This bill aims to enhance transparency and accountability in Medicaid provider payments in Idaho, particularly for residential habilitation services. It amends Section 56-265 of the Idaho Code to establish new payment structures for Medicaid providers, specifying that payments for home and community-based services without a Medicare equivalent will be determined through annual cost surveys, which must include audits of at least 15% of responses. Additionally, providers are required to allocate a specified amount to direct care worker wages and employee-related expenses, with consequences for non-compliance. The bill also mandates that the Department of Health and Welfare report on the use of funds to ensure accountability for taxpayer dollars.

Furthermore, the bill declares certain administrative rules in IDAPA 16.03.26 as null and void, effective July 1, 2026, and emphasizes the need for value-based payment agreements with providers that focus on measurable healthcare quality. It includes provisions for reimbursement rates for various types of hospitals and outlines a plan for the department to work with Idaho hospitals to establish quality payment programs. The bill is declared an emergency measure, taking effect immediately upon passage and approval.

Statutes affected:
Bill Text: 56-265