House Bill 351 — Medicaid reimbursements

Parrish Miller 2020 House bill ratings Leave a Comment

Bill description: HB 351 reduces Medicaid reimbursements from the state general fund.

Rating: -1

Does it increase government spending (for objectionable purposes) or debt? Conversely, does it decrease government spending or debt?

HB 351 instructs the Idaho Department of Health and Welfare to work with Idaho nursing facility providers to establish a new prospective payment method for nursing facilities to replace existing reimbursement methods. Furthermore, the department is instructed to work with Idaho hospitals to establish value-based payment methods for inpatient and outpatient hospital services and a quality payment program for inpatient and outpatient adjustment payments. According to the bill’s statement of purpose, these shifts are designed to “move Medicaid payment methods away from cost-based reimbursement to allow better control of Medicaid expenditures as well as incentivize and promote quality care and better health outcomes.”


HB 351 institutes new reimbursement rates that are estimated to reduce the impact of Medicaid on the state general fund by 1% in 2020 and by 2% in 2021. But it is also anticipated that dedicated and federal spending on Medicaid will increase as a result. Such appropriations will result in a net increase in total Medicaid spending.


Does it in any way restrict public access to information related to government activity or otherwise compromise government transparency or accountability? Conversely, does it increase public access to information related to government activity or increase government transparency or accountability?

The budgetary sleight-of-hand inherent in HB 351 is designed to make it look like the state is cutting spending. But the funding shifts in the bill will make the Medicaid funding process less transparent, even as the overall expenditures related to Medicaid increase.