MedicaidAdministrativeHigh impact
Private Duty Nursing Members Providing Care
South Dakota Medicaid·SD · Pediatrics, General Practice·Specialty Services
Effective date
May 9, 2025
We identified it
Jun 21, 2026
Summary
South Dakota Medicaid is prohibiting immediate family members or household members from providing Private Duty Nursing services to recipients, based on EVV data review showing violations of existing regulations. Agencies have 30 days to make alternative staffing arrangements for affected cases.
Action Required
By May 9, 2025: Private Duty Nursing agencies must identify all cases where immediate family members or household members are currently providing care to recipients and arrange alternative staffing. Review current caregiver assignments against recipient household compositions. Failure to comply will result in payment denials for services provided by ineligible caregivers.