Dear USET/USET SPF Family,
Today, June 6, 2024, the Supreme Court of the United States (SCOTUS) ruled in a 5-4 decision that the federal government is required to reimburse Tribal Nations for contract support costs (CSC) incurred by Tribal Nations when spending third-party revenues to operate healthcare programs.
More specifically, these cases involved the important question of whether the U.S. Department of Health and Human Services (HHS) owes CSC related to funding reimbursed by third-party payors, such as Medicare, Medicaid, and private insurers. These cases asked whether HHS owes CSC not only to support HHS-funded activities, but also to support Tribal Nations’ expenditure of program income collected from third-party payors. Both types of funding are utilized by Tribal Nations to finance Indian health care programs contracted for through the Indian Self-Determination and Education Assistance Act (ISDEAA).
SCOTUS heard oral argument on this case on March 25, 2024. In February, USET SPF and other Tribal Nations and organizations signed onto a Tribal amicus brief, described and linked below, urging SCOTUS to rule in favor of Tribal Nations. This ruling advances the purpose of ISDEAA by promoting Tribal self-determination and ensuring that Tribal Nations will have access to adequate resources to administer our healthcare programs and services. We thank the Tribal Nations who advanced this litigation effort, as well as the organizations that coordinated and drafted the amicus briefs, for their efforts to definitively secure CSC for all Tribal Nations involved in healthcare self-determination activities.
USET SPF is encouraged by this decision and we are continuing to analyze the ruling and its implications. Specifically, we will continue our efforts to advocate for CSC funding, as well as funding for Section 105(l) leases, to be moved to the mandatory side of the budget in order to free up discretionary dollars for the IHS. USET SPF will continue to monitor this issue and provide updates on HHS's actions when relevant.
For more information, please contact Liz Malerba, USET SPF Director of Policy and Legislative Affairs, at lmalerba@usetinc.org
or Katie Klass, USET SPF General Counsel, at kklass@usetinc.org.
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