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Read. Follow. Verify.Idaho restricts hospital Medicaid presumptive eligibility determinations and sets violation penalties
Last action · March 9, 2026: Reported Printed and Referred to Health & Welfare
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What This Bill Proposed
Idaho House Bill 845 limits Medicaid determinations exclusively to qualified hospitals, establishing strict performance standards, written notification requirements for applicants, and a tiered penalty system for hospital violations taking effect July 1, 2026.
Hospitals face losing their qualification to determine temporary Medicaid eligibility if they commit multiple performance standard violations within a twelve-month period, while patients must file full Medicaid applications by the end of the following month to maintain coverage.
Who It Would Have Affected
Groups the bill's text would have affected, as described in the record. Being affected is not a position for or against it.
qualified hospitals
Must follow mandatory reporting timelines, assist patients with full Medicaid applications, adhere to department performance standards, and face tiered penalties including training and loss of qualification for violations.
Medicaid applicants
Receive written notices regarding temporary eligibility timeframes and must submit full Medicaid applications by the end of the following month to maintain uninterrupted temporary coverage.
Idaho Department of Health and Welfare
Must establish performance standards, track hospital compliance, issue notices of violation, conduct mandatory staff training, and manage an appeals process.
Key Facts
- The director of the department shall limit presumptive eligibility determinations exclusively to qualified hospitals.
- A hospital making a presumptive eligibility determination must notify the department within five business days after the determination date.
- The hospital must assist presumptively eligible individuals with completing and submitting a full Medicaid application.
- Applicants must be notified in writing using plain language and large print that presumptive eligibility ends on the last day of the following month unless a full Medicaid application is filed.
Show all 10 facts
- If a full application is filed before the deadline, presumptive eligibility continues until the department makes a final eligibility determination.
- The department must establish hospital performance standards, an appeals process, and tracking for compliance timeliness and application submission rates.
- A first violation in a calendar year triggers a written notice from the department within five days describing the standard not met and available appeals.
- A second violation within a twelve-month period requires applicable hospital staff to participate in mandatory training performed by the department.
- A third violation within a twelve-month period results in the hospital immediately losing its qualification to make Medicaid presumptive eligibility determinations.
- Hospitals appealing a violation finding must provide clear and convincing evidence during the appeals process that the standard was met.
Frequently Asked Questions
Which hospitals are allowed to make presumptive eligibility determinations under this bill?
How long does a patient have to file a full Medicaid application after being determined presumptively eligible?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
This bill did not become law - Died at adjournment · in House committee.
Procedural history
2 actions- Mar 9, 2026CommitteeReported Printed and Referred to Health & Welfare
- Mar 6, 2026IntroducedIntroduced, read first time, referred to JRA for Printing
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Connected Entities
Sources
legislature.idaho.gov
Analysis Score
0–100- Significance20Lowered because this bill did not pass (its text scored 65)
- Controversy40Intensity of disagreement among stakeholders
- Entertainment10Compellingness for a non-policy-wonk reader
- Buzz30Current news / social attention level
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