View original fileNOTICE OF INTENT TO SUBMIT IDAHO MEDICAID MANAGED CARE QUALITY STRATEGY AND SOLICITATION OF PUBLIC INPUT
Pursuant to 42 C.F.R. §438.340 Managed care State quality strategy, 42 C.F.R. § 440.345 EPSDT and other required benefits, 42 C.F.R. § 440.386 Public notice, 42 C.F.R. § 447.204 Medicaid provider participation and public process to inform access to care, 42 C.F.R. § 447.205 Public notice of changes in Statewide methods and standards for setting payment rates, and 42 C.F.R. § 457.65 Effective date and duration of State plans and plan amendments, the Idaho Department of Health and Welfare Division of Medicaid (Department) provides public notice of its intent to submit State Plan Amendments (SPAs) to the Centers for Medicare and Medicaid Services (CMS).
PROPOSED CHANGES Idaho Medicaid intends to update its managed care quality strategy in accordance with 42 C.F.R. §438.364 External quality review results(a)(4) and 42 C.F.R. §438.340 Managed care State quality strategy(c)(3). Following CMS guidance, updates to the strategy will include a period for stakeholder engagement and feedback. The State Medicaid Agency’s quality strategy provides an overview of managed care in Idaho and outlines a framework to assess, improve, and ensure quality care for dual-eligible Medicaid and Medicare individuals, behavioral health, and dental benefits for all Medicaid-eligible individuals. Each managed care program contract is uniquely structured to best serve Idahoans’ needs, promoting quality services and improved outcomes for members.
The Department intends to submit this to CMS with a requested effective date of July 1, 2025.
ESTIMATE OF EXPECTED CHANGE IN ANNUAL AGGREGATE EXPENDITURES There is no expected increase or decrease in annual aggregate expenditures.
PUBLIC REVIEW The draft is posted on the IDHW website at https://publicdocuments.dhw.idaho.gov/WebLink/Browse.aspx?id=21079&dbid=0&repo=PUBLIC-DOCUMENTS&cr=1
Unless otherwise specified, copies are also available upon request for public review during regular business hours at any Regional Medicaid Services office of the Idaho Department of Health and Welfare.
LOCATIONS FOR PUBLIC REVIEW OF Custer County Oneida County PROPOSED STATE PLAN AMENDMENT Eastern Idaho Public Health, 1050 N. Clinic Road, Southeastern Idaho Public Health, 175 South 300 Ada County Suite A, Challis, ID 83226 East, Malad, ID 83252 DHW Region 4, 1720 Westgate Drive, Boise, ID Elmore County Owyhee County 83704 DHW Region 4, 2420 American Legion Blvd., Southwest District Health, 132 E. Idaho, Homedale, Central District Health Department, 707 North Mountain Home, ID 83647 ID 83628 Armstrong Place, Boise, ID 83704 Central District Health Department, 520 E. 8th Street Payette County Adams County N, Mountain Home, ID 83647 DHW Region 3, 515 N. 16th Street, Payette, ID Adams County Clerk’s Office, 201 Industrial Avenue, Franklin County 83661 Council, ID 83612 DHW Region 6, 223 North State, Preston, ID 83263 Southwest District Health, 1155 Third Avenue North, Bannock County Southeastern Idaho Public Health, 50 West 1 St. Payette, ID 83661 DHW Region 6, 1070 Hiline, Pocatello, ID 83201 South, Preston, ID 83263 Power County Southeastern Idaho Public Health, 1901 Alvin Fremont County Southeastern Idaho Public Health, 590 1/2 Gifford, Ricken Drive, Pocatello, ID 83201 Eastern Idaho Public Health, 45 South 2nd West, St. American Falls, ID 83211 Bear Lake County Anthony, ID 83445 Shoshone County Southeastern Idaho Public Health, 455 Washington, Gem County DHW Region 1, 35 Wildcat Way, Suite B, Kellogg, Suite #2, Montpelier, ID 83254 Southwest District Health, 1008 East Locust, ID 83837 Benewah County Emmett, ID 83617 Panhandle Health District, 114 Riverside Avenue W, Panhandle Health District, 137 N 8th Street, St Gooding County Kellogg, ID 83837 Maries, ID 83861 South Central Public Health, 255 North Canyon Teton County Bingham County Drive, Gooding, ID 83330 