House Concurrent Resolution No. 15 directs the Idaho Department of Health and Welfare to convene a council aimed at revising and improving the Medicaid reimbursement methodology for skilled nursing facilities. This initiative is in response to a requirement from the Centers for Medicare and Medicaid Services (CMS) that mandates changes to the reimbursement system by July 1, 2026. The resolution emphasizes the need for a collaborative approach, involving a broad range 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 payments as part of a minimum fee schedule.

Additionally, the resolution outlines the responsibilities of the Division of Medicaid, which include obtaining CMS approval for the revised methodology and updating quality metrics with stakeholder input. The council is tasked with reporting its findings, recommendations, and proposed legislation to the Idaho Legislature by January 31, 2026, ensuring that the new reimbursement methodology is effectively administered by Medicaid MCOs and aligns with state and federal requirements.