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--- version:Bill Text
+++ version:(document, no version)
@@ -1,3192 +1,506 @@
-LEGISLATURE
+REVISED
+ST
+A
+TEMENT
OF
-THE
-STATE
-OF
-IDAHO
-Sixty-eighth
-Legislature
-Second
-Regular
-Session
--
-2026
-IN
-THE
-HOUSE
-OF
-REPRESENTATIVES
-HOUSE
-BILL
-NO.
-912
-BY
-WAYS
-AND
-MEANS
-COMMITTEE
-AN
-ACT
-1
-RELATING
-TO
-MEDICAID;
-AMENDING
-CHAPTER
-2,
-TITLE
-56,
-IDAHO
-CODE,
-BY
-THE
-AD
--
-2
-DITION
-OF
-A
-NEW
-SECTION
-56
--
-276,
-IDAHO
-CODE,
-TO
-ESTABLISH
-PROVISIONS
-3
-REGARDING
-MEDICAID
-WORK
-REQUIREMENTS;
-AMENDING
-CHAPTER
-2,
-TITLE
-56,
-4
-IDAHO
-CODE,
-BY
-THE
-ADDITION
-OF
-A
-NEW
-SECTION
-56
--
-277,
-IDAHO
-CODE,
-TO
-5
-ESTABLISH
-PROVISIONS
-REGARDING
-MEDICAID
-ELIGIBILITY
-VERIFICATION;
-6
-AMENDING
-CHAPTER
-2,
-TITLE
-56,
-IDAHO
-CODE,
-BY
-THE
-ADDITION
-OF
-A
-NEW
-SEC
--
-7
-TION
-56
--
-278,
-IDAHO
-CODE,
-TO
-ESTABLISH
-PROVISIONS
-REGARDING
-INELIGIBLE
-8
-ALIENS;
-AMENDING
-CHAPTER
-2,
-TITLE
-56,
-IDAHO
-CODE,
-BY
-THE
-ADDITION
-OF
-9
-A
-NEW
-SECTION
-56
--
-279,
-IDAHO
-CODE,
-TO
-ESTABLISH
-PROVISIONS
-REGARDING
-10
-MULTISTATE
-ENROLLMENT;
-AMENDING
-CHAPTER
-2,
-TITLE
-56,
-IDAHO
-CODE,
-BY
-THE
-1
-1
-ADDITION
-OF
-A
-NEW
-SECTION
-56
--
-280,
-IDAHO
-CODE,
-TO
-ESTABLISH
-PROVISIONS
-12
-REGARDING
-DECEASED
-ENROLLEES;
-AMENDING
-CHAPTER
-2,
-TITLE
-56,
-IDAHO
-CODE,
-13
-BY
-THE
-ADDITION
-OF
-A
-NEW
-SECTION
-56
--
-281,
-IDAHO
-CODE,
-TO
-ESTABLISH
-PROVI
--
-14
-SIONS
-REGARDING
-RETROACTIVE
-ELIGIBILITY;
-AND
-DECLARING
-AN
-EMERGENCY.
-15
-Be
+PURPOSE
+RS33718
+/
+H0912
+This
+legislation
+incorporates
+2025
+federal
+Medicaid
+mandates
+into
+Idaho
+law
+,
+specifically
+enforcing
+strict
+community
+engagement
+and
+work
+requirements
+while
+removing
+the
+state’
+s
+ability
+to
+grant
+optional
+exemptions.
It
-Enacted
-by
-the
-Legislature
-of
-the
-State
-of
-Idaho:
-16
-SECTION
-1.
-That
-Chapter
-2,
-Title
-56,
-Idaho
-Code,
-be,
-and
-the
-same
-is
-17
-hereby
-amended
-by
-the
-addition
-thereto
-of
-a
-NEW
-SECTION
+eliminates
+self-attestation
+for
+eligibility
,
-to
+requiring
+instead
+that
+medical
+frailty
be
-known
-and
-des
--
-18
-ignated
-as
-Section
-56
--
-276,
-Idaho
-Code,
-and
-to
-read
-as
-follows:
-19
-56
--
-276.
-MEDICAID
-WORK
-REQUIREMENTS.
-(1)
-As
+certified
+by
+a
+provider
+and
+that
+regular
+data
+cross-checks
+be
used
-in
-this
-section:
-20
-(a)
-"Applicable
-individual"
-means
-an
-individual
-who
-is
-eligible
-21
-to
-enroll
-under
-the
+to
+disqualify
+ineligible
+participants.
