IHS Funding Change Ends Cherokee Nation Contract Health Funds for UKB Members

TAHLEQUAH, Okla. - Cherokee Nation announced today that, as a result of their agreement with Indian Health Service (IHS), the United Keetoowah Band of Cherokee Indians in Oklahoma (UKB) will assume responsibility for their exclusive UKB members' purchase and referred care (PRC) program - a federally funded, independent health care program for tribes - effective January 1, 2025. Cherokee Nation objected to this IHS decision earlier this year and warned of harmful impacts to care for tribal citizens.

The federal IHS agency and a number of tribes operating IHS-funded programs administer PRC programs, formerly known as "contract health," to pay for specialty care for Native Americans from third-party providers.

IHS notified Cherokee Nation in the fall that it struck an agreement with the UKB to grant $5.6 million in PRC funding specifically for the Band. These federal dollars will now cover a program for UKB members, in lieu of the care these individuals previously received from Cherokee Nation.

"Cherokee Nation objected to the UKB's new federal funding stream granted by IHS because it is duplicative and wasteful," said Cherokee Nation Health Services Executive Director and CEO Dr. R. Stephen Jones. "UKB will now administer their own PRC program using this new stream of federal dollars while we continue to serve all other eligible individuals with the funds provided to Cherokee Nation."

Cherokee Nation, the largest tribal health system in Indian Country, has for decades administered a federally funded PRC program for members of all federally recognized tribes, including UKB members, on an equal basis.

"We provided access to federal PRC funds on an equal basis to all eligible patients, including all UKB patients," said Dr. Jones. "IHS took funds from other Native American healthcare programs to provide UKB with an opportunity to run their own federally funded PRC program."

"Federal PRC funds provide a fraction of tribal communities' overall need but are vital to our citizens' care, and Cherokee Nation is proud to provide the best health care in Indian Country," said Cherokee Nation Principal Chief Chuck Hoskin Jr. "It makes no sense for IHS to divert precious funds for native health care to essentially duplicate our contract health program. We have a responsibility to avoid 'double dipping' - an outcome IHS could not have intended and that our new policy avoids."

"Until IHS inexplicably diverted funds to duplicate our contract health system, it simply never occurred to Cherokee Nation to do anything other than share federal health funds with UKB members on an equal basis," said Hoskin. "Our contract health policy change is a direct result of IHS' poor decision making."

Under the new policy, UKB members will continue to have access to Cherokee Nation's vast health system, which includes ten health centers, W.W. Hastings Hospital, and, by the end of this fiscal year, the newly acquired Claremore Indian Hospital.

Cherokee Nation's health system providers will also continue to refer UKB patients for outside specialty care as needed.

What will change under the policy is the process through which UKB members access funds to pay for outside specialists, which, effective January 1, 2025, will come from UKB's new pool of contract health funds.

Today, Cherokee Nation advised IHS, UKB, and affected patients of the new policy.

"Our goal is to make this as seamless as possible for UKB patients," said Dr. Jones. "IHS has effectively ended our system of treating all patients the same for the purposes of contract health."