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LEGISLATURE
OF
THE
STATE
OF
IDAHO
Sixty-eighth
Legislature
Second
Regular
Session
-
2026
IN
THE
HOUSE
OF
REPRESENTATIVES
HOUSE
BILL
NO.
828
BY
HEALTH
AND
WELFARE
COMMITTEE
AN
ACT
1
RELATING
TO
THE
MERIT
-
BASED
HEALTH
CARE
ACT;
AMENDING
TITLE
56,
IDAHO
CODE,
2
BY
THE
ADDITION
OF
A
NEW
CHAPTER
25,
TITLE
56,
IDAHO
CODE,
TO
PROVIDE
3
A
SHORT
TITLE,
TO
PROVIDE
LEGISLATIVE
FINDINGS
AND
INTENT,
TO
DEFINE
4
TERMS,
TO
ESTABLISH
PROVISIONS
REGARDING
PROHIBITED
ACTS,
TO
ESTABLISH
5
PROVISIONS
REGARDING
MEDICAID
CONTRACTUAL
COMPLIANCE,
TO
ESTABLISH
6
PROVISIONS
REGARDING
ENFORCEMENT
AND
PENALTIES,
TO
ESTABLISH
PROVI
-
7
SIONS
REGARDING
A
LIMITED
PRIVATE
RIGHT
OF
ACTION,
AND
TO
ESTABLISH
8
PROVISIONS
REGARDING
FEDERAL
PREEMPTION;
AND
DECLARING
AN
EMERGENCY
9
AND
PROVIDING
AN
EFFECTIVE
DATE.
10
Be
It
Enacted
by
the
Legislature
of
the
State
of
Idaho:
1
1
SECTION
1.
That
Title
56,
Idaho
Code,
be,
and
the
same
is
hereby
amended
12
by
the
addition
thereto
of
a
NEW
CHAPTER
,
to
be
known
and
designated
as
Chap
-
13
ter
25,
Title
56,
Idaho
Code,
and
to
read
as
follows:
14
CHAPTER
25
15
MERIT
-
BASED
HEALTH
CARE
ACT
16
56
-
2501.
SHORT
TITLE.
This
chapter
shall
be
known
and
may
be
cited
as
17
the
"Merit
-
Based
Health
Care
Act."
18
56
-
2502.
LEGISLATIVE
FINDINGS
AND
INTENT.
(1)
The
legislature
finds
19
that:
20
(a)
Medicaid
participation
is
voluntary
and
subject
to
reasonable
con
-
21
ditions
imposed
by
the
state
as
a
steward
of
public
funds;
22
(b)
Employment
decisions
based
on
merit
and
professional
qualifica
-
23
tions
promote
patient
trust
and
high
-
quality
care;
and
24
(c)
Employment
practices
unrelated
to
job
-
related
qualifications
or
25
business
necessity
undermine
program
integrity,
workforce
competency,
26
and
the
efficient
use
of
public
funds.
27
(2)
It
is
the
intent
of
the
legislature
to:
28
(a)
Ensure
that
health
care
employment
and
contracting
decisions
29
funded
by
medicaid
are
based
on
individual
merit,
qualifications,
and
30
clinical
competency;
31
(b)
Prohibit
the
use
of
state
medicaid
funds
to
support
ideological
or
32
discriminatory
employment
practices;
and
33
(c)
Preserve
compliance
with
all
applicable
federal
civil
rights
and
34
medicaid
requirements.
35
(3)
Nothing
in
this
chapter
is
intended
to
authorize
discrimination
36
prohibited
by
federal
law
or
to
interfere
with
patient
-
specific
medical
37
decision
-
making.
38
56
-
2503.
DEFINITIONS.
As
used
in
this
chapter:
39
2
(1)
"Discriminatory
hiring"
means
granting
a
preference
or
imposing
a
1
disadvantage
in
employment
or
contracting
based
on
race,
sex,
sexual
orien
-
2
tation,
gender
identity,
or
national
origin,
except
as
expressly
required
by
3
federal
law.
