MN HF4347

Health plans are prohibited from imposing any quantity limitations on home care nursing services coverage for individuals who are dually enrolled in both a private health plan and Medical Assistance (Medicaid)

"Home care nursing services" is defined as ongoing, individual, and continuous nursing services ordered by a physician, advanced practice registered nurse, or physician assistant, and provided by a registered nurse or licensed practical nurse

Services must be medically necessary to maintain, stabilize, or restore health due to medical complexity, and required for a duration or frequency that cannot be safely met through intermittent or visit-based nursing

Health plans must use the term "home care nursing services" consistently in all policy documents, utilization review policies, claims forms, and communications to enrollees and providers

The quantity limits prohibition takes effect January 1, 2026, for policies issued, offered, or renewed on or after that date; the definition and terminology requirements take effect August 1, 2026