Survey of 2022 Idaho Health Care Legislation

The Idaho 2022 Legislative Session saw the passage and approval of 333 bills, six of which were vetoed, and 327 were passed, 325 of which were signed by Gov. Brad Little and two became law without signature.

Out of all of those, the Idaho Business Review has identified 24 bills, one House Concurrent Resolution and one House Joint Memorial that we find relevant or of note regarding the business of health care in the state. What follows is a survey of those bills.

Bills regarding abortion

The Legislature passed three bills that substantially change the landscape of legal abortion in Idaho. Senate Bill 1309, sometimes referred to as a Texas-style copycat law, allows family members — including the siblings, father, grandparents, aunts and uncles — of a fetus aborted after six weeks of gestation to file a civil lawsuit against the “medical professionals” who “attempted, performed, or induced” an abortion. The persons entitled to sue can do so at any time up to four years after the abortion. If they are successful in court, they will be awarded a minimum judgment of $20,000 plus attorney fees. The law stipulates a minimum jail sentence for the medical professionals of two years and suspension of license. Affects Idaho Code §18-87, §18-88.

Originally, this law was scheduled to go into effect on April 22, 2022. Planned Parenthood filed a suit claiming that the law is unconstitutional. On April 8, the Idaho Supreme Court has granted a stay on its implementation until the case can be decided. The court also extended the deadline for the Idaho Attorney General to file its brief rebutting the Planned Parenthood suit to April 28. Planned Parenthood has until May 12 to file its reply to the state’s brief.

Senate Bill 1358 amends some parts of Senate Bill 1309 regarding what constitutes a defense, excludes the father of an aborted fetus from suing if the pregnancy was the result of rape or incest, and imposes conditions on the awarding of damages. Originally scheduled to go into effect April 22, 2022, its fate is now dependent on the legal challenge of the constitutionality of S1309 currently pending in the Idaho Supreme Court. Affects Idaho Code §18-87, §18-88.

House Bill 521 removed language in Idaho Law about abortion inconsistent with subsequent legislation, including language that was compliant with Roe vs. Wade, leading to claims that parts of the law are unconstitutional. Goes into effect April 22, 2022. Affects Idaho Code §18-608.

Consumer and patient rights

House Bill 778 is a revision of the Idaho Patient Act, which was passed in 2021 as House Bill 42. The original act limited the practice of punitive extraordinary collection actions on medical debts and lengthened the permissible payment time before collections could start and before adverse actions could be sent to credit rating agencies. The 2022 legislation made changes to what the Idaho Medical Association flagged as unworkable or impractical parts of the 2021 legislation for care providers. The Idaho Hospital Association has a detailed explanation of the act on its website. Sections §48-308 and §48-310 of the law are retroactive to Jan. 1, 2021. The rest of the law took effect on March 25, 2022. Affects Idaho Code §48-303, §48-304, §48-305, §48-306, §48-307, §48-308, §48-309, §48-310, §48-314, §48-315.

Senate Bill 1353 establishes that a resident in a health care facility has the right to essential caregiver visitation. The law was in reaction to the exclusion of COVID-19 victims who were isolated from their families, caregivers or designated advocates during hospital stays. Goes into effect July 1, 2022. Creates Idaho Code §39-97.

Drugs

House Bill 445 removes outdated code regarding the storage temperatures for vaccines. Goes into effect July 1, 2022. Repeals Idaho Code §39-1501.

House Bill 446 excludes nabiximols from the definitions of marijuana and tetrahydrocannabinols (THC) from the state’s Uniform Controlled Substance Act if it is in product form and approved by the Food and Drug Administration (FDA). Nabiximols would be allowed for consumption pending FDA approval, Drug Enforcement Administration scheduling and a valid prescription from a licensed provider. Takes effect July 1, 2022. Affects Idaho Code §37-2701, §37-2705.

