Latest news with #IdahoDepartmentofHealthandWelfare
Yahoo
2 days ago
- Business
- Yahoo
Idaho Medicaid to be privately managed in 2029, health officials officials expect
The state flags hangs from the rotunda of the Idaho State Capitol Building in Boise on Jan. 7, 2025. (Pat Sutphin for the Idaho Capital Sun) Idaho health officials say it'll take years to switch all Idaho Medicaid benefits to being managed by private companies. Through a sweeping bill meant to cut Medicaid costs, the Idaho Legislature this year directed the Idaho Department of Health and Welfare to change a range of Medicaid policies — including to pursue switching Medicaid benefits to being run by private companies. That model, called managed care, is used widely across the country. Right now, Idaho Medicaid already uses managed care — somewhat. But it's more of a patchwork approach, where some services are managed by the state health department, some by managed care organizations, and some by doctors' offices. Shifting Idaho Medicaid to managed care will take time to do well, Idaho Medicaid Deputy Director Juliet Charron told a panel of state lawmakers late last month. The Idaho Department of Health and Welfare expects the new comprehensive Idaho Medicaid managed care contract to start in 2029, following years of prep work, she told the Idaho Legislature's Medicaid Review Panel on May 22. 'We have been evaluating all of the different scenarios and timelines under which we could implement this — looking at it as early as 2027 or 2028 — and have determined' that going much earlier is risky, Charron said. 'Because you're going to start to have pieces overlapping throughout this. And that will be particularly challenging for our provider communities.' Medicaid is a largely federally funded health care assistance program that covers about 260,000 Idahoans, including low-income earners, people with disabilities, pregnant women, and some older people. Roughly 92,000 Idahoans are enrolled in Medicaid expansion, a voter-approved policy that raised the income eligibility cap. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Idaho governor signs bill to privatize management, add work requirements to Medicaid program The new Idaho Medicaid cost cutting bill also called for Idaho to seek federal approval for Medicaid work requirements for able-bodied adults. The Idaho Department of Health and Welfare plans to apply for that by July 2026. The federal spending and tax cut bill being considered by Congress might ease the process for Idaho to seek Medicaid work requirements. Instead of applying for a Medicaid waiver that could temporarily allow for work requirements, Idaho could seek a longer-lasting state plan amendment for Medicaid work requirements — if the federal bill becomes law, Charron said. (The bill would require nationwide Medicaid work requirements years later. After passing the U.S. House, it heads to the Senate, where changes are expected.) Other states' experiences and a federal watchdog report suggest costs for Medicaid work requirements are high, the Idaho Capital Sun previously reported. Since almost half of Idahoans on Medicaid are already working, some advocates say work requirements are effectively just expensive administrative barriers to access the program. Overall, only 6% of Idaho Medicaid enrollees are in comprehensive managed care — the roughly 27,000 Idahoans dually eligible for Medicare and Medicaid, Idaho Idaho Medicaid Deputy Administrator Sasha O'Connell told the legislative panel. CONTACT US Idaho's existing Medicaid managed care contracts mostly carve out private management for certain benefits, like mental health, medical transportation and dental. That split makes it complicated for the state to oversee, O'Connell said. 'What this has led to is we have particularly high turnover, I would say, in state agencies. And I think that that happens in Medicaid as well,' she said. The various contracts have put Idaho Medicaid's limited staff in a cycle of 'amending these contracts constantly,' she said, instead of putting the contracts up for a new competitive bid, a process called procurement. 'Because procurement is such a huge lift,' O'Connell said. Idaho is also on track to end doctors' offices managing Medicaid benefits next year, Charron told lawmakers. The new Idaho Medicaid cost cutting bill called for the end of that model, called value-based care, which is unique to Idaho and has existed for a few years. The new Idaho Medicaid managed care contract is likely to become the biggest contract given out by the state of Idaho. Idaho's contract for the company Magellan to run mental health Medicaid benefits is already the state's largest contract, initially pegged at $1.4 billion over four years. Like under Idaho Medicaid's first managed care mental health organization, Idaho Medicaid providers have reported payment delays from Magellan, the Idaho Capital Sun reported. Sen. Kevin Cook, R-Idaho Falls, raised that issue to Idaho health officials. 