+Furthermore,
+the
+bill
+aligns
state
-medicaid
-program
-pursuant
-to
-42
-U.S.C.
-22
-1396a(a)(10)(A)(i)(VIII)
-or
-who
-is
-otherwise
-eligible
-to
-enroll
-or
-23
-is
-enrolled
-under
-a
-waiver
-of
-such
-plan
-that
-provides
+policy
+with
+federal
+standards
+regarding
+non-citizen
+eligibility
+,
+multi-state
+enrollment
+verification,
+and
+retroactive
coverage
-that
-is
-24
-equivalent
-to
-minimum
-essential
-coverage
-and
-has
-attained
-the
-age
-of
-25
-nineteen
-(19)
-and
+windows,
+while
+establishing
+new
+reporting
+and
+federal
+referral
+protocols.
+FISCAL
+NOTE
+If
+the
+state’
+s
+error
+payment
+rate
+exceeds
+the
+federally
+mandated
+3%
+threshold
+by
+one
+percentage
+point,
+the
+state
+will
+be
+penalized
+approximately
+$30
+million
+a
+year
+until
+the
+error
+rate
is
under
-sixty
--
-five
-(65)
-years
-of
-age,
+3%.
+The
+legislative
+provisions
+of
+HB
+912
+are
+designed
+to
+protect
+the
+state
+from
+these
+penalties.
+T
+o
+implement
+these
+changes
+as
+proposed
+in
+HB
+912,
+the
+Department
+of
+Health
+and
+W
+elfare
+estimates
+HB
+912
+will
+have
+a
+total
+fiscal
+impact
+of
+$1,930,000.
+This
+includes
+one-time
+costs
+of
+$1,160,000
+($812,000
+Federal
+Funds
+and
+$348,000
+General
+Funds)
+and
+ongoing
+costs
+of
+$770,000
+($578,000
+in
+Federal
+Funds
+and
+$192,000
+in
+General
+Funds).
+T
+otal
+General
+Fund
+impact
+of
+both
+one-time
+and
+ongoing
+funds
is
-not
-preg
--
-26
-nant,
-is
-not
-entitled
-to
-or
-enrolled
-for
-benefits
-under
-part
-A
-of
-title
-27
-XVIII
-of
-the
-social
-security
-act,
-or
-enrolled
-for
-benefits
-under
-part
-B
-28
-of
-title
-XVIII
-of
-the
-social
-security
-act,
-and
-is
-not
-otherwise
-eligible
-29
-to
-enroll
-under
-such
-plan,
-and
-is
-subject
-to
-work
-requirements.
-30
-(b)
-"Department"
-means
-the
-Idaho
-department
-of
-health
-and
-welfare.
-31
-(c)
-"Work
-requirements"
-means
-the
-requirements
-established
-by
-42
-32
-U.S.C.
-1396a(xx).
-33
-(2)
-No
-later
-than
-December
-31,
-2026,
-the
-department
-shall
+$540,000.
+Funds
+are
+needed
+to
implement
-34
+eligibility
+system
+change
+to
+include
+interface
+development
+costs
+and
+ongoing
+usage
+costs.
+There
+are
+no
+new
+additional
+FTE’
+s
+with
+this
+request
+as
+they
+were
+included
+in
+the
+Self-Reliance
+enhancement
+budget
+request
+this
+year
+.
+Once
+the
+program
+integrity
+provisions
+are
+in
+place
+we
+expect
+this
+legislation
+will
+begin
+to
+reduce
+state
+general
+fund
+expenditures.
+Near
+-term
+savings
+will
+be
+driven
+by
+more
+frequent
+eligibility
+determinations,
+expanded
+data
+cross-checks,
+and
+robust
work
requirements
+that
+promptly
+remove
+ineligible
+enrollees.
+Furthermore,
+administrative
+costs
+will
+be
+of
+fset
+by
+federal
+implementation
+funding,
+including
+a
+share
+of
+the
+$200
+million
+allocated
+nationwide
for
-applicable
-individuals.
-35
-(a)
-No
-applicable
-individual
-shall
+work
+requirement
+programs.
+In
+the
+long
+term,
+these
+reforms
+will
+mitigate
+significant
+financial
+risks
+associated
+with
+federal
+penalties
+for
+eligibility
+error
+rates
+exceeding
+3%
+(OB3
+includes
+a
+formula
+of
+1%
+multiplied
+by
+the
+state’
+s
+Medicaid
+federal
+expenditures
+to
+determine
+the
+penalty).
+Proactive
+verification
+and
+the
+removal
+of
+work-requirement
+waivers
+protect
+Idaho’
+s
+budget
+from
+substantial
+fines.
