Healthcare (Medicaid)

in committee · Idaho · House Mar 20, 2026

H 828: MERIT-BASED HEALTH CARE – Adds to existing law to establish the Merit-Based Health Care Act.

This bill establishes the Merit-Based Health Care Act in Idaho, which requires healthcare providers participating in Medicaid to make employment and contracting decisions based on merit and professional qualifications rather than ideological or discriminatory practices. The law defines specific prohibited actions, including the use of state Medicaid funds for diversity, equity, and inclusion training or policies that focus on race or sex-based preferences, while explicitly allowing compliance with federal civil rights laws and legitimate clinical training. Healthcare providers who violate these provisions could face civil penalties ranging from $5,000 to $100,000 depending on company size, and the attorney general can investigate complaints from health care professionals who claim retaliation for refusing to participate in prohibited DEI activities.

Topics ✗ HealthcareOpposes HealthcareBill restricts Medicaid provider practices by prohibiting DEI training and requiring merit-based decisions, limiting healthcare access and diversity initiatives.85% confidence

Sub-Topics Medicaid

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failed · Idaho · Senate Mar 12, 2026

S 1375: APPROPRIATIONS – HEALTH AND HUMAN SERVICES – Relates to the maintenance appropriations to the Department of Health and Welfare and the State Independent Living Council for fiscal year 2027.

This bill appropriates state funding to Idaho's Department of Health and Welfare and the State Independent Living Council for fiscal year 2027, covering programs like Medicaid, child welfare, mental health services, and substance abuse treatment. It establishes specific budget allocations for various divisions including youth safety, early learning, family partnerships, and benefit payments, while also setting limits on the number of authorized full-time positions. The legislation includes requirements for program integrity, monthly Medicaid tracking reports, and specific fund transfers to support initiatives such as rural physician incentives and smoking cessation programs.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill explicitly appropriates state funding for health and welfare programs, strengthening budget allocation for essential public services.95% confidence ✓ HealthcareSupports HealthcareBill appropriates state funding for health and human services, including Medicaid, mental health, and substance abuse treatment programs, directly supporting healthcare access.90% confidence

Sub-Topics Appropriations State Budget Medicaid Mental Health Substance Abuse

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signed · Idaho · House Apr 2, 2026

H 928: MERIT-BASED HEALTH CARE – Adds to existing law to establish the Merit-Based Health Care Act.

This bill establishes the Merit-Based Health Care Act in Idaho, which requires health care providers participating in Medicaid to base employment and contracting decisions on individual merit and professional qualifications rather than ideological or discriminatory practices. The law specifically prohibits the use of state Medicaid funds to support diversity, equity, and inclusion initiatives, bias training, or other policies that consider race or sex in hiring, promotion, or compensation decisions. Providers must comply with these requirements as a condition of their Medicaid agreements, and violations can result in civil penalties ranging from $5,000 to $100,000 depending on the size of the organization and the number of violations. The bill also includes a limited private right of action allowing health care professionals to sue if they face retaliation for refusing to participate in prohibited DEI conduct.

Topics ✗ HealthcareOpposes HealthcareBill restricts Medicaid funding for DEI initiatives and mandates merit-based hiring, limiting inclusive healthcare practices and diversity programs.85% confidence

Sub-Topics Medicaid

signed · Idaho · Senate Apr 2, 2026

S 1410: 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.

This bill requires legislative approval for the Idaho Department of Health and Welfare to adjust Medicaid payment rates for Federally Qualified Health Centers and Rural Health Clinics when their scope of services changes. It establishes a process where clinics must notify the department 60 days before implementing service changes and submit a rate adjustment application after six months of full implementation, requiring a minimum 4.5% cost increase to qualify. The legislation sets specific timelines for department review and allows clinics to appeal final rate decisions, while also repealing certain existing administrative rules effective October 1, 2026.

Topics ✓ HealthcareSupports HealthcareBill establishes process for adjusting Medicaid payment rates for health centers when services expand, supporting healthcare provider sustainability and access.75% confidence

Sub-Topics Medicaid

in committee · Idaho · House Mar 9, 2026

H 845: MEDICAID – Adds to existing law to establish provisions regarding hospital presumptive eligibility determinations.

This bill establishes rules for hospitals in Idaho to make temporary Medicaid eligibility decisions for patients who may qualify but haven't completed full applications. It requires hospitals to notify the state within five days of making these determinations and to help patients finish their applications before the temporary coverage ends. The bill creates a performance tracking system where hospitals face mandatory training after two violations and lose their ability to make these determinations after three violations within a year. Hospitals can appeal violation findings, and the state must provide clear written notices explaining any standards they failed to meet.

Topics ✓ HealthcareSupports HealthcareBill expands Medicaid eligibility through presumptive determinations, improving patient access to healthcare services and strengthening public assistance programs.90% confidence

Sub-Topics Hospitals Medicaid

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in committee · Idaho · Senate Mar 17, 2026

S 1390: INSURANCE – Amends existing law to revise provisions regarding 340B drug pricing program reporting.

