WeVote
Log In

Bill

Bill

SR 154

NURSES: Requests the Louisiana Department of Health to study the adequacy of the in-home skilled nursing services market in Louisiana.

2026 Regular Session Introduced by Patrick McMath

Louisiana will study and address barriers to timely, continuous in-home skilled nursing for Medicaid beneficiaries to improve access and reduce hospital-based care.

Enrolled. Signed by the President of the Senate and sent to the Secretary of State by the Secretary of the Senate.
0
WeVote Research Nonpartisan
Bill Summary · SR 154

Summary of SR 154 (2026, Louisiana) – NURSES: Study of in-home skilled nursing services market

Purpose and intent

  • Requests the Louisiana Department of Health (LDH) to study the adequacy of Louisiana’s in-home skilled nursing services market for Medicaid beneficiaries.
  • Focuses on continuous or extended-hour skilled nursing services provided at home, especially for medically fragile children and adults.
  • Aims to identify barriers to timely delivery of authorized hours and to develop recommendations for improving access, while safeguarding patient safety and program integrity.
  • Requires LDH to report findings and recommendations to the Senate Committee on Health and Welfare.

Key provisions and areas the study must examine

  1. Provider network capacity

    • Assess current capacity for continuous/extended-hour skilled nursing services.
    • Map geographic distribution and identify parishes where enrolled/actively serving providers are insufficient to meet authorized hours.

  2. Utilization of authorized hours and contributing factors

    • Determine the extent to which authorized hours are filled.
    • Analyze workforce, operations, and regulatory factors causing unfilled hours (e.g., wage competition with hospitals, training pipeline limitations, scope of practice issues).

  3. Licensure/enrollment policies

    • Evaluate whether licensure and enrollment policies for continuous/extended-hour services are appropriately calibrated.
    • Compare Louisiana’s framework with other states and note any state-level accommodations that maintain access.
    • Consider targeted adjustments, including whether continuous skilled nursing should be treated differently from traditional home health for provider participation.

  4. Prior authorization and utilization management

    • Review Medicaid managed care organizations’ prior authorization criteria and utilization management for these services.
    • Assess reliance on commercial clinical guidelines and impact on hours authorized versus ordered.

  5. Payment rates and financing

    • Examine how rates are determined under fee-for-service and incorporated into managed care capitation.
    • Analyze the relationship between current rates and prevailing RN/LPN wage rates in Louisiana.
    • Compare Louisiana rates with neighboring states.

  6. Patient placement and expenditures

    • Identify the number of Medicaid beneficiaries (including medically fragile children) who are housed in hospitals, long-term acute care, pediatric subacute, or nursing facilities mainly because staffed in-home hours could not be provided.
    • Estimate the associated Medicaid expenditures.

  7. Complementary community-based services

    • Assess availability/capacity of Pediatric Day Health Care and other community-based models that support in-home nursing, including geographic distribution and unmet demand.

  8. Impact on families and caregivers

    • Evaluate the extent to which gaps in authorized hours are offset by family caregivers.
    • Look for evidence of caregivers reducing or leaving paid employment and the resulting economic implications for families.

Stakeholder consultation

  • LDH must consult a broad set of stakeholders, including:
    • Beneficiaries and families, in-home skilled nursing providers, home health agencies, and managed care organizations
    • Clinical professionals familiar with medically fragile care
    • Louisiana State Board of Nursing
    • Bureau of Family Health and Children’s Hospitals
    • Pediatric subspecialty groups (e.g., Louisiana Chapter of the American Academy of Pediatrics)
    • Disability rights and family-support groups (e.g., Families Helping Families, The Arc of Louisiana, Advocacy Center)
    • Long-term acute care hospital representatives
    • Legislative Auditor (as appropriate)

Use of existing data

  • LDH should leverage existing Medicaid claims, encounter data, electronic visit verification, prior authorization data, and managed care network adequacy filings to minimize administrative burden.

Timeline and reporting

  • Preliminary status update due: no later than October 1, 2026 (scope, data sources, interim observations).
  • Final report due: no later than February 1, 2027, to the Senate Committee on Health and Welfare.
  • A copy of the resolution is to be transmitted to the LDH Secretary and the Legislative Auditor.

Potential impact and implications

  • The study could inform potential legislative or regulatory actions to improve access to continuous/extended-hour in-home skilled nursing services for Medicaid beneficiaries.
  • May guide adjustments to provider participation requirements, licensure/enrollment policies, payment rates, and utilization management practices.
  • Aims to reduce reliance on more costly institutional settings by addressing workforce capacity and funding barriers, ultimately improving timely delivery of medically necessary home-based care.

Quick reference points

  • Bill type: Senate Resolution
  • Sponsor: Senator McMath (and co-sponsor Senator Patrick McMath)
  • Jurisdiction: Louisiana
  • Focus: In-home skilled nursing services for Medicaid beneficiaries, continuous/extended-hour care
  • Key deliverables: Preliminary update (Oct 1, 2026) and final recommendations/report (Feb 1, 2027) to the Senate Health and Welfare Committee

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

Sign in to ask a question.