WASHINGTON (NEWSnet/AP) — The Supreme Court sided with Native American tribes Thursday in a dispute with the federal government over the cost of health care administration when tribes handle programs on behalf of their own communities.

The 5-4 decision means the government will cover millions in overhead costs that two tribes incurred after they took over the programs under a law meant to give Native Americans local control.

The Department of Health and Human Services argued it wasn’t responsible for the costs associated with billing insurance companies, Medicare and Medicaid.

The federal Indian Health Service has provided tribal health care since the 1800s under treaty obligations, but the facilities are often inadequate and understaffed, the San Carlos Apache Tribe in Arizona said in court documents.

Health care spending per person by the IHS is just one-third of federal spending in the rest of the country, the Northern Arapaho Tribe in Wyoming said in court documents. Native American tribal populations have an average life expectancy of about 65 years, nearly 11 years less than the U.S. as a whole.

The tribes contracted with IHS to run their own programs ranging from emergency services to substance-abuse treatment.

The agency paid the tribes the money it would have spent to run those services, but the contract didn't include the administrative costs for billing insurance companies or Medicare and Medicaid.

The tribes had to do the billing themselves.

The work cost the San Carlos Apache Tribe nearly $3 million in overhead over three years and the Northern Arapaho Tribe $1.5 million over a two-year period, they said.

Two lower courts agreed with the tribes.

The majority of federally recognized tribes now contract with IHS to run at least part of their own health care programming, and reimbursing billing costs for all those programs could total between $800 million and $2 billion per year, the agency said.

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