+Similar
+initiatives
+in
+states
+like
+Louisiana
+and
+Indiana
+demonstrate
+these
+measures
+ef
+fectively
+limit
+waste,
+fraud,
+and
+abuse
+while
+preserving
+resources
+for
+truly
+eligible
+populations.
+Ultimately
+,
+the
+state
+will
be
-enrolled
-in
-medicaid
-unless,
-at
-36
-the
-time
-of
-application,
-the
-individual
-demonstrates
-compliance
-with
-37
-the
-work
-requirements
-for
-the
-three
-(3)
-consecutive
-months
-immediately
-38
-preceding
-the
-month
-during
-which
-the
-individual
-applies.
-The
-depart
--
-39
-ment
-shall
-require
-documentary
-evidence
-and
-shall
-not
-accept
-self
--
-at
--
-40
-testation
-at
-the
-time
-of
-application.
-41
-
-2
-(b)
-The
-department
-shall
-verify
-an
-applicable
-individual's
-compliance
-1
-with
-work
-requirements
-through
-state
-wage
-data,
-education
-or
-training
-2
-program
-enrollment,
-or
-verified
-volunteer
-service
-documentation.
-The
-3
-department
-shall
-verify
-an
-applicable
-individual's
-compliance
-with
-4
-work
-requirements
-on
-an
+shielded
+from
+significant
+federal
+penalties
+by
+adopting
+these
+policies
+despite
+the
+relatively
+small
+up
+front
+and
ongoing
-basis,
-at
-least
-quarterly
-between
-re
--
-5
-determination
-periods,
-and
-shall
-not
-accept
-self
--
-attestation.
-Such
-6
-verification
-shall
-occur
-between
-periods
-of
-formal
-redetermination
-for
-7
-individuals.
-8
-(c)
-No
-applicable
-individual
-shall
-remain
-enrolled
-in
-medicaid
-in
-any
-9
-month
-unless
-the
-individual
-has
-demonstrated
-compliance
-with
-the
-work
-10
-requirements.
-1
-1
-(3)
-An
-applicable
-individual
-seeking
-an
-exemption
-from
-work
-require
--
-12
-ments
-shall
-provide
-documentation
-for
-the
-exemption
-sought.
-The
-department
-13
-shall
-verify
-all
-exemptions
-and
-shall
-not
-accept
-self
--
-attestation
-from
-indi
--
-14
-viduals
-seeking
-exemptions.
-15
-(a)
-The
-department
-shall
-not
-seek
-or
-implement
-any
-additional
-optional
-16
-exemptions
-under
-42
-U.S.C.
-1396a(xx)(3)(B)
-or
-any
-other
-optional
-exemp
--
-17
-tion
-without
-obtaining
-approval
-from
-the
-legislature.
-Such
-approval
-18
-shall
-be
-provided
-in
-statute.
-19
-(b)
-The
-department
-shall
-not
-accept
-exemption
-designations,
-approvals,
-20
-or
-determinations
-by
-a
-managed
-care
-organization.
-21
-(c)
-The
-department
-shall
-only
-approve
-an
-exemption
-for
-an
-individual
-22
-who
-is
-medically
-frail
-or
-otherwise
-an
-individual
-with
-special
-needs
-23
-if
-the
-individual
-has
-been
-medically
-certified
-by
-a
-statement
-from
-a
-24
-physician,
-physician's
-assistant,
-nurse,
-nurse
-practitioner,
-desig
--
-25
-nated
-representative
-of
-a
-physician's
-office,
-a
-licensed
-or
-certified
-26
-psychologist,
-or
-a
-social
-worker
-as
-having
-a
-disabling
-mental
-disorder,
-27
-having
-a
-physical,
-intellectual,
-or
-mental
-disability
-that
-signif
--
-28
-icantly
-impairs
-the
-ability
-to
-perform
-activities
-of
-daily
-living,
-29
-including
-eating,
-dressing,
-bathing,
-grooming,
-getting
-in
-and
-out
-of
-30
-beds
-and
-chairs,
-walking,
-going
-outdoors,
-or
-using
-the
-toilet,
-or
-is
-31
-in
-treatment
-for
-chronic
-substance
-use
-disorder.
-In
-no
-case
-may
-the
-32
-department
-expand
-the
-definition
-of
-"medically
-frail
-or
-otherwise
-an
-33
-individual
-with
-special
-needs"
-beyond
-the
-scope
-of
-the
-definition
-es
--
-34
-tablished
-under
-42
-CFR
-440.315(f).
