All Roll Calls
Yes: 33 • No: 0
IdahoS 14102026 regular legislative sessionSenateWALLET
MEDICAID – Adds to existing law to provide legislative approval for the Department of Health and Welfare to submit a state plan amendment regarding change in encounter rate due to change in scope of services.
Sponsored By: STATE AFFAIRS COMMITTEE
Signed by Governor
MEDICAID
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 1 benefits, 0 costs, 2 mixed.
How clinics apply for rate changes
Clinics should give written notice 60 days before changing services; no penalties apply for these filings. Run the new services for six straight months, then file by the last day of the third month after. You may submit only one scope-based application per fiscal year. Include a narrative of changes, a full six‑month cost and encounter report, and any extra data the department reasonably requests. The department must act within 90 days, pausing the clock for up to two weeks if it asks for more records. It sends a draft rate; you have 60 days to review; the final rate issues 45 days later. You may appeal the final rate within 30 days.
Medicaid clinic rates adjust for new services
The department adjusts FQHC and rural clinic PPS rates when service scope changes. A scope change means the type, intensity, duration, or number of services changes; adding, dropping, or expanding services counts. Higher costs alone do not count as a scope change. To qualify, the change must shift cost per visit by at least 4.5% against the current PPS rate. The final rate is effective the first day the change began, and the state reconciles payments back to that date, including any not handled by managed care.
New Medicaid plan steps by 2026
The Department must submit needed Medicaid state plan amendments by October 1, 2026. The law takes effect upon passage. The prior rule in IDAPA 16.03.26 Section 307.03 ends on October 1, 2026. Clinics that began scope changes before that date may finish under the old rule.
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Sponsors & Cosponsors
Sponsor
STATE AFFAIRS COMMITTEE
Affiliation unavailable
Cosponsors
Julie VanOrden
Republican • Senate
Roll Call Votes
Senate vote • 3/26/2026
Senate Floor Vote
Yes: 33 • No: 0
Actions Timeline
Signed by Governor on 04/02/26 Session Law Chapter 308 Effective: 04/02/2026; 07/01/2026 IDAPA Sunset Clause - SECTION 2
4/2/2026Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
4/1/2026SenateRead third time in full – PASSED - 33-0-2
3/26/2026SenateRead second time; filed for Third Reading
3/25/2026SenateReported out of Committee with Do Pass Recommendation; Filed for second reading
3/24/2026SenateReported Printed; referred to Health & Welfare
3/19/2026SenateIntroduced; read first time; referred to JR for Printing
3/18/2026Senate
Bill Text
Bill Text
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