Public comment on Health and Welfare’s 4% Medicaid provider reimbursement rate cuts is open

BOISE, ID – The Idaho Department of Health and Welfare is accepting public comments on recent pay rate cuts for health care providers who treat Medicaid patients.

Last month, the state health agency announced it would cut Medicaid reimbursement rates for all provider types and services by 4%, starting Sept. 1. The news came a week after Idaho Gov. Brad Little ordered state agencies to cut budgets mid-year by 3% ahead of an $80 million projected budget shortfall.

The Medicaid cuts are meant to reduce rapidly rising Medicaid costs, and more could come, state officials said. But said the cuts — coupled with another Medicaid program set to end soon — could push some doctors’ offices to stop accepting Medicaid, Idaho Medical Association CEO Susie Keller previously told the Idaho Capital Sun.

About 354,000 Idahoans are enrolled in Medicaid, a public assistance program that provides health insurance for people with low incomes, disabilities, children, pregnant moms and some seniors.

The cuts took effect Monday, but Health and Welfare is working with the federal Centers for Medicare and Medicaid Services “to clarify operational expectations with any claims needing to be reprocessed,” agency spokesperson AJ McWhorter told the Idaho Capital Sun.

At the Idaho Legislature’s Medicaid Review Panel’s Wednesday meeting, Idaho Medicaid Deputy Director Juliet Charron said “making changes to this proposal is not out of the question.”

“What we expect to see and dig into — in addition to some folks just saying we disagree with this — is ‘are there specific access or impact concerns within specific communities that we need to look at?’” she said in response to a question from a lawmaker. “For example, maybe it’s a specific home and community-based service in a very rural community.”

Here’s how the cuts will work, according to Health and Welfare’s announcement last month:

• The providers: That includes hospitals, nursing and intermediate care facilities, home and community-based services for people with disabilities, hospice, ambulatory surgical centers, school-based services and more. Pharmacy benefit rates will also face 4% cuts. Tribal providers will be exempt from the cuts, since they are “reimbursed entirely with federal funds when serving tribal members.”
• Managed care: Payments to private companies that manage Medicaid benefits will also be cut by 4%. The cuts to those payments, called capitation rates, may come through “provider rate reductions or changes to optional covered costs.” Some Idaho Medicaid services — like mental health care, medical transportation and dental care — are run by private managed care organizations. Idaho hopes to shift all Medicaid benefits to managed care by 2029, under a state law passed this year.

How to submit public comment on Idaho’s Medicaid cuts

Public comment on the plan to reduce provider reimbursement rates is open until Sept. 27. Here’s how to weigh in:

• Email comments to MCPT@dhw.idaho.gov
• Call 208-364-1887 to leave recorded comments
• Fax 208-287-1170
• Mail comments to:

Division of Medicaid

PO Box 83720

Boise, ID 83720-0009

Attn: Policy Team

More resources about the proposed cuts are available online:

• Find more info on the public comment process on Townhall Idaho, the state’s public meeting website. More information on the public comment process is available online.
• See Health and Welfare’s announcement on the rate cuts on the agency’s website.

Idaho Capital Sun is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Idaho Capital Sun maintains editorial independence. Contact Editor Christina Lords for questions: info@idahocapitalsun.com.