Fort McDermitt Paiute and Shoshone Tribe v. Xavier Becerra, 6f4th6

Fort McDermitt Paiute and Shoshone Tribe entered a Title V self-governance compact to assume operation of a clinic and part of its EMS program previously run by the Indian Health Service (IHS).
IHS awarded a much smaller “secretarial amount” than the Tribe requested, withholding: (a) the portion IHS had internally allocated as the Winnemucca Tribe’s “tribal share,” and (b) the Medicare/Medicaid reimbursements IHS had historically collected for clinic services.
Fort McDermitt sued; the district court granted summary judgment to the Tribe on both issues, ordering the withheld funds paid.
The government appealed. The D.C. Circuit reviewed statutory interpretation questions de novo.
The court held that the secretarial amount is tied to the program (or portion of the program) a tribe operates, so Fort McDermitt is entitled to the funding IHS would have provided to operate the entire clinic (no tribal-share deduction).
The court held that Medicare/Medicaid reimbursements are third-party income excluded from the secretarial amount; such income is “supplemental” under ISDA/IHCIA and cannot be double-counted. The case was remanded to determine the precise funding adjustment for the tribal-share ruling.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the secretarial amount includes funds IHS had allocated to benefit another tribe ("tribal share").	Fort McDermitt: entitled to all funds IHS would have provided for clinic operations because the Tribe now operates the entire clinic.	IHS: secretarial funding limited to each tribe's "tribal share" based on eligible users; cannot transfer another tribe's share without its consent.	Court: Secretarial amount is tied to the portions of programs a tribe operates; since Fort McDermitt operates the entire clinic, it is entitled to the funding IHS would have provided—IHS erred in withholding the Winnemucca allocation.
Whether the secretarial amount must include Medicare/Medicaid reimbursements that IHS previously collected on the Tribe's behalf.	Fort McDermitt: include the value because IHS would have provided those reimbursements absent the compact.	IHS: reimbursements are third-party income supplied by CMS, designated by statute as "supplemental" and excluded from the secretarial amount; allowing inclusion would permit double recovery.	Court: Reimbursements are excluded from the secretarial amount under ISDA and IHCIA (third-party income is "supplemental"); Tribe cannot recover those amounts as part of the secretarial funding.

Lincoln v. Vigil, 508 U.S. 182 (deference to IHS discretion in ordering program priorities)
Salazar v. Ramah Navajo Chapter, 567 U.S. 182 (interpretation of ISDA secretarial funding concept)
Env’t Def. v. Duke Energy Corp., 549 U.S. 561 (use of consistent statutory meaning across provisions)
Russello v. United States, 464 U.S. 16 (expressio unius canon: express provisions imply exclusions elsewhere)
Morales v. Trans World Airlines, Inc., 504 U.S. 374 (specific statutory provisions control over broader ones)
Montana v. Blackfeet Tribe of Indians, 471 U.S. 759 (canon to construe ambiguous statutes liberally for Indians)
Merck Sharp & Dohme Corp. v. Albrecht, 139 S. Ct. 1668 (clarification that burden-of-proof standards generally govern facts, not pure questions of law)