Friday, March 10, 2023

Medicaid Managed Care Proposal

In 2020, in an effort to control Medicaid spending, the Idaho Legislature passed a law to implement a value care organization model (VCO).  Three years later, and with the appearance of Medicaid costs rising, legislators continue to explore ways to reduce spending.

On March 8, the House Health and Welfare Committee held a hearing on one such proposal.  Introduced by Rep. Jordan Redman (R-Coeur d’Alene), HB 200 would have provided $1,500,000 to the Department of Health and Welfare to explore and create an eventual path that would move the state away from a VCO model and instead towards a managed care model (MCO). 

The Idaho Hospital Association led an effort, supported by IMA, to educate the committee on the negative ramifications HB 200 could have on providers. 

For nearly 90 minutes, the committee heard testimony unanimously opposing the proposal.  Medical leaders from across the state highlighted the benefits of VCOs, including the incentive for physicians to be innovative in their approach to improve patient care and save money. With just one performance year completed and a second-year trending in the right direction, scraping the commitment and financial support doesn't make sense. 

Ultimately, HB 200 was held in committee, which may eventually provide an avenue for an alternative approach, but the bill will not advance to the full House at this time.

HB 61: Allowing Behavioral Telehealth Services Without Idaho Licensure

On January 31, Rep. Julianne Young (R-Blackfoot) introduced HB 61, legislation allowing out-of-state providers without an Idaho license to provide mental and behavioral telehealth services to Idaho patients, including prescriptions.  A few weeks later, HB 61 unanimously passed the House Health and Welfare Committee and then the full House with a 54-14-2 vote. 

IMA and other mental health provider groups have several concerns with the legislation:

1. The provider doesn’t need to be licensed in Idaho. Instead, a simple registration is required with the provider licensed in a state “similar to Idaho.” Registration does not provide adequate provider accountability and patient safeguards.
2. The bill would allow providers to prescribe medication – including controlled substances – and doesn’t explicitly require Idaho Board of Pharmacy controlled substance registration or PDMP usage.
3. Lacks transparency in not requiring disclosure to Idaho patients that their behavioral health provider is not licensed in Idaho.

The Lobby Team is actively working with Senators on the Health & Welfare Committee to express our concerns. We anticipate the Committee to hold a hearing on HB 61 next week. 

Throughout the Legislative Session, IMA monitors legislation and provides status updates every Friday. Click here to view the IMA Bill Tracker.