20-237B. MEDICAL COSTS OF STATE PRISONERS HOUSED IN CORRECTIONAL FACILITIES. (1) The state board of correction or any privatized medical provider under contract with the department of correction shall pay to a provider of a medical service, other than hospital inpatient or outpatient services, for any and all prisoners, committed to the custody of the department of correction, confined in a correctional facility, as defined in section 18-101A(1), Idaho Code, an amount equal to the reimbursement rates of the Idaho medicaid reimbursement fee schedule in place at the time services are provided. Hospitals shall be paid for inpatient and outpatient facility services provided to such prisoners in an amount equal to the interim Idaho medicaid rates in place at the time of service except for outpatient services paid by Idaho medicaid according to the Idaho medicaid fee schedule. These limitations apply to all medical care services provided outside the facility, including inpatient and outpatient hospitalizations, emergency services, professional services, durable and nondurable goods, prescription drugs and medications provided to any and all prisoners confined in a correctional facility, as defined in section 18-101A(1), Idaho Code. For services that are not included in the Idaho medicaid fee schedule or the interim Idaho medicaid rates, the state board of correction or any privatized medical provider under contract with the department of correction shall pay the reasonable value of such service. If a privatized medical provider is contracted with the department of correction, no hospital or any medical services provider shall be required to provide medical services to prisoners, except for emergency hospital services, in the absence of a contract between the privatized medical provider and the hospital or medical services provider. Any contract between the department of correction and a privatized medical provider must contain a requirement that the privatized medical provider enter into contracts with each hospital providing non-emergency services outside of the correctional facility. The contract between the privatized medical provider and the department of correction shall require, and the contracts between the privatized medical provider and any hospital or non-hospital providers shall include, at least the following terms reasonably and practicably consistent with those used by Idaho medicaid:
(a) Claims adjudication processing;
(b) Timing;
(c) Payment;
(d) Authorizations;
(e) Utilization review;
(f) Audit; and
(g) Appeals processes.
(2) Subsection (1) of this section shall apply only to companies, professional associations and other health care service entities whose services are billed directly to the department of correction or any privatized medical provider under contract with the department of correction. Subsection (1) of this section shall not apply to:
(a) Privatized correctional medical providers under contract with the department of correction to provide health care to prison inmates;
(b) Private prison companies;
(c) Out-of-state correctional facilities contracting with the department of correction to house prisoners;
(d) County jails; and
(e) Companies, professional associations and other health care service entities whose services are provided within the terms of agreements with privatized correctional medical providers under contract with private prison companies and county jails.
History:
[20-237B, added 2005, ch. 157, sec. 1, p. 487; am. 2008, ch. 61, sec. 1, p. 153; am. 2018, ch. 321, sec. 2, p. 749.]
Structure Idaho Code
Title 20 - STATE PRISON AND COUNTY JAILS
Chapter 2 - STATE BOARD OF CORRECTION
Section 20-201 - DEPARTMENT OF CORRECTION CREATED.
Section 20-202 - INTERIM APPOINTMENTS — CHAIRMAN.
Section 20-203 - REMOVAL OF MEMBERS — GROUNDS — HEARING AND PROCEEDINGS.
Section 20-204 - POLITICAL ACTIVITY OF BOARD MEMBERS OR EMPLOYEES RESTRICTED.
Section 20-205 - QUALIFICATIONS OF BOARD OR BOARD MEMBERS.
Section 20-206 - ORGANIZATION OF BOARD — ELECTION OF VICE-CHAIRMAN AND SECRETARY, TERMS.
Section 20-207 - OFFICE OF BOARD AT PENITENTIARY — MEETINGS — QUORUM — MAJORITY VOTE.
Section 20-208 - SALARIES AND EXPENSES OF BOARD MEMBERS.
Section 20-209A - COMPUTATION OF TERM.
Section 20-209B - DUTY TO CONTROL DISTURBANCES AT STATE PENITENTIARY.
Section 20-209C - AUTHORITY TO DESIGNATE EMPLOYEES AS PEACE OFFICERS.
Section 20-209D - FORFEITURE OF CONTRABAND PROPERTY OR MONEY FOUND IN POSSESSION OF INMATES.
Section 20-209E - PRISON DISCIPLINARY ACTION FOR FRIVOLOUS OR MALICIOUS COURT PROCEEDINGS.
Section 20-209F - WARRANTS FOR CERTAIN FUGITIVES.
Section 20-209G - AUTHORITY TO INVESTIGATE AND ISSUE SUBPOENAS.
Section 20-209H - DUTY TO ESTABLISH INMATE ACCOUNTS — PAYMENT OF RESTITUTION.
Section 20-209I - ASSIGNMENT OF INMATES TO DO CONSERVATION WORK.
Section 20-212 - RULES — AUTHORITY OF BOARD.
Section 20-214 - ASSISTANTS AND OFFICERS.
Section 20-216 - RECORDS, REPORTS AND STATISTICS.
Section 20-217A - APPOINTMENT OF DIRECTOR — SALARY — POWERS AND DUTIES.
Section 20-218 - ANNUAL REPORTS OF RECEIPTS AND EXPENDITURES.
Section 20-219 - PROBATION AND PAROLE SUPERVISION AND TRAINING — LIMITED SUPERVISION — RULEMAKING.
Section 20-220 - INVESTIGATION AND EXAMINATION TO PRECEDE PROBATION OR SUSPENSION OF SENTENCE.
Section 20-222 - FIXED PERIOD OF PROBATION OR SUSPENSION OF SENTENCE — REARREST AND REVOCATION.
Section 20-223 - PAROLE — LEGISLATIVE INTENT — REQUIRED REPORT.
Section 20-224 - INFORMATION REGARDING PRISONERS TO BE SECURED.
Section 20-225 - PAYMENT FOR COST OF SUPERVISION.
Section 20-225A - PAYMENT FOR INTERSTATE COMPACT APPLICATION.
Section 20-226 - RECORDS OF PRISONERS.
Section 20-228A - PAROLE SUBPOENA TO ASSIST IN APPREHENDING PAROLE ABSCONDERS.
Section 20-230 - APPLICATION TO CONVICTIONS PRIOR TO ACT
Section 20-235 - CERTIFICATION AND WARRANTS FOR EXPENSES.
Section 20-237B - MEDICAL COSTS OF STATE PRISONERS HOUSED IN CORRECTIONAL FACILITIES.
Section 20-239 - DISCHARGE UPON SERVICE OF MAXIMUM TERM.
Section 20-239A - RELEASE UPON GRANT OF PAROLE.
Section 20-241 - ACCEPTANCE OF FEDERAL OR OTHER FUNDS OR PROPERTY.
Section 20-241A - AGREEMENTS FOR CONFINEMENT OF INMATES.
Section 20-242A - INMATE INCENTIVE PAY.
Section 20-244 - GOVERNMENT AND DISCIPLINE OF THE CORRECTIONAL FACILITY — RULES AND REGULATIONS.
Section 20-245 - OFFENDER LABOR ON STATE AND COMMUNITY SERVICE PROJECTS.
Section 20-246 - PENITENTIARY — POWERS OF BOARD OF CORRECTION.
Section 20-247 - TRANSFER OF PRISONER TO FEDERAL PENAL OR CORRECTIONAL INSTITUTION.
Section 20-248 - CONTRACT FOR CARE OF TRANSFERRED PRISONER.
Section 20-249 - TRANSFERRED PRISONER SUBJECT TO TERMS OF ORIGINAL SENTENCE.
Section 20-250 - DEPARTMENT OF CORRECTION REPORTING REQUIREMENTS.