Idaho Enacts Major Medicaid Reform

The Idaho Governor signed into law a bill that makes substantive changes to the state’s Medicaid program. HB 345 was a negotiated compromise between legislative leadership that reforms both eligibility and coverage delivery for the Medicaid program. The measure provides for the following:

• Require cost-sharing from enrollees as a condition of participation at levels developed by other states and up to the maximum charged by other states. 

• Transition of the Medicaid program to a managed care model utilizing managed care organizations to drive coverage and reimbursement for enrollees. 

• Establish work requirements for able-bodied adults enrolled in Medicaid expansion, requiring 20 hours or more of work per week, averaged monthly, inclusive of numerous exempted populations.

• Establishes site-neutrality requirements, ensuring that reimbursement rates for hospital outpatient departments and hospital-acquired physician practices are reimbursed at the same rate as physician-owned medical practices for equivalent outpatient services. 

The legislation takes effect immediately upon signing. The bill’s fiscal note estimates that with these provisions in place, it’s estimated to save the state $15.9 million FY2026, with that figure to increase in future years with the transition to Medicaid managed care.

Track Health Care Policy

The ever-evolving state health policy landscape will continue to influence how health care organizations make business decisions. MultiState’s team pulls from decades of expertise to help you effectively navigate and engage. MultiState’s team understands the issues, knows the key players and organizations, and we harness that expertise to help our clients effectively navigate and engage on their policy priorities. We offer customized strategic solutions to help you develop and execute a proactive multistate agenda focused on your company’s goals. Learn more about our Health Care Policy Practice.