AB 2240: Medi-Cal: private duty nursing.
<p>The bill requires the California Department of Health Care Services to assess whether private duty nursing services under the Medi-Cal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program comply with federal Medicaid requirements. The assessment must compare authorized EPSDT private duty nursing hours to those actually provided and determine if reimbursement rates are adequate for all authorized hours to be delivered. Additionally, the department is required to submit a report on these findings to the legislature by March 1, 2027.</p>
| May. 14, 2026 | In committee: Held under submission. |
| May. 06, 2026 | In committee: Set, first hearing. Referred to APPR. suspense file. |
| Apr. 22, 2026 | From committee: Do pass and re-refer to Com. on APPR. with recommendation: To Consent Calendar. (Ayes 16. Noes 0.) (April 21). Re-referred to Com. on APPR. |
| Apr. 20, 2026 | Re-referred to Com. on HEALTH. |
| Apr. 16, 2026 | From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended. |
| Amended IN Assembly April 16, 2026 |
| Introduced by Assembly Member Stefani |
February 19, 2026 |
LEGISLATIVE COUNSEL'S DIGEST
Existing law provides for the licensure of private duty nursing agencies and home health agencies by the State Department of Public Health. Existing law defines “private duty nursing services” as skilled nursing services provided on a shift basis for patients who require individual and continuous nursing care in the patient’s temporary or permanent place of residence or other community-based setting, as specified.
Under this bill, private duty nursing services, provided to a child under 21 years of age by a home health agency, would be considered specialty care for purposes of Medi-Cal reimbursement under the provisions of the Medi-Cal Act. The bill would not apply this designation for purposes of Medi-Cal reimbursement under the provisions of the Protect Access to Health Care Act of 2024, an initiative measure enacted by Proposition 35, as approved by the voters at the November 5, 2024, statewide general election.
The people of the State of California do enact as follows:
SECTION 1.
Section 14149.96 is added to the Welfare and Institutions Code, to read:14149.96.
(a) The department shall measure and assess whether private duty nursing services provided as part of the early periodic screening, diagnostic, and treatment (EPSDT) benefit are in compliance with federal Medicaid requirements for the provision of private duty nursing services to children under 21 years of age. The assessment shall include, but is not limited to, both of the following:(a) “Private duty nursing agency” means a private or public organization, including, but not limited to, any partnership, corporation, political subdivision of the state, or other government agency within the state, that provides, or arranges for the provision of, private duty nursing services, as described in Section 1743.3.
(b) “Private duty nursing services” means skilled nursing services provided on a shift basis for patients who require individual and continuous nursing care, and that meets all of the following requirements:
(1) Is provided by a registered nurse or a licensed vocational nurse, except that any person accepted for service whose care requires medical orders shall be under the care of a physician, dentist, podiatrist, or other licensed practitioner within their scope of practice.
(2) Is provided to the patient in their temporary or permanent place of residence or other community-based setting and includes, one or both of the following locations:
(A) The patient’s home.
(B) Outside of the patient’s home, as necessitated by normal life activities.
(c)Private duty nursing services, provided to a child under 21 years of age by a home health agency, as defined in Section 1727, shall be considered specialty care for purposes of Medi-Cal reimbursement under Chapter 7 (commencing with Section 14000) of, but not Chapter 7.5 (commencing with Section 14199.100) of, Part 3 of Division 9 of the Welfare and Institutions Code.