Justice Department Settles Litigation to Provide for Healthcare Costs of the Alaska Native Tribal Health Consortium

Today, the Justice Department announced its authorization of the settlement of a lawsuit brought by the Alaska Native Tribal Health Consortium (ANTHC) for contract support costs owed under the Indian Self-Determination and Education Assistance Act (ISDEAA). ANTHC was formed in the 1990s to provide health services throughout the state of Alaska. Among other things, ANTHC operates the non-primary care functions of the Alaska Native Medical Center, which is one of the largest tribally run hospitals in our Nation.

"Congress directed, and the Supreme Court clarified, that Indian tribes should be reimbursed by HHS for qualifying administrative costs when administering their own healthcare programs," said Acting Attorney General Blanche. "Our $400M settlement with ANTHC provides the consortium with support and autonomy for the healthcare services they provide to American Indians and Alaska Natives."

"This settlement reflects our commitment to resolving litigation fairly and ensuring that federal resources are appropriately directed toward serving Native communities," said Associate Attorney General Stanley Woodward. "We are pleased to have reached an authorized agreement that benefits American Indian and Alaska Native communities and remains consistent with the legal framework established by Congress."

Through a compact with the federal government under ISDEAA, ANTHC is responsible for administering certain healthcare programs that the federal government otherwise would administer for the benefit of American Indians and Alaska Natives in Alaska. In 2021, ANTHC filed litigation claiming the government had failed to pay certain contract support costs owed under ISDEAA and the compact. Specifically, ANTHC claimed the government owed contract support costs on revenue that ANTHC had collected from third-party payers, such as Medicare and private insurers, while administering the federal healthcare programs.

While the litigation was pending, in 2024, the Supreme Court decided in a similar case, Becerra v. San Carlos Apache Tribe, that Title I of ISDEAA requires the federal government to pay contract support costs on revenue from third-party payers when the relevant ISDEAA contract requires the revenue to be used for the healthcare program.

Following that landmark decision, the Justice Department engaged in extensive negotiations with ANTHC to reach a fair resolution of ANTHC's litigation and Acting Attorney General Todd Blanche made an official visit to the state in July 2026.