET conference (2/14)
Harjo: GOP calls Indian health care 'race-based' (2/12)
Tribes forced to ration funds for health services (2/2)
Interview: Inadequate health care in Indian Country (01/16)
Joint hearing on Indian health care act postponed (11/14)
Final push for health care bill in 109th Congress (11/13)
White House hit over delays in health care and Cobell (10/05)
Still no Indian Health Care Improvement Act (09/22)
New Standard: U.S. failing to deliver health care (7/18)
Senate panel advances Indian health care measure (10/28)
Senate committee takes up slate of Indian bills (10/27)
Hearing on Indian Health Care Improvement Act (07/13)
Oklahoma senator loses Indian health care vote (06/29)

Copyright © Indianz.Com
More headlines...
Stay Connected:
On Facebook

On Twitter

On Google+

On SoundCloud
Local Links:
Federal Register | Indian Gaming | Jobs & Notices | In The Hoop | Message Board
Latest News:
Native Sun News: Tribal member speaks out against fracking (11/27)
Lakota Country Times: Rosebud mothers address meth issues (11/27)
Tim Giago: Walk a mile in the moccasins of Native Americans (11/27)
Vince Two Eagles: Focus on being thankful this holiday season (11/27)
Native Sun News: Keystone fighters celebrate permit's defeat (11/27)
Kevin Leecy: Tribes remain a vital segment of our community (11/27)
Steven Newcomb: Even media treats our nations as 'nothing' (11/27)
Ray Cook: Thanksgiving flies in the face of original Americans (11/27)
Terese Mailhot: Racism prevails in American popular culture (11/27)
Ilya Somin: Persistent 'myth' justified taking of Indian lands (11/27)
Ak-Chin Indian Community sued for same-sex marriage ban (11/27)
Cahuilla Band celebrates new travel center at gaming facility (11/27)
Opinion: Don't break promise to Mashpee Wampanoag Tribe (11/27)
Native Sun News: Family questions FBI on reservation death (11/25)
Lakota Country Times: Rosebud students earn top scholarship (11/25)
Brandon Ecoffey: Making a difference for people on Pine Ridge (11/25)
Yurok Tribe: Mourning the passing of 'visionary' Troy Fletcher (11/25)
Ned Blackhawk: Supreme Court case jeopardizes tribal rights (11/25)
Steve Russell: The real origins of the world's terrorism crisis (11/25)
Ramona Peters: Sharing a Wampanoag story of Thanksgiving (11/25)
Yatibaey Evans: Let's all teach the truth about Native history (11/25)
Martie Simmons: Every Native parent dreads this time of year (11/25)
Eric Metaxas: The 'miracle' of Squanto and first Thanksgiving (11/25)
Presidential Medal of Freedom presented to late Billy Frank Jr (11/25)
Oneida Nation opens first branch location of tribal-owned bank (11/25)
Virginia tribes continue to pay tribute required by 1677 treaty (11/25)
Chukchansi Tribe reaches new agreement for shuttered casino (11/25)
Poarch Band to welcome visitors to $65M expansion at casino (11/25)
Stillaguamish Tribe debuts eatery and microbrewery at casino (11/25)
Connecticut tribes consider proposals for third gaming facilty (11/25)
Mark Pilarski: Why are games different at some tribal casinos? (11/25)
Tribes seek support for Native language instruction programs (11/24)
Rep. Mullin confirms divisions in Indian Country on Carcieri fix (11/24)
President Obama to award Medal of Freedom to Billy Frank Jr. (11/24)
Sault Tribe pushes for passage of Tribal Labor Sovereignty Act (11/24)
Lakota Country Times: Charles Trimble recognized for writings (11/24)
Native Sun News Editorial: Some new names in Indian Country (11/24)
Jim Kent: South Dakota lands in the news again for corruption (11/24)
John Yellowbird Steele: Bill tries to hijack recognition process (11/24)
Albert Bender: 'The Green Inferno' hits new low in racist films (11/24)
Peter d'Errico: Anti-Indian wars continue in US Supreme Court (11/24)
Anne Keala Kelly: US government wants to steal Hawaii again (11/24)
Counties ask Supreme Court to hear Ute Tribe boundary case (11/24)
Shinnecock Nation considers entering medical marijuana field (11/24)
more headlines...

Home | Arts & Entertainment | Business | Canada | Cobell Lawsuit | Education | Environment | Federal Recognition | Federal Register | Forum | Health | Humor | Indian Gaming | Indian Trust | Jack Abramoff Scandal | Jobs & Notices | Law | National | News | Opinion | Politics | Sports | Technology | World

Indianz.Com Terms of Service | Indianz.Com Privacy Policy
About Indianz.Com | Advertise on Indianz.Com

Indianz.Com is a product of Noble Savage Media, LLC and Ho-Chunk, Inc.