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Bill

H 76

MEDICAID – Amends existing law to provide that certain value-based payment agreements align with the fiscal year.

68th Legislature, 1st Regular Session (2025)

House Bill 76 standardizes Medicaid value-based payment agreements in Idaho to one year, aligning with the fiscal year, impacting providers and potentially improving care quality.

Reported Printed and Referred to Health & Welfare
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Bill Summary · H 76

Summary of House Bill 76 (H 76)

Purpose and Intent

House Bill 76 (H 76) aims to amend existing Medicaid law in Idaho to establish a standardized duration for certain value-based payment agreements between the Department of Health and Welfare and healthcare providers. The bill seeks to align these agreements with the state’s fiscal year, which runs from July 1 to June 30.

Key Provisions

  • Duration of Agreements: The bill specifies that any value-based payment agreements made after July 1, 2025, will have a duration of one year, aligning with the fiscal year. Agreements established prior to this date will retain their original terms until they expire or are renewed.

  • Payment Structure: The bill maintains existing payment structures for Medicaid providers, which include:

    • Up to 100% of the current Medicare rate for primary care procedure codes.
    • 90% of the current Medicare rate for all other procedure codes.

  • Value-Based Payments: The Department of Health and Welfare is authorized to enter into agreements with providers to pay for services based on their value, focusing on measurable healthcare quality and positive health outcomes. These agreements must be cost-neutral or cost-saving compared to other payment methods.

  • Emergency Clause: The bill includes an emergency declaration, allowing it to take effect immediately on July 1, 2025.

Affected Parties

  • Healthcare Providers: The bill directly impacts Medicaid providers in Idaho, particularly those involved in value-based payment agreements.
  • Department of Health and Welfare: The department will be responsible for implementing the new agreement structure and ensuring compliance with the fiscal year alignment.
  • Medicaid Recipients: While the bill does not directly change benefits for Medicaid recipients, the shift to value-based payments may influence the quality of care they receive.

Fiscal Impact

According to the fiscal note attached to the bill, there is no anticipated increase or decrease in revenue or additional expenditures at the state or local government levels. Therefore, the legislation is expected to have no fiscal impact.

Legislative Timeline

  • Introduced: January 28, 2025
  • Reported Printed and Referred: January 29, 2025

This summary provides an overview of House Bill 76, detailing its purpose, key provisions, and potential impacts on healthcare providers and the Medicaid system in Idaho.

Compiled from official sources — confirm details with the bill’s official record.

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