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Today, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the section 1115 demonstration, “Idaho Behavioral Health Transformation.” This amendment will allow Idaho to continue the COVID-19 Public Health Emergency (PHE) flexibility to reimburse legally responsible individuals (LRIs) for providing personal care services (PCS), typically provided by direct care workers in the home. Under this amendment, LRIs must meet certain provider requirements set by the state and all other criteria established by the demonstration to receive payments for providing direct care. These additional provider requirements will be phased in by the state.
The amendment is effective March 29, 2024 through the current demonstration expiration date of March 31, 2025. The state may request to extend all authorities in the current demonstration, including the LRI PCS authority, when it submits its extension request. You can view today’s amendment approval, as well as other demonstration documents, in the demonstration’s administrative record.
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