Idaho § 56-263 MEDICAID MANAGED CARE PLAN

Idaho Statutes

§ 56-263 — MEDICAID MANAGED CARE PLAN

Idaho·Title 56 PUBLIC ASSISTANCE AND WELFARE·Ch. 2 PUBLIC ASSISTANCE LAW

(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 any comprehensive managed care plan in accordance with 42 CFR 438, with thirty percent (30%) of the directed payments being utilized for general fund medicaid needs. Such funds shall be continuously appropriated. [(1) (2)]

(2)Subject to written approval by the centers for medicare and medicaid services, the department shall make directed payments to qualifying hospitals participating in medicaid managed care programs in an amount not to exceed the maximum allowable payment authorized by federal regulations. [(3)]

(3)Qualifying behavioral health hos

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(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 any comprehensive managed care plan in accordance with 42 CFR 438, with thirty percent (30%) of the directed payments being utilized for general fund medicaid needs. Such funds shall be continuously appropriated. [(1) (2)]
(2) Subject to written approval by the centers for medicare and medicaid services, the department shall make directed payments to qualifying hospitals participating in medicaid managed care programs in an amount not to exceed the maximum allowable payment authorized by federal regulations. [(3)]
(3) Qualifying behavioral health hospitals assessed pursuant to this section for the Idaho behavioral health plan are exempt from assessment pursuant to section 56-1404, Idaho Code. [(4)]
(4) The department shall discontinue contracting and reimbursing as part of the healthy connections value care program through value care organizations and the healthy connections primary care case management program by January 1, 2026.

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Legislative History

[56-263, added 2011, ch. 164, sec. 14, p. 473; am. 2019, ch. 318, sec. 3, p. 946; am. 2024, ch. 170, sec. 1, p. 652; am. 2025, ch. 118, sec. 4, p. 624; am. 2025, ch. 192, sec. 3, p. 889.]