Indian Health Services settles $193 million in claims to tribal organizations

Alex DeMarban

The Indian Health Service said Friday it has so far settled $193 million in claims with six Alaska tribal health care organizations as part of an ongoing effort to fulfill contractual obligations with American Indian and Alaska Native tribes that for years have gone underpaid.

"This is huge," said Sen. Mark Begich, who joined Sen. Lisa Murkowski and Rep. Don Young in pushing aggressively for the settlements. "That is money owed that these organizations had to fork out from their own operations and reduced the health care that was supposed to be delivered by the federal government."

The Indian Health Service contracts with tribes to provide health care services to Alaska Natives and American Indians, part of long-standing agreements related to the loss of Indian lands.

For years the agency has not paid what are known as contract support costs that go along with delivering health care, such as expenses related to insurance, audits and other administrative requirements.

The lack of payment led some tribally run hospitals in bigger cities and clinics in villages to reduce medical care.

After key court victories and direction from Congress spelled out in the appropriations act this year, the agency has begun settling what it owed.

With many claims outstanding around the country, the total settlements with tribes nationwide could ultimately rise to $2 billion, said Lloyd Miller, an Anchorage attorney who represents many of the tribal health care groups.

The latest recipient is Southcentral Foundation in Anchorage, which announced this week that it had settled for $96 million.

The organization is part-operator and part-owner of the Alaska Native Medical Center and manages other facilities providing health care services throughout Southcentral Alaska to more than 60,000 Alaska Natives and American Indians.

The agency typically underfunded Southcentral Foundation about 10 percent a year, said the organization in a statement.

Dr. Douglas Eby, vice president of medical services for Southcentral, said the agreement will bring an important chunk of money that will be used to improve health care delivery.

While Southcentral is grateful, the federal government still isn't doing enough to meet its obligations to Alaska Native people who prepaid for health care by giving up land and resources, he said.

"We will continue to work to raise the level of funding in order to broaden care," he said, noting that important services are still not funded by the agency, such as mental health services and long-term physical therapy.

Yvette Roubideaux, acting director of the Indian Health Service, sent a letter updating Begich on Friday -- which his office forwarded to reporters -- that outlines settlements with Alaska tribal health care organizations that began last year.

The additional settlements are:

• Arctic Slope Native Association based in Barrow for $6.7 million.

• Ketchikan Indian Corp. in Southeast Alaska for $365,000.

• Bristol Bay Area Health Corp. in Dillingham for $25.5 million.

• Maniilaq Association in Kotzebue for $25 million.

• Yukon-Kuskokwim Health Corp. in Bethel for $39 million.

The settlements in Alaska represent 71 percent of the value of the $273 million that has been settled to date, Roubideaux said in her letter.

Several other tribes or tribal organizations in Alaska have also filed claims and are hoping for a fast resolution, Miller said Miller.

Some are small village-based groups and others are large organizations such as the Alaska Native Tribal Health Consortium, the largest tribal health organization in the country, Miller said.

Roubideaux said negotiations over additional claims are under way but did not say which tribal organizations are involved. "We will continue to focus on speedy resolution through settlement whenever possible," he said.

Contact Alex DeMarban at

Alaska Dispatch