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@@-LEGISLATURE+REVISED+ST+A+TEMENTOF-THE-STATE-OF-IDAHO-Sixty-eighth-Legislature-Second-Regular-Session---2026-IN-THE-HOUSE-OF-REPRESENTATIVES-HOUSE-BILL-NO.-928-BY-WAYS-AND-MEANS-COMMITTEE-AN-ACT-1-RELATING-TO-THE-MERIT---BASED-HEALTH-CARE-ACT;-AMENDING-TITLE-56,-IDAHO-CODE,-2-BY-THE-ADDITION-OF-A-NEW-CHAPTER-25,-TITLE-56,-IDAHO-CODE,-TO-PROVIDE-3-A-SHORT-TITLE,-TO-PROVIDE-LEGISLATIVE-FINDINGS-AND-INTENT,-TO-DEFINE-4-TERMS,-TO-ESTABLISH-PROVISIONS-REGARDING-PROHIBITED-ACTS,-TO-ESTABLISH-5-PROVISIONS-REGARDING-MEDICAID-CONTRACTUAL-COMPLIANCE,-TO-ESTABLISH-6-PROVISIONS-REGARDING-ENFORCEMENT-AND-PENALTIES,-TO-ESTABLISH-PROVI---7-SIONS-REGARDING-A-LIMITED-PRIVATE-RIGHT-OF-ACTION,-AND-TO-ESTABLISH-8-PROVISIONS-REGARDING-FEDERAL-PREEMPTION;-AND-DECLARING-AN-EMERGENCY-9-AND-PROVIDING-AN-EFFECTIVE-DATE.-10-Be-It-Enacted-by-the-Legislature-of-the-State-of-Idaho:-1-1-SECTION-1.-That-Title-56,-Idaho-Code,-be,-and-the-same-is-hereby-amended-12-by-the-addition-thereto-of-a-NEW-CHAPTER-,-to-be-known-and-designated-as-Chap---13-ter-25,-Title-56,-Idaho-Code,-and-to-read-as-follows:-14-CHAPTER-25-15-MERIT---BASED-HEALTH-CARE-ACT-16-56---2501.-SHORT-TITLE.-This-chapter-shall-be-known-and-may-be-cited-as-17-the-"Merit---Based+PURPOSE+RS33759+/+H0928+The+Merit-BasedHealthCare-Act."-18+Act+amends+T+itle56---2502.-LEGISLATIVE-FINDINGS-AND-INTENT.-(1)-The-legislature-finds-19-that:-20-(a)-Medicaid-participation-is-voluntary-and-subject+of+Idaho+Codeto-reasonable-con---21-ditions-imposed-by-the-state-as-a-steward-of-public-funds;-22-(b)-Employment-decisions-based-on-merit-and-professional-qualifica---23-tions-promote-patient-trust-and-high---quality-care;-and-24-(c)-Employment-practices-unrelated-to-job---related-qualifications-or-25-business-necessity-undermine-program-integrity,-workforce-competency,-26-and-the-efficient-use-of-public-funds.-27-(2)-It-is-the-intent-of-the-legislature-to:-28-(a)-Ensure+requirethat-health-care+Medicaid-fundedemploymentandcontractingdecisions-29-funded-by-medicaid-are+bebased+solelyon-individualmerit,+professionalqualifications,and-30clinical-competency;-31-(b)-Prohibit-the-use-of-state-medicaid-funds-to-support+competency+.+It+prohibits+discriminatory+hiring+and+specified+DEI+practices—such+as+race-+or+sex-based+preferences,+mandatory+bias+training,+andideological-or-32-discriminatory-employment-practices;-and-33-(c)-Preserve-compliance-with-all-applicable+pledges—while+preserving+exemptions+forfederalcivilrights-and-34-medicaid-requirements.-35-(3)-Nothing-in+compliance,+clinical+data+collection,+and+accredited+medical+training.+Compliance+is+made+a+material+condition+of+Medicaid+participation,+enforced+by+the+Attorney+General+through+civil+penalties,+with+a+limited+private+right+of+action+for+professionals+facing+retaliation.+FISCAL+NOTE+This+legislation+has+no+fiscal+impact+on+the+state+general+fund+or+local+governments,+as+it+is+implemented+through+existing+provider+agreements+and+contracts,+with+enforcement+handled+within+current+appropriations+and+minimal+expected+penalty+revenue.+Contact:+Representative+Clint+Hostetler+Representative+Jordan+Redman+Senator+Ben+T+oews+Senator+Joshua+Kohl+(208)+332-1000+DISCLAIMER:+This+statement+of+purpose+and+fiscal+note+ar+e+a+mer+e+attachment+tothis-chapter+bill+and+pr+epar+ed+by+a+pr+oponent+of+the+bill.+Itis+neitherintended-to-authorize-discrimination-36-prohibited-by-federal-law-or-to-interfere-with-patient---specific-medical-37-decision---making.