Indian Health Service

Chappabitty v. IHS Complaint and Press Release

Matthew L.M. Fletcher

Here:

FTCA Complaint

Order.Motion for Relief

Press Release 12.8.11

An excerpt from the press release:

On December 7, 2011, Edwin Chappabitty, Jr., MD, Lawton, Oklahoma, filed a Federal Tort Claims Act lawsuit for monetary damages in the United States Court for the Western District of Oklahoma alleging that officials of the United States Department of Health and Human, Indian Health Service, negligently failed to follow federal laws and regulations governing the conduct of investigations into alleged professional misconduct by physicians employed by the Indian Health Service. Dr. Chappabitty never expected to be accused of leveling racist statements to his patients on May 1, 2008 just four months from the end of his thirty year career in the federal service.

Chappabitty, Comanche/Ft. Sill Apache, retired from the IHS in August 2008 as a naval captain, having come to the service as an officer in the U.S. Public Health Service Commissioned Corps, a uniformed, non-military government agency under the purview of the U.S. Department of Health and Human Services.

SCIA Press Release on GAO Report on IHS Billing

Matthew L.M. Fletcher1 Comment

SENATORS URGE IMPROVEMENTS TO INDIAN HEALTH SERVICE

WASHINGTON – A bipartisan group of senators is urging Health and Human Services Secretary Kathleen Sebelius and other top administration officials to act quickly to improve health care delivery to American Indians and Alaska Natives.

In a letter to Secretary Sebelius and Indian Health Service Director Dr. Yvette Roubideaux, the senators pointed to a U.S. Government Accountability Office report issued Friday, September 23, that highlights billing and other problems in the IHS system that make it difficult for American Indians and Alaska natives to receive care from health providers and makes it difficult for health care providers offering the services to get reimbursed.

The GAO report, called “Indian Health Service: Increased Oversight Needed to Ensure Accuracy of Data Used for Estimating Contract Health Service Need,” states that due to inadequate and inconsistent data collection by IHS, it has been very difficult for health care providers who contract with IHS to quickly determine a patient’s eligibility for services.  Poor data collection also makes it difficult for IHS to know what contractual services are needed by American Indians and Native Alaskans and whether it has adequate funds to pay for such services.

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New General Accounting Office Report on IHS

Matthew L.M. Fletcher

Here. H/t Pechanga.

Here is the GAO summary:

The Indian Health Service (IHS), an agency in the Department of Health and Human Services (HHS), provides health care to American Indians and Alaska Natives. When care at an IHS-funded facility is unavailable, IHS’s contract health services (CHS) program pays for care from external providers if the patient meets certain requirements and funding is available. The Patient Protection and Affordable Care Act requires GAO to study the adequacy of federal funding for IHS’s CHS program. To examine program funding needs, IHS collects data on unfunded services–services for which funding was not available–from the federal and tribal CHS programs. GAO examined (1) the extent to which IHS ensures the data it collects on unfunded services are accurate to determine a reliable estimate of CHS program need, (2) the extent to which federal and tribal CHS programs report having funds available to pay for contract health services, and (3) the experiences of external providers in obtaining payment from the CHS program. GAO surveyed 66 federal and 177 tribal CHS programs and spoke to IHS officials and 23 providers.

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Tenth Circuit Sides with Southern Ute in Contract Support Costs Dispute with IHS

Matthew L.M. Fletcher1 Comment

Here is the opinion in Southern Ute Tribe v. Sebelius.

The briefs:

Southern Ute Opening Brief

USA Opening Brief

Southern Ute Reply

USA Reply Brief

 

Quechan Tribe Claim re: Indian Hospital Services Fails

Matthew L.M. Fletcher1 Comment

Here is the opinion: Quechan v US — IHS Claim

An excerpt:

This is an action brought by the Quechan Indian Tribe against the United States seeking a declaration that the United States has a duty to operate its medical facilities and practices at a level that meets or exceeds a minimum generally accepted standard of care, and that the United States has breached that duty. Plaintiff also seeks equitable relief requiring defendants to ensure its medical services at the Fort Yuma Indian Reservation do not fall below the minimum standard of care.

Quechan Tribe v. United States — Demand for Reservation Health Care

Matthew L.M. Fletcher

Here is the complaint: Quechan Complaint.

An excerpt:

Plaintiff Quechan Indian Tribe (“Tribe”), in its own capacity and as parens patriae on behalf of its members, seeks a declaratory judgment that the United States of America, acting through the Department of Health and Human Services, Indian Health Service (“IHS“), and the IHS Fort Yuma Service Unit (“United States”) is in breach of its statutory obligation and special trust responsibility to provide the Tribe and its members within the Fort Yuma Indian Reservation (“Reservation”) with health care facilities and services that meet generally accepted, appropriate, and best available standards of care.

Menominee Tribe Wins Contract Support Costs Case against Indian Health Service

Matthew L.M. Fletcher2 Comments

Here is the D.C. Circuit’s opinion in Menominee Tribe v. United States.

Interesting case, since the Tribe brought suit for indirect costs under the Contract Disputes Act.

Federal Court Dismisses Tort Claim against US and Remands to State Court

Matthew L.M. Fletcher

The opinion in this matter is here: Loza v Native American Air Ambulance An excerpt:

On January 29, 2009, Plaintiffs filed a complaint in the Maricopa County Superior Court alleging medical malpractice against certain named defendants, including Dr. Jesus Carpio. On February 2, 2009, Plaintiffs filed an administrative tort clam with allegations pertaining to Dr. Carpio similar to those contained in Plaintiffs’ January 29 complaint. At the time of the alleged acts of malpractice, Dr. Carpio was an employee of Parker Indian Hospital-a hospital operated by the Indian Health Service, an agency of the United States Department of Health and Human Services.

On May 11, 2009, the United States, on behalf of Dr. Carpio, removed Plaintiffs’ action to this Court and substituted the United States for Defendant Dr. Carpio under 28 U.S.C. § 2679(d)(2). Shortly thereafter, Defendant United States filed its Motion to Dismiss.

Emotionally Potent Oversimplification of the Day: Terry Anderson on the Indian Health Service

Matthew L.M. Fletcher4 Comments

Thanks to Rick Collins for sending this around — Terry Anderson WSJ Op-Ed on Indian Health Service

I’m not surprised that the WSJ carries the material that Terry Anderson writes. The NYTs does, too. I know that Terry is a really nice guy, despite my reservations about his free market/property rights approach to Indian affairs. We had him speak at Fed Bar a few years ago, and he expressed a great deal of support for tribal sovereignty. I had hoped he would engage tribal advocates on the positions they take on the federal trust relationship with the United States, and vice versa, but nothing really happened. I wanted this because I find his brand of editorial commentary (as opposed to his scholarly work) very troubling.

It’s usually a syllogism, repeating oversimplifications about Indian affairs again and again. For example, the one about Indian trust lands that gets noticed in the NYTs:

1. The United States owns all Indian lands.
2. Indians are poor.
2a. Quote/story from Indians angry at government.
3. Therefore, get rid of U.S. trust responsibility.

And the WSJ editorial (above), an obvious attack on the Obama health plan, unsurprising from a free market advocate:

1. IHS handles Indian health.
2. Indians are unhealthy.
3. Get rid of IHS.

Terry gets published in very respectful journals (Journal of Law & Econ., for example), but the work (despite the regression analyses) seems a little superficial to someone with roots in Indian Country. He wrote on tribal courts a few years back, attempting to refute the Cornell/Kalt theory that tribal courts help to develop tribal economies.

Here is the abstract to that paper, which advocates for PL280 to be expanded to all of Indian Country:

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