Nansemond Indian Nation sues Virginia over Medicaid reimbursement discrimination

The Nansemond Indian Nation and its tribally chartered health arm, Fishing Point Healthcare, are suing the Commonwealth of Virginia for withholding Medicaid reimbursements and discriminating against tribal healthcare providers.

[This story was originally published in Native News Online.]

The lawsuit filed Tuesday alleges Gov. Glenn Youngkin and state officials protected the financial interests of powerful Managed Care Organizations (MCOs) at the expense of low-income patients.

Fishing Point Healthcare was established in 2023 in Portsmouth, Va., to serve Nansemond members and low-income, non-tribal members. Its services include primary care, behavioral health, addiction recovery, home health and an onsite pharmacy.

The suit alleges Virginia began refusing to reimburse Fishing Point for certain Medicaid services in Oct. 2024, pressuring the tribal provider to transfer patients to MCOs.

“Virginia is undermining our sovereignty and our patients’ care to benefit healthcare giants,” Nansemond Chief Keith Anderson said in a statement. “We will not stand by.”

Virginia contracts with five MCOs, all owned by major health insurers. The lawsuit alleges that the companies limit care through cost-cutting measures that disproportionately affect vulnerable patients.

According to a press release issued by the tribe, a federal audit in Nov. 2024 confirmed that Fishing Point followed billing procedures approved by federal and state agencies; its services are covered under Virginia’s Medicaid plan; and the Commonwealth underpaid and illegally withheld reimbursement.

Virginia’s Department of Medical Assistance Services failed to share the audit results with the Nansemond Nation and refused to issue the required reimbursement.

While awaiting payment, Fishing Point has been self-financing care.  In the press release, Fishing Point CEO Lance Johnson said the health program offered to cover Virginia’s share of costs for non-Tribal Medicaid patients—an offer that would have saved the Commonwealth money. 

“We presented a cost-neutral plan for taxpayers,” Johnson said. “The state rejected it, showing this is about punishing tribal care and protecting MCO profits.”

The lawsuit argues that documents obtained by the Nation through the Freedom of Information Act show that DMAS knowingly misled legislators during the 2025 General Assembly, falsely claiming that federal law requires the state to route Tribal providers through MCOs.

The suit challenges a budget amendment endorsed by Youngkin on March 24, which imposes new, unlawful restrictions on Tribal healthcare.

The lawsuit asks the court to order Virginia to reimburse Fishing Point in full for underpaid and unpaid services, block enforcement of the illegal budget amendment, and require DMAS to cease its discriminatory practices.

“Fishing Point offers low-income patients a choice—and they’re choosing tribal care,” attorney Jessie Barrington of the law firm Cultural Heritage Partners and counsel for the Nation and Fishing Point, said in the press release. “That threatens insurers who profit from fewer choices and shocks state officials used to grease the wheels for big insurance. But my clients know how David vs. Goliath ends.”