-35
-(4)
-The
-department
-shall
-disenroll
-any
-applicable
-individual
-who
-fails
-36
-to
-comply
-with
-the
-work
-requirements.
-37
-(5)
-The
-department
-shall
-submit
-quarterly
-reports
-to
-the
-legislature
-38
-and
-the
-governor
-on
-compliance
-rates,
-the
-number
-and
-type
-of
-exemptions
-39
-granted,
-and
-the
-impact
-on
-medicaid
-enrollment,
-consistent
-with
-the
-report
--
-40
-ing
-requirements
-of
-section
-71119,
-P.L.
-119
--
-21.
-41
-(6)
-The
-requirements
-of
-this
-section
-shall
-be
-implemented
-no
-later
-than
-42
-December
-31,
-2026,
-or
-such
-earlier
-date
-as
-permitted
-by
-federal
-law
-and
-ap
--
-43
-proved
-by
-the
-centers
-for
-medicare
-and
-medicaid
-services.
-44
-SECTION
-2.
-That
-Chapter
-2,
-Title
-56,
-Idaho
-Code,
-be,
-and
-the
-same
-is
-45
-hereby
-amended
-by
-the
-addition
-thereto
-of
-a
-NEW
-SECTION
-,
-to
-be
-known
-and
-des
--
-46
-ignated
-as
-Section
-56
--
-277,
-Idaho
-Code,
-and
-to
-read
-as
-follows:
-47
-56
--
-277.
-MEDICAID
-ELIGIBILITY
-VERIFICATION.
-(1)
-Except
-as
-required
-un
--
-48
-der
-federal
-law,
-the
-department
-of
-health
-and
-welfare
-shall
-not
-accept
-self
--
-49
-
-3
-attestation
-of
-any
-of
-the
-following
-in
-the
-administration
-of
-the
-medicaid
-1
-program
-without
-verification
-before
-enrollment:
-2
-(a)
-Income;
-3
-(b)
-Residency;
-4
-(c)
-Identity;
-5
-(d)
-Household
-composition;
-or
-6
-(e)
-Citizenship
-or
-immigration
-status.
-7
-(2)
-On
-at
-least
-a
-monthly
-basis,
-the
-department
-of
-health
-and
-welfare
-8
-shall
-receive
-and
-review
-information
-concerning
-medicaid
-recipients
-that
-9
-indicates
-a
-change
-in
-circumstances
-that
-may
-affect
-medicaid
-eligibility
-10
-from:
-1
-1
-(a)
-The
-state
-tax
-commission;
-12
-(b)
-The
-United
-States
-social
-security
-administration,
-including
-13
-earned
-income
-information,
-death
-register
-information,
-incarcera
--
-14
-tion
-records,
-supplemental
-security
-income
-information,
-beneficiary
-15
-records,
-earnings
-information,
-and
-pension
-information;
-16
-(c)
-The
-United
-States
-department
-of
-health
-and
-human
-services,
-includ
--
-17
-ing
-income
-and
-employment
-information
-maintained
-in
-the
-national
-direc
--
-18
-tory
-of
-new
-hires
-database
-and
-child
-support
-enforcement
-data;
-19
-(d)
-The
-United
-States
-department
-of
-housing
-and
-urban
-development,
-in
--
-20
-cluding
-payment
-and
-earnings
-information;
-and
-21
-(e)
-The
-federal
-bureau
-of
-investigation,
-including
-national
-fleeing
-22
-felon
-information.
-23
-(3)
-On
-at
-least
-a
-quarterly
-basis,
-the
-department
-of
-health
-and
-welfare
-24
-shall
-receive
-and
-review
-information
-from
-the
-department
-of
-labor
-concerning
-25
-medicaid
-recipients
-that
-indicates
-a
-change
-in
-circumstances
-that
-may
-affect
-26
-medicaid
-eligibility,
-including
-changes
-to
-employment
-or
-wages.
-27
-(4)
-On
-at
-least
-an
-annual
-basis,
-the
-department
-of
-health
-and
-welfare
-28
-shall
-receive
-and
-review
-information
-concerning
-medicaid
-recipients
-that
-29
-indicates
-a
-change
-in
-circumstances
-that
-may
-affect
-medicaid
-eligibility
-30
-from:
-31
-(a)
-The
-state
-tax
-commission,
-including
-adjusted
-gross
-income
-and
-fam
--
-32
-ily
-composition;
-and
-33
-(b)
-The
-internal
-revenue
-service,
-including
-tax
-filing
-data,
-adjusted
-34
-gross
-income,
-and
-family
-composition.
