GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 2025

S                                                                                                                                                     1

SENATE BILL 366

Short Title:      Increase Medicaid PCS and PDN Rates.		(Public)
Sponsors:	Senators Burgin, Moffitt, and Adcock (Primary Sponsors).
Referred to:	Rules and Operations of the Senate

March 24, 2025

A BILL TO BE ENTITLED

AN ACT to increase medicaid reimbursement rates for personal care services and private duty nursing services.

The General Assembly of North Carolina enacts:

SECTION 1.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Health Benefits, the sum of one hundred nineteen million two hundred thousand dollars ($119,200,000) in recurring funds for each year of the 2025‑2027 fiscal biennium to be used to increase to seven dollars and fifty cents ($7.50) per 15‑minute increment the Medicaid rate paid for personal care services pursuant to Medicaid Clinical Coverage Policies 3L, 3K‑1, and 3K‑2 provided to Medicaid beneficiaries through the State Plan Personal Care Services Program (PCS), Community Alternatives Program for Children (CAP/C), Community Alternatives Program for Disabled Adults (CAP/DA), and Community Alternatives Program Choice (CAP/CO). These funds shall provide a State match for two hundred seventeen million eight hundred thousand dollars ($217,800,000) in recurring federal funds for each year of the 2025‑2027 fiscal biennium, and those funds are appropriated to the Division of Health Benefits for the same purpose.

SECTION 2.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Health Benefits, the sum of nineteen million eight hundred thousand dollars ($19,800,000) in recurring funds for each year of the 2025‑2027 fiscal biennium to be used to increase to sixteen dollars and twenty‑five cents ($16.25) per 15 minutes the Medicaid rate paid for private duty nursing services pursuant to Medicaid Clinical Coverage Policies 3G‑1: Private Duty Nursing for Beneficiaries Age 21 and Older and 3G‑2: Private Duty Nursing for Beneficiaries Under 21 Years of Age. These funds shall provide a State match for thirty‑six million two hundred thousand dollars ($36,200,000) in recurring federal funds for each year of the 2025‑2027 fiscal biennium, and those funds are appropriated to the Division of Health Benefits for the same purpose.

SECTION 3.  This act becomes effective July 1, 2025.