The bill amends Section 56-265 of the Idaho Code to establish specific requirements for value care organizations within the Medicaid framework. It introduces new provisions that mandate value care organizations to select minimum risk-sharing levels, which will progressively increase from 40% in 2026 to 70% by 2029. Additionally, the bill emphasizes the importance of cost-neutral or cost-saving agreements between the department and providers, while allowing the department to pursue federal waiver agreements to support value-based payment arrangements.

Furthermore, the bill outlines various reimbursement rates for different types of hospitals, including critical access, out-of-state, and state-owned hospitals, and mandates equitable reductions in net reimbursements to meet budgetary goals. It also requires the department to collaborate with Idaho hospitals to develop value-based payment methods and a quality payment program for inpatient and outpatient services, with the aim of transitioning away from existing cost-based reimbursement methods by July 1, 2021. The bill declares an emergency, making it effective immediately on July 1, 2025.

Statutes affected:
Bill Text: 56-265