-35
-(5)
-The
-department
-of
-health
-and
-welfare
-shall
-enter
-into
-any
-36
-data
--
-sharing
-agreements
-with
-the
-agencies,
-departments,
-and
-bureaus
-de
--
-37
-scribed
-in
-this
-section
-as
-necessary
-to
-effectuate
-the
-requirements
-of
-this
-38
-section.
-39
-(6)
-The
-department
-of
-health
-and
-welfare
-may
-contract
-with
-an
-indepen
--
-40
-dent
-third
-party
-for
-database
-searches
-that
-may
-contain
-information
-that
-in
--
-41
-dicates
-a
-change
-in
-circumstances
-that
-may
-affect
-medicaid
-applicant
-or
-re
--
-42
-cipient
-eligibility.
-43
-(7)
-Upon
-receiving
-information
-concerning
-a
-medicaid
-recipient
-that
-44
-indicates
-a
-change
-in
-circumstances
-that
-may
-affect
-medicaid
-eligibility,
-45
-the
-department
-of
-health
-and
-welfare
-shall
-promptly
-conduct
-an
-eligibility
-46
-redetermination
-for
-the
-recipient.
-47
-(8)
-Unless
-prohibited
-under
-federal
-law,
-the
-department
-of
-health
-and
-48
-welfare
-shall
-conduct
-eligibility
-redeterminations
-for
-all
-nonelderly
-adult
-49
-medicaid
-recipients
-whose
-eligibility
-is
-determined
+costs
based
on
the
-appli
--
-50
-
-4
-cation
-of
-modified
-adjusted
-gross
-income
-standards
-under
-42
-CFR
-435.603,
-1
-including
-adults
-eligible
-under
-42
-U.S.C.
-1396a(a)(10)(A)(i)(VIII)
-and
-42
-2
-U.S.C.
-1396u
--
-1
-at
-least
-once
-every
-six
-(6)
-months.
-3
-(9)
-The
-department
-of
-health
-and
-welfare
-shall
-conduct
-eligibility
-re
--
-4
-determinations
-for
-all
-medicaid
-recipients
-not
-described
-in
-subsection
-(8)
-5
-of
+department’
+s
+projections.
+Contact:
+Representative
+John
+V
+ander
+W
+oude
+(208)
+332-1000
+DISCLAIMER:
+This
+statement
+of
+purpose
+and
+fiscal
+note
+ar
+e
+a
+mer
+e
+attachment
+to
this
-section
-at
-least
-once
-every
-twelve
-(12)
-months.
-6
-SECTION
-3.
-That
-Chapter
-2,
-Title
-56,
-Idaho
-Code,
-be,
-and
-the
-same
+bill
+and
+pr
+epar
+ed
+by
+a
+pr
+oponent
+of
+the
+bill.
+It
is
-7
-hereby
-amended
-by
-the
-addition
-thereto
-of
-a
-NEW
-SECTION
-,
-to
-be
-known
-and
-des
--
-8
-ignated
-as
-Section
-56
--
-278,
-Idaho
-Code,
-and
-to
-read
-as
-follows:
-9
-56
--
-278.
-INELIGIBLE
-ALIENS.
-(1)
-The
-department
-of
-health
-and
-welfare
-10
-shall
-not
-provide
-medical
-assistance
-to
-an
-individual
-in
-Idaho
-unless
-the
-in
--
-1
-1
-dividual
-is:
-12
-(a)
-A
-resident
-of
-the
-United
-States;
-and
-13
-(b)
-At
-least
-one
-(1)
-of
-the
-following:
-14
-(i)
-A
-citizen
-or
-national
-of
-the
-United
-States;
-15
-(ii)
-An
-alien
-lawfully
-admitted
-for
-permanent
-residence
+neither
+intended
as
an
-im
--
-16
-migrant,
-as
-defined
-in
-8
-U.S.C.
-1101(a)(15)
-and
-(20),
-excluding
-17
-alien
-visitors,
-tourists,
-diplomats,
-students,
-or
-other
-individ
--
-18
-uals
-admitted
-temporarily
-without
+expr
+ession
+of
+legislative
intent
-to
-abandon
-their
-resi
--
-19
-dence
-in
-a
-foreign
-country;
-20
-(iii)
-An
-alien
-who
-has
-been
-granted
-the
-status
-of
-Cuban
-or
-Haitian
-21
-entrant,
-as
-defined
-in
-section
-501(e),
-P.L.
