Senate Bill 1142 - Health Care Assistance Act Summary

• Establishes a Health Care Assistance Program administered by the Idaho Department of Health and Welfare to provide primary care, limited prescriptions, and care coordination to uninsured individuals with income below 100% of federal poverty level.

• Participants must be U.S. citizens and Idaho residents, have completed applications, verified household composition, and pass health assessments; annual reassessment required with transition period of 6-12 months if income temporarily exceeds 100% federal poverty level.

• Providers (physicians, physician assistants, nurse practitioners, clinical nurse specialists) who operate coordinated care business models may participate; department cannot exclude willing providers and must pay monthly fees per participant, with participants charged maximum $20 per visit.

• Required provider services include annual wellness exams, same-day/next-day visits, electronic communications, diabetes/hypertension/cholesterol management, mental health screening, hospital follow-up, and limited prescriptions procured through federal 340B drug pricing program.

• Program includes optional care coordination and care management for up to 250 high-risk participants with personal improvement plans and participant accountability measures; act becomes effective July 1, 2017 with enrollment beginning January 1, 2018, and sunsets June 30, 2022.