'You're saying, I'm getting reports back from the (managed care organization), and they're saying, 'Everything is great. All of our providers are happy. They're loving it,'' Cook said. ''That's like asking the fox, … 'How's the hen house?'' Idaho's existing managed care contracts will be phased out for the broader contract to come. Idaho Medicaid mental health contractor hires three state government employees 'Idaho is a very large state. But our health care infrastructure is somewhat limited. And people access health care all over the state. Frequently, we are sending Medicaid participants to different parts of the state, based on the service that they need,' Charron said. The new contract will task three different managed care organizations to run Idaho Medicaid benefits, for a few reasons, she explained, like: Federal requirements for Medicaid enrollees to have choice under managed care; Creating competition between companies to drive efficiencies; and Redundancy, in case a plan terminates. Before Idaho launches the new managed care contract, Idaho has a lot of preparation to do, state health officials say. Like engaging stakeholders, seeking out more information and contracting out for actuarial services, a pharmacy benefits manager (PBM), a new enrollment broker for Medicaid enrollees to pick managed care plans, and Idaho Medicaid's information system. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
6 days ago
- Business
- Yahoo
Are you dually enrolled in Medicaid and Medicare? Here's what to know on Idaho switching contractors
Only 2,000 Idahoans dually enrolled in Medicare and Medicaid chose a specific insurance plan so far. But there's 90 days to decide. (Getty Images) Idaho is switching contractors that run health insurance plans for vulnerable patients. Starting June 1, the private health insurance companies running Idaho Medicaid and Medicare's plans will change to Molina Healthcare and UnitedHealthcare. That will only apply to the about 27,000 Idahoans who are dually eligible for Medicaid and Medicare, said Idaho Department of Health and Welfare spokesperson AJ McWhorter. Over half of them were already enrolled in an insurance plan run by a private company, called managed care. People dually enrolled in Medicare and Medicaid qualify for disabilities, low income and age. Many patients have already been automatically enrolled in one of the new duals insurance plans. But patients will have 90 days, or until Aug. 30, to pick, McWhorter told the Sun in an email. Only 2,000 people chose a specific insurance plan so far, after Health and Welfare sent out letters in March, he said on May 22. 'Many people haven't chosen a new plan because they like the plan they will be enrolled in if they do not make a selection. But we want to be sure that everyone who wants to make an active choice does so,' he said. Idaho's dual Medicaid and Medicare offers two types of plans. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX For people dually eligible, Medicaid generally covers costs not fully covered by Medicare, such as for nursing homes and home and community-based services, according to the federal Centers for Medicare and Medicaid Services. Both of the new Idaho companies, Molina and United, will be required to honor existing patient authorizations for the first 90 days of the contract, the Idaho Department of Health and Welfare says. Health and Welfare is winding down readiness reviews of the new companies and hasn't spotted any concerning issues, Idaho Medicaid Deputy Director Juliet Charron told the Idaho Capital Sun in a May 19 interview. 