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posted on October 03, 2018 13:12

The Idaho Department of Health and Welfare will be holding public hearings during October on proposed rulemaking or scheduling public hearings if requested by at least 25 people on a variety of proposed rule changes.

These include updates to the Time Sensitive Emergency Standards Manual, the EMS Physician Commission’s Standards Manual and the Council on Domestic Violence and Victim Assistance Standards Manual; federal fee increases for annual child support services; clarification for self-employment for food stamp eligibility; amending Temporary Assistance for Families in Idaho rules regarding children; several changes to Medicaid Basic Plan or Enhanced Plan Benefits; and authority to conduct criminal background checks for substance use disorder services. More information on each docket is provided in the links below.

Docket 16-0201-1801Rules of Idaho Time Sensitive Emergency System Council: The incorporated document is being revised and updated to more current standards in the “Time Sensitive Emergency Standards Manual,” Edition 2019-1, that will be become effective July 1, 2019, along with these rules.

Docket 16-0202-1801Rules of the Idaho EMS Physician Commission: To best protect the public’s health and safety, the EMS Physician Commission is revising its Standards Manual that is incorporated by reference in this chapter of rules. The revision to these rules will ensure that the most recent edition of the manual has the force and effect of law.

Docket 16-0303-1801Child Support Services: The Department needs to comply with amendments to the Social Security Act that require an increase to the annual federal fee and the threshold of when this fee is imposed. The annual federal fee increases from $25 to $35 and amount of when a fee is imposed is being increased to $550.

Docket 16-0304-1801Food Stamp Program in Idaho: These rules are being updated to provide clarification for self-employment and update obsolete language. The rules as currently written cause confusion for participants and staff when determining eligibility. These rules define self-employment and include a referral process for the state's mandatory employment and training program. Updates are also being made for participation in the Workforce Investment Act (WIA), now known as the Workforce Innovation and Opportunity Act (WIOA) programs.

Docket 16-0308-1801Temporary Assistance to Families in Idaho (TAFI): The Department is amending these rules relating to children receiving Supplemental Security Income (SSI) income when their families apply for and receive TAFI benefits; and a child’s eligibility when the child turns 18 years old.

Docket 16-0309-1801Medicaid Basic Plan Benefits: When individuals from rural communities need skilled nursing services, they are placed in skilled nursing facilities that are up to 50 miles away from where they and their families live, limiting access to support networks that significantly contribute to their recovery and quality of life. These rule changes will allow eligible Critical Access Hospitals to designate additional acute care beds as swings beds to provide necessary care for individuals, without having to place them in facilities outside of their community and away from their support system.

Docket 16-0309-1804Medicaid Basic Plan Benefits: Laboratory rules in this chapter haven’t been updated since 2007. Laboratory tests have rapidly changed in the past 11 years, and a foundation in rule is needed for Department coverage of these services.

Docket 16-0309-1805Medicaid Basic Plan Benefits: The 2017 Idaho Legislature passed House Bill 128, amending Section 56-265(5), Idaho Code, that provided the Department with the authority to develop a value-based payment model approach to provide Medicaid services to participants. This rulemaking incorporates new procedural requirements needed to implement a fixed participant enrollment process to support the value-based model through the existing Healthy Connections Program.

Docket 16-0309-1806Medicaid Basic Plan Benefits: These rule changes are being made to implement policy (coverage) and reimbursement changes to the Medicaid Pharmacy program rules that are the result of recent changes in federal regulations and corresponding changes that have been made to the Idaho Medicaid State Plan.

Docket 16-0309-1807Medicaid Basic Plan Benefits: In House Bill 695 (2018), the Legislature directed the Department’s Division of Medicaid to implement processes to improve the Non-Emergency Medical Transportation (NEMT) program. These processes will include developing and implementing a provider training program and conducting a rate review process to set reimbursement rates at a level that will enhance service quality and participant access. These rule changes are needed to meet the legislative intent of House Bill 695 (2018).

Docket 16-0309-1808Medicaid Basic Plan Benefits: These proposed changes align definitions for Community Based Rehabilitation Services (CBRS) in schools and in the community.

Docket 16-0309-1810Medicaid Basic Plan Benefits: These rule changes were prompted by upcoming changes in federal regulations specific to third-party liability. This rule change will remove the prenatal exemption language from the third-party liability rules to align with changes in the Balanced Budget Act of 2018.

Docket 16-0310-1807Medicaid Enhanced Plan Benefits: These rules are being amended to add the requirement for termination of enrollment when a participant no longer meets Home and Community Based Services (HCBS) eligibility criteria, as required in Centers for Medicare and Medicaid Service (CMS) guidance for state programs operating under the federal authority of Sections 1915(c) and 1915(i) of the Social Security Act.

Docket 16-0504-1801Idaho Council on Domestic Violence: To best protect the public’s health and safety, the Council on Domestic Violence and Victim Assistance is revising its standards manual that is incorporated by reference in this chapter of rules. The revision to these rules will ensure that the most recent edition of the manual has the force and effect of law.

Docket 16-0506-1801Criminal History and Background Checks: With the adoption of IDAPA 16.07.17, “Substance Use Disorders Services,” DHW has identified a new class of individuals that must complete a DHW criminal history and background check in order to provide those services. This requires that this class of individuals be added to the chapter to ensure that the Department of Health and Welfare retains the statutory authority to complete those background checks. Key elements were inadvertently missed with the previous rulemaking and are now included as part of the pending rule.