Adds to existing law to establish provisions regarding Medicaid prior authorization exemptions for certain preceptorships.
MEDICAID -- Adds to existing law to establish provisions regarding Medicaid prior authorization exemptions for certain preceptorships.
STATEMENT OF PURPOSE
This legislation establishes a prior authorization exemption for certain physicians who provide substantial preceptorshiptrainingtograduatemedicalstudentsinIdaho,particularlyinruralandunderservedcommunities. Physicians practicing in primary care, psychiatry, or obstetrics and gynecology who provide at least 360 hours ofqualifyingpreceptorshipinacalendaryear, withatleast60percentofthosehoursoccurringinqualifiedrural areas, are eligible for a twelve-month exemption from prior authorization requirements for medically necessary services billed to Idaho Medicaid managed care plans and state-contracted insurers. The bill directs the Department of Health and Welfare to verify reported preceptorship hours and administer the exemption and allows insurers to rescind exemptions if claims fail to meet medical necessity standards. Annual participation is limited to one hundred physicians per eligible specialty. The legislation is intended to encourage physician participation in training programs, strengthen Idaho's healthcare workforce pipeline, and improve access to care in rural and underserved areas.
LATEST ACTION
Reported Printed and Referred to Health & Welfare