'Could there be bumps in the road? Of course,' she said. But that's why she said Idaho officials are communicating proactively. People who have questions or concerns should reach out to the Idaho Department of Health and Welfare, or United or Molina, she said. The Idaho Department of Health and Welfare has resources about the contract change available online on a frequently asked questions webpage. Patients can also contact Health and Welfare, or the new insurance companies. Here's how: Idaho Department of Health and Welfare: Website: Email: IdahoDuals@ Phone: 833-814-8568 UnitedHealthcare Website: Phone: 866-785-1628 for Medicaid participants, or 855-819-5909 for providers Molina Healthcare of Idaho: Website: Phone: 866-403-8293 for Medicaid participants, or 844-239-4914 for providers The health insurer Blue Cross of Idaho previously ran Idaho's dual Medicaid and Medicare plans. Last year, Idaho went out for a competitive bid for the contract for the first time. Initially, there was a six-month gap starting this June when Blue Cross's contract ended and United would've started, Idaho Reports reported in January. But since then, Health and Welfare has worked with the new insurance companies to start June 1. One United plan is available starting Jan. 1, 2026. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Newsweek
19-05-2025
- Health
- Newsweek
SNAP Ban on Candy and Soda Pushing Ahead In Idaho
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. Idaho submitted a waiver request to the U.S. Department of Agriculture (USDA) to prevent Supplemental Nutrition Assistance Program (SNAP) recipients from purchasing soft drinks and candy, East Idaho News reported on Sunday. Governor Brad Little directed the Idaho Department of Health and Welfare to pursue federal approval following his April signature on House Bill 109. The change depends on the United States Department of Agriculture (USDA) response to the waiver application. Newsweek has contacted Little's office for comment via email. Why It Matters Several states are either considering SNAP bans on soda and other items or have already submitted waiver requests to the USDA as part of Secretary of Health and Human Services Robert F. Kennedy Jr.'s "Make America Healthy Again" initiative. In the 2024 fiscal year, SNAP served 130,900 Idaho residents—about 7 percent of the state's population. As of 2023, SNAP served about 42.1 million people monthly nationwide, or 12.6 percent of the U.S. population. What To Know House Bill 109 passed both chambers—48-20 in the House and 25-10 in the Senate—and received Governor Little's signature in April. The Idaho Department of Health and Welfare then submitted a formal waiver request to the USDA on Friday, a necessary step as current federal rules require USDA approval for any state-level restrictions on what SNAP can purchase. In April, Agriculture Secretary Rollins and Health Secretary Kennedy Jr. published a joint article in USA Today calling on "all governors to submit waivers to help promote access to these critical sources of nutrition, including waivers that can limit what can be purchased with food stamps." Stock image/file photo: A person shopping in a grocery stores. Stock image/file photo: A person shopping in a grocery stores. GETTY The USDA has confirmed to Newsweek that Iowa, Nebraska, Arkansas, and Indiana have all submitted similar waivers to change what can be purchased using SNAP benefits. "States have always been the greatest laboratories of democracy, and I am confident the best ideas will come from them," USDA Secretary Brooke Rollins said in a statement sent to Newsweek. "Whether demonstration pilots on allowable purchases, or newfound ways to connect work-capable adults to jobs, or even new ways to get food to communities, I will continue to encourage States to be bold and enact change." Food policy advocates are sharply divided. Supporters say the goal is to reduce preventable chronic health conditions by encouraging healthier food choices through SNAP. But critics have argued the policy is paternalistic and fails to address the fact that many low-income communities lack access to healthy, affordable food options. What People Are Saying Governor Brad Little said on the signing of House Bill 109: "Idaho welcomes the MAHA movement. It is all about looking for creative ways to improve nutrition and increase exercise, the two main factors that influence overall health. Secretary Kennedy said it so well: we need to take better care of ourselves and each other. He said it is an act of patriotism, and the future of our nation depends on it. Idaho couldn't agree more." Valerie Imbruce, the director of the Center for Environment and Society at Washington College, previously told Newsweek: "Controlling how the poor eat is a paternalistic response to a problem that is not based in SNAP recipients' inability to make good decisions about healthy foods, it is a problem of the price differential in choosing healthy or junk foods." What Happens Next If the waiver request is approved, Idaho's soda and candy ban for SNAP will take effect on July 1.