4
(2)
"Diversity,
equity,
and
inclusion"
or
"DEI"
means
the
policies
com
-
5
monly
known
and
practiced
as
DEI,
critical
race
theory,
or
anti
-
racism,
any
6
form
of
race
or
sex
stereotyping
or
scapegoating,
or
the
concepts
that:
7
(a)
One
race
or
sex
is
inherently
superior
to
another
race
or
sex;
8
(b)
The
United
States
is
fundamentally
racist
or
sexist;
9
(c)
An
individual,
by
virtue
of
the
individual's
race
or
sex,
is
in
-
10
herently
racist,
sexist,
or
oppressive,
whether
consciously
or
uncon
-
1
1
sciously;
12
(d)
An
individual
should
be
discriminated
against
or
receive
adverse
13
treatment
solely
or
partly
because
of
the
individual's
race
or
sex;
14
(e)
Members
of
one
race
or
sex
cannot
and
should
not
attempt
to
treat
15
others
without
respect
to
race
or
sex;
16
(f)
An
individual's
moral
character
is
necessarily
determined
by
the
17
individual's
race
or
sex;
18
(g)
An
individual,
by
virtue
of
the
individual's
race
or
sex,
bears
re
-
19
sponsibility
for
actions
committed
in
the
past
by
other
members
of
the
20
same
race
or
sex;
21
(h)
An
individual
should
feel
discomfort,
guilt,
anguish,
or
any
other
22
form
of
psychological
distress
on
account
of
the
individual's
race
or
23
sex;
24
(i)
Meritocracy
or
traits
such
as
a
hard
work
ethic
are
racist
or
sexist
25
or
were
created
by
a
particular
race
to
oppress
another
race;
or
26
(j)
All
people
should
be
compelled
to
believe
in
and
speak
in
a
manner
27
consistent
with
the
concept
that
an
individual
can
change
the
individ
-
28
ual's
sex
or
gender.
29
(3)
"Health
care
provider"
means
any
individual
or
entity
that
volun
-
30
tarily
participates
in
the
Idaho
medicaid
program
or
receives
medicaid
reim
-
31
bursements
in
whole
or
in
part
through
a
state
-
contracted
managed
care
net
-
32
work.
33
(4)
"Prohibited
DEI
conduct"
means
any
policy,
practice,
training,
or
34
requirement
that
includes:
35
(a)
Consideration
of
DEI
in
hiring,
promotion,
compensation,
disci
-
36
pline,
termination,
or
contracting
decisions;
37
(b)
Race
-
based
or
sex
-
based
preferences,
targets,
benchmarks,
quotas,
38
or
equity
goals;
39
(c)
Mandatory
bias,
implicit
bias,
systemic
bias,
or
similar
training
40
that
assigns
responsibility,
disadvantage,
or
professional
outcomes
41
based
on
protected
characteristics
rather
than
individual
merit
or
per
-
42
formance;
or
43
(d)
Required
statements,
pledges,
attestations,
or
affirmations
en
-
44
dorsing
diversity,
equity,
and
inclusion
principles
or
related
ideo
-
45
logical
frameworks
as
a
condition
of
employment
or
contracting.
46
(5)
"Public
-
facing
communication"
means
any
communication
made
avail
-
47
able
to
the
public,
including
marketing
materials,
websites,
mission
or
48
value
statements,
publicly
presented
staff
trainings,
facility
signage,
or
49
social
media.
50
3
56
-
2504.
PROHIBITED
ACTS.
(1)
With
respect
to
employment,
policies,
1
training,
or
communications,
a
health
care
provider
shall
not:
2
(a)
Engage
in
discriminatory
hiring
or
prohibited
DEI
conduct;
3
(b)
Adopt
or
implement
internal
policies
or
trainings
that
constitute
4
prohibited
DEI
conduct;
or
5
(c)
Use
state
funds,
including
medicaid
reimbursements,
for
any
pub
-
6
lic
-
facing
communication
that
promotes
prohibited
DEI
conduct.
