ID H0863

Requires legislative approval for Medicaid payment rates where no Medicare equivalent exists, replacing the previous system where rates were set by department rule alone.

Mandates annual cost surveys for residential habilitation, personal care services, developmental disability agency services, community-supported employment, and targeted service coordination, with at least 15% of responses audited.

Requires providers to spend at least the appropriated amount allocated to direct care worker wages and employee-related expenses on those categories, with noncompliance potentially resulting in corrective action plans, intake closure, or termination of provider agreements.

Nullifies administrative rules in IDAPA 16.03.26, Sections 051 and 052 (relating to Medicaid Plan Benefits) effective July 1, 2026.

Declared an emergency measure, taking effect immediately upon passage; enables approximately $21.8 million in general fund savings by reducing rate increases tied to service enhancements halted by a court order in the KW v. Armstrong lawsuit.