States findings of the Legislature and directs the Department of Health and Welfare to convene a council to coordinate and develop revisions to the skilled nursing facility upper payment limit.

This resolution directs the Idaho Department of Health and Welfare to convene a stakeholder council to develop necessary revisions to Idaho’s Skilled Nursing Facility (SNF) Medicaid reimbursement system. The goal is to ensure compliance with federal requirements while improving financial stability and operational efficiency for skilled nursing facilities. The resolution calls for integrating Upper Payment Limit (UPL) reimbursements into daily Medicaid rates, requiring Managed Care Organizations (MCOs) to adopt a minimum fee schedule, and shifting the nursing facility fee assessment from annual to quarterly payments. These changes will provide SNFs with a more stable and predictable revenue stream, ensuring financial sustainability and reliable care for patients. Additionally, the resolution directs the Division of Medicaid to secure CMS approval and report findings and recommendations to the 2026 Idaho Legislature for potential legislative action. These reforms will enhance Idaho’s long-term care infrastructure, ensuring continued access to high-quality skilled nursing services.