The Justice Department announced July 21, 2026, that it authorized a $400 million settlement resolving a lawsuit brought by the Alaska Native Tribal Health Consortium (ANTHC). The litigation concerned 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 Alaska. It operates the non-primary care functions of the Alaska Native Medical Center, described in the announcement as one of the largest tribally run hospitals in the United States.
The underlying dispute
Under a compact with the federal government pursuant to ISDEAA, ANTHC administers certain healthcare programs that the federal government would otherwise administer for the benefit of American Indians and Alaska Natives in Alaska. In 2021, ANTHC filed litigation alleging that the government had failed to pay contract support costs required under ISDEAA and the compact.
The consortium specifically claimed that the government owed contract support costs on revenue it collected from third-party payers, including Medicare and private insurers, while administering the federal healthcare programs. In 2024, while the litigation was pending, the U.S. Supreme Court decided a similar case, Becerra v. San Carlos Apache Tribe. The Court held that Title I of ISDEAA requires the federal government to pay contract support costs on third-party payer revenue when the relevant ISDEAA contract requires that revenue to be used for the healthcare program.
“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.”
Associate Attorney General Stanley Woodward said the settlement reflects the Justice Department’s commitment to resolving litigation fairly and directing federal resources toward Native communities. After the Supreme Court’s decision, the department engaged in extensive negotiations with ANTHC to resolve the litigation. Acting Attorney General Todd Blanche made an official visit to Alaska in July 2026.