31-3519. APPROVAL AND PAYMENT BY THE BOARD. (1) Upon receipt of the clerk’s statement, a final determination of the county commissioners and the completed application, the board shall approve an application for financial assistance under the catastrophic health care cost program if it determines that:

(a) Necessary medical services have been provided for a medically indigent resident in accordance with this chapter;

(b) The obligated county paid the first eleven thousand dollars ($11,000) of necessary medical services; and

(c) The cost of necessary medical services when paid at the reimbursement rate exceeds the total sum of eleven thousand dollars ($11,000) in the aggregate per resident in any consecutive twelve (12) month period.

(2) Payment to a hospital or provider pursuant to this chapter shall be payment of the debt in full and the hospital or provider shall not seek additional funds from the applicant.

(3) In no event shall the board be obligated to pay a claim, pursuant to this chapter, in excess of an amount based on the application of the appropriate reimbursement rate to those medical services determined to be necessary medical services. The board may use contractors to undertake utilization management review in any part of that analysis.

(4) The board shall, within forty-five (45) days after approval by the board, submit the claim to the state controller for payment. Payment by the state controller shall be made pursuant to section 67-2302, Idaho Code.

History:

[31-3519, added 1982, ch. 190, sec. 5, p. 511; repealed 1990, ch. 87, sec. 1, p. 553; reinstated and am. 1991, ch. 233, sec. 13, p. 561; am. 1995, ch. 9, sec. 3, p. 16; am. 1996, ch. 410, sec. 24, p. 1371; am. 2009, ch. 177, sec. 18, p. 572; am. 2010, ch. 273, sec. 29, p. 709; am. 2011, ch. 291, sec. 24, p. 811.]