House Bill 562 simplifies the drug outlet registration process for resident and nonresident drug outlets as part of the initiative to reduce bureaucratic red tape. The law takes effect July 1, 2022. Affects Idaho Code §54-1705.

Senate Bill 1246 is the yearly updating of Idaho’s lists of Schedule I, II, IV and V controlled substances. Goes into effect July 1, 2022. Affects Chapter 27 of Idaho Title 37.

Licenses

Senate Bill 1305 will enter licensed Idaho psychologists into the Psychology Interjurisdictional Compact, which will allow these professionals to provide telehealth services in other compact states and also allows licensed psychologists in other compact states to practice via telehealth in Idaho. Goes into effect July 1, 2022. Creates Idaho Code §54-2321.

Senate Bill 1330 sets up a voluntary naturopath registry to license naturopathic doctors. Creates the Idaho board of naturopathic health care. The bill defines naturopathic doctors as those licensed medical doctors, doctors of osteopathy, doctors of podiatric medicine, naturopathic medical doctors, doctors of chiropractic, doctors of dental medicine, doctors of nursing practice who have obtained an approved naturopathic doctoral degree, fulfill experience or examination requirements, and other requirements of the board of naturopathic. The bill restricts the use of the titles licensed naturopathic doctor (LND) and licensed naturopathic practitioner (LNP). Goes into effect July 1, 2022. Creates Chapter 59 of Idaho Code Title 54.

Medical education and training

House Bill 718 requires medical students in one of the designated Idaho slots in the WWAMI program or the University of Utah School of Medicine to either pay back their state-funded tuition or work in Idaho for four years after completing their training. The law will apply to students entering these programs in the fall of 2023. Creates Idaho Code §33-3731.

House Concurrent Resolution 38 encourages the State Board of Education to request additional WWAMI seats beginning in 2025.

Senate Bill 1418 provides funds for an additional family medical resident position in western Idaho; an addiction medical fellowship position in western Idaho; an additional family medical resident position in northern Idaho; a behavioral health fellowship in northern Idaho; three additional family medical resident positions based at Idaho State University; three additional psychiatry resident positions in eastern Idaho; six additional family medical resident positions in eastern Idaho; an additional rural health fellowship position in northern Idaho; funding to offset a disparity of resident support for eastern Idaho residents through Family Medical Residencies; an additional pharmacist resident position in western Idaho; two addiction medicine residents in western Idaho and an additional internal medicine resident in western Idaho. Takes effect July 1, 2022. Affects Chapter 35 of Idaho Code Title 67.

Financial

House Bill 561 updates Idaho Code §56-1018B to expand the potential use of grant funds for emergency medical services to encompass not only the purchase of vehicles and equipment but also to include training, licensing, technology and costs not related to the salary of personnel. Went into effect on March 21, 2022.

Senate Bill 1283 provides supplemental reimbursement for ground emergency medical transport. Medicare only reimburses approximately a quarter of the cost of ground transport. The aim of the legislation is to help cover ambulance service without cost to state or local government, especially in rural areas. Went into effect March 17, 2022. Creates Idaho Code §56-286.

Senate Bill 1327 amends existing law to clarify cost coverage for hospitalization of mentally ill individuals and to revise provisions regarding such hospitalizations. Went into effect on March 21, 2022. Amends §66-317, §66-318, §66-319, §66-320, §66-322, §66-324, §66-326, §66-329, §66-330, §66-337, §66-354. Repeals and replaces §66-327.

Senate Bill 1350 creates means to contain costs of the Medicaid program to cover a $66 million budget shortfall caused by a federal court settlement that mandated provider reimbursement increases. The legislation eliminates restrictive language in Idaho law for both the hospital assessment calculation and how funds collected can be used. The funding to cover the shortfall will come from the hospital assessment that is contingent on obtaining a waiver from the U.S. Centers for Medicare and Medicaid Services. Will be implemented at the start of the 2024 fiscal year (July 1, 2023). Amends Idaho Code §56-1403, §56-1404, §56-1408, §56-1410.

