Health Reform WK-EDGE Native American tribe’s VA benefits review barred
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Monday, August 27, 2018

Native American tribe’s VA benefits review barred

By Elizabeth M. Dries, J.D.

The Veteran’s Judicial Review Act, 38 U.S.C. § 511(a), bars the review of questions of law that affect the provision of benefits by the Department of Veterans Affairs (VA). Section 511(a) provides that the VA Secretary shall decide all questions of law and fact necessary to a decision that affects provision of benefits to veterans. The VA’s decision is considered final and conclusive and may not be reviewed by any other official or court. A Native American community’s lawsuit against the VA for failing to reimburse the community for care provided to veterans at tribal facilities was properly dismissed for lack of subject matter jurisdiction. The district court decision was affirmed and the case dismissed (Gila River Indian Community v. U.S. Dept. of Veterans Affairs, August 15, 2018, Fletcher, W.).

Background. The Gila River Indian Community is a federally recognized Native American tribe that occupies the Gila River reservation in Arizona. The Gila River Health Care Corporation (GRHC) is a wholly owned tribal organization that provides health care services to veterans who are entitled to receive services from the VA. In March 2016, the GRHC filed suit against the VA alleging that the VA violated two provisions of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), specifically §§1623(b) and 1645(c), for failure to reimburse the community absent a sharing agreement. The district court dismissed the lawsuit after determining that the Veteran’s Judicial Review Act, 38 U.S.C. § 511(a), deprived it of jurisdiction over the claims. The GRHC appealed, arguing that its claims do not fall within § 511(a) because its suit concerns reimbursement, rather than eligibility of services.

Appeal. The Ninth Circuit held that § 511(a) bars the GRHC’s suits as it requires a review of the VA’s determination that the ACA provisions in question do not require it to reimburse the GRHC. The appellate court noted that is clearly a question of law. The relief requested by the GRHC would clearly affect the provision of benefits by requiring the VA to reimburse the GRHC both retrospectively and prospectively.

The GRHC argued that Blackfeet Tribe presumption applied, which holds that "statutes are to be construed liberally in favor of the Indians, with ambiguous provisions interpreted to their benefit." The Ninth Circuit rejected this argument stating that it did not apply to § 511(a) because the presumption only applied to federal statutes that were passed for the benefit of Native American Tribes. Additionally, the Ninth Circuit rejected the GRHC’s argument that the district court had jurisdiction under 28 U.S.C. § 1362, which provides the district court with original jurisdiction over civil actions brought by Native American tribes that present a federal question. The Ninth Circuit panel noted that the GRHC did not make this argument in the district court; the argument was considered waived. The district court decision was affirmed and the case dismissed.

The case is No. 17-15629.

Attorneys: Linus Everling (Gila River Indian Community) for Gila River Indian Community and Gila River Health Care Corp. Laura Myron, U.S. Department of Justice, for U.S. Department of Veterans Affairs.

Companies: Gila River Indian Community; Gila River Health Care Corp.; U.S. Department of Veterans Affairs

Cases: CaseDecisions NewsFeed AccessNews CostSharingNews GeneralNews AlaskaNews ArizonaNews CaliforniaNews HawaiiNews IdahoNews MontanaNews NevadaNews OregonNews WashingtonNews

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