Idaho Administrative Code
Title IDAPA 16 - Health and Welfare, Department of
Rule 16.03.09 - MEDICAID BASIC PLAN BENEFITS
Section 16.03.09.000 - LEGAL AUTHORITY

Universal Citation: ID Admin Code 16.03.09.000

Current through August 31, 2023

01. Rulemaking Authority. The Idaho Department of Health and Welfare has the authority to promulgate public assistance rules under Section 56-202(b), 56-264, 56-265, and 56-1610, Idaho Code. (3-17-22)

02. General Administrative Authority. Titles XIX and XXI of the Social Security Act, as amended, and the companion federal regulations, are the basic authority for administration of the federal program. General administrative duties for the Department are found under Section 56-202, Idaho Code. (3-17-22)

03. Administration of the Medical Assistance Program. (3-17-22)

a. Section 56-203(7), Idaho Code, empowers the Department to define persons entitled to medical assistance. (3-17-22)

b. Section 56-203(9), Idaho Code, empowers the Department to identify the amount, duration, scope of care, and services to be purchased as medical assistance on behalf of individuals eligible to receive benefits under the Medical Assistance Program. (3-17-22)

c. Sections 56-250 through 56-257, and 56-260 through 56-266, Idaho Code, establish minimum standards that enable these rules. (3-17-22)

04. Fiscal Administration. (3-17-22)

a. Fiscal administration of these rules is authorized by Titles XIX and XXI of the Social Security Act, as well as 42 CFR Part 447 and the Provider Reimbursement Manual (PRM) Part I and Part II found in CMS Publication 15-1 and 15-2. Provisions of the PRM, as incorporated in Section 004 of these rules, apply unless otherwise provided for in these rules. (3-17-22)

b. Title 56, Chapter 1, Idaho Code, establishes standards for provider payment for certain Medicaid providers. (3-17-22)

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