-38-56---2503.-DEFINITIONS.-As-used-in-this-chapter:-39--2-(1)-"Discriminatory-hiring"-means-granting-a-preference-or-imposing-a-1-disadvantage-in-employment-or-contracting-based-on-race,-sex,-sexual-orien---2-tation,-gender-identity,-or-national-origin,-exceptas-expressly-required-by-3-federal-law.-4-(2)-"Diversity,-equity,-and-inclusion"-or-"DEI"-means-the-policies-com---5-monly-known-and-practiced-as-DEI,-critical-race-theory,-or-anti---racism,-any-6-form-of-race-or-sex-stereotyping-or-scapegoating,-or-the-concepts-that:-7-(a)-One-race-or-sex-is-inherently-superior-to-another-race-or-sex;-8-(b)-The-United-States-is-fundamentally-racist-or-sexist;-9-(c)-An-individual,-by-virtue-of-the-individual's-race-or-sex,-is-in---10-herently-racist,-sexist,-or-oppressive,-whether-consciously-or-uncon---1-1-sciously;-12-(d)-An-individual-should-be-discriminated-against-or-receive-adverse-13-treatment-solely-or-partly-because-of-the-individual's-race-or-sex;-14-(e)-Members-of-one-race-or-sex-cannot-and-should-not-attempt-to-treat-15-others-without-respect-to-race-or-sex;-16-(f)-An-individual's-moral-character-is-necessarily-determined-by-the-17-individual's-race-or-sex;-18-(g)-An-individual,-by-virtue-of-the-individual's-race-or-sex,-bears-re---19-sponsibility-for-actions-committed-in-the-past-by-other-members-of-the-20-same-race-or-sex;-21-(h)-An-individual-should-feel-discomfort,-guilt,-anguish,-or-any-other-22-form-of-psychological-distress-on-account-of-the-individual's-race-or-23-sex;-24-(i)-Meritocracy-or-traits-such-as-a-hard-work-ethic-are-racist-or-sexist-25-or-were-created-by-a-particular-race-to-oppress-another-race;-or-26-(j)-All-people-should-be-compelled-to-believe-in-and-speak-in-a-manner-27-consistent-with-the-concept-thatan-individual-can-change-the-individ---28-ual's-sex-or-gender.-29-(3)-"Health-care-provider"-means-any-individual-or-entity-that-volun---30-tarily-participates-in-the-Idaho-medicaid-program-or-receives-medicaid-reim---31-bursements-in-whole-or-in-part-through-a-state---contracted-managed-care-net---32-work.-33-(4)-"Prohibited-DEI-conduct"-means-any-policy,-practice,-training,-or-34-requirement-that-includes:-35-(a)-Consideration-of-DEI-in-hiring,-promotion,-compensation,-disci---36-pline,-termination,-or-contracting-decisions;-37-(b)-Race---based-or-sex---based-preferences,-targets,-benchmarks,-quotas,-38-or-equity-goals;-39-(c)-Mandatory-bias,-implicit-bias,-systemic-bias,-or-similar-training-40-that-assigns-responsibility,-disadvantage,-or-professional-outcomes-41-based-on-protected-characteristics-rather-than-individual-merit-or-per---42-formance;-or-43-(d)-Required-statements,-pledges,-attestations,-or-affirmations-en---44-dorsing-diversity,-equity,-and-inclusion-principles-or-related-ideo---45-logical-frameworks-as-a-condition-of-employment-or-contracting.-46-(5)-"Public---facing-communication"-means-any-communication-made-avail---47-able-to-the-public,-including-marketing-materials,-websites,-mission-or-48-value-statements,-publicly-presented-staff-trainings,-facility-signage,-or-49-social-media.-50--3-56---2504.-PROHIBITED-ACTS.-(1)-With-respect-to-employment,-policies,-1-training,-or-communications,-a-health-care-provider-shall-not:-2-(a)-Engage-in-discriminatory-hiring-or-prohibited-DEI-conduct;-3-(b)-Adopt-or-implement-internal-policies-or-trainings-that-constitute-4-prohibited-DEI-conduct;-or-5-(c)-Use-state-funds,-including-medicaid-reimbursements,+expr+ession+of+legislative+intent+nor+intendedforany-pub---6-lic---facing-communication-that-promotes-prohibited-DEI-conduct.