The Indian Health Service has agreed to pay the Alaska Native Tribal Health Consortium $153 million in unpaid costs dating back to 1999, the largest settlement to date for any tribe or tribal health organization in the nation seeking overdue payments from the federal agency.
Announced Friday, the settlement agreement comes after years of negotiations, according to a press release sent out by ANTHC spokesperson Joshua Niva on Friday. The $153 million represents $115.5 million in back payments due from 1999 to 2013, and $37.5 million in interest.
Attorney Lloyd Miller represented ANTHC in the negotiations. He called the settlement "historic."
"This is a significant step and will help us fulfill our commitment to provide essential health care and services to our people," Andy Teuber, president and chairman of ANTHC, said in Friday's release. "Yet, while this settlement will enable us to continue improving critically needed health care and access for one of the nation's most underserved populations, we continue to struggle due to the funding gap left by an overall IHS budget that is less than half of what is needed to provide basic health care for our people."
ANTHC is the largest tribal health contractor in the nation, providing health care services to more than 143,000 Alaska Native and American Indian people, according to ANTHC's release.
The Indian Health Service contracts with tribes to provide health care services to Alaska Natives and American Indians, part of longstanding agreements related to the loss of Alaska Native and American Indian lands.
For years, the agency has not paid what are known as contract support costs, such as expenses related to insurance, audits and other administrative requirements.
"The government knew they had to pay these costs but did not prioritize payments," Miller said. "They simply budgeted too little."
"The agency thought they could get away with it, that these contracts would not be treated like ordinary government contracts," he added.
Miller said a major turning point came in January, when Congress, and specifically the Alaska delegation, pushed to get the IHS contracts fully funded for 2014. After that, the political atmosphere surrounding the negotiations for back payments changed, Miller said.
"We're no longer dealing with an ongoing problem, we're dealing with a historic problem," Miller said.
Indian Health Service Acting Director Yvette Roubideaux wrote in a letter to tribal leaders in May that "one major reason for the accelerated progress is a recent increase in resources and staff involved in the claims settlement process. IHS has also recently adopted a more efficient approach to the settlement process that is helping us make further progress. Our goal is to extend settlement offers to as many tribes as possible by the end of calendar year 2014."
Roubideaux wrote that as of May, 729 claims were being analyzed nationwide, settlement offers had been made on 300 claims, and 181 claims had settlement agreements that were either finalized or in the process of being finalized.
By contrast, in November 2013, 82 claims had been analyzed, 60 had settlement offers on the table, and only 3 had been settled, Roubideaux wrote.
In Alaska, roughly a dozen claims had been resolved, the bulk of the settlements occurring since January. However, a dozen or so claims were still pending in Alaska, Miller said.
"The administration has made great strides ... in accelerating the pace in which they're settling the cases," Miller said.
But with the remaining outstanding claims, it's "still going to take a couple of years to resolve the last of these claims, and that's not right," Miller said.
This isn't the first substantial settlement going to an Alaska health care organization. In April, the Indian Health Service agreed to pay the Southcentral Foundation $96 million in unpaid costs dating back to 1997. In December 2013, the Yukon Kuskokwim Health Corp. settled back payment claims for $40 million.
"I am extremely pleased to hear that the Alaska Native Tribal Health Consortium has reached a landmark settlement of $153 million with the Indian Health Service," Sen. Mark Begich wrote in an email Monday.
"Alaska received the lion's share of contract service cost settlements to date and this is due to the dedication of our tribal health leaders and the joint efforts of Alaska's congressional delegation. I will continue fighting for the rest of our tribes and tribal organizations so that they too are able to receive full payments for past health care funding shortfalls."
By Laurel Andrews