A bipartisan group of lawmakers has introduced the Continuous Skilled Nursing Quality Improvement Act of 2025 (H.R. 6592 / S. 1920), legislation that modernizes Medicaid’s approach to continuous skilled (private duty) nursing and improves access to high-quality in-home care for medically complex individuals, especially medically fragile children. We need your voice now to help build momentum and move this bill forward.

Why This Matters

Medicaid’s continuous skilled nursing benefit has not kept pace with the needs of patients, families, or providers. Outdated terminology, inconsistent oversight, and unnecessary regulatory barriers create confusion and limit access to essential care. H.R. 6592 / S. 1920 takes a meaningful step toward fixing these challenges by establishing national quality standards, modernizing policy, and strengthening Medicaid’s home- and community-based care framework. The Continuous Skilled Nursing Quality Improvement Act of 2025 would:

1. Modernize terminology by updating “private duty nursing” to “continuous skilled nursing services”
2. Establish national quality standards through an HHS-led stakeholder working group
3. Reduce regulatory burden by clarifying that Medicaid providers are not subject to Medicare home health participation requirements
4. Expand HCBS waivers to explicitly include continuous skilled nursing services
5. Update Medicaid quality measures for skilled nursing care