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Resource Use (Cost/Utilization) Measurement and Reporting in Idaho

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Resource Use (Cost/Utilization) Measurement and Reporting in Idaho

Subtopic Statute/Regulation Description
Provider cost reporting Idaho Admin. Code r. 16.03.07.060, Statistical and Reporting System Requires home health agencies to maintain a statistical and reporting system and specifies the data that such system ‘may’ include (e.g...
Idaho Admin. Code r. 16.03.10.030, Cost Reporting Requires providers to submit Medicaid cost reports to the Department of Health and Welfare on a form designated by the Department. Permits the...
Idaho Admin. Code r. 16.03.10.270, Nursing Facility: Special Rates Defines ‘special rate’ as the daily reimbursement for a patient plus an add-on amount. Permits nursing facilities to apply for a special...
Idaho Admin. Code r. 16.03.10.280, Nursing Facility: Reporting System Creates a payment reporting system to as a means of generating reports that will assure proper financial disclosure, provide statistical resources...
Idaho Admin. Code r. 16.03.10.281, Nursing Facility: Reporting System Principle and Application Requires providers to file annual cost reports and specifies in the information that each report must include (e.g., income statement, balance sheet...
Idaho Admin. Code r. 16.03.10.284, Nursing Facility: Failure to File Establishes penalties for facilities that fail to file cost reports (e.g., rate reductions, payment suspension, etc.). Requires the Department of...
Idaho Admin. Code r. 16.03.10.603, ICF/ID: Reporting System Principle and Application Establishes cost reporting requirements for ICF/ID providers. Specifies the information that must be included in annual cost reports (e.g., income...
Idaho Admin. Code r. 16.03.10.606, ICF/ID: Failure to File Establishes penalties for ICF/ID providers that fail to file cost reports (e.g., rate reductions, payment suspension, etc.). Requires the Department...
Idaho Admin. Code r. 18.04.04.014, Annual Report to the Director Requires managed care organizations to annually file a financial report with the Insurance Director. Requires the report to be prepared using...
Idaho Code Ann. § 31-3503A, Powers and Duties of the Board Identifies the powers and duties of the Board of the Catastrophic Healthcare Cost Program as including the provision of payments for medically...
Idaho Code Ann. § 31-3710, Financial Reports Requires hospital treasurers to make their annual financial report available to the city council and board of county commissioners within 30 days of...
Required utilization/cost reporting Idaho Admin. Code r. 16.03.09.300, Cost Reporting Requires Medicaid providers to use the Department of Health and Welfare’s Medicaid cost report forms when filing their cost reports. Permits...
Idaho Admin. Code r. 16.03.09.704, Inpatient Behavioral Health Services: Provider Qualifications Requires a physician to provide inpatient hospital psychiatric services in a facility that is licensed by Idaho or another state and has received...
Idaho Code Ann. § 39-3123, Designation of State Mental Health Authority and State Substance Use Disorder Authority Designates the Department of Health and Welfare as the state behavioral health authority (“Authority”) and tasks the Authority with...
Idaho Code Ann. § 39-9105, Behavioral Health Community Crisis Center Evaluation Requires crisis centers to conduct annual effectiveness and cost efficacy evaluations and to submit their findings to the Department of Health and...
Idaho Code Ann. § 41-3910, Reports to the Director Requires Managed Care Organizations to file financial reports to the Insurance Director by June 1 of every year.
Financial information data collection Idaho Code Ann. § 31-3503A, Powers and Duties of the Board Identifies the powers and duties of the Board of the Catastrophic Healthcare Cost Program as including the provision of payments for medically...
Click on the individual state law in the table above to see our summary of the individual law.


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