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SB 2399

AN ACT to create and enact a new section to chapter 50-24.1 of the North Dakota Century Code, relating to medical assistance reimbursement of psychiatric residential treatment facilities; to provide for a legislative management report; and to provide an appropriation.

69th Legislative Assembly (2025-26) Introduced by Diane Larson and 4 co-sponsors

ND Medicaid reimbursement for psychiatric residential treatment facilities will cap therapeutic leave at $500/day and require utilization controls, with rule changes and a 2026 rep

Filed with Secretary Of State 05/01
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Bill Summary · SB 2399

SB 2399 — Summary (North Dakota, 2025)

Status: Enacted — Signed by Governor 04/30/2025; filed with Secretary of State 05/01/2025.

Purpose

SB 2399 directs the Department of Health and Human Services (DHHS) to revise Medicaid (medical assistance) reimbursement rules for psychiatric residential treatment facilities (PRTFs) to better define and cover "direct care" costs, add utilization controls, and to report to the legislature on implementation and progress toward value‑based care. The bill also provides a targeted appropriation to support PRTF reimbursement during the 2025–2027 biennium.

Key provisions

  • Rulemaking mandate
    • DHHS must amend rules for Medicaid reimbursement of PRTFs to address direct care costs, explicitly including costs associated with:
    • clinical supervisors,
    • medical directors,
    • family engagement in care,
    • therapeutic leave days,
    • an administrative cost cap.
  • Therapeutic leave payments
    • Reimbursement for therapeutic leave days is capped at $500 per day.
    • DHHS must implement utilization controls for therapeutic leave days, including a service authorization requirement.
  • Legislative reporting
    • DHHS must submit a report to Legislative Management by October 1, 2026, describing the changes to reimbursement rules (including the items listed above) and progress toward value‑based care.
  • Appropriation (biennium July 1, 2025 – June 30, 2027)
    • $647,149 from the state general fund.
    • $660,025 from other funds (federal and special funds).
    • Funds are for PRTF reimbursement.

Who is affected

  • Psychiatric residential treatment facilities licensed in North Dakota:
    • Will be subject to revised Medicaid reimbursement rules, new utilization controls, and the $500/day cap on therapeutic leave payments.
    • May see changes in which direct care items are reimbursable (e.g., supervision, medical director time, family engagement).
  • North Dakota Department of Health and Human Services:
    • Required to amend rules, implement utilization controls/service authorization processes, and produce the October 1, 2026 report.
  • Medicaid program and state budget:
    • The appropriation increases available state and federal spending for PRTF reimbursement during the 2025–27 biennium and may affect Medicaid outlays going forward.
  • Residents and families:
    • Potential indirect effects on access to therapeutic leave and family‑engagement services depending on how utilization controls and reimbursement changes are implemented.

Implementation and timeline

  • DHHS rule changes to be made pursuant to the bill (no specific rule deadline beyond standard rulemaking processes).
  • Report to Legislative Management due October 1, 2026.
  • Appropriation covers the biennium July 1, 2025 – June 30, 2027.

Notes on bill evolution

  • Earlier drafts of the bill contained more detailed definitions for “direct care costs” and a process for emergency (nonrecurring) cost reimbursement with defined review and payment timelines. The final enacted language focuses on directing DHHS to amend reimbursement rules, sets the therapeutic‑leave cap and utilization controls, requires the October 1, 2026 report, and includes the appropriation.

Compiled from official sources — confirm details with the bill’s official record.

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