GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 2025

S                                                                                                                                                     1

SENATE BILL 896

 

 

Short Title:      Increase Medicaid PCS and PDN Rates.

(Public)

Sponsors:

Senator Burgin (Primary Sponsor).

Referred to:

Rules and Operations of the Senate

April 30, 2026

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 (DHB), the sum of one hundred twenty million eight hundred thousand dollars ($120,800,000) in recurring funds beginning in the 2026‑2027 fiscal year 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 sixteen million two hundred thousand dollars ($216,200,000) in recurring federal funds for the 2026‑2027 fiscal year, and those funds are appropriated to DHB 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 (DHB), the sum of twenty million one hundred thousand dollars ($20,100,000) in recurring funds beginning in the 2026‑2027 fiscal year to be used to increase to sixteen dollars and twenty‑five cents ($16.25) per 15‑minute increment 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‑five million nine hundred thousand dollars ($35,900,000) in recurring federal funds for the 2026‑2027 fiscal year, and those funds are appropriated to DHB for the same purpose.

SECTION 3.  This act becomes effective July 1, 2026.