This bill requires healthcare organizations participating in the federal 340B drug pricing program to submit annual reports to Idaho state agencies about their program participation and financial details. The reports must include information on drug acquisition costs, payments to contract pharmacies, savings generated, and how those savings are used for charity care or community benefits, broken down by insurance payer type. The data will be kept confidential and shared through a secure portal, with an aggregated summary made available publicly on the state website. The attorney general may use the information to investigate potential Medicaid fraud and ensure compliance with federal requirements.

Topics ✓ HealthcareSupports HealthcareBill enhances transparency and accountability in 340B drug pricing program, ensuring savings are used for charity care and community benefits, strengthening healthcare access.75% confidence

Sub-Topics Medicaid Prescription Drugs

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in committee · Idaho · House Feb 4, 2026

H 578: MEDICAID – Adds to existing law to provide legislative approval for a state plan amendment regarding incarcerated juveniles transition services.

This Idaho bill (H 578) requires legislative approval for a Medicaid state plan amendment to provide transition services for juveniles in custody. It directly affects incarcerated juveniles within 30 days of release from correctional facilities after a court hearing, ensuring they receive medical/dental screenings and case management referrals. Key provisions mandate that these services - screenings meeting medical standards and referrals to local care - must be included in a state plan submitted by July 2026, with services starting no earlier than July 2027. The bill also specifies that services must align with federal Medicaid requirements and depend on annual legislative funding.

Topics ✓ Criminal JusticeSupports Criminal JusticeMandates medical/dental screenings and case management for juveniles post-release from custody, directly supporting rehabilitation and reducing recidivism through transitional services.95% confidence ✓ HealthcareSupports HealthcareMandates Medicaid medical/dental screenings and case management referrals for incarcerated juveniles post-release, expanding healthcare access through state plan amendment.95% confidence

Sub-Topics Courts Medicaid

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in committee · Idaho · House Feb 13, 2026

H 655: MEDICAID – Adds to existing law to establish provisions regarding Medicaid prior authorization exemptions for certain preceptorships.

This Idaho bill (H 655) exempts physicians in primary care, psychiatry, or OB/GYN from needing prior approval for Medicaid-covered services if they provide 360+ hours of unpaid mentoring (preceptorship) to graduate students annually, with at least 60% of those hours in rural shortage areas. Physicians must track and report hours to the state health department, which verifies eligibility and grants a 12-month exemption starting the next calendar year. The exemption is limited to 100 physicians per specialty yearly, and the state can revoke it if claims review shows insufficient adherence to the program. This directly affects Idaho physicians mentoring students in rural areas, aiming to reduce administrative barriers for rural healthcare training.

Topics ✓ HealthcareSupports HealthcareExempts physicians from Medicaid prior authorization for services when mentoring in rural areas, improving access to care in underserved regions and addressing provider shortages.92% confidence

Sub-Topics Medicaid Primary Care

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in committee · Idaho · Senate Feb 17, 2026

S 1312: MEDICAID – Amends existing law to revise provisions regarding provider payment.

S 1312 revises Idaho's Medicaid payment rules for healthcare providers, directly affecting hospitals, mental health facilities, and home care services. It sets payment rates at 100% of Medicare for primary care and 90% for other services where Medicare equivalents exist, while requiring annual cost surveys (with 15% audits) for services without Medicare rates. The bill mandates providers to allocate funds to staff wages and employee costs, reduces general fund needs by $3.1 million in FY2020 and $8.72 million in FY2021, and transitions most hospitals to value-based payment systems by July 2021. It also nullifies specific administrative rules (IDAPA 16.03.26) after July 2026.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill reduces general fund needs by $3.1M through revised Medicaid payment rates, promoting fiscal responsibility in state budget management.92% confidence ✓ HealthcareSupports HealthcareBill sets Medicaid payment rates at 100% of Medicare for primary care, strengthening provider funding and access while requiring cost efficiency measures.90% confidence

Sub-Topics State Budget Long-Term Care Medicaid Primary Care

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in committee · Idaho · House Feb 24, 2026

H 753: ASSERTIVE COMMUNITY TREATMENT – Adds to existing law to provide legislative approval for and to establish provisions regarding assertive community treatment.

Idaho's H 753 establishes a framework for Assertive Community Treatment (ACT) programs to provide intensive, community-based mental health support. It directly affects individuals with serious mental illness who have experienced frequent hospitalizations, crisis services, or failed to benefit from standard outpatient care. The bill defines ACT as 24/7 multidisciplinary teams delivering comprehensive services in community settings, requiring specific staff composition (including clinicians, peer specialists, and substance use counselors). It mandates the Department of Health and Welfare to seek federal Medicaid approval by March 2026 to implement these programs, aiming to reduce hospitalizations and support community living. The law sets eligibility criteria based on medical need, functional impairment, and documented service failures.

Topics ✓ HealthcareSupports HealthcareEstablishes ACT framework for community mental health services, requiring multidisciplinary teams to improve access for serious mental illness patients previously failing standard care.95% confidence

Sub-Topics Medicaid Mental Health

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