,,ii #aai? ,,congress #a/ ,session ,s4 #aibj ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,may #bb1 #bjbe ,mr4 ,tillis 7= himself1 ,ms4 ,hassan1 ,mr4 ,sullivan1 & ,ms4 ,cortez ,ma/o7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xix ( ! ,social ,security ,act to develop national quality /&>ds = cont9u\s skill$ nurs+ s]vices provid$ ?r\gh ,m$icaid1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,cont9u\s ,skill$ ,nurs+ ,quality ,improvem5t ,act ( #bjbe4 #b4 ,def9itions ,9 ?is ,act3 7#a7 ,full-b5efit dual eligible individual ,! t]m full-b5efit dual eligible individual means an individual :o is entitl$ to1 or enroll$ =1 b5efits "u "p ,a ( title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 or enroll$ = b5efits "u "p ,b ( title ,,xviii ( su* ,act1 & is eligible = m$ical assi/ance "u ! ,m$icaid program = full b5efits "u section #aijb7;a77#aj77;,a7 ( su* ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77 or #aijb7;a77#aj77;,c7 ( su* ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,c771 by reason ( section #aijb7;f7 ( su* ,act 7#db ,u4,s4,c4 #acif;a7f771 or "u any o!r category ( eligibility = m$ical assi/ance = full b5efits1 z det]m9$ by ! ,secret>y4 7#b7 ,m$icaid b5efici>y ,! t]m ,m$icaid b5efici>y means an individual :o is eligible =1 & enroll$ 91 a ,/ate ,m$icaid program4 7#c7 ,m$icaid program ,! t]m ,m$icaid program means1 ) respect to a ,/ate1 ! ,/ate program "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 7includ+ any waiv] or demon/ration "u su* title or "u section #aaae ( su* ,act 7#db ,u4,s4,c4 #acae7 relat+ to su* title74 7#d7 ,private duty nurs+ s]vices ,! t]m private duty nurs+ s]vices has ! mean+ giv5 t t]m = purposes ( section #aije7;a77#h7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#h77 7z 9 effect on ! date ( enactm5t ( ?is ,act74 7#e7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,heal? & ,human ,s]vices4 7#f7 ,/ate ,! t]m ,/ate has ! mean+ giv5 su* t]m 9 section #aaja7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acja7;a77 = purposes ( title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq474 #c4 ,r$ef9+ private duty nurs+ s]vices provid$ ?r\gh ,m$icaid 7a7 ,def9ition ( m$ical assi/ance 7#a7 ,9 g5]al ,section #aije7;a77#h7 ( ! ,social ,security ,act 7#db ,u4,s4 #acif;d7a77#h77 is am5d$ by /rik+ private duty nurs+ s]vices2 & ins]t+ cont9u\s skill$ nurs+ s]vices24 7#b7 ,effective date ,! am5dm5t made by p>agraph 7#a7 takes effect on ! date t is #ah mon?s aft] ! date ( enactm5t ( ?is ,act4 7b7 ,def9ition ( cont9u\s skill$ nurs+ s]vices ,n lat] ?an #ah mon?s aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y1 ?r\gh notice & comm5t rulemak+1 %all-- 7#a7 revise ! def9ition ( private duty nurs+ s]vices 9 section #ddj4hj ( title #db1 ,code ( ,f$]al ,regulations1 to be cont9u\s skill$ nurs+ s]vices2 & 7#b7 require t su* s]vices "u ! ,m$icaid program provid$ to complex-c>e pati5ts :o require multiple h\rs ( cont9u\s nurs+ s]vices p] day1 z det]m9$ by ! ,/ate1 are provid$ by a lic5s$ nurse1 includ+ a regi/]$ nurse or a lic5s$ practical nurse4 #d4 ,developm5t ( national quality /&>ds = cont9u\s skill$ nurs+ s]vices provid$ ?r\gh ,m$icaid 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y %all conv5e a work+ gr\p t includes repres5tatives ( indep5d5t & national provid]s ( private duty nurs+ s]vices "u ! ,m$icaid program1 o!r private duty nurs+ ag5cies1 associations repres5t+ provid]s ( cont9u\s skill$ nurs+ s]vices1 full-b5efit dual eligible individuals1 ,m$icaid b5efici>ies1 pati5t advocacy gr\ps1 (ficials ( ,/ate ,m$icaid programs1 private duty nurs+ accr$it+ bodies1 & o!r relevant /akehold]s1 to develop & e/abli% national quality /&>ds = ! purposes ( improv+ ! /&>d ( c>e = private duty nurs+ s]vices provid$ by ,/ates "u ! ,m$icaid program4 7b7 ,ensur+ cl9ically appropriate /&>ds ,! ,secret>y %all issue a lett] to ,/ate ,m$icaid ,directors /at+ t provid]s ( private duty nurs+ s]vices "u ! ,m$icaid program are n requir$ to adh]e to conditions ( p>ticipation = home heal? ag5cies "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7c7 ,publication ( national /&>ds ,n lat] ?an #a ye> aft] ! date on :i* ! work+ gr\p describ$ 9 subsection 7a7 is fir/ conv5$1 ! ,secret>y1 aft] provid+ a p]iod ( public notice & opportunity = comm5t1 %all publi% ! national quality /&>ds develop$ by ! work+ gr\p = use by ,/ate ,m$icaid programs1 manag$ c>e entities t ent] into contracts ) su* programs1 & provid]s ( items & s]vices "u su* programs4 #e4 ,ma9ta9+ up-to-date cont9u\s skill$ nurs+ /&>ds 7a7 ,updat+ home & community-,bas$ waiv] s]vices ,n lat] ?an #ah mon?s aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y1 ?r\gh notice & comm5t rulemak+1 %all revise ! li/ ( s]vices t are includ$ z home & community-bas$ waiv] s]vices "u section #ddj4ahj7;b7 ( title #db1 ,code ( ,f$]al ,regulations1 to include cont9u\s skill$ nurs+ c>e s]vices1 z def9$ = purposes ( section #aije7;a77#h7 ( ! ,social ,security ,act 7z am5d$ by section #c7;a77 "u section #ddj4hj ( title #db1 ,code ( ,f$]al ,regulations 7z revis$ aft] ! application ( section #c7;b774 7b7 ,updat+ ! home & community-,bas$ s]vices quality measure set 7#a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y %all update & publi% ! ,,hcbs ,quality ,measure ,set1 describ$ 9 ! ,/ate ,m$icaid ,director ,lett] #bb-jjc issu$ on ,july #ba1 #bjbb1 to include core & supplem5tal quality measures = cont9u\s skill$ nurs+ s]vices = use by ,/ate ,m$icaid programs1 manag$ c>e entities t ent] into contracts ) su* programs1 & provid]s ( items & s]vices "u su* programs4 7#b7 ,regul> reviews & updates ,! ,secret>y %all review & update ! core set & supplem5tal set ( cont9u\s skill$ nurs+ s]vices quality measures publi%$ "u p>agraph 7#a7 n less frequ5tly ?an e #h ye>s4 ,any su* update %all include a p]iod ( public notice & opportunity = comm5t4