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Committee hears health‑care related OPE study requests on Medicaid billing and plan selection
Summary
Representative Jordan Redmond presented OPE study requests on Medicaid hospital billing (concerned about upcoding and impacts of diagnosis‑based payment) and on Your Health Idaho plan selection and uninsured populations; the state Medicaid administrator said the department supports additional analysis but lacks staff without extra resources.
Committee members heard two health‑focused study requests from Representative Jordan Redmond and received a Department of Health and Welfare response.
Redmond described a proposal to have OPE analyze hospital billing patterns in Medicaid since Idaho’s switch to diagnosis‑based payment in 2021, citing concerns about upcoding in hospital stays and the potential for billing trends to affect premiums and…
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