-96
--
-422;
-or
-22
-(iv)
-An
-individual
-lawfully
-residing
-in
-the
-United
-States
-in
-ac
--
-23
-cordance
-with
-a
-compact
-of
-free
-association
-pursuant
-to
-8
-U.S.C.
-24
-1612(b)(2)(G).
-25
-(2)
-The
-department
-of
-health
-and
-welfare
-shall
-require
-that
-all
-income
-26
-of
-ineligible
-household
-members
-be
-included
-when
-calculating
-financial
-eli
--
-27
-gibility
+nor
+intended
for
-medicaid.
-28
-(3)
-The
-department
-of
-health
-and
-welfare
-shall
-include
-an
-immigration
-29
-status
-on
-all
-presumptive
-eligibility
-applications
-submitted
-to
-the
-depart
--
-30
-ment.
-The
-department
-shall
-require
-hospitals,
-clinics,
-and
-other
-qualified
-31
-entities
-conducting
-presumptive
-eligibility
-determinations
-to
-collect
-and
-32
-transmit
-such
-attestations
-to
-the
-department.
-No
-presumptive
-eligibility
-33
-application
-shall
-be
-approved
-unless
-the
-applicant
-certifies
-that
-the
-appli
--
-34
-cant
-is
-a
-qualified
-citizen.
-35
-(4)
-The
-department
-of
-health
-and
-welfare
-shall
-verify
-citizen
--
-36
-ship
-or
-immigration
-status
-prior
-to
-enrollment
-and
-shall
-conduct
-regular
-37
-cross
--
-checks
-of
-applicant
-and
-recipient
-information
-against
-federal
-38
-databases,
+any
+use
+outside
+of
+the
+legislative
+pr
+ocess,
including
-the
-systematic
-alien
-verification
-for
-entitlements
-39
-program.
-A
-match
-through
-any
-electronic
-or
-data
-verification
-system
-shall
-40
-not,
-by
-itself,
-be
-accepted
-as
-proof
-of
-identity.
-Each
-applicant
-shall
-be
-41
-required
-to
-provide
-documentary
-proof
-of
-United
-States
-citizenship,
-United
-42
-States
-national
-status,
-or
-alien
-status
-eligible
-for
-medical
-assistance.
-43
-The
-department
-shall
-promptly
-refer
-any
-applicant
-identified
-as
-an
-individ
--
-44
-ual
-who
-is
-not
-a
-citizen
-or
-national
-of
-the
-United
-States
-and
-does
-not
-have
-45
-lawful
-immigration
-status
-as
-defined
-under
-federal
-law
-to
-the
-United
-States
-46
-immigration
-and
-customs
-enforcement
-or
-other
-appropriate
-federal
-authori
--
-47
-ties
-for
-further
-investigation
-and
-enforcement.
-48
-
-5
-(5)
-This
-section
-shall
-not
-affect
-coverage
-for
-emergency
-medical
-1
-services
-provided
-to
-all
-individuals
-as
-required
-pursuant
-to
-42
-U.S.C.
-2
-1396b(v).
-3
-(6)
-The
-requirements
-set
-forth
-in
-this
-section
-shall
-be
-implemented
-no
-4
-later
-than
-October
-1,
-2026.
-5
-SECTION
-4.
-That
-Chapter
-2,
-Title
-56,
-Idaho
-Code,
-be,
-and
-the
-same
-is
-6
-hereby
-amended
-by
-the
-addition
-thereto
-of
-a
-NEW
-SECTION
-,
-to
-be
-known
-and
-des
--
-7
-ignated
-as
-Section
-56
--
-279,
-Idaho
-Code,
-and
-to
-read
-as
-follows:
-8
-56
--
-279.
-MULTISTATE
-ENROLLMENT.
-(1)
-The
-department
-of
-health
-and
-wel
--
-9
-fare
-shall
-receive
-and
-review
-address
-change
-information
-from
-returned
-mail
-10
-by
-the
-United
-States
-postal
-service,
-the
-national
-change
-of
-address
-data
--
-1
-1
-base,
-and
-medicaid
-managed
-care
-companies
-operating
-in
-Utah.
-The
-department
-12
-shall
-conduct
-cross
--
-checks
-of
-such
-address
-change
-information
-against
-state
-13
-medicaid
-enrollment
-at
-least
-monthly
-to
-identify
-enrollees
-who
-have
-moved
-14
-out
-of
-state.
-The
-requirements
-of
-this
-subsection
-shall
-be
-implemented
-no
-15
-later
-than
-January
-1,
-2027.
