SC S0486

Requires Medicaid Home and Community-Based Services (HCBS) provider agencies to pay direct care workers at least 70% of Medicaid reimbursement by January 1, 2026, increasing to 75% by January 1, 2028, and 80% by January 1, 2030

Defines "compensation" broadly to include wages, overtime, health/dental/life/disability insurance, paid leave, retirement benefits, tuition reimbursement, and employer payroll taxes

Allows provider agencies to deduct costs for training, travel, and personal protective equipment before calculating the minimum compensation percentage

Mandates HCBS provider agencies submit annual cost reports to the Department of Health and Human Services, attested under penalty of perjury, documenting compliance with wage pass-through requirements

Authorizes the Department to require independent audits at the provider agency's expense if fraud or inaccuracies are suspected, and to take enforcement actions including fund recoupment and contract termination for non-compliance