Yahoo
19-05-2025
- Health
- Yahoo
Federal government cancels $49M in Idaho health department grants
In this file photo, signs lead people to a COVID-19 vaccination clinic set up at a park in Caldwell. Following a directive from President Donald Trump, the federal government terminated about $49.4 million in grants for the Idaho Department of Health and Welfare. Idaho's canceled grants were among over $12 billion dollars in federal grants the Trump administration terminated following Trump's directive. The U.S. Department of Health and Human Services, or HHS, terminated the grants to Idaho's state health department, and other state and local health departments. An HHS spokesperson said the funds were largely used for COVID-related efforts — including COVID testing, vaccination and global projects. The U.S. Centers for Disease Control and Prevention expects to save $11.4 billion, the spokesperson told the Idaho Capital Sun. 'The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,' the HHS spokesperson said. 'HHS is prioritizing funding projects that will deliver on President Trump's mandate to address our chronic disease epidemic and Make America Healthy Again.' SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Idaho Department of Health and Welfare spokesperson AJ McWhorter told the Sun that all the canceled grants 'are all pandemic related funding that provided a one-time infusion.' About $29 million of Idaho's canceled grants were focused on vaccines for children. Almost $13.3 million of Idaho's canceled grants were focused on mental health. Another $6.9 million grant was for substance abuse. CONTACT US Idaho spent about $25.8 million of the canceled grants. The federal government had paid Idaho nearly that same amount through the grants so far, HHS's data shows. HHS terminated Idaho's grants on March 24, according to HHS's public list of all canceled grants. The grants' cancellation does not affect ongoing Idaho health programs, McWhorter said. The Idaho Department of Health and Welfare is 'executing its exit strategies to minimize any disruptions for the one-time pandemic grants,' he said. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
25-03-2025
- Health
- Yahoo
Idaho health official nominated to federal Health and Human Services role in Trump administration
Idaho Department of Health and Welfare Director Alex Adams joins state officials and business leaders to announce the Idaho State Park Foster Family Passport at Lucky Peak State Park, as foster parents and families stand behind him. (Kyle Pfannenstiel/Idaho Capital Sun) President Donald Trump nominated Idaho's new top health official to a role in the U.S. Department of Health and Human Services, or HHS. Alex Adams, who has been the Idaho Department of Health and Welfare's director since June 2024, is tapped to serve as the HHS assistant secretary for family support. The U.S. Senate, which confirms presidential nominations, received the president's nomination of Adams on Monday. It isn't immediately clear when his confirmation hearings are planned. The Idaho governor's office and Adams couldn't be immediately reached for comment Tuesday. Adams previously served for years as Idaho Gov. Brad Little's budget chief, and also served as interim Idaho Public Charter School Commission director, executive director of the Idaho Board of Pharmacy and formerly worked in the pharmacy industry. Soon after he took over the Idaho Department of Health and Welfare, Adams announced foster care as a top priority. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Adams holds a master's degree in public health from Johns Hopkins University, along with a bachelor's degree and a Doctor of Pharmacy degree from the University of Toledo in Ohio. Adams directed the Idaho Board of Pharmacy starting in 2015, the Idaho Press reported. Adams previously served as vice president of pharmacy programs at the National Association of Chain Drug Stores, a trade association in Arlington, Virginia, that represents over 40,000 pharmacies in the U.S, according to a news release last year from the governor's office. When then-Idaho governor-elect Little named Adams budget chief in 2018, Little said Adams oversaw a nearly 40% reduction in the Idaho Board of Pharmacy's regulations that boosted jobs and expanded pharmacy services in underserved areas, the Associated Press reported. The Idaho Department of Health and Welfare is Idaho's largest state government agency, with a more than $5 billion budget that is mostly federally funded. The Idaho Department of Health and Welfare runs social programs like Medicaid, the Supplemental Nutrition Assistance Program and the Women and Infant Children program. The health department also provides public health services, regulates long-term care facilities, runs the state's mental health hospitals, provides child welfare and provides services for people with developmental disabilities. SUPPORT: YOU MAKE OUR WORK POSSIBLE
