Health Care

In 2010, after more than ten years of legislative effort, the Indian Health Care Improvement Act was permanently authorized and amended as part of the Affordable Care Act. Our attorneys worked closely with tribal advocates from across the country to achieve this important milestone and ensure that the law is designed to help fully implement the federal government’s trust responsibility to provide health care to American Indians and Alaska Natives. The newly revised law, along with improvements to the Medicaid statute enacted in 2009 and the Indian-specific provisions in the Affordable Care Act are designed to improve access by Indian health care providers to a wide range of federal health care programs.

Our attorneys are among the leading practitioners in this field, and are actively working on behalf of tribes and tribal organizations to ensure that major aspects of health reform, including the new Health Insurance Marketplaces and Medicaid Expansion, are implemented in a manner that will allow tribal health care programs and their beneficiaries to meaningfully participate in these new programs. We represent tribes and tribal organizations at the national level in direct negotiations and tribal consultations with the federal agencies responsible for implementing health care reform, including the Indian Health Service, the Department of Health and Human Services (HHS), the Center for Medicare and Medicaid Services (CMS), the Office of Personnel Management, the Center for Consumer Information and Insurance Oversight, the Internal Revenue Service and others. Our attorneys participate in CMS’ Medicare/Medicaid Policy Committee and serve as Technical Advisors to the CMS Tribal Technical Advisory Group, and to the Secretary of HHS’ Tribal Advisory Committee. Our attorneys are actively working with our tribal clients to design the best strategies to access the new federal resources made available through the Affordable Care Act.

We provide counsel to tribes and tribal organizations on operation and expansion of health programs under the Indian Self-Determination and Education Assistance Act, and work with tribal health care providers to maximize the resources available to them under those programs. We also advise tribal health care providers in negotiations with States on the design and implementation of State Medicaid programs, and on issues involving Contract Health Care services, including billing arrangements and Medicare-like rates. We also assist tribal clients in complying with the privacy and security requirements of the Health Insurance Portability and Accountability Act, and the application of the Federal Tort Claims Act to medical malpractice claims against tribal health contractors. We have helped our clients with health care facility construction and renovation projects, and with arranging medical leases for improved access to health care in state-of-the-art facilities.

As health care reform is implemented and tribal health care becomes more integrated, we are also advising tribal health care providers seeking to enter into new partnerships and innovative arrangements with other entities. We help clients negotiate reimbursement arrangements with third parties and agreements for coordinated care, and help develop the best strategies for structuring relationships with specialty providers and acquisition of private practices, among other relationships, as consistent with health care fraud and abuse laws. We also provide advice on federal and state licensing requirements and the authority of tribes to make the determination to serve non-Indians.