The Seneca Nation of Indians recently filed a federal lawsuit charging the U.S. Department of Health and Human Services under-counted the number of Seneca patients receiving federally reimbursed health care by 12,150 visits and thus under-funded the Nation in 2010 and 2011 by more than $7 million.
The lawsuit against HHS, filed Sept. 10 in Washington, D.C., says an agency subsidiary worked with the wrong number of eligible patients in 2010 4,122 when 6,156 were actually eligible.
The Nation seeks reimbursement of $7.5 million, plus interest for two years of under-counting, and attorney fees. This amount is based on the per-patient amount of health care funding the Indian Health Service, an HHS subsidiary agency, previously determined to be appropriate ($1,855), times the 2,034 patients not counted by HHS.
Nation President Robert Odawi Porter wrote April 29, 2011 to Martha Ketchner, acting director of the Indian Health Service's Nashville Area Office, proposing the reimbursement through amendments to the federal contracts the Nation has with the Indian Health Service.
"The Nation believes that federal accounting in this case is incorrect and the Nation simply seeks reimbursement for the value of that under-count," said President Porter. "We have a disagreement about numbers, which we have not yet been able to resolve in discussions with HHS, so we had to file suit to protect our claim."
The law requires the Indian Health Service to decline a contract amendment proposal within 90 days or it will be deemed approved as a matter of law. The service failed to take action on the Nation's April 2011 amendment proposals within the time allotted. Thus, the service is now required to fund the deemed-approved contract amendment to add $3.7 million for both fiscal years 2010 and 2011.
