indianz.com your internet resource indianz.com on facebook indianz.com on twitter indianz.com on Google+ indianz.com on soundcloud
phone: 202 630 8439
Native American Bank - Native people investing in Native communities
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 - http://www.ahcccs.state.az.us
Centers for Medicare & Medicaid Services - http://www.cms.hhs.gov
Indian Health Service - http://www.ihs.gov
National Indian Health Board - http://www.nihb.org

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: First Nations Sculpture Garden breaks ground (8/28)
Native Sun News: Lower Brule Sioux Tribe misses Cobell deadline (8/28)
James Giago Davies: There's trouble brewing on the racist horizon (8/28)
Simon Moya-Smith: A Republican slur on our indigenous relatives (8/28)
Kyle Mays: Connections between Creole and Native communities (8/28)
Mike Myers: Tribes deserve our own seats on international level (8/28)
Opinion: Supreme Court should pass on Jim Thorpe NAGPRA case (8/28)
Navajo Nation to reopen irrigation canal after Gold King mine spill (8/28)
Native executive wasn't surprised by 'No Natives please' rental ad (8/28)
Tribal members in Minnesota assert treaty right to gather wild rice (8/28)
County hopes to revive foreclosure lawsuit against Cayuga Nation (8/28)
Washington Supreme Court affirms legality of tribal gas compacts (8/28)
County sheriff questions authority of tribal officers in New Mexico (8/28)
Nooksack Tribe concerned about impact of slowly melting glaciers (8/28)
Supreme Court Justice Thomas favors conservative leaning briefs (8/28)
Mashpee Wampanoag Tribe prepares for decision on gaming plan (8/28)
San Manuel Band hires executive director for gaming commission (8/28)
Kumeyaay Nation still waiting to repatriate ancestors despite win (8/27)
IHS plans to expand service area for Aquinnah Wampanoag Tribe (8/27)
Native Sun News: Health workers join together for race relations (8/27)
Ivan Star: Oglala Sioux government fails majority of our people (8/27)
Steve Russell: Donald Trump isn't the only crazy one in the race (8/27)
Harlan McKosato: Isleta Pueblo opposes city development plan (8/27)
Julianne Jennings: People of color must unite for justice or else (8/27)
Hillary Clinton campaign reaches out to tribal voters in Nevada (8/27)
EPA releases internal report into Gold King Mine spill disaster (8/27)
Southern Ute Tribe hosts top DOJ officials at crime conference (8/27)
Paper must ask to attend Eastern Cherokee council meetings (8/27)
Koi Nation praises charges against man accused of looting site (8/27)
Pokagon Band breaks ground on village with housing complex (8/27)
Tribes provide fire services on and off reservations in California (8/27)
Chumash Tribe signs new Class III casino compact in California (8/27)
Tohono O'odham Nation heading back in court in casino lawsuit (8/27)
Ak-Chin Indian Community announces $100M casino expansion (8/27)
Lower Sioux Indian Community debuts $22M casino expansion (8/27)
Little Traverse Bay Bands plan new development at old casino (8/27)
Seminole Tribe wins major ruling in taxation dispute in Florida (8/26)
Senate Indian Affairs Committee sets hearing on EPA mine spill (8/26)
Indian Health Service to hold a second meeting for LGBT issues (8/26)
Obama picks for National Advisory Council on Indian Education (8/26)
Native Sun News: Lakota grandmother debuts film about uranium (8/26)
Native Sun News: Miss Crow Fair thanks family for strong support (8/26)
Terese Marie Mailhot: Beware of vicious and deadly gossip on rez (8/26)
Former Navajo Nation leaders blamed for lack of women's shelter (8/26)
Man charged with murder of Crow Tribe couple could face death (8/26)
Former executives charged with theft from Chippewa Cree Tribe (8/26)
Northern Arapaho Tribe asks Obama to drop appeal in eagle case (8/26)
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.