Overview
Idaho has stepped up its efforts to promote price transparency and control healthcare costs in recent legislative sessions. Signed into law in 2020, the Idaho Patient Act adds transparency to the medical billing process and protects consumers from unfair medical debt collection practices. The state legislature also made a notable effort but failed to pass the No Surprises Act, which would have implemented surprising billing protections by prohibiting health care providers from charging higher rates for out-of-network services.
The state has also taken affirmative steps to curb anticompetitive practices in the healthcare market. Idaho law prohibits most favored nation clauses, or clauses having a similar effect, against hospital and service corporations, stock or mutual insurance companies, and managed care organizations entering into agreements with participating providers. Additionally, the state regulates non-compete agreements for physicians by requiring that such provisions be limited to protecting legitimate business interests.
Idaho further exercises regulatory oversight over the healthcare provider market by requiring written notice to the attorney general prior to entering into any nonprofit conversion or transaction. In a landmark antitrust enforcement case against St. Luke’s Health Systems and Saltzer Medical Group, the Idaho AG and the FTC filed a joint complaint to challenge the merger between the Idaho-based, not-for-profit health system and the state’s largest independent, multi-specialty physician group. 16 states filed an amicus brief to the Ninth Circuit, explaining that the acceleration of health care costs due to the growth of large health care provider systems has become a matter of grave concern for the states. The Ninth Circuit affirmed the federal district court’s ruling that the acquisition violated Section 7 of the Clayton Act and the Idaho Competition Act and ordered a full divestiture of Saltzer from St. Luke’s Health System, restoring competition in the local adult primary care services market.
In 2024, the state passed legislation providing for regulation and oversight of the practices of pharmacy benefit managers.
See below for an overview of existing Idaho state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).
State Action
Latest Legislative Session: 1/9/2023 - 4/8/2023 (2023 term). *Current session bill updates are ongoing. Check back weekly for updates.
SB 1127 – Idaho
Introduced: 2021 Status: Inactive / Dead
TELEHEALTH – Amends existing law to revise provisions regarding the establishment of a provider-patient relationship using telehealth technologies.
SB 1128 – Idaho
Introduced: 2021 Status: Inactive / Dead
Naturopathic doctors, licensing/scope of practice: OCCUPATIONAL LICENSING – Adds to existing law to provide for the licensing of naturopathic practitioners.
SB 1204 – Idaho
Introduced: 2019 Status: Enacted
The director is hereby encouraged and empowered to obtain federal approval in order that Idaho design and implement changes to its medicaid program that advance the quality of services to participants while allowing access to …
SB 1236 – Idaho
Introduced: 2022 Status: Enacted
HEALTH SAVINGS ACCOUNTS — Amends existing law to revise provisions regarding the state contribution to state employees’ health savings accounts.
SB 1288 – Idaho
Introduced: 2018 Status: Enacted
OUT-OF-STATE INSURERS: Adds to and amends existing law to provide for interstate health insurance sales and to authorize out-of-state insurers to sell health insurance in Idaho under certain conditions. This legislation will establish the Idaho …
HB 275 – Idaho
Introduced: 2019 Status: Enacted
Establishes enhanced short-term health insurance plans: This bill amends sections 41-5203, 41-5207, Chapter 52, Title 41 and adds a new section of Idaho code to define and provide for the purchase of enhanced short-term health …
Idaho Code Ann. § 39-1303b. Agreements for allocation of services between neighboring hospitals: Hospital Licenses and Inspection – Idaho
Introduced: Status: Enacted
Hospitals serving the same, or generally the same, geographical area may, by agreement or other arrangement to eliminate duplication, allocate as between themselves, in whole or in part, the provision of those services and facilities …
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Idaho Code Ann. § 41-1846. Health care policies — Applicability — Requirement: The Insurance Contract – Idaho
Introduced: Status: Enacted
Governs requirements in health care policies.
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Idaho Code Ann. § 41-210. General powers, duties: The Department of Insurance – Idaho
Introduced: Status: Enacted
Sets forth the general powers and duties of the insurance director.
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Idaho Code Ann. § 41-213. Enforcement: The Department of Insurance – Idaho
Introduced: Status: Enacted
The director may institute such suits or other lawful proceedings as he may deem necessary for the enforcement of any provision of title 41 of the Idaho Code.
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Federal Trade Commission and State of Idaho v. St. Luke’s Health System, Ltd and Saltzer Medical Group, P.A. – California, Connecticut, Delaware, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Mississippi, Montana, Nevada, New Mexico, Oregon, Pennsylvania, Tennessee, Washington
District Court: District of Idaho Status: Decided
In March 2013, the FTC and the Idaho Attorney General filed a joint complaint challenging the merger betweenSt. Luke’s Health System, Idaho’s largest health system, …
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
Idaho operates on an annual budget cycle. The legislature adopts the budget in March and the fiscal year begins in July.
STATE LEGISLATURE
The Idaho statehouse has 35 senators and 70 representatives in the House of Representatives. Both senators and representatives are elected to two-year terms. The Legislature meets annually from January until mid-March, although sessions have been known to last into May. The Governor of Idaho may also call special sessions at any time. Bills do not carry over from year to year.