The largest Alaska Native healthcare provider in the state will receive hundreds of millions of dollars after the federal government settled a lawsuit over claims it owed the organization years of unpaid expenses
On Tuesday, the U.S. Department of Justice announced a $400 million settlement with the Alaska Native Tribal Health Consortium, the nation’s largest Native health organization. The settlement follows a 2021 lawsuit in which the tribal health organization said the Indian Health Service failed to reimburse the consortiumfor support costs over nearly a decade
Attorneys representing the consortium, also called ANTHC, told a federal court they were dismissing the case July 9 because a settlement had been reached
“This settlement marks an important step toward ensuring that resources accurately reflect the true cost of operating a complex Tribal health system and advancing self-determination in healthcare,” Natasha Singh, president and CEO of the Alaska Native Tribal Health Consortium, wrote in a statement. “Elements of ANTHC’s settlement are still being finalized, but this gives us a stronger foundation to expand access, improve care, support our workforce, and make thoughtful long-term investments to advance the health of Alaska Native and American Indian people.”
Other terms of the agreement have not been disclosed
The settlement “provides the consortium with support and autonomy for the healthcare services they provide to American Indians and Alaska Natives,” acting U.S. Attorney General Todd Blanche said in a statement
Anticipating the settlement, the consortium “committed ret co-operates, the construction of a skilled nursing facility and technology improvements, according to the ANTHC statement
The federal government owed the tribal healthcare provider about $634 million for unreimbursed overhead, or “contract support” costs, for all fiscal years between 2014 and 2022 except 2015, ANTHC said in an amended civil complaint filed last year
Those costs were related to the consortium’s billing third parties like Medicare and private insurance for patient care and unreimbursed costs that could include financial audits and management, required by the Indian Health Service, ANTHC said in the civil complaint
ANTHC, which operates the Alaska Native Medical Center with Southcentral Foundation, was established as a nonprofit in 1998 and now provides healthcare for more than 175,000 Alaska Native and Indigenous people. It also provides other services, like climate change mitigation recording to its website
The lawsuit that prompted the federal settlement involved payments for services the Indian Health Service previously provided but were now managed by the consortium, through partnerships with dozens of tribal health organizations around the state under the Indian Self-Determination and Education Assistance Act
That act gave tribes and organizations more autonomy to design services that best fit them and allowed them to receive money meant for direct services, like Indian Health Service healthcare, and instead provide it themselves
Tribes or tribal entities that offer healthcare with Indian Health Service funding will often bill third parties, like Medicare, Medicaid or private insurance, for those costs, the same as non-tribal providers. The Indian Health Service also required certain costs for third-party billing to comply with self-determination contract rules but had refused to reimburse tribes for those expenses, according to the Pacific Northwest law firm Schwabe
Those unreimbursed expenses, ANTHC said, could include financial management or audit expenses and personnel or facility expenses, according to the civil complaint
Numerous other tribes and tribal organizations nationwide have made similar claims
A 2024 U.S. Supreme Court ruling in a similar case involving the San Carlos Apache Tribe validated ANTHC’s argument that the federal government was obligated to reimburse it for such expenses under the self-determination act and prompted the settlement, according to the Justice Department statement
