A federal public health emergency (PHE) was issued on January 27, 2020. Idaho Medicaid enacted some temporary policy changes to make sure participants continued to have access to Medicaid services and to support the provider networks. The PHE Ended May 11, 2023.
Below you will find answers to frequently asked questions, and links to other important items to help you plan for the end of the PHE.
For information about Medicaid coverage and Medicaid Protection, visit the Medicaid Protection web page.
Public Health Emergency Policy
- Idaho Medicaid sought and secured several temporary federal authorities, including an 1135 waiver, Appendix Ks for 1915(c) waivers, and Medicaid and CHIP Disaster State Plan Amendments.
- See the list of rules waived in Idaho Administrative Code that are under the authority of the director of the Idaho Department of Health and Welfare. These are tied to the end of the federal PHE. Current Idaho Administrative Code also refers to the current PHE in a number of places.
- Idaho Medicaid also published a number of Medicaid Information Releases beginning in 2020, that establish and/or describe these temporary changes.
- Idaho Medicaid has updated its virtual care services policy: see the General Information and Requirements section in the Idaho Medicaid Provider Handbook for the most current version. The Idaho Medicaid program remains committed to the use of virtual care to support access to services in our state.
- Regarding participant eligibility and enrollment, CMS is working with states to ensure evaluation of eligibility after the end of the PHE.
Thank You
Idaho Medicaid deeply appreciates the dedication providers have shown during this challenging and demanding time.
General - Cost Sharing
Yes. Participants and services subject to co-payments will return to their normal status after the end of the PHE.
Yes. They will go back to paying their normal premium amount at the end of the PHE.
General - Benefits/Limitations
No. While some prior authorizations were suspended during the PHE, you will be required to submit a prior authorization for all services that you normally would have prior to the PHE.
No. At the end of the PHE, they will go back to what their policies were prior to the PHE.
No. The state will resume normal operations after the PHE.
Yes, Idaho has submitted an amendment to its 1115 demonstration waiver to allow the parents of minor children to be caregivers. Please work with your provider for information on how to access these services.
Yes, Idaho has submitted an amendment to its 1115 demonstration waiver to allow spouses to be caregivers. Please, work with your provider for information on how to access these services.
General - Provider Requirements
Providers should contact their respective licensing board to ensure they meet all licensure requirements.
No. At the end of the PHE you will no longer receive reimbursement for providing services in those expanded locations.
Yes. Idaho Medicaid will resume normal operations with provider revalidation.
No. The state will resume normal operations at the end of the PHE.
No. At the end of the PHE, you will have to refer these patients to other facilities or providers.
Developmental Disabilities Requirements
No, after November 11, 2023 (six months after the end of the PHE), DD waiver participants will be required to use services as defined in their plan.
Yes, until November 11, 2023 (six months after the end of the PHE). Then you will be required to go back to providing services in the normal settings.
Yes, until November 11, 2023 (six months after the end of the PHE). After that prior authorizations will go back to what they were normally before the PHE.
No. Staff will need to complete all required training prior to working with participants.
Yes. Staff will need to complete all required training prior to working with participants.
Yes, if the services can be provided safely and effectively and meet the requirements of Idaho Medicaid’s virtual care policies, they can continue to be provided via virtual care.
No. You will only be able to provide services to a group of three siblings at a time.
Developmental Disabilities Benefits/Limitations
Yes, until November 11, 2023 (six months after the end of the PHE). After that, all requirements will return to normal.
No. You will only be able to provide family education trainings to two families at once.
Yes. They will return to one staff to two or three children.
No. After the PHE ends, the child will need a new exam to qualify for benefits.
Developmental Disabilities Documentation
Idaho Medicaid has updated its electronic signature policy, see the General Information and Requirements for Providers, Idaho Medicaid Provider Handbook, for the most current version.
Aged and Disabled Personal Care Services (PCS)
Refer to updated Medicaid Information Releases for Personal Assistance Agencies related to specific guidance.
Idaho Medicaid has updated its electronic signature policy, see the General Information and Requirements for Providers, Idaho Medicaid Provider Handbook, for the most current version.
No. The rate increase tied to the PHE will no longer be available. However, Adult Day Health received a permanent rate increase effective July 1, 2022. For additional information see information release MA22-09.
Yes, until November 11, 2023 (six months after the end of the PHE). After that it will transition back to in-person services.
Yes, Idaho has submitted an amendment to its 1115 demonstration waiver to allow the parents of minor children to be caregivers. Please, work with your provider for information on how to access these services.
Inpatient Hospital Providers
No. At the end of the PHE the state will resume normal operations.
No. This will be discontinued at the end of the PHE.
Virtual Care Services
Yes, until November 11, 2023 (six months after the end of the PHE). After that it will transition back to on-site visits.
Yes, if services can be provided safely and effectively.
Yes, when audio-only virtual care services are safe, effective, and appropriate. Idaho Medicaid has updated its virtual care services policy, see the General Information and Requirements for Providers in the Idaho Medicaid Provider Handbook, for more information.
Yes, when audio-only virtual care is safe, effective, and appropriate. Idaho Medicaid has updated its virtual care services policy, see the General Information and Requirements for Providers, Idaho Medicaid Provider Handbook, for more information.
Yes, Idaho Medicaid has updated its virtual care services policy, see the General Information and Requirements for Providers section in the Idaho Medicaid Provider Handbook, for more information.
Yes, if services can be provided safely and effectively. Please follow all documentation and service requirements, including accurately identifying the location of the participant.
Yes, Idaho Medicaid has updated its virtual care services policy, see the General Information and Requirements for Providers section in the Idaho Medicaid Provider Handbook, for more information.