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Committee hears $190 million hospital assessment, capitation and quality-review supplementals in Medicaid request
Summary
Analysts and the Department of Health and Welfare described five fiscal 2025 supplementals and multiple ongoing 2026 enhancement requests, including a $190 million hospital assessment supplemental, a $108.8 million capitation-rate adjustment for managed care plans and funds for an external quality review required by CMS.
Alex Williamson, budget and policy analyst with Legislative Services, outlined five supplementals recommended by the governor for fiscal 2025 and additional ongoing enhancement requests tied to Medicaid operations.
Williamson told the committee the fiscal 2025 supplementals include a one-time request of about $1.3 million to comply with a federal requirement for an External Quality Review (EQR) of managed care plans. She said previous requests for proposals failed to attract vendors and an RFI showed market prices have risen compared with historical payments.
Another supplemental would fund system configuration and testing tied to onboarding a new vendor for Idaho's behavioral health plan; that request included an estimated $113.8 million in one-time interest in benefit payments from federal funds driven by hospital and…
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