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Public Notice of Final Action for Consolidation of Private Duty Nursing and Update to Personal Care Services

The South Carolina Department of Health and Human Services (SCDHHS) gives notice of the following actions regarding private duty nursing and personal care services under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for dates of service on or afterJuly 1, 2023, SCDHHS will amend the South Carolina Title XIX State Plan to consolidate registered nurse (RN) and licensed practical nurse (LPN) services into one consolidated nursing service.

Home-based private duty nursing reimbursement will be combined into one blended rate for services provided by an RN and/or LPN. The blended rate for private duty nursing will be $42/hr. The blended rate for enhanced private duty nursing will be $45/hr.

The purpose of the amendment is to consolidate services, reduce administrative burden, and support access to care through the provider network.

SCDHHS also intends to revise the policy for reimbursement to certain family members under the Early and Periodic Screening, Diagnostic, & Treatment benefit. The State Plan currently indicates the policy for reimbursement to certain family members applies to both home-based private duty nursing and personal care services. The State Plan will be updated to indicate that the policy applies to personal care services. Language indicating that the policy applies to home-based private duty nursing will be removed.

Based on the actions above, SCDHHS anticipates an annual budget impact of approximately $5 million (total dollars).

Copies of this notice are available at each South Carolina Healthy Connections Medicaid county office and at www.scdhhs.gov for public review. Additional information regarding these actions is available upon request at the address cited below.

Any written comments submitted may be reviewed by the public at SCDHHS, Bureau of Policy, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9 a.m. and 5 p.m.

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