Healthcare

in committee · Idaho · House Mar 6, 2026

H 829: PROMPT PAYMENT OF CLAIMS – Amends and adds to existing law to revise and establish provisions regarding prompt payment of insurance claims.

This bill updates Idaho's insurance laws to establish clearer rules for how quickly health insurers must process and pay medical claims. It directly affects insurance companies, healthcare providers, and patients by setting specific time limits for claim decisions based on whether claims are submitted electronically or on paper. Under the new provisions, electronic claims must be paid or denied within 30 days, while paper claims have a 45-day deadline, with additional time allowed if insurers request more information. The legislation also adds protections against retaliatory conduct by insurers, requires transparency in claim processes, and creates new civil action options for beneficiaries who face delays or unfair treatment.

Topics ✓ HealthcareSupports HealthcareBill establishes clearer rules for prompt payment of insurance claims, improving patient access to healthcare services and protecting patient rights by reducing delays in receiving medical payments.85% confidence

Track

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

Track

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

Track

signed · Idaho · Senate Apr 1, 2026

S 1294: INFANTS AND NEWBORNS – Adds to existing law to establish provisions regarding hearing loss screening.

This bill requires all infants and newborns in Idaho to be screened for hearing loss before leaving a hospital, health care facility, or birthing facility. For births outside these settings, screening must occur within 21 days of birth. The screening must use approved methods (like otoacoustic emissions) and results must be reported to the Idaho Educational Services for the Deaf and Blind (IESDB) within seven days. The law is contingent on maintaining federal funding for these screenings, and would not take effect if federal support ends and state costs increase.

Topics ✓ HealthcareSupports HealthcareMandates universal newborn hearing screenings, enhancing early detection in public health programs, aligning with healthcare service expansion and patient access improvements.95% confidence

Sub-Topics Hospitals

signed · Idaho · Senate Apr 2, 2026

S 1254: CHIROPRACTIC PRACTICE ACT – Amends existing law to clarify the existing right of persons licensed to practice chiropractic to prescribe certain prescription drug products.

This bill clarifies that Idaho chiropractors with clinical nutrition certification may prescribe specific non-controlled medications, including certain vitamins (A, B complex, C), minerals (calcium, magnesium, zinc), fluids (saline, dextrose), epinephrine, and oxygen for emergencies. It specifies these drugs must be obtained from licensed sources and administered via approved routes, while prohibiting chiropractors from compounding vitamins/minerals themselves. The law directly affects certified chiropractors in Idaho, allowing them to prescribe these items during practice without altering existing non-prescription supplement use. The bill takes effect July 1, 2026, after passing unanimously in the Idaho Senate.

Topics ✓ HealthcareSupports HealthcareExpands chiropractor prescribing rights for non-controlled meds (vitamins, epinephrine), improving patient access to preventive/urgent care without physician referrals.90% confidence

Sub-Topics Prescription Drugs

in committee · Idaho · House Feb 10, 2026

H 611: INSURANCE – Adds to exsiting law to establish the Idaho Prior Authorization Refom Act.

This bill establishes the Idaho Prior Authorization Reform Act, requiring health insurance companies to follow standardized processes for approving medical treatments before coverage. It mandates electronic submission of requests, sets specific timeframes for reviews (including expedited approvals for urgent cases), and requires clear explanations when requests are denied. The law directly affects doctors, hospitals, and patients by limiting insurer interference with medical decisions and ensuring transparency in coverage denials. It applies to most health insurance plans but excludes self-insured employer plans and workers' compensation, while preserving existing federal and state health coverage requirements.

Topics ✓ HealthcareSupports HealthcareReforms prior authorization to standardize insurer approvals, reduce delays, and require clear denials - improving patient access to medical treatments.90% confidence

Sub-Topics Insurance

Track

passed · Idaho · Senate Mar 4, 2026

S 1319: INSURANCE – Adds to existing law to establish the Emergency Care Affordability Act.

Idaho's S 1319, the Emergency Care Affordability Act, protects patients from surprise bills by requiring out-of-network freestanding emergency rooms to accept the in-network rate as full payment for emergency services. It prohibits these facilities from billing patients for costs exceeding the in-network rate (known as "balance billing") and mandates that health insurance plans pay providers directly for emergency care at the in-network rate, including covering the patient's cost-sharing. The law applies specifically to emergency services provided in freestanding emergency rooms (like standalone facilities not attached to hospitals) and covers all health benefit plans, including self-funded plans. This ensures patients receive emergency care without facing unexpected high costs from out-of-network providers.

Topics ✓ HealthcareSupports HealthcareProtects patients from surprise bills by banning balance billing and mandating in-network rates for emergency care, enhancing patient access and financial protection.95% confidence

Sub-Topics Insurance

Track

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

Track

signed · Idaho · Senate Apr 2, 2026

S 1313: NATUROPATHIC DOCTOR LICENSING AND NATUROPATH REGISTRATION – Amends existing law to provide for the voluntary licensure of pharmacists as naturopathic doctors.

S 1313 creates a voluntary licensure pathway for pharmacists in Idaho to become naturopathic doctors by requiring them to complete a 160-credit-hour naturopathic program and pass a competency exam, while maintaining their existing pharmacy license. The bill amends Idaho Code to include pharmacists in the definition of "licensed naturopathic doctor" and updates committee structures to reflect this new option, including adding a pharmacist to the formulary committee. The law will take effect on July 1, 2026.

Topics ✓ HealthcareSupports HealthcareCreates voluntary licensure pathway for pharmacists to become naturopathic doctors, expanding healthcare provider options and access to naturopathic services.95% confidence

Sub-Topics Medical Licensing Prescription Drugs