Blue Cross Reimbursement Case Revived in Win for Indian Tribe

An American Indian tribe revived its lawsuit accusing Blue Cross Blue Shield of Michigan of mismanaging a tribal health plan by failing to obtain discounts on medical services available to tribe members, according to a Sixth Circuit opinion issued Monday.

Federal law requires certain hospitals to accept discounted payments—called Medicare-Like Rates—for medical care authorized by a tribe or tribal organization carrying out a Contract Health Services program under the Indian Self-Determination and Education Assistance Act, the U.S. Court of Appeals for the Sixth Circuit said.

These discounts aren’t limited to instances in which a tribe’s CHS program is the entity ...