The year 2026 has brought a definitive turning point for the North Dakota healthcare landscape. In a state where “rural” is the rule rather than the exception, the recent legislative action by Governor Kelly Armstrong has unleashed nearly $200 million in federal funding for the first year of the Rural Health Transformation Program (RHTP).
For Home Health Care Providers North Dakota, this isn’t just a budget increase; it is a mandate to modernize. Combined with the official transition of North Dakota Medicaid to the Patient-Driven Payment Model (PDPM), the “business as usual” approach to home health and long-term care is effectively over. Agencies must now navigate a system that rewards clinical complexity and technological integration over mere service volume.
1. The $200M Rural Health Transformation: A Digital Mandate
The RHTP, supported by the federal “One Big Beautiful Bill Act,” is designed to stabilize the rural health workforce and bring high-quality care closer to the frontier. A significant portion of these grants is specifically earmarked for technology and data integration.
In the North Dakota of 2026, the state is no longer asking agencies to digitize it is providing the capital to make it happen. The focus areas for these grants include:
- Expansion of Telehealth Hubs: Creating “Clinics without Walls” that connect rural patients to specialists in Fargo or Bismarck.
- Remote Patient Monitoring (RPM): Using AI-assisted tools to track vitals and chronic conditions from the patient’s living room.
- Infrastructure Upgrades: Hardening cybersecurity and modernizing the digital backbone of rural clinics.
To qualify for these sustainability grants, agencies must demonstrate they have a robust, hipaa compliant infrastructure. The state’s goal is seamless data sharing; if a patient is seen by a home health aide in Williston, those clinical notes must be instantly accessible to the entire care team through a secure cloud environment.
2. Navigating the ND Medicaid PDPM Shift
Effective January 1, 2026, North Dakota Medicaid officially retired the old RUG-IV (Resource Utilization Group) system in favor of the ND PDPM. This shift mirrors the Medicare transition of 2019 but with specific North Dakota refinements.
Under PDPM, reimbursement is no longer driven by the number of therapy minutes provided. Instead, it is based on the patient’s clinical characteristics and complexity. This means your documentation must be more precise than ever. Capturing “Non-Therapy Ancillary” (NTA) costs such as complex medication management or specialized nursing needs is now the primary driver of your case-mix index.
Why Accuracy is the New Currency
Because PDPM focuses on the “whole patient,” agencies using an outdated or fragmented EHR are at a severe disadvantage. The system now requires meticulous ICD-10 coding and interdisciplinary coordination. If your nursing staff and therapy teams are operating in silos, you will likely miss the clinical indicators that justify higher reimbursement tiers.
3. Operations in the Age of Accountability
With the influx of $200 million in grant funding comes a heightened level of state oversight. The North Dakota Department of Health and Human Services (HHS) is utilizing data-driven audits to ensure that the “Rural Revolution” is actually improving outcomes.
The Role of Mandatory Verification
The state’s reliance on EVV (Electronic Visit Verification) has evolved into a sophisticated anti-fraud tool. In 2026, EVV data will be integrated directly into the PDPM billing workflow. Agencies must provide high-fidelity GPS and timestamp data for every home visit to release Medicaid payments. This “locked-in” documentation ensures that the services being billed align perfectly with the care plans submitted in the digital system.
4. Scaling with myEZhome Care Software
As the legislative landscape shifts toward value-based care, your choice of platform determines your agency’s ceiling. Using a solution like myEZhome care software allows North Dakota agencies to automate the complexities of both RHTP reporting and PDPM billing.
- Integrated Workflow: Move from referral to billing without manual data re-entry.
- Compliance by Design: Ensure every note meets the new 2026 North Dakota transparency standards.
- Workforce Retention: Use mobile tools to reduce the administrative “paperwork” burden on your rural caregivers, helping them work at the top of their licenses.
In a state where the “Grow Your Own” workforce pipeline is a top priority, providing your team with modern, intuitive tech from myEZcare is one of the most effective retention strategies available.
North Dakota 2026 Home Care FAQ
Is the $200M grant only for hospitals?
No. While hospitals are central hubs, the Rural Health Transformation Program explicitly includes home care agencies and clinics that provide services to rural or underserved populations.
How does the 3.2% inflationary increase work?
North Dakota Medicaid approved a 3.2% increase for all Nursing Facility and Home Health services effective Jan 1, 2026, to help offset rising labor and supply costs.
Does PDPM mean I should provide less therapy?
No. It means therapy should be provided based on clinical need rather than reimbursement targets. The focus is on outcomes and patient-centered care.
What is the “One Big Beautiful Bill Act”?
It is the federal legislation that provides the $10 billion annual nationwide allocation for rural health transformation, with North Dakota receiving nearly $100M-$200M annually through 2030.
Can AI-assisted care be billed under Medicaid in ND?
The 2026 regulations allow for AI-assisted remote monitoring as a reimbursable “extender” of care, provided it is overseen by a licensed human professional.
What happens if my agency doesn’t meet the new licensing standards?
Under the 2026 reforms, agencies failing to maintain digital, interoperable records may be disqualified from state grant opportunities and face stricter audit cycles.
