Sixth Circuit (again) Rules in Favor of Saginaw Chippewa in Beef with Blue Cross

Here is the opinion in Saginaw Chippewa Indian Tribe v. Blue Cross Blue Shield of Michigan.

An excerpt:

The Saginaw Chippewa Indian Tribe and its Benefit Plan brought federal and common law claims against Blue Cross Blue Shield of Michigan (BCBSM or Blue Cross) for failing to fulfill its fiduciary duties in administering tribal health insurance plans. When we first encountered this dispute three years ago, we reversed the district court’s dismissal of the Tribe’s claims based on Blue Cross’s alleged failure to insist on “Medicare-like rates” for care authorized by the Tribe’s Contract Health Services1 program and provided to tribal members by Medicare-participating hospitals. On remand, the district court granted summary judgment to Blue Cross, concluding that the Tribe’s payments for qualified CHS care through the Blue Cross plans were not eligible for Medicare-like rates. The district court interpreted the relevant federal regulations as limiting the requirement of Medicare-like rates to payments for care that was authorized by CHS, provided to tribal members by Medicare- participating hospitals, and directly paid for with CHS funds. Based on the plain wording of the applicable regulations, we REVERSE and REMAND the case to the district court for further proceedings consistent with this opinion.

Briefs:

Lower court materials here.

Split Sixth Circuit Vacates Conviction and Sentence of D.V. Perpetrator of Saginaw Chippewa Tribal Citizens

Here are the materials in United States v. Johnson:

CA6 Opinion

Opening Brief

US Brief

Reply

 

The University of Michigan federal appellate clinic represented the appellant.

Tribal Amicus Brief Supporting Cert Petition in LTBB v. Whitmer

Here:

Petition here.

LTBB v. Whitmer Cert Petition

Here:

Cert Petition

Question presented:

Whether the 1855 Treaty of Detroit established a federal reservation for the Little Traverse Bay Bands of Odawa Indians?

Lower court materials here.

Sixth Circuit Decides Little Traverse Bay Bands of Odawa Indians v. Whitmer

Here:

LTBB v Whitmer

Briefs here.

Sixth Circuit Oral Argument in LTBB v. Whitmer

Here:

Briefs are here.

Insurance Company Prevails over Saginaw Chippewa Indian Tribe in Suit Alleging Failure to Seek Medicare-Like Rates

Here are the materials in Saginaw Chippewa Indian Tribe v. Blue Cross Blue Shield (E.D. Mich.):

173 BCBS Motion for Summary Judgment

177 Response

178 Reply

197 DCT Order

Prior post here.

Update (2/2/2021):

199 Motion to Amend

201 Response

202 DCT Order