NOTICE OF INTENT TO SUBMIT STATE PLAN AMENDMENT AND SOLICITATION OF PUBLIC INPUT Camas County Camas County Clerk’s Office, 501 Soldier Road, Fairfield, ID 83327 Pursuant to 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 Canyon County participation and public process to inform access to care, 42 C.F.R. § 447.205 DHW Region 3, 3402 Franklin Road, Caldwell, ID 83605 Public notice of changes in Statewide methods and standards for setting Southwest District Health, 13307 Miami Lane, Caldwell, ID 83607 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 Caribou County Division of Medicaid (Department) provides public notice of its intent to submit Southeastern Idaho Public Health, 55 East 1st South, Soda Springs, ID 83276 a State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS). Cassia County DHW Region 5, 2241 Overland Avenue, Burley, ID 83318 PROPOSED CHANGES Idaho Medicaid intends to submit a State Plan Amendment (SPA) to the Clark County Centers for Medicare and Medicaid Services (CMS) to discontinue contracting Eastern Idaho Public Health, 332 West Main, Dubois, ID 83423 and reimbursing as part of the Healthy Connections Value Care (HCVC) program through value care organizations and the Healthy Connections (HC) Clearwater County primary care case management program. North Central Health District, 105 115th Street, Orofino, ID 83544 Idaho House Bill H0345 MEDICAID (2025), became effective when it was Custer County signed into law on March 19, 2025 (Gov. Little signs the Medicaid Reform Eastern Idaho Public Health, 1050 N. Clinic Road, Suite A, Challis, ID 83226 and Cost Containment Act). In part, it added language to Idaho Code § 56-263 Medicaid Managed Care Plan. Elmore County DHW Region 4, 2420 American Legion Blvd., Mountain Home, ID 83647 The department shall discontinue contracting and reimbursing as part of the Central District Health Department, 520 E. 8th Street N, Mountain Home, healthy connections value care program through value care organizations ID 83647 and the healthy connections primary care case management program by January 1, 2026. Franklin County DHW Region 6, 223 North State, Preston, ID 83263 Background And Changes: Healthy Connections (HC) Southeastern Idaho Public Health, 50 West 1 St. South, Preston, ID 83263 Idaho Medicaid primary care providers sign the Idaho Medicaid Provider Fremont County Agreement and those providers who choose to participate in HC also sign a Eastern Idaho Public Health, 45 South 2nd West, St. Anthony, ID 83445 Coordinated Care Agreement and an optional Tier Application. In addition to payment for services rendered, they receive a monthly case management fee Gem County for each member enrolled with them as of the first day of the month. Southwest District Health, 1008 East Locust, Emmett, ID 83617 The HC program will sunset, and Idaho Medicaid will discontinue contracting Gooding County and reimbursing through value care organizations and the primary care case South Central Public Health, 255 North Canyon Drive, Gooding, ID 83330 management program. HC providers will receive notice that their Coordinated Care Agreement is being terminated. The HC primary care case management Idaho County (per member per month) payment will cease. Idaho Medicaid will stop DHW Region 2, Camas Resource Center, 216 South C Street, Grangeville, enrolling new Healthy Connections providers. ID 83530 North Central Health District, 903 W Main, Grangeville, ID 83530 Idaho Medicaid Provider Agreements will remain active and effective. Jefferson County Primary care is still covered by Idaho Medicaid. Eastern Idaho Public Health, 380 Community Lane, Rigby, ID 83442 HC member enrollments will cease. Idaho Medicaid members may now see Jerome County the primary care provider of their choice, without formal assignment. Referrals South Central Public Health, 951 East Avenue H, Jerome, ID 83338 from a primary care provider are still encouraged. Kootenai County The Idaho Medicaid program remains committed to comprehensive and DHW Region 1, 1120 Ironwood Drive, Coeur d’Alene, ID 83814 continuous medical care to a member with the goal of improving health Panhandle Health District, 8500 N. Atlas Road, Hayden, ID 83835 outcomes. This includes: Latah County • Ensuring appropriate and timely access to healthcare. DHW Region 2, 1350 Troy Highway, Moscow, ID 83843 • Improving the quality of healthcare and overall well-being of Medicaid North Central Health District, 333 E Palouse River Drive, Moscow, ID 83843 members. • Emphasizing care coordination and continuity of care. Lemhi County • Encouraging members to be involved in their healthcare decisions. DHW Region 7, 111 Lillian Street, Suite 104, Salmon, ID 83467 • Achieving cost efficiencies for the Idaho Medicaid Program. Eastern Idaho Public Health, 801 Monroe, Salmon, ID 83467 Though the HC and HCVC programs are ending, the importance of primary Lewis County and preventive care is the same. North Central Health District, 132 N Hill Street, Kamiah, ID 83536 Background And Changes: Healthy Connections Value Care (HCVC) Lincoln County South Central Public Health, Lincoln County Community Center, 201 South Under