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Committee introduces bill to raise outlier‑claim thresholds for VCOs in Medicaid
Summary
Representative Jordan Redmond introduced RS32085 to increase the threshold for outlier claims submitted by VCOs, moving the floor from $100,000 to $250,000, then to $500,000 and $1 million in subsequent years, with the sponsor saying the change aims to stabilize Medicaid budgeting.
Representative Jordan Redmond introduced RS32085, a bill that would raise the threshold for outlier claims submitted by value care organizations (VCOs) in Idaho’s Medicaid program.
Redmond said an outlier claim is any claim by a VCO above a threshold currently set at $100,000. He said the recent year had 473 outlier claims,…
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