Idaho Admin. Code r. 16.03.10.077

Current through September 2, 2024
Section 16.03.10.077 - MANAGED CARE FOR DUALS: PROGRAM AUTHORITY AND IMPLEMENTATION
01.Program Authority. Idaho Medicaid Plus is a managed care program for dual eligible participants administered with approval from the Centers for Medicare and Medicaid Services (CMS). The Idaho Medicaid Plus program allows for a health plan to administer Medicaid benefits to dual eligible participants.
02.Implementation. Idaho Medicaid Plus will be implemented using a phased-in approach.
a. Idaho Medicaid Plus will be implemented in a pilot county upon approval from CMS and after the Department determines that participating health plans have passed a readiness review for implementation.
b. Implementation in additional counties will occur in a phased-in manner upon successful implementation in the pilot county as determined by the Department. Phased-in implementation in any and all additional counties will be subject to Department approval.
c. Participating health plans must meet established performance benchmarks prior to Idaho Medicaid Plus implementation in each successive geographic service area.

Idaho Admin. Code r. 16.03.10.077

Effective March 17, 2022