HCVC, Value Care Organizations (VCOs) contracted with Idaho Beverly St., Shoshone, ID 83352 Medicaid are held accountable for improving member health outcomes and controlling costs. Many HC providers are affiliated with a VCO. The Madison County agreements between each VCO and affiliated HC provider are separate and DHW Region 7, 333 Walker Drive, Rexburg, ID 83440 unique from the HC Coordinated Care Agreement. Eastern Idaho Public Health, 314 North 3rd East, Rexburg, ID 83440 The HCVC program will sunset, and Idaho Medicaid will discontinue Minidoka County contracting and reimbursing through VCOs. VCOs will receive notice that South Central Public Health, 485 22nd Street, Heyburn, ID 83336 their agreement with Idaho Medicaid is being terminated. The settlement for performance year 4 (Calendar Year 2025) will follow the settlement process Nez Perce County outlined in Article VI of the HCVC Provider Agreement. Settlements are DHW Region 2, 1118 F Street, Lewiston, ID 83501 estimated to be finalized by December 31, 2026. North Central Health District, 215 10th Street, Lewiston, ID 83501 The Department intends to submit these State Plan Amendments to CMS with Oneida County a requested effective date of January 1, 2026. Southeastern Idaho Public Health, 175 South 300 East, Malad, ID 83252 ESTIMATE OF EXPECTED CHANGE IN ANNUAL AGGREGATE Owyhee County EXPENDITURES Southwest District Health, 132 E. Idaho, Homedale, ID 83628 There is no expected increase or decrease in annual aggregate expenditures. Payette County PUBLIC REVIEW DHW Region 3, 515 N. 16th Street, Payette, ID 83661 When available, copies of the draft SPA pages will be posted on the IDHW Southwest District Health, 1155 Third Avenue North, Payette, ID 83661 website at https://healthandwelfare.idaho.gov/about-dhw/policies-procedures- and-waivers (under “Medicaid policies”, PUBLIC-DOCUMENTS > About DHW Power County > Policies & Standards > Medicaid > Draft State Plan Amendments). Southeastern Idaho Public Health, 590 1/2 Gifford, American Falls, ID 83211 Unless otherwise specified, copies are also available upon request for public Shoshone County review during regular business hours at any Regional Medicaid Services DHW Region 1, 35 Wildcat Way, Suite B, Kellogg, ID 83837 office of the Idaho Department of Health and Welfare. Panhandle Health District, 114 Riverside Avenue W, Kellogg, ID 83837 LOCATIONS FOR PUBLIC REVIEW OF PROPOSED STATE PLAN Teton County AMENDMENT Eastern Idaho Public Health, 820 Valley Centre Drive, Driggs, ID 83422 Ada County DHW Region 4, 1720 Westgate Drive, Boise, ID 83704 Twin Falls County Central District Health Department, 707 North Armstrong Place, Boise, ID DHW Region 5, 601 Pole Line Road, Twin Falls, ID 83301 83704 South Central Public Health, 1020 Washington Street North, Twin Falls, ID 83301 Adams County Adams County Clerk’s Office, 201 Industrial Avenue, Council, ID 83612 Valley County Central District Health Department, 703 1st Street, McCall, ID 83638 Bannock County DHW Region 6, 1070 Hiline, Pocatello, ID 83201 Washington County Southeastern Idaho Public Health, 1901 Alvin Ricken Drive, Pocatello, ID Southwest District Health, 46 West Court, Weiser, ID 83672 83201 PUBLIC COMMENT Bear Lake County The Department is accepting written and recorded comments regarding the Southeastern Idaho Public Health, 455 Washington, Suite #2, Montpelier, proposed SPA for a period of at least thirty (30) calendar days. Any persons ID 83254 wishing to provide input may submit comments. Benewah County Comments must be received by the Department within thirty (30) days of the Panhandle Health District, 137 N 8th Street, St Maries, ID 83861 posting of this notice, and must be sent using one of the following methods: • Send Email Comments To: MCPT@dhw.idaho.gov Bingham County • Call and Leave Recorded Comments At: (208)-364-1887 DHW Region 6, 701 East Alice, Blackfoot, ID 83221 • Send Fax Comments To: 1-208-287-1170 Southeastern Idaho Public Health, 145 W Idaho Street, Blackfoot, ID 83221 • Mail Comments To: Division of Medicaid PO Box 83720, Boise, ID 83720-0009 Blaine County Attn: Policy Team South Central Public Health, 117 East Ash Street, Bellevue, ID 83313 Hand Deliver Comments During Regular Business Hours (M-F from 8AM to Boise County 5PM, except holidays) To: Boise County Clerk’s Office, 420 Main Street, Idaho City, ID 83631 Division of Medicaid 450 West State Street, 6th Floor, Boise, ID 83720 Bonner County Attn: Policy Team DHW Region 1, 207 Larkspur Street, Ponderay, ID 83852 Panhandle Health District, 2101 W. Pine Street, Sandpoint, ID 83864 The Department will review all comments received prior to submitting the SPA to CMS. Bonneville County DHW Region 7, 150 Shoup Avenue, Idaho Falls, ID 83402 PUBLIC HEARING Eastern Idaho Public Health, 1250 Hollipark Drive, Idaho Falls, ID 83401 No public hearings have been scheduled at this time. Boundary County QUESTIONS Panhandle Health District, 7402 Caribou Street, Bonners Ferry, ID 83805 For technical questions or to review the changes, e-mail the request to MCPT@dhw.idaho.gov. Butte County Southeastern Idaho Public Health, 178 Sunset Drive, Arco, ID 83213