Plain-English summary
Court rules tribes get contract-support payments when they collect and use health program income
The Supreme Court held that under the Indian Self-Determination and Education Assistance Act (ISDA), the Indian Health Service (IHS) must pay tribes the contract support costs (CSCs) they incur when tribal contractors collect and spend program income from third-party payers such as Medicare and Medicaid. The decision affirms the Ninth Circuit and was issued June 6, 2024.
Why this matters
The ruling clarifies how federal contracting law treats tribes that run health programs: tribes contracting under ISDA can recover the administrative costs of handling money they collect from Medicare, Medicaid and other payers. That means more predictable federal funding and support for tribal health programs, affecting tribal budgets, patient services, and the workings of the Indian Health Service.
Who may feel it
- Federally recognized Indian tribes that contract to run health programs under ISDA
- Indian Health Service (IHS) and the Department of Health and Human Services
- Patients who rely on tribal health facilities, including Native American communities
- State and federal third-party payers (Medicare, Medicaid, private insurers)
Key questions
- Does ISDA require the Indian Health Service to pay tribes contract support costs for expenses they incur when they collect and spend program income from third-party payers?