-16
-(2)
-The
-department
-of
-health
-and
-welfare
-shall
-receive
-and
-review
-in
--
-17
-formation
-regarding
-out
--
-of
--
-state
-electronic
-benefit
-transactions
-and
-con
--
-18
-duct
-cross
--
-checks
-of
-such
-information
-against
-state
-medicaid
-enrollment
-at
-19
-least
-monthly
-to
-identify
-enrollees
-who
-have
-moved
-out
-of
-state.
-The
-re
--
-20
-quirements
-of
-this
-subsection
-shall
-be
-implemented
-no
-later
-than
-January
-1,
-21
-2027.
-22
-(3)
-Upon
-receiving
-information
-concerning
-a
-medicaid
-enrollee
-that
-in
--
-23
-dicates
-a
-change
-in
-circumstances
-that
-may
-affect
-medicaid
-eligibility,
-in
--
-24
-cluding
-a
-change
-in
-residency,
-the
-department
-of
-health
-and
-welfare
-shall
-25
-promptly
-conduct
-an
-eligibility
-redetermination
-for
-the
-enrollee.
-26
-(4)
-The
-department
-of
-health
-and
-welfare
-shall
-submit
-enrollment
-infor
--
-27
-mation
-to
-the
-centers
-for
-medicare
-and
-medicaid
-services
-national
-medicaid
-28
-enrollment
-database
-every
-month
-to
-identify
-individuals
-enrolled
-in
-medic
--
-29
-aid
-in
-multiple
-states
-at
-the
-same
-time.
-The
-requirements
-of
-this
-subsection
-30
-shall
-be
-implemented
-no
-later
-than
-October
-1,
-2029.
-31
-(5)
-No
-later
-than
-August
-31
-of
-each
-year,
-the
-department
-of
-health
-and
-32
-welfare
-shall
-submit
-an
-annual
-report
-to
-the
-legislature
-detailing
-the
-im
--
-33
-plementation
-of
-the
-requirements
-established
-in
-this
-section.
-The
-annual
-34
-report
-shall
-be
-made
-publicly
-available
-on
-the
-department
-of
-health
-and
-wel
--
-35
-fare
-website
-and
-shall
-include:
-36
-(a)
-The
-number
-of
-enrollees
-flagged
-through
-address
-change
-information
-37
-and
-out
--
-of
--
-state
-electronic
-benefit
-transactions;
-38
-(b)
-The
-number
-of
-enrollees
-removed
-from
-medicaid
-due
-to
-enrollment
-in
-39
-multiple
-states;
-and
-40
-(c)
-The
-estimated
-fiscal
-impact
-to
-the
-state
-due
-to
-implementing
-the
-re
--
-41
-quirements
-of
-this
-section.
-42
-SECTION
-5.
-That
-Chapter
-2,
-Title
-56,
-Idaho
-Code,
-be,
-and
-the
-same
-is
-43
-hereby
-amended
-by
-the
-addition
-thereto
-of
-a
-NEW
-SECTION
-,
-to
-be
-known
-and
-des
--
-44
-ignated
-as
-Section
-56
--
-280,
-Idaho
-Code,
-and
-to
-read
-as
-follows:
-45
-
-6
-56
--
-280.
-DECEASED
-ENROLLEES.
-(1)
-As
-used
-in
-this
-section,
-"death
-master
-1
-file"
-means
-the
-database
-maintained
-by
-the
-United
-States
-social
-security
-ad
--
-2
-ministration
-containing
-reported
-deaths.
-3
-(2)
-The
-department
-of
-health
-and
-welfare
-shall
-receive
-and
-review
-in
--
-4
-formation
-from
-the
-death
-master
-file
-and
-shall
-conduct
-cross
--
-checks
-of
-such
-5
-information
-against
-state
-medicaid
-enrollment
-at
-least
-monthly
-to
-identify
-6
-deceased
-medicaid
-enrollees.
-7
-(3)
-The
-department
-of
-health
-and
-welfare
-shall
-receive
-and
-review
-data
-8
-regarding
-birth
-and
-death
-records
-from
-the
-bureau
-of
-vital
-records
-and
-health
-9
-statistics
-and
-shall
-conduct
-cross
--
-checks
-of
-such
-data
-against
-state
-medic
--
-10
-aid
-enrollment
-at
-least
-monthly
-to
-identify
-deceased
-medicaid
-enrollees.
-1
-1
-(4)
-The
-department
-of
-health
-and
-welfare
-shall
-remove
-any
-deceased
-en
--
-12
-rollee
-from
-the
-medicaid
-program
-promptly
-upon
-confirmation
-of
-death.