-7-(2)-Nothing-in-this-section-shall-be-construed-to-prohibit:-8-(a)-Compliance-with-title-VI-of-the-civil-rights-act-of-1964-or-other-9-applicable-federal-civil-rights-laws;-10-(b)-Collection-of-demographic-data-for-legitimate-clinical-care,-qual---1-1-ity-reporting,-or-public-health-purposes;-12-(c)-Patient---specific-medical-discussions-related-to-biological,-ge---13-netic,-or-epidemiological-risk-factors;-14-(d)-Non---ideological-training-required-for-clinical-competency,-licen---15-sure,-accreditation,-or-federal-program-compliance;-or-16-(e)-Workforce-training,-quality-improvement-initiatives,-or-dispar---17-ity---reduction-programs-required-or-encouraged-by-federal-law,-centers-18-for-medicare-and-medicaid-services-guidance,-or-accreditation-bodies.-19-56---2505.-MEDICAID-CONTRACTUAL-COMPLIANCE.-(1)-Compliance-with-this-20-chapter-shall-be-a-material-condition-of-all-Idaho-participating-medicaid-21-health-care-provider-agreements-as-applied-to-medicaid---funded-activities.-22-(2)-This-section-shall-be-implemented-in-a-manner-consistent-with-fed---23-eral-medicaid-requirements-and-centers-for-medicare-and-medicaid-services-24-guidance.-25-56---2506.-ENFORCEMENT-AND-PENALTIES.-(1)-The-attorney-general-may-in---26-vestigate-alleged-violations-of-this-chapter-upon-receipt-of-a-formal-com---27-plaint.-28-(2)-Prior-to-the-imposition-of-civil-penalties,-the-department-shall-29-provide-written-notice-and-an-opportunity-for-corrective-action.-30-(3)-The-attorney-general-may-seek-civil-penalties-for-violations-of-31-this-chapter-as-follows:-32-(a)-For-a-health-care-provider-with-fifty-(50)-or-more-employees:-33-(i)-A-penalty-not-to-exceed-ten-thousand-dollars-($10,000)-for-a-34-first-violation;-35-(ii)-A-penalty-not-to-exceed-fifty-thousand-dollars-($50,000)-for-36-a-second-violation;-and-37-(iii)-A-penalty-not-to-exceed-one-hundred-thousand-dollars-38-($100,000)-for-a-third-or-subsequent-violation;-and-39-(b)-For-a-health-care-provider-with-fewer-than-fifty-(50)-employees:-40-(i)-A-penalty-not-to-exceed-five-thousand-dollars-($5,000)-for-a-41-first-violation;-42-(ii)-A-penalty-not-to-exceed-twenty---five-thousand-dollars-43-($25,000)-for-a-second-violation;-and-44-(iii)-A-penalty-not-to-exceed-fifty-thousand-dollars-($50,000)-for-45-a-third-or-subsequent-violation.-46--4-56---2507.-LIMITED-PRIVATE-RIGHT-OF-ACTION.-A-health-care-professional-1-may-bring-an-action-solely-for-retaliation-arising-from-refusing-to-partici---2-pate-in-prohibited-DEI-conduct.-Remedies-may-include-reinstatement,-injunc---3-tive-relief,-compensatory-damages,-and-reasonable-attorney's-fees.-4-56---2508.-SAVINGS-CLAUSE-AND-FEDERAL-PREEMPTION.-Nothing-in-this-chap---5-ter-shall-be-construed-to-restrict-conduct-required-or-encouraged-by-fed---6-eral-civil-rights-law,-centers-for-medicare-and-medicaid-services-guidance,-7-or-federal-conditions-of-participation.-If-any-provision-of-this-chapter-is-8-preempted-by-federal-law,-such-provision-shall-be-severed-while-the-remain---9-der-remains-in-full-force-and-effect.-10-SECTION-2.-An-emergency-existing-therefor,-which-emergency-is-hereby-1-1-declared-to-exist,-this-act-shall-be-in-full-force-and-effect-on-and-after-12-July-1,-2026.-13+use+outside+of+the+legislative+pr+ocess,+including+judicial+r+eview+(Joint+Rule+18).+Statement+of+Purpose+/+Fiscal+Note+Bill+SOP/FN+REVISED:+03/19/2026,+10:47+AM
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