House Concurrent Resolution No. 15 directs the Idaho Department of Health and Welfare to establish a council aimed at revising and improving the Medicaid reimbursement methodology for skilled nursing facilities. This initiative is in response to the Centers for Medicare and Medicaid Services (CMS) requirement for the state to modify its reimbursement system by July 1, 2026. The resolution emphasizes the need for a collaborative approach, involving a diverse group of stakeholders, to ensure that the current upper payment limit (UPL) payments are integrated into the daily Medicaid rates and that managed care organizations (MCOs) implement these changes effectively.

Additionally, the resolution mandates the Division of Medicaid to take necessary actions to secure CMS approval for the revised methodology, which includes submitting required documentation and negotiating with CMS. It also calls for updates to quality metrics and potential contractual adjustments with Medicaid MCOs to facilitate the implementation of the new reimbursement system. The council is expected to report its findings and recommendations, along with proposed legislation, to the Idaho Legislature by January 31, 2026.