-13
-(5)
-The
-department
-of
-health
-and
-welfare
-shall
-ensure
-that
-no
-medicaid
-14
-payments
-are
-made
-on
-behalf
-of
-a
-deceased
-enrollee
-for
-services
-rendered
-af
--
-15
-ter
-the
-date
-of
-death.
-16
-(6)
-The
-department
-of
-health
-and
-welfare
-shall
-recoup
-any
-funds
-ex
--
-17
-pended
-on
-deceased
-enrollees
-for
-capitations
-or
-services
-occurring
-after
-the
-18
-date
-of
-death.
-19
-(7)
-The
-requirements
-of
-this
-section
-shall
-be
-implemented
-no
-later
-than
-20
-January
-1,
-2027.
-21
-SECTION
-6.
-That
-Chapter
-2,
-Title
-56,
-Idaho
-Code,
-be,
-and
-the
-same
-is
-22
-hereby
-amended
-by
-the
-addition
-thereto
-of
-a
-NEW
-SECTION
-,
-to
-be
-known
-and
-des
--
-23
-ignated
-as
-Section
-56
--
-281,
-Idaho
-Code,
-and
-to
-read
-as
-follows:
-24
-56
--
-281.
-RETROACTIVE
-ELIGIBILITY.
-(1)
-As
-used
-in
-this
-section:
-25
-(a)
-"Expansion
-population"
-means
-individuals
-who
-are
-eligible
-for
-26
-medical
-assistance
-under
-42
-U.S.C.
-1396a(a)(10)(A)(i)(VIII),
-commonly
-27
-known
-as
-the
-medicaid
-expansion
-population
-under
-the
-affordable
-care
-28
-act.
-29
-(b)
-"Medicaid"
-means
-the
-medical
-assistance
-program
-established
-under
-30
-title
-XIX
-of
-the
-social
-security
-act
-and
-administered
-by
-the
-department
-31
-of
-health
-and
-human
-services.
-32
-(c)
-"Non
--
-expansion
-population"
-means
-all
-individuals
-eligible
-for
-med
--
-33
-icaid
-who
-do
-not
-qualify
-under
-the
-expansion
-population
-definition,
-in
--
-34
-cluding
-but
-not
-limited
-to
-pregnant
-women,
-children,
-elderly
-individu
--
-35
-als,
-and
-persons
-with
-disabilities.
-36
-(d)
-"Retroactive
-eligibility"
-means
-medicaid
-coverage
-for
-services
-37
-provided
-prior
-to
-the
-month
-of
-application,
-as
-authorized
-by
-42
-U.S.C.
-38
-1396a(a)(34).
-39
-(2)
-The
-department
-of
-health
-and
-welfare
-shall
-limit
-retroactive
-eligi
--
-40
-bility
-for
-medicaid
-benefits
-as
-follows:
-41
-(a)
-For
-individuals
-determined
-to
-be
-eligible
-as
-part
-of
-the
-expansion
-42
-population,
-medicaid
-coverage
-may
-be
-made
-retroactive
-for
-no
-more
-than
-43
-one
-(1)
-month
-prior
-to
-the
-month
-in
-which
-the
-individual
-submits
-a
-com
--
-44
-pleted
-medicaid
-application.
-45
-(b)
-For
-individuals
-eligible
-as
-part
-of
-the
-non
--
-expansion
-population,
-46
-medicaid
-coverage
-may
-be
-made
-retroactive
-for
-no
-more
-than
-two
-(2)
-47
-months
-prior
-to
-the
-month
-in
-which
-the
-individual
-submits
-a
-completed
-48
-medicaid
-application.
-49
-
-7
-(3)
-The
-limitations
-set
-forth
-in
-subsection
-(2)
-of
-this
-section
-apply
-1
-only
-to
-initial
-applications
-for
-medicaid
-and
-do
-not
-affect
-eligibility
-for
-2
-continuous
-or
-ongoing
-coverage.
-3
-SECTION
-7.
-An
-emergency
-existing
-therefor,
-which
-emergency
-is
-hereby
-4
-declared
-to
-exist,
-this
-act
-shall
-be
-in
-full
-force
-and
-effect
-on
-and
-after
-its
-5
-passage
-and
-approval.
-6
+judicial
+r
+eview
+(Joint
+Rule
+18).
+Statement
+of
+Purpose
+/
+Fiscal
+Note
+Bill
+SOP/FN
+REVISED:
+03/19/2026,
+12:08
+PM

Diffs are computed deterministically from extracted bill text and show additions, deletions, and section moves. Scanned-PDF text extracted via OCR is flagged where confidence is low; see methodology.