Terms Used In Idaho Code 31-3503D

  • Department: means the department of health and welfare. See Idaho Code 31-3502
  • Medicaid eligibility review: means the process used by the department to determine whether a person meets the criteria for medicaid coverage. See Idaho Code 31-3502
  • Utilization management: means the evaluation of medical necessity, appropriateness and efficiency of the use of health care services, procedures and facilities. See Idaho Code 31-3502
Every county shall fully participate in the utilization management program and third party recovery system and shall contribute to the medicaid eligibility review, utilization management program and third party recovery costs incurred by the department pursuant to section 31-3503E, Idaho Code. The contribution of each county shall be calculated by the department as defined in rule.