Tribes Overpaying for Medical Services

During just one three-month period in 2008, the Indian Health Service and tribes paid $14 million over the Medicare rate for medical services, according to a Health and Human Services Inspector General’s report released last week. The money for the services comes from the Contract Health Services program -- a program so cash-strapped every year that it cannot cover medical care for tribal members for a full fiscal year, giving rise to the wry admonishment frequently heard in Indian Country … “Don’t get sick after June.”

Between January and March last year, IHS and tribes paid above the Medicare rate for 22 percent of hospital claims, resulting in $1 million in overpayments. But most overpayments were for hospital outpatient claims. If IHS and tribal payments for non hospital claims were capped at the Medicare rate, they could have saved as much as $13 million between January and March 2008.

While 22 percent of hospital claims were paid above the Medicare rate, the resulting overpayments only accounted for 3 percent of the total $33 million that IHS and tribes spent on hospital claims between January and March 2008, according to the report. IHS and tribes paid above the Medicare rate for 71 percent of non hospital claims. Most of these claims paid above the Medicare rate were for physician services.

Thomas May be Ousted as Pequot Chairman

The Mashantucket Pequot Tribal Council could vote tomorrow to expel tribal chairman Michael Thomas from the council, according to the New London Day.

Thomas has been on administrative leave since August 31, “pending the outcome of an internal review.” On August 19, in a letter to tribal members, Thomas revealed the tribe's dire financial circumstances and his plans to deal with the crisis.

The council told Thomas they were “appalled” by his letter and that he had betrayed their trust. In the letter, Thomas pledged to preserve tribal government and incentive payments to tribal members before paying creditors. Under the tribe's constitution and by-laws, the council may, by a three-fifths vote, expel any council member “for neglect of duty or gross misconduct after due notice and opportunity to be heard.”

The Day reported on Thomas' letter in an Aug. 26 story that also reported the tribe, which owns Foxwoods Resort Casino and MGM Grand at Foxwoods, was nearing default and seeking to restructure $2.3 billion worth of debt.

Indian Affairs Secretary Addresses N.D. School Children

Interior Assistant Secretary-Indian Affairs Larry Echo Hawk speaks at the Bureau of Indian Education’s Theodore Jamerson Elementary School in Bismarck, N.D., following President Obama’s national address to students on working hard and setting educational goals.

Mashantucket Pequot Want to Restructure $2.3 Billion in Debt

Reeling from the economy, Foxwoods Casino is seeking to restructure more than $2.3 billion in debt, according TheDay.com. The article described the Mashantucket Pequot, owners of Foxwoods, as being on the "brink of default." The debt is $1 billion more than the tribe's Foxwoods Resort Casino - North America's largest casino and once the world's most profitable - can sustain, a source said.

In an e-mail to tribal members, sent out last week, tribal council Chairman Michael Thomas described the situation: "Earnings are down considerably and there are no signs of immediate improvement. These are dire financial times for our tribe."

In the past two years, the tribe has laid off workers at The Foxwoods Resort, reduced the size of the tribal government and reduced payments to tribal members.

Nisqually Use Stimulus Funds to Clean Puget Sound

Here's a story in the New York Times about the Nisqually Tribe's $4.6 million stimulus-financed effort to clean up Puget Sound. The Tribe has formed a dive team that removes fishing nets that were lost or discarded decades ago but can still kill fish, birds and other animals. Check out the photos too.

Justice Department Listening Conference -- Will it Help Indian Country

Below is a release from the Department of Justice regarding a tribal nations listening conference. We'd like to hear from anyone who was part of the last Justice Deparment listening conference -- the one described in the last paragraph of the release.

Do you think it had any impact on fighting crime in Indian Country? Did you feel as if your concerns were addressed by the Administration and/or Congress?

Dates for Justice Department Listening Conference Set

The Justice Department today announced the dates of the 2009 Tribal Nations Listening Conference to be led by Attorney General Eric Holder. Prior to the Listening Conference, the Department will also convene two working sessions with tribal leaders and experts in law enforcement to be led by Deputy Attorney General David W. Ogden and Associate Attorney General Tom Perrelli:

• Working Session #1: Aug. 25-26 in Seattle, Wash.
• Working Session #2: Sept. 21-22 in Albuquerque, N.M.
• Listening Conference: Oct 28-29 Minneapolis, M.N.
  

The Listening Conference is part of an ongoing Justice Department initiative to increase engagement, coordination and action on tribal justice in Indian Country. It will allow top Department officials to confer with tribal leaders on how to address the chronic problems of public safety in Indian Country and other important issues affecting tribal communities. The working sessions will include Department component leaders and tribal experts in relevant areas to begin a dialogue on a range of important issues including, law enforcement policy and personnel; communications and consultation; grants and technical assistance; detention facilities; federal prosecution in Indian country; tribal court development; domestic violence; drug courts and substance abuse; federal litigation involving tribes; and civil rights.

In 1994, Attorney General Janet Reno convened the only other National Listening Conference, sponsored jointly with the Department of the Interior, which led to numerous initiatives, including major funding for tribal police, jails and courts.

IHS Not Like Public Option Insurance, Says White House

The Indian Health Service (IHS) is not an example of how public option health insurance would work, says an Obama administration official.

Yesterday on the White House blog, Kimberly Teehee, a senior policy advisor for Native American Affairs at the White House Domestic Policy Council, posted a rebuttal to those who have used the Indian Health Service as an example of what could go wrong with a public option health insurance plan.

“The IHS system is not an insurance plan,” Teehee said in a video and written message. “And comparing the two is like comparing apples to oranges. IHS provides comprehensive health care services to approximately 1.9 million American Indians and Alaska Natives living on or near reservations in 35 states. Some of these health services include doctor visits and check-ups, dental and vision care, diabetes prevention and treatment, mental health and substance abuse treatment, and home health care. IHS also helps construct hospitals and clinics and provides safe drinking water and sanitation facilities to American Indians and Alaska Natives. Health insurance, by contrast, provides individuals a guarantee to a defined set of benefits for a price. While the IHS accepts insurance payments for care it provides, it is not an insurance plan.”

In a recent interview with the Rapid City Journal, South Dakota Gov. Mike Rounds pointed to the Indian Health Service to caution South Dakotans against supporting more government involvement in medical care.

"Right now in South Dakota, we've got one of the best examples of a health-care system run amok, and that is Indian health," Rounds said in an interview with the Journal. "And I wouldn't wish that health care on anybody. It would be an absolute disaster in America."