Corrado Bill Raising Reimbursement Rates for Medicaid Private Duty Nurses Advances

Bipartisan legislation sponsored by Senator Kristin Corrado that would boost minimum Medicaid reimbursement rates paid for private duty nursing services (PDN) was advanced by the Senate Health, Human Services and Senior Citizens Committee.

PDN services are individualized nursing tasks provided by licensed nurses on a continuous basis in the homes of certain qualifying patients.

“Skilled medical professionals are delivering high-quality, in-home care, but reimbursement rates have failed to keep up with the true cost of services,” said Corrado. “Thousands of residents rely on PDN nurses to improve their health and maintain their standard of living. To ensure a reliable roster of skilled nurses to meet the need, it makes sense to escalate reimbursement rates to a level that more reasonably reflects the work. Reimbursing more money to the providers will allow them to increase pay to the hard-working professionals caring for patients.”

The bill, S-2191, is also sponsored by Senator Loretta Weinberg. It would establish minimum Medicaid reimbursement rates for PDN services provided in the Medicaid fee-for-service delivery system or through a managed care delivery system. The minimum reimbursement for services rendered by a registered professional nurse would increase to not less than $60 per hour, and $48 per hour for a licensed practical nurse (LPN).

Under current State regulations, the maximum Medicaid reimbursement rate is not more than $40 per hour when a registered nurse provides the services, and not more than $28 for an LPN.

The bill will require all providers that receive reimbursement for PDN services under a Medicaid managed care contract to annually report to the State Division of Medical Assistance and Health Services (DMAHS) regarding the use of funds as reimbursement for the healthcare workers.