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Supreme Court Ruling Empowers Tribes

The U.S. Supreme Court’s recent decision in Becerra v. San Carlos Apache Tribe marks a significant victory for Native American tribes. The court ruled that the federal government must cover administrative costs incurred by tribes running their own healthcare programs, extending to funds from Medicare, Medicaid, and private insurers. This decision stems from a recognition of the financial burdens tribes face when managing these programs and aims to prevent a “systemic funding shortfall” that could penalize tribes opting for self-determination.

Understanding the Ruling

By a narrow 5-4 margin, the Supreme Court upheld that the Indian Health Service (IHS) must reimburse tribes for “contract support costs” related to external funding sources like Medicare and Medicaid. This ruling ensures that tribes will not be financially disadvantaged for choosing to manage their healthcare programs independently. The decision aligns with the Indian Self-Determination and Education Assistance Act, which promotes tribal self-governance and aims to provide tribes with an effective voice in their healthcare programs’ planning and implementation.

This ruling affects tribes across the United States, particularly those managing their own healthcare services. The decision could potentially bring in an additional $800 million to $2 billion for these tribes.

How DAS Health Can Help

This landmark ruling opens a significant opportunity for tribes to secure additional funds. To capitalize on this decision, tribes must act swiftly due to a six-year statute of limitations on claims. DAS Health can provide invaluable support to healthcare practices in this endeavor. Our consultants are adept at navigating the intricacies of NextGen, a leading electronic health record (EHR) system. We can assist practices in gathering necessary claim files, addressing NextGen-specific functionality questions, and overcoming any obstacles that may arise when handling claims dating back six years.

NextGen’s capability to search Electronic Data Interchange (EDI) files will be crucial in this process. DAS Health can help identify, compile, and manage these files efficiently, ensuring that practices maximize their potential reimbursement under the new ruling.

For tribes looking to take full advantage of this Supreme Court decision, partnering with DAS Health ensures expert guidance and streamlined processes, turning a complex challenge into a manageable task. For more information on how we can help email