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. Although we have not received a formal notice announcing the end date of the PHE, the White House has issued a statement which strongly indicates that the PHE will end on May 11, 2023. Based on that statement, we are preparing for some changes to occur on May 11, 2023. We will post the official end date as soon as it is announced.
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 is developing policies and parameters for telehealth and virtual services when the PHE ends. The Idaho Medicaid program remains committed to the use of telehealth 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.
We're waiting federal approval on a two month extension of this flexibility. Please reach out to your agency to discuss options. We continue to seek a permanent path for this
We're waiting federal approval on a two month extension of this flexibility. Please reach out to your agency to discuss options. For six months after the PHE, spouses may provide Attendant Care. We continue to seek a permanent path for this
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
Yes, for six-months after the PHE ends, then they will be required to use services as defined in their plan.
Yes, for six-months after the PHE ends. Then you will be required to go back to providing services in the normal settings.
Yes, for six-months after the PHE ends. 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 telehealth policies.
No. You will only be able to provide services to a group of three siblings at a time.
Developmental Disabilities Benefits/Limitations
Yes, for six-months after the PHE ends. 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
Medicaid is updating their electronic signature policy and will provide information as soon as it is complete.
Aged and Disabled Personal Care Services (PCS)
Refer to updated Medicaid Information Releases for Personal Assistance Agencies related to specific guidance.
Medicaid is updating their electronic signature policy and will provide information as soon as it is complete.
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, for six-months after the PHE ends. After that it will transition back to in-person services.
We're waiting federal approval on a two month extension of this flexibility. Please reach out to your agency to discuss options. For six months after the PHE, spouses may provide Attendant Care. We continue to seek a permanent path for this.
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.
Telehealth
Yes, for six-months after the PHE ends. After that it will transition back to on-site visits.
Yes, if services can be provided safely and effectively.
No. This will be discontinued at the end of the PHE.
Yes, with modifications. We will publish updated policy on this in the future. Until then, you may utilize audio-only telehealth where it is safe, effective, and appropriate.
Yes, with modifications. We will publish updated policy on this in the future. Until then, you may continue utilizing this flexibility.
Yes, if services can be provided safely and effectively. Please follow all documentation and service requirements, including accurately identifying the location of the participant.
The state is still evaluating this.