7
(2)
Nothing
in
this
section
shall
be
construed
to
prohibit:
8
(a)
Compliance
with
title
VI
of
the
civil
rights
act
of
1964
or
other
9
applicable
federal
civil
rights
laws;
10
(b)
Collection
of
demographic
data
for
legitimate
clinical
care,
qual
-
1
1
ity
reporting,
or
public
health
purposes;
12
(c)
Patient
-
specific
medical
discussions
related
to
biological,
ge
-
13
netic,
or
epidemiological
risk
factors;
14
(d)
Non
-
ideological
training
required
for
clinical
competency,
licen
-
15
sure,
accreditation,
or
federal
program
compliance;
or
16
(e)
Workforce
training,
quality
improvement
initiatives,
or
dispar
-
17
ity
-
reduction
programs
required
or
encouraged
by
federal
law,
centers
18
for
medicare
and
medicaid
services
guidance,
or
accreditation
bodies.
19
56
-
2505.
MEDICAID
CONTRACTUAL
COMPLIANCE.
(1)
Compliance
with
this
20
chapter
shall
be
a
material
condition
of
all
Idaho
medicaid
provider
agree
-
21
ments
as
applied
to
medicaid
-
funded
activities.
22
(2)
The
department
of
health
and
welfare
shall
ensure
that
all
managed
23
care
contracts
require
network
-
wide
compliance
with
the
provisions
of
this
24
chapter
for
medicaid
-
funded
activities.
25
(3)
This
section
shall
be
implemented
in
a
manner
consistent
with
fed
-
26
eral
medicaid
requirements
and
centers
for
medicare
and
medicaid
services
27
guidance.
28
56
-
2506.
ENFORCEMENT
AND
PENALTIES.
(1)
The
attorney
general
may
in
-
29
vestigate
alleged
violations
of
this
chapter
upon
receipt
of
a
formal
com
-
30
plaint.
31
(2)
Prior
to
the
imposition
of
civil
penalties,
the
department
shall
32
provide
written
notice
and
an
opportunity
for
corrective
action.
33
(3)
The
attorney
general
may
seek
civil
penalties
for
violations
of
34
this
chapter
as
follows:
35
(a)
For
a
health
care
provider
with
fifty
(50)
or
more
employees:
36
(i)
A
penalty
not
to
exceed
ten
thousand
dollars
($10,000)
for
a
37
first
violation;
38
(ii)
A
penalty
not
to
exceed
fifty
thousand
dollars
($50,000)
for
39
a
second
violation;
and
40
(iii)
A
penalty
not
to
exceed
one
hundred
thousand
dollars
41
($100,000)
for
a
third
or
subsequent
violation;
and
42
(b)
For
a
health
care
provider
with
fewer
than
fifty
(50)
employees:
43
(i)
A
penalty
not
to
exceed
five
thousand
dollars
($5,000)
for
a
44
first
violation;
45
(ii)
A
penalty
not
to
exceed
twenty
-
five
thousand
dollars
46
($25,000)
for
a
second
violation;
and
47
4
(iii)
A
penalty
not
to
exceed
fifty
thousand
dollars
($50,000)
for
1
a
third
or
subsequent
violation.
2
56
-
2507.
LIMITED
PRIVATE
RIGHT
OF
ACTION.
A
health
care
professional
3
may
bring
an
action
solely
for
retaliation
arising
from
refusing
to
partici
-
4
pate
in
prohibited
DEI
conduct.
Remedies
may
include
reinstatement,
injunc
-
5
tive
relief,
compensatory
damages,
and
reasonable
attorney's
fees.
6
56
-
2508.
SAVINGS
CLAUSE
AND
FEDERAL
PREEMPTION.
Nothing
in
this
chap
-
7
ter
shall
be
construed
to
restrict
conduct
required
or
encouraged
by
fed
-
8
eral
civil
rights
law,
centers
for
medicare
and
medicaid
services
guidance,
9
or
federal
conditions
of
participation.
If
any
provision
of
this
chapter
is
10
preempted
by
federal
law,
such
provision
shall
be
severed
while
the
remain
-
1
1
der
remains
in
full
force
and
effect.
12
SECTION
2.
An
emergency
existing
therefor,
which
emergency
is
hereby
13
declared
to
exist,
this
act
shall
be
in
full
force
and
effect
on
and
after
14
July
1,
2026.
15