Department of Health and Welfare

House Bill 756 is the Crisis Standards of Care Act, a new law might backtrack on Idaho’s efforts to cut down on bureaucracy and cut down on government regulation. It inserts an entirely new government entity, the Office of the Patient Ombudsman (OPO) within the Idaho Department of Health and Welfare (IDHW), and could add a significant new bureaucratic burden on hospitals and the IDHW during the implementation of the Idaho crisis standards of care (CSC).

The CSC are the standards by which hospitals operate during a medical emergency where the demand on the health care system has exceeded its capacity in the state or some significant regional subset of the state.

The OPO will oversee patient grievances and hospital conduct during CSC. Patient grievances during CSC conditions were handled between the patient and the hospital. The OPO will also regulate “crisis mitigation plans” for when an emergency necessitates the imposition of CSC. Hospitals now have a new regulatory requirement to draft mitigation plans and submit them for approval to OPO/IDHW before crisis standards are activated for a hospital.

The new law also adds a new reporting requirement during CSC. Prior to this law, IDHW required hospitals to provide a daily report of the current capacity of beds, staff and supplies and its ability to meet demand during a CSC emergency. The new law requires IDHW to make additional daily assessments about a hospital’s implementation of its mitigation plan and whether a hospital should continue to qualify for using CSC. The new daily assessment requirement potentially removes decisions about how to allocate inadequate resources and triage care during a CSC emergency from medical professionals, which is a double burden both on care providers and the IDHW. Went into effect on March 25, 2022. Creates Chapter 17 in Title 56 of Idaho Code.

Senate Bill 1257 amends Idaho Code §56-234 to remove a description of the Southwest Idaho Treatment Center as an intermediate care facility for individuals with intellectual disabilities. Not to do so places $7 million of federal funding for SWITC at risk as IDHW moves to a new model of services. Takes effect July 1, 2022.

Senate Bill 1258 amends Idaho Code to account for changes in IDHW facilities, mostly to add the newly opened State Hospital West where applicable. Takes effect July 1, 2022. Affects Idaho Code §36-401, §56-203, §56-235, §56-1003, §56-1004, §56-1408, §67-5339, §67-5303, §54-1761.

General

House Bill 515 amends the 2021 House Bill 396 and subsequently Idaho Code §39-401 and §39-422, to clarify that public health district employees are not part of the state personnel system. Retroactive to March 1, 2022.

House Bill 516 amends Idaho Code §39-413 to enable a district health director to establish a personnel system. Retroactive to March 1, 2022.

House Bill 603 allows for a hospital district to convey its property to a nonprofit corporation. This legislation extends an established ability of county hospitals to convey property to independent hospital districts, filling in a gap that existed in law. Goes into effect July 1, 2022. Creates Idaho Code §39-1358.

Senate Bill 1270 is the Down Syndrome Diagnosis Information Act, which calls for the creation of an annually updated expert-reviewed evidence-based sheet for affected health care recipients in Idaho on Down syndrome. The document will be provided at the time of diagnosis or when an ultrasound test detects a high likelihood of Down syndrome. Takes effect July 1, 2022. Creates Idaho Code Chapter 97 in Title 39.

House Joint Memorial 4 calls upon Idaho’s congressional delegation for federal acknowledgement and redress of problems related to the Office of Management and Budget’s method for designating metropolitan statistical areas (MSAs) in Idaho, a circumstance which has already negatively impacted the Lost Rivers Hospital District in Butte County where a corner of the county includes a corner of the Idaho National Laboratory site in the Arco Desert. Current policies force rural counties housing large federal installations to receive metropolitan designations, and those designations disrupt grant eligibility and other economic opportunities that the county would otherwise receive. Federal authorities are called on to ensure that relevant rural counties are not negatively impacted by statistical area designations imposed by the Office of Management and Budget.