Title 56, PUBLIC ASSISTANCE AND WELFARE

56-238. Definitions. As used in this section and section 56-239, Idaho Code: (1) "CHIP Plan A" means the existing Idaho children’s health insurance program for children eligible under federal title XXI whose families’ modified adjusted gross incomes do not exceed one hundred fift…

56-239. CHIP Plan B. (1) There is hereby created in the department a CHIP Plan B that shall be made available by the department to eligible children, as defined in section 56-238, Idaho Code, whose family’s modified adjusted gross income is between one hundred fifty percent (150%…

56-250. Short title. This act shall be known and may be cited as the "Idaho Medicaid Simplification Act."

56-251. Legislative intent. (1) The legislature finds that the current federal medicaid law and regulations have not kept pace with modern health care management practices, create obstacles to quality care and impose unnecessary costs on the delivery of effective and efficient he…

56-254. Eligibility for medical assistance. The department shall make payments for medical assistance to, or on behalf of, the following persons eligible for medical assistance. (1) The benchmark plan for low-income children and working-age adults with no special health needs inc…

56-255. Medical assistance program — Services to be provided. (1) The department may make payments for the following services furnished by providers to participants who are determined to be eligible on the dates on which the services were provided. Any service under this section …

56-256. Preventive health assistance. (1) The department of health and welfare may establish preventive health assistance benefits available to a medicaid participant in order to provide incentives to promote healthy behavior and responsible use of health care services. (2) Preve…

56-257. Copayments. (1) Within the limits of federal medicaid law and regulations, the department of health and welfare shall establish enforceable cost sharing in order to increase the awareness and responsibility of medicaid participants for the cost of their health care and to…

56-260. short title. Sections 56-260 through 56-266, Idaho Code, shall be known and may be cited as the "Medicaid Cost Containment and Health Care Improvement Act."

56-261. Legislative Findings and Intent. (1) The legislature finds that the current health care delivery system of payment to medicaid health care providers on a fee for service basis does not provide the appropriate incentives and can be improved by incorporating managed care to…

56-263. medicaid managed care plan. (1) The department shall seek approval as soon as practicable but no later than July 1, 2027, from the centers for medicare and medicaid services for directed payments to qualifying entities participating in the Idaho behavioral health plan or …

56-265. provider payment. (1) Where there is an equivalent, the payment to medicaid providers: (a) May be up to but shall not exceed one hundred percent (100%) of the current medicare rate for primary care procedure codes as defined by the centers for medicare and medicaid servic…

56-266. authorization to obtain federal approval. The department is authorized to obtain federal approval for the requirements set forth in sections 56-260 through 56-266, Idaho Code.

56-267. MEDICAID ELIGIBILITY EXPANSION. (1) Except as provided by subsection (6) of this section, the state shall amend its state plan to expand medicaid eligibility to include those persons under sixty-five (65) years of age whose modified adjusted gross income is one hundred th…

56-268. SUPPLEMENTAL MEDICAID REIMBURSEMENT FOR ground emergency medical TRANSPORTATION. (1) An eligible provider, as described in subsection (2) of this section, in addition to the rate of payment that the provider would otherwise receive for medicaid ground emergency medical tr…

56-269. changes in eligibility criteria to be provided in statute. Effective July 1, 2025, any change that would expand eligibility criteria for a public assistance program, or that would expand the benefit provided by a public assistance program, must be provided in statute and …

56-270. State plan amendment — postpartum medicaid coverage. (1) The state shall amend its state plan to extend medicaid eligibility for twelve (12) months postpartum to individuals who, while pregnant, are eligible for and receive medicaid, in accordance with section 9812 of the…

56-271. MEDICAID BUDGET STABILIZATION FUND. There is hereby created in the state treasury the medicaid budget stabilization fund. By the close of fiscal year 2025 or as soon thereafter as practicable, a total of twelve million dollars ($12,000,000) of all unobligated general fund…

56-273. Prohibition on reimbursement and coverage. (1) Pursuant to chapter 89, title 18, Idaho Code, the Idaho medicaid program shall not reimburse or provide coverage for any surgical operation or medical intervention described in section 18-1506C(3), Idaho Code, for purposes of…

56-274. medicaid legislative review panel. (1) A medicaid legislative review panel is hereby established. (2) The cochairs of the panel shall be the chair of the house health and welfare committee and the chair of the senate health and welfare committee. Additional members shall …

56-275. waiver to enhance nutrition in the supplemental nutrition assistance program. (1) For the purposes of this section: (a) "Candy" means a preparation of sugar, honey, or other natural or artificial sweeteners in combination with chocolate, fruits, nuts, or other ingredients…

56-276. preceptors — prior authorization exemption. (1) An eligible practitioner who provides three hundred sixty (360) hours or more of preceptorship in a calendar year, with at least sixty percent (60%) of those hours occurring in a qualified rural or underserved area, shall qu…