H.R. 6592: Continuous Skilled Nursing Quality Improvement Act of 2025

This bill, known as the Continuous Skilled Nursing Quality Improvement Act of 2025, aims to enhance the quality of continuous skilled nursing services provided through Medicaid in the United States. Here is a summary of the main components of the bill:

1. Changes to Definitions

The bill redefines relevant terms regarding nursing services under Medicaid:

• Private Duty Nursing Services will be amended to be called Continuous Skilled Nursing Services.
• This change will take effect 18 months after the bill is enacted.
• The definition of Continuous Skilled Nursing Services will include those provided by licensed nurses to complex-care patients who require extensive nursing assistance.

2. Development of National Quality Standards

The bill mandates the establishment of national quality standards for continuous skilled nursing services provided through Medicaid:

• Within 180 days of enactment, the Secretary of Health and Human Services will form a working group consisting of various stakeholders such as healthcare providers, patient advocacy groups, and state officials.
• This working group will develop national quality standards aimed at improving the quality of care in nursing services.
• These standards will be published one year after the working group is convened, following a public comment period.

3. Ensuring Quality Care Standards

The Secretary will issue guidance to state Medicaid directors clarifying that providers of private duty nursing services will not have to meet certain conditions that apply to home health agencies, ensuring that care remains focused on the needs of Medicaid beneficiaries.

4. Updates to Waiver Services

The bill requires revisions to the current list of home and community-based waiver services:

• Continuous skilled nursing care services will be incorporated into the home and community-based services list within 18 months of the bill’s enactment.

5. Ongoing Quality Oversight

The Secretary is also tasked with updating the quality measure set for home and community-based services:

• Within one year of enactment, a new set of quality measures for continuous skilled nursing services will be developed and published.
• The quality measures will be reviewed and potentially updated at least every 8 years.

Relevant Companies

• CNC (Centene Corporation) - As a significant provider of managed care services, changes in Medicaid service definitions and standards could directly impact Centene’s operations and service delivery.
• HUM (Humana Inc.) - With its focus on healthcare and Medicaid programs, the bill’s quality standards may influence Humana’s nursing service offerings and compliance requirements.
• UNH (UnitedHealth Group Incorporated) - As a major player in the healthcare sector, UnitedHealth Group may need to adapt its services and quality measures in light of the proposed changes to Medicaid nursing services.