The U.S. Supreme Court ruled on June 6, 2024, that the Indian Health Service (IHS) must pay contract support costs with respect to program income – payments from Medicare, Medicaid and private insurers – received by tribes that administer healthcare programs under a self-determination contract. Becerra v. San Carlos Apache Tribe, --- S.Ct. ---- 2024 WL 2853107 (June 6, 2024). For the past 30 years, tribes have sought such compensation, and IHS has refused to provide it. The Court's ruling is a notable victory for Indian Country.

All tribes who have a 638 contract (or a compact) with IHS to provide health services should move promptly to take advantage of this decision and secure the additional funds to which they are entitled. A number of tribes have been following this issue and have already preserved their claims regarding past years. But even tribes that have not previously done so can gain the benefit of this decision.

There is a six-year statute of limitations on claims for additional compensation under a self-determination agreement. IHS faces a large amount of financial liability as a result of this decision, and it will vigorously enforce this limitations period. Thus, it is essential that any tribe that has not already filed a claim for these contract support costs proceed to do so now, without delay.