Gila River Indian Community v. Becerra

CourtDistrict Court, District of Columbia
DecidedMay 31, 2024
DocketCivil Action No. 2021-1401
StatusPublished

This text of Gila River Indian Community v. Becerra (Gila River Indian Community v. Becerra) is published on Counsel Stack Legal Research, covering District Court, District of Columbia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Gila River Indian Community v. Becerra, (D.D.C. 2024).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

GILA RIVER INDIAN COMMUNITY, et al.,

Plaintiffs,

v. Civil Action No. 21-cv-1401 (TSC) XAVIER BECERRA, Secretary, U.S. Department of Health and Human Services, et al.,

Defendants.

MEMORANDUM OPINION

Plaintiffs Gila River Indian Community (“the Community”) and Gila River Health Care

Corporation (“GRHC”) sued the United States and officials at the Department of Health and

Human Services (“HHS”) and its component agency the Indian Health Service (“IHS”).

Plaintiffs seek unpaid reimbursements for healthcare services provided to veterans, and allege

that their damages stem from Defendants’ breach of a Compact of Self Governance between the

Community and IHS. Compl. ¶¶ 8, 18, 45–47, ECF No. 1. Because Plaintiffs lack standing, the

court will GRANT Defendants’ Motion to Dismiss, ECF No. 22 (“Motion”), and dismiss this

action.

I. BACKGROUND

The United States provides health care to Native Americans as part of its “special trust

responsibilities and legal obligations to Indians.” 25 U.S.C. § 1602. It does so through IHS. 25

U.S.C. § 1661(c)(3); see also Gila River Indian Cmty. v. United States Dep’t of Veterans Affs.,

2:16-cv-772-PHX-ROS, 2017 WL 2424721, at *1 (D. Ariz. Mar. 23, 2017). The Community

and IHS entered a Compact of Self Governance in 2002, under which the Community assumed

Page 1 of 20 responsibility to provide health care services to members of the Community and other eligible

beneficiaries. ECF No. 24-2, Decl. of Andrew Brantingham, Ex. A (“Compact”), Art. III § 3;

see also Compl., Ex. B at 3. 1 Under a self-determination contract like the Compact, “the federal

government supplies funding to a tribal organization, allowing [the Tribe] to plan, conduct and

administer a program or service that the federal government otherwise would have provided

directly.” Rancheria v. Hargan, 296 F. Supp. 3d 256, 260 (D.D.C. 2017) (quoting FGS

Constructors, Inc. v. Carlow, 64 F.3d 1230, 1234 (8th Cir. 1995)).

The Community is a federally recognized Indian tribe that occupies the Gila River

reservation in Arizona. Compl. ¶ 7. GRHC is a tribal organization wholly owned by the

Community and is responsible for providing health care services pursuant to the Compact. Id.

¶ 9. The Community also provides health care services directly, without going through GRHC.

Id. The health care Plaintiffs provide is financed through funding agreements (which the court

has not been provided) between the Community and IHS. Gila River Indian Cmty. v. United

States Dep’t of Veterans Affs., 899 F.3d 1076, 1077 (9th Cir. 2018); Compl. ¶ 8.

The Community and GRHC provide health care services to Indian and non-Indian

veterans who are entitled to receive services from the Department of Veterans Affairs (“VA”).

Gila River, 899 F.3d at 1077. Before 2010, care provided by the Community and GRHC to

veterans was paid for through IHS. Gila River, 2017 WL 2424721, at *1. After 2010, the

Patient Protection and Affordable Care Act (“ACA”), Pub. L. No. 111-148, 124 Stat. 119 (2010),

included a provision that “allows tribal organizations, such as GRHC, to be reimbursed for health

1 On a motion to dismiss for lack of subject-matter jurisdiction, the court may consider “any documents either attached to or incorporated in the complaint[,]” EEOC v. St. Francis Xavier Parochial Sch., 117 F.3d 621, 624 & n.3 (D.C. Cir. 1997), as well as “materials outside the pleadings,” Gulf Coast Mar. Supply, Inc. v. United States, 867 F.3d 123, 128 (D.C. Cir. 2017).

Page 2 of 20 care provided to individuals eligible to receive care from the VA.” Gila River, 2017 WL

2424721, at *1 (citing 25 U.S.C. § 1645(c)). Specifically, section 1645(c) provided that the

“[IHS], Indian tribe, or tribal organization shall be reimbursed by the Department of Veterans

Affairs or the Department of Defense . . . where services are provided through the [IHS], an

Indian tribe, or a tribal organization to beneficiaries eligible for services from either such

Department, notwithstanding any other provision of law.” 2

According to Plaintiffs, the VA opposed enactment of this provision and has resisted

complying with it. Compl. ¶ 18. They contend that “IHS should have immediately sought

reimbursement from [the] VA for itself and assisted self-governance tribes like the Community

in doing the same.” Id. ¶ 19. But “[i]nstead of providing reimbursements directly under the

ACA, the VA developed template reimbursement agreements with the IHS, and it required

recipients to enter into an agreement as a condition of receiving reimbursement.” Gila River,

899 F.3d at 1077–78. The Community alleges that the “VA sought to include provisions in its

template agreements specifically designed to limit tribal reimbursement rights guaranteed by the

statute.” Compl. ¶ 20. Those provisions included terms providing that “reimbursement would

be limited to prospective services and would not be retroactive to the statute’s effective date,”

2 Plaintiffs and the VA disagree over section 1645(c)’s interpretation. Plaintiffs believe that “shall be reimbursed” cannot reasonably be read “to require reimbursement only if agreed to by VA.” Compl. ¶ 28. Plaintiffs’ prior suit against the VA provides the VA’s interpretation: Relying on the new statutory provision, GRHC sought reimbursement from the VA for that care. The VA refused to reimburse GRHC, claiming § 1645(c) is not self-executing. In the VA’s view, § 1645(c) allows it to negotiate the terms whereby it will provide reimbursements to tribal organizations. Gila River, 2017 WL 2424721, at *1. Section 1645(c) was amended in 2021 to “clarify the requirement of the Department of Veterans Affairs and the Department of Defense to reimburse the Indian Health Service” for certain health services. Proper and Reimbursed Care for Native Veterans Act, Pub. L. No. 116-311, 134 Stat. 4927 (2021); see also Compl. ¶ 33.

Page 3 of 20 limiting reimbursement “to direct care services only,” and excluding reimbursement for “non-

Native veterans receiving care from the Tribal Plaintiffs.” Id. ¶ 25.

Plaintiffs claim that IHS “initially opposed such limitations, and even submitted the

dispute over interpretation of § 1645(c) to the Department of Justice (‘DOJ’).” Id. ¶ 20. But IHS

“capitulated to VA’s reimbursement terms before receiving guidance from DOJ,” and eventually

“endorsed” template agreements including the terms above. Id. ¶¶ 20, 21. The Complaint

alleges that “IHS’s complicity in VA’s wrongful conduct directly affected the Community’s

ability to vindicate its rights” under section 1645(c) because once “IHS had already agreed to

VA’s national template agreement, VA insisted that the Community enter into the same

compromise IHS had endorsed.” Id. ¶ 25 (internal quotations omitted). “The Community

disagreed with the limitations VA sought to impose.” Id. ¶ 28. But the “VA refused to

negotiate,” allegedly “stating it had already resolved the scope of reimbursements” under section

1645(c) in its negotiations with IHS, and that the “agreement reached with IHS would define the

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