This bill amends Section 56-265 of the Idaho Code to enhance the payment structure for Medicaid providers, particularly focusing on residential habilitation services for individuals with disabilities. The legislation aims to increase transparency and accountability in Medicaid spending, which currently exceeds $176.5 million from the general fund. It introduces new provisions that allow the department to establish payment rates through legislative-approved rules when there is no Medicare equivalent. Additionally, it mandates annual cost surveys for various services and requires providers to allocate a specified amount to direct care worker wages and related expenses. Failure to comply may lead to corrective actions or termination of provider agreements.

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 legislative oversight in adjusting provider payment rates through the annual budget process. It also outlines reimbursement rates for different types of hospitals and encourages the development of value-based payment methods. The bill is declared an emergency measure, taking effect immediately upon passage and approval.

Statutes affected:
Bill Text: 56-265