Eastern Idaho Public Health, 820 Valley Centre DHW Region 6, 701 East Alice, Blackfoot, ID 83221 Idaho County Drive, Driggs, ID 83422 Southeastern Idaho Public Health, 145 W Idaho DHW Region 2, Camas Resource Center, 216 South Twin Falls County Street, Blackfoot, ID 83221 C Street, Grangeville, ID 83530 DHW Region 5, 601 Pole Line Road, Twin Falls, Blaine County North Central Health District, 903 W Main, ID 83301 South Central Public Health, 117 East Ash Street, Grangeville, ID 83530 South Central Public Health, 1020 Washington Bellevue, ID 83313 Jefferson County Street North, Twin Falls, ID 83301 Boise County Eastern Idaho Public Health, 380 Community Lane, Valley County Boise County Clerk’s Office, 420 Main Street, Idaho Rigby, ID 83442 Central District Health Department, 703 1st Street, City, ID 83631 Jerome County McCall, ID 83638 Bonner County South Central Public Health, 951 East Avenue H, Washington County DHW Region 1, 207 Larkspur Street, Ponderay, Jerome, ID 83338 Southwest District Health, 46 West Court, Weiser, ID 83852 Kootenai County ID 83672 Panhandle Health District, 2101 W. Pine Street, DHW Region 1, 1120 Ironwood Drive, Coeur PUBLIC COMMENT Sandpoint, ID 83864 d’Alene, ID 83814 The Department is accepting written and recorded Bonneville County Panhandle Health District, 8500 N. Atlas Road, comments for a period of at least thirty (30) calendar DHW Region 7, 150 Shoup Avenue, Idaho Falls, Hayden, ID 83835 days. Any persons wishing to provide input may ID 83402 Latah County submit comments. Eastern Idaho Public Health, 1250 Hollipark Drive, DHW Region 2, 1350 Troy Highway, Moscow, ID Comments must be received by the Department Idaho Falls, ID 83401 83843 within thirty (30) days of the posting of this Boundary County North Central Health District, 333 E Palouse River notice, and must be sent using one of the Panhandle Health District, 7402 Caribou Street, Drive, Moscow, ID 83843 following methods: Bonners Ferry, ID 83805 Lemhi County • Send Email Comments To: Butte County DHW Region 7, 111 Lillian Street, Suite 104, QualityStrategy@dhw.idaho.gov Southeastern Idaho Public Health, 178 Sunset Salmon, ID 83467 • Call and Leave Recorded Comments At: Drive, Arco, ID 83213 Eastern Idaho Public Health, 801 Monroe, Salmon, (208)-364-1887 Camas County ID 83467 • Send Fax Comments To: 1-208-287-1170 Camas County Clerk’s Office, 501 Soldier Road, Lewis County • Mail Comments To: Fairfield, ID 83327 North Central Health District, 132 N Hill Street, Division of Medicaid Canyon County Kamiah, ID 83536 PO Box 83720, Boise, ID 83720-0009 DHW Region 3, 3402 Franklin Road, Caldwell, Lincoln County Attn: Managed Care Team ID 83605 South Central Public Health, Lincoln County Hand Deliver Comments During Regular Business Southwest District Health, 13307 Miami Lane, Community Center, 201 South Beverly St., Hours (M-F from 8AM to 5PM, except holidays) To: Caldwell, ID 83607 Shoshone, ID 83352 Division of Medicaid Caribou County Madison County 450 West State Street, 6th Floor, Southeastern Idaho Public Health, 55 East 1st DHW Region 7, 333 Walker Drive, Rexburg, ID Boise, ID 83720 South, Soda Springs, ID 83276 83440 Attn: Managed Care Team Cassia County Eastern Idaho Public Health, 314 North 3rd East, The Department will review all comments received DHW Region 5, 2241 Overland Avenue, Burley, Rexburg, ID 83440 prior to submitting to CMS. ID 83318 Minidoka County PUBLIC HEARING Clark County South Central Public Health, 485 22nd Street, No public hearings have been scheduled at this Eastern Idaho Public Health, 332 West Main, Heyburn, ID 83336 time. Dubois, ID 83423 Nez Perce County QUESTIONS Clearwater County DHW Region 2, 1118 F Street, Lewiston, ID 83501 For technical questions or to review the changes, North Central Health District, 105 115th Street, North Central Health District, 215 10th Street, e-mail the request to Orofino, ID 83544 Lewiston, ID 83501 QualityStrategy@dhw.idaho.gov.