ID S1246

State board of correction or privatized medical providers under contract with the department of correction shall pay medical service providers at rates equal to Idaho medicaid reimbursement rates in place at the time services are provided.

Hospitals shall be paid for inpatient and outpatient facility services at interim Idaho medicaid rates, except outpatient services paid according to Idaho medicaid fee schedule.

Payment limitations apply to all medical care services provided outside correctional facilities, including hospitalizations, emergency services, professional services, durable and nondurable goods, and prescription drugs.

Privatized medical providers contracted with the department of correction must enter into contracts with each hospital providing non-emergency services and include terms for claims processing, timing, payment, authorizations, utilization review, audit, and appeals processes consistent with Idaho medicaid.

Amendments do not apply retroactively to hospital or non-hospital medical services provided before enactment